Constructing a Successful Cross-National Virtual Learning Environment in Primary and Secondary Education

NARCIS (Netherlands)

Ligorio, Maria Beatrice; van Veen, Klaas

2006-01-01

Virtual environments are more and more used in primary schools. One of the most interesting potentialities of these environments is to foster cross-national applications. Yet, this specific feature is not fully exploited. This paper presents a successful virtual learning environment for primary

78 FR 69168 - Self-Regulatory Organizations; National Securities Clearing Corporation; Order Approving Proposed...

Science.gov (United States)

2013-11-18

... approve a proposed rule change of a self-regulatory organization if it finds that such proposed rule... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-70848; File No. SR-NSCC-2013-10] Self-Regulatory Organizations; National Securities Clearing Corporation; Order Approving Proposed Rule Change To...

National Security in the Nuclear Age: Public Library Proposal and Booklist. May 1987 Update.

Science.gov (United States)

Dane, Ernest B.

To increase public understanding of national security issues, this document proposes that a balanced and up-to-date collection of books and other materials on national security in the nuclear age be included in all U.S. public libraries. The proposal suggests that the books be grouped together on an identified shelf. Selection criteria for the…

The Quest for Strategic Malaysian Quality National Primary School Leaders

Science.gov (United States)

Ali, Hairuddin Mohd

2012-01-01

Purpose: The purpose of this paper is to investigate the nine-point strategic leadership characteristics of Malaysian Quality National Primary School Leaders (QNPSL) and to indicate the implications of these findings for the current educational management and leadership practices in their quest for Malaysian quality education.…

78 FR 26062 - Proposed Information Collection: National Blueways System Application

Science.gov (United States)

2013-05-03

... proposed public information collection necessary as part of the process to nominate a river and associated... be nominated voluntarily for National Blueways recognition by stakeholder partnerships, in... Management and Budget control number. Dated: April 25, 2013. Rebecca Wodder, Senior Advisor to the Secretary...

Proposal for a United Nations Basic Space Technology Initiative

Science.gov (United States)

Balogh, Werner

Putting space technology and its applications to work for sustainable economic and social development is the primary objective of the United Nations Programme on Space Applications, launched in 1971. A specific goal for achieving this objective is to establish a sustainable national space capacity. The traditional line of thinking has supported a logical progression from building capacity in basic space science, to using space applications and finally - possibly - to establishing indigenous space technology capabilities. The experience in some countries suggests that such a strict line of progression does not necessarily hold true and that priority given to the establishment of early indigenous space technology capabilities may contribute to promoting the operational use of space applications in support of sustainable economic and social development. Based on these findings and on the experiences with the United Nations Basic Space Science Initiative (UNBSSI) as well as on a series of United Nations/International Academy of Astronautics Workshops on Small Satellites in the Service of Developing Countries, the United Nations Office for Outer Space Affairs (UNOOSA) is considering the launch of a dedicated United Nations Basic Space Technology Initiative (UNBSTI). The initiative would aim to contribute to capacity building in basic space technology and could include, among other relevant fields, activities related to the space and ground segments of small satellites and their applications. It would also provide an international framework for enhancing cooperation between all interested actors, facilitate the exchange of information on best practices, and contribute to standardization efforts. It is expected that these activities would advance the operational use of space technology and its applications in an increasing number of space-using countries and emerging space nations. The paper reports on these initial considerations and on the potential value-adding role

Whiteness and National Identity: Teacher Discourses in Australian Primary Schools

Science.gov (United States)

Walton, Jessica; Priest, Naomi; Kowal, Emma; White, Fiona; Fox, Brandi; Paradies, Yin

2018-01-01

The study examines how white teachers talked to children about national identity and cultural diversity by drawing on qualitative research with eight- to 12-year-old students and their teachers from four Australian primary schools with different racial, ethnic and cultural demographics. Despite a range of explicit and implicit approaches that…

75 FR 9277 - Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment...

Science.gov (United States)

2010-03-01

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... use of other forms of information technology. Title: Nation-wide Customer Satisfaction Surveys, VA...

77 FR 2349 - Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment...

Science.gov (United States)

2012-01-17

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0712] Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment Request AGENCY: Veterans Health Administration... techniques or the use of other forms of information technology. Title: Nation-wide Customer Satisfaction...

76 FR 2737 - Self-Regulatory Organizations; National Securities Clearing Corporation; Order Approving Proposed...

Science.gov (United States)

2011-01-14

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-63668; File No. SR-NSCC-2010-09] Self-Regulatory Organizations; National Securities Clearing Corporation; Order Approving Proposed Rule Change... Facility January 6, 2011. I. Introduction On August 30, 2010, the National Securities Clearing Corporation...

77 FR 37869 - Agency Information Collection Activities: Proposed Collection; Comment Request-National Hunger...

Science.gov (United States)

2012-06-25

...: Proposed Collection; Comment Request--National Hunger Clearinghouse Database Form AGENCY: Food and... Hunger Clearinghouse. DATES: Written comments must be received on or before August 24, 2012. ADDRESSES... Magee, Program Analyst, at 703-305-2657. SUPPLEMENTARY INFORMATION: Title: National Hunger Clearinghouse...

Hypothesis: primary antiangiogenic method proposed to treat early stage breast cancer

International Nuclear Information System (INIS)

Retsky, Michael W; Hrushesky, William JM; Gukas, Isaac D

2009-01-01

Women with Down syndrome very rarely develop breast cancer even though they now live to an age when it normally occurs. This may be related to the fact that Down syndrome persons have an additional copy of chromosome 21 where the gene that codes for the antiangiogenic protein Endostatin is located. Can this information lead to a primary antiangiogenic therapy for early stage breast cancer that indefinitely prolongs remission? A key question that arises is when is the initial angiogenic switch thrown in micrometastases? We have conjectured that avascular micrometastases are dormant and relatively stable if undisturbed but that for some patients angiogenesis is precipitated by surgery. We also proposed that angiogenesis of micrometastases very rarely occurs before surgical removal of the primary tumor. If that is so, it seems possible that we could suggest a primary antiangiogenic therapy but the problem then arises that starting a therapy before surgery would interfere with wound healing. The therapy must be initiated at least one day prior to surgical removal of the primary tumor and kept at a Down syndrome level perhaps indefinitely. That means the drug must have virtually no toxicity and not interfere meaningfully with wound healing. This specifically excludes drugs that significantly inhibit the VEGF pathway since that is important for wound healing and because these agents have some toxicity. Endostatin is apparently non-toxic and does not significantly interfere with wound healing since Down syndrome patients have no abnormal wound healing problems. We propose a therapy for early stage breast cancer consisting of Endostatin at or above Down syndrome levels starting at least one day before surgery and continuing at that level. This should prevent micrometastatic angiogenesis resulting from surgery or at any time later. Adjuvant chemotherapy or hormone therapy should not be necessary. This can be continued indefinitely since there is no acquired resistance that

OZ: An Innovative Primary Flight Display, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — The proposed SBIR project will develop OZ, an innovative primary flight display for aircraft. The OZ display, designed from "first principles" of vision science,...

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

Science.gov (United States)

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

77 FR 3646 - Proposed Expansion of Fagatele Bay National Marine Sanctuary, Regulatory Changes, and Sanctuary...

Science.gov (United States)

2012-01-25

.... 100908440-1615-01] RIN 0648-BA24 Proposed Expansion of Fagatele Bay National Marine Sanctuary, Regulatory Changes, and Sanctuary Name Change AGENCY: Office of National Marine Sanctuaries (ONMS), National Ocean... in the Federal Register to revise the regulations for the Fagatele Bay National Marine Sanctuary (76...

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

DEFF Research Database (Denmark)

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

2011-01-01

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

76 FR 67200 - Proposed National Toxicology Program (NTP) Review Process for the Report on Carcinogens: Request...

Science.gov (United States)

2011-10-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed National Toxicology... Session AGENCY: Division of the National Toxicology Program (DNTP), National Institute of Environmental.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2011-28132 Filed 10-28-11; 8:45 am...

Observing proposals on the Web at the National Optical Astronomy Observatories

Science.gov (United States)

Pilachowski, Catherine A.; Barnes, Jeannette; Bell, David J.

1998-07-01

Proposals for telescope time at facilities available through the National Optical Astronomy Observatories can now be prepared and submitted via the WWW. Investigators submit proposal information through a series of HTML forms to the NOAO server, where the information is processed by Perl CGI scripts. PostScript figures and ASCII files may be attached by investigators for inclusion in their proposals using their browser's upload feature. Proposal information is saved on the server so that investigators can return in later sessions to continue work on a proposal and so that collaborators can participate in writing the proposal if they have access to the proposal account name and password. The system provides on-line verification of LATEX syntax and a spellchecker, and confirms that all sections of the proposal are filled out. Users can request a LATEX or PostScript copy of their proposal by e-mail, or view the proposal on line. The advantages of the Web-based process for our users are convenience, access to on-line documentation, and the simple interface which avoids direct confrontation with LATEX. From the NOAO point of view, the advantage is the use of standardized formats and syntax, particularly as we begin to receive proposals for the Gemini telescopes and some independent observatories.

The Cuban National Healthcare System: Characterization of primary healthcare services.

Directory of Open Access Journals (Sweden)

Keli Regina DAL PRÁ

2015-10-01

Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association

Directory of Open Access Journals (Sweden)

David Little

2003-06-01

Full Text Available The Primary Care Informatics Working Group (PCIWG of the American Medical Informatics Association (AMIA has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI, to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.

76 FR 71037 - Proposed National Toxicology Program (NTP) Review Process for the Report on Carcinogens: Request...

Science.gov (United States)

2011-11-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Proposed National Toxicology Program (NTP) Review Process...: Division of the National Toxicology Program (DNTP), National Institute of Environmental Health Sciences.... Bucher, Associate Director, National Toxicology Program. [FR Doc. 2011-29615 Filed 11-15-11; 8:45 am...

78 FR 47191 - Air Quality Designations for the 2010 Sulfur Dioxide (SO2) Primary National Ambient Air Quality...

Science.gov (United States)

2013-08-05

... Air Quality Designations for the 2010 Sulfur Dioxide (SO[bdi2]) Primary National Ambient Air Quality... air quality designations for certain areas in the United States for the 2010 primary Sulfur Dioxide (SO 2 ) National Ambient Air Quality Standard (NAAQS). The EPA is issuing this rule to identify areas...

Overview of the current National Primary Drinking Water Regulations and regulation development process

International Nuclear Information System (INIS)

Cotruvo, J.A.; Regelski, M.

1989-01-01

The promulgation of the National Primary Drinking Water Regulations (NPDWR) follows specific steps. First, the Advance Notice of Proposed Rule Making (ANPRM) is published. Second, the EPA, as mandated by the SDWA Amendments, proposes maximum contaminant levels (MCLs), (enforceable standards) and maximum contaminant level goals (MCLGs) simultaneously. The Office of Drinking Water developed a six-phase schedule that has attempted to parallel the SDWA-specified deadlines: Phase I - Voltile organic chemicals - July 8, 1987; Phase II - Synthetic organic chemicals and inorganic chemicals - June 1989, microbials and surface water treatment - June 1989, and Lead/copper - December 1988; Phase III - Radionuclides - December 1988; Phase IV - Disinfectants and disinfection by-products - June 1989; Phase V - Other inorganic chemicals, synthetic organic chemicals, and pesticides - June 1989; and Phase VI - 25 additional chemicals - January 199. In selecting contaminants for regulation, the most relevant criteria are (1) potential health risk; (2) ability to detect a contaminant in the drinking water; and (3) occurrence or potential occurrence in drinking water. The EPA uses a three category approach for setting maximum contaminant level goals for carcinogens: Category I, strong evidence of carcinogenicity-zero; Category II, equivocal evidence - reference dose (RfD) approach or 0.00001 to 0.000001 cancer risk range; and Category III, inadequate or no evidence from animal studies - RfD approach. 10 refs., 5 tabs

78 FR 13379 - Wrangell-St. Elias National Park and Preserve, Alaska; Proposed Mining Plan of Operations

Science.gov (United States)

2013-02-27

...] Wrangell-St. Elias National Park and Preserve, Alaska; Proposed Mining Plan of Operations AGENCY: National...) unpatented placer claims within Wrangell-St. Elias National Park and Preserve. Public Availability: This plan...: Wrangell-St. Elias National Park and Preserve Headquarters, Mile 106.8 Richardson Highway, Post Office Box...

Fast reactor primary cover gas system proposals for CDFR

International Nuclear Information System (INIS)

Harrison, L.M.T.

1987-01-01

A primary sodium gas cover has been designed for CDFR, it comprises plant to maintain and control; cover gas pressure for all reactor operating at fault conditions, cover gas purity by both blowdown and by a special clean-up facility and the clean argon supply for the failed fuel detection system and the primary pump seal purge. The design philosophy is to devise a cover gas system that can be specified for any LMFBR where only features like vessel and pipework size need to be altered to suit different design and operating conditions. The choice of full power and shutdown operating pressures is derived and the method chosen to control these values is described. A part active/part passive system is proposed for this duty, a surge volume of 250 m 3 gives passive control between full power and hot shutdown. Pressure control operation criteria is presented for various reactor operating conditions. A design for a sodium aerosol filter, based on that used on PFR is presented, it is specifically designed so that it can be fitted with an etched disc type particulate filter and maintenance is minimised. Two methods that maintain cover gas purity are described. The first, used during normal reactor operation with a small impurities ingress, utilises the continuous blowdown associated with the inevitable clean argon purge through the various reactor component seals. The second method physically removes the impurities xenon and krypton from the cover gas by their adsorption, at cryogenic temperature, onto a bed of activated carbon. The equipment required for these two duties and their mode of operation is described with the aid of a system flow diagram. The primary pump seals requires a gas purge to suppress aerosol migration. A system where the argon used for this task is recirculated and partially purified is described. (author)

Expanding Global Language Education in Public Primary Schools: The National English Programme in Mexico

Science.gov (United States)

Sayer, Peter

2015-01-01

The paper examines the recent national programme of English language instruction in the Mexican public primary schools, called the "Programa Nacional de Inglés en Educación Básica" (PNIEB). The programme, initiated in 2009 by the Ministry of Education as part of the national curriculum, represents the largest expansion of English…

Findings from the 2013 NZCER Primary and Intermediate Schools National Survey

Science.gov (United States)

New Zealand Council for Educational Research, 2014

2014-01-01

The New Zealand Council for Educational Research (NZCER) primary and intermediate schools national survey was carried out in July-August 2013. NZCER questioned principals, teachers and trustees at a representative sample of schools, and sought the views of a random sample of 1 in 4 parents in 36 of these schools. In all, the survey gathered data…

Sandia National Laboratories, California proposed CREATE facility environmental baseline survey.

Energy Technology Data Exchange (ETDEWEB)

Catechis, Christopher Spyros

2013-10-01

Sandia National Laboratories, Environmental Programs completed an environmental baseline survey (EBS) of 12.6 acres located at Sandia National Laboratories/California (SNL/CA) in support of the proposed Collaboration in Research and Engineering for Advanced Technology and Education (CREATE) Facility. The survey area is comprised of several parcels of land within SNL/CA, County of Alameda, California. The survey area is located within T 3S, R 2E, Section 13. The purpose of this EBS is to document the nature, magnitude, and extent of any environmental contamination of the property; identify potential environmental contamination liabilities associated with the property; develop sufficient information to assess the health and safety risks; and ensure adequate protection for human health and the environment related to a specific property.

A VBA Desktop Database for Proposal Processing at National Optical Astronomy Observatories

Science.gov (United States)

Brown, Christa L.

National Optical Astronomy Observatories (NOAO) has developed a relational Microsoft Windows desktop database using Microsoft Access and the Microsoft Office programming language, Visual Basic for Applications (VBA). The database is used to track data relating to observing proposals from original receipt through the review process, scheduling, observing, and final statistical reporting. The database has automated proposal processing and distribution of information. It allows NOAO to collect and archive data so as to query and analyze information about our science programs in new ways.

THE PROPOSED NATIONAL ARBORETUM AT WASHINGTON.

Science.gov (United States)

Coville, F V

1925-12-25

Nature. The proposed national arboretum at Washington would contain a permanent living collection of trees and other outdoor plants for purposes of scientific research and education. It would include the trees, shrubs, and perennials used in forestry and horticulture, and the wild relatives of these plants. It would be a bureau of standards for horticulture. It would contain a water garden and a wildrice preserve, and it would serve incidentally as a bird sanctuary. Economic value. The arboretum would make the work of the Department of Agriculture more valuable to the country in many ways, but especially through plant breeding. The development of faster-growing timber trees, improved fruits, and disease-resistant plants generally, through the facilities afforded by the arboretum, would increase profoundly the agricultural wealth and welfare of the United States. Location. The Mount Hamilton and Hickey Hill tracts in the District of Columbia, together with the Anacostia River flats above Benning Bridge, constitute an admirable site for the arboretum, convenient in location and with a great variety of soils. Cost. About 400 acres of the proposed site is already owned by the government. It consists of marsh land, about to be drained by army engineers. The Mount Hamilton and Hickey Hill area, 408 acres, privately owned, was reported by the assessor in January, 1925, to be valued at $343,048, distributed among thirty owners. Maintenance. If the purchase of the Mount Hamilton and Hickey Hill tracts in the fiscal year 1927 is authorized, it is estimated that the cost of maintenance of the arboretum for the first three years would be as follows: 1927. Nothing 1928. $25,000 1929. $50,000.

Development of Quality Assurance System in Culture and Nation Character Education in Primary Education in Indonesia

Science.gov (United States)

Susilana, Rudi; Asra

2013-01-01

The purpose of national education is to develop skills and build dignified national character and civilization in educating nation life (Act No. 20, 2003). The paper describes a system of quality assurance in culture and character education in primary education. This study employs the six sigma model which consists of the formula DMAIC (Define,…

A proposed periodic national inventory of land use land cover change

Science.gov (United States)

Hans T. Schreuder; Paul W. Snook; Raymond L. Czaplewski; Glenn P. Catts

1986-01-01

Three alternatives using digital thematic mapper (TM), analog TM, and a combination of either digital or analog TM data with low altitude photography are discussed for level I and level II land use/land cover classes for a proposed national inventory. Digital TM data should prove satisfactory for estimating acreage in level I classes, although estimates of precision...

Rev-Changes in Primary Energy Use and CO2 Emissions—An Impact Assessment for a Building with Focus on the Swedish Proposal for Nearly Zero Energy Buildings

Directory of Open Access Journals (Sweden)

Mattias Gustafsson

2017-07-01

Full Text Available In the European Union’s Energy Performance of Buildings Directive, the energy efficiency goal for buildings is set in terms of primary energy use. In the proposal from the National Board of Housing, Building, and Planning, for nearly zero energy buildings in Sweden, the use of primary energy is expressed as a primary energy number calculated with given primary energy factors. In this article, a multi-dwelling building is simulated and the difference in the primary energy number is investigated when the building uses heat from district heating systems or from heat pumps, alone or combined with solar thermal or solar photovoltaic systems. It is also investigated how the global CO2 emissions are influenced by the different energy system combinations and with different fuels used. It is concluded that the calculated primary energy number is lower for heat pump systems, but the global CO2 emissions are lowest when district heating uses mostly biofuels and is combined with solar PV systems. The difference is up to 140 tonnes/year. If the aim with the Swedish building code is to decrease the global CO2 emissions then the ratio between the primary energy factors for electricity and heat should be larger than three and considerably higher than today.

40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

Science.gov (United States)

2010-07-01

... the data handling procedures for the reported data). 2.3Comparisons with the Primary and Secondary... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY...

A methodology proposed for a South African national wetland inventory

CSIR Research Space (South Africa)

Thompson, M

2002-03-01

Full Text Available improvements in accuracy provided by increasing spatial resolution, assuming that both sensor and land-cover spectral characteristics remain constant. Since the target mapping accuracies referred to in the ToR are given in terms of area-based parameters (i... 4.14 4.4 REFERENCES 4.16 APPENDIX 4.1: PROPOSED SYSTEM REQUIREMENTS TO HOST WEB-BASED IMS SITE 4.17 CHAPTER 5: COST BENEFIT ANALYSIS 5.1 Pilot Project for National Wetland inventory – 2002 ACKNOWLEDGEMENTS We would...

The websites of primary and secondary schools in Portugal: an evaluation proposal

Directory of Open Access Journals (Sweden)

Ana Maria SANTOS

2017-10-01

Full Text Available This article proposes an evaluation the quality in educational websites of two degrees of education, Primary School and the High school. To stablish this analysis was used a Model of Evaluation of the Quality of Educational Websites (EQEWS divided into Functional Aspects, with five criteria: authority, update, usability, accessibility and communication; and Technical-Aesthetic Aspects, with five principles: graphic design and multimedia quality, content, navigation, speed of access and interaction. This propose model of evaluation applied to 57 websites, according to the Likert scale of 0 to 4. We conclude that Secondary School web sites achieved better results in most of the evaluated criteria, it is verified that the authors of these resources are entirely identified with the needs and with the requirement that this degree of education requires the students, with levels of focused on achieving excellent results for university entrance.

77 FR 70460 - Notice of Intent To Prepare an Environmental Impact Statement for the Proposed Ho-Chunk Nation...

Science.gov (United States)

2012-11-26

... Impact Statement for the Proposed Ho-Chunk Nation Beloit Casino Project, City of Beloit, Rock County, WI...) application for a proposed 33-acre fee-to-trust transfer and casino project to be located in the City of... address, and ``DEIS Scoping Comments, Ho-Chunk Nation Beloit Casino Project'' on the first page of your...

78 FR 29731 - Agency Information Collection Activities; Proposed Collection; Comment Request; CPSC National...

Science.gov (United States)

2013-05-21

... communications efforts to achieve a greater impact on consumer behavior. The CPSC's activities aim to serve a... CONSUMER PRODUCT SAFETY COMMISSION [Docket No. CPSC-2013-0020] Agency Information Collection Activities; Proposed Collection; Comment Request; CPSC National Awareness Survey AGENCY: Consumer Product...

Primary Criteria for Near Surface Disposal Facility in Egypt Proposal approach

International Nuclear Information System (INIS)

Abdellatif, M.M.

2013-01-01

The objective of radioactive waste disposal is to isolate waste from the surrounding media to protect human health and environment from the harmful effect of the ionizing radiation. The required degree of isolation can be obtained by implementing various disposal methods, of which near surface disposal represents an option commonly used and demonstrated in several countries. Near surface disposal has been practiced for some decades, with a wide variation in sites, types and amounts of wastes, and facility designs employed. Experience has shown that the effective and safe isolation of waste depends on the performance of the overall disposal system, which is formed by three major components or barriers: the site, the disposal facility and the waste form. The site selection process for low-level and intermediate level radioactive waste disposal facility addressed a wide range of public health, safety, environmental, social and economic factors. The primary goal of the sitting process is to identify a site that is capable of protecting public health, safety and the environment. This paper is concerning a proposal approach for the primary criteria for near surface disposal facility that could be applicable in Egypt.

Access to primary energy sources - the basis of national energy security

Science.gov (United States)

Szlązak, Jan; Szlązak, Rafał A.

2017-11-01

National energy security is of fundamental importance for economic development of a country. To ensure such safety energy raw material, also called primary energy sources, are necessary. Currently in Poland primary energy sources include mainly fossil fuels, such as hard coal, brown coal, natural gas and crude oil. Other sources, e.g. renewable energy sources account for c. 15% in the energy mix. Primary energy sources are used to produce mainly electricity, which is considered as the cleanest form of energy. Poland does not have, unfortunately, sufficient energy sources and is forced to import some of them, mainly natural gas and crude oil. The article presents an insightful analysis of energy raw material reserves possessed by Poland and their structure taking account of the requirements applicable in the European Union, in particular, those related to environmental protection. The article also describes demand for electricity now and in the perspective of 2030. Primary energy sources necessary for its production have also been given. The article also includes the possibilities for the use of renewable energy sources in Poland, however, climatic conditions there are not are not particularly favourable to it. All the issues addressed in the article are summed up and ended with conclusions.

Proposal of a national system to supervise nuclear installations out of international safeguards

International Nuclear Information System (INIS)

Rosa, L.P.

1990-01-01

It is proposed a national system to safeguard, supervise and inspect nuclear facilities in Brazil, apart from international safeguards. It discusses also the military nuclear activities and the uranium enrichment plants. The system should be controlled by Brazilian CNEN. (A.C.A.S.)

Systematic review of the use of data from national childhood obesity surveillance programmes in primary care: a conceptual synthesis.

Science.gov (United States)

Henderson, E J; Ells, L J; Rubin, G P; Hunter, D J

2015-11-01

This study reviewed the use in primary care of national surveillance data for children to determine the data's potential utility to inform policy and practice decisions on how to prevent and treat childhood obesity. We reviewed the 28 countries identified by the World Obesity Federation as having high-quality comparable body mass index data for children. Literature published from any period up to December 2013 was included. Peer review literature was searched using Web of Science (Core Collection, MEDLINE). Grey literature was searched using the Internet by country name, programme name and national health and government websites. We included studies that (i) use national surveillance obesity data in primary care, or (ii) explore practitioner or parent perspectives about the use of such data. The main uses of national surveillance data in primary care were to identify and recruit obese children and their parents to participate in school and general practice-based research and/or interventions, and to inform families of children's measurements. Findings indicate a need for school staff and practitioners to receive additional training and support to sensitively communicate with families. Translation of these findings into policy and practice could help to improve current uses of national child obesity surveillance data in primary care. © 2015 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

Assessing the state/nation distributional equity issues associated with the proposed Yucca Mountain repository: A conceptual approach

International Nuclear Information System (INIS)

Kasperson, R.E.; Ratick, S.; Renn, O.

1988-06-01

This paper addresses one quite specific part of this broad range of issues -- the distribution of impacts to the state of Nevada and to the nation likely to be associated with the proposed Yucca Mountain repository. As such, it is one of four analyses of the overall equity problems and needs to be read in conjunction with our proposed overall framework for the equity studies and the several other specific analyses. The objective of this report is to consider how an analysis might be made of the distribution of projected outcomes between the state and nation. At the same time, it needs to be clear that no attempt will be made actually to implement the analysis that is proposed. What follows is a conceptual statement that identifies the analytical issues and problems and proposes an approach for overcoming them. Significantly, it must be remembered that this report will not address procedural equity issues between the state and nation for this is the subject of a separate analysis. 10 refs., 2 figs

Primary care physicians' use of the proposed classification of common mental disorders for ICD-11

DEFF Research Database (Denmark)

Goldberg, David P.; Lam, Tai-Pong; Minhas, Fareed

2017-01-01

Background. The World Health Organization is revising the classification of common mental disorders in primary care for ICD-11. Major changes from the ICD-10 primary care version have been proposed for: (i) mood and anxiety disorders; and (ii) presentations of multiple somatic symptoms (bodily...... stress syndrome). This three-part field study explored the implementation of the revised classification by primary care physicians (PCPs) in five countries. Methods. Participating PCPs in Brazil, China, Mexico, Pakistan and Spain were asked to use the revised classification, first in patients...... that they suspected might be psychologically distressed (Part 1), and second in patients with multiple somatic symptoms causing distress or disability not wholly attributable to a known physical pathology, or with high levels of health anxiety (Part 2). Patients referred to Part 1 or Part 2 underwent a structured...

The National Singing Programme for Primary Schools in England: An Initial Baseline Study

Science.gov (United States)

Welch, G. F.; Himonides, E.; Papageorgi, I.; Saunders, J.; Rinta, T.; Stewart, C.; Preti, C.; Lani, J.; Vraka, M.; Hill, J.

2009-01-01

The "Sing Up" National Singing Programme for primary schools in England was launched in November 2007 under the UK government's "Music Manifesto". "Sing Up" is a four-year programme whose overall aim is to raise the status of singing and increase opportunities for children throughout the country to enjoy singing as…

Model for Physical Education Content Standards at Early Stages of Primary Education in the Republic of Macedonia

OpenAIRE

Klincarov, Ilija; Popeska, Biljana

2011-01-01

The aim of this article is to propose a model for designing national physical education content standards in early stages of primary education in the Republic of Macedonia. Proposed model is based on the findings about motor structure of children at the early stage of primary education obtained in researches realized in 5 primary schools in Skopje, the Republic of Macedonia, in relation with Macedonian PE curriculum, and overarching standards for children at this age in California, USA,chosen...

Regional economic effects of current and proposed management alternatives for Arrowwood National Wildlife Refuge

Science.gov (United States)

Koontz, Lynne; Lambert, Heather

2005-01-01

The National Wildlife Refuge System Improvement Act of 1997 requires all units of the National Wildlife Refuge System to be managed under a Comprehensive Conservation Plan (CCP). The CCP must describe the desired future conditions of a Refuge and provide long range guidance and management direction to achieve Refuge purposes. Arrowwood National Wildlife Refuge (NWR), located along the James River in east central North Dakota, is in the process of developing a range of management goals, objectives, and strategies for the CCP. The CCP for Arrowwood NWR must contain an analysis of expected effects associated with current and proposed Refuge management strategies.

40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section 50.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL...

Child development in primary care: a surveillance proposal.

Science.gov (United States)

Coelho, Renato; Ferreira, José Paulo; Sukiennik, Ricardo; Halpern, Ricardo

2016-01-01

To evaluate a child development surveillance tool proposal to be used in primary care, with simultaneous use of the Denver II scale. This was a cross-sectional study of 282 infants aged up to 36 months, enrolled in a public daycare in a countryside community in Rio Grande do Sul/Brazil. Child development was assessed using the surveillance tool and the Denver II scale. The prevalence of probable developmental delay was 53%; most of these cases were in the alert group and 24% had normal development, but with risk factors. At the Denver scale, the prevalence of suspected developmental delay was 32%. When risk factors and sociodemographic variables were assessed, no significant difference was observed. The evaluation of this surveillance tool resulted in objective and comparable data, which were adequate for a screening test. It is easily applicable as a screening tool, even though it was originally designed as a surveillance tool. The inclusion of risk factors to the scoring system is an innovation that allows for the identification of children with suspected delay in addition to developmental milestones, although the definition of parameters and choice of indicators should be thoroughly studied. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

National radiation exposures and risks caused by implementing EPA's proposed revised national primary drinking water regulations

International Nuclear Information System (INIS)

Morris, S.C.; Rowe, M.D.; Holtzman, S.; Meinhold, A.F.

1993-05-01

This report estimates risks to workers and the public associated with treatment processes and their associated waste products that would be mandated under proposed regulations of radium, radon, and uranium in drinking water. Three scenarios were examined: (1) all wastes flushed to the sanitary sewer; (2) all wastes disposed on land; (3) similar to (2) but radon removal by granulated activated carbon rather than packed tower aeration. Risks considered included accidental injury and cancer. Worker risks for both scenarios I and II were estimated to be 0.025 and 0.01 deaths per year of operation for radium-226 and radium-228, respectively. Worker risks for uranium were estimated to be 0.13 deaths/year of operation for scenario I and 0.5 deaths/year of operation for scenario II. Worker risks for radon removal were estimated to be 1.7 deaths/year of operation for scenario I and 2.2 deaths/year of operation for scenario II. Risks to the public for scenarios I and II for radium-226 were 4 x 10 -4 and for radium-228 were 9 x 10 -5 deaths/year of operation. Risks to the public for scenarios I and II for uranium were 7.3 x 10 -2 and 2 x 10 -4 , respectively. Risks to the public for scenario I and II for radon were 24 deaths/year of operation and for scenario III were nil. Public risks were quantified only for people exposed during a year of operation. For example, effects of public exposures in future years via groundwater contamination associated with landfill of treatment waste were not considered

76 FR 32967 - Proposed Extensions and Waivers: National Early Childhood Technical Assistance Center

Science.gov (United States)

2011-06-07

... under Parts B and C of the IDEA that ultimately improve their developmental and early learning outcomes... strengthen State and local early childhood systems and improve outcomes for infants, toddlers, and children... DEPARTMENT OF EDUCATION [CFDA No. 84.326H] Proposed Extensions and Waivers: National Early...

75 FR 51867 - Self-Regulatory Organizations; National Securities Clearing Corporation; Order Approving Proposed...

Science.gov (United States)

2010-08-23

... VII (CNS Accounting Operation) NSCC will modify Procedure VII to provide for the tracking of customer.... I. Introduction On June 4, 2010, National Securities Clearing Corporation (``NSCC'') filed with the... 19(b)(1) of the Securities Exchange Act of 1934 (``Act'').\\1\\ The proposed rule change was published...

Monitoring, reporting and verification for national REDD + programmes: two proposals

International Nuclear Information System (INIS)

Herold, Martin; Skutsch, Margaret

2011-01-01

Different options have been suggested by Parties to the UNFCCC (United Framework Convention on Climate Change) for inclusion in national approaches to REDD and REDD + (reduced deforestation, reduced degradation, enhancement of forest carbon stocks, sustainable management of forest, and conservation of forest carbon stocks). This paper proposes that from the practical and technical points of view of designing action for REDD and REDD + at local and sub-national level, as well as from the point of view of the necessary MRV (monitoring, reporting and verification), these should be grouped into three categories: conservation, which is rewarded on the basis of no changes in forest stock, reduced deforestation, in which lowered rates of forest area loss are rewarded, and positive impacts on carbon stock changes in forests remaining forest, which includes reduced degradation, sustainable management of forest of various kinds, and forest enhancement. Thus we have moved degradation, which conventionally is grouped with deforestation, into the forest management group reported as areas remaining forest land, with which it has, in reality, and particularly as regards MRV, much more in common. Secondly, in the context of the fact that REDD/REDD + is to take the form of a national or near-national approach, we argue that while systematic national monitoring is important, it may not be necessary for REDD/REDD + activities, or for national MRV, to be started at equal levels of intensity all over the country. Rather, areas where interventions seem easiest to start may be targeted, and here data measurements may be more rigorous (Tier 3), for example based on stakeholder self-monitoring with independent verification, while in other, untreated areas, a lower level of monitoring may be pursued, at least in the first instance. Treated areas may be targeted for any of the three groups of activities (conservation, reduced deforestation, and positive impact on carbon stock increases in

Monitoring, reporting and verification for national REDD + programmes: two proposals

Energy Technology Data Exchange (ETDEWEB)

Herold, Martin [Center for Geoinformation, Department of Environmental Science, Wageningen University, Droevendaalsesteeg 3, 6708 PB Wageningen (Netherlands); Skutsch, Margaret, E-mail: martin.herold@wur.nl [Centro de Investigaciones en GeografIa Ambiental, UNAM Campus Morelia (Mexico)

2011-01-15

Different options have been suggested by Parties to the UNFCCC (United Framework Convention on Climate Change) for inclusion in national approaches to REDD and REDD + (reduced deforestation, reduced degradation, enhancement of forest carbon stocks, sustainable management of forest, and conservation of forest carbon stocks). This paper proposes that from the practical and technical points of view of designing action for REDD and REDD + at local and sub-national level, as well as from the point of view of the necessary MRV (monitoring, reporting and verification), these should be grouped into three categories: conservation, which is rewarded on the basis of no changes in forest stock, reduced deforestation, in which lowered rates of forest area loss are rewarded, and positive impacts on carbon stock changes in forests remaining forest, which includes reduced degradation, sustainable management of forest of various kinds, and forest enhancement. Thus we have moved degradation, which conventionally is grouped with deforestation, into the forest management group reported as areas remaining forest land, with which it has, in reality, and particularly as regards MRV, much more in common. Secondly, in the context of the fact that REDD/REDD + is to take the form of a national or near-national approach, we argue that while systematic national monitoring is important, it may not be necessary for REDD/REDD + activities, or for national MRV, to be started at equal levels of intensity all over the country. Rather, areas where interventions seem easiest to start may be targeted, and here data measurements may be more rigorous (Tier 3), for example based on stakeholder self-monitoring with independent verification, while in other, untreated areas, a lower level of monitoring may be pursued, at least in the first instance. Treated areas may be targeted for any of the three groups of activities (conservation, reduced deforestation, and positive impact on carbon stock increases in

77 FR 5243 - Proposed Priority, Requirements, Definitions, and Selection Criteria-Arts in Education National...

Science.gov (United States)

2012-02-02

...-quality arts education and arts integration activities and services in music, dance, theater, media arts... DEPARTMENT OF EDUCATION Proposed Priority, Requirements, Definitions, and Selection Criteria--Arts in Education National Program (AENP) AGENCY: Office of Innovation and Improvement, Department of...

75 FR 80410 - Proposed Rules Governing Notification of Employee Rights Under the National Labor Relations Act

Science.gov (United States)

2010-12-22

... proposed rule, search ``documents open for comment'' and use key words such as ``National Labor Relations... their Beck rights. See footnote 5 above. In other words, existing law already requires notice of this.... Proposed Sec. 104.202(e) states that the Board will print the notice poster and provide copies to employers...

77 FR 3935 - National Environmental Policy Act Compliance for Proposed Tower Registrations; Effects of...

Science.gov (United States)

2012-01-26

.... 08-61; WT Docket No. 03-187; FCC 11-181] National Environmental Policy Act Compliance for Proposed... Commission. ACTION: Final rule. SUMMARY: In this document, the Federal Communications Commission (FCC or... interim measure pending completion of a programmatic environmental analysis and subsequent rulemaking...

A proposal for the geographic delineation of boundaries of the "Val d'Agri-Lagonegrese" National Park

OpenAIRE

Pierangeli D; Donnoli A

2007-01-01

In this work, different proposal are reviewed that have been moved for geographical delineation and boundaries definition of the National Park "Val d'Agri and Lagonegrese" in Basilicata (Italy) and a working methodology is proposed for a better definition of the park boundaries, taking into consideration oil extraction activities carried out in the area.

76 FR 25331 - Agency Information Collection Activities; Proposed Collection; Comment Request; National Oil and...

Science.gov (United States)

2011-05-04

... Activities; Proposed Collection; Comment Request; National Oil and Hazardous Substance Pollution Contingency... http://www.regulations.gov to obtain a copy of the draft collection of information, submit or view... comments: 1. Explain your views as clearly as possible and provide specific examples. 2. Describe any...

Regional economic effects of current and proposed management alternatives for Sand Lake National Wildlife Refuge

Science.gov (United States)

Koontz, Lynne; Lambert, Heather

2005-01-01

The National Wildlife Refuge System Improvement Act of 1997 requires all units of the National Wildlife Refuge System to be managed under a Comprehensive Conservation Plan (CCP). The CCP must describe the desired future conditions of a Refuge and provide long range guidance and management direction to achieve Refuge purposes. Sand Lake National Wildlife Refuge (NWR), located 27 miles northeast of Aberdeen, South Dakota, is in the process of developing a range of management goals, objectives, and strategies for the CCP. The CCP for Sand Lake NWR must contain an analysis of expected effects associated with current and proposed Refuge management strategies.

Comparing primary energy attributed to renewable energy with primary energy equivalent to determine carbon abatement in a national context.

Science.gov (United States)

Gallachóir, Brian P O; O'Leary, Fergal; Bazilian, Morgan; Howley, Martin; McKeogh, Eamon J

2006-01-01

The current conventional approach to determining the primary energy associated with non-combustible renewable energy (RE) sources such as wind energy and hydro power is to equate the electricity generated from these sources with the primary energy supply. This paper compares this with an approach that was formerly used by the IEA, in which the primary energy equivalent attributed to renewable energy was equated with the fossil fuel energy it displaces. Difficulties with implementing this approach in a meaningful way for international comparisons lead to most international organisations abandoning the primary energy equivalent methodology. It has recently re-emerged in prominence however, as efforts grow to develop baseline procedures for quantifying the greenhouse gas (GHG) emissions avoided by renewable energy within the context of the Kyoto Protocol credit trading mechanisms. This paper discusses the primary energy equivalent approach and in particular the distinctions between displacing fossil fuel energy in existing plant or in new plant. The approach is then extended provide insight into future primary energy displacement by renewable energy and to quantify the amount of CO2 emissions avoided by renewable energy. The usefulness of this approach in quantifying the benefits of renewable energy is also discussed in an energy policy context, with regard to increasing security of energy supply as well as reducing energy-related GHG (and other) emissions. The approach is applied in a national context and Ireland is case study country selected for this research. The choice of Ireland is interesting in two respects. The first relates to the high proportion of electricity only fossil fuel plants in Ireland resulting in a significant variation between primary energy and primary energy equivalent. The second concerns Ireland's poor performance to date in limiting GHG emissions in line with its Kyoto target and points to the need for techniques to quantify the potential

A proposal for the geographic delineation of boundaries of the "Val d'Agri-Lagonegrese" National Park

Directory of Open Access Journals (Sweden)

Pierangeli D

2007-01-01

Full Text Available In this work, different proposal are reviewed that have been moved for geographical delineation and boundaries definition of the National Park "Val d'Agri and Lagonegrese" in Basilicata (Italy and a working methodology is proposed for a better definition of the park boundaries, taking into consideration oil extraction activities carried out in the area.

Validation of Proposed "DSM-5" Criteria for Autism Spectrum Disorder

Science.gov (United States)

Frazier, Thomas W.; Youngstrom, Eric A.; Speer, Leslie; Embacher, Rebecca; Law, Paul; Constantino, John; Findling, Robert L.; Hardan, Antonio Y.; Eng, Charis

2012-01-01

Objective: The primary aim of the present study was to evaluate the validity of proposed "DSM-5" criteria for autism spectrum disorder (ASD). Method: We analyzed symptoms from 14,744 siblings (8,911 ASD and 5,863 non-ASD) included in a national registry, the Interactive Autism Network. Youth 2 through 18 years of age were included if at least one…

76 FR 13673 - National Endowment for the Arts; Agency Information Collection Activities: Proposed Collection...

Science.gov (United States)

2011-03-14

... calculations that justify the proposed sample size, the expected response rate, methods for assessing potential... of Qualitative Feedback on Agency Service Delivery AGENCY: The National Endowment for the Arts, NFAH... Qualitative Feedback on Agency Service Delivery'' to OMB for approval under the Paperwork Reduction Act (PRA...

