WorldWideScience

Sample records for provide adequate definition

  1. Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

    Science.gov (United States)

    Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

    2017-07-01

    To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

  2. Does the new conceptual framework provide adequate concepts for reporting relevant information about performance?

    NARCIS (Netherlands)

    Brouwer, A.; Faramarzi, A; Hoogendoorn, M.

    2014-01-01

    The basic question we raise in this paper is whether the 2013 Discussion Paper (DP 2013) on the Conceptual Framework provides adequate principles for reporting an entity’s performance and what improvements could be made in light of both user needs and evidence from academic literature. DP 2013

  3. A model for determining when an analysis contains sufficient detail to provide adequate NEPA coverage for a proposed action

    International Nuclear Information System (INIS)

    Eccleston, C.H.

    1994-11-01

    Neither the National Environmental Policy Act (NEPA) nor its subsequent regulations provide substantive guidance for determining the Level of detail, discussion, and analysis that is sufficient to adequately cover a proposed action. Yet, decisionmakers are routinely confronted with the problem of making such determinations. Experience has shown that no two decisionmakers are Likely to completely agree on the amount of discussion that is sufficient to adequately cover a proposed action. one decisionmaker may determine that a certain Level of analysis is adequate, while another may conclude the exact opposite. Achieving a consensus within the agency and among the public can be problematic. Lacking definitive guidance, decisionmakers and critics alike may point to a universe of potential factors as the basis for defending their claim that an action is or is not adequately covered. Experience indicates that assertions are often based on ambiguous opinions that can be neither proved nor disproved. Lack of definitive guidance slows the decisionmaking process and can result in project delays. Furthermore, it can also Lead to inconsistencies in decisionmaking, inappropriate Levels of NEPA documentation, and increased risk of a project being challenged for inadequate coverage. A more systematic and less subjective approach for making such determinations is obviously needed. A paradigm for reducing the degree of subjectivity inherent in such decisions is presented in the following paper. The model is specifically designed to expedite the decisionmaking process by providing a systematic approach for making these determination. In many cases, agencies may find that using this model can reduce the analysis and size of NEPA documents

  4. Are parents in the UK equipped to provide adequate burns first aid?

    Science.gov (United States)

    Graham, Hamish E; Bache, Sarah E; Muthayya, Preetha; Baker, Julie; Ralston, David R

    2012-05-01

    Simple first aid following a burn injury has been shown to improve outcome. With this in mind, a prospective study was conducted to evaluate the knowledge of burns first aid amongst parents in South Yorkshire, United Kingdom. This information was used to identify which aspects of burn first aid need to be highlighted in an education campaign and who the target audience should be. A simple mnemonic is suggested to assist parental education on the topic. Parents attending outpatient clinics at Sheffield Children's Hospital were interviewed and asked about the first aid they would provide for a child with a large scald. Removal of hot clothes and jewellery; application of cold water for 10-20 min; obtaining medical advice; and covering the burn with a plastic film or clean cloth were all considered to be ideal responses. Variations in responses in relation to the age and ethnicity of the parent were noted. One hundred and eighty eight parents were included in the questionnaire. Of these, 81% (n=152) were white British and 20% (n=36) were from other ethnic groups. Only 10% (n=18) of all respondent would give all the ideal first aid steps. Less than 40% (n=73) of parents questioned would remove hot clothes and jewellery. There was no significant difference in responses between ethnic groups when assessing knowledge of the need to remove hot soaked clothing. Although 73% (n=137) of parents would run the burn under cool water, only 35% (n=66) would cool the burn for an adequate length of time. White British parents were significantly more likely to run cool water over the burn, and to continue this for the recommended 10-20 min. Whilst 88% (n=165) of parents would seek medical attention, this was significantly less in parents under 20 years old. Finally, 92% (n=173) of parents would protect the wound with appropriate dressings, but of note, 26% (n=9) of parents from minority ethnic groups would potentially impair burn healing by using inappropriate dressings and topical

  5. Funding an Adequate Education for America's Youth: A Plan for Melding Political and Market Definitions of Educational Adequacy.

    Science.gov (United States)

    Guthrie, James W.

    Noting that American society has conventionally relied on both the political process and the marketplace to arrive at a "definition" of adequate education, but that the political process fails to account for individual preferences while the marketplace can cater to many individual preferences, this paper attempts to combine the two…

  6. Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement.

    Science.gov (United States)

    Powell, Arfon G M T; Paterson-Brown, Simon; Drummond, Gordon B

    2014-02-20

    Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as "too esoteric", the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and "fitness for purpose", and avoid omission of vital knowledge.

  7. Are doctor of pharmacy curricula in developing countries adequate to train graduates to provide pharmaceutical care?

    Directory of Open Access Journals (Sweden)

    Ramalingam Peraman

    2017-01-01

    Full Text Available Doctor of Pharmacy (PharmD program is a new dimension of pharmacy education in developing countries. The PharmD graduates are expected to participate in patient health care by providing pharmaceutical care. The graduates should have enough necessary clinical knowledge, competitiveness and skills in community, hospital and clinical pharmacy related services. There is a need of curriculum that fit into the program outcome that helps to attain graduate competency. Programs in India, Pakistan, Iran and Nepal were reviewed based on the available literature. Even though it is evident that the PharmD curriculum in developing countries has made an attempt to provide patient-oriented approach for pharmacists, the existing curriculum, training and orientation have several pitfalls. It needs assessment, evaluation and improvement.

  8. Adequate Education: Issues in Its Definition and Implementation. School Finance Project, Working Papers.

    Science.gov (United States)

    Tron