National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

Science.gov (United States)

Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

2017-12-01

To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Dental Procedures in Primary Health Care of the Brazilian National Health System

Directory of Open Access Journals (Sweden)

Suellen R. Mendes

2017-12-01

Full Text Available The aim of this study was to examine the procedures of primary dental health care performed by oral health teams (OHTs adhering to the second cycle of the ‘National Programme for Improving Access and Quality of Primary Care’ (PMAQ-AB in Brazil. A cross-sectional descriptive analysis was performed, across 23 dental procedures comprising preventive, restorative/prosthetic, surgical, endodontic and oral cancer monitoring. Descriptive analysis shows that most of the oral health teams carry out basic dental procedures. However, most of the time, they do not keep adequate records of suspected cases of oral cancer, diagnosis tests or follow-ups, and do not perform dental prosthetic procedures. Data also showed disparities in the average number of procedures performed in each Brazilian geographical region in 2013–2014, ranging from 13.9 in the northern to 16.5 in the southern and south-eastern regions, reinforcing the great social disparities between them. Brazilian regions with the highest volume of dental need deliver the lowest number of dental procedures. The need to tackle inequalities and further shape the supply of appropriate primary health care (PHC is evident.

New Regional and Global HFC Projections and Effects of National Regulations and Montreal Protocol Amendment Proposals

Science.gov (United States)

Velders, G. J. M.

2015-12-01

Hydrofluorocarbons (HFCs) are used as substitutes for ozone-depleting substances that are being phased out globally under Montreal Protocol regulations. New global scenarios of HFC emissions reach 4.0-5.3 GtCO2-eq yr-1 in 2050, which corresponds to a projected growth from 2015 to 2050 which is 9% to 29% of that for CO2 over the same time period. New baseline scenarios are formulated for 10 HFC compounds, 11 geographic regions, and 13 use categories. These projections are the first to comprehensively assess production and consumption of individual HFCs in multiple use sectors and geographic regions with emission estimates constrained by atmospheric observations. In 2050, in percent of global HFC emissions, China (~30%), India and the rest of Asia (~25%), Middle East and northern Africa (~10%), and USA (~10%) are the principal source regions; and refrigeration and stationary air conditioning are the major use sectors. National regulations to limit HFC use have been adopted recently in the European Union, Japan and USA, and four proposals have been submitted in 2015 to amend the Montreal Protocol to substantially reduce growth in HFC use. Calculated baseline emissions are reduced by 90% in 2050 by implementing the North America Montreal Protocol amendment proposal. Global adoption of technologies required to meet national regulations would be sufficient to reduce 2050 baseline HFC consumption by more than 50% of that achieved with the North America proposal for most developed and developing countries. The new HFC scenarios and effects of national regulations and Montreal Protocol amendment proposals will be presented.

Optimization of the National Ignition Facility primary shield design

International Nuclear Information System (INIS)

Annese, C.E.; Watkins, E.F.; Greenspan, E.; Miller, W.F.

1993-10-01

Minimum cost design concepts of the primary shield for the National Ignition laser fusion experimental Facility (NIF) are searched with the help of the optimization code SWAN. The computational method developed for this search involves incorporating the time dependence of the delayed photon field within effective delayed photon production cross sections. This method enables one to address the time-dependent problem using relatively simple, time-independent transport calculations, thus significantly simplifying the design process. A novel approach was used for the identification of the optimal combination of constituents that will minimize the shield cost; it involves the generation, with SWAN, of effectiveness functions for replacing materials on an equal cost basis. The minimum cost shield design concept was found to consist of a mixture of polyethylene and low cost, low activation materials such as SiC, with boron added near the shield boundaries

Nomenclature of primary amenorrhea: A proposal document of the Japan Society of Obstetrics and Gynecology committee for the redefinition of primary amenorrhea.

Science.gov (United States)

Shozu, Makio; Ishikawa, Hiroshi; Horikawa, Reiko; Sakakibara, Hideya; Izumi, Shun-Ichiro; Ohba, Takashi; Hirota, Yasushi; Ogata, Tsutomu; Osuga, Yutaka; Kugu, Koji

2017-11-01

The aim of this study was to provide medical terms to describe the condition of a girl who should be evaluated for primary amenorrhea in order to facilitate intervention at an appropriate time. We performed a literature and clinical guidelines search for recent practices with regard to menarche and discussed relevant cases that had been experienced by committee members. Additionally, we theoretically reviewed medical terms defined in the Glossary Book of Obstetrics and Gynecology in Japan (Japan Society of Obstetrics and Gynecology, 3rd edition). The committee for the redefinition of primary amenorrhea proposed the introduction of two terms and the deletion of one term that had been defined by the Japan Society of Obstetrics and Gynecology, instead of changing the age definition of primary amenorrhea. 'Delayed menarche' was introduced to describe a condition in which a girl has never experienced cyclic menstruation (menarche) by 15-17 years of age. 'Late menarche' was also introduced to describe a condition in which a girl has experienced menarche at 15 years of age or older. 'Delayed menstruation,' which was defined as a condition in which a girl experiences menarche at 15-18 years of age, was deleted. The new terms 'delayed menarche' and 'late menarche' were introduced, and the term 'delayed menstruation' was deleted. The new system might help in the early detection and appropriate treatment of primary amenorrhea. © 2017 Japan Society of Obstetrics and Gynecology.

Primary care physician decision making regarding referral for bariatric surgery: a national survey.

Science.gov (United States)

Stolberg, Charlotte Røn; Hepp, Nicola; Juhl, Anna Julie Aavild; B C, Deepti; Juhl, Claus B

2017-05-01

Bariatric surgery is the most effective treatment for severe obesity. It results in significant and sustained weight loss and reduces obesity-related co-morbidities. Despite an increasing prevalence of severe obesity, the number of bariatric operations performed in Denmark has decreased during the past years. This is only partly explained by changes in the national guidelines for bariatric surgery. The purpose of the cross-sectional study is to investigate referral patterns and possible reservations regarding bariatric surgery among Danish primary care physicians (PCPs). Primary care physicians in Denmark METHODS: A total of 300 Danish PCPs were invited to participate in a questionnaire survey regarding experiences with bariatric surgery, reservations about bariatric surgery, attitudes to specific patient cases, and the future treatment of severe obesity. Most questions required a response on a 5-point Likert scale (strongly disagree, disagree, neither agree nor disagree, agree, and strongly agree) and frequency distributions were calculated. 133 completed questionnaires (44%) were returned. Most physicians found that they had good knowledge about the national referral criteria for bariatric surgery. With respect to the specific patient cases, a remarkably smaller part of physicians would refer patients on their own initiative, compared with the patient's initiative. Fear of postoperative surgical complications and medical complications both influenced markedly the decision to refer patients for surgery. Only 9% of the respondents indicated that bariatric surgery should be the primary treatment option for severe obesity in the future. Danish PCPs express severe concerns about surgical and medical complications following bariatric surgery. This might, in part, result in a low rate of referral to bariatric surgery. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Innovation and Standardization in School Building: A Proposal for the National Code in Italy.

Science.gov (United States)

Ridolfi, Giuseppe

This document discusses the University of Florence's experience and concepts as it developed the research to define a proposal for designing a new national school building code. Section 1 examines the current school building code and the Italian Reform Process in Education between 1960 and 2000. Section 2 details and explains the new school…

Arts Shoved Aside: Changing Art Practices in Primary Schools since the Introduction of National Standards

Science.gov (United States)

Irwin, Michael Ray

2018-01-01

This article reports on the understandings and practices of primary teachers in implementing the arts curriculum since the 2010 introduction of National Standards in Numeracy and Literacy within the New Zealand Education system. The ever-mounting pressure on schools to perform to these standards has resulted in a reduction of emphasis and time…

Physics and national socialism an anthology of primary sources

CERN Document Server

1996-01-01

This anthology of primary sources is a collection of 121 documents in English translation portraying the role of physics, both perceived and actual, in the Nazi state. These texts were written predominantly by influential German scientists, particularly physicists, both inside and outside Germany in the period from 1933 to 1945. The semipopular articles, private correspondence, and official memoranda selected for the volume reflect the contemporary developments in science as well as the change in political climate and working conditions after the National Socialists' rise to power. The extensive annotation is clearly distinguished from the original text, and the appendix provides an aid to the reader with biographical information on the more important figures and brief outlines of frequently mentioned institutions, journals and companies. The introduction surveys the latest results in the secondary literature.   ------    (…) the envisaged audience includes not only scholars and students of science, hist...

75 FR 69129 - Proposed Revision of Information Collection: Comment Request National Medical Support Notice-Part B

Science.gov (United States)

2010-11-10

... DEPARTMENT OF LABOR Employee Benefits Security Administration Proposed Revision of Information Collection: Comment Request National Medical Support Notice--Part B AGENCY: Employee Benefits Security... assess the impact of its collection requirements on respondents. Currently, the Employee Benefits...

Proposal of a New Public Health End of Life approach for Brazil: how the Project EstaraoSeuLado-Primary Palliative Care is working and how it can help.

Science.gov (United States)

Corrêa, Santiago

2018-01-01

Brazil has 206 million people, and 1.2 million deaths and 600,000 new cases of cancer per year. Palliative Care services are patchily distributed. The Family Health Strategy, made up from 41,000 primary care teams across Brazil forms a comprehensive primary care network. The Project EstaraoSeuLado-Primary Palliative Care developed working from Community Centers. We created a model based on compassionate communities, with community carers working alongside primary care teams. We identified people who need palliative care, gave them specific care and enrolled their carers into a program of monthly meetings called "Comunidade Cuidador". We discussed caring at end of life and provided skills training. During 2015 we ran 8 training programmes with an average of 10 carers. The major themes of discussion were carer burnout, dealing with denial and skills needed daily. The effect of these meetings was better relations between carers and professionals with expansion of the naturally occurring supportive network. The results of this project have been remarkable. The joint working of professionals and supportive networks together is recognised as being transformational. Carers themselves spread this approach by recommending it to others they know with life limiting illness. We will discuss the model and how it can be replicated more broadly across Brazil. Family Health teams can use tools of identification, evaluation and assessment working with networks including the community as an important part. We will propose a new model of End-of-Life Care to be adopted as national policy. We have implemented a compassionate community programme in the area of Rio Grande in Brazil. This has been a combination of primary care working in harmony with communities, providing education, resources and training to enhance the skill of communities to care for their dying. This is a necessary solution for Brazil, where resources and access to healthcare is limited. Our model is successful and

R&D Proposal for the National Muon Acccelerator Program

Energy Technology Data Exchange (ETDEWEB)

2010-02-01

This document contains a description of a multi-year national R&D program aimed at completing a Design Feasibility Study (DFS) for a Muon Collider and, with international participation, a Reference Design Report (RDR) for a muon-based Neutrino Factory. It also includes the supporting component development and experimental efforts that will inform the design studies and permit an initial down-selection of candidate technologies for the ionization cooling and acceleration systems. We intend to carry out this plan with participants from the host national laboratory (Fermilab), those from collaborating U.S. national laboratories (ANL, BNL, Jlab, LBNL, and SNAL), and those from a number of other U.S. laboratories, universities, and SBIR companies. The R&D program that we propose will provide the HEP community with detailed information on future facilities based on intense beams of muons - the Muon Collider and the Neutrino Factory. We believe that these facilities offer the promise of extraordinary physics capabilities. The Muon Collider presents a powerful option to explore the energy frontier and the Neutrino Factory gives the opportunity to perform the most sensitive neutrino oscillation experiments possible, while also opening expanded avenues for the study of new physics in the neutrino sector. The synergy between the two facilities presents the opportunity for an extremely broad physics program and a unique pathway in accelerator facilities. Our work will give clear answers to the questions of expected capabilities and performance of these muon-based facilities, and will provide defensible ranges for their cost. This information, together with the physics insights gained from the next-generation neutrino and LHC experiments, will allow the HEP community to make well-informed decisions regarding the optimal choice of new facilities. We believe that this work is a critical part of any broad strategic program in accelerator R&D and, as the P5 panel has recently

R&D PROPOSAL FOR THE NATIONAL MUON ACCELERATOR PROGRAM

Energy Technology Data Exchange (ETDEWEB)

Muon Accelerator Program; Zisman, Michael S.; Geer, Stephen

2010-02-24

This document contains a description of a multi-year national R&D program aimed at completing a Design Feasibility Study (DFS) for a Muon Collider and, with international participation, a Reference Design Report (RDR) for a muon-based Neutrino Factory. It also includes the supporting component development and experimental efforts that will inform the design studies and permit an initial down-selection of candidate technologies for the ionization cooling and acceleration systems. We intend to carry out this plan with participants from the host national laboratory (Fermilab), those from collaborating U.S. national laboratories (ANL, BNL, Jlab, LBNL, and SNAL), and those from a number of other U.S. laboratories, universities, and SBIR companies. The R&D program that we propose will provide the HEP community with detailed information on future facilities based on intense beams of muons--the Muon Collider and the Neutrino Factory. We believe that these facilities offer the promise of extraordinary physics capabilities. The Muon Collider presents a powerful option to explore the energy frontier and the Neutrino Factory gives the opportunity to perform the most sensitive neutrino oscillation experiments possible, while also opening expanded avenues for the study of new physics in the neutrino sector. The synergy between the two facilities presents the opportunity for an extremely broad physics program and a unique pathway in accelerator facilities. Our work will give clear answers to the questions of expected capabilities and performance of these muon-based facilities, and will provide defensible ranges for their cost. This information, together with the physics insights gained from the next-generation neutrino and LHC experiments, will allow the HEP community to make well-informed decisions regarding the optimal choice of new facilities. We believe that this work is a critical part of any broad strategic program in accelerator R&D and, as the P5 panel has recently

Likely social impacts of proposed national-level policy initiatives

Energy Technology Data Exchange (ETDEWEB)

Piernot, C.A.; Rothweiler, M.A.; Levine, A.; Crews, R.

1981-03-01

The results are described of an investigation of likely social effects of enacting nine proposed national-level policy initiatives to accelerate development and use of solar energy. This study is part of the Technology Assessment of Solar Energy Systems (TASE) project supported by the US Department of Energy. The report presents general social impact information about the variety of ways in which the American people could be affected by enactment of these initiatives. It identifies the effects of each initiative on individuals, groups, organizations, communities, and society as a whole. In addition, it provides a framework for organizing a myriad of impact information into a set of conceptually exclusive impact categories. It illustrates that social impacts means effects on people as individuals, groups, organizations, and communities as well as on the infrastructure of society. Finally, it demonstrates the importance of specifying an audience of impact with a case example from the residential rental market.

Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit.

Science.gov (United States)

Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

2018-01-01

Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Clinical audit of cancer diagnosis in general practices in England. Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15-86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0-27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. © British Journal of General Practice 2018.

The Impacts of Retention, Expenditures, and Class Size on Primary School Completion in Sub-Saharan Africa: A Cross-National Analysis

Science.gov (United States)

Ruff, Ryan Richard

2016-01-01

Education in Sub-Saharan Africa is increasingly viewed as a means of emancipation and a transformative project for social mobility. Developing nations have pursued policies such as universal or free primary education to increase access to education and improve student outcomes. In this study, direct and indirect precursors to primary school…

Primary Percutaneous Coronary Intervention as a National Reperfusion Strategy in Patients With ST-Segment Elevation Myocardial Infarction

DEFF Research Database (Denmark)

Terkelsen, Christian J; Jensen, Lisette O; Hansen, Hans-Henrik Tilsted

2011-01-01

In Denmark, primary percutaneous coronary intervention (PPCI) was chosen as a national reperfusion strategy for patients with ST-segment elevation myocardial infarction in 2003. This study describes the temporal implementation of PPCI in Western Denmark, the gradual introduction of field triage...

Didactic proposal with Jclic application for the development of reading comprehension in Primary Education

Directory of Open Access Journals (Sweden)

María Santamarina Sancho

2017-12-01

Full Text Available The introduction of ICT in the educational system is clearly evident because of the many advantages for professors and students. Our main objective is to improve the development of reading comprehension in students of Primary Education through the use of technologies, specifically with the Jclic application; a tool that will allow the teacher to design activities designed for this purpose that, in addition, is easy to access and manage, therefore it can also serve for the teacher who wants to start using the technologies in the classroom. With our proposal we also aim to highlight and emphasize the importance of ICT in the teaching and learning process.

Preliminary radiation transport analysis for the proposed National Spallation Neutron Source (NSNS)

International Nuclear Information System (INIS)

Johnson, J.O.; Lillie, R.A.

1997-01-01

The use of neutrons in science and industry has increased continuously during the past 50 years with applications now widely used in physics, chemistry, biology, engineering, and medicine. Within this history, the relative merits of using pulsed accelerator spallation sources versus reactors for neutron sources as the preferred option for the future. To address this future need, the Department of Energy (DOE) has initiated a pre-conceptual design study for the National Spallation Neutron Source (NSNS) and given preliminary approval for the proposed facility to be built at Oak Ridge National Laboratory (ORNL). The DOE directive is to design and build a short pulse spallation source in the 1 MS power range with sufficient design flexibility that it can be upgraded and operated at a significantly higher power at a later stage. The pre-conceptualized design of the NSNS initially consists of an accelerator system capable of delivering a 1 to 2 GeV proton beam with 1 MW of beam power in an approximate 0.5 microsecond pulse at a 60 Hz frequency onto a single target station. The NSNS will be upgraded in stages to a 5 MW facility with two target stations (a high power station operating at 60 Hz and a low power station operating at 10 Hz). Each target station will contain four moderators (combinations of cryogenic and ambient temperature) and 18 beam liens for a total of 36 experiment stations. This paper summarizes the radiation transport analysis strategies for the proposed NSNS facility

76 FR 22714 - Proposed Collection; Comment Request; Health Information National Trends Survey 4 (HINTS 4) (NCI)

Science.gov (United States)

2011-04-22

... questions with inquiries into the communication channels through which understanding is being obtained, and... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment... content of the survey will focus on understanding the degree to which members of the general population...

Proposed goals for radioactive waste management

International Nuclear Information System (INIS)

Bishop, W.P.; Hoos, I.R.; McGrath, P.E.; Metlay, D.S.; Stoneman, W.C.

1978-05-01

A special, seven member, interdisciplinary task group of consultants was established in January 1976 to propose goals for the national waste management program. This is the report of that group. The proposed goals are intended as a basis for the NRC to establish a policy by which to guide and coordinate the activities of government, business, and academic organizations whose responsibility it will be to manage radioactive wastes. The report is based on findings, interpretations and analysis by the authors who examined selected primary literature and interviewed many individuals concerned with waste management. The authors extended the scope of their inquiry and proposed goals to cover 'all technical and societal aspects necessary to an operating waste management system, rather than dealing with the regulatory process alone.' The waste management goals as developed are simple statements of principles which appear to the authors to be important conditions to insure the proper establishment and operation of a system to manage radioactive wastes.' In brief, the goals are designed to protect people and things of value in an equitable manner

National Security in the Nuclear Age. A Proposed Booklist and Public Education Ideas for Libraries.

Science.gov (United States)

Dane, Ernest B.

A bibliography on national security in the nuclear age is divided into three sections. The first section describes a proposal calling for the compilation of a balanced and up-to-date collection of books and other materials on this issue to be included in all U.S. public libraries. Also discussed are selection criteria for the book list, project…

PATTERNS OF DOMINANCE OF LANGUAGE VITALITIES AMONG MALAYSIAN STUDENTS IN PRIMARY NATIONAL-TYPE AND SECONDARY SCHOOLS

Directory of Open Access Journals (Sweden)

Soo Ying How

2017-01-01

Full Text Available Multilingualism is embedded in the Malaysian Education Blueprint (2015-2025 as a stated goal towards nation building. The education system provides opportunity to learn Malay which is the national language, the mother tongue (Mandarin or Tamil and the English language as part of formal schooling. In fact, Malaysian primary schools are classified into two major divisions. Students can opt to study in national schools in which the medium of instruction is Malay with the provision for the learning of English and a mother tongue. The other option allows students to enrol in national-type schools of which the medium of instruction is either Mandarin or Tamil, with English and Malay taught as academic subjects. At secondary level, the medium of instruction in national schools is Malay and students are provided the opportunity to learn their mother tongue and English. Other than in school, other social milieus also allow the use and practice of these languages. Given this linguistic environment, there exists a myriad of language experiences within and outside formal learning which together would influence the totality of language vitality. This paper investigates language vitality featured in this multilingual environment. It focuses on the vitality of the English language among students that appears to co-exist with the learning and use of other languages as they progress through the primary and secondary levels. The vitality is measured by the following indicators: language preference, choice, dominance, use, attitude and motivation and proficiency which were used to develop a questionnaire to obtain data on strength evaluation of these languages. The methodology encompasses random and convenient sampling to obtain representative responses from students with different levels of education and language experiences. The study reveals relative vitalities of languages used and highlights values attached to languages at different points of language

Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit

Science.gov (United States)

Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

2018-01-01

Background Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. Aim To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Design and setting Clinical audit of cancer diagnosis in general practices in England. Method Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Results Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15–86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0–27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. Conclusion The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. PMID:29255111

A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol

OpenAIRE

Cohen, Deborah J.; Balasubramanian, Bijal A.; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I.; Crabtree, Benjamin F.; Stange, Kurt C.; Davis, Melinda; Miller, William L.; Damschroder, Laura J.; McConnell, K. John; Creswell, John

2016-01-01

Background The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to...

Rapid forest clearing in a Myanmar proposed national park threatens two newly discovered species of geckos (Gekkonidae: Cyrtodactylus.

Directory of Open Access Journals (Sweden)

Grant M Connette

Full Text Available Myanmar's recent transition from military rule towards a more democratic government has largely ended decades of political and economic isolation. Although Myanmar remains heavily forested, increased development in recent years has been accompanied by exceptionally high rates of forest loss. In this study, we document the rapid progression of deforestation in and around the proposed Lenya National Park, which includes some of the largest remaining areas of lowland evergreen rainforest in mainland Southeast Asia. The globally unique forests in this area are rich in biodiversity and remain a critical stronghold for many threatened and endangered species, including large charismatic fauna such as tiger and Asian elephant. We also conducted a rapid assessment survey of the herpetofauna of the proposed national park, which resulted in the discovery of two new species of bent-toed geckos, genus Cyrtodactylus. We describe these new species, C. lenya sp. nov. and C. payarhtanensis sp. nov., which were found in association with karst (i.e., limestone rock formations within mature lowland wet evergreen forest. The two species were discovered less than 35 km apart and are each known from only a single locality. Because of the isolated nature of the karst formations in the proposed Lenya National Park, these geckos likely have geographical ranges restricted to the proposed protected area and are threatened by approaching deforestation. Although lowland evergreen rainforest has vanished from most of continental Southeast Asia, Myanmar can still take decisive action to preserve one of the most biodiverse places on Earth.

Rapid forest clearing in a Myanmar proposed national park threatens two newly discovered species of geckos (Gekkonidae: Cyrtodactylus).

Science.gov (United States)

Connette, Grant M; Oswald, Patrick; Thura, Myint Kyaw; LaJeunesse Connette, Katherine J; Grindley, Mark E; Songer, Melissa; Zug, George R; Mulcahy, Daniel G

2017-01-01

Myanmar's recent transition from military rule towards a more democratic government has largely ended decades of political and economic isolation. Although Myanmar remains heavily forested, increased development in recent years has been accompanied by exceptionally high rates of forest loss. In this study, we document the rapid progression of deforestation in and around the proposed Lenya National Park, which includes some of the largest remaining areas of lowland evergreen rainforest in mainland Southeast Asia. The globally unique forests in this area are rich in biodiversity and remain a critical stronghold for many threatened and endangered species, including large charismatic fauna such as tiger and Asian elephant. We also conducted a rapid assessment survey of the herpetofauna of the proposed national park, which resulted in the discovery of two new species of bent-toed geckos, genus Cyrtodactylus. We describe these new species, C. lenya sp. nov. and C. payarhtanensis sp. nov., which were found in association with karst (i.e., limestone) rock formations within mature lowland wet evergreen forest. The two species were discovered less than 35 km apart and are each known from only a single locality. Because of the isolated nature of the karst formations in the proposed Lenya National Park, these geckos likely have geographical ranges restricted to the proposed protected area and are threatened by approaching deforestation. Although lowland evergreen rainforest has vanished from most of continental Southeast Asia, Myanmar can still take decisive action to preserve one of the most biodiverse places on Earth.

The user with respiratory symptoms of tuberculosis in the primary care: assessment of actions according to national recommendations

Directory of Open Access Journals (Sweden)

Luize Barbosa Antunes

2016-06-01

Full Text Available Objective: to investigate the evaluation of the user with respiratory symptoms of tuberculosis in Primary Health Care services according to the norms of the National Program for Tuberculosis Control. Methods: cross-sectional study with application of a form to 99 people with pulmonary tuberculosis. Results: a total of 87.9% participants reported cough as the symptom that motivated the search for Primary Care; from these, 27.3% sought Primary Care units, 96.3% received care in this service, of which 46.2% reported that sputum smear was requested by professionals in the units. Conclusion: more than half of participants sought secondary or tertiary services due to the symptoms of tuberculosis, and also less than half of patients assisted in Primary Care had diagnostic tests requested by professionals of that service.

Primary care research in Denmark

DEFF Research Database (Denmark)

Vedsted, Peter; Kallestrup, Per

2016-01-01

International Perspectives on Primary Care Research examines how the evidence base from primary care research can strengthen health care services and delivery, tackle the growing burden of disease, improve quality and safety, and increase a person-centred focus to health care. Demonstrating...... the inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...... histories from research-rich to resource-poor nations that illustrate the range of research development and capacity building. This book argues the importance of primary care research, especially to policy makers, decision makers and funders in informing best practice, training primary health care providers...

National trajectories of carbon emissions: analysis of proposals to foster the transition to low-carbon economies

International Nuclear Information System (INIS)

Kinzig, A.P.; Kammen, D.M.

1998-01-01

In this paper we develop a framework for analyzing carbon dioxide (CO 2 ) emissions trajectories from the energy and industrial sectors of the world's nations under various policy options. A robust conclusion of our analysis is that early action by both developed and developing nations will be required to hold atmospheric CO 2 at or below doubled pre-industrial levels and incentives for renewed investments in energy-sector technologies are a required component of early action. We therefore develop and examine an international emissions regime that: (a) in the short-term 'jump starts' the political and project-implementation process by providing incentives to exploit profitable or low-cost carbon reduction opportunities; (b) in the near- and medium-term addresses the inequities resulting from historic imbalances in greenhouse-gas emissions while promoting efficient pathways for carbon reduction; and (c) in the long-term recognizes the equal rights of individuals to exploit the services of the atmosphere and pursue a reasonable standard of living in a low-carbon economy. We present and analyze a proposal to promote near-term activity in carbon reduction and energy innovation through a revitalized program of international joint implementation (JI) projects for carbon emissions reduction or carbon sequestration projects. Under our proposal, JI partner nations both receive full credit for carbon reductions that can be 'banked' and applied at a later date toward national emissions quotas in the climate convention. A finite program lifetime provides further impetus counting' of credits results in only modest additional cumulative carbon emissions relative to a similar scenario without cooperative partnerships. This 'JI banking' plan promotes critically needed scientific and institutional experience and innovation, initiates cost-effective carbon reductions, and provides vital national flexibility in meeting eventual targets. (author)

The Argentine nuclear policy: evaluation and proposals of the National Atomic Energy Commission

International Nuclear Information System (INIS)

2001-01-01

The document summarizes de medium term plan for the nuclear activities of the country proposed to the Government by the National Atomic Energy Commission (CNEA). An analysis of the present situation is followed by the consideration of the main topics: nuclear power generation, regulatory activities, fuel cycle, radioisotopes and ionizing radiations, radioactive wastes and spent fuels, research, development and human resources, international relations, and the role of the CNEA and its associate companies in the implementation of the plan. A short review is made of the economical aspects of the Argentine nuclear sector

[Individual linkage of primary data with secondary and registry data within large cohort studies - capabilities and procedural proposals].

Science.gov (United States)

Stallmann, C; Ahrens, W; Kaaks, R; Pigeot, I; Swart, E; Jacobs, S

2015-02-01

Some German cohort studies have already linked secondary and registry data with primary data from interviews and medical examinations. This offers the opportunity to obtain more valid information by taking advantage of the strengths of these data synergistically and overcome their individual weaknesses at the same time. The potential and the requirements for linking secondary and registry data with primary data from cohort studies is described generally and illustrated by the example of the "German National Cohort" (GNC). The transfer and usage of secondary and registry data require that administrative and logistic efforts be made over the whole study period. In addition, rigid data protection regulations for using social data have to be observed. The particular strengths of secondary and registry data, namely their objectivity and independence from recall bias, add to the strengths of newly collected primary data and improve the assessment of morbidity endpoints, exposure history and need of patient care. Moreover, new insights on quality and on the added value of linking different data sources may be obtained. © Georg Thieme Verlag KG Stuttgart · New York.

Variation in primary site resection practices for advanced colon cancer: a study using the National Cancer Data Base.

Science.gov (United States)

Healy, Mark A; Pradarelli, Jason C; Krell, Robert W; Regenbogen, Scott E; Suwanabol, Pasithorn A

2016-10-01

Treatment of metastatic colon cancer may be driven as much by practice patterns as by features of disease. To optimize management, there is a need to better understand what is determining primary site resection use. We evaluated all patients with stage IV cancers in the National Cancer Data Base from 2002 to 2012 (50,791 patients, 1,230 hospitals). We first identified patient characteristics associated with primary tumor resection. Then, we assessed nationwide variation in hospital resection rates. Overall, 27,387 (53.9%) patients underwent primary site resection. Factors associated with resection included younger age, having less than 2 major comorbidities, and white race (P primary tumor resection rates ranged from 26.0% to 87.8% with broad differences across geographical areas and hospital accreditation types. There is statistically significant variation in hospital rates of primary site resection. This demonstrates inconsistent adherence to guidelines in the presence of conflicting evidence regarding resection benefit. Copyright © 2016 Elsevier Inc. All rights reserved.

Proposed goals for radioactive waste management

International Nuclear Information System (INIS)

Bishop, W.P.; Frazier, D.H.; Hoos, I.R.; McGrath, P.E.; Metlay, D.S.; Stoneman, W.C.; Watson, R.A.

1977-04-01

Goals are proposed for the national radioactive waste management program to establish a policy basis for the guidance and coordination of the activities of government, business, and academic organizations whose responsibility it will be to manage radioactive wastes. The report is based on findings, interpretations, and analyses of selected primary literature and interviews of personnel concerned with waste management. Public concerns are identified, their relevance assessed, and a conceptual framework is developed that facilitates understanding of the dimensions and demands of the radioactive waste management problem. The nature and scope of the study are described along with the approach used to arrive at a set of goals appropriately focused on waste management

R and D PROPOSAL FOR THE NATIONAL MUON ACCELERATOR PROGRAM

International Nuclear Information System (INIS)

Zisman, Michael S.; Geer, Stephen

2010-01-01

This document contains a description of a multi-year national R and amp;D program aimed at completing a Design Feasibility Study (DFS) for a Muon Collider and, with international participation, a Reference Design Report (RDR) for a muon-based Neutrino Factory. It also includes the supporting component development and experimental efforts that will inform the design studies and permit an initial down-selection of candidate technologies for the ionization cooling and acceleration systems. We intend to carry out this plan with participants from the host national laboratory (Fermilab), those from collaborating U.S. national laboratories (ANL, BNL, Jlab, LBNL, and SNAL), and those from a number of other U.S. laboratories, universities, and SBIR companies. The R and D program that we propose will provide the HEP community with detailed information on future facilities based on intense beams of muons--the Muon Collider and the Neutrino Factory. We believe that these facilities offer the promise of extraordinary physics capabilities. The Muon Collider presents a powerful option to explore the energy frontier and the Neutrino Factory gives the opportunity to perform the most sensitive neutrino oscillation experiments possible, while also opening expanded avenues for the study of new physics in the neutrino sector. The synergy between the two facilities presents the opportunity for an extremely broad physics program and a unique pathway in accelerator facilities. Our work will give clear answers to the questions of expected capabilities and performance of these muon-based facilities, and will provide defensible ranges for their cost. This information, together with the physics insights gained from the next-generation neutrino and LHC experiments, will allow the HEP community to make well-informed decisions regarding the optimal choice of new facilities. We believe that this work is a critical part of any broad strategic program in accelerator R and D and, as the P5 panel has

R and D Proposal for the National Muon Acccelerator Program

International Nuclear Information System (INIS)

2010-01-01

This document contains a description of a multi-year national R and D program aimed at completing a Design Feasibility Study (DFS) for a Muon Collider and, with international participation, a Reference Design Report (RDR) for a muon-based Neutrino Factory. It also includes the supporting component development and experimental efforts that will inform the design studies and permit an initial down-selection of candidate technologies for the ionization cooling and acceleration systems. We intend to carry out this plan with participants from the host national laboratory (Fermilab), those from collaborating U.S. national laboratories (ANL, BNL, Jlab, LBNL, and SNAL), and those from a number of other U.S. laboratories, universities, and SBIR companies. The R and D program that we propose will provide the HEP community with detailed information on future facilities based on intense beams of muons - the Muon Collider and the Neutrino Factory. We believe that these facilities offer the promise of extraordinary physics capabilities. The Muon Collider presents a powerful option to explore the energy frontier and the Neutrino Factory gives the opportunity to perform the most sensitive neutrino oscillation experiments possible, while also opening expanded avenues for the study of new physics in the neutrino sector. The synergy between the two facilities presents the opportunity for an extremely broad physics program and a unique pathway in accelerator facilities. Our work will give clear answers to the questions of expected capabilities and performance of these muon-based facilities, and will provide defensible ranges for their cost. This information, together with the physics insights gained from the next-generation neutrino and LHC experiments, will allow the HEP community to make well-informed decisions regarding the optimal choice of new facilities. We believe that this work is a critical part of any broad strategic program in accelerator R and D and, as the P5 panel has

Primary energy use for heating in the Swedish building sector-Current trends and proposed target

International Nuclear Information System (INIS)

Johansson, P.; Nylander, A.; Johnsson, F.

2007-01-01

recently proposed introduction of energy performance certification of buildings in Sweden (and in EU), it can be concluded that such a certification system must take into account the primary energy use and local conditions. A politically acceptable way to do so would be to propose municipalities to develop 'best strategies' on development of the heating market for various house types and districts within the municipality which can then be included as recommendations in the energy performance certification of the buildings

The National Educational Loan Bank: A Proposal for Improving the System of Lending for Higher Education. Working Paper, Preliminary Draft.

Science.gov (United States)

Deitch, Kenneth M.

A National Education Loan Bank (NELB) is proposed as an alternative to existing federal loan programs for education, such as the National Direct Student Loan program and the Guaranteed Student Loan program. The history and structures of these two programs are detailed: financing, costs, insurance arrangements, agencies, volume, and interest rates.…

National Bioethics Council: a Brazilian proposal.

NARCIS (Netherlands)

Garrafa, V.; Have, H.A.M.J. ten

2010-01-01

The number of national bioethics commissions has burgeoned since the establishment of the first one in 1983. They provide an arena in which stakeholders with widely differing moral views can discuss, interact and negotiate about controversial matters. The establishment of the Brazilian committee is

77 FR 64311 - Potential Market Impact of the Proposed Fiscal Year 2014 Annual Materials Plan; National Defense...

Science.gov (United States)

2012-10-19

... actually be associated with the two material research and development projects will depend on the market... Market Impact of the Proposed Fiscal Year 2014 Annual Materials Plan; National Defense Stockpile Market... Stockpile Market Impact Committee, co-chaired by the Departments of Commerce and State, is seeking public...

40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

Science.gov (United States)

2010-07-01

... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data.... Primary and Secondary Ambient Air Quality Standards for Ozone. 2.1 Data Reporting and Handling Conventions... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of...

Healthcare is primary

Directory of Open Access Journals (Sweden)

Raman Kumar

2015-01-01

Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

National Physical Education Standards: Level of Physical Fitness Male Student Primary School in Malaysia

OpenAIRE

Ahmad Hashim; Mohd. Sani Madon; Nur Haziyanti Mohd Khalid; Nelfianty binti Mohd Rashid; Sadzali bin Hassan; Yusop bin Ahmad

2014-01-01

This study aims to analyze the level of physical fitness in the development of the National Standards of Physical Education. The study was conducted on 279 primary school boys age 10 years (n = 79), 11 years (n = 94) and 12 years (n = 106) in five randomly selected schools in the state of Perak. FITNESSGRAM was used to test the level of physical fitness among subjects. This includes trunk lift, 90 degree push-ups, modified pull-up, back saver sit and reach and PACER. ANOVA analysis showed a s...

U.S. National Committee proposed revision to the ISO Laser Damage Standard

Science.gov (United States)

Arenberg, Jonathan W.; Howland, Donna; Thomas, Michael; Turner, Trey; Bellum, John; Field, Ella; Carr, C. Wren; Shaffer, Gary; Brophy, Matthew; Krisiloff, Allen

2017-11-01

This paper reports on the fundamental idea behind a US National Committee, The Optics and Electro-Optics Standards Council (OEOSC) Task Force (TF) 7, proposal for a so-called Type 1 laser damage test procedure. A Type 1 test is designed to give a simple binary, pass or fail, result. Such tests are intended for the transactional type of damage testing typical of acceptance and quality control testing. As such is it intended for bulk of certification of optics for the ability to survive a given fluence, useful for manufacturers of optics and their customers, the system builders. At the root of the proposed method is the probability that an optic of area A will have R or less damage occurrences with a user specified probability P at test fluence Φ. This assessment is made by a survey of area and the observation of n events. The paper presents the derivation of probability of N or less damage sites on A given n events observed in area a. The paper concludes with the remaining steps to development of a useful test procedure based on the idea presented.

Y-12 Groundwater Protection Program Extent Of The Primary Groundwater Contaminants At The Y-12 National Security Complex

Energy Technology Data Exchange (ETDEWEB)

None, None

2013-12-01

This report presents data summary tables and maps used to define and illustrate the approximate lateral extent of groundwater contamination at the U.S. Department of Energy (DOE) Y-12 National Security Complex (Y-12) in Oak Ridge, Tennessee. The data tables and maps address the primary (i.e., most widespread and mobile) organic, inorganic, and radiological contaminants in the groundwater. The sampling locations, calculated contaminant concentrations, plume boundary values, and paired map format used to define, quantify, delineate, and illustrate the approximate extent of the primary organic, inorganic, and radiological contaminants in groundwater at Y-12 are described.

Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

Directory of Open Access Journals (Sweden)

Ramona Fernanda Ceriotti Toassi

2013-06-01

Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

The proposed EROSpace institute, a national center operated by space grant universities

Science.gov (United States)

Smith, Paul L.; Swiden, LaDell R.; Waltz, Frederick A.

1993-01-01

The "EROSpace Institute" is a proposed visiting scientist program in associated with the U.S. Geological Survey's EROS Data Center (EDC). The Institute would be operated by a consortium of universities, possible drawn from NASA's Space Grant College and Fellowship Program consortia and the group of 17 capability-enhancement consortia, or perhaps from consortia though out the nation with a topical interest in remote sensing. The National Center for Atmospheric Research or the Goddard Institute for Space Studies provide models for the structure of such an institute. The objectives of the Institute are to provide ready access to the body of data housed at the EDC and to increase the cadre of knowledgeable and trained scientists able to deal with the increasing volume of remote sensing data to become available from the Earth Observing System. The Institute would have a staff of about 100 scientists at any one time, about half permanent staff, and half visiting scientists. The latter would include graduate and undergraduate students, as well as faculty on temporary visits, summer fellowships, or sabbatical leaves. The Institute would provide office and computing facilities, as well as Internet linkages to the home institutions so that scientists could continue to participate in the program from their home base.

The Security Education Concepts in the Textbooks of the National and Civic Education of the Primary Stage in Jordan--An Analytical Study

Science.gov (United States)

Al-Edwan, Zaid Suleiman

2016-01-01

The present study aimed at exploring the concepts of the security education in the textbooks of the national and civic education of the higher primary stage in Jordan. It adopted the descriptive analytical method. The study sample consisted of the textbooks of the national and civic education for the basic eighth, ninth and tenth grades. To…

Radon in Irish primary and post-primary schools. The results of a national survey

International Nuclear Information System (INIS)

Synnott, H.; Fennell, S.; Pollard, D.; Colgan, P.A.; Hanley, O.; O'Colmain, M.; Maloney, L.

2004-05-01

This report presents the results of a survey of radon concentrations in schools in the Republic of Ireland. The survey was carried out by the Radiological Protection Institute of Ireland (RPII) on behalf of the Department of Education and Science. A workplace Reference Level of 400 Bq/m3 is set down in national legislation. However, in the case of schools the RPII has recommended that, wherever possible, radon concentrations should be reduced to below 200 Bq/m3. The objective of the survey was to assess the distribution of radon in Irish schools and to identify those requiring remedial work to reduce radon exposure to children and staff. The survey was carried out on a phased basis from 1998 to 2002. All schools in the Free Education System were invited to participate. Indoor radon concentrations were measured using passive alpha track-etch detectors with a measurement period of one academic year from September to the following June. Measurements were completed in the ground floor classrooms and offices of 3444 schools, representing over 85% of the approximate 4000 primary and post-primary schools in Ireland. Of these, 898 had radon concentrations greater than 200 Bq/m3 and 307 had radon concentrations in excess of the national Reference Level for workplaces of 400 Bq/m3 in one or more ground floor rooms. The average radon concentration in the schools surveyed was 93 Bq/m3. Different remediation strategies have been adopted for schools with maximum radon concentrations between 200 and 400 Bq/m3 and for schools with radon concentrations in excess of 400 Bq/m3. In schools with radon concentrations below 400 Bq/m3, passive remediation through increased background ventilation is, where practicable, being used to reduce the radon concentrations. Where the initial radon concentration exceeded 400 Bq/m3, a remediation consultant assessed the school and remedial measures specific to each school have been designed. In the majority of these cases active remediation in the

Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study.

LENUS (Irish Health Repository)

Whitford, David L

2009-01-01

BACKGROUND: Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. METHODS: Postal survey of random sample of general practitioners undertaken (N = 204; 46% response). Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. RESULTS: Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. CONCLUSION: General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.

MaRIE; a proposed materials facility at Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Bourke, M.A.M. [Los Alamos National Laboratory, Los Alamos, New Mexico 87545 (United States)

2009-06-15

This presentation will describe the current definition of a proposed new facility called MaRIE at Los Alamos National Laboratory. The concept is of decadal scope and is predicated on the collocation of a fourth-generation X-ray light source with a proton accelerator spallation neutron source and complementary synthesis and characterization capabilities. MaRIE is an acronym which stands for Matter-Radiation Interactions in Extremes. The facility has been conceived partly in response to the increasing role that control science is expected to play in materials research compared to observation science. If new materials are to be implemented in a timely fashion for the most aggressive conditions of proposed fission and fusion energy applications they will have to rely, at least in part, on models, simulations and scientific insight. Validation of these models will require measurements at spatial and temporal scales that have only recently become enabled by the latest generations of light sources. A hallmark of the MaRIE concept is an emphasis on in situ studies (under extreme neutron, photon and ion irradiation conditions) of the phenomena that lead to swelling, phase transformations, thermal properties and corrosion. Insights and data, relevant to atomistic and quantum mechanical models, are major goals, as well as the facilitation of rapid materials discovery. It is hoped that this presentation will solicit input on aspects of the facility definition that should be strengthened or diminished to meet the needs of the fission community. (authors)

Prayer for Health and Primary Care: Results From the 2002 National Health Interview Survey

Science.gov (United States)

Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry

2009-01-01

Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839

Proposal for a national inventory adjustment for trade in the presence of border carbon adjustment: Assessing carbon tax policy in Japan

International Nuclear Information System (INIS)

Zhou, Xin; Yano, Takashi; Kojima, Satoshi

2013-01-01

In this paper we pointed out a hidden inequality in accounting for trade-related emissions in the presence of border carbon adjustment. Under a domestic carbon pricing policy, producers pay for the carbon costs in exchange for the right to emit. Under border carbon adjustment, however, the exporting country pays for the carbon costs of their exports to the importing country but not be given any emission credits. As a result, export-related emissions will be remained in the national inventory of the exporting country based on the UNFCCC inventory approach. This hidden inequality is important to climate policy but has not yet been pointed out. To address this issue we propose a method of National Inventory Adjustment for Trade, by which export-related emissions will be deducted from the national inventory of the exporting country and added to the national inventory of the importing country which implements border carbon adjustment. To assess the policy impacts, we simulated a carbon tax policy with border tax adjustment for Japan using a multi-region computable general equilibrium model. The results indicate that with the National Inventory Adjustment for Trade, both Japan′s national inventory and the carbon leakage effects of Japan′s climate policy will be greatly different. - Highlights: • The inequality in GHG accounting caused by border carbon adjustment presented. • National inventory adjustment for trade under border carbon adjustment proposed. • Policy impacts on international competitiveness and carbon leakage assessed. • Practical issues related to the national inventory adjustment for trade discussed

A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol.

Science.gov (United States)

Bello, Aminu K; Ronksley, Paul E; Tangri, Navdeep; Singer, Alexander; Grill, Allan; Nitsch, Dorothea; Queenan, John A; Lindeman, Cliff; Soos, Boglarka; Freiheit, Elizabeth; Tuot, Delphine; Mangin, Dee; Drummond, Neil

2017-08-04

Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery. The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods. The CPCSSN is committed to high ethical standards when dealing with

76 FR 10083 - 60-Day Notice of Proposed Information Collection: DS-7652, U.S. National Commission for UNESCO...

Science.gov (United States)

2011-02-23

... UNESCO (IO/UNESCO). Form Number: DS-7646. Respondents: U.S. college and university students applying for... students at U.S. colleges and universities, will submit descriptions of self-designed proposals for brief... Collection: DS-7652, U.S. National Commission for UNESCO Laura W. Bush Traveling Fellowship ACTION: Notice of...

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

Directory of Open Access Journals (Sweden)

Jordan Rita

2008-10-01

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

A national cohort study of long-course preoperative radiotherapy in primary fixed rectal cancer in Denmark

DEFF Research Database (Denmark)

Bulow, S.; Jensen, L.H.; Altaf, R.

2010-01-01

OBJECTIVE: Preoperative radiotherapy has been shown to enable a fixed rectal cancer to become resectable which in turn may result in long-time survival. In this study, we analysed the outcome of long-course preoperative radiotherapy in fixed rectal cancer in a national cohort including all Danish...... patients registered with primary inoperable rectal cancer and treated in the period May 2001 to December 2005. METHOD: The study was based on surgical and demographic data from a continuously updated and validated national database. In addition, retrospective data were retrieved from all departments...... of radiotherapy concerning technique of radiotherapy, dose and fractionation and use of concomitant chemotherapy. Outcome was determined by actuarial analysis of local control, disease-free survival and overall survival. RESULTS: A total of 258 patients with fixed rectal cancer received long-course radiotherapy...

The cost-effectiveness of training US primary care physicians to conduct colorectal cancer screening in family medicine residency programs.

Science.gov (United States)

Edwardson, Nicholas; Bolin, Jane N; McClellan, David A; Nash, Philip P; Helduser, Janet W

2016-04-01

Demand for a wide array of colorectal cancer screening strategies continues to outpace supply. One strategy to reduce this deficit is to dramatically increase the number of primary care physicians who are trained and supportive of performing office-based colonoscopies or flexible sigmoidoscopies. This study evaluates the clinical and economic implications of training primary care physicians via family medicine residency programs to offer colorectal cancer screening services as an in-office procedure. Using previously established clinical and economic assumptions from existing literature and budget data from a local grant (2013), incremental cost-effectiveness ratios are calculated that incorporate the costs of a proposed national training program and subsequent improvements in patient compliance. Sensitivity analyses are also conducted. Baseline assumptions suggest that the intervention would produce 2394 newly trained residents who could perform 71,820 additional colonoscopies or 119,700 additional flexible sigmoidoscopies after ten years. Despite high costs associated with the national training program, incremental cost-effectiveness ratios remain well below standard willingness-to-pay thresholds under base case assumptions. Interestingly, the status quo hierarchy of preferred screening strategies is disrupted by the proposed intervention. A national overhaul of family medicine residency programs offering training for colorectal cancer screening yields satisfactory incremental cost-effectiveness ratios. However, the model places high expectations on primary care physicians to improve current compliance levels in the US. Copyright © 2016 Elsevier Inc. All rights reserved.

National inquiry system of radiological events: a viable proposal

International Nuclear Information System (INIS)

Xavier, Ana Maria; Cavalcante, Vera Lucia.

1996-01-01

The SINAER- National Inquiry System of Radiological Events is a supportive structure devised to deal with the request of help or complaints that involve sources of ionizing radiations in the national territory

The Emergence of Political Opposition in Mexico, 1949-1952. Two Proposals for Electoral

Directory of Open Access Journals (Sweden)

José Fernando Ayala López

2017-01-01

Full Text Available Using methodological elements from political and institutional history, the present article analyzes, the first proposal for the implementation of an electoral system of proportional representation in Mexico and its primary repercussions in the formulation of subsequent electoral laws. This initiative was presented by Vicente Lombardo Toledano and the Popular Party (PP in 1951, during the XLI Legislature (1949-1952. This event is correlated with the emergence of political opposition in the Chamber of Deputies. In the same year as the PP proposes reform, the National Action Party (PAN proposes another initiative of electoral reform. Both proposals propitiate a legislative debate that identifies the importance of elections as an instrument of State political control and proposed its reformulation. In this sense, the principal contribution of this study is to visibilize the proreform discourses of political opposition in a period which is often through of as being characterized by authoritarianism and censorship.

Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study

Directory of Open Access Journals (Sweden)

O'Sullivan Bernadette

2009-04-01

Full Text Available Abstract Background Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. Methods Postal survey of random sample of general practitioners undertaken (N = 204; 46% response. Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. Results Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. Conclusion General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.

Determinants of outpatient expenditure within primary care in the Brazilian National Health System

Directory of Open Access Journals (Sweden)

Bruna Camilo Turi

2017-04-01

Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING: Cross-sectional study conducted in five primary care units in Bauru (SP, Brazil. METHODS: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests. Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01, hypertension (OR = 3.04; 95% CI: 1.91-4.82 and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81. Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47 and female sex (OR = 1.70; 95% CI: 1.14-2.55. CONCLUSIONS: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.

'Sauvons le Climat' presents its '15 proposals of the National debate on energy transition'

International Nuclear Information System (INIS)

2013-01-01

This document presents the background, meaning and objectives of the 15 proposals made by 'Sauvons le Climat' (Save the Climate) within the French national debate on energy transition. These proposals are: a transition which gives an orientation on the long term and complies with France commitments; a transition by all and for all; priority to the struggle against energy poverty; integration of energy efficiency and sobriety in the growth model; to bring the whole built environment at a high level of thermal performance by 2030; for a sustainable mobility; energy transition as a competitiveness lever for France; energy transition as booster for rural world revival; a valorisation of French values and strengths; a resilient, diversified, balanced and competitive energy mix, marked by a development of renewable energies; to massively attract and orient investors towards energy transition; to strengthen local abilities in order to ease the decentralisation of the implementation of energy transition; to develop jobs, anticipate, prepare and be successful in professional transitions; a more ambitious and better coordinated European policy; to conduct and adapt energy transition

Achieving Value in Primary Care: The Primary Care Value Model.

Science.gov (United States)

Rollow, William; Cucchiara, Peter

2016-03-01

The patient-centered medical home (PCMH) model provides a compelling vision for primary care transformation, but studies of its impact have used insufficiently patient-centered metrics with inconsistent results. We propose a framework for defining patient-centered value and a new model for value-based primary care transformation: the primary care value model (PCVM). We advocate for use of patient-centered value when measuring the impact of primary care transformation, recognition, and performance-based payment; for financial support and research and development to better define primary care value-creating activities and their implementation; and for use of the model to support primary care organizations in transformation. © 2016 Annals of Family Medicine, Inc.

[Proposal for presbycusis screening in a primary care clinic].

Science.gov (United States)

Proupín Vázquez, Norberto; Lorenzo Martínez, Ana; Del Río Valeiras, María; Alvarez Alonso, Lorena; Segade Buceta, Xosé; Labella Caballero, Torcuato

2007-01-01

Presbycusis is one of the causes of deafness that has increased most in our society. To show the levels of presbycusis in people over 60 who attend our health centre for other reasons and to assess the utility of certain tests employed in primary care to detect hearing problems. One-hundred and ten people. prior specialist diagnosis, lack of consent or impossibility of running the tests. Assessment of auditory invalidity: otoscopy, Weber, Rinne, whispered voice, auditory disability test. Audiological validation by audiometry assessed by ORL. Results analysed with SPSS statistical packet. Mean age 714 (6.1). Otoscopy was normal in 81.8%. Weber's test had no significant relationship with the otoscopy, but did with the Rinne. Presbycusis was seen in 68.2% of the audiometries. Everyone (100%) who had worked in a noisy environment had audiometric deficit. There were high figures (87%) for hypoacusis in our population of elderly people. In 68.2%, this was due to presbycusis. The sensitivity and negative predictive value (Vp-) of most of the tests used in primary care to detect auditory disorders are low.

HANPP Collection: Human Appropriation of Net Primary Productivity as a Percentage of Net Primary Productivity

Data.gov (United States)

National Aeronautics and Space Administration — The Human Appropriation of Net Primary Productivity (HANPP) as a Percentage of Net Primary Product (NPP) portion of the HANPP Collection represents a map identifying...

Primary Hyperparathyroidism

Science.gov (United States)

... Neoplasia Type 1 Thyroid Disease & Pregnancy Primary Hyperparathyroidism Prolactinoma National Hormone and Pituitary Program (NHPP): Information for ... qualified health care provider nearby. Eating, Diet, and Nutrition Eating, diet, and nutrition have not been shown ...

African Primary Care Research: qualitative interviewing in primary care.

Science.gov (United States)

Reid, Steve; Mash, Bob

2014-06-05

This article is part of a series on African Primary Care Research and focuses on the topic of qualitative interviewing in primary care. In particular it looks at issues of study design, sample size, sampling and interviewing in relation to individual and focus group interviews.There is a particular focus on helping postgraduate students at a Masters level to write their research proposals.

Licensing telemedicine: the need for a national system.

Science.gov (United States)

Jacobson, P D; Selvin, E

2000-01-01

The expansion of information technology has shattered geographic boundaries, allowing for extraordinarily increased access to health information and expanded opportunities for telemedicine practice across state boundaries. But despite its recent growth, telemedicine technology remains embedded in a state-based licensure system that places severe limits on its expansion. The current system of medical licensure is based primarily on statutes written at the turn of the 20th century. This system is inadequate to address the emerging medical practices and future uses of medical technology in the telecommunications age. To respond to the changes offered by the telecommunications revolution, we need to design a new regulatory structure for the 21st century. The purpose of this article is to propose a policy of national telemedicine licensure. The primary goal here is not to simply develop a policy proposal, but to discuss the rationale for national licensure and place it on the policy agenda. A national licensure system will expand the market for telemedicine, promote both the use and development of new technologies, and simultaneously eliminate many of the legal and regulatory ambiguities that plague and constrain the present system.

Regional economic impacts of current and proposed management alternatives for Charles M. Russell National Wildlife Refuge

Science.gov (United States)

Koontz, Lynne; Sexton, Natalie; Ishizaki, Asuka; Ritten, John

2013-01-01

The National Wildlife Refuge System Improvement Act of 1997 requires all units of the National Wildlife Refuge System to be managed under a Comprehensive Conservation Plan (CCP). The CCP must describe the desired future conditions of a refuge and provide long-range guidance and management direction to achieve refuge purposes. Charles M. Russell (CMR) National Wildlife Refuge, located in north-central Montana, is in the process of developing a range of management goals, objectives, and strategies for the CCP. The CCP for the Refuge must contain an analysis of expected effects associated with current and proposed refuge-management strategies. For refuge CCP planning, an economic analysis provides a means of estimating how current management (No Action Alternative) and proposed management activities (Alternatives) affect the local economy. This type of analysis provides two critical pieces of information: (1) it illustrates a refuge’s contribution to the local community; and (2) it can help in determining whether economic effects are or are not a real concern in choosing among management alternatives. It is important to note that the economic value of a refuge encompasses more than just the impacts on the regional economy. Refuges also provide substantial nonmarket values (values for items not exchanged in established markets) such as maintaining endangered species, preserving wetlands, educating future generations, and adding stability to the ecosystem (Carver and Caudill, 2007). However, quantifying these types of nonmarket values is beyond the scope of this study. This report first presents a description of the local community and economy near the Refuge. Next, the methods used to conduct a regional economic impact analysis are described. An analysis of the final CCP management strategies that could affect stakeholders and residents and the local economy is then presented. The refuge management activities of economic concern in this analysis are:

Perceived Barriers to Implementing Individual Choosing Wisely® Recommendations in Two National Surveys of Primary Care Providers.

Science.gov (United States)

Zikmund-Fisher, Brian J; Kullgren, Jeffrey T; Fagerlin, Angela; Klamerus, Mandi L; Bernstein, Steven J; Kerr, Eve A

2017-02-01

While some research has examined general attitudes about efforts to reduce overutilization of services, such as the Choosing Wisely ® (CW) initiative, little data exists regarding primary care providers' attitudes regarding individual recommendations. We sought to identify whether particular CW recommendations were perceived by primary care providers as difficult to follow, difficult for patients to accept, or both. Two national surveys, one by mail to a random sample of 2000 U.S. primary care physicians in November 2013, and the second electronically to a random sample of 2500 VA primary care providers (PCPs) in October-December 2014. A total of 603 U.S. primary care physicians and 1173 VA primary care providers. Response rates were 34 and 48 %, respectively. PCP ratings of whether 12 CW recommendations for screening, testing and treatments applicable to adult primary care were difficult to follow and difficult for patients to accept; and ratings of potential barriers to reducing overutilization. For four recommendations regarding not screening or testing in asymptomatic patients, less than 20 % of PCPs found the CW recommendations difficult to accept (range 7.2-16.6 %) or difficult for patients to follow (12.2-19.3 %). For five recommendations regarding testing or treatment for symptomatic conditions, however, there was both variation in reported difficulty to follow (9.8-32 %) and a high level of reported difficulty for patients to accept (35.7-87.1 %). The most frequently reported barriers to reducing overuse included malpractice concern, patient requests for services, lack of time for shared decision making, and the number of tests recommended by specialists. While PCPs found many CW recommendations easy to follow, they felt that some, especially those for symptomatic conditions, would be difficult for patients to accept. Overcoming PCPs' perceptions of patient acceptability will require approaches beyond routine physician education, feedback and

Proposal for a slow positron facility at Jefferson National Laboratory

Science.gov (United States)

Mills, Allen P.

2018-05-01

One goal of the JPos-17 International Workshop on Physics with Positrons was to ascertain whether it would be a good idea to expand the mission of the Thomas Jefferson National Accelerator Facility (JLab) to include science with low energy (i.e. "slow") spin polarized positrons. It is probably true that experimentation with slow positrons would potentially have wide-ranging benefits comparable to those obtained with neutron and x-ray scattering, but it is certain that the full range of these benefits will never be fully available without an infrastructure comparable to that of existing neutron and x-ray facilities. The role for Jefferson Laboratory would therefore be to provide and maintain (1) a dedicated set of machines for making and manipulating high intensity, high brightness beams of polarized slow positrons; (2) a suite of unique and easily used instruments of wide utility that will make efficient use of the positrons; and (3) a group of on-site positron scientists to provide scientific leadership, instrument development, and user support. In this note some examples will be given of the science that might make a serious investment in a positron facility worthwhile. At the same time, the lessons learned from various proposed and successful positron facilities will be presented for consideration.

Availability of herbal medicines and medicinal plants in the primary health facilities of the state of São Paulo, Southeast Brazil: results from the National Program for Access and Quality Improvement in Primary Care.

Science.gov (United States)

Caccia-Bava, Maria do Carmo Gullaci Guimarães; Bertoni, Bianca Waléria; Pereira, Ana Maria Soares; Martinez, Edson Zangiacomi

2017-05-01

This study aims to describe the availability of herbal medicines and medicinal plants in the primary care facilities in the state of São Paulo, Southeast Brazil, from the results of the first cycle of the National Program for Access and Quality Improvement in Primary Care (PMAQ). The PMAQ uses a national cross-sectional multicenter design, with data from 4,249 health facilities distributed among 645 municipalities of the state of São Paulo. Of these facilities, 467 (11%) had herbal medicines and/or medicinal plants. Among the 645 municipalities, 104 (16.1%) had at least one health facility that provided these drugs. We observed that the availability of herbal medicines is greater in larger cities with better social and economic conditions. Furthermore, we found that use of industrialized herbal medicines prevailed over that of vegetal drugs or compounded herbal medicines.

Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data.

Science.gov (United States)

Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

2015-02-17

For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of

Trends in primary and revision anterior cruciate ligament reconstruction among National Basketball Association team physicians.

Science.gov (United States)

Mall, Nathan A; Abrams, Geoffrey D; Azar, Frederick M; Traina, Steve M; Allen, Answorth A; Parker, Richard; Cole, Brian J

2014-06-01

Anterior cruciate ligament (ACL) tears are common in athletes. Techniques and methods of treatment for these injuries continue to vary among surgeons. Thirty National Basketball Association (NBA) team physicians were surveyed during the NBA Pre-Draft Combine. Survey questions involved current and previous practice methods of primary and revision ACL reconstruction, including technique, graft choice, rehabilitation, and treatment of combined ACL and medial collateral ligament injuries. Descriptive parametric statistics, Fisher exact test, and logistic regression were used, and significance was set at α = 0.05. All 30 team physicians completed the survey. Eighty-seven percent indicated they use autograft (81% bone-patellar tendon-bone) for primary ACL reconstruction in NBA athletes, and 43% indicated they use autograft for revision cases. Fourteen surgeons (47%) indicated they use an anteromedial portal (AMP) for femoral tunnel drilling, whereas 5 years earlier only 4 (13%) used this technique. There was a significant (P = .009) positive correlation between fewer years in practice and AMP use. NBA team physicians' use of an AMP for femoral tunnel drilling has increased over the past 5 years.

Shielding assessment for the proposed HRIBF upgrade to the National ISOL Facility

International Nuclear Information System (INIS)

Slater, C.O.; Olsen, D.K.; Johnson, J.O.; Lillie, R.A.; Gabriel, T.A.

1997-04-01

An upgrade of the existing ORNL Holifield Radioactive Ion Beam Facility (HRIBF) to the National Radioactive Ion Beam Isotope Separator On Line (RIB ISOL) Facility is being proposed. Part of the upgrade involves increasing the source proton energy and current, resulting in more intense, higher energy radiation. Shielding requirements for the proposed upgrade to the HRIBF have been assessed with respect to weight, space, and dose-rate constraints. Shielding assessments were made for operating, shutdown, and accident conditions. The results indicate reasonable shielding solutions for the target room except for the marginal dose rate on the roof. Shielding requirements in the target room were greatly reduced by decisions to move the target to a more interior room and to direct the proton beam downward into the target. A slightly more difficult shielding problem arises for proton beam extraction losses from the cyclotron. Here, the assumed isotropic beam losses (hence, neutron emissions) mean higher roof dose rates than those over the target room unless substantial localized shielding is placed over the cyclotron. Shutdown dose rates were found to present no problems. While dose rates through the sides of the facility during accident conditions will probably satisfy the accident dose-rate constraints, dose rates above the roof will be well above the constraints unless a solution is devised to shield the locations where beam losses are likely to occur. Ground activation analysis was postponed for this study

RHIC and quark matter: proposal for a relativistic heavy ion collider at Brookhaven National Laboratory

International Nuclear Information System (INIS)

1984-08-01

This document describes the Brookhaven National Laboratory Proposal for the construction of a Relativistic Heavy Ion Collider (RHIC). The construction of this facility represents the natural continuation of the laboratory's role as a center for nuclear and high-energy physics research and extends and uses the existing AGS, Tandem Van de Graaff and CBA facilities at BNL in a very cost effective manner. The Administration and Congress have approved a project which will provide a link between the Tandem Van de Graaf and the AGS. Completion of this project in 1986 will provide fixed target capabilities at the AGS for heavy ions of about 14 GeV/amu with masses up to approx. 30 (sulfur). The addition of an AGS booster would extend the mass range to the heaviest ions (A approx. 200, e.g., gold); its construction could start in 1986 and be completed in three years. These two new AGS experimental facilities can be combined with the proposed Relativistic Heavy Ion Collider to extend the energy range to 100 x 100 GeV/amu for the heaviest ions. BNL proposes to start construction of RHIC in FY 86 with completion in FY 90 at a total cost of 134 M$

Aesthetic Education of Primary School Pupils as an Integral Part of the National System of Continuous Art Education in Japan

Science.gov (United States)

Kuchai, Tetiana

2014-01-01

The article examines aesthetic education of primary school pupils as an integral part of the national system of continuous art education in Japan. One of the most important traditional means of aesthetic education in Japan, according to L. Tsaryova is considered nature. Analysis of the scientific literature by domestic and foreign scientists…

National program for family planning and primary health care Pakistan: a SWOT analysis.

Science.gov (United States)

Wazir, Mohammad Salim; Shaikh, Babar Tasneem; Ahmed, Ashfaq

2013-11-22

The National Program for Family Planning and Primary Healthcare was launched in 1994. It is one of the largest community based programs in the world, providing primary healthcare services to about 80 million people, most of which is rural poor. The program has been instrumental in improving health related indicators of maternal and child health in the last two decades. SWOT analysis was used by making recourse to the structure and dynamics of the program as well as searching the literature. Strengths of the program include: comprehensive design of planning, implementation and supervision mechanisms aided by an MIS, selection and recruitments processes and evidence created through improving health impact indicators. Weaknesses identified are slow progress, poor integration of the program with health services at local levels including MIS, and de-motivational factors such as job insecurity and non-payment of salaries in time. Opportunities include further widening the coverage of services, its potential contribution to health system research, and its use in areas other than health like women empowerment and poverty alleviation. Threats the program may face are: political interference, lack of funds, social threats and implications for professional malpractices. Strengthening of the program will necessitate a strong political commitment, sustained funding and a just remuneration to this bare foot doctor of Pakistan, the Lady Health Worker.

Proposed National Large Solar Telescope Jagdev Singh

Indian Academy of Sciences (India)

proposed to design, fabricate and install a 2-meter class solar telescope at a suitable site in India to ... which can facilitate simultaneous measurements of the solar atmospheric parameters and of the vector ... Intensity variation of. 1% or less.

The evolution of emissions trading in the EU. Tensions between national trading schemes and the proposed EU directive

International Nuclear Information System (INIS)

Boemare, Catherine; Quirion, Philippe; Sorrell, Steve

2003-12-01

The EU is pioneering the development of greenhouse gas emissions trading, but there is a tension between the 'top-down' and 'bottom-up' evolution of trading schemes. While the Commission is introducing a European emissions trading scheme (EU ETS) in 2005, several member states have already introduced negotiated agreements that include trading arrangements. Typically, these national schemes have a wider scope than the proposed EU directive and allow firms to use relative rather than absolute targets. The coexistence of 'top-down' and 'bottom-up' trading schemes may create some complex problems of policy interaction. This paper explores the potential interactions between the EU ETS and the negotiated agreements in France and UK and uses these to illustrate some important generic issues. The paper first describes the proposed EU directive, outlines the UK and French policies and compares their main features to the EU ETS. It then discusses how the national and European policies may interact in practice. Four issues are highlighted, namely, double regulation, double counting of emission reductions, equivalence of effort and linking trading schemes. The paper concludes with some recommendations for the future development of UK and French climate policy

Health financing reform in Uganda: How equitable is the proposed National Health Insurance scheme?

Directory of Open Access Journals (Sweden)

Orem Juliet

2010-10-01

Full Text Available Abstract Background Uganda is proposing introduction of the National Health Insurance scheme (NHIS in a phased manner with the view to obtaining additional funding for the health sector and promoting financial risk protection. In this paper, we have assessed the proposed NHIS from an equity perspective, exploring the extent to which NHIS would improve existing disparities in the health sector. Methods We reviewed the proposed design and other relevant documents that enhanced our understanding of contextual issues. We used the Kutzin and fair financing frameworks to critically assess the impact of NHIS on overall equity in financing in Uganda. Results The introduction of NHIS is being proposed against the backdrop of inequalities in the distribution of health system inputs between rural and urban areas, different levels of care and geographic areas. In this assessment, we find that gradual implementation of NHIS will result in low coverage initially, which might pose a challenge for effective management of the scheme. The process for accreditation of service providers during the first phase is not explicit on how it will ensure that a two-tier service provision arrangement does not emerge to cater for different types of patients. If the proposed fee-for-service mechanism of reimbursing providers is pursued, utilisation patterns will determine how resources are allocated. This implies that equity in resource allocation will be determined by the distribution of accredited providers, and checks put in place to prohibit frivolous use. The current design does not explicitly mention how these two issues will be tackled. Lastly, there is no clarity on how the NHIS will fit into, and integrate within existing financing mechanisms. Conclusion Under the current NHIS design, the initial low coverage in the first years will inhibit optimal achievement of the important equity characteristics of pooling, cross-subsidisation and financial protection. Depending

a System Dynamics Model to Study the Importance of Infrastructure Facilities on Quality of Primary Education System in Developing Countries

Science.gov (United States)

Pedamallu, Chandra Sekhar; Ozdamar, Linet; Weber, Gerhard-Wilhelm; Kropat, Erik

2010-06-01

The system dynamics approach is a holistic way of solving problems in real-time scenarios. This is a powerful methodology and computer simulation modeling technique for framing, analyzing, and discussing complex issues and problems. System dynamics modeling and simulation is often the background of a systemic thinking approach and has become a management and organizational development paradigm. This paper proposes a system dynamics approach for study the importance of infrastructure facilities on quality of primary education system in developing nations. The model is proposed to be built using the Cross Impact Analysis (CIA) method of relating entities and attributes relevant to the primary education system in any given community. We offer a survey to build the cross-impact correlation matrix and, hence, to better understand the primary education system and importance of infrastructural facilities on quality of primary education. The resulting model enables us to predict the effects of infrastructural facilities on the access of primary education by the community. This may support policy makers to take more effective actions in campaigns.

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

NARCIS (Netherlands)

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

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

Intertechnology Corporation proposed test and evaluation plan, commercial buildings. National Solar Demonstration Program

Energy Technology Data Exchange (ETDEWEB)

None

1976-09-01

This report has three major parts. The first of these derives the requirements for the Test and Evaluation plan from the System Level Plan which is summarized in Section II. The second part contains the proposed plan to fill these requirements and includes hardware and software recommendations as well as procedures and management considerations. Primary emphasis has been given to the remote site because this is the area in which the commercial part of the demonstration is most unique. Finally, some pre-demonstration activities are described. The pilot program is intended to resolve a number of issues which arose in the course of the T and E plan. These relate to choice of scan frequencies, compression algorithms, etc. It is also intended to confirm performance and cost effectiveness of the site data collection package. The base line measurements of attitudes, etc. provide a reference mark against which one can measure the non-technical effectiveness of the demonstration program. (WDM)

English Language Teaching in Public Primary Schools in Mexico: The Practices and Challenges of Implementing a National Language Education Program

Science.gov (United States)

Ramírez Romero, José Luis; Sayer, Peter; Pamplón Irigoyen, Elva Nora

2014-01-01

Over the past 15?years, many state governments in Mexico have initiated local programs to introduce English at the primary school level. In 2009, the Mexican Ministry of Education formalized the "Programa Nacional de Inglés en Educación Básica" (PNIEB) as part of the national curriculum, based on the argument that increasing the number…

A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.

Science.gov (United States)

Cohen, Deborah J; Balasubramanian, Bijal A; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I; Crabtree, Benjamin F; Stange, Kurt C; Davis, Melinda; Miller, William L; Damschroder, Laura J; McConnell, K John; Creswell, John

2016-06-29

The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. ESCALATES is

Proposed Coastal Critical Habitat Areas

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — When a species is proposed for listing as endangered or threatened under the Endangered Species Act, NOAA National Marine Fisheries Service and the U.S. Fish &...

Inquiry-Based Science Education Competencies of Primary School Teachers: A literature study and critical review of the American National Science Education Standards

Science.gov (United States)

Alake-Tuenter, Ester; Biemans, Harm J. A.; Tobi, Hilde; Wals, Arjen E. J.; Oosterheert, Ida; Mulder, Martin

2012-11-01

Inquiry-based science education is an important innovation. Researchers and teachers consider it to be stimulating for pupils' application of research skills, construction of meaning and acquiring scientific knowledge. However, there is ambiguity as to what competencies are required to teach inquiry-based science. Our purpose is to develop a profile of professional competence, required for effective inquiry-based science teaching in primary schools in the Netherlands. This article reviews literature and compares the outcomes to the American National Science Education Standards (NSES). In so doing, it seeks to answer the following research questions: What elements of competencies required by primary school teachers who teach inquiry-based science are mentioned, discussed and researched in recent literature? To what extent are the American NSES (introduced 15 years ago) consistent with elements of competencies found in recent literature? A comprehensive literature review was conducted using Educational Resources Information Centre and Google Scholar databases. Fifty-seven peer-reviewed scientific journal articles from 2004 to 2011 were found using keyword combinations. Analysis of these articles resulted in the identification and classification of 22 elements of competencies. This outcome was compared to the American NSES, revealing gaps in the standards with respect to a lack of focus on how teachers view science teaching and themselves as teachers. We also found that elements of competencies are connected and poor mastery of one may affect a teacher's mastery of another. Therefore, we propose that standards for the Netherlands should be presented in a non-linear, holistic, competence-based model.

Assessing primary care data quality.

Science.gov (United States)

Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

Health promotion practices as perceived by primary healthcare professionals at the Ministry of National Guard Health Affairs, Saudi Arabia.

Science.gov (United States)

Altamimi, Samar; Alshoshan, Feda; Al Shaman, Ghada; Tawfeeq, Nasser; Alasmary, May; Ahmed, Anwar E

2016-01-01

In recent years, several research studies have investigated health promotion practices in Saudi healthcare organizations, yet no published literature exists on health promotion practices of primary healthcare professionals working for the Ministry of National Guard Health Affairs (MNG-HA). A cross-sectional study was conducted in a convenience sample of 206 primary healthcare professionals at the MNG-HA. A self-reporting questionnaire was used to investigate the attitudes, awareness, satisfaction, and methods regarding health promotion practices of primary healthcare professionals. Of the 206 primary healthcare professionals surveyed, 58.1% reported awareness of health promotion programs conducted in the hospitals and 64.6% reported that the health promotion system in the hospitals needs to be improved. Language barriers and cultural beliefs were viewed as obstacles to carrying out effective health promotion by 65% and 64.6% of primary healthcare professionals, respectively. The majority (79.9%) of the primary healthcare professionals perceived themselves as having the necessary skills to promote health and 80.6% believed that printed educational materials are the most prevalent method of health promotion/education, whereas 55.8% reported that counseling was the most preferred method of health promotion. The awareness level of health promotion policies, strategies, and programs conducted in the hospitals was not found to be satisfactory. Therefore, widespread training programs are recommended to improve the health promotion system in the hospitals. These programs include facilitating behavioral change, introducing health promotion policies and strategies in hospitals, mandatory workshops, and systematic reminders.

77 FR 36292 - Proposed Collection, Comments Requested: FBI National Academy Level III Evaluation; FBI National...

Science.gov (United States)

2012-06-18

... Management and Budget (OMB) for review and approval in accordance with the Paperwork Reduction Act of 1995...: Approval of a reinstated collection. 2. Title of the Forms: FBI National Academy Post-Course Questionnaire... FBI National Academy. These surveys have been developed that will measure the effectiveness of...

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Terminal Operations HITL 1B Primary Results

Science.gov (United States)

Rorie, Conrad; Monk, Kevin; Roberts, Zach; Brandt, Summer

2018-01-01

This presentation provides an overview of the primary results from the Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project's second Terminal Operations human-in-the-loop simulation. This talk covers the background of this follow-on experiment, which includes an overview of the first Terminal Operations HITL performed by the project. The primary results include a look at the number and durations of detect and avoid (DAA) alerts issued by the two DAA systems under test. It also includes response time metrics and metrics on the ability of the pilot-in-command (PIC) to maintain sufficient separation. Additional interoperability metrics are included to illustrate how pilots interact with the tower controller. Implications and conclusions are covered at the end.

The National School Lunch Program: Ideas, proposals, policies, and politics shaping students' experiences with school lunch in the United States, 1946 - present

OpenAIRE

Gosliner, Wendi Anne

2013-01-01

AbstractThe National School Lunch Program:Ideas, proposals, policies, and politics shaping students' experiences with school lunch in the United States, 1946 - presentBy Wendi Anne GoslinerDoctor of Public HealthUniversity of California, BerkeleyProfessor Ann Keller, ChairOn an average school day in 2012, The National School Lunch Program (NSLP) supported the provision of lunch meals to almost 2/3 of school-age youth in the United States. Recent spikes in childhood obesity rates and the emerg...

Physics with primary beams of the KEK-PS

International Nuclear Information System (INIS)

Tanaka, Kazuhiro; Yoshii, Masahito

1993-08-01

The 12-GeV Proton Synchrotron (PS) at the National Laboratory for High Energy Physics (KEK) has provided great opportunities to high-energy-physics and related communities as a unique high-energy hadron machine, since its operation in 1976. Activities of the KEK-PS are indispensable for the rapid development in the field. Six experimental subjects are proposed in this Report; (1) media effects in φ meson decay, (2) multifragmentation in high-energy reactions, (3) mechanism of high-energy reactions by means of radio-chemical methods, (4) physics with polarized high-energy neutrons, (5) physics with polarized high-energy deuterons, and (6) hypernucleus with high-energy heavy-ion beams. As a summary, new facilities (a new injector, a new beamline and a new experimental area) and physics programs with primary beams, proposed in this Report are themselves unique and valuable. Moreover, technical developments and physics outcomes stimulated with those new facilities are indispensable for future plans of the KEK-PS. (J.P.N.)

75 FR 8731 - Proposed Appointment to the National Indian Gaming Commission

Science.gov (United States)

2010-02-25

... National Indian Gaming Commission ACTION: Notice. SUMMARY: The Indian Gaming Regulatory Act provides for a three-person National Indian Gaming Commission. One member, the chairman, is appointed by the President... as an associate member of the National Indian Gaming Commission for a term of 3 years. DATES...

Implementing primary health care: some problems of creating national programmes.

Science.gov (United States)

Vaughan, J P; Walt, G

1984-07-01

While there is a great deal of agreement about the principles underlying Primary Health Care (PHC), there exist many problems, political, planning and management, involved in putting the approach into effect. Some of these difficulties are discussed. It is clear that the PHC approach is essentially political; the way it is implemented in each country will reflect the political priorities and systems of that country. Moreover, ministries of health are not known for their strong position in the ministerial pecking order. Finance and planning ministeries would have to be won over to the importance of the concept of PHC to try to eexpand the health budget and to change the emphasis of existing resource allocation patterns. Costs incurred by a PHC approach ( e.g., expensive transport and communication systems), and resources needed to finance it may be available; however, they may not be channelled to the politically less articulate groups in rural areas. Political implications are not limited to national levels; considerable conflict may exist between different status groups and classes at the village level, thus sabotaging PHC plans. Professional politics will also be played at all levels. It is equally essential to recognize the historical context in which PHC is being introduced. Many countries have inherited colonial infrastructures. Changing the values, perceptions, expectations, administration and organization that accompany such systems is extremely hard, and to put PHC into effect demands radical changes. The planning difficulties which beset PHC are related to the still large private provision of social services like health, and to a flourishing traditional private sector in many developing countries. These may limit the implementation of a national health policy and PHC may thus result in a very patchy service throughout the country. The level of centralized planning will also affect resource allocation and therefore the policy, planning and implementation

Summary of proposed approach for deriving cleanup guidelines for radionuclides in soil at Brookhaven National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Meinhold, A.F.; Morris, S.C.; Dionne, B.; Moskowitz, P.D.

1996-11-01

Past activities at Brookhaven National Laboratory (BNL) resulted in soil and groundwater contamination. As a result, BNL was designated a Superfund site under the Comprehensive Environmental Response Compensation and Liability Act (CERCLA). BNL`s Office of Environmental Restoration (OER) is overseeing environmental restoration activities at the Laboratory, carried out under an Interagency Agreement (IAG) with the United States Department of Energy (DOE), the United States Environmental Protection Agency (EPA) and the New York State Department of Environmental Conservation (NYSDEC). The objective of this paper is to propose a standard approach to deriving risk-based cleanup guidelines for radionuclides in soil at BNL.

Summary of proposed approach for deriving cleanup guidelines for radionuclides in soil at Brookhaven National Laboratory

International Nuclear Information System (INIS)

Meinhold, A.F.; Morris, S.C.; Dionne, B.; Moskowitz, P.D.

1996-11-01

Past activities at Brookhaven National Laboratory (BNL) resulted in soil and groundwater contamination. As a result, BNL was designated a Superfund site under the Comprehensive Environmental Response Compensation and Liability Act (CERCLA). BNL's Office of Environmental Restoration (OER) is overseeing environmental restoration activities at the Laboratory, carried out under an Interagency Agreement (IAG) with the United States Department of Energy (DOE), the United States Environmental Protection Agency (EPA) and the New York State Department of Environmental Conservation (NYSDEC). The objective of this paper is to propose a standard approach to deriving risk-based cleanup guidelines for radionuclides in soil at BNL

[Primary care in Italy].

Science.gov (United States)

Sánchez-Sagrado, T

Italy is not a country where Spanish doctors emigrate, as there is an over-supply of health care professionals. The Italian Servizio Sanitario Nazionale has some differences compared to the Spanish National Health System. The Servizio Sanitario Nazionale is financed by national and regional taxes and co-payments. There are taxes earmarked for health, and Primary Care receives 50% of the total funds. Italian citizens and residents in Italy have the right to free health cover. However, there are co-payments for laboratory and imaging tests, pharmaceuticals, specialist ambulatory services, and emergencies. Co-payments vary in the different regions. The provision of services is regional, and thus fragmentation and major inequities are the norm. Doctors in Primary Care are self-employed and from 2000 onwards, there are incentives to work in multidisciplinary teams. Salary is regulated by a national contract and it is the sum of per-capita payments and extra resources for specific activities. Responsibilities are similar to those of Spanish professionals. However, medical care is more personal. Relationships between Primary Care and specialised care depend on the doctors' relationships. Primary Care doctors are gatekeepers for specialised care, except for gynaecology, obstetrics and paediatrics. Specialised training is compulsory in order to work as general practitioner. The Italian Health Care System is a national health system like the Spanish one. However, health care professionals are self-employed, and there are co-payments. In spite of co-payments, Italians have one of the highest average life expectancy, and they support a universal and publicly funded health-care system. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

The maternal early warning criteria: a proposal from the national partnership for maternal safety.

Science.gov (United States)

Mhyre, Jill M; D'Oria, Robyn; Hameed, Afshan B; Lappen, Justin R; Holley, Sharon L; Hunter, Stephen K; Jones, Robin L; King, Jeffrey C; D'Alton, Mary E

2014-01-01

Case reviews of maternal death have revealed a concerning pattern of delay in recognition of hemorrhage, hypertensive crisis, sepsis, venous thromboembolism, and heart failure. Early-warning systems have been proposed to facilitate timely recognition, diagnosis, and treatment for women developing critical illness. A multidisciplinary working group convened by the National Partnership for Maternal Safety used a consensus-based approach to define The Maternal Early Warning Criteria, a list of abnormal parameters that indicate the need for urgent bedside evaluation by a clinician with the capacity to escalate care as necessary in order to pursue diagnostic and therapeutic interventions. This commentary reviews the evidence supporting the use of early-warning systems, describes The Maternal Early Warning Criteria, and provides considerations for local implementation. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

National Wind Technology Center sitewide, Golden, CO: Environmental assessment

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-11-01

The National Renewable Energy Laboratory (NREL), the nation`s primary solar and renewable energy research laboratory, proposes to expand its wind technology research and development program activities at its National Wind Technology Center (NWTC) near Golden, Colorado. NWTC is an existing wind energy research facility operated by NREL for the US Department of Energy (DOE). Proposed activities include the construction and reuse of buildings and facilities, installation of up to 20 wind turbine test sites, improvements in infrastructure, and subsequent research activities, technology testing, and site operations. In addition to wind turbine test activities, NWTC may be used to support other NREL program activities and small-scale demonstration projects. This document assesses potential consequences to resources within the physical, biological, and human environment, including potential impacts to: air quality, geology and soils, water resources, biological resources, cultural and historic resources, socioeconomic resources, land use, visual resources, noise environment, hazardous materials and waste management, and health and safety conditions. Comment letters were received from several agencies in response to the scoping and predecisional draft reviews. The comments have been incorporated as appropriate into the document with full text of the letters contained in the Appendices. Additionally, information from the Rocky Flats Environmental Technology Site on going sitewide assessment of potential environmental impacts has been reviewed and discussed by representatives of both parties and incorporated into the document as appropriate.

[Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

Science.gov (United States)

Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

2017-01-23

This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care

Directory of Open Access Journals (Sweden)

Darko Gvozdanovi_

2007-09-01

Full Text Available In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1 to provide efficient healthcare-related data management in support of decision-making processes; (2 to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

A proposal for a long-pulse spallation source at Los Alamos National Laboratory

International Nuclear Information System (INIS)

Pynn, R.; Weinacht, D.

1995-01-01

Los Alamos National Laboratory is proposing a new spallation neutron source that will provide the US with an internationally competitive facility for neutron science and technology that can be built in approximately three years for less than $100 million. The establishment of a 1-MW, long-pulse spallation source (LPSS) at the Los Alamos Neutron Science Center (LANSCE) will meet many of the present needs of scientists in the neutron scattering community and provide a significant boost to neutron research in the US. The new facility will support the development of a future, more intense spallation neutron source, that is planned by DOE's Office of Energy Research. Together with the existing short pulse spallation source (SPSS) at the Manual Lujan, Jr. Neutron Scattering Center (MLNSC) at Los Alamos, the new LPSS will provide US scientists with a complementary pair of high-performance neutron sources to rival the world's leading facilities in Europe

A proposal for a long-pulse spallation source at Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Pynn, R; Weinacht, D [Los Alamos National Lab., NM (United States)

1995-11-01

Los Alamos National Laboratory is proposing a new spallation neutron source that will provide the U.S. with an internationally competitive facility for neutron science and technology that can be built in approximately three years for less than $100 million. The establishment of a 1-MW long-pulse spallation source (LPSS) at the Los Alamos Neutron Science Center (LANSCE) will meet many of the present needs of scientists in the neutron scattering community and provide a significant boost to neutron research in the U.S. The new facility will support the development of a future, more intense spallation neutron source, that is planned by DOE`s Office of Energy Research. Together with the existing short pulse spallation source (SPSS) at the Manual Lujan, Jr. Neutron Scattering Center (MLNSC) at Los Alamos, the new LPSS will provide U.S. scientists with a complementary pair of high-performance neutron sources to rival the world`s leading facilities in Europe. (author) 1 ref.

A proposal for a long-pulse spallation source at Los Alamos National Laboratory

International Nuclear Information System (INIS)

Pynn, R.; Weinacht, D.

1995-01-01

Los Alamos National Laboratory is proposing a new spallation neutron source that will provide the U.S. with an internationally competitive facility for neutron science and technology that can be built in approximately three years for less than $100 million. The establishment of a 1-MW long-pulse spallation source (LPSS) at the Los Alamos Neutron Science Center (LANSCE) will meet many of the present needs of scientists in the neutron scattering community and provide a significant boost to neutron research in the U.S. The new facility will support the development of a future, more intense spallation neutron source, that is planned by DOE's Office of Energy Research. Together with the existing short pulse spallation source (SPSS) at the Manual Lujan, Jr. Neutron Scattering Center (MLNSC) at Los Alamos, the new LPSS will provide U.S. scientists with a complementary pair of high-performance neutron sources to rival the world's leading facilities in Europe. (author) 1 ref

76 FR 59660 - Proposed Information Collection; Comment Request; National Marine Sanctuary Permits

Science.gov (United States)

2011-09-27

... Collection; Comment Request; National Marine Sanctuary Permits AGENCY: National Oceanic and Atmospheric... and extension of this information collection. National Marine Sanctuary regulations at 15 CFR part 922 list specific activities that are prohibited in national marine sanctuaries. These regulations also...

Resolution s/n it approves the proposal by the National Directorate of Energy and Nuclear Technology in the terms set out in the working groups mentioned

International Nuclear Information System (INIS)

2006-01-01

The following Resolution has been stated because of the results of the workshops Elaboration of proposals for strategic guidelines held from 2 to May 5, 2006, elaboration of proposals for the Strategic Lines instruments held from 24 to July 28, 2006, as well as documents Proposal of politic energetic Uruguayan Energy Sector development and proposal of Energy Policy Instruments developed by the National Directorate of Nuclear Energy and Technology and the Energy Strategy Guidelines Uruguay 2006.

Depressive Disorders in Primary Health Care

OpenAIRE

Vuorilehto, Maria

2008-01-01

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

PROPOSAL OF RATIONAL SCREENING FOR OSTEOPOROSIS IN THE PRIMARY CARE SETTING

Directory of Open Access Journals (Sweden)

Rok Hren

2002-12-01

Full Text Available Background. Early identification of postmenopausal women with osteoporosis by means of bone mineral density (BMD measurement is a prerequisite for reducing the incidence of osteoporotic fractures. Primary care physicians have a leading role in referring such patients, however, given the cost of the BMD measurement, efficient screening criteria remain to be determined. Currently available criteria (e. g., SCORE, ORAI are very broad with low specificity. Objective of our study is to assess simple decision rules that could enhance identifying patients with high risk of fracture while concurrently minimizing number of unnecessary measurements.Methods. In the study, 357 primary care physicians (GPs and gynecologists referred their patients to BMD measurements based on the following decision rules: women (i should be postmenopausal for at least 5 years, (ii should have body mass index (BMI less than 26 kg/m2, and (iii should have never been diagnosed with osteoporosis. BMD of lumbar spine and/ or hip was measured by dual-energy x-ray absorptiometry (DXA in 5 centers using Hologic (Hologic Corp., Bedford, MA or Lunar (Lunar Corp., Madison, WI densitometers. Results of BMD measurements were expressed in terms of the T-score and were forwarded to the primary care physicians.Results. 2339 postmenopausal women participated in the study; by the end of the study, 327 physicians (92% reported results on 2196 women (94%. 1332 women of 2196 (61% were identified as osteoporotic, 637 (29% as osteopenic, and 227 (10% had normal BMD. Approximately 30% of patients with osteoporosis suffered from previous low-trauma fracture. Among all women, the prevalence of osteoporosis was 34% for ages less than 55 years, 50% for ages 55–59 years, and 69% for ages above 60 years. The number of DXA measurements needed to detect one osteoporotic patient among women older than 60 years and with BMI < 24.5 kg/m2 was 1.32.Conclusions. Results of our study suggest that three simple

The Use of Twitter to Analyze Citizen Proposals: the Economic News of the National Reference Newspapers

Directory of Open Access Journals (Sweden)

María del Mar Soria Ibáñez

2014-06-01

Full Text Available Twitter has become the primary means of public expression and platform on which to build a new way of doing journalism. In the Spanish case, the covers of national reference newspapers and its contents on the microblogging conversations generate traffic that is a true reflection of a social and political context marked by the economic crisis. Therefore, this study aims to reflect the degree of citizen participation in the information content on Twitter, based on the quantification of their interactions or their messages tone. The content analysis presented in this work maps the use by major Spanish newspapers of this new social media, notes the importance it attaches to citizenship expressed by sections of economy news and reveals which are the most active posts on the microblogging and therefore, the most popular.

Primary care ... where?

Science.gov (United States)

Adcock, G B

1999-07-01

Corporate-based nurse managed centers are not the national norm. More prevalent is the use of an occupational health or physician-directed medical model of care. The author describes how a 14-year-old primary care center at a North Carolina computer software company is just "business as usual" when viewed in the context of the company's philosophy, goals, and culture. Included are considerations for nurse practitioners interested in the successful transplantation of this primary care model to other settings.

A national day with near zero emissions and its effect on primary and secondary pollutants

Science.gov (United States)

Levy, Ilan

2013-10-01

Traffic related air pollution is a major health concern in many countries. The potential costs and benefits of different abatement policies are usually estimated by either models, case studies or previously implemented intervention measures. Such estimations have, however, limited ability to predict the effect of a reduction in primary pollutants' emissions on secondary pollutants such as ozone, because of the nonlinear nature of the photochemical reactions. This study examines the short term effects of a drastic change in emissions on a national scale during the Jewish holiday of Day of Atonement (DA) in Israel. During the holiday nearly all anthropogenic emission sources are ceased for a period of 25 h, including all vehicles, commercial, industrial and recreational activities. DAs during the 15 years period of 1998-2012 are analyzed at three sites with respect to primary and secondary air pollutants, and in greater details for 2001. A dramatic decrease in primary pollutants emissions (83-98% in NO) causes an 8 ppbv increase in ozone at the urban core. Downwind (27 km), ozone decreases by only 5 ppbv. Nighttime O3 is shown to increase to 20 ppbv at the urban sites and 30 ppbv downwind. In spite of the striking reduction in emissions, changes in ozone are not greater than what is reported in the literature about less significant events like the ozone weekend effect. Changes in ambient pollution levels observed during DA provide some indication to the possible outcomes of a major change in anthropogenic emissions. These may be considered as the best case scenario for emissions reduction intervention measures and thus aid policy makers in evaluating potential benefits of such measures.

Preliminary shielding estimates for the proposed Oak Ridge National Laboratory (ORNL) Radioactive Ion Beam Facility (RIBF)

International Nuclear Information System (INIS)

Johnson, J.O.; Gabriel, T.A.; Lillie, R.A.

1996-01-01

The Oak Ridge National Laboratory (ORNL) has proposed designing and implementing a new target-ion source for production and injection of negative radioactive ion beams into the Hollifield tandem accelerator. This new facility, referred to as the Radioactive Ion Beam Facility (RIBF), will primarily be used to advance the scientific communities' capabilities for performing state-of-the-art cross-section measurements. Beams of protons or other light, stable ions from the Oak Ridge Isochronous Cyclotron (ORIC) will be stopped in the RIBF target ion source and the resulting radioactive atoms will be ionized, charge exchanged, accelerated, and injected into the tandem accelerator. The ORIC currently operates with proton energies up to 60 MeV and beam currents up to 100 microamps with a maximum beam power less than 2.0 kW. The proposed RIBF will require upgrading the ORIC to generate proton energies up to 200 MeV and beam currents up to 200 microamps for optimum performance. This report summarizes the results of a preliminary one-dimensional shielding analysis of the proposed upgrade to the ORIC and design of the RIBF. The principal objective of the shielding analysis was to determine the feasibility of such an upgrade with respect to existing shielding from the facility structure, and additional shielding requirements for the 200 MeV ORIC machine and RIBF target room

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

Science.gov (United States)

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

2016-10-13

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

Landslides susceptibility mapping at Gunung Ciremai National Park

Science.gov (United States)

Faizin; Nur, Bambang Azis

2018-02-01

In addition to agriculture, tourism became one of primary economic income for communities around Mount Ciremai, West, Java. Unfortunately, the landscape of West Java has many potential causes to disasters, mainly landslides. Mapping of disaster susceptibility area is needed as a consideration of tourism planning. The study was conducted in Gunung Ciremai National Park, West Java. This paper propose a methodology to map landslides susceptibilities based on spatial data. Using Geographic Information System tools, several environmental parameters such as slope, land use, elevation, and lithology are scored to build a landslide susceptibility map. Then, susceptibility map is overlaid with Utilization Zone.

Proposal for the establishment of a national underground physics laboratory

International Nuclear Information System (INIS)

Mann, A.K.; Sharp, R.R. Jr.

1982-01-01

Advances in elementary particles physics and astrophysics during the past decade have indicated certain areas in those fields in which experiments of high potential significance, albeit great difficulty, need to be done. In general, these are experiments that seek to uncover rare, new physical phenomena, or to study quantitatively phenomena that are especially difficult to observe. Among them are: (1) the study of solar and other cosmic neutrinos; (2) the search for nucleon instability; (3) the search for non-zero neutrino mass through the study of neutrino stability and double beta-decay; and (4) intensive searches for and attempts to measure accurately very energetic, rare elementary particle interactions such as may be manifested, for example, in the so-called Centauro events. The nature of these experiments requires that they be shielded from the intense flux of cosmic ray muons and air showers on the earth's surface, and therefore that the experimental apparatus be located deep underground or in the deep sea. However, for most of the experiments, and the apparatus also needs to be very large in mass and volume, and highly instrumented to achieve the necessary measurement capability. It is proposed to establish a laboratory deep underground of sufficient scope to be capable of housing and maintaining a variety of experiments that employ the most advanced technology. A specific channel is discussed whereby a national underground physics laboratory might be formed. The desirable characteristics of such a laboratory are described, and a possible location is recommended. Detailed cost estimates are provided

The UK National Air Quality Strategy: the effects of the proposed changes on Local Air Quality Management

Energy Technology Data Exchange (ETDEWEB)

Beattie, C.I.; Ling, K.; Longhurst, J.W.S. [Univ. of the West of England, Faculty of Applied Sciences, Bristol (GB)] [and others

1999-07-01

The UK has implemented a system of Local Air Quality Management (LAQM) to tackle the many contemporary sources of air pollution, notably transport, industry and domestic fuel burning, in a holistic manner. The current legislation stems from the Environment Act 1995, which required a National Air Quality Strategy (NAQS) to be published outlining the Governments policies with respect to the assessment and management of air quality. The NAQS, originally published in March 1997, is on a rolling programme of reviews in order to reflect developments in European legislation, technological and scientific advances, improved air pollution modelling techniques and an increasingly better understanding of the economic and social issues involved. Following the first review (currently at consultation state), this paper will comment on how the proposed changes may affect the LAQM process. The proposed changes will also be summarised and discussed in the context of European Union air quality objectives and the economic analysis of NAQS.

Proposals for in-service inspection and monitoring of selected components located within or part of the primary containment of sodium cooled fast reactors

International Nuclear Information System (INIS)

Bolt, P.R.

1976-01-01

Design and operational experience of CEGB gas cooled reactors and certain overseas reactor plant is reviewed in relation to in-service inspection and monitoring capabilities. Design guidelines and preliminary proposals are given for in-service inspection and monitoring of selected components located within or part of the primary containment of sodium cooled fast reactors. Specific comments are made on the items of further design and development work believed to be necessary

Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry.

Science.gov (United States)

Kaiser, Daniel W; Tsai, Vivian; Heidenreich, Paul A; Goldstein, Mary K; Wang, Yongfei; Curtis, Jeptha; Turakhia, Mintu P

2015-10-01

Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs. Using data from the National Cardiovascular Data Registry's ICD Registry, we identified patients who received ICDs for primary prevention from January 2006 to December 2008. We determined whether patients met the inclusion criteria of at least 1 of the 4 ICD primary prevention trials: Multicenter Automatic Defibrillator Implantation Trial (MADIT), MADIT-II, Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), and the Multicenter Unsustained Tachycardia Trial (MUSTT). Among 150,264 patients, 86% met criteria for an ICD implantation based on trial data. The proportion of patients who did not meet trial-based criteria increased as age decreased. In multivariate analysis, the significant predictors for not meeting trial criteria included prior cardiac transplantation (odds ratio [OR] 2.1), pediatric electrophysiology operator (OR 2.0), and high-grade atrioventricular conduction disease (OR 1.4). Among National Cardiovascular Data Registry registrants receiving first-time ICDs for primary prevention, the majority met trial-based criteria. Multivariate analyses suggested that many patients who did not meet the trial-based criteria may have had clinical circumstances that warranted ICD implantation. These findings caution against the use of trial-based indications to determine site quality metrics that could penalize sites that care for younger patients. The planned incorporation of appropriate use criteria into the ICD registry may better characterize patient- and site-level quality and performance. Published by Elsevier Inc.

77 FR 47913 - The National Center for Mobility Management Under FTA's National Research Program

Science.gov (United States)

2012-08-10

... Management Under FTA's National Research Program AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY: Federal Transit Administration (FTA), as the primary staff agency to the Federal... transportation service delivery. FTA, under its National Research Program, plans to fund a National Center for...

The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China.

Science.gov (United States)

Guo, Zhigang; Guan, Xiaodong; Shi, Luwen

2017-11-13

In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010. A questionnaire survey developed by the study team was distributed to all of the primary healthcare institutions. Nine indicators from three dimensions as the outcome variables were used and calculated to evaluate the impacts of implementation of policies. All of the outcome variables were tested using independent-samples T test between the treatment group (with the NEMPs implemented) and the control group (without the NEMPs implemented). The ratio of drug sales and institution revenues at primary healthcare institutions was 42.99% in the treatment group, which was significantly lower than the control group (53.90%, p financial subsidies of the treatment group was shown to be higher (30.78% VS 20.82%, p institutions, the improvement of the mechanisms for government investment, and the healthcare pricing system. Meanwhile, the gaps between urban and rural areas need to be addressed. In conclusion, the NEMPs of China are instrumental to the aim of providing basic healthcare services to every citizen.

Environmental Assessment for the proposed Induction Linac System Experiments in Building 51B at Lawrence Berkeley National Laboratory, Berkeley, California

International Nuclear Information System (INIS)

1995-08-01

The US Department of Energy (DOE) has prepared an Environmental Assessment (EA), (DOE/EA-1087) evaluating the proposed action to modify existing Building 51B at Lawrence Berkeley National Laboratory (LBNL) to install and conduct experiments on a new Induction Linear Accelerator System. LBNL is located in Berkeley, California and operated by the University of California (UC). The project consists of placing a pre-fabricated building inside Building 51B to house a new 10 MeV heavy ion linear accelerator. A control room and other support areas would be provided within and directly adjacent to Building 51B. The accelerator system would be used to conduct tests, at reduced scale and cost, many features of a heavy-ion accelerator driver for the Department of Energy's inertial fusion energy program. Based upon information and analyses in the EA, the DOE has determined that the proposed action is not a major Federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act of 1969. Therefore, an Environmental Impact Statement is not required. This report contains the Environmental Assessment, as well as the Finding of No Significant Impact (FONSI)

Primary care and health reform in New Zealand.

Science.gov (United States)

Grant, C C; Forrest, C B; Starfield, B

1997-02-14

(1) To describe New Zealand's primary care system (2) to compare New Zealand to other Anglo-American members of the OECD with respect to the adequacy of primary care, and (3) to assess the cost-efficiency and effectiveness of New Zealand's system by comparing health spending and health indicators relevant to primary care. A cross-national comparison of primary care, health spending and health indicators in New Zealand, Australia, Canada, the United Kingdom and the United States of America. Main outcome measures were health spending measured in purchasing power parties. Health indicators: mean life expectancy in years, years of potential life lost and infant mortality rates. New Zealand's primary care system ranked below the UK, above the USA and similar to Canada and Australia. Favourable characteristics of New Zealand's primary care system were the use of generalists as the predominant type of practitioner and the low proportion of active physicians who were specialists. Compared to the other countries, New Zealand scored poorly for financial that are necessary for the practise of good primary care. New Zealand and the UK had the lowest spending per capita on health care. New Zealand and the USA scored lowest for all three of the health care indicators. The quality of primary care in New Zealand is limited by barriers to access to care and the intermediate level of practise characteristics essential to primary care. Compared to other AngloAmerican OECD nations, New Zealand has relatively low levels of national health expenditure. In order to improve the quality of primary care, future reform should aim to facilitate access to care, increase the gatekeeping role of primary care physicians, and promote the practise characteristics essential to primary care.

Assessment of the National Research Universal Reactor Proposed New Stack Sampling Probe Location for Compliance with ANSI/HPS N13.1-1999

Energy Technology Data Exchange (ETDEWEB)

Glissmeyer, John A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Antonio, Ernest J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Flaherty, Julia E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2016-02-29

This document reports on a series of tests conducted to assess the proposed air sampling location for the National Research Universal reactor (NRU) complex exhaust stack, located in Chalk River, Ontario, Canada, with respect to the applicable criteria regarding the placement of an air sampling probe. Due to the age of the equipment in the existing monitoring system, and the increasing difficulty in acquiring replacement parts to maintain this equipment, a more up-to-date system is planned to replace the current effluent monitoring system, and a new monitoring location has been proposed. The new sampling probe should be located within the exhaust stack according to the criteria established by the American National Standards Institute/Health Physics Society (ANSI/HPS) N13.1-1999, Sampling and Monitoring Releases of Airborne Radioactive Substances from the Stack and Ducts of Nuclear Facilities. These criteria address the capability of the sampling probe to extract a sample that represents the effluent stream. The internal Pacific Northwest National Laboratory (PNNL) project for this task was 65167, Atomic Energy Canada Ltd. Chalk River Effluent Duct Flow Qualification. The testing described in this document was guided by the Test Plan: Testing of the NRU Stack Air Sampling Position (TP-STMON-032).

Merger of Science Agencies Proposed

Science.gov (United States)

1992-07-01

A bill proposing the establishment of a cabinet-level Department of Science, Space, Energy and Technology was introduced in the House of Representatives on July 1 by Robert Walker (R-Pa.), George Brown (D-Calif.), Ron Packard (R-Calif.), and Joe Kolter (D-Pa.). The department would be a conglomerate of existing civilian science and technology agencies, including NASA, the Environmental Protection Agency, the National Oceanic and Atmospheric Administration, the National Institute of Standards and Technology, the National Telecommunications and Information Administration, the National Technical Information Service, and research functions at the Department of Energy.

Optimization-based scatter estimation using primary modulation for computed tomography

Energy Technology Data Exchange (ETDEWEB)

Chen, Yi; Ma, Jingchen; Zhao, Jun, E-mail: junzhao@sjtu.edu.cn [School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200240 (China); Song, Ying [Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu 610041 (China)

2016-08-15

Purpose: Scatter reduces the image quality in computed tomography (CT), but scatter correction remains a challenge. A previously proposed primary modulation method simultaneously obtains the primary and scatter in a single scan. However, separating the scatter and primary in primary modulation is challenging because it is an underdetermined problem. In this study, an optimization-based scatter estimation (OSE) algorithm is proposed to estimate and correct scatter. Methods: In the concept of primary modulation, the primary is modulated, but the scatter remains smooth by inserting a modulator between the x-ray source and the object. In the proposed algorithm, an objective function is designed for separating the scatter and primary. Prior knowledge is incorporated in the optimization-based framework to improve the accuracy of the estimation: (1) the primary is always positive; (2) the primary is locally smooth and the scatter is smooth; (3) the location of penumbra can be determined; and (4) the scatter-contaminated data provide knowledge about which part is smooth. Results: The simulation study shows that the edge-preserving weighting in OSE improves the estimation accuracy near the object boundary. Simulation study also demonstrates that OSE outperforms the two existing primary modulation algorithms for most regions of interest in terms of the CT number accuracy and noise. The proposed method was tested on a clinical cone beam CT, demonstrating that OSE corrects the scatter even when the modulator is not accurately registered. Conclusions: The proposed OSE algorithm improves the robustness and accuracy in scatter estimation and correction. This method is promising for scatter correction of various kinds of x-ray imaging modalities, such as x-ray radiography, cone beam CT, and the fourth-generation CT.

75 FR 45151 - National Security Division; Agency Information Collection Activities: Proposed Collection...

Science.gov (United States)

2010-08-02

... DEPARTMENT OF JUSTICE [OMB Number 1124-0006] National Security Division; Agency Information...), National Security Division (NSD), will be submitting the following information collection request to the..., 10th & Constitution Avenue, NW., National Security Division, Counterespionage Section/Registration Unit...

75 FR 45153 - National Security Division; Agency Information Collection Activities: Proposed Collection...

Science.gov (United States)

2010-08-02

... DEPARTMENT OF JUSTICE [OMB Number 1124-0001] National Security Division; Agency Information..., 10th & Constitution Avenue, NW., National Security Division, Counterespionage Section/Registration Unit... Justice sponsoring the collection: Form Number: NSD- 1. National Security Division, U.S. Department of...

75 FR 45152 - National Security Division: Agency Information Collection Activities: Proposed Collection...

Science.gov (United States)

2010-08-02

... DEPARTMENT OF JUSTICE [OMB Number 1124-0004] National Security Division: Agency Information...), National Security Division (NSD), will be submitting the following information collection request to the... write to U.S. Department of Justice, 10th & Constitution Avenue, NW., National Security Division...

Proposal for revisions of the United Nations Moon Treaty

Science.gov (United States)

Fernandes, Vera; Abreu, Neyda; Fritz, J.; Knapmeyer, Martin; Smeenk, Lisa; Ten Kate, Inge; Trüninger, Monica

Valleys of Southern Victoria Land) will also be instrumental in improving the current Moon Treaty. To update the Moon Treaty, we propose the creation of a Council composed of a diverse group of individuals to ensure that this document will have broad, long-term impact. It will be an interdisciplinary endeavour that needs to bring together natural ("hard") sciences, social sciences, and humanities to produce a sensitive and thorough document. Most importantly, it will be imperative to change the current status on the use of lunar resources, as it will certainly destroy the pristine environment the Moon presents. There-fore, we are currently at a very important time to reconsider the U.N. Moon Treaty and make all the necessary amendments and addendums that will assure the preservation of the Moon while at the same time maximizing the amount of scientific data acquired from, of, and on the Moon [the Earth and the Solar System] from this natural information storage (e.g., impact flux since the early Solar System, formation and differentiation of a large planetary body). The goal of the revision of the Moon Treaty is three fold: (1) the preservation of the existing in-formation existing the Moon regarding the formation and evolution of the Earth and the inner early Solar System, while at the same time maximizing the scientific data acquisition, (2) the promotion and improvement of the international cooperation in science and, technology, and (3) balance and regulate the competing scientific, economic, strategic and cultural interests. This will assure that future generations will still be able to take advantage of the pristine Moon and further explore it. In order to be most effective the responsibilities drawn in the new doc-ument(s) should be reformed into an agreement, which shall be abided by all nations, private enterprises, multi-nationals and individuals who do not. As first step in reaching this goal the current, rather failed, treaty (most of the Moon-faring nations

Primary Productivity (PP_Master)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This data set included primary production for each subregion in the study (Georges Bank, Gulf of Maine, Southern New England, Middle Atlantic Bight) . The data came...

Results of elemental analyses of water and waterborne sediment samples from areas of Alaska proposed for the Chukchi Imuruk National Reserve, Selawik National Wildlife Refuge, and Cape Krusenstern National Monument

International Nuclear Information System (INIS)

Sharp, R.R. Jr.

1978-10-01

During July--August 1976, waters and sediments were collected from streams and lakes over an area of 100,000 km 2 around Kotzebue, Alaska, as part of the National Uranium Resource Evaluation Hydrogeochemical and Stream Sediment Reconnaissance. The work provides multielement results for 949 waters and 886 sediments from 979 locations. Of these, 492 waters and 452 sediments are from 517 locations in the proposed Chukchi Imuruk Reserve; 447 waters and 423 sediments are from 451 locations in the proposed Selawik Wildlife Refuge; and 10 waters and 11 sediments are from 11 locations in the proposed Cape Krusenstern Monument. The field data, with concentrations of 13 elements in the waters and 43 in the sediments, are presented, and the sample locations are shown on accompanying plates. The waters were analyzed for uranium by fluorometry or delayed-neutron counting and calcium, chromium, cobalt, copper, iron, lead, magnesium, manganese, molybdenum, nickel, titanium, and zinc by plasma-source emission spectrography. The sediment samples were analyzed for uranium by delayed-neutron counting, beryllium and lithium by arc-source emission spectrography, bismuth, cadmium, copper, lead, nickel, niobium, silver, tin, and tungsten by x-ray fluorescence, and aluminum, antimony, barium, calcium, cerium, cesium, chlorine, chromium, cobalt, dysprosium, europium, gold, hafnium, iron, lanthanum, lutetium, magnesium, manganese, potassium, rubidium, samarium, scandium, sodium, strontium, tantalum, terbium, thorium, titanium, vanadium, ytterbium, and zinc by neutron activation. Uranium to thorium ratios in each sediment are also provided

Chinese National Condition Based Power Dispatching Optimization in Microgrids

Directory of Open Access Journals (Sweden)

Gang Chen

2018-01-01

Full Text Available This paper proposed a study on the power dispatching optimization in the microgrid aiming at Chinese national condition based on PSO algorithm. The whole work is on the basis of the weighted factor variation of the objective function due to different weather conditions. Three cases including the good contamination-diffusing weather condition, the smog weather condition, and the normal condition are considered, respectively. In the case of smog weather, the new energy generation and the battery system will be all out to use as less power as possible from the primary grid so that the pollution produced by coal consumption in the thermal power plants can be upmost reduced. However, in the case of perfect contamination-diffusing weather, the battery is not used to reserve its lifetime, while a large amount of exchanged power from the primary grid is used to obtain a most economic-efficient effect. In normal condition, the power dispatching is performed in a most balanced way considering not only the cost but also the environmental management. The case study in Suzhou Industrial Part confirms the effectiveness of the proposed method in this paper.

78 FR 46332 - Proposed Information Collection Request; Comment Request; National Estuary Program

Science.gov (United States)

2013-07-31

... Request; Comment Request; National Estuary Program AGENCY: Environmental Protection Agency (EPA). ACTION... request (ICR), ``National Estuary Program'' (EPA ICR No. 1500.08, OMB Control No. 2040-0138 to the Office... comments to OMB. Abstract: The National Estuary Program (NEP) involves collecting information from the...

Modified Angle's Classification for Primary Dentition.

Science.gov (United States)

Chandranee, Kaushik Narendra; Chandranee, Narendra Jayantilal; Nagpal, Devendra; Lamba, Gagandeep; Choudhari, Purva; Hotwani, Kavita

2017-01-01

This study aims to propose a modification of Angle's classification for primary dentition and to assess its applicability in children from Central India, Nagpur. Modification in Angle's classification has been proposed for application in primary dentition. Small roman numbers i/ii/iii are used for primary dentition notation to represent Angle's Class I/II/III molar relationships as in permanent dentition, respectively. To assess applicability of modified Angle's classification a cross-sectional preschool 2000 children population from central India; 3-6 years of age residing in Nagpur metropolitan city of Maharashtra state were selected randomly as per the inclusion and exclusion criteria. Majority 93.35% children were found to have bilateral Class i followed by 2.5% bilateral Class ii and 0.2% bilateral half cusp Class iii molar relationships as per the modified Angle's classification for primary dentition. About 3.75% children had various combinations of Class ii relationships and 0.2% children were having Class iii subdivision relationship. Modification of Angle's classification for application in primary dentition has been proposed. A cross-sectional investigation using new classification revealed various 6.25% Class ii and 0.4% Class iii molar relationships cases in preschool children population in a metropolitan city of Nagpur. Application of the modified Angle's classification to other population groups is warranted to validate its routine application in clinical pediatric dentistry.

Integrated primary health care in Australia

Directory of Open Access Journals (Sweden)

Gawaine Powell Davies

2009-10-01

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

Integrated primary health care in Australia.

Science.gov (United States)

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

2009-10-14

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

How to use The National Gallery as a cross curricular approach to weather and climate studies at primary level.

Science.gov (United States)

Hansen, P. J. K.

2009-09-01

How to use The National Gallery as a cross curricular approach to weather and climate studies at primary level. Pål J. Kirkeby Hansen Faculty of Education and International Studies, Oslo University College (PalKirkeby.Hansen@lui.hio.no) Weather and climate are topics in natural science and geography in primary and secondary education in most countries. The pupils are often doing own weather observations and measurements and are presenting the results oral, by posters or with digital aids. They also use the Internet with all its relevant resources in their studies to develop vocabulary, practical and conceptual knowledge. Knowledge about weather and climate is parts of liberal education and could be projected to other topics in science and to topics in other subjects, for instance: history, social geography, literature and arts. This article reports from a case study in grade 3 classes (age 9 year) during their Weather Week. Their science teacher was, quite untypical, also educated in art history. She arranged a visited to The National Gallery with the double agenda: 1. To introduce the pupils to Norwegian canon paintings from the national romantic period, our so-called "golden age”. 2. To look for and discuss weather elements in this paintings. For one hour the museum curator guided the pupils around the water cycle by using the paintings. While the pupils' own observations of weather, clouds and wind and measurements of temperature and precipitation during the Weather Week only are point checks, the guided tour in The National Gallery gave literally "the whole picture” of the Norwegian weather and climate and of the water cycle. During the tour, the curator constantly invited the pupils to tell about and discuss what weather and water elements they were looking at when standing in front of a painting. The pupils were responsive and interested all the time. Back at school, they demonstrated that they had learned much about both weather elements, the water

Suicide prevention: a proposed national strategy for South Africa

African Journals Online (AJOL)

The first is a multicentre programme targeting non-fatal suicidal behaviours, known as ... Keywords: Suicide; Prevention; National strategy; South Africa. Received: 16/08/2012 ... to enter university or the open labour market).2,5,7-8. Risk factors.

78 FR 18363 - Proposed Appointment to the National Indian Gaming Commission

Science.gov (United States)

2013-03-26

... Gaming Commission AGENCY: Office of the Secretary, Interior. ACTION: Notice. SUMMARY: Before appointing a member to the National Indian Gaming Commission, the Secretary must provide public notice and allow a... member of the National Indian Gaming Commission for a term of 3 years. DATES: Comments must be received...

National Wind Technology Center sitewide, Golden, CO: Environmental assessment

International Nuclear Information System (INIS)

1996-11-01

The National Renewable Energy Laboratory (NREL), the nation's primary solar and renewable energy research laboratory, proposes to expand its wind technology research and development program activities at its National Wind Technology Center (NWTC) near Golden, Colorado. NWTC is an existing wind energy research facility operated by NREL for the US Department of Energy (DOE). Proposed activities include the construction and reuse of buildings and facilities, installation of up to 20 wind turbine test sites, improvements in infrastructure, and subsequent research activities, technology testing, and site operations. In addition to wind turbine test activities, NWTC may be used to support other NREL program activities and small-scale demonstration projects. This document assesses potential consequences to resources within the physical, biological, and human environment, including potential impacts to: air quality, geology and soils, water resources, biological resources, cultural and historic resources, socioeconomic resources, land use, visual resources, noise environment, hazardous materials and waste management, and health and safety conditions. Comment letters were received from several agencies in response to the scoping and predecisional draft reviews. The comments have been incorporated as appropriate into the document with full text of the letters contained in the Appendices. Additionally, information from the Rocky Flats Environmental Technology Site on going sitewide assessment of potential environmental impacts has been reviewed and discussed by representatives of both parties and incorporated into the document as appropriate

Radiology standards for primary dental care: report by the Royal College of Radiologists and the National Radiological Protection Board

International Nuclear Information System (INIS)

Hudson, Tony

1994-01-01

In 1992 a joint venture between the Royal College of Radiologists (RCR) and the National Radiological Protection Board (NRPB) resulted in the formation of a Working Party (WP) to consider dental radiology. Although individual doses to patients are low, WP identified considerable scope for reducing the collective dose to patients and for improving the diagnostic quality of radiographs. The report published in the Documents of the NRPB series presents the WP conclusions in the form of guidelines that deal with all aspects of dental radiology in primary dental care. (Author)

Regional economic analysis of current and proposed management alternatives for Rappahannock River Valley National Wildlife Refuge

Science.gov (United States)

Koontz, Lynne; Sexton, Natalie; Donovan, Ryan

2009-01-01

The National Wildlife Refuge System Improvement Act of 1997 requires all units of the National Wildlife Refuge System to be managed under a Comprehensive Conservation Plan. The Comprehensive Conservation Plan must describe the desired future conditions of a refuge and provide long-range guidance and management direction to achieve refuge purposes. The Rappahannock River Valley National Wildlife Refuge (refuge) is in the process of developing a range of management goals, objectives, and strategies for the Comprehensive Conservation Plan. The Comprehensive Conservation Plan for the refuge must contain an analysis of expected effects associated with current and proposed refuge management strategies. The purpose of this study was to assess the regional economic implications associated with draft Comprehensive Conservation Plan management strategies. Special interest groups and local residents often criticize a change in refuge management, especially if there is a perceived negative impact to the local economy. Having objective data on economic impacts may show that these fears are overstated. Quite often, the extent of economic benefits a refuge provides to a local community is not fully recognized, yet at the same time the effects of negative changes is overstated. Spending associated with refuge recreational activities, such as wildlife viewing and hunting, can generate considerable tourist activity for surrounding communities. Additionally, refuge personnel typically spend considerable amounts of money purchasing supplies in local stores, repairing equipment and purchasing fuel at the local service stations, and reside and spend their salaries in the local community. For refuge Comprehensive Conservation Plan planning, a regional economic assessment provides a means of estimating how current management (no action alternative) and proposed management activities (alternatives) could affect the local economy. This type of analysis provides two critical pieces of

77 FR 15737 - Proposed Information Collection; Comment Request

Science.gov (United States)

2012-03-16

... concerning its National Performance Measurement Assessment through a proposed survey and follow up interview... for National and Community Service. Title: National Performance Measurement Assessment. OMB Number... ensure that requested data can be provided in the desired format, reporting burden (time and financial...

76 FR 8381 - Proposal Review for Physics; Notice of Meeting

Science.gov (United States)

2011-02-14

... NATIONAL SCIENCE FOUNDATION Proposal Review for Physics; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463, as amended), the National Science Foundation announces the following meeting: Name: Proposal Review for the Center for Magnetic Self-Organization in...

Modified angle's classification for primary dentition

Directory of Open Access Journals (Sweden)

Kaushik Narendra Chandranee

2017-01-01

Full Text Available Aim: This study aims to propose a modification of Angle's classification for primary dentition and to assess its applicability in children from Central India, Nagpur. Methods: Modification in Angle's classification has been proposed for application in primary dentition. Small roman numbers i/ii/iii are used for primary dentition notation to represent Angle's Class I/II/III molar relationships as in permanent dentition, respectively. To assess applicability of modified Angle's classification a cross-sectional preschool 2000 children population from central India; 3–6 years of age residing in Nagpur metropolitan city of Maharashtra state were selected randomly as per the inclusion and exclusion criteria. Results: Majority 93.35% children were found to have bilateral Class i followed by 2.5% bilateral Class ii and 0.2% bilateral half cusp Class iii molar relationships as per the modified Angle's classification for primary dentition. About 3.75% children had various combinations of Class ii relationships and 0.2% children were having Class iii subdivision relationship. Conclusions: Modification of Angle's classification for application in primary dentition has been proposed. A cross-sectional investigation using new classification revealed various 6.25% Class ii and 0.4% Class iii molar relationships cases in preschool children population in a metropolitan city of Nagpur. Application of the modified Angle's classification to other population groups is warranted to validate its routine application in clinical pediatric dentistry.

Validity of estimated prevalence of decreased kidney function and renal replacement therapy from primary care electronic health records compared with national survey and registry data in the United Kingdom.

Science.gov (United States)

Iwagami, Masao; Tomlinson, Laurie A; Mansfield, Kathryn E; Casula, Anna; Caskey, Fergus J; Aitken, Grant; Fraser, Simon D S; Roderick, Paul J; Nitsch, Dorothea

2017-04-01

Anonymous primary care records are an important resource for observational studies. However, their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We thus compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry. Among all people ≥25 years of age registered in the CPRD for ≥1 year on 31 March 2014, we identified patients with an estimated glomerular filtration rate (eGFR) primary care data have good external validity for the prevalence of decreased kidney function and RRT. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider.

Science.gov (United States)

Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna

2014-01-01

Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

Development of proposed free release criteria for Idaho National Engineering Laboratory lead

International Nuclear Information System (INIS)

Losinski, S.J.

1994-01-01

The INEL Lead Management Project (LMP) performed an investigation of the origin of lead used as shielding at the INEL and developed radiological profile information that was then used to establish a baseline for the DOE ''no-rad-added'' standard. Primary findings of the investigation include the following: (a) Much of the lead at the INEL was obtained from a DOE lead bank; (b) Lead inventory at the DOE lead bank was derived primarily from recycled sources and was most likely in the form of pure lead; (c) Secondary lead (lead from recycled sources), available in today's market, is expected to have radiological characteristics similar to those of the DOE lead bank; (d) Highly sensitive radiological testing of 20 samples of lead from secondary sources revealed the lead to be radiologically pristine. Beta-, gamma-, and alpha-emitting radionuclide concentrations were all found to be less than detectable, except for a very small quantity of lead-210 (an alpha emitter), which is a naturally occurring isotope of lead. Based on the pristine nature of lead, a proposed free release criterion for lead was developed based on a statistical null hypothesis approach. The free release criterion compares the natural background count of a clean lead standard with the natural background count of a sample. When the sample background count cannot be distinguished as different from the standard background count at the 95% confidence level, then the sample is considered radiologically clean

Teacher of primary English

CERN Multimedia

2003-01-01

Part-time teacher of primary English needed for September 2003 to teach English National Curriculum (KS2) and NLS to mother tongue or good second language English-speakers aged 7-10. 4 hours contact time per week, team planning, marking and meetings. Candidates should be English mother tongue qualified teachers, confident, flexible classroom practitioners and team players. For further details and how to apply see http://enpferney.org/staff_vacancies.htm English National Programme, Lycée International, Ferney-Voltaire (http://enpferney.org/)

Proposal for an energy - environment strategy in Romania

International Nuclear Information System (INIS)

Leca, A.; Scripcariu, D.; Scripcariu, M.

1996-01-01

The paper presents the results of a study carried out from a environmental protection point of view by a multi-branch team of 25 Romanian experts. A general block diagram type procedure of elaborating a national energy-environment strategy has been proposed. The sustainable development has been chosen as an overall evaluating criterion involving the fulfillment of the following conditions: the environmental protection; the best use of material, financial and human resources; the promotion of equity. For strategic objectives have been identified: increasing energy efficiency; reconsidering the existing generation capacities and their future trends; diversifying the primary resources and their suppliers; reducing the energy impacts on the environment, and three support objectives: creation of an economic and financial framework market oriented; setting up a regulatory system for efficient market operation; establishing an institutional framework for the energy sector. The fundamental concepts promoted and recommended to be used have been: sustainable development, energy efficiency, competition, integrated resources planning, demand-side management. (author). 2 figs. 4 refs

HANPP Collection: Global Patterns in Net Primary Productivity (NPP)

Data.gov (United States)

National Aeronautics and Space Administration — The Global Patterns in Net Primary Productivity (NPP) portion of the Human Appropriation of Net Primary Productivity (HANPP) Collection maps the net amount of solar...

78 FR 27370 - Proposed Change to Data Protection

Science.gov (United States)

2013-05-10

... DEPARTMENT OF ENERGY U.S. Energy Information Administration Proposed Change to Data Protection...-Traders and Brokers. EIA proposes to change and strengthen the data protection provisions on Forms EIA-3... and National Mining Association, to explain the proposed change in the confidentiality protections and...

Working to Reduce Poverty: A National Subsidized Employment Proposal

Directory of Open Access Journals (Sweden)

Indivar Dutta-Gupta

2018-02-01

Full Text Available Subsidized employment programs that increase labor supply and demand are a proven, underutilized strategy for reducing poverty in the short and long term. These programs use public and private funds to provide workers wage-paying jobs, training, and wraparound services to foster greater labor force attachment while offsetting employers’ cost for wages, on-the-job training, and overhead. This article proposes two new separate but harmonized federal funding streams for subsidized employment that would expand automatically when and where economic conditions deteriorate. Participating states and local organizations would be offered generous matching funds to target adult workers most in need and to secure employer participation. The proposal would effectively reduce poverty among workers during work placements, and improve long-term unsubsidized employment and other outcomes for participants and their families.

EBR-II Primary Tank Wash-Water Alternatives Evaluation

Energy Technology Data Exchange (ETDEWEB)

Demmer, R. L.; Heintzelman, J. B.; Merservey, R. H.; Squires, L. N.

2008-05-01

The EBR-II reactor at Idaho National Laboratory was a liquid sodium metal cooled reactor that operated for 30 years. It was shut down in 1994; the fuel was removed by 1996; and the bulk of sodium metal coolant was removed from the reactor by 2001. Approximately 1100 kg of residual sodium remained in the primary system after draining the bulk sodium. To stabilize the remaining sodium, both the primary and secondary systems were treated with a purge of moist carbon dioxide. Most of the residual sodium reacted with the carbon dioxide and water vapor to form a passivation layer of primarily sodium bicarbonate. The passivation treatment was stopped in 2005 and the primary system is maintained under a blanket of dry carbon dioxide. Approximately 670 kg of sodium metal remains in the primary system in locations that were inaccessible to passivation treatment or in pools of sodium that were too deep for complete penetration of the passivation treatment. The EBR-II reactor was permitted by the Idaho Department of Environmental Quality (DEQ) in 2002 under a RCRA permit that requires removal of all remaining sodium in the primary and secondary systems by 2022. The proposed baseline closure method would remove the large components from the primary tank, fill the primary system with water, react the remaining sodium with the water and dissolve the reaction products in the wash water. This method would generate a minimum of 100,000 gallons of caustic, liquid, low level radioactive, hazardous waste water that must be disposed of in a permitted facility. On February 19-20, 2008, a workshop was held in Idaho Falls, Idaho, to look at alternatives that could meet the RCRA permit clean closure requirements and minimize the quantity of hazardous waste generated by the cleanup process. The workshop convened a panel of national and international sodium cleanup specialists, subject matter experts from the INL, and the EBR-II Wash Water Project team that organized the workshop. The

Geothermal energy. A national proposal for geothermal resources research

Energy Technology Data Exchange (ETDEWEB)

Denton, J.C. (ed.)

1972-01-01

Discussions are given for each of the following topics: (1) importance to the Nation of geothermal resources, (2) budget recommendations, (3) overview of geothermal resources, (4) resource exploration, (5) resource assessment, (6) resource development and production, (7) utilization technology and economics, (8) environmental effects, (9) institutional considerations, and (10) summary of research needs.

Yakama Nation Renewable Energy Plan

Energy Technology Data Exchange (ETDEWEB)

Rigdon, Phillip [Yakama Nation, Toppenish, WA (United States)

2016-05-10

It is the intention of the Yakama Nation to make improvements on the Wapato Irrigation Project (WIP) for the benefit of all stakeholders. Water management, water conservation and water allocation on the Wapato Irrigation Project is equally as important as hydropower. Irrigation will always be the primary purpose of this water system, but the irrigation system can also generate energy. The purpose of this project is the purchase and installation of inflow water turbines to generate an additional one megawatt of hydro-electrical power. The project will occur in two phases, Environmental Assessment and Project Implementation. The core objective for this proposal is to meet the Yakama Nation’s goal in hydroelectric power development. This will include the installation of inflow water turbines on the Wapato Irrigation Project. The Yakama Nation will prepare an Environmental Assessment in preparation to purchase and install new water turbines for hydropower generation of 1 Megawatt. This is a valuable economic development strategy for Yakama Nation that will create new jobs, improve and increase rural electrification, and attract private investments. This water system has an untapped low head/low power potential without the need to construct a new dam. The objective of Phase 1 is to complete an environmental assessment and obtain approval to proceed with installation of the hydroelectric power system.

Action plan for energy efficiency 2003-2006. A Working Group Proposal

International Nuclear Information System (INIS)

2003-02-01

proposed to be launched in order to promote energy saving in transport and energy efficiency in the community structure. The Working Group also proposes considering the possibility of further strengthening building regulations. For the improvement of the information on energy saving, the Working Group proposes drawing up of a communication plan for the action plan period. The action plan proposed by the Working Group is estimated to save Finland the emission of some 4-6 million tonnes of CO 2 , depending on the fuel to be replaced, in comparison with the basic scenario for 2010. The action plan is estimated to result in a 4-6 percent reduction in the consumption of primary sources of energy in 2010 compared with a situation where no new actions were taken. The Working Group proposes setting up of a monitoring group for the implementation and monitoring of the impact of the action plan. The data obtained from monitoring will be published in connection with the monitoring of the implementation of the climate strategy. The Working Group considers that the measures proposed should be subjected to a new evaluation in connection with the national introduction of the EU scheme for emission allowance trading. (orig.)

Assessing the EC ILUC proposal. Dutch national ILUC Impact Assessment

Energy Technology Data Exchange (ETDEWEB)

Peters, D.; Toop, G.; Van den Bos, A.; Spoettle, M.

2013-04-15

Indirect Land Use Change (ILUC) is the effect that when existing agricultural land producing food is used for biofuel feedstock production, food production is reduced and this reduction is partially compensated by the conversion of non-agricultural land into new cropland elsewhere. ILUC can have a negative impact on the GHG performance of biofuels and can lead to loss of biodiversity. ILUC, its quantification and possible policy measures have been debated in the EU since 2008. The final legislative text to be negotiated on the basis of the ILUC proposal is likely to have a profound impact on the current EU biofuels market but especially on its future development. This report assesses the legal soundness and factual basis of the proposal. It also assesses the policy risks, effectiveness of, and economic consequences resulting from the four most important proposed measures. Alternative scenarios are explored for each of the proposed measures. The report starts with a description of the Dutch biofuels market as the current situation and future perspective of this market is naturally of specific concern for Dutch negotiators in Brussels. This report takes the IFPRI (International Food Policy Research Institute) 2011 modelling study as a starting point when assessing the ILUC impacts of EU biofuels. The IFPRI study modelling results assign high ILUC emissions to conventional biodiesel and assigns much lower ILUC emissions to conventional ethanol. The study does not model ILUC effects of advanced biofuels. The Dutch biofuels market is dominated by biodiesel, of which a large share is double counting. Following the IFPRI 2011 ILUC modelling, this means that a high share of biofuels with a high ILUC risk are supplied to the market but also a high share of advanced, double counting biofuels with a low to medium ILUC risk. The Netherlands hosts a relatively large oilseed crushing and biofuel production industry, of which an important share consists of advanced biofuel

Recommendations on the proposed Monitored Retrievable Storage Facility

Energy Technology Data Exchange (ETDEWEB)

1985-10-01

Following the Department of Energy's announcement in April 1985 that three Tennessee sites were to be considered for the Monitored Retrievable Storage facility, Governor Lamar Alexander initiated a review of the proposal to be coordinated by his Safe Growth Team. Roane County and the City of Oak Ridge, the local governments sharing jurisdiction over DOE's primary and secondary sites, were invited to participate in the state's review of the MRS proposal. Many issues related to the proposed MRS are being considered by the Governor's Safe Growth Team. The primary objective of the Clinch River MRS Task Force has been to determine whether the proposed Monitored Retrievable Storage facility should be accepted by the local governments, and if so, under what conditions. The Clinch River MRS Task Force is organized into an Executive Committee cochaired by the Roane County Executive and Mayor of Oak Ridge and three Study Groups focusing on environmental (including health and safety), socioeconomic, and transportation issues.

Recommendations on the proposed Monitored Retrievable Storage Facility

Energy Technology Data Exchange (ETDEWEB)

1985-10-01

Following the Department of Energy`s announcement in April 1985 that three Tennessee sites were to be considered for the Monitored Retrievable Storage facility, Governor Lamar Alexander initiated a review of the proposal to be coordinated by his Safe Growth Team. Roane County and the City of Oak Ridge, the local governments sharing jurisdiction over DOE`s primary and secondary sites, were invited to participate in the state`s review of the MRS proposal. Many issues related to the proposed MRS are being considered by the Governor`s Safe Growth Team. The primary objective of the Clinch River MRS Task Force has been to determine whether the proposed Monitored Retrievable Storage facility should be accepted by the local governments, and if so, under what conditions. The Clinch River MRS Task Force is organized into an Executive Committee cochaired by the Roane County Executive and Mayor of Oak Ridge and three Study Groups focusing on environmental (including health and safety), socioeconomic, and transportation issues.

75 FR 49946 - National Drug Intelligence Center: Agency Information Collection Activities: Proposed Extension...

Science.gov (United States)

2010-08-16

... DEPARTMENT OF JUSTICE [OMB Number 1105-0087] National Drug Intelligence Center: Agency Information...), National Drug Intelligence Center (NDIC), will be submitting the following information collection request... Kevin M. Walker, General Counsel, National Drug Intelligence Center, Fifth Floor, 319 Washington Street...

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

Science.gov (United States)

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

2015-04-01

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

Establishment of a Photon Data Section of the BNL National Nuclear Data Center: A preliminary proposal

International Nuclear Information System (INIS)

Hanson, A.L.; Pearlstein, S.

1992-05-01

It is proposed to establish a Photon Data Section (PDS) of the BNL National Nuclear Data Center (NNDC). This would be a total program encompassing both photon-atom and photon-nucleus interactions. By utilizing the existing NNDC data base management expertise and on-line access capabilities, the implementation of photon interaction data activities within the existing NNDC nuclear structure and nuclear-reaction activities can reestablish a viable photon interaction data program at minimum cost. By taking advantage of the on-line capabilities, the x-ray users' community will have access to a dynamic, state-of-the-art data base of interaction information. The proposed information base would include data that presently are scattered throughout the literature usually in tabulated form. It is expected that the data bases would include at least the most precise data available in photoelectric cross sections, atomic form factors and incoherent scattering functions, anomalous scattering factors, oscillator strengths and oscillator densities, fluorescence yields, Auger electron yields, etc. It could also include information not presently available in tabulations or in existing data bases such as EXAFS (extended x-ray absorption fine structure) reference spectra, chemical bonding induced shifts in the photoelectric absorption edge, matrix corrections, x-ray Raman, and x-ray resonant Raman cross sections. The data base will also include the best estimates of the accuracy of the interaction data as it exists in the data base. It is proposed that the PDS would support computer programs written for calculating scattering cross sections for given solid angles, sample geometries, and polarization of incident x-rays, for calculating Compton profiles, and for analyzing data as in EXAFS and x-ray fluorescence

78 FR 49728 - Availability of Seats for National Marine Sanctuary Advisory Councils

Science.gov (United States)

2013-08-15

...: Fishing (primary member); Fishing (alternate); and Education (alternate). Florida Keys National Marine... (primary member); Research and Monitoring (alternate); Tourism--Lower Keys (primary member); and Tourism--Lower Keys (alternate). Gulf of the Farallones National Marine Sanctuary Advisory Council: Education...

Versatile user-oriented atomic and molecular beam apparatus for use with the National Synchrotron Light Source

International Nuclear Information System (INIS)

Mitchell, J.B.A.; Grover, J.R.

1978-11-01

A proposed atomic and moleuclar beam apparatus is described for photon interaction studies using the National Sychrotron Light Source at the Brookhaven National Laboratory. This apparatus will employ ultrahigh vacuum techniques compatible with storage ring operation. Supersonic nozzle sources will be used to produce the beams and signal detection will be accomplished using a quadrupole mass analysis system. The equipment is intended for use both by in-house and outside users and primary consideration has been given to flexibility of design. The application of photoionization techniques to the study of crossed beam reactive scattering with particular emphasis on internal energy distribution analysis is discussed

Decentralization and Distribution Primary Education Access in Indonesia 2014

OpenAIRE

Benita, Novinaz

2016-01-01

This paper examines decentralisation and distribution of access to primary school in Indonesia. Data come from Indonesia National Socio Economic Survey 2014, and statistic reports from Ministry of education, Ministry Of Finance, and General Election Commision. Descriptive statistic is used to describe spatial distribution of decentralization in primary education system and distribution of primary education access. The results show there are districts disparities in decentralization of primary...

75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

Science.gov (United States)

2010-03-01

... Sports Clinic Application, VA Form 0924--233 hours. b. National Veterans Wheelchair Games Application, VA.... National Veterans TEE Tournament Application, VA Form 0927--133 hours. e. National Veterans Summer Sports... Form 0929--67 hours. OMB Control Number: 2900-New (VA Form 0924). Type of Review: Existing collection...

Hazardous air pollutant emissions from process units in the synthetic organic chemical manufacturing industry: Background information for proposed standards. Volume 1A. National impacts assessment. Draft report

International Nuclear Information System (INIS)

1992-11-01

A draft rule for the regulation of emissions of organic hazardous air pollutants (HAP's) from chemical processes of the synthetic organic chemical manufacturing industry (SOCMI) is being proposed under the authority of Sections 112, 114, 116, and 301 of the Clean Air Act, as amended in 1990. The volume of the Background Information Document presents the results of the national impacts assessment for the proposed rule

Environmental assessment for the proposed CMR Building upgrades at the Los Alamos National Laboratory, Los Alamos, New Mexico. Final document

International Nuclear Information System (INIS)

1997-01-01

In order to maintain its ability to continue to conduct uninterrupted radioactive and metallurgical research in a safe, secure, and environmentally sound manner, the US Department of Energy (DOE) proposes to upgrade the Los Alamos National Laboratory (LANL) Chemistry and Metallurgy Research (CMR) Building. The building was built in the early 1950s to provide a research and experimental facility for analytical chemistry, plutonium and uranium chemistry, and metallurgy. Today, research and development activities are performed involving nuclear materials. A variety of radioactive and chemical hazards are present. The CMR Building is nearing the end of its original design life and does not meet many of today's design codes and standards. The Proposed Action for this Environmental Assessment (EA) includes structural modifications to some portions of the CMR Building which do not meet current seismic criteria for a Hazard Category 2 Facility. Also included are upgrades and improvements in building ventilation, communications, monitoring, and fire protection systems. This EA analyzes the environmental effects of construction of the proposed upgrades. The Proposed Action will have no adverse effects upon agricultural and cultural resources, wetlands and floodplains, endangered and threatened species, recreational resources, or water resources. The Proposed Action would have negligible effects on human health and transportation, and would not pose a disproportionate adverse health or environmental impact on minority or low-income populations within an 80 kilometer (50 mile) radius of the CMR Building

Environmental assessment for the proposed CMR Building upgrades at the Los Alamos National Laboratory, Los Alamos, New Mexico. Final document

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-02-04

In order to maintain its ability to continue to conduct uninterrupted radioactive and metallurgical research in a safe, secure, and environmentally sound manner, the US Department of Energy (DOE) proposes to upgrade the Los Alamos National Laboratory (LANL) Chemistry and Metallurgy Research (CMR) Building. The building was built in the early 1950s to provide a research and experimental facility for analytical chemistry, plutonium and uranium chemistry, and metallurgy. Today, research and development activities are performed involving nuclear materials. A variety of radioactive and chemical hazards are present. The CMR Building is nearing the end of its original design life and does not meet many of today`s design codes and standards. The Proposed Action for this Environmental Assessment (EA) includes structural modifications to some portions of the CMR Building which do not meet current seismic criteria for a Hazard Category 2 Facility. Also included are upgrades and improvements in building ventilation, communications, monitoring, and fire protection systems. This EA analyzes the environmental effects of construction of the proposed upgrades. The Proposed Action will have no adverse effects upon agricultural and cultural resources, wetlands and floodplains, endangered and threatened species, recreational resources, or water resources. The Proposed Action would have negligible effects on human health and transportation, and would not pose a disproportionate adverse health or environmental impact on minority or low-income populations within an 80 kilometer (50 mile) radius of the CMR Building.

Classification of the lymphatic drainage status of a primary tumor: a proposal

International Nuclear Information System (INIS)

Munz, D.L.; Maza, S.; Ivancevic, V.; Geworski, L.

2000-01-01

Aim: Creation of a classification of the lymphatic drainage status of a primary tumour. It shall enable comparison of different approaches, standardisation and quality control. Methods: Identification and topographic localisation of the sentinel node(s) using lymphatic radionuclide gamma camera imaging and/or gamma probe detection and/or vital dye mapping. Results: A classification comprising four classes (D-Class I-IV) and distinct subclasses (A-E) proved to be simply to be learned and applicable as well as reliably reproducible. It is based on the number of sentinel lymph nodes and their locations and can be combined with the pathological and molecular biological lymph node status. D-classes/subclasses obtained in 420 patients with malignant melanoma of the skin are presented. Conclusions: The classification is applicable to different approaches. Its diagnostic, therapeutic and prognostic value should be studied prospectively in those primary tumours which preferably metastasise via their draining lymphatic vessels. (orig.) [de

Review of heavy ion collider proposals

International Nuclear Information System (INIS)

Ruggiero, A.G.

1985-01-01

In this paper we review proposals for heavy-ion colliders generated during the last few years for several national laboratories. The proposals span over a large range of energy and luminosity to accommodate the experimental needs of both the nuclear and the high-energy physicists. We report also briefly efforts in the same field happening in Europe

The National Security Council Reform Project: Foundational Proposal for the Next Administration

Science.gov (United States)

2016-06-23

connectedness of information in the digital age has resulted in a shift of power and influence from nation-states to nonstate actors. Growing...School of Citizenship and Public Affairs, Syracuse University Former Deputy Secretary of State, US Department of State Former Deputy National

75 FR 15460 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2010-03-29

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463, as amended), the National Science Foundation announces the following meeting. Name: Proposal Review Panel for Physics, LIGO Site Visit in Louisiana (1208...

77 FR 69505 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2012-11-19

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463, as amended), the National Science Foundation announces the following meeting. Name: LIGO Operations Proposal and Annual Review in Physics (1208). Date...

Philosophy of Nationalism in Africa

NARCIS (Netherlands)

Boele Van Hensbroek, Pieter; Afolayan, A.; Falola, T.

2017-01-01

Central to the endeavor of nationalist thought is the nineteenth-century idea of the nation as the primary political community, resulting in territorially bounded nation-states becoming the globally dominant model. In this chapter, Boele van Hensbroek identifies the imaginative intellectuals and

[The strategic purchasing of health services: a big opportunity for the National Universal Health System].

Science.gov (United States)

González-Block, Miguel Ángel; Alarcón Irigoyen, José; Figueroa Lara, Alejandro; Ibarra Espinosa, Ignacio; Cortés Llamas, Noemí

2015-01-01

proposed to establish a service packages, whether through a single obligatory list or through the definition of a flexible, high priority set to be offered to specific populations according to their economic possibilities. For the strategic purchasing of services, two alternatives are proposed: to assign the fund either to a single national manager or to each of the existing public provider institutions, with the expectation that they would contract across each other and with private providers to fulfill their complementary needs.The proposal does not consider the risks and alternatives to a single tax contribution fund, which could have been suggested given that it is not an essential part of a National Universal Health System. However, it is necessary to discuss in more detail the roles and strategies for a national single-payer, especially for the strategic purchasing of high-cost and specialized interventions in the context of public and private providers. The alternative of allocating funds directly to providers would undermine the incentives for competition and collaboration and the capacity to steer providers towards the provision of high quality health services.It is proposed to focus the discussion of the reform of the national health system around strategic purchasing and the functions and structure of a single-payer as well as of agencies to articulate integrated health service networks as tools to promote quality and efficiency of the National Universal Health System. The inclusion of economic incentives to providers will be vital for competition, but also for the cooperation of providers within integrated, multi-institutional health service networks.Health professionals and sector policy specialists coordinated by the Centro de Estudios Espinosa Yglesi as in Mexico propose a policy to anchor the health system in primary care centered on the individual. The vision includes effective stewardship,solid financing, and the provision of services by a

National CrossTalk. Volume 17, Number 2

Science.gov (United States)

Trombley, William, Ed.

2009-01-01

"National CrossTalk" is a publication of the National Center for Public Policy and Higher Education. The National Center promotes public policies that enhance opportunities for quality education and training beyond high school. The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher…

National CrossTalk. Volume 18, Number 2

Science.gov (United States)

National Center for Public Policy and Higher Education, 2010

2010-01-01

"National CrossTalk" is a publication of the National Center for Public Policy and Higher Education. The National Center promotes public policies that enhance opportunities for quality education and training beyond high school. The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher…

National CrossTalk. Volume 18, Number 1

Science.gov (United States)

National Center for Public Policy and Higher Education, 2010

2010-01-01

"National CrossTalk" is a publication of the National Center for Public Policy and Higher Education. The National Center promotes public policies that enhance opportunities for quality education and training beyond high school. The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher…

National CrossTalk. Volume 19, Number 1

Science.gov (United States)

National Center for Public Policy and Higher Education, 2011

2011-01-01

"National CrossTalk" is a publication of the National Center for Public Policy and Higher Education. The National Center promotes public policies that enhance opportunities for quality education and training beyond high school. The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher…

Nuclear Power and Resource Efficiency—A Proposal for a Revised Primary Energy Factor

Directory of Open Access Journals (Sweden)

Ola Eriksson

2017-06-01

Full Text Available Measuring resource efficiency can be achieved using different methods, of which primary energy demand is commonly used. The primary energy factor (PEF is a figure describing how much energy from primary resources is being used per unit of energy delivered. The PEF for nuclear power is typically 3, which refers to thermal energy released from fission in relation to electricity generated. Fuel losses are not accounted for. However; nuclear waste represents an energy loss, as current plans for nuclear waste management mostly include final disposal. Based on a literature review and mathematical calculations of the power-to-fuel ratio for nuclear power, PEF values for the open nuclear fuel cycle (NFC option of nuclear power and different power mixes are calculated. These calculations indicate that a more correct PEF for nuclear power would be 60 (range 32–88; for electricity in Sweden (41% nuclear power PEF would change from 1.8 to 25.5, and the average PEF for electricity in the European Union (EU would change from 2.5 to 18. The results illustrate the poor resource efficiency of nuclear power, which paves the way for the fourth generation of nuclear power and illustrates the policy implication of using PEFs which are inconsistent with current waste management plans.

The GP Patient Survey for use in primary care in the National Health Service in the UK--development and psychometric characteristics.

Science.gov (United States)

Campbell, John; Smith, Patten; Nissen, Sonja; Bower, Peter; Elliott, Marc; Roland, Martin

2009-08-22

The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9) involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3%) was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%). Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care) accounting for 68.3% of the variance in the sample. The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of pound sterling 65 million ($107 million) of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

32 CFR 206.5 - Final proposal process.

Science.gov (United States)

2010-07-01

... the basis of “educational value for the dollar.” NSEP is interested in funding proposals in areas... institution to integrate the efforts of the proposed program into the educational process? What plans are...) MISCELLANEOUS NATIONAL SECURITY EDUCATION PROGRAM (NSEP) GRANTS TO INSTITUTIONS OF HIGHER EDUCATION § 206.5...

Quasi-Experimental Evaluation of a National Primary School HIV Intervention in Kenya

Science.gov (United States)

Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

2007-01-01

This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant…

Essential drugs in primary health centres of north central Nigeria ...

African Journals Online (AJOL)

To assess the availability of essential drugs and the perceptions of clients on drugs situation in the primary health centres of Tafa Local Government Area, north central Nigeria. Checklist consisting ofminimum drugs expected in a generic primary health centre developed by the National Primary Health Care Development ...

SPRITE: the Spitzer proposal review website

Science.gov (United States)

Crane, Megan K.; Storrie-Lombardi, Lisa J.; Silbermann, Nancy A.; Rebull, Luisa M.

2008-07-01

The Spitzer Science Center (SSC), located on the campus of the California Institute of Technology, supports the science operations of NASA's infrared Spitzer Space Telescope. The SSC issues an annual Call for Proposals inviting investigators worldwide to submit Spitzer Space Telescope proposals. The Spitzer Proposal Review Website (SPRITE) is a MySQL/PHP web database application designed to support the SSC proposal review process. Review panel members use the software to view, grade, and write comments about the proposals, and SSC support team members monitor the grading and ranking process and ultimately generate a ranked list of all the proposals. The software is also used to generate, edit, and email award letters to the proposers. This work was performed at the California Institute of Technology under contract to the National Aeronautics and Space Administration.

Monitoring, reporting and vrification for national REDD+programmes: two proposals

NARCIS (Netherlands)

Herold, M.; Skutsch, M.

2011-01-01

Different options have been suggested by Parties to the UNFCCC (United Framework Convention on Climate Change) for inclusion in national approaches to REDD and REDD + (reduced deforestation, reduced degradation, enhancement of forest carbon stocks, sustainable management of forest, and conservation

Comparing MODIS Net Primary Production Estimates with Terrestrial National Forest Inventory Data in Austria

Directory of Open Access Journals (Sweden)

Mathias Neumann

2015-04-01

Full Text Available The mission of this study is to compare Net Primary Productivity (NPP estimates using (i forest inventory data and (ii spatio-temporally continuous MODIS (MODerate resolution Imaging Spectroradiometer remote sensing data for Austria. While forest inventories assess the change in forest growth based on repeated individual tree measurements (DBH, height etc., the MODIS NPP estimates are based on ecophysiological processes such as photosynthesis, respiration and carbon allocation. We obtained repeated national forest inventory data from Austria, calculated a “ground-based” NPP estimate and compared the results with “space-based” MODIS NPP estimates using different daily climate data. The MODIS NPP estimates using local Austrian climate data exhibited better compliance with the forest inventory driven NPP estimates than the MODIS NPP predictions using global climate data sets. Stand density plays a key role in addressing the differences between MODIS driven NPP estimates versus terrestrial driven inventory NPP estimates. After addressing stand density, both results are comparable across different scales. As forest management changes stand density, these findings suggest that management issues are important in understanding the observed discrepancies between MODIS and terrestrial NPP.

R&D PROPOSAL FOR THE NATIONAL MUON ACCELERATOR PROGRAM

OpenAIRE

Zisman, Michael S.

2011-01-01

This document contains a description of a multi-year national R&D program aimed at completing a Design Feasibility Study (DFS) for a Muon Collider and, with international participation, a Reference Design Report (RDR) for a muon-based Neutrino Factory. It also includes the supporting component development and experimental efforts that will inform the design studies and permit an initial down-selection of candidate technologies for the ionization cooling and acceleration systems. We intend to ...

Draft Legislative Proposals

DEFF Research Database (Denmark)

Turcan, Romeo V.; Bugaian, Larisa; Niculita, Angela

2015-01-01

the objectives of the legislative proposals; discusses risks and challenges that HE in Moldova faces today and in the next 10-15 years; identifies expected outcomes; identifies basic principles on which the process will be founded; proposes a new structure for the HE sector; offers an example...... of a rationalization process, incl., a road map, recommending that there should be 7 universities in Moldova: 3 regional universities and 4 universities in Chisinau (capital); following the principle of clear demarcation between state regulation and institutional university autonomy, specifies universities powers...... and responsibilities; suggests a distinct separation between governance and management; suggests teaching and research funding formulae based on inputs and outputs; and outlines a new National Qualifications Framework....

A national probability survey of American Medical Association gynecologists and primary care physicians concerning menopause.

Science.gov (United States)

Singh, Betsy; Liu, Xiao-Dong; Der-Martirosian, Claudia; Hardy, Mary; Singh, Vijay; Shepard, Neil; Gandhi, Sonal; Khorsan, Raheleh

2005-09-01

This survey intended to clarify physicians' understanding of the issues surrounding women, menopause, alternative medicine, and drug therapy for the treatment of menopause. This study was designed as a national probability sample survey of primary care physicians and gynecologists nationwide. Its focus was to identify major concerns and issues identified by patients about menopause and perceived communication with effectiveness how to communicate with their patients. Physicians were also asked to rate their comfort level in recommending the use of herbal remedies and which herbal remedy they felt comfortable recommending to interested patients. Data indicated that a patient's complaint about menopausal symptoms was the most common factor leading to discussion of menopausal issues with physicians (91%) and that the primary concern to the patient was management of menopausal symptoms. Other factors were controversies about hormone replacement therapy, long-term health implications of menopause, and hormone replacement therapy. Eighty percent of the physician found confusing messages with regard to menopause to be the most challenging aspect in patient communication. The second most challenging issue is "inconclusive data about hormone replacement therapy" (56%). Seventy-six percent of the physicians found "showing sympathy" to be the most important factor for the physicians to communicate effectively with patients, whereas "being honest and open" was the most important patient attitude cited for the same purpose. When it comes to herbal therapy for menopause symptom control, only 4% of the physicians indicated that none of their patients take any remedies. Only 18% were not very comfortable in discussing or recommending herbal therapies, whereas the rest ranged from fairly comfortable to completely comfortable. This study has provided data with regard to physician understanding of menopause treatment options and their primary interaction with patients on this issue

Monitoring quality in Israeli primary care: The primary care physicians' perspective

Directory of Open Access Journals (Sweden)

Nissanholtz-Gannot Rachel

2012-06-01

Full Text Available Abstract Background Since 2000, Israel has had a national program for ongoing monitoring of the quality of the primary care services provided by the country's four competing non-profit health plans. Previous research has demonstrated that quality of care has improved substantially since the program's inception and that the program enjoys wide support among health plan managers. However, prior to this study there were anecdotal and journalistic reports of opposition to the program among primary care physicians engaged in direct service delivery; these raised serious questions about the extent of support among physicians nationally. Goals To assess how Israeli primary care physicians experience and rate health plan efforts to track and improve the quality of care. Method The study population consisted of primary care physicians employed by the health plans who have responsibility for the quality of care of a panel of adult patients. The study team randomly sampled 250 primary-care physicians from each of the four health plans. Of the 1,000 physicians sampled, 884 met the study criteria. Every physician could choose whether to participate in the survey by mail, e-mail, or telephone. The anonymous questionnaire was completed by 605 physicians – 69% of those eligible. The data were weighted to reflect differences in sampling and response rates across health plans. Main findings The vast majority of respondents (87% felt that the monitoring of quality was important and two-thirds (66% felt that the feedback and subsequent remedial interventions improved medical care to a great extent. Almost three-quarters (71% supported continuation of the program in an unqualified manner. The physicians with the most positive attitudes to the program were over age 44, independent contract physicians, and either board-certified in internal medicine or without any board-certification (i.e., residents or general practitioners. At the same time, support for the

32 CFR 206.4 - Proposal development and review.

Science.gov (United States)

2010-07-01

... representatives from the research, business, and government communities. Every effort will be made to ensure balance (geographical, ethnic, gender, institutional type, subject matter) across the entire competition... following issues in the preliminary proposal: (1) How the proposal addresses issues of national capacity in...

Pre-Launch Tasks Proposed in our Contract of December 1991

Science.gov (United States)

1998-01-01

We propose, during the pre-EOS phase to: (1) develop, with other MODIS Team Members, a means of discriminating different major biome types with NDVI and other AVHRR-based data; (2) develop a simple ecosystem process model for each of these biomes, BIOME-BGC; (3) relate the seasonal trend of weekly composite NDVI to vegetation phenology and temperature limits to develop a satellite defined growing season for vegetation; and (4) define physiologically based energy to mass conversion factors for carbon and water for each biome. Our final core at-launch product will be simplified, completely satellite driven biome specific models for net primary production. We will build these biome specific satellite driven algorithms using a family of simple ecosystem process models as calibration models, collectively called BIOME-BGC, and establish coordination with an existing network of ecological study sites in order to test and validate these products. Field datasets will then be available for both BIOME-BGC development and testing, use for algorithm developments of other MODIS Team Members, and ultimately be our first test point for MODIS land vegetation products upon launch. We will use field sites from the National Science Foundation Long-Term Ecological Research network, and develop Glacier National Park as a major site for intensive validation.

Potential for improved radiation thermometry measurement uncertainty through implementing a primary scale in an industrial laboratory

Science.gov (United States)

Willmott, Jon R.; Lowe, David; Broughton, Mick; White, Ben S.; Machin, Graham

2016-09-01

A primary temperature scale requires realising a unit in terms of its definition. For high temperature radiation thermometry in terms of the International Temperature Scale of 1990 this means extrapolating from the signal measured at the freezing temperature of gold, silver or copper using Planck’s radiation law. The difficulty in doing this means that primary scales above 1000 °C require specialist equipment and careful characterisation in order to achieve the extrapolation with sufficient accuracy. As such, maintenance of the scale at high temperatures is usually only practicable for National Metrology Institutes, and calibration laboratories have to rely on a scale calibrated against transfer standards. At lower temperatures it is practicable for an industrial calibration laboratory to have its own primary temperature scale, which reduces the number of steps between the primary scale and end user. Proposed changes to the SI that will introduce internationally accepted high temperature reference standards might make it practicable to have a primary high temperature scale in a calibration laboratory. In this study such a scale was established by calibrating radiation thermometers directly to high temperature reference standards. The possible reduction in uncertainty to an end user as a result of the reduced calibration chain was evaluated.

Plagiarism in Grant Proposals

Science.gov (United States)

Markin, Karen M.

2012-01-01

It is not news that software exists to check undergraduate papers for plagiarism. What is less well known is that some federal grant agencies are using technology to detect plagiarism in grant proposals. That variety of research misconduct is a growing problem, according to federal experts. The National Science Foundation, in its most recent…

Frequency and pattern of cytogenetic alterations in primary ...

African Journals Online (AJOL)

Background: Primary amenorrhea (PA) is proposed to have multiple etiological factors that include genetic factors, intrauterine malformations, endocrine dysfunction and environmental factors, as revealed by previous studies pertaining to amenorrhea. However, among the various proposed etiologies, genetic factors ...

European recommendations for primary prevention of congenital anomalies: a joined effort of EUROCAT and EUROPLAN projects to facilitate inclusion of this topic in the National Rare Disease Plans.

Science.gov (United States)

Taruscio, Domenica; Arriola, Larraitz; Baldi, Francesca; Barisic, Ingeborg; Bermejo-Sánchez, Eva; Bianchi, Fabrizio; Calzolari, Elisa; Carbone, Pietro; Curran, Rhonda; Garne, Ester; Gatt, Miriam; Latos-Bieleńska, Anna; Khoshnood, Babak; Irgens, Lorentz; Mantovani, Alberto; Martínez-Frías, Maria Luisa; Neville, Amanda; Rißmann, Anke; Ruggeri, Stefania; Wellesley, Diana; Dolk, Helen

2014-01-01

Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention to an integrated preventive strategy has led to the prevalence of CA remaining relatively stable in recent decades. The 2 European projects, EUROCAT and EUROPLAN, have joined efforts to provide the first science-based and comprehensive set of recommendations for the primary prevention of CA in the European Union. The resulting EUROCAT-EUROPLAN 'Recommendations on Policies to Be Considered for the Primary Prevention of Congenital Anomalies in National Plans and Strategies on Rare Diseases' were issued in 2012 and endorsed by EUCERD (European Union Committee of Experts on Rare Diseases) in 2013. The recommendations exploit interdisciplinary expertise encompassing drugs, diet, lifestyles, maternal health status, and the environment. The recommendations include evidence-based actions aimed at reducing risk factors and at increasing protective factors and behaviors at both individual and population level. Moreover, consideration is given to topics specifically related to CA (e.g. folate status, teratogens) as well as of broad public health impact (e.g. obesity, smoking) which call for specific attention to their relevance in the pre- and periconceptional period. The recommendations, reported entirely in this paper, are a comprehensive tool to implement primary prevention into national policies on rare diseases in Europe. © 2014 S. Karger AG, Basel.

The Brazilian Unified National Health System: Proposal of a Cost-effectiveness Evaluation Model

Directory of Open Access Journals (Sweden)

Lilian Ribeiro de Oliveira

2016-04-01

Full Text Available The Brazilian Unified National Health System (Sistema Único de Saúde [SUS] is in a prominent position compared to the existing social policies. One of the new tools used by SUS is known as Performance Index of the Unified Health System (Índice de Desempenho do Sistema Único de Saúde [IDSUS], which is intended to measure the performance of each municipality. Therefore, the aim of this study was to propose a model of cost-effectiveness to compare IDSUS performance against total revenues achieved in Homogeneous Group 2, consisting of 94 municipalities and analysed using data from IDSUS and the System Information of the Public Budget for Health Care (Sistema de Informação do Orçamento Público em Saúde [SIOPS] for the year 2011. After structuring this data, we carried out descriptive statistical and cluster analysis in order to group similar municipalities in accordance with established variables: IDSUS performance, population and total revenue in health per capita. Even with the division of municipalities into homogeneous groups and after using variables such as population and revenue to regroup them, the results showed there are municipalities with heterogeneous characteristics. Another finding is in the use and intersection of two distinct databases (IDSUS and SIOPS, which allowed for visualizing the impact of health care revenue on the municipalities performance.

Primary care for opioid use disorder

Directory of Open Access Journals (Sweden)

Mannelli P

2016-08-01

Full Text Available Paolo Mannelli,1 Li-Tzy Wu1–41Department of Psychiatry and Behavioral Sciences, 2Department of Medicine, 3Duke Clinical Research Institute, Duke University Medical Center, 4Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, NC, USARecent reports on prescription opioid misuse and abuse have described unprecedented peaks of a national crisis and the only answer is to expand prevention and treatment, including different levels of care.1 Nonetheless, concerns remain about the ability of busy primary care settings to manage problem opioid users along with other patients. In particular, proposed extensions of buprenorphine treatment, a critically effective intervention for opioid use disorder (OUD, are cautiously considered due to the potential risk of misuse or abuse.2 General practitioners are already facing this burden daily in the treatment of chronic pain, and expert supervision and treatment model adjustment are needed to help improve outcomes. Approximately 20% of patients in primary care have noncancer pain symptoms, with most of them receiving opioid prescriptions by their physicians, and their number is increasing.3 Pain diagnoses are comparable in severity to those of tertiary centers and are complicated by significant psychiatric comorbidity, with a measurable lifetime risk of developing OUD.4,5 Some primary care physicians report frustration about opioid abuse and diversion by their patients; support from pain specialists would improve their competence, the quality f their performance, and the ability to identify patients at risk of opioid misuse.6 Thus, buprenorphine treatment should not be adding to a complex clinical scenario. To this end, the promising models of care emphasize the integration of medical with psychological and pharmacological expertise for the management of OUD. 

78 FR 64442 - NASA FAR Supplement: Proposal Adequacy Checklist

Science.gov (United States)

2013-10-29

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION 48 CFR Parts 1815 and 1852 RIN 2700-AE13 NASA FAR...: Proposed rule. SUMMARY: NASA is proposing to amend the NASA FAR Supplement (NFS) to incorporate a proposal... or pricing data. DATES: Interested parties should submit comments to NASA at the address below on or...

User's guide for the implementation of level one of the proposed American National Standard Specifications for an information interchange data descriptive file on control data 6000/7000 series computers

CERN Document Server

Wiley, R A

1977-01-01

User's guide for the implementation of level one of the proposed American National Standard Specifications for an information interchange data descriptive file on control data 6000/7000 series computers

[Primary care in the United Kingdom].

Science.gov (United States)

Sánchez-Sagrado, T

2016-03-01

The inadequate planning of health professionals in Spain has boosted the way out of doctors overseas. The United Kingdom is one of the countries chosen by Spanish doctors to develop their job. The National Health Service is a health system similar to the Spanish one. Health care services are financing mainly through taxes. The right to health care is linked to the citizen condition. The provision of health care is a mix-up of public and private enterprises. Primary Care is much closed to Spanish Primary Care. Doctors are "self-employed like" professionals. They can set their surgeries in a free area previously designed by the government. They have the right to make their own team and to manage their own budget. Medical salary is linked to professional capability and curriculum vitae. The main role of a General Practitioner is the prevention. Team work and coordination within primary and specialised care is more developed than in Spain. The access to diagnostic tests and to the specialist is controlled through waiting lists. General Practitioners work as gate-keepers. Patients may choose freely their doctor and consultations and hospital care are free at the point of use. Within the United Kingdom there are also health regions with problems due to inequalities to access and to treatment. There is a training path and the access to it is by Curricula. The number of training jobs is regulated by the local needs. Continuing education is compulsory and strictly regulated local and nationally. The National Health Service was the example for the Spanish health reform in 1986. While Spanish Primary health care is of quality, the efficiency of the health system would improve if staff in Primary Care settings were managed in a similar way to the British's. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Prediction of National Wealth

Science.gov (United States)

Whetzel, Deborah L.; McDaniel, Michael A.

2006-01-01

In their book, IQ and the Wealth of Nations, Lynn and Vanhanen ([Lynn, R. and Vanhanen, T. (2002). IQ and the wealth of nations. Westport, CT: Praeger.]) proposed the hypothesis that "the intelligence of the populations has been a major factor responsible for the national differences in economic growth and for the gap in per capita income between…

76 FR 24537 - Paperwork Reduction Act; Proposed Collection; Comment Request

Science.gov (United States)

2011-05-02

... President, Office of National Drug Control Policy, Drug-Free Communities (DFC) Support Program, 750 17th... OFFICE OF NATIONAL DRUG CONTROL POLICY Paperwork Reduction Act; Proposed Collection; Comment Request AGENCY: Office of National Drug Control Policy. ACTION: 60-Day notice and request for comments...

78 FR 21911 - Proposed Information Collection; Comment Request; Fish and Seafood Promotion; Correction

Science.gov (United States)

2013-04-12

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Fish and Seafood Promotion; Correction AGENCY: National Oceanic and Atmospheric... Federal Register (78 FR 20092) on the proposed information collection, Fish and Seafood Promotion. The...

Proposed indicators for a monitoring programme. Summary

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-07-01

The report presents proposals for a set of indicators to be used in a coordinated monitoring programme for the North Sea and Skagerrak ecosystems. This report suggests reference values and action thresholds for the indicators and suitable monitoring stations and survey transects, based on existing time series where possible. The relevance of the proposed indicators is also assessed to national and international environmental policy goals. The national targets of Norway's environmental policy and indicators used in the monitoring systems for the other Norwegian open sea areas were taken into account when drawing up the proposals. In the international context, The management plan was also assessed to the Convention on Biological Diversity, the International Council for the Exploration of the Sea (ICES), the Convention for the Protection of the Marine Environment of the North-East Atlantic (the OSPAR Convention) and the EU's Marine Strategy Framework Directive (MSFD).(Author)

Proposed indicators for a monitoring programme. Summary

International Nuclear Information System (INIS)

2012-01-01

The report presents proposals for a set of indicators to be used in a coordinated monitoring programme for the North Sea and Skagerrak ecosystems. This report suggests reference values and action thresholds for the indicators and suitable monitoring stations and survey transects, based on existing time series where possible. The relevance of the proposed indicators is also assessed to national and international environmental policy goals. The national targets of Norway's environmental policy and indicators used in the monitoring systems for the other Norwegian open sea areas were taken into account when drawing up the proposals. In the international context, The management plan was also assessed to the Convention on Biological Diversity, the International Council for the Exploration of the Sea (ICES), the Convention for the Protection of the Marine Environment of the North-East Atlantic (the OSPAR Convention) and the EU's Marine Strategy Framework Directive (MSFD).(Author)

78 FR 75442 - Designation of the Primary Freight Network

Science.gov (United States)

2013-12-11

...] Designation of the Primary Freight Network AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice... period for the Designation of the highway Primary Freight Network (PFN) notice, which was published on... the complete National Freight Network (NFN), and to solicit comments on aspects of the NFN. The five...

Integration in primary community care networks (PCCNs: examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

Directory of Open Access Journals (Sweden)

Lin Blossom Yen-Ju

2007-06-01

Full Text Available Abstract Background Taiwan's primary community care network (PCCN demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at

The strength of primary care in Europe: an international comparative study.

Science.gov (United States)

Kringos, Dionne; Boerma, Wienke; Bourgueil, Yann; Cartier, Thomas; Dedeu, Toni; Hasvold, Toralf; Hutchinson, Allen; Lember, Margus; Oleszczyk, Marek; Rotar Pavlic, Danica; Svab, Igor; Tedeschi, Paolo; Wilm, Stefan; Wilson, Andrew; Windak, Adam; Van der Zee, Jouke; Groenewegen, Peter

2013-11-01

A suitable definition of primary care to capture the variety of prevailing international organisation and service-delivery models is lacking. Evaluation of strength of primary care in Europe. International comparative cross-sectional study performed in 2009-2010, involving 27 EU member states, plus Iceland, Norway, Switzerland, and Turkey. Outcome measures covered three dimensions of primary care structure: primary care governance, economic conditions of primary care, and primary care workforce development; and four dimensions of primary care service-delivery process: accessibility, comprehensiveness, continuity, and coordination of primary care. The primary care dimensions were operationalised by a total of 77 indicators for which data were collected in 31 countries. Data sources included national and international literature, governmental publications, statistical databases, and experts' consultations. Countries with relatively strong primary care are Belgium, Denmark, Estonia, Finland, Lithuania, the Netherlands, Portugal, Slovenia, Spain, and the UK. Countries either have many primary care policies and regulations in place, combined with good financial coverage and resources, and adequate primary care workforce conditions, or have consistently only few of these primary care structures in place. There is no correlation between the access, continuity, coordination, and comprehensiveness of primary care of countries. Variation is shown in the strength of primary care across Europe, indicating a discrepancy in the responsibility given to primary care in national and international policy initiatives and the needed investments in primary care to solve, for example, future shortages of workforce. Countries are consistent in their primary care focus on all important structure dimensions. Countries need to improve their primary care information infrastructure to facilitate primary care performance management.

Implementation of primary health care - package or process ...

African Journals Online (AJOL)

After establishing the commitment of the government to comprehensive primary health care (PHC), the Department of Health and provinces are now faced with the challenge of implementation. An important response has come with the recent proposed'core package of primary health care services'.' After consultation with ...

Bradley vs. Gore: how media covered proposals for health insurance reform in the context of the 2000 presidential campaign.

Science.gov (United States)

Mebane, Felicia

2003-01-01

This study examines how often national media reported key aspects of Senator Bill Bradley's and Vice President Al Gore's proposals for health insurance reform during the 2000 Democratic primary campaign. The results show that news media reported on Bradley's plan and major features of his plan significantly more often than Gore's. Additionally, few reports contained explicit comparisons that explained which plan would have covered more people or cost more. Public health and media professionals need to work together to improve the quality of information the public depends on to develop views about and support for the uninsured.

"Free Primary Education" in Lesotho and the Disadvantages of the Highlands

Science.gov (United States)

Urwick, James

2011-01-01

This article explores the effects of national policies associated with "Education for All" on a disadvantaged region, the highlands of Lesotho. Since 2000 a programme of "Free Primary Education" has improved the position of the highlands in access to primary schooling; nevertheless, highland primary schools compare poorly with…

US primary care physicians' opinions about conscientious refusal: a national vignette experiment.

Science.gov (United States)

Brauer, Simon G; Yoon, John D; Curlin, Farr A

2016-02-01

Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate. We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements. Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86). This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Clinical bioethics for primary health care].

Science.gov (United States)

González-de Paz, L

2013-01-01

The clinical decision making process with ethical implications in the area of primary healthcare differs from other healthcare areas. From the ethical perspective it is important to include these issues in the decision making model. This dissertation explains the need for a process of bioethical deliberation for Primary Healthcare, as well as proposing a method for doing so. The decision process method, adapted to this healthcare area, is flexible and requires a more participative Healthcare System. This proposal involves professionals and the patient population equally, is intended to facilitate the acquisition of responsibility for personal and community health. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Distributional equity problems at the proposed Yucca Mountain facility

International Nuclear Information System (INIS)

Kasperson, R.E.; Abdollahzadeh, S.

1988-07-01

This paper addresses one quite specific part of this broad range of issues -- the distribution of impacts to the state of Nevada and to the nation likely to be associated with the proposed Yucca Mountain repository. As such, it is one of four needed analyses of the overall equity problems and needs to be read in conjunction with our proposed overall framework for equity studies. The objective of this report is to consider how an analysis might be made of the distribution of projected outcomes between the state and nation. At the same time, it needs to be clear that no attempt will be made actually to implement the analysis that is proposed. What follows is a conceptual statement that identifies the analytical issues and pro poses an approach for overcoming them. Significantly, it must also be noted that this report will not address procedural equity issues between the state and nation for this is the subject of a separate analysis. 14 refs., 8 figs., 3 tabs

Expanding Medicaid Access without Expanding Medicaid: Why Did Some Nonexpansion States Continue the Primary Care Fee Bump?

Science.gov (United States)

Wilk, Adam S; Evans, Leigh C; Jones, David K

2018-02-01

Six states that have rejected the Patient Protection and Affordable Care Act's (ACA) Medicaid expansion nonetheless extended the primary care "fee bump," by which the federal government increased Medicaid fees for primary care services up to 100 percent of Medicare fees during 2013-14. We conducted semistructured interviews with leaders in five of these states, as well as in three comparison states, to examine why they would continue a provision of the ACA that moderately expands access at significant state expense while rejecting the expansion and its large federal match, focusing on relevant economic, political, and procedural factors. We found that fee bump extension proposals were more successful where they were dissociated from major national policy debates, actionable with the input of relatively few stakeholder entities, and well aligned with preexisting policy-making structures and decision trends. Republican proposals to cap or reduce federal funding for Medicaid, if enacted, would compel states to contain program costs. In this context, states' established decision-making processes for updating Medicaid fee schedules, which we elucidate in this study, may shape the future of the Medicaid program. Copyright © 2018 by Duke University Press 2018.

Incidence and significance of Multiple Primary Malignant Neoplasms

International Nuclear Information System (INIS)

Choi, Eun Kyung; Cho, Moon June; Ha, Sung Whan; Park, Charn Il; Bang, Young Ju; Kim, Noe Kyung

1986-01-01

To know the three questions about multiple primary cancers: 1) what are the characteristics of persons having multiple primary cancer? 2) Dose presence of a single primary concern after the susceptibility to multiple primary cancers? 3) Dose the location of one multiple primary cancer influence the site of others?, we analysed 121 cases of multiple primary malignant neoplasms registered in Seoul National University Hospital during 8years from July 1978 to August 1986. Of 121 cases, double primary malignant neoplasms were 119 cases and triple were 2 cases. The incidence of multiple primary malignant neoplasms was 0.7%. The metachronous tumor(> 6 months) was found in 70 cases and the median time between the first and the second was 32 months. The most commonly associated tumors were stomach and primary liver carcinoma. Cervix and Lung cancer, Stomach and Rectal cancer, Stomach and Esophagus cancer were also commonly associated

Proposed medical applications of the National Accelerator Centre facilities

International Nuclear Information System (INIS)

Jones, D.T.L.

1982-01-01

The National Accelerator Centre is at present under construction at Faure, near Cape Town. The complex will house a 200 MeV separated-sector cyclotron which will provide high quality beams for nuclear physics and related diciplines as well as high intensity beams for medical use. The medical aspects catered for will include particle radiotherapy, isotope production and possibly proton radiography. A 30-bed hospital is to be constructed on the site. Building operations are well advanced and the medical facilities should be available for use by the end of 1984

Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data.

Science.gov (United States)

Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

2016-06-01

The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. To determine whether primary care access is associated with the route of emergency admission-via a GP versus via an A and E department. Retrospective analysis of national administrative data from English hospitals for 2011-2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access-the percentage of patients able to get a general practice appointment on their last attempt-was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Among hospital inpatients admitted as an emergency, patients registered to more accessible general practices were more

76 FR 77852 - Agency Information Collection Activities: Proposed Collection; Comment Request

Science.gov (United States)

2011-12-14

... teaching and learning. Method of Collection Teachers who have registered to use NSDL resources through... NATIONAL SCIENCE FOUNDATION Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: National Science Foundation. ACTION: Notice. SUMMARY: The National Science Foundation (NSF...

THE PROPOSED YUCCA MOUNTAIN REPOSITORY FROM A CORROSIVE PERSPECTIVE

International Nuclear Information System (INIS)

PAYER JH

2006-01-01

The proposed Yucca Mountain Repository presents a familiar materials performance application that is regularly encountered in energy, transportation and other industries. The widely accepted approach to dealing with materials performance is to identify the performance requirements, to determine the operating conditions to which materials will be exposed and to select materials of construction that perform well in those conditions. A special feature of the proposed Repository is the extremely long time frame of interest, i.e. 10,000's of years and longer. Thus, the time evolution of the environment in contact with waste package surfaces and the time evolution of corrosion damage that may result are of primary interest in the determination of expected performance. Researchers at Case are part of a Department of Energy Corrosion and Materials Performance Cooperative. This team of leading scientists/engineers from major universities and national laboratories is working together to further enhance the understanding of the role of engineered barriers in waste isolation. The team is organized to address important topics: (1) Long-term behavior of protective, passive films; (2) Composition and properties of moisture in contact with metal surfaces; and (3) Rate of penetration and extent of corrosion damage over extremely long times. The work will also explore technical enhancements and seek to offer improvements in materials costs and reliability

Parliament tears up 'feeble' auto-oil proposals

International Nuclear Information System (INIS)

Anon.

1997-01-01

Recent discussions in the European Parliament concerning the ''auto-oil'' proposals, i.e. the effects of automotive fuel specifications on the environment, are described in this paper. Legislative changes or amendments proposed by various national, or other interest groups are also noted. In particular, the sulphur content of diesel fuels is a matter of widespread concern because of its use for city taxis and buses. Further fuel proposals in the ''auto-oil'' style are expected in the near future. (UK)

77 FR 2072 - Proposed Collection; Comment Request; Prevalence, Incidence, Epidemiology and Molecular Variants...

Science.gov (United States)

2012-01-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request; Prevalence, Incidence, Epidemiology and Molecular Variants of HIV in Blood Donors in Brazil... 1995, for opportunity for public comment on proposed data collection projects, the National Heart, Lung...

National Energy Balance - 1984

International Nuclear Information System (INIS)

Anon.

1984-01-01

The National Energy Balance - 1984 shows energy fluxes of several primary and secondary energy sources, since the productions to final consumption in the main economic sectors, since 1973 to 1983. (E.G.) [pt

National Energy Balance-1987

International Nuclear Information System (INIS)

Anon.

1987-01-01

The National Energy Balance - 1987 showns energy fluxes of several primary and secondary energy sources, since the production to final consumption in the main economic sectors, since 1971 to 1986. (E.G.) [pt

78 FR 44135 - Proposed Collection; 60-Day Comment Request: Application for the Postdoctoral Research Associate...

Science.gov (United States)

2013-07-23

... comments in writing or request more information on the proposed project, contact Ms. Tammy Dean-Maxwell... public comment on proposed data collection projects, the National Institute of General Medical Sciences (NIGMS), the National Institutes of Health (NIH) will publish periodic summaries of proposed projects to...

78 FR 53763 - Proposed Collection; 60-day Comment Request Cancer Trials Support Unit (CTSU) (NCI)

Science.gov (United States)

2013-08-30

... proposed data collection projects, the National Cancer Institute (NCI), National Institutes of Health (NIH), will publish periodic summaries of proposed projects to be submitted to the Office of Management and... proposed collection of information, including the validity of the methodology and assumptions used; (3...

Working to Reduce Poverty: A National Subsidized Employment Proposal

OpenAIRE

Indivar Dutta-Gupta; Kali Grant; Julie Kerksick; Dan Bloom; Ajay Chaudry

2018-01-01

Subsidized employment programs that increase labor supply and demand are a proven, underutilized strategy for reducing poverty in the short and long term. These programs use public and private funds to provide workers wage-paying jobs, training, and wraparound services to foster greater labor force attachment while offsetting employers’ cost for wages, on-the-job training, and overhead. This article proposes two new separate but harmonized federal funding streams for subsidized employment tha...

A proposed minimum data set for international primary care optometry: a modified Delphi study.

Science.gov (United States)

Davey, Christopher J; Slade, Sarah V; Shickle, Darren

2017-07-01

To identify a minimum list of metrics of international relevance to public health, research and service development which can be extracted from practice management systems and electronic patient records in primary optometric practice. A two stage modified Delphi technique was used. Stage 1 categorised metrics that may be recorded as being part of a primary eye examination by their importance to research using the results from a previous survey of 40 vision science and public health academics. Delphi stage 2 then gauged the opinion of a panel of seven vision science academics and achieved consensus on contentious metrics and methods of grading/classification. A consensus regarding inclusion and response categories was achieved for nearly all metrics. A recommendation was made of 53 metrics which would be appropriate in a minimum data set. This minimum data set should be easily integrated into clinical practice yet allow vital data to be collected internationally from primary care optometry. It should not be mistaken for a clinical guideline and should not add workload to the optometrist. A pilot study incorporating an additional Delphi stage prior to implementation is advisable to refine some response categories. © 2017 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

A cross-national investigation into the individual and national cultural antecedents of consumer innovativeness

NARCIS (Netherlands)

Steenkamp, JBEM; ter Hofstede, F; Wedel, M

The authors examine antecedents of consumer innovativeness in a cross-national context. They propose a framework that distinguishes individual difference variables and national cultural variables. Two types of individual difference variables are considered: personal values and

Proposals now being accepted for 'INCITE'

CERN Multimedia

2003-01-01

Secretary of Energy, Spencer Abraham, has announced that proposals are now being accepted for a new DOE Office of Science program to support innovative, large-scale computational science projects. The program, entitled "Innovative and Novel Computational Impact on Theory and Experiment" will award a total of 4.5 million supercomputer processor hours and 100 trillion bytes of data storage space at the National Energy Research Scientific Computing Center at DOE's Lawrence Berkeley National Laboratory (1 page).

77 FR 7171 - Agency Information Collection Activities: Proposed Collection; Comment Request, National Fire...

Science.gov (United States)

2012-02-10

..., National Fire Incident Reporting System (NFIRS) v5.0 AGENCY: Federal Emergency Management Agency, DHS... accordance with the Paperwork Reduction Act of 1995, this notice seeks comments concerning National Fire... standardized reporting methods, to collect and analyze fire incident data at the Federal, State, and local...

National Energy Balance - 1985

International Nuclear Information System (INIS)

Anon.

1985-01-01

The National Energy Balance - 1985 shows energy fluxes of several primary and secondary energy sources, since the production to the final consumption in the main economic sectors, since 1974 to 1984 (E.G.) [pt

76 FR 60934 - Proposal Review Panel for Human Resource Development; Notice of Meeting

Science.gov (United States)

2011-09-30

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Human Resource Development; Notice of...; Proposal Review Panel Human Resource Development ( 1199). Date/Time: November 1, 2011; 5 p.m. to 10 p.m...: Part-Open. Contact Person: Kelly Mack, Division of Human Resource Development, Room 815, National...

78 FR 14822 - Proposed Information Collection; National Park Service Concessions

Science.gov (United States)

2013-03-07

... together with, if requested by the NPS, a written certification from a certified public accountant (CPA... and respondent burden, we invite the general public and other Federal agencies to take this...: (1) Proposals (partially approved under OMB Control Number 1024- 0125). The public solicitation...

Partnership effectiveness in primary community care networks: A national empirical analysis of partners' coordination infrastructure designs.

Science.gov (United States)

Lin, Blossom Yen-Ju; Lin, Yung-Kai; Lin, Cheng-Chieh

2010-01-01

Previous empirical and managerial studies have ignored the effectiveness of integrated health networks. It has been argued that the varying definitions and strategic imperatives of integrated organizations may have complicated the assessment of the outcomes/performance of varying models, particularly when their market structures and contexts differed. This study aimed to empirically verify a theoretical perspective on the coordination infrastructure designs and the effectiveness of the primary community care networks (PCCNs) formed and funded by the Bureau of National Health Insurance since March 2003. The PCCNs present a model to replace the traditional fragmented providers in Taiwan's health care. The study used a cross-sectional mailed survey designed to ascertain partnership coordination infrastructure and integration of governance, clinical care, bonding, finances, and information. The outcome indicators were PCCNs' perceived performance and willingness to remain within the network. Structural equation modeling examined the causal relationships, controlling for organizational and environmental factors. Primary data collection occurred from February through December 2005, via structured questionnaires sent to 172 PCCNs. Using the individual PCCN as the unit of analysis, the results found that a network's efforts regarding coordination infrastructures were positively related to the PCCN's perceived performance and willingness to remain within the network. In addition, PCCNs practicing in rural areas and in areas with higher density of medical resources had better perceived effectiveness and willingness to cooperate in the network.Practical Implication: The lack of both an operational definition and an information about system-wide integration may have obstructed understanding of integrated health networks' organizational dynamics. This study empirically examined individual PCCNs and offers new insights on how to improve networks' organizational design and

75 FR 70952 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2010-11-19

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463, as amended), the National Science Foundation... Director for Elementary Particle Physics, National Science Foundation, 4201 Wilson Blvd., Arlington, VA...

76 FR 24921 - Proposal Review Panel for Chemistry; Notice of Meeting

Science.gov (United States)

2011-05-03

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Chemistry; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463, as amended), the National Science Foundation..., Program Director, Chemistry Centers Program, Division of Chemistry, Room 1055, National Science Foundation...

78 FR 4464 - Proposal Review Panel for Chemistry; Notice of Meeting

Science.gov (United States)

2013-01-22

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Chemistry; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463, as amended), the National Science Foundation... Chemistry, Room 1055, National Science Foundation, 4201 Wilson Boulevard, Arlington, VA 22230, (703) 292...

76 FR 12996 - Proposal Review Panel for Chemistry; Notice of Meeting

Science.gov (United States)

2011-03-09

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Chemistry; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463 as amended), the National Science Foundation... Director, Chemistry Centers Program, Division of Chemistry, Room 1055, National Science Foundation, 4201...

76 FR 6499 - Proposal Review Panel for Chemistry; Notice of Meeting

Science.gov (United States)

2011-02-04

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Chemistry; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463 as amended), the National Science Foundation... Director, Chemistry Centers Program, Division of Chemistry, Room 1055, National Science Foundation, 4201...

76 FR 60933 - Proposal Review Panel for Human Resource Development; Notice of Meeting

Science.gov (United States)

2011-09-30

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Human Resource Development; Notice of..., Proposal Review Panel Human Resource Development ( 1199). Date/Time: October 17, 2011; 5 p.m. to 10 p.m... Meeting: Part-Open. Contact Person: Kelly Mack, Division of Human Resource Development, Room 815, National...

National CrossTalk. Volume 12, Number 1, Winter 2004

Science.gov (United States)

Trombley, William, Ed.

2004-01-01

"National CrossTalk" is a publication of the National Center for Public Policy and Higher Education. The National Center promotes public policies that enhance opportunities for quality education and training beyond high school. The primary purpose of "National CrossTalk" is to stimulate informed discussion and debate of higher…

US Army primary radiation standards complex

Energy Technology Data Exchange (ETDEWEB)

Rogers, S.C. [Radiation Standards and Dosimetry Laboratory, Redstone Arsenal, AL (United States)

1993-12-31

This paper describes the U.S. Army Primary Radiation Standards Complex (PRSC) to be constructed at Redstone Arsenal, Alabama. The missions of the organizations to be located in the PRSC are described. The health physics review of the facility design is discussed. The radiation sources to be available in the PRSC and the resulting measurement capabilities of the Army Primary Standards Laboratory Nucleonics section are specified. Influence of the National Voluntary Laboratory Accrediation Program (NVLAP) accreditation criteria on facility design and source selection is illustrated.

Pregnancy Options Counseling and Abortion Referrals Among US Primary Care Physicians: Results From a National Survey.

Science.gov (United States)

Holt, Kelsey; Janiak, Elizabeth; McCormick, Marie C; Lieberman, Ellice; Dehlendorf, Christine; Kajeepeta, Sandhya; Caglia, Jacquelyn M; Langer, Ana

2017-07-01

Primary care physicians (PCPs) can play a critical role in addressing unintended pregnancy through high-quality options counseling and referrals. We surveyed a nationally representative sample of 3,000 PCPs in general, family, and internal medicine on practices and opinions related to options counseling for unintended pregnancy. We assessed predictors of physician practices using multivariable logistic regression weighted for sampling design and differential non-response. Response rate was 29%. Seventy-one percent believed residency training in options counseling should be required, and 69% believed PCPs have an obligation to provide abortion referrals even in the presence of a personal objection to abortion. However, only 26% reported routine options counseling when caring for women with unintended pregnancy compared to 60% who routinely discuss prenatal care. Among physicians who see women seeking abortion, 62% routinely provide referrals, while 14% routinely attempt to dissuade women. Family physicians were more likely to provide routine options counseling when seeing patients with unintended pregnancy than internal medicine physicians (32% vs 21%, P=0.002). In multivariable analyses, factors associated with higher odds of routine abortion referrals were more years in practice (OR=1.03 for each additional year, 95% CI: 1.00-1.05), identifying as a woman vs a man (OR=2.11, 95% CI: 1.31-3.40), practicing in a hospital vs private primary care/multispecialty setting (OR=3.17, 95% CI: 1.10-9.15), and no religious affiliation of practice vs religious affiliation (OR for Catholic affiliation=0.27, 95% CI: 0.11-0.66; OR for other religious affiliation=0.36, 95% CI: 0.15-0.83). Personal Christian religious affiliation among physicians who regularly attend religious services vs no religious affiliation was associated with lower odds of counseling (OR=0.48, 95% CI: 0.26-0.90) and referrals (OR=0.31, 95% CI: 0.15-0.62), and higher odds of abortion dissuasion (OR=4.03, 95

Global nuclear waste repository proposal highlights Australia's nuclear energy vacuum

International Nuclear Information System (INIS)

Anon.

1999-01-01

The Pangea proposal is disscused and considered relevant to Australia. A five-year research program by the company has identified Australia and Argentina as having the appropriate geological, economic and democratic credentials for such a deep repository, with Australia being favoured. A deep repository would be located where the geology has been stable for several hundred million years, so that there need not be total reliance on a robust engineered barrier system to keep the waste securely isolated for thousands of years. It would be a commercial undertaking and would have dedicated port and rail infrastructure. It would take spent fuel and other wastes from commercial reactors, and possibly also waste from weapons disposal programs. Clearly, while the primary ethical and legal principle is that each country is entirely responsible for its own waste, including nuclear waste (polluter pays etc), the big question is whether the concept of an international waste repository is acceptable ethically. Political and economic questions are secondary to this. By taking a fresh look at the reasons for the difficulties which have faced most national repository programs, and discarding the preconception that each country must develop its own disposal facilities, it is possible to define a class of simple, superior high isolation sites which may provide a multi-national basis for solving the nuclear waste disposal problem. The relatively small volumes of high-level wastes or spent fuel which arise from nuclear power production make shared repositories a feasible proposition. For small countries, the economies of scale which can be achieved make the concept attractive. For all countries, objective consideration of the relative merits of national and multi-national solutions is a prudent part of planning the management of long-lived radioactive wastes

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

Science.gov (United States)

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

2014-10-01

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

EBR-II Primary Tank Wash-Water Alternatives Evaluation

International Nuclear Information System (INIS)

Demmer, R.; Heintzelman, J.; Squires, L.; Meservey, R.

2009-01-01

The EBR-II reactor at Idaho National Laboratory was a liquid sodium metal cooled reactor that operated for 30 years. Approximately 1100 kg of residual sodium remained in the primary system after draining the bulk sodium. To stabilize the remaining sodium, both the primary and secondary systems were treated with a purge of moist carbon dioxide. The passivation treatment was stopped in 2005 and the primary system is maintained under a blanket of dry carbon dioxide. Approximately 670 kg of sodium metal remains in the primary system in locations that were inaccessible to passivation treatment or in pools of sodium that were too deep for complete penetration of the passivation treatment. The EBR-II reactor was permitted by the Idaho Department of Environmental Quality (DEQ) in 2002 under a RCRA permit that requires removal of all remaining sodium. The proposed baseline closure method would remove the large components from the primary tank, fill the primary system with water, react the remaining sodium with the water and dissolve the reaction products in about 100,000 gallons of wash water. On February 19-20, 2008, a workshop was held in Idaho Falls, Idaho, to evaluate alternatives that could meet the RCRA permit clean closure requirements and minimize the quantity of hazardous waste generated by the cleanup process. The workshop convened a panel of national and international sodium cleanup specialists, subject matter experts from the INL, and the EBR-II Wash Water Project team that organized the workshop. The workshop was conducted by a trained facilitator using Value Engineering techniques to elicit the most technically sound solutions from the workshop participants. A brainstorming session was held to identify possible alternative treatment methods that would meet the primary functions and criteria of neutralizing the hazards, maximizing byproduct removal and minimizing waste generation. An initial list of some 20 probable alternatives was evaluated and refined down

National laboratories

International Nuclear Information System (INIS)

Moscati, G.

1983-01-01

The foundation of a 'National Laboratory' which would support a Research center in synchrotron radiation applications is proposed. The essential features of such a laboratory differing of others centers in Brazil are presented. (L.C.) [pt

Playing Music, Playing with Music: A Proposal for Music Coding in Primary School

Science.gov (United States)

Baratè, Adriano; Ludovico, Luca Andrea; Mangione, Giuseppina Rita; Rosa, Alessia

2015-01-01

In this work we will introduce the concept of "music coding," namely a new discipline that employs basic music activities and simplified languages to teach the computational way of thinking to musically-untrained children who attend the primary school. In this context, music represents both a mean and a goal: in fact, from one side…

Political, cultural and economic foundations of primary care in Europe.

NARCIS (Netherlands)

Kringos, D.S.; Boerma, W.G.W.; Zee, J. van der; Groenewegen, P.P.

2013-01-01

This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political agenda,

Political, cultural and economic foundations of primary care in Europe

NARCIS (Netherlands)

Kringos, Dionne S.; Boerma, Wienke G. W.; van der Zee, Jouke; Groenewegen, Peter P.

2013-01-01

This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political agenda,

Political, cultural and economic foundations of primary care in Europe

NARCIS (Netherlands)

Kringos, D.S.; Boerma, W.G.W.; Zee, J. van der; Groenewegen, P.P.

2013-01-01

This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political

A Proposed Framework for Applying the National Standards of Quality Assurance in Higher Education in Sudan from the Teaching Staff’s Perspective - Faculties of Business Administration

Directory of Open Access Journals (Sweden)

Alfatih Alamin Elfaki

2017-08-01

Full Text Available This study aimed to clarify the importance of having national standards and their role in achieving quality, as well as establishing a framework for the actual application of national standards in quality assurance so as to achieve quality in higher education institutions. The researchers  followed a descriptive analytical method to achieve the objectives of the study and developed a questionnaire covering primary and secondary variables that have a role in the design of specific models to help in applying the national standards by the Sudanese universities. The questionnaire included one dependent variable; the effective application of national standards of quality assurance in higher education institutions, and the four main variables (independent are: the national standards of quality assurance in higher education in Sudan, the standard of quality assurance, the standard of teaching and learning and the standard of scientific research and publication. The study revealed a number of conclusions: there were statistically significant differences in the extent of familiarity with the  national quality assurance standards in Sudan according to the academic rank of the  faculty members; there were also significant differences in the extent of compliance with the  national quality assurance standards in Sudan according to the academic rank of the faculty members; there was full agreement between the national standards for quality assurance in Sudan and the international standards for quality assurance; and  there were statistically significant differences in that the absence of specific models would have a negative impact on effective application of national standards of quality assurance in higher education in Sudan, according to the academic rank of the faculty members. Keywords: Quality, The program, Standards, University, Total quality management.

78 FR 65609 - Medicine Bow-Routt National Forests and Thunder Basin National Grassland; Wyoming; Thunder Basin...

Science.gov (United States)

2013-11-01

... National Grassland; Wyoming; Thunder Basin National Grassland Prairie Dog Amendment Environmental Impact... Cooperating Agencies. No changes to the Proposed Action or Purpose of and Need for Action have been made... alternatives will be analyzed in the Thunder Basin National Grassland Prairie Dog Amendment EIS. The EIS will...

The Role of National Adult Education Centre in Curriculum Development in Somalia in Selected Government Primary Adult Schools of Mogadisho. African Studies in Curriculum Development and Evaluation, No. 109.

Science.gov (United States)

Bahar, Ismail F. S.

A study of curriculum development in Somalia focused on the role of the National Adult Education Centre (NAEC) and involvement of teachers and inspectors. The sample consisted of 80 Mogadisho primary adult school teachers. Information sources were related literature, teacher questionnaires, and unstructured interviews with school inspectors,…

The GP Patient Survey for use in primary care in the National Health Service in the UK – development and psychometric characteristics

Directory of Open Access Journals (Sweden)

Bower Peter

2009-08-01

Full Text Available Abstract Background The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9 involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. Methods The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. Results The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3% was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%. Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care accounting for 68.3% of the variance in the sample. Conclusion The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of £65 million ($107 million of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

Science.gov (United States)

Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

2018-04-10

In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or

Policy Board Proposals Ignore Real Problems.

Science.gov (United States)

Hawley, Willis D.

1989-01-01

The recent National Policy Board for Educational Administration report ("Improving the Preparation of School Administrators: An Agenda for Reform") does not address fundamental questions or make convincing proposals concerning the preparation of school administrators. The report's nine overall recommendations for improving school administration…

Research on persistent organic pollutants in China on a national scale: 10 years after the enforcement of the Stockholm Convention.

Science.gov (United States)

Liu, Li-Yan; Ma, Wan-Li; Jia, Hong-Liang; Zhang, Zi-Feng; Song, Wei-Wei; Li, Yi-Fan

2016-10-01

As a signatory of the Stockholm Convention and the largest developing country, China plays a very important role in implementation of the convention to reduce and finally eliminate persistent organic pollutants (POPs) in the world. In the past ten years after the enforcement in 2004, Chinese Government and scientists have made great progress on the study of POPs. The present work aims to provide an overview on recent studies on POPs in China, with particular focus on usage/emission inventory, residue inventory, and pollution status of POPs on national scale. Several legend (old) and new target POPs were comprehensively summarized with progress on inventory. Furthermore, several national scale monitoring programs have been selected for the occurrence, spatial and temporal trends of POPs in China, which are compared with Asian data and Global data. Based on the observed results, some important scientific issues, such as the primary and secondary distribution patterns, the primary and secondary fractionations, and air-soil exchange of POPs, are also discussed. It is proposed that more studies should be carried out for the new targeted POPs in future for both the national and global interests. Copyright © 2016 Elsevier Ltd. All rights reserved.

75 FR 27789 - Proposed Collection; Comment Request; Application for the Pharmacology Research Associate Program

Science.gov (United States)

2010-05-18

... comment on proposed data collection projects, the National Institute of General Medical Sciences (NIGMS), the National Institutes of Health (NIH) will publish periodic summaries of proposed projects to be... develop leaders in pharmacological research for key positions in academic, industrial, and Federal...

African primary care research: performing surveys using questionnaires.

Science.gov (United States)

Govender, Indiran; Mabuza, Langalibalele H; Ogunbanjo, Gboyega A; Mash, Bob

2014-04-25

The aim of this article is to provide practical guidance on conducting surveys and the use of questionnaires for postgraduate students at a Masters level who are undertaking primary care research. The article is intended to assist with writing the methods section of the research proposal and thinking through the relevant issues that apply to sample size calculation, sampling strategy, design of a questionnaire and administration of a questionnaire. The articleis part of a larger series on primary care research, with other articles in the series focusing on the structure of the research proposal and the literature review, as well as quantitative data analysis.

Australian National University Science Extension Day

Science.gov (United States)

Fletcher, Sarah

2016-01-01

The first Australian National University (ANU) Science Extension Day was held on September 8, 2015. The ANU Science Extension Day is a project that was initiated by Theodore Primary School (ACT) and developed by Theodore Primary, Calwell High School, Science Educators Association of the ACT (SEA*ACT), and the ANU. The project was developed with a…

Primary energy and greenhouse gases embodied in Australian final consumption: an input-output analysis

International Nuclear Information System (INIS)

Lenzen, M.

1998-01-01

Input-output modeling of primary energy and greenhouse gas embodiments in goods and services is a useful technique for designing greenhouse gas abatement policies. The present paper describes direct and indirect primary energy and greenhouse gas requirements for a given set of Australian final consumption. It considers sectoral disparities in energy prices, capital formation and international trade flows and it accounts for embodiments in the Gross National Expenditure as well as the Gross Domestic Product. Primary energy and greenhouse gas intensities in terms of MJ/$ and kg CO 2 -e/$ are reported, as well as national balance of primary energy consumption and greenhouse gas emissions. (author)

The distribution of lung cancer across sectors of society in the United Kingdom: a study using national primary care data

Directory of Open Access Journals (Sweden)

Iyen-Omofoman Barbara

2011-11-01

Full Text Available Abstract Background There is pressing need to diagnose lung cancer earlier in the United Kingdom (UK and it is likely that research using computerised general practice records will help this process. Linkage of these records to area-level geo-demographic classifications may also facilitate case ascertainment for public health programmes, however, there have as yet been no extensive studies of data validity for such purposes. Methods To first address the need for validation, we assessed the completeness and representativeness of lung cancer data from The Health Improvement Network (THIN national primary care database by comparing incidence and survival between 2000 and 2009 with the UK National Cancer Registry and the National Lung Cancer Audit Database. Secondly, we explored the potential of a geo-demographic social marketing tool to facilitate disease ascertainment by using Experian's Mosaic Public Sector ™ classification, to identify detailed profiles of the sectors of society where lung cancer incidence was highest. Results Overall incidence of lung cancer (41.4/100, 000 person-years, 95% confidence interval 40.6-42.1 and median survival (232 days were similar to other national data; The incidence rate in THIN from 2003-2006 was found to be just over 93% of the national cancer registry rate. Incidence increased considerably with area-level deprivation measured by the Townsend Index and was highest in the North-West of England (65.1/100, 000 person-years. Wider variations in incidence were however identified using Mosaic classifications with the highest incidence in Mosaic Public Sector ™types 'Cared-for pensioners, ' 'Old people in flats' and 'Dignified dependency' (191.7, 174.2 and 117.1 per 100, 000 person-years respectively. Conclusions Routine electronic data in THIN are a valid source of lung cancer information. Mosaic ™ identified greater incidence differentials than standard area-level measures and as such could be used as a tool

The Danish National Chronic Lymphocytic Leukemia Registry

DEFF Research Database (Denmark)

da Cunha-Bang, Caspar; Geisler, Christian Hartmann; Enggaard, Lisbeth

2016-01-01

AIM: In 2008, the Danish National Chronic Lymphocytic Leukemia Registry was founded within the Danish National Hematology Database. The primary aim of the registry is to assure quality of diagnosis and care of patients with chronic lymphocytic leukemia (CLL) in Denmark. Secondarily, to evaluate...

Multiple somatic symptoms in primary care

DEFF Research Database (Denmark)

Goldberg, D. P.; Reed, G. M.; Robles, R.

2016-01-01

Objective A World Health Organization (WHO) field study conducted in five countries assessed proposals for Bodily Stress Syndrome (BSS) and Health Anxiety (HA) for the Primary Health Care Version of ICD-11. BSS requires multiple somatic symptoms not caused by known physical pathology and associated...... with distress or dysfunction. HA involves persistent, intrusive fears of having an illness or intense preoccupation with and misinterpretation of bodily sensations. This study examined how the proposed descriptions for BSS and HA corresponded to what was observed by working primary care physicians (PCPs......) in participating countries, and the relationship of BSS and HA to depressive and anxiety disorders and to disability. Method PCPs referred patients judged to have BSS or HA, who were then interviewed using a standardized psychiatric interview and a standardized measure of disability. Results Of 587 patients...

Primary Science Education in China

Science.gov (United States)

Pook, Gayle

2013-01-01

Consider the extent to which primary science teaching has evolved since it became a core subject in England with the introduction of the National Curriculum in 1988, and the pace at which theory-driven classroom practice has advanced. It is no wonder that, given the recent economic restructuring and boom in technological development in China,…

Population need for primary eye care in Rwanda: A national survey.

Directory of Open Access Journals (Sweden)

Tess Bright

Full Text Available Universal access to Primary Eye Care (PEC is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI. PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE and create a referral pathway for specialist eye care, thus offering a potential solution to a lack of eye health specialists in low-income countries. However, there is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa.A national survey was conducted of people aged 7 and over in Rwanda in September-December 2016. Participants were selected through two-stage probability proportional to size sampling and compact segment sampling. VI (visual acuity<6/12 was assessed using Portable Eye Examination Kit (PEEK; URE was detected using a pinhole and presbyopia using local near vision test. We also used validated questionnaires to collect socio-demographic and minor eye symptoms information. Prevalence estimates for VI, URE and need for PEC (URE, presbyopia with good distance vision, need for referrals and minor eye conditions were age and sex standardized to the Rwandan population. Associations between age, sex, socio-economic status and the key outcomes were examined using logistic regression.4618 participants were examined and interviewed out of 5361 enumerated (86% response rate. The adjusted population prevalence of VI was 3.7% (95%CI = 3.0-4.5%, URE was 2.2% (95%CI = 1.7-2.8% and overall need for PEC was 34.0% (95%CI = 31.8-36.4%. Women and older people were more likely to need PEC and require a referral.Nearly a third of the population in Rwanda has the potential to benefit from PEC, with greater need identified in older people and women. Universal access to PEC can address unmet eye health needs and public health planning needs to ensure equitable access to older people and women.

Primary Sjogren's syndrome associated with inappropriate ...

African Journals Online (AJOL)

A patient in whom primary Sjogren's syndrome and inappropriate antiduretic hormone secretion were associated is reported. This is the first report of such an association. The possible pathophysiological mechanisms are discussed and vasculitis proposed as the underlying pathogenetic mechanism.

A statistical analysis of the characteristics of the intended curriculum for Japanese primary science and its relationship to the attained curriculum

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Kenji Matsubara

2016-08-01

Full Text Available Abstract This study statistically investigates the characteristics of the intended curriculum for Japanese primary science, focusing on the learning content. The study used the TIMSS 2011 Grade 4 Curriculum Questionnaire data as a major source for the learning content prescribed at the national level. Confirmatory factor analysis was used to determine the extent to which a topic area was covered, as compared to the average among the 59 TIMSS 2011 participating countries. The study revealed that the topic areas of “Human Health” and “Changes in Environments,” both in the life science domain, showed statistically less coverage in the Japanese primary science curriculum when compared to the international average. Furthermore, in discussion, the study relates the characteristics found in the intended curriculum to those in the attained curriculum, examining the percent correct statistics for relevant items from the science assessment. Based on these findings, the study proposes two recommendations for revision of the Japanese primary science curriculum.

Human Trafficking and National Morality

Directory of Open Access Journals (Sweden)

William R. DI PIETRO

2015-12-01

Full Text Available The paper proposes that national morality is an important variable for explaining national anti-trafficking policy. It uses cross country regression analysis to see whether or not empirically national morality is a determinant of anti-trafficking policy. The findings of the paper are consistent with the notion that improved levels of national morality lead to better national anti-trafficking policy. National morality is found to be statistically relevant for national anti-trafficking policy when controlling for the extent of democracy, the share of the private sector in the economy, and the degree of globalization.

A proposed national strategic framework for the management of Cactaceae in South Africa

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Haylee Kaplan

2017-03-01

Full Text Available Background: South Africa has a long history of managing biological invasions. The rapid increase in the scale and complexity of problems associated with invasions calls for new, more strategic management approaches. This paper explores strategic management approaches for cactus invasions in South Africa. Cacti (Cactaceae have had a long history of socio-economic benefits, considerable negative environmental and socio-economic impacts, and a wide range of management interventions in South Africa. Objectives: To guide the future management of cactus invasions, a national strategic framework was developed by the South African Cactus Working Group. The overarching aim of this framework is to reduce the negative impacts of cacti to a point where their benefits significantly outweigh the losses. Method: Four strategic objectives were proposed: (1 all invasive and potentially invasive cactus species should be prevented from entering the country, (2 new incursions of cactus species must be rapidly detected and eradicated, (3 the impacts of invasive cacti must be reduced and contained and (4 socio-economically useful cacti (both invasive and non-invasive species must be utilised sustainably to minimise the risk of further negative impacts. Results: There are currently 35 listed invasive cactus species in the country; 10 species are targeted for eradication and 12 are under partial or complete biological control. We discuss approaches for the management of cactus species, their introduction and spread pathways and spatial prioritisation of control efforts. Conclusion: A thorough understanding of context-specific invasion processes and stakeholder support is needed when implementing strategies for a group of invasive species.

National Energy Balance - 1981

International Nuclear Information System (INIS)

Anon.

1981-01-01

The National Energy Balance - 1981, shows a new metodology and information in level of several economic sectors, as well as a separation of primary and secondary energy sources, its energy fluxes, i.e. production, imports, exports, consumption, etc...(E.G.) [pt

7 CFR 1491.6 - Ranking considerations and proposal selection.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Ranking considerations and proposal selection. 1491.6... PROGRAM General Provisions § 1491.6 Ranking considerations and proposal selection. (a) Before the State.... The national ranking criteria will be established by the Chief and the State criteria will be...

Mercury distribution characteristics in primary manganese smelting plants

International Nuclear Information System (INIS)

Back, Seung-Ki; Sung, Jin-Ho; Moon, Young-Hoon; Kim, Young-Hee; Seok, Kwang-Seol; Song, Geum-Ju; Seo, Yong-Chil

2017-01-01

The mercury (Hg) distribution characteristics were investigated in three primary manganese smelting plants in Korea for the assessment of anthropogenic Hg released. Input and output materials were sampled from each process, and Hg concentrations in the samples were analyzed. Among the input materials, the most mercury was found in the manganese ore (83.1–99.7%) and mercury was mainly released through fly ash or off gas, depending on the condition of off gas cleaning system. As off gas temperature decreases, proportion and concentration of emitted gaseous elemental mercury (Hg 0 ) in off gas decreases. Based on mass balance study from these three plants and national manganese production data, the total amount of mercury released from those Korean plants was estimated to 644 kg/yr. About half of it was emitted into the air while the rest was released to waste as fly ash. With the results of this investigation, national inventory for Hg emission and release could be updated for the response to Minamata Convention on Mercury. - Graphical abstract: 1. Lack of data on mercury (Hg) distribution in manganese smelters. 2. Mass distribution of Hg released from 3 plants (as normalized values) were made as follows by measurements. 3. Information of distribution of Hg in Manganese smelters would be used for emission in to air and releases to other streams for the nation and globe in UNEP mercury report. - Highlights: • The mass balance study by on-site measurement from primary manganese smelting plants was made at first time in the world. • Hg distribution and main input and release pathways of Hg from primary manganese smelting plants could be found as the first time. • Gas temperature in bag filter affects Hg behavior and speciation changes in APCDs. • National inventory of Hg emssion has been updated with new data. - Mercury distribution in manganese smelting plant was investigated as the first measurements at commercial plants in the world. National Hg release

Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data.

Science.gov (United States)

Atun, Rifat; Gurol-Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

2016-12-01

Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Using routinely collected health billing records for 2005-2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co-morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply-side variables, and PHC use. Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow-up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

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

Directory of Open Access Journals (Sweden)

Tsima BM

2016-08-01

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

77 FR 30263 - Proposed Information Collection; Comment Request

Science.gov (United States)

2012-05-22

... proposed data collection for the Social Innovation Fund (SIF) National Evaluation. Research questions for... brief telephone surveys with 138 sub grantees to obtain contextual and explanatory information...

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

The Bush administration climate proposal: rhetoric and reality

Energy Technology Data Exchange (ETDEWEB)

Blanchard, O.

2003-03-01

This paper examines the Bush administration proposal and subsequent actions in terms of the United Nations Framework Convention on Climate Change (UNFCCC). It has four sections. Section one describes the main features of the Bush Administration climate proposal. Section 2 identifies the main underlying factors that shape this proposal. Section 3 rebuts the Administration critique in deciding to reject the Kyoto protocol. Section 4 explores the prospects of the US climate mitigation actions over the next few years. (A.L.B.)

78 FR 55777 - Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event...

Science.gov (United States)

2013-09-11

... techniques or the use of other forms of information technology. Titles: a. National Disabled Veterans Winter... Form 0928h. m. Surfing Personnel Application, VA Form 0928i. n. Venue Personnel Application, VA Form... Creative Arts Festival, National Veterans TEE Tournament, National Disabled Veterans Winter Sports Clinic...

Study for Action Plan proposal on some issues of the national nuclear infrastructure for the new research reactor project in phase 1&2

International Nuclear Information System (INIS)

Cao Hong Lan; Bui Dang Hanh; Nguyen Nhi Dien

2017-01-01

The Project on construction for a new research reactor in Vietnam is under preparation. At the same time, it is necessary to prepare a firm and comprehensive national nuclear infrastructure which is aimed to implement smoothly and ensure safety and security for the project. How is the status of the nuclear infrastructure for research reactor project in Vietnam, how can it be assessed, what is the assessment used for and what are we going to do with that? So, all of these things are the goals set out to address in this Task. However, due to time constraints and conformity with requirement of project progress, this Task assessed only 8 critical issues in infrastructure in phase 1&2, including National position; Management; Legislative framework; Regulatory framework; Human resource development; Radioactive waste; Site survey, site selection and evaluation; and Environmental protection. Conditions and criteria in the documents on milestones and assessment of the national nuclear infrastructure to support a new research reactor project of the International Atomic Energy Agency (IAEA) were used as bases for assessing the Vietnam's infrastructure status. The results of the Task are assessment and identification for gaps which need to be addressed and proposing for a plan on completing the national nuclear infrastructure for the research reactor project on 8 issues in stages 1&2. (author)

A new methodology for cost-effectiveness studies of domestic radon remediation programmes: Quality-adjusted life-years gained within Primary Care Trusts in Central England

International Nuclear Information System (INIS)

Coskeran, Thomas; Denman, Antony; Phillips, Paul; Gillmore, Gavin; Tornberg, Roger

2006-01-01

Radon is a naturally occurring radioactive gas, high levels of which are associated with geological formations such as those found in Northamptonshire and North Oxfordshire in the UK. The UK's National Radiological Protection Board have designated both districts as radon Affected Areas. Radiation levels due to radon, therefore, exceed 200 Bq m -3 , the UK's domestic Action Level, in over one percent of domestic properties. Because of radon's radioactivity, exposure to the gas can potentially cause lung cancer, and has been linked to some 2000 deaths a year in the UK. Consequently, when radiation levels exceed the Action Level, remediation against radon's effects is recommended to householders. This study examines the cost-effectiveness of remediation measures in Northamptonshire and North Oxfordshire by estimating cost per quality-adjusted life-year gained in four Primary Care Trusts, organisations that play a key public health policy role in the UK's National Health Service. The study is the first to apply this approach to estimating the cost-effectiveness of radon remediation programmes. Central estimates of cost per quality-adjusted life-year in the four Primary Care Trusts range from Pounds 6143 to Pounds 10 323. These values, when assessed against generally accepted criteria, suggest the remediation programmes in the trusts were cost-effective. Policy suggestions based on the estimates, and designed to improve cost-effectiveness further, are proposed for the four Primary Care Trusts and the UK's National Health Service

76 FR 39402 - Proposed Information Collection Activity; Comment Request

Science.gov (United States)

2011-07-06

..., thereby reducing the amount of primary data collection needed. Respondents: RPG Grantees. Annual Burden... Information Collection Activity; Comment Request Title: Regional Partnership Grant (RPG) Program Data... and understand the outcomes. No other national data collection measures these critical child, adult...

75 FR 1555 - National Organic Program; Proposed Amendments to the National List of Allowed and Prohibited...

Science.gov (United States)

2010-01-12

... in organic crop production. Tetracycline is a broad-spectrum antibiotic for control of bacteria... also antibiotics used in human and animal drugs. Per the Federal Food, Drug, and Cosmetic Act (FFDCA... material in organic crop production. Consistent with the recommendations from the NOSB, this proposed rule...

Relay-Assisted Primary and Secondary Transmissions in Cognitive Radio Networks

KAUST Repository

Shafie, Ahmed El

2016-09-27

We assume a set of cognitive relay nodes that assists both primary and secondary transmissions in a time-slotted cognitive radio networks. To regulate the channel access of the various nodes in the network, we propose an overlapped spectrum sensing strategy for channel sensing, where the secondary source node senses the channel from the beginning of the time slot and the cognitive relay nodes sense the channel for double the sensing time used by the secondary source node to detect the activities of both the primary and secondary source nodes. Hence, the secondary source node has an intrinsic priority over the relay nodes. The relay nodes help both the primary user and the secondary user to deliver their unsuccessfully decoded packets at their destinations. In a given time slot, the scheduled relay node for data transmission starts its transmission when both the primary and secondary users are sensed to be inactive (i.e. have no data to transmit). We propose two optimization-based formulations with quality-of-service (QoS) constraints involving average queueing delay and average service rate requirements. We investigate both cases of perfect and imperfect spectrum sensing. To further enhance the users\\' QoS requirements, we propose three packet decoding strategies at the relay nodes and compare their performance. We derive an upper bound on the secondary queue average service rate to determine which decoding strategy can achieve that bound. Our numerical results show the benefits of relaying and its ability to enhance the performance of both the primary and secondary users. Moreover, the performance of the proposed schemes is close to the derived upper bound.

[Development of national neglect norm for urban primary school students of China].

Science.gov (United States)

Pan, Jian-ping; Wang, Fei; Li, Min; Chen, Jing-qi; Zhang, Hui-ying; Wang, Gui-xiang; Gu, Gui-xiong; Guo, Wei-wei; Peng, Yu-lin; Shi, Shu-hua; Chen, Guang-hu; Yi, Hua-ni; Fu, Ping; Xia, Li; Yu, Hong; Lu, Biao; Duan, Zhi-xian; Wang, Ying-xiong; Zhong, Zhao-hui; Li, Jian; Wang, Lin; Cao, Chun-hong; Luo, Sha-sha; Zhang, Song-jie; Zhang, Hua

2013-02-01

To develop the national neglect norms for urban primary school students in China. According to multi-stage stratified cluster sampling principle, 24 cities of 13 provinces (municipalities) in China were selected during December 1 to 31, 2008. A total of 1491 students in grade 1 - 3 and 2236 students in grade 4 - 6 were selected. Questionnaire was designed by authors and the final norms were determined through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norms. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm was completed. The two questionnaires of grade 1 - 3 and grade 4 - 6 students consisted of 55 and 57 items, respectively, whose item loadings were ranged from 0.301 to 0.687 and 0.321 to 0.730, which met the statistical requirements. For grade 1 - 3 students, the scale's total Cronbach α coefficients was 0.914, the total split-half reliability coefficients was 0.896, the Cronbach α coefficients of four level was above 0.737 except medical and social neglect, split-half reliability was ranged from 0.461 to 0.757; for grade 4-6 students, the scale's total Cronbach α coefficients was 0.916, split-half reliability was 0.883, except social neglect, the Cronbach α coefficients of other level was ranged 0.457 to 0.856, split-half reliability was ranged from 0.500 to 0.798. The total neglect cut-off score of the two scales grade 1-3 and 4-6 were 125 and 155, respectively. The structure of two norms was reasonable. The scales have good stability and reliability.

Interlibrary loan in primary access libraries: challenging the traditional view.

Science.gov (United States)

Dudden, R F; Coldren, S; Condon, J E; Katsh, S; Reiter, C M; Roth, P L

2000-10-01

Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Three hypotheses were developed. HI: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher

78 FR 78493 - National Rural Transportation Assistance Program: Solicitation for Proposals

Science.gov (United States)

2013-12-26

... effective and efficient public transportation in rural areas. Objective 2--To support State and local...; leveraging and adopting the current technology developed and used by National RTAP in the Cloud; performing... specifies what will be the costs associated with the project. A progress report after each project quarter...

75 FR 11327 - Proposed Establishment of Certification Programs for Health Information Technology

Science.gov (United States)

2010-03-10

... Certification Programs for Health Information Technology; Proposed Rule #0;#0;Federal Register / Vol. 75, No. 46... for Health Information Technology AGENCY: Office of the National Coordinator for Health Information... granted to the National Coordinator for Health Information Technology (the National Coordinator) by...

77 FR 77035 - Proposed Information Collection; Comment Request; Malcolm Baldrige National Quality Award and...

Science.gov (United States)

2012-12-31

... to Dawn Bailey, Baldrige Performance Excellence Program, 100 Bureau Drive, Stop 1020, National... Commerce is responsible for the Baldrige Performance Excellence Program (BPEP) and the Malcolm Baldrige... Collection; Comment Request; Malcolm Baldrige National Quality Award and Examiner Applications AGENCY...

Proposal for a EU quality label for aerospace education

Directory of Open Access Journals (Sweden)

Franco BERNELLI-ZAZZERA

2018-06-01

Full Text Available The paper presents a possible roadmap for the definition of a European quality label for aerospace related higher education degrees. The proposal is the result of a two-years long Horizon 2020 project that has involved a great portion of the European stakeholders in aerospace: Universities, research centres, industries (both small and large networks, associations and accreditation agencies. The core concept established is that it is possible to establish a sector-specific, content based, quality system, that can complement the existing national or European accreditation systems, providing added value to the internal and/or external quality assurance processes that are in place in most EU countries. The tools and processes proposed are sufficiently simple to be manageable by Universities in addition to their national accreditation processes or as stand-alone assessment. The main goal of the proposed process is the evaluation of the quality of the aerospace curricula in the European context, whereas the accreditation of the programme can be seen as an optional extension of the process, subject to further national regulations. The process is proposed in view of the awarding of a sector-specific, content based, quality label, to be issued by an appropriate legally recognized and qualified institution. 8 field tests with volunteering universities throughout Europe have been performed. They experienced the method as very practical and to the point.

Computational geomechanics and applications at Sandia National Laboratories

International Nuclear Information System (INIS)

Arguello, Jose Guadalupe Jr.

2010-01-01

Sandia National Laboratories (SNL) is a multi-program national laboratory in the business of national security, whose primary mission is nuclear weapons (NW). It is a prime contractor to the USDOE, operating under the NNSA and is one of the three NW national laboratories. It has a long history of involvement in the area of geomechanics, starting with the some of the earliest weapons tests at Nevada. Projects in which geomechanics support (in general) and computational geomechanics support (in particular) are at the forefront at Sandia, range from those associated with civilian programs to those in the defense programs. SNL has had significant involvement and participation in the Waste Isolation Pilot Plant (low-level defense nuclear waste), the Yucca Mountain Project (formerly proposed for commercial spent fuel and high-level nuclear waste), and the Strategic Petroleum Reserve (the nation's emergency petroleum store). In addition, numerous industrial partners seek-out our computational/geomechanics expertise, and there are efforts in compressed air and natural gas storage, as well as in CO 2 Sequestration. Likewise, there have also been collaborative past efforts in the areas of compactable reservoir response, the response of salt structures associated with reservoirs, and basin modeling for the Oil and Gas industry. There are also efforts on the defense front, ranging from assessment of vulnerability of infrastructure to defeat of hardened targets, which require an understanding and application of computational geomechanics. Several examples from some of these areas will be described and discussed to give the audience a flavor of the type of work currently being performed at Sandia in the general area of geomechanics.

National Energy Balance - 1986

International Nuclear Information System (INIS)

Anon.

1986-01-01

The National Energy Balance - 1986 shows energy fluxes of several primary and secondary energy sources, since the production to the final consumption in the main economic sectors, since 1970 to 1985. The incorporation of a new brazilian information is done. (E.G.) [pt

Low cycle fatigue of Alloy 690 and welds in a simulated PWR primary water environment

Energy Technology Data Exchange (ETDEWEB)

Hong, Jongdae; Cho, Pyungyeon; Jang, Changheui [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Cho, Pyungyeon [Khalifa Univ., Abu Dhabi (United Arab Emirates); Kim, Tae Soon; Lee, Yong Sung [Korea Hydro and Nuclear Power Co., Daejeon (Korea, Republic of)

2013-05-15

In this study, environmental fatigue tests for these materials were performed and the new prediction model of fatigue life of Alloy 690 and weld in primary water condition was proposed. To evaluate the fatigue life of Alloy 690 and 52M in a PWR environment, low cycle fatigue tests were performed and revised fatigue life prediction models and environmental factor were proposed. With the revised Fen model for Alloy 690 and 52M, the reliability of the fatigue life prediction has been improved. The reduction of low cycle fatigue life of metallic materials in the primary coolant water environments has been the subject of debate between the utility and regulator since 1980s. It became the significant licensing problem since the issue of RG-1.207 by U. S. NRC. The statistical model for the environmental factor, Fen, specified in RG-1.207 was based on the extensive test results accumulated by the ANL and Japanese national program. Of the materials, the limited fatigue life data of Ni-Cr-Fe alloys were used to develop the Fen for the alloys. Furthermore, test data for Alloy 690 and its weld are limited. Considering that Alloy 690 will be extensively used in the new nuclear power plants, additional effort to validate or improve current Fen model is required.

fantsika National Park

African Journals Online (AJOL)

We often observed domestic mammals such as cattle, cats and dogs in the forest at Ampijoroa. Although the primary forest in Ampijoroa is managed by Madagascar National Parks, local people leave these domestic animals in the forest. Introduced animals may be a threat to endemic animals. Cattle can be transmitters of ...

Perspectives on the value of advanced medical imaging: a national survey of primary care physicians.

Science.gov (United States)

Hughes, Christine M; Kramer, Erich; Colamonico, Jennifer; Duszak, Richard

2015-05-01

To understand perceptions of primary care physicians (PCPs) about the value of advanced medical imaging. A national quantitative survey of 500 PCPs was conducted using an online self-administered questionnaire. Questions focused on advanced medical imaging (CT, MRI, and PET) and its perceived impact on the delivery of patient care. Responses were stratified by physician demographics. Large majorities of the PCPs indicated that advanced imaging increases their diagnostic confidence (441; 88%); provides data not otherwise available (451; 90%); permits better clinical decision making (440; 88%); increases confidence in treatment choices (438; 88%), and shortens time to definitive diagnosis (430; 86%]). Most (424; 85%) believe that patient care would be negatively affected without access to advanced imaging. PCPs whose clinical careers predated the proliferation of advanced imaging modalities (>20 years of practice) assigned higher value to advanced imaging on several dimensions compared with younger physicians whose training overlapped widespread technology availability. By a variety of metrics, large majorities of PCPs believe that advanced medical imaging provides considerable value to patient care. Those whose careers predated the widespread availability of advanced imaging tended to associate it with even higher value. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Global nuclear waste repository proposal highlights Australia`s nuclear energy vacuum

Energy Technology Data Exchange (ETDEWEB)

Anon.

1999-06-01

The Pangea proposal is disscused and considered relevant to Australia. A five-year research program by the company has identified Australia and Argentina as having the appropriate geological, economic and democratic credentials for such a deep repository, with Australia being favoured. A deep repository would be located where the geology has been stable for several hundred million years, so that there need not be total reliance on a robust engineered barrier system to keep the waste securely isolated for thousands of years. It would be a commercial undertaking and would have dedicated port and rail infrastructure. It would take spent fuel and other wastes from commercial reactors, and possibly also waste from weapons disposal programs. Clearly, while the primary ethical and legal principle is that each country is entirely responsible for its own waste, including nuclear waste (polluter pays etc), the big question is whether the concept of an international waste repository is acceptable ethically. Political and economic questions are secondary to this. By taking a fresh look at the reasons for the difficulties which have faced most national repository programs, and discarding the preconception that each country must develop its own disposal facilities, it is possible to define a class of simple, superior high isolation sites which may provide a multi-national basis for solving the nuclear waste disposal problem. The relatively small volumes of high-level wastes or spent fuel which arise from nuclear power production make shared repositories a feasible proposition. For small countries, the economies of scale which can be achieved make the concept attractive. For all countries, objective consideration of the relative merits of national and multi-national solutions is a prudent part of planning the management of long-lived radioactive wastes

Recurrent Primary Spontaneous Pneumothorax is Common Following Chest Tube and Conservative Treatment

DEFF Research Database (Denmark)

Olesen, Winnie Hedevang; Lindahl-Jacobsen, Rune; Katballe, Niels

2016-01-01

INTRODUCTION: Previous studies on primary spontaneous pneumothorax reported variable recurrence rates, but they were based on heterogeneous patient populations including secondary pneumothorax. We investigated young patients with primary spontaneous pneumothorax exclusively and used a national...... registry to track readmissions and calculate independent predictors of recurrence. METHODS: A prospective cohort study of consecutive young patients who were admitted over a 5-year period with their first episode of primary spontaneous pneumothorax and treated conservatively with a chest tube. Baseline...... characteristics were obtained from questionnaires presented on admittance. All patients were discharged with fully expanded lungs on chest radiography. Patient charts were identified in the national electronic patient registry for detailed information on readmissions due to recurrent spontaneous pneumothorax...

Heart failure guidelines and prescribing in primary care across Europe

Directory of Open Access Journals (Sweden)

Hobbs FD Richard

2005-08-01

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

76 FR 17625 - Proposed Information Collection; Comment Request; Emergency Beacon Registrations

Science.gov (United States)

2011-03-30

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Emergency Beacon Registrations AGENCY: National Oceanic and Atmospheric... emergency radio beacon. Persons purchasing a digital distress beacon, operating in the frequency range of...

Literacy Education for Nursery School Children of Cross-National Marriages in Taiwan

Science.gov (United States)

Yeh, Yu-ching

2014-01-01

In the past decade, more and more Taiwanese men have married women from Southeast Asian countries and China. Children of cross-national marriages now account for one-tenth of primary school pupils. Previous research on primary and secondary school pupils' performance in different subjects has indicated that the children of cross-national marriages…

The United States Chiropractic Workforce: An alternative or complement to primary care?

Directory of Open Access Journals (Sweden)

Davis Matthew A

2012-11-01

Full Text Available Abstract Background In the United States (US a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation’s primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians. Methods We used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types. Results According to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson’s correlation 0.17, p-value  Conclusion These findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access.

Six elements of integrated primary healthcare.

Science.gov (United States)

Brown, Lynsey J; Oliver-Baxter, Jodie

2016-03-01

Integrated care has the potential to deliver efficiencies and improvements in patient experiences and health outcomes. Efforts towards integrated care, especially at the primary and community health levels, have increasingly been under focus, both nationally and internationally. In Australia, regional integration is a priority, and integration of care is a task for meso-level organisations such as Primary Health Networks (PHNs). This paper seeks to provide a list of elements and questions for consideration by organisations working across primary healthcare settings, looking to enact and improve the delivery of integrated care. Six elements that consistently emerged during the development of a series of rapid reviews on integrated primary healthcare in Australia are presented in this paper. The elements identified are context, governance and leadership, infrastructure, financing, engagement, and communication. They offer a starting point for reflection in the planning and practices of organisations in their drive for continuous improvements in integrated care.

Applying organizational behavior theory to primary care.

Science.gov (United States)

Mullangi, Samyukta; Saint, Sanjay

2017-03-01

Addressing the mounting primary care shortage in the United States has been a focus of educators and policy makers, especially with the passage of the Affordable Care Act in 2010 and the Medicare Access and CHIP Reauthorization Act in 2015, placing increased pressure on the system. The Association of American Medical Colleges recently projected a shortage of as many as 65,000 primary care physicians by 2025, in part because fewer than 20% of medical students are picking primary care for a career. We examined the issue of attracting medical students to primary care through the lens of organizational behavior theory. Assuming there are reasons other than lower income potential for why students are inclined against primary care, we applied various principles of the Herzberg 2-factor theory to reimagine the operational flow and design of primary care. We conclude by proposing several solutions to enrich the job, such as decreasing documentation requirements, reducing the emphasis on specialty consultations, and elevating physicians to a supervisory role.

Evidence-based medicine in primary care: qualitative study of family physicians

Directory of Open Access Journals (Sweden)

Dantas Guilherme

2003-05-01

Full Text Available Abstract Background The objectives of this study were: a to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM in primary care; b to investigate the influence of patient preferences on clinical decision-making; and c to explore the role of intuition in family practice. Method Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. Results Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. Discussion Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour.

Evidence-based medicine in primary care: qualitative study of family physicians.

Science.gov (United States)

Tracy, C Shawn; Dantas, Guilherme Coelho; Upshur, Ross E G

2003-05-09

The objectives of this study were: a) to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM) in primary care; b) to investigate the influence of patient preferences on clinical decision-making; and c) to explore the role of intuition in family practice. Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour.

Mode of primary cancer detection as an indicator of screening practice for second primary cancer in cancer survivors: a nationwide survey in Korea

Directory of Open Access Journals (Sweden)

Suh Beomseok

2012-11-01

Full Text Available Abstract Background While knowledge and risk perception have been associated with screening for second primary cancer (SPC, there are no clinically useful indicators to identify who is at risk of not being properly screened for SPC. We investigated whether the mode of primary cancer detection (i.e. screen-detected vs. non-screen-detected is associated with subsequent completion of all appropriate SPC screening in cancer survivors. Methods Data were collected from cancer patients treated at the National Cancer Center and nine regional cancer centers across Korea. A total of 512 cancer survivors older than 40, time since diagnosis more than 2 years, and whose first primary cancer was not advanced or metastasized were selected. Multivariate logistic regression was used to examine factors, including mode of primary cancer detection, associated with completion of all appropriate SPC screening according to national cancer screening guidelines. Results Being screen-detected for their first primary cancer was found to be significantly associated with completion of all appropriate SPC screening (adjusted odds ratio, 2.13; 95% confidence interval, 1.36–3.33, after controlling for demographic and clinical variables. Screen-detected cancer survivors were significantly more likely to have higher household income, have other comorbidities, and be within 5 years since diagnosis. Conclusions The mode of primary cancer detection, a readily available clinical information, can be used as an indicator for screening practice for SPC in cancer survivors. Education about the importance of SPC screening will be helpful particularly for cancer survivors whose primary cancer was not screen-detected.

The Development of a United Nations Counter-Terrorism Policy: A pragmatic approach to the problem of a definition of Terrorism

OpenAIRE

Turney-Harris, Latasha

2014-01-01

The primary object of this thesis is to propose a pragmatic solution to the legitimacy problems associated with the absence of a definition of Terrorism within United Nations Counter Terrorism Policy. It contends that the attempts to draft such a definition within the Ad Hoc Committee on Terrorism have now come to a political standstill and are unlikely to result in a strong legal definition of terrorism. Any outcome is likely to be a political compromise in nature. This thesis therefore ...

76 FR 38617 - Proposed Information Collection; Comment Request; Fishermen's Contingency Fund

Science.gov (United States)

2011-07-01

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Fishermen's Contingency Fund AGENCY: National Oceanic and Atmospheric Administration (NOAA). ACTION: Notice. SUMMARY: The Department of Commerce, as part of its continuing effort to...

Indicators for monitoring screening programs with primary HPV test.

Science.gov (United States)

Zorzi, Manuel; Giorgi Rossi, Paolo

2017-01-01

following scientific evidence produced in numerous studies, as well as national and international guidelines, organized cervical cancer screening programs in Italy have gradually introduced the HPV test as primary screening test, replacing cytology. As public health interventions, screening programs must ensure equity, improvement in quality of life, and adequate information for the population involved with regards to benefits and possible risks; therefore, it is essential for quality to be constantly checked at every phase of the project.The Italian Cervical Screening Group (Gruppo Italiano per lo Screening Cervicale, GISCi) has written a handbook for the calculation and interpretation of cervical screening program monitoring indicators that take into account the new protocol based on primary HPV test with cytology triage. based on the European guidelines and Italian recommendations on primary HPVbased screening, the working group, which includes professionals from all the fields involved in cervical screening, identified the essential points needed to monitor the screening process, the accuracy of individual tests, and early outcomes, defining a specific indicator for each aspect. The indicators were grouped as follows: baseline indicators, indicators for test repeat after one year, cumulative indicators, and waiting times. For every indicator, the source of data, calculation formula, any standards or critical thresholds, and interpretation were defined. The standards are based on the results of NTCC trials or Italian pilot studies. the main indicators proposed for the organization are the following: number of invitations, compliance with first invitation, with one-year test repeat and with colposcopy; for test and process accuracy, a cohort approach was utilised, where indicators are based on women who must be followed for at least one year, so as to integrate the results obtained after the first HPV test with the outcome of the test's repetition after one year

Trabecular metal acetabular components in primary total hip arthroplasty

DEFF Research Database (Denmark)

Laaksonen, Inari; Lorimer, Michelle; Gromov, Kirill

2018-01-01

Background and purpose - Trabecular metal (TM) cups have demonstrated favorable results in acetabular revision and their use in primary total hip arthroplasty (THA) is increasing. Some evidence show that TM cups might decrease periprosthetic infection (PPI) incidence. We compared the survivorship...... of TM cups with that of other uncemented cups in primary THA, and evaluated whether the use of TM cups is associated with a lower risk of PPI. Patients and methods - 10,113 primary THAs with TM cup and 85,596 THAs with other uncemented cups from 2 high-quality national arthroplasty registries were...

77 FR 46658 - Proposed Priority; Technical Assistance To Improve State Data Capacity-National Technical...

Science.gov (United States)

2012-08-06

... Assistance To Improve State Data Capacity--National Technical Assistance Center To Improve State Capacity To... and later years. We take this action to focus attention on an identified national need to provide TA to improve the capacity of States to meet the data collection requirements of the Individuals with...

78 FR 43863 - Proposed Collection; Comment Request

Science.gov (United States)

2013-07-22

... proposal and associated collection instruments, please write to: Defense Security Service, Industrial.... Needs and Uses: Executive Order 12829, ``National Industrial Security Program (NISP)'', (January 6, 1993... entered into agreements with the Secretary of Defense for industrial security services required for...

Proposed Fermilab fixed target experiment: Kaons at the Tevatron

International Nuclear Information System (INIS)

1993-12-01

The US Department of Energy (DOE) has prepared an Environmental Assessment (EA), DOE/EA-0898, evaluating the impacts associated with the proposed fixed target experiment at the Fermi National Accelerator Laboratory (Femilab) in Batavia, Illinois, known as Kaons at the Tevatron (KTeV). The proposed KTeV project includes reconfiguration of an existing target station, enhancement of an existing beam transport system connected to existing utility facilities, and construction of a new experimental detector hall area. The study of the K meson, a type of subatomic particle, has been going on at Fermilab for 20 years. The proposed KTEV project advances the search for the origins of a violation of a fundamental symmetry of nature called charge parity (CP) violation. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major Federal action significantly affecting the quality of the human environment, within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, the preparation of an Environmental Impact Statement is not required

78 FR 16301 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2013-03-14

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: LIGO Annual Review Site Visit at Hanford Observatory for Physics... Physics, National Science Foundation, Arlington, VA (703) 292-4432. [[Page 16302

Primary endosymbiosis: have cyanobacteria and Chlamydiae ever been roommates?

Directory of Open Access Journals (Sweden)

Philippe Deschamps

2014-12-01

Full Text Available Eukaryotes acquired the ability to process photosynthesis by engulfing a cyanobacterium and transforming it into a genuine organelle called the plastid. This event, named primary endosymbiosis, occurred once more than a billion years ago, and allowed the emergence of the Archaeplastida, a monophyletic supergroup comprising the green algae and plants, the red algae and the glaucophytes. Of the other known cases of symbiosis between cyanobacteria and eukaryotes, none has achieved a comparable level of cell integration nor reached the same evolutionary and ecological success than primary endosymbiosis did. Reasons for this unique accomplishment are still unknown and difficult to comprehend. The exploration of plant genomes has revealed a considerable amount of genes closely related to homologs of Chlamydiae bacteria, and probably acquired by horizontal gene transfer. Several studies have proposed that these transferred genes, which are mostly involved in the functioning of the plastid, may have helped the settlement of primary endosymbiosis. Some of these studies propose that Chlamydiae and cyanobacterial symbionts coexisted in the eukaryotic host of the primary endosymbiosis, and that Chlamydiae provided solutions for the metabolic symbiosis between the cyanobacterium and the host, ensuring the success of primary endosymbiosis. In this review, I present a reevaluation of the contribution of Chlamydiae genes to the genome of Archaeplastida and discuss the strengths and weaknesses of this tripartite model for primary endosymbiosis.

Vapor vacuum extraction treatability study at the Idaho National Engineering Laboratory

International Nuclear Information System (INIS)

Herd, M.D.; Matthern, G.; Michael, D.L.; Spang, N.; Downs, W.; Weidner, J.; Cleary, P.

1993-01-01

During the 1960s and early 1970s, barreled mixed waste containing volatile organic compounds (VOCS) and radioactive waste was buried at the Subsurface Disposal Area (SDA) at the Idaho National Engineering Laboratory (INEL) Radioactive Waste Management Complex (RWMC). Over time, some of the barrels have deteriorated allowing, VOC vapors to be released into the vadose zone. The primary VOC contaminates of concern are CCl 4 and trichloroethylene; however, chloroform, tetrachloroethylene, and 1,1,1-trichloroethane have also been detected. Vapor Vacuum Extraction (VVE) is one alternative being considered for remediation of the RWMC SDA vadose zone. A proposed pilot-scale treatability study (TS) will provide operation and maintenance costs for the design of the potential scale-up of the system

76 FR 61757 - Agency Information Collection Activities: Proposed Collection; Comment Request

Science.gov (United States)

2011-10-05

... Additional Survey of Master Teaching Fellows (MTFs) as Part of the Evaluation of the National Science... possible career in teaching. Under the NSF Teaching Fellowship and Master Teaching Fellowship track, the... NATIONAL SCIENCE FOUNDATION Agency Information Collection Activities: Proposed Collection; Comment...

76 FR 66998 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2011-10-28

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: LIGO Annual Review Site Visit at Hanford Observatory for Physics...: Partially Closed. Contact Person: Thomas Carruthers, Program Director, Division of Physics, National Science...

77 FR 14441 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2012-03-09

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: LIGO Annual Review Site Visit at Hanford Observatory for Physics...: Partially Closed. Contact Person: Thomas Carruthers, Program Director, Division of Physics, National Science...

76 FR 19147 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2011-04-06

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: LIGO Laboratory Annual Review at Livingston Observatory for Physics...: Partially Closed. Contact Person: Thomas Carruthers, Program Director, Division of Physics, National Science...

Audit of HIV counselling and testing services among primary healthcare facilities in Cameroon: a protocol for a multicentre national cross-sectional study.

Science.gov (United States)

Tianyi, Frank-Leonel; Tochie, Joel Noutakdie; Agbor, Valirie Ndip; Kadia, Benjamin Momo

2018-03-01

HIV testing is an invaluable entry point to prevention, care and treatment services for people living with HIV and AIDS. Poor adherence to recommended protocols and guidelines reduces the performance of rapid diagnostic tests, leading to misdiagnosis and poor estimation of HIV seroprevalence. This study seeks to evaluate the adherence of primary healthcare facilities in Cameroon to recommended HIV counselling and testing (HCT) procedures and the impact this may have on the reliability of HIV test results. This will be an analytical cross-sectional study involving primary healthcare facilities from all the 10 regions of Cameroon, selected by a multistaged random sampling of primary care facilities in each region. The study will last for 9 months. A structured questionnaire will be used to collect general information concerning the health facility, laboratory and other departments involved in the HCT process. The investigators will directly observe at least 10 HIV testing processes in each facility and fill out the checklist accordingly. Clearance has been obtained from the National Ethical Committee to carry out the study. Informed consent will be sought from the patients to observe the HIV testing process. The final study will be published in a peer-reviewed journal and the findings presented to health policy-makers and the general public. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Proposal of the Physicians' Working Group for Single-Payer National Health Insurance.

Science.gov (United States)

Woolhandler, Steffie; Himmelstein, David U; Angell, Marcia; Young, Quentin D

2003-08-13

The United States spends more than twice as much on health care as the average of other developed nations, all of which boast universal coverage. Yet more than 41 million Americans have no health insurance. Many more are underinsured. Confronted by the rising costs and capabilities of modern medicine, other nations have chosen national health insurance (NHI). The United States alone treats health care as a commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need. In this market-driven system, insurers and providers compete not so much by increasing quality or lowering costs, but by avoiding unprofitable patients and shifting costs back to patients or to other payers. This creates the paradox of a health care system based on avoiding the sick. It generates huge administrative costs that, along with profits, divert resources from clinical care to the demands of business. In addition, burgeoning satellite businesses, such as consulting firms and marketing companies, consume an increasing fraction of the health care dollar. We endorse a fundamental change in US health care--the creation of an NHI program. Such a program, which in essence would be an expanded and improved version of traditional Medicare, would cover every American for all necessary medical care. An NHI program would save at least 200 billion dollars annually (more than enough to cover all of the uninsured) by eliminating the high overhead and profits of the private, investor-owned insurance industry and reducing spending for marketing and other satellite services. Physicians and hospitals would be freed from the concomitant burdens and expenses of paperwork created by having to deal with multiple insurers with different rules, often designed to avoid payment. National health insurance would make it possible to set and enforce overall spending limits for the health care system, slowing cost growth over the long run. An NHI program

Rationale for revision and proposed changes of the WHO diagnostic criteria for polycythemia vera, essential thrombocythemia and primary myelofibrosis

International Nuclear Information System (INIS)

Barbui, T; Thiele, J; Vannucchi, A M; Tefferi, A

2015-01-01

The 2001/2008 World Health Organization (WHO)-based diagnostic criteria for polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) were recently revised to accomodate new information on disease-specific mutations and underscore distinguishing morphologic features. In this context, it seems to be reasonable to compare first major diagnostic criteria of the former WHO classifications for myeloproliferative neoplasm (MPN) and then to focus on details that have been discussed and will be proposed for the upcoming revision of diagnostic guidelines. In PV, a characteristic bone marrow (BM) morphology was added as one of three major diagnostic criteria, which allowed lowering of the hemoglobin/hematocrit threshold for diagnosis, which is another major criterion, to 16.5 g/dl/49% in men and 16 g/dl/48% in women. The presence of a JAK2 mutation remains the third major diagnostic criterion in PV. Subnormal serum erythropoietin level is now the only minor criterion in PV and is used to capture JAK2-unmutated cases. In ET and PMF, mutations that are considered to confirm clonality and specific diagnosis now include CALR, in addition to JAK2 and MPL. Also in the 2015 discussed revision, overtly fibrotic PMF is clearly distinguished from early/prefibrotic PMF and each PMF variant now includes a separate list of diagnostic criteria. The main rationale for these changes was to enhance the distinction between so-called masked PV and JAK2-mutated ET and between ET and prefibrotic early PMF. The proposed changes also underscore the complementary role, as well as limitations of mutation analysis in morphologic diagnosis. On the other hand, discovery of new biological markers may probably be expected in the future to enhance discrimination of the different MPN subtypes in accordance with the histological BM patterns and corresponding clinical features

Europeanizing Danish Primary School Students

DEFF Research Database (Denmark)

Ratner, Helene Gad

, the primary school’s annual national test was changed to better align with PISA’s scale of assessment. With the new test, PISA becomes more than a means for comparison between different (EU) countries as the ‘Danish’ data links up to PISA data. The paper explores how ‘Europeanised’ national test data......EU uses the OECD’s Programme for International Student Assessment (PISA) to assemble and govern the different member states’ student populations (Nóvoa and Lord, 2002; Grek, 2009). This paper explores how ‘Europe-building’ occurs through PISA-affected Danish governmental data practices. In 2015...... inwards, tracking a temporal movement within each individual. This resonates a shift in EU policy from ‘education’ to ‘learning’ (Ozga et al, 2011). The conception of the population has also changed. A big data analysis concluded that students’ national test results can predict their PISA performance...

Rapid turns in European renewable energy policy: advocacy and framing of the proposed trading of guarantees of origin

Energy Technology Data Exchange (ETDEWEB)

Nilsson, Maans; Nilsson, Lars J.; Ericsson, Karin

2008-10-15

The EU has assumed ambitious targets and strategies for the promotion of renewable sources of energy (RES) binding to all its member states. This report sets out to examine the proposed EU-wide policy instrument designed to help achieve the targets on renewable electricity and heat - the trading of Guarantees of Origin (GO). It analyses the fate of the GO trading proposal in the European policy-making machinery during 2007 and 2008. It first discusses its origins, key components and points of contention, and then examines key factors behind the policy development leading first to its development and subsequently to its abandonment in 2008. Addressing these factors, the report explores first the near-term policy-making process before and after the proposal on GO trading was tabled in January 2008, focusing on processes in the European bureaucracy and how they were influenced by different interest groups and member state governments. It then takes a step back and looks at how competing policy frames over time have shaped the GO instrument debate. Results show how a strong internal market frame acted as a primary driving force in the Commission throughout the 2000s to promote the GO trading instrument. The subsequent collapse of the GO trading proposal can be largely attributed to a) the lack of a strong lobby in favour of GO, b) the accumulated experience with and institutionalisation of national RES support policy, and c) growing general political concerns for supply security, innovation and competitiveness. In the end, the fall of the GO trading instrument is indicative of how the underlying political battle line between advocates of the European internal market and guardians of national interests has moved in favour of the latter in recent years. (author). refs

Introducing Pre-university Students to Primary Scientific Literature Through Argumentation Analysis

NARCIS (Netherlands)

Koeneman, Marcel; Goedhart, Martin; Ossevoort, Miriam

2013-01-01

Primary scientific literature is one of the most important means of communication in science, written for peers in the scientific community. Primary literature provides an authentic context for showing students how scientists support their claims. Several teaching strategies have been proposed using

76 FR 9734 - Endangered and Threatened Species; Proposed Threatened Status for Distinct Population Segments of...

Science.gov (United States)

2011-02-22

... Population Segments of the Bearded Seal AGENCY: National Marine Fisheries Service (NMFS), National Oceanic... December 10, 2010, we, NMFS, published a proposed rule to list the Beringia and Okhotsk Distinct Population..., 2010 (75 FR 77476), we published a proposed rule to list the Beringia and Okhotsk Distinct Population...

Implementation of the Brazilian primary standard for x-rays

International Nuclear Information System (INIS)

Peixoto, J.G.P.; Almeida, C.E.V. de

2002-01-01

In the field of ionizing radiation metrology, a primary standard of a given physical quantity is essentially an experimental set-up which allows one to attribute a numerical value to a particular sample of that quantity in terms of a unit given by an abstract definition. The absolute measurement of the radiation quantity air kerma, is performed with a free-air ionization chamber. A great deal of research to determine the absolute measurement resulted in different designs for primary standard free-air ionization chambers such as cilindrics or plane parallel chambers. The implementation of primary standard dosimetry with free-air ionization chambers is limited to the National Metrology Institutes - NMIs. Since 1975, the Bureau International des Poids et Mesures - BIPM has been conducting comparisons of NMIs primary free-air standard chambers in the medium energy x-rays range. These comparisons are carried out indirectly through the calibration at both the BIPM and at the NMI of one or more transfer ionization chambers at a series of four reference radiation qualities. The scientific work programme of the National Laboratory for Ionizing Radiation Metrology - LNMRI of the Institute of Radioprotection and Dosimetry - IRD, which belongs to the National Commission of Nuclear Energy - CNEN, includes the establishment of a primary standard for x-rays of medium energy x-ray range. This activity is justified by the demand to calibrate periodically Brazilian network of the secondary standards without losing quality of the measurement. The LNMRI decided to implement four reference radiation qualities establishing the use of a transfer chamber calibrated at BIPM. The LNMRI decided to implement the primary standard dosimetry using a free-air ionization chamber with variable volume, made by Victoreen, model 480. Parameters related to the measurement of the quantity air kerma were evaluated, such as: air absorption, scattering inside the ionization chamber, saturation, beam

75 FR 81315 - Earth Sciences Proposal Review Panel; Notice of Meeting

Science.gov (United States)

2010-12-27

... NATIONAL SCIENCE FOUNDATION Earth Sciences Proposal Review Panel; Notice of Meeting In accordance... announces the following meeting. Name: Proposal Review Panel in Earth Sciences (1569). Date and Time... Kelz, Program Director, Instrumentation & Facilities Program, Division of Earth Sciences, Room 785...

77 FR 27804 - Proposal Review Panel for Chemistry; Notice of Meeting

Science.gov (United States)

2012-05-11

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Chemistry; Notice of Meeting In accordance with the Federal Advisory Committee Act (Pub. L. 92- 463, as amended), the National Science Foundation announces the following meeting: Name: Centers for Chemical Innovation (CCI) Solar Fuels: Powering the...

75 FR 8408 - Agency Information Collection Activities: Proposed Collection; Comment Request

Science.gov (United States)

2010-02-24

... respondent confidentiality, also will be made available to researchers on CD-ROM and on the World Wide Web... NATIONAL SCIENCE FOUNDATION Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: National Science Foundation. ACTION: Notice and request for comments. SUMMARY: Under the...

76 FR 27369 - Agency Information Collection Activities: Proposed Collection; Comment Request

Science.gov (United States)

2011-05-11

... public use file is also made available on the world-wide Web. Data are obtained primarily by Web survey... NATIONAL SCIENCE FOUNDATION Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: National Science Foundation. ACTION: Notice and request for comments. SUMMARY: Under the...

75 FR 3493 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2010-01-21

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: University of Nebraska Site Visit in Physics (1208). Date and Time... Director for Elementary Particle Physics, National Science Foundation, 4201 Wilson Blvd., Arlington, VA...

75 FR 57298 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2010-09-20

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: University of Notre Dame Site Visit in Physics (1208). Date and Time..., Program Director for Physics Education and Disciplinary Research, National Science Foundation, 4201 Wilson...

75 FR 63865 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2010-10-18

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: Michigan State University Site Visit in Physics (1208). Date and Time... Reidy, Program Director for Elementary Particle Physics, National Science Foundation, 4201 Wilson Blvd...

75 FR 70951 - Proposal Review Panel for Physics; Notice of Meeting

Science.gov (United States)

2010-11-19

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel for Physics; Notice of Meeting In accordance... announces the following meeting. Name: LIGO Laboratory Annual Review at Hanford Observatory for Physics... Physics, National Science Foundation, (703) 292-7373. Purpose of Meeting: To provide an evaluation of the...

HANPP Collection: Global Patterns in Net Primary Productivity (NPP)

Data.gov (United States)

National Aeronautics and Space Administration — The Global Patterns in Net Primary Productivity (NPP) portion of the HANPP Collection maps the net amount of solar energy converted to plant organic matter through...

Quality of sickness certification in primary health care: a retrospective database study.

Science.gov (United States)

Skånér, Ylva; Arrelöv, Britt; Backlund, Lars G; Fresk, Magdalena; Aström, Amanda Waleh; Nilsson, Gunnar H

2013-04-12

In the period 2004-2009, national and regional initiatives were developed in Sweden to improve the quality of sickness certificates. Parameters for assessing the quality of sickness certificates in primary health care have been proposed. The aim of this study was to measure the quality of sickness certification in primary health care by means of assessing sickness certificates issued between 2004 and 2009 in Stockholm. This was a retrospective study using data retrieved from sickness certificates contained in the electronic patient records of 21 primary health care centres in Stockholm County covering six consecutive years. A total number of 236 441 certificates were used in the current study. Seven quality parameters were chosen as outcome measures. Descriptive statistics and regression models with time, sex and age group as explanatory variables were used. During the study period, the quality of the sickness certification practice improved as the number of days on first certification decreased and the proportion of duly completely and acceptable certificates increased. Assessment of need for vocational rehabilitation and giving a prognosis for return to work were not significantly improved during the same period. Time was the most influential variable. The quality of sickness certification practice improved for most of the parameters, although additional efforts to improve the quality of sickness certificates are needed. Measures, such as reminders, compulsory certificate fields and structured guidance, could be useful tools to achieve this objective.

Proposed Issuance of NPDES Permit for NTUA Kayenta WWTF

Science.gov (United States)

Public Notice of proposed Issuance of National Pollutant Discharge Elimination System Permit (NPDES No. NN0020281) for Navajo Tribal Utility Authority (“NTUA”) Kayenta Wastewater Treatment Facility.

78 FR 38996 - Proposed Collection; 60-Day Comment Request; Family Life, Activity, Sun, Health, and Eating...

Science.gov (United States)

2013-06-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; 60-Day Comment Request; Family Life, Activity, Sun, Health, and Eating (FLASHE) Study (NCI) Summary: In.... Proposed Collection: Family Life, Activity, Sun, Health, and Eating (FLASHE) Study 0925--NEW, National...

Does providing more services increase the primary hospitals' revenue? An assessment of national essential medicine policy based on 2,675 counties in China.

Directory of Open Access Journals (Sweden)

Fei Chen

Full Text Available To understand whether the increased outpatient service provision (OSP brings in enough additional income (excluding income from essential medicine for primary hospitals (INCOME to compensate for reduced costs of medicine.The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province. We fitted bivariate five-level random effects regression models to examine correlations between OSP and INCOME in terms of their mean values and dose-response effects of the essential medicine policy (EMP. We adjusted for the effects of time period and selected hospital resources.The estimated correlation coefficients between the two outcomes' mean values were strongly positive among provinces (r = 0.910, moderately positive among counties (r = 0.380, and none among hospitals (r = 0.002 and time (r = 0.007. The correlation between their policy effects was weakly positive among provinces (r = 0.234, but none at the county and hospital levels. However, there were markedly negative correlation coefficients between the mean and policy effects at -0.328 for OSP and -0.541 for INCOME at the hospital level.There was no evidence to suggest an association between the two outcomes in terms of their mean values and dose-response effects of EMP at the hospital level. This indicated that increased OSP did not bring enough additional INCOME. Sustainable mechanisms to compensate primary hospitals are needed.

Antidepressant medication use for primary care patients with and without medical comorbidities: a national electronic health record (EHR) network study.

Science.gov (United States)

Gill, James M; Klinkman, Michael S; Chen, Ying Xia

2010-01-01

Because comorbid depression can complicate medical conditions (eg, diabetes), physicians may treat depression more aggressively in patients who have these conditions. This study examined whether primary care physicians prescribe antidepressant medications more often and in higher doses for persons with medical comorbidities. This secondary data analysis of electronic health record data was conducted in the Centricity Health Care User Research Network (CHURN), a national network of ambulatory practices that use a common outpatient electronic health record. Participants included 209 family medicine and general internal medicine providers in 40 primary care CHURN offices in 17 US states. Patients included adults with a new episode of depression that had been diagnosed during the period October 2006 through July 2007 (n = 1513). Prescription of antidepressant medication and doses of antidepressant medication were compared for patients with and without 6 comorbid conditions: diabetes, coronary heart disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, and cancer. 20.7% of patients had at least one medical comorbidity whereas 5.8% had multiple comorbidities. Overall, 77% of depressed patients were prescribed antidepressant medication. After controlling for age and sex, patients with multiple comorbidities were less likely to be prescribed medication (adjusted odds ratio, 0.58; 95% CI, 0.35-0.96), but there was no significant difference by individual comorbidities. Patients with cerebrovascular disease were less likely to be prescribed a full dose of medication (adjusted odds ratio, 0.26; 95% CI, 0.08-0.88), but there were no differences for other comorbidities or for multiple comorbidities, and there was no difference for any comorbidities in the prescription of minimally effective doses. Patients with new episodes of depression who present to a primary care practice are not treated more aggressively if they have medical

78 FR 25309 - Proposal Review Panel Physics; Notice of Meeting

Science.gov (United States)

2013-04-30

... NATIONAL SCIENCE FOUNDATION Proposal Review Panel Physics; Notice of Meeting In accordance with..., 2013 8:30 a.m.-6:30 p.m. May 15, 2013 8:30 a.m.-6:00 p.m. Place: University of Maryland, College Park... Physics Frontier Center; National Science Foundation, 4201 Wilson Blvd., Arlington, VA 22230. Telephone...

INCA project for investigation of primary cosmic radiation spectrum

International Nuclear Information System (INIS)

Aleksandrov, K.V.; Erlykin, A.D.; Zhdanov, G.B.

2002-01-01

The scientific purposes of the INCA project and application of the ionization-neutron calorimeter for direct measurements of the cosmic rays spectrum and composition in the knee area and the primary electrons spectrum by 10 14 - 10 13 eV are discussed. The new effective method for the primary electrons and protons separation with the complex rejection coefficient of 10 -5 - 10 -6 is proposed for studying the primary electrons spectrum by E e > 1 TeV. The experimental and calculation data are in good agreement [ru

Spirometry in primary care for children with asthma.

Science.gov (United States)

Banasiak, Nancy Cantey

2014-01-01

Spirometry is an essential part of diagnosing a child with asthma. The National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA) expert panels recommend spirometry to be performed on children five years of age and older as an objective assessment of lung function, to diagnosis asthma, and for ongoing yearly management of asthma (GINA, 2012; NAEPP, 2007). According to the NAEPP expert panel, history and physical examination alone are not reliable to accurately diagnose asthma, exclude alternative diagnosis, or determine lung impairment (NAEPP, 2007 Dombkowski, Hassan, Wasilevich, and Clark (2010) found 52% of physicians who provide primary care to children used spirometry, but only 21% used spirometry according to the national guidelines, and only 35% of physicians surveyed were comfortable interpreting the test results. Zanconato, Meneghelli, Braga, Zacchello, and Baraldi (2005) found that 21% of spirometry readings were interpreted incorrectly, concluding that proper training and quality control were important to provide if spirometry in the primary care office setting is to be used. The purpose of this article is to review the appropriate use of spirometry in pediatric primary care.

Continuous Biometric Authentication for Authorized Aircraft Personnel: A Proposed Design

National Research Council Canada - National Science Library

Carrillo, Cassandra

2003-01-01

.... The primary goal of this thesis is to propose a hypothetical design for the use of a non- intrusive mechanism on the flight deck of an aircraft to provide continuous or periodic authentication...

76 FR 72003 - Proposed Collection, Laura Bush 21st Century Librarian Grant Program Evaluation

Science.gov (United States)

2011-11-21

... Services Act, Public Law 104-208 and is the primary source of federal support for the nation's 123,000... Century Librarian Grant Program Evaluation AGENCY: Institute of Museum and Library Services, National Foundation for the Arts and the Humanities. ACTION: Notice, request for comments, collection of information...

Second primary cancers after adjuvant radiotherapy in early breast cancer patients: A national population based study under the Danish Breast Cancer Cooperative Group (DBCG)

International Nuclear Information System (INIS)

Grantzau, Trine; Mellemkjær, Lene; Overgaard, Jens

2013-01-01

Background and purpose: To analyze the long-term risk of second primary solid non-breast cancer in a national population-based cohort of 46,176 patients treated for early breast cancer between 1982 and 2007. Patients and methods: All patients studied were treated according to the national guidelines of the Danish Breast Cancer Cooperative Group. The risk of second primary cancers was estimated by Standardised incidence ratios (SIRs) and multivariate Cox regression models were used to estimate adjusted hazard ratios (HR) among irradiated women compared to non-irradiated. All irradiated patients were treated on linear accelerators. Second cancers were a priori categorized into two groups; radiotherapy-associated- (oesophagus, lung, heart/mediastinum, pleura, bones, and connective tissue) and non-radiotherapy-associated sites (all other cancers). Results: 2358 second cancers had occurred during the follow-up. For the radiotherapy-associated sites the HR among irradiated women was 1.34 (95% CI 1.11–1.61) with significantly increased HRs for the time periods of 10–14 years (HR 1.55; 95% CI 1.08–2.24) and ⩾15 years after treatment (HR 1.79; 95% CI 1.14–2.81). There was no increased risk for the non-radiotherapy-associated sites (HR 1.04; 95% CI 0.94–1.1). The estimated attributable risk related to radiotherapy for the radiotherapy-associated sites translates into one radiation-induced second cancer in every 200 women treated with radiotherapy. Conclusions: Radiotherapy treated breast cancer patients have a small but significantly excess risk of second cancers

The association between socioeconomic status and visual impairments among primary glaucoma: the results from Nationwide Korean National Health Insurance Cohort from 2004 to 2013.

Science.gov (United States)

Sung, Haejune; Shin, Hyun Ho; Baek, Yunseng; Kim, Gyu Ah; Koh, Jae Sang; Park, Eun-Cheol; Shin, Jaeyong

2017-08-23

Glaucoma is one of the most leading causes of permanent visual impairments in Korea, and social expenses spent for the glaucoma are increasing. This study is to identify association between socioeconomic status and the visual impairments caused by primary glaucoma in Korea. This study is based on a cohort study using stratified representative samples in the National Health Insurance claim data from 2002 to 2013 with 1,025,340 representative subjects. Target subjects were patients who are newly diagnosed with primary glaucoma from 2004 to 2013. We conducted a multiple logistic regression analysis depending on the occurrence of visual impairment and its temporal order compared to the glaucoma diagnosis. Among 1728 patients with primary glaucoma, those with low and middle income shows higher odds ratio (OR) of the visual impairments than those with high income group (low income; OR = 3.42, 95% Confidential Interval (CI):2.06-5.66, middle income; OR = 2.13, 95% CI: 1.28-3.55), in case of the occurrence of the visual impairments preceded the diagnosis of glaucoma. Glaucoma patients without pre-existing glaucoma history before visual impairment have higher association between socioeconomic status and the occurrence of visual impairments by primary glaucoma. Since glaucoma had not been diagnosed and recognized yet, the differences may have been derived from the disparities of the awareness of the glaucoma. These findings call attention to the correlation between socioeconomic factors and the visual impairments by glaucoma, and raise public health needs over the importance of glaucoma awareness and eye screening for glaucoma, especially for low socioeconomic status.

77 FR 9137 - National Practitioner Data Bank

Science.gov (United States)

2012-02-15

... Parts 60 and 61 National Practitioner Data Bank; Proposed Rule #0;#0;Federal Register / Vol. 77, No. 31... CFR Parts 60 and 61 RIN 0906-AA87 National Practitioner Data Bank AGENCY: Health Resources and... section 1921 of the Social Security Act, governing the National Practitioner Data Bank, to incorporate...

Fast Appearance Modeling for Automatic Primary Video Object Segmentation.

Science.gov (United States)

Yang, Jiong; Price, Brian; Shen, Xiaohui; Lin, Zhe; Yuan, Junsong

2016-02-01

Automatic segmentation of the primary object in a video clip is a challenging problem as there is no prior knowledge of the primary object. Most existing techniques thus adapt an iterative approach for foreground and background appearance modeling, i.e., fix the appearance model while optimizing the segmentation and fix the segmentation while optimizing the appearance model. However, these approaches may rely on good initialization and can be easily trapped in local optimal. In addition, they are usually time consuming for analyzing videos. To address these limitations, we propose a novel and efficient appearance modeling technique for automatic primary video object segmentation in the Markov random field (MRF) framework. It embeds the appearance constraint as auxiliary nodes and edges in the MRF structure, and can optimize both the segmentation and appearance model parameters simultaneously in one graph cut. The extensive experimental evaluations validate the superiority of the proposed approach over the state-of-the-art methods, in both efficiency and effectiveness.

76 FR 44306 - Proposed Information Collection; Comment Request; Fisheries Finance Program Requirements

Science.gov (United States)

2011-07-25

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Fisheries Finance Program Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice. SUMMARY: The Department of Commerce, as part of its continuing...

A framework to evaluate proposals for scientific activities in wilderness

Science.gov (United States)

Peter Landres

2010-01-01

Every year, the four Federal wilderness management agencies - U.S. DOI Bureau of Land Management, Fish and Wildlife Service, National Park Service, and the USDA Forest Service - receive hundreds of proposals to conduct scientific studies within wilderness. There is no consistent and comprehensive framework for evaluating such proposals that accounts for the unique...

Primary health care and public policy.

Science.gov (United States)

Mangelsdorf, K L; Luna, J; Smith, H L

1988-01-01

The health problems of Ecuador are similar to those in other developing countries where the standard of living is low, and housing and sanitation are inadequate. Women, children, and those living in rural areas are those most severely affected. National policy has been to attempt to increase access to health care in rural areas through the construction of new facilities and the appointment of highly paid medical staff. However, little attention was paid to sociocultural factors, which caused the peasantry to reject the medical care system, or to problems of internal efficiency which inhibited utilization. Since the 1970s various national and international organizations have attempted to implement primary health care (PHC) through the use of trained community health workers (CHWs). The primary problems faced by the CHWs were shortages of medicines and supplies, an almost total lack of supervision, and lack of transportation available to take staff to isolated villages. The poor supervision is blamed for the 17% drop out rate among CHWs since 1980. Independent PHC programs have also been established in Ecuador by voluntary organizations. These work best when coordinated with governmental programs, in order to allow monitoring and to avoid the duplication of services. Problems with the establishment of PHC programs in Ecuador will continue, as the government has no clear cut policy, and difficulties financing on a broad national scale. Other problems include the absence of effective supervision and logistical support for even small pilot programs, and inconsistencies in the training and role definition for CHWs. These problems need to be met in the implementation of a national PHC policy.

Analysis of energy poverty in the light of the 2013 National Housing Survey (ENL). Energy poverty in the light of the 2013 National Housing Survey - Synthesis

International Nuclear Information System (INIS)

Bernard, Charles-Andre; Teissier, Olivier

2016-01-01

This study is based on the results of the French national housing survey (ENL, Enquete Nationale Logement) of 2013 which gives information on the housing stock and on tenure conditions for households in their primary residence. After a brief presentation of this source and of its limitations, this study aims at characterising households in a situation of energy poverty according to indicators defined by the ONPE (national observatory of energy poverty), and at assessing their dwelling conditions. It also aims at highlighting the different aspects of the phenomenon of energy poverty. Evolutions of indicators are considered on the 1996-2013 period, based on the survey results in 1996, 2002, 2006 and 2013. After a recall of the ONPE indicators, the authors discuss statistic results related to these indicators, try to assess the severity of the energy poverty phenomenon, and the impact of the 'energy check'. Social-economic characteristics of households are presented in a table and discussed, as well as housing characteristics, the case of social housing, some behavioural characteristics of households, financial supports for works and works performed by occupying owners. The next part comments evolutions of indicators, their continuities and deviations, by examining their sensitivity to energy prices, and their evolution in time. A synthesis of results is proposed and lessons learned are finally discussed. Appendices address various issues (factors influencing a statement of the cold, methodologies of calculation of indicators), and propose additional results, and values of indicators in time

Operating states of PFBR-primary sodium pump

International Nuclear Information System (INIS)

Sreedharan, K.V.; Rao, A.S.L.K.; Raju, C.; Kale, R.D.

1994-01-01

The proposed 500 MWe Prototype Fast Breeder Reactor (PFBR), the design of which is in progress at the Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam will be equipped with four centrifugal sodium pumps each in its primary and secondary circuits. This paper discusses the various operating states of the primary pumps viz. (i) normal steady state (ii) transient state operation. The paper also discusses the safe limits on the pump operating speed and a few design basis incidents. (author). 1 ref., 2 figs., 3 tabs

Health system challenges to integration of mental health delivery in primary care in Kenya--perspectives of primary care health workers.

Science.gov (United States)

Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

2013-09-30

Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other

Introducing Pre-University Students to Primary Scientific Literature through Argumentation Analysis

Science.gov (United States)

Koeneman, Marcel; Goedhart, Martin; Ossevoort, Miriam

2013-01-01

Primary scientific literature is one of the most important means of communication in science, written for peers in the scientific community. Primary literature provides an authentic context for showing students how scientists support their claims. Several teaching strategies have been proposed using (adapted) scientific publications, some for…

Cinema Sessions in Primary Care

Directory of Open Access Journals (Sweden)

Francisco Ignacio MORETA-VELAYOS

2016-04-01

Full Text Available For a long time films have been used in teaching and at various levels of professional training  and more specifically in the medical area. In this case, through the description of a project developed in a Primary Care Health Center, we intend to justify the use of movies as a tool that could ease, the sometimes difficult task of continued education among Primary Care professionals. We propose different aspects of everyday practice in which cinema can be potentially useful, as well as the way to include it in the Plan of Continued Education of the Centre and its accreditation.Films and issues discussed in each session, and the project evaluation, are detailed.

A Nineteenth-Century French Proposal to Use School Vouchers.

Science.gov (United States)

Van Vliet, W.; Smyth, J. A.

1982-01-01

In light of the current American interest in school vouchers as proposed by economist Milton Friedman, recapitulates the origins, content, and fate of an 1872 law drafted by a French parliamentary commission to establish a countrywide voucher scheme for primary schools. (NEC)

15 CFR 917.22 - National Projects funding.

Science.gov (United States)

2010-01-01

... Projects funding proposals will be expected to address: (1) The relevance of the proposed project to a... projects. Innovation and uniqueness will be significant factors in determining whether to fund a proposed... National Projects can be up to 100 percent of the total cost of the project involved. ...

[Effect of implementation of essential medicine system in the primary health care institution in China].

Science.gov (United States)

Huang, Donghong; Ren, Xiaohua; Hu, Jingxuan; Shi, Jingcheng; Xia, Da; Sun, Zhenqiu

2015-02-01

Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.

76 FR 38401 - National Institute of Child Health and Human Development; Revision to Proposed Collection...

Science.gov (United States)

2011-06-30

... (b) shall-- (1) incorporate behavioral, emotional, educational, and contextual consequences to enable... Director, Office of Science Policy, Analysis and Communication, National Institute of Child Health and.... Glavin, Deputy Director, Office of Science Policy, Analysis and Communications, National Institute of...

Medical home capabilities of primary care practices that serve sociodemographically vulnerable neighborhoods.

Science.gov (United States)

Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Schneider, Eric C

2010-06-14

Under current medical home proposals, primary care practices using specific structural capabilities will receive enhanced payments. Some practices disproportionately serve sociodemographically vulnerable neighborhoods. If these practices lack medical home capabilities, their ineligibility for enhanced payments could worsen disparities in care. Via survey, 308 Massachusetts primary care practices reported their use of 13 structural capabilities commonly included in medical home proposals. Using geocoded US Census data, we constructed racial/ethnic minority and economic disadvantage indices to describe the neighborhood served by each practice. We compared the structural capabilities of "disproportionate-share" practices (those in the most sociodemographically vulnerable quintile on each index) and others. Racial/ethnic disproportionate-share practices were more likely than others to have staff assisting patient self-management (69% vs 55%; P = .003), on-site language interpreters (54% vs 26%; P primary care practices serving sociodemographically vulnerable neighborhoods were more likely than other practices to have structural capabilities commonly included in medical home proposals. Payments tied to these capabilities may aid practices serving vulnerable populations.

Identification of early childhood caries in primary care settings.

Science.gov (United States)

Nicolae, Alexandra; Levin, Leo; Wong, Peter D; Dave, Malini G; Taras, Jillian; Mistry, Chetna; Ford-Jones, Elizabeth L; Wong, Michele; Schroth, Robert J

2018-04-01

Early childhood caries (ECC) is the most common chronic disease affecting young children in Canada. ECC may lead to pain and infection, compromised general health, decreased quality of life and increased risk for dental caries in primary and permanent teeth. A multidisciplinary approach to prevent and identify dental disease is recommended by dental and medical national organizations. Young children visit primary care providers at regular intervals from an early age. These encounters provide an ideal opportunity for primary care providers to educate clients about their children's oral health and its importance for general health. We designed an office-based oral health screening guide to help primary care providers identify ECC, a dental referral form to facilitate dental care access and an oral health education resource to raise parental awareness. These resources were reviewed and trialled with a small number of primary care providers.

Present situation and proposal for nuclear medicine development

International Nuclear Information System (INIS)

Oliva Gonzalez, Juan P.

2003-01-01

In the present paper, the current situation of the Cuban nuclear medicine, after its introduction in the country in the 40s of the 20 th century and its expansion since 1962 and, particularly, from the installation of the first gamma camera in 1980, is analyzed. Nowadays, there is a total 14 Nuclear Medicine Departments or Services in our country within the National Oncology Networks and national Health System (SNS), which provide medical attention to the population depending on the nuclear equipment available A Program for the medical and technical personnel's training is proposed, as well as for gradual development of nuclear medicine department's (including the installation of gamma cameras, divided into two stages: 2003-2004 and 2005-2006). The prospective results of the proposed program are analyzed, as well as the impact on the populations health

77 FR 18791 - Proposed Information Collection; Comment Request; NIST Associates Information System

Science.gov (United States)

2012-03-28

... DEPARTMENT OF COMMERCE National Institute of Standards and Technology Proposed Information Collection; Comment Request; NIST Associates Information System AGENCY: National Institute of Standards and... access to the NIST campuses or NIST resources. The NIST Associates Information System (NAIS) information...

Interprofessional Competencies in Integrative Primary Healthcare

Science.gov (United States)

Brooks, Audrey J.; Maizes, Victoria; Goldblatt, Elizabeth; Klatt, Maryanna; Koithan, Mary S.; Kreitzer, Mary Jo; Lee, Jeannie K.; Lopez, Ana Marie; McClafferty, Hilary; Rhode, Robert; Sandvold, Irene; Saper, Robert; Taren, Douglas; Wells, Eden; Lebensohn, Patricia

2015-01-01

In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 “meta-competencies” through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year. PMID:26421232

ILK statement about the proposed EU directives on nuclear safety and the management of radioactive waste

International Nuclear Information System (INIS)

2003-01-01

In November 2002, the European Commission proposed a package of measures for a community concept of the EU on nuclear safety. It includes a proposed directive on the safety of nuclear installations during operating and decommissioning, and a proposed directive on the management of radioactive waste. In the opinion of the International Nuclear Committee (ILK), the competences and obligations of the member states and their safety authorities must be preserved in the future. Primary responsibility for plant safety rests with the operator. This objective is served by transparent, harmonized EU-wide safety standards. New standards and definitions are not generally required. Harmonized safety standards to be developed should initially be limited to nuclear power plants because of the fundamental differences in design of nuclear facilities. The Commission should obtain the technical competence required to perform the duties arising from the application of the proposed directive. Formal inspections by the Commission of the national regulatory authorities are not necessary. Instead, a peer review process will be the better solution. A reporting system at three-year intervals is generally regarded as the most effective approach. The ILK considers the tight schedule for final storage, especially of high-level waste, problematic. Joint repository projects, also for countries with low waste arisings, are suitable approaches. The envisaged reports about the state of radioactive waste management should be integrated into the reporting systems under other international agreements. The Commission's intention to intensify cooperation in the field of research is welcomed. (orig.) [de

Stress sources and manifestations in a nation-wide sample of pre-primary, primary and secondary educators in Greece

Directory of Open Access Journals (Sweden)

Nadia eKourmousi

2016-04-01

Full Text Available BackgroundTeachers experience high levels of stress as a result of their professional duties and research has shown a growing interest in this phenomenon during the recent years. Aim of this study was to explore the associations of stress sources and manifestations with individual and job-related characteristics in educators of all levels. MethodsIn a cross–sectional design, following an informative e-campaign on the study aims through the official and the main teachers’ portals in Greece, respondents completed online the Teachers Stress Inventory (TSI and the 14-item Perceived Stress Scale (PSS-14. 974 male and 2473 female pre-primary, primary and secondary educators with a mean age of 41.2 years responded. ResultsWomen and younger teachers reported significantly higher levels of stress, mainly due to lack of time and other work-related stressors, and also more emotional and gastronomic manifestations. Increased age and working experience were associated with lower levels of several stress sources. Teachers of administrative positions had increased time management stressors, but less professional distress, professional investment and discipline and motivation stressors. Additionally, working and residing far from family increased teachers’ stress levels associated to control, motivation and investment. Teachers of pre-primary education had reduced professional investment and motivation stress factors while vocational lyceum teachers of secondary education reported less work-related stressors and manifestations and more discipline and motivation related ones. Having students supported or in need of support from special educators and students with difficulties in speaking or comprehension was associated with most of the teachers' stress sources and manifestations (i.e. TSI subscales. Finally, colleagues’ and mainly supervisors' support seemed to provide a strong and consistent protection against both stress sources and manifestations

global health strategies versus local primary health care priorities

African Journals Online (AJOL)

CARE PRIORITIES - A CASE STUDY. OF NATIONAL ... development of comprehensive primary health care (pHC). The routine ..... on injection safety will be sustainable. On the negative side, ... This is mainly at management level, where time ...

Three proposals for revitalising the European Union

Directory of Open Access Journals (Sweden)

Mario Tonveronachi

2016-12-01

Full Text Available Widespread perception that convergence on the current set of rules is not capable of producing convergence on results, or anyway generally better results, has increased the socio-political fragmentation inside the European Union. The result has been an increasing demand for a partial re-nationalisation of sovereign powers, whose physiology comes from the necessity of higher national flexibility. Asking how feasible changes in the current set of rules could accommodate the increased demand of national flexibility, the paper focuses on the euro area and proposes to revise the monetary operations of the European Central Bank, current fiscal rules, and the financial regulatory approach. The proposed new design is based on the premise that no changes in the Treaty on the Functioning of the European Union are possible at the moment, even though a minimum political convergence is necessary. If successfully implemented, the proposal would contribute to give a viable perspective to the design of the Economic and Monetary Union, capable of attracting those EU non-euro area countries that consider the mismanagement of the recent crisis and of its after-effects reason enough for resisting further losses of sovereignty. JEL: E52, E62, F33, F36, F45, G28

National Wildlife Refuges of Louisiana, UTM Zone 15 NAD83, USFWS (2001) [National_Wildlife_Refuges_LA_USFWS_2001

Data.gov (United States)

Louisiana Geographic Information Center — National Wildlife Refuges are federal lands managed by the U.S. Fish and Wildlife Service (USFWS). The primary source for boundary information is the USFWS Realty...

[Primary care in Ireland].

Science.gov (United States)

Sánchez-Sagrado, T

Spanish doctors are still leaving the country to look for quality work. Ireland is not a country with many Spanish professionals but it is interesting to know its particular Health care system. Ireland is one of the countries with a national health care system, although it has a mixture of private health care insurance schemes. People have a right to health care if they have been living in Ireland at least for a year. Access to the primary care health system depends on age and income: free of charge for Category 1 and co-payments for the rest. This division generates great inequalities among the population. Primary Care doctors are self-employed, and they work independently. However, since 2001 they have tended to work in multidisciplinary teams in order to strengthen the Primary Care practice. Salary is gained from a combination of public and private incomes which are not differentiated. The role of the General Practitioner consists in the treatment of acute and chronic diseases, minor surgery, child care, etc. There is no coordination between Primary and Secondary care. Access to specialised medicine is regulated by the price of consultation. Primary Care doctors are not gatekeepers. To be able to work here, doctors must have three years of training after medical school. After that, Continuing Medical Education is compulsory, and the college of general practitioners monitors it annually. The Irish health care system does not fit into the European model. Lack of a clear separation between public and private health care generates great inequalities. The non-existence of coordination between primary and specialised care leads to inefficiencies, which Ireland cannot allow itself after a decade of economic crisis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

75 FR 73125 - Proposed Information Collection; National Park Service Visitor Survey Card

Science.gov (United States)

2010-11-29

... general management plan. The Government Performance and Results Act (GPRA) of 1993 (Pub. L. 103-62... unit and System-wide. This effort is required by GPRA and other NPS and DOI strategic planning efforts... safety. Other Federal mandates (National Environmental Policy Act and NPS Management Policies) require...

An application of multiple criteria decision-making techniques for ranking different national Iranian oil refining and distribution companies

Directory of Open Access Journals (Sweden)

Ibrahim Nazari

2012-10-01

Full Text Available Performance measurement plays an essential role on management of governmental agencies especially when profitability is not the primary concern and we need to consider other important factors than profitability such as customer satisfaction, etc. In this paper, we propose a multi-criteria decision making method to rank different national Iranian oil refining and distribution companies. The proposed study of this paper uses six factors including per capita supply, energy cost, physical productivity of labor, staff participation, quality control inspection of stations and education per capita. The proposed study uses Entropy to find the relative importance of each criterion and TOPSIS to rank 37 alternatives based on cities and three regions. The results of the implementation of our method indicate that central regions close to capital city of the country maintains the highest ranking (0.9122 while southern regions maintains the lowest comes in the lowest priority (0.0569 and the northern region is in the middle (0.7635.

National Tests and minorities

DEFF Research Database (Denmark)

Andreasen, Karen Egedal

Assessment in school represent a technology and materiality with profound impact on the life, activities and interactions in school (eg. Lawn & Grosvenor, 2005). It can be considered as an integrated and in different ways also dominating part of pedagogic practice which influence processes of in...... – in the classroom – as well as at the macro level – the nation.The practice of teachers offering national tests occurs in different forms in primary schools throughout the world (eg. McNess et al. 2015). These practices are often associated with a curriculum and learning objectives that are nationalistic...... in their orientation. In a policy perspective, the underlying motive may be a desire to evaluate and compare students’ academic development and performance as well as schools’ performance and goal attainment at the national level. National testing are based on the assumption that the tested pupils all speak the same...

25 CFR 900.125 - What shall a construction contract proposal contain?

Science.gov (United States)

2010-04-01

... organization shall also include in its construction contract proposal the following: (1) In the case of a... accept the tribally proposed standards; and (2) In the case of a contract for construction activities... methods (including national, regional, state, or tribal building codes or construction industry standards...

78 FR 58608 - Proposed Collection; Comment Request for the EFTPS Primary Contact Information Change Form

Science.gov (United States)

2013-09-24

... form is being submitted for renewal purposes only. Type of Review: Extension of a currently approved... EFTPS Primary Contact Information Change Form AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... effort to reduce paperwork and respondent burden, invites the general public and other Federal agencies...

Net primary productivity of subalpine meadows in Yosemite National Park in relation to climate variability

Science.gov (United States)

Peggy E. Moore; Jan W. van Wagtendonk; Julie L. Yee; Mitchel P. McClaran; David N. Cole; Neil K. McDougald; Matthew L. Brooks

2013-01-01

Subalpine meadows are some of the most ecologically important components of mountain landscapes, and primary productivity is important to the maintenance of meadow functions. Understanding how changes in primary productivity are associated with variability in moisture and temperature will become increasingly important with current and anticipated changes in climate....

75 FR 42376 - Proposed Information Collection; Comment Request; NTIA/FCC Web-based Frequency Coordination System

Science.gov (United States)

2010-07-21

... Information Collection; Comment Request; NTIA/FCC Web- based Frequency Coordination System AGENCY: National.... Abstract The National Telecommunications and Information Administration (NTIA) hosts a Web-based system...) bands that are shared on a co-primary basis by federal and non-federal users. The Web-based system...

Nutrition knowledge and nutritional status of primary school children ...

African Journals Online (AJOL)

2010-01-04

Jan 4, 2010 ... are a decreased fibre intake and increased intakes of total protein and animal protein ... has implemented various national nutrition and primary health- .... fish, chicken, dried beans, legumes, peas and soy, 4) the dairy group,.

Conflict-affected displaced persons need to benefit more from HIV and malaria national strategic plans and Global Fund grants

Directory of Open Access Journals (Sweden)

Paik Eugene

2010-01-01

Full Text Available Abstract Background Access to HIV and malaria control programmes for refugees and internally displaced persons (IDPs is not only a human rights issue but a public health priority for affected populations and host populations. The primary source of funding for malaria and HIV programmes for many countries is the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund. This article analyses the current HIV and malaria National Strategic Plans (NSPs and Global Fund approved proposals from rounds 1-8 for countries in Africa hosting populations with refugees and/or IDPs to document their inclusion. Methods The review was limited to countries in Africa as they constitute the highest caseload of refugees and IDPs affected by HIV and malaria. Only countries with a refugee and/or IDP population of ≥ 10,000 persons were included. NSPs were retrieved from primary and secondary sources while approved Global Fund proposals were obtained from the organisation's website. Refugee figures were obtained from the United Nations High Commissioner for Refugees' database and IDP figures from the Internal Displacement Monitoring Centre. The inclusion of refugees and IDPs was classified into three categories: 1 no reference; 2 referenced; and 3 referenced with specific activities. Findings A majority of countries did not mention IDPs (57% compared with 48% for refugees in their HIV NSPs. For malaria, refugees were not included in 47% of NSPs compared with 44% for IDPs. A minority (21-29% of HIV and malaria NSPs referenced and included activities for refugees and IDPs. There were more approved Global Fund proposals for HIV than malaria for countries with both refugees and IDPs, respectively. The majority of countries with ≥10,000 refugees and IDPs did not include these groups in their approved proposals (61%-83% with malaria having a higher rate of exclusion than HIV. Interpretation Countries that have signed the 1951 refugee convention have an obligation

Academy panel proposes new form of regional institution

International Nuclear Information System (INIS)

Kloman, E.H.

1977-01-01

A panel of the National Academy of Public Administration has proposed development of a new form of interstate regional institution as an instrument for the siting, licensing, and regulating of nuclear facilities. Noting the danger that the nation's energy supplies may prove inadequate to meet basic needs of the economy despite increasing emphasis on greater use of coal and energy conservation, the panel pointed to the virtual stalemate in the national decision-making process for siting and licensing nuclear plants. A basic cause of the logjam is the growing conflict and overlap between federal and state agencies for authorizing nuclear development. The panel recommended setting up a new form of regional organization to fill an institutional void between federal and state levels of government. The proposed regional organizations would be established through federal legislation preempting to the Federal Government the regulation of siting, licensing, and construction of nuclear facilities. They would have jurisdiction over all matters in the operation of nuclear plants relating to public health and safety including those environmental factors and socio-economic factors covered in the preparation of environmental impact statements

78 FR 27189 - Proposed Information Collection; Comment Request; Developing Social Wellbeing Indicators for...

Science.gov (United States)

2013-05-09

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Developing Social Wellbeing Indicators for Marine Management AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice. SUMMARY: The Department of...

Child-Labor Proposal Eyes Private Model

Science.gov (United States)

Cech, Scott J.

2007-01-01

Proposed child-labor-rule changes--the most ambitious in 30 years--would carve out a permanent exemption to U.S. Department of Labor regulations for the work-study program run by a national network of Roman Catholic high schools. The program is a requirement of the Chicago-based Cristo Rey Network, which now has 12 high schools around the country…

76 FR 22383 - National Fire Codes: Request for Proposals for Revision of Codes and Standards

Science.gov (United States)

2011-04-21

... Chemical Extinguishing Systems. NFPA 22-2008 Standard for Water 5/23/2011 Tanks for Private Fire Protection... Ensembles for Technical Rescue Incidents. NFPA 1925-2008 Standard on Marine Fire- 5/23/2011 Fighting Vessels... DEPARTMENT OF COMMERCE National Institute of Standards and Technology National Fire Codes: Request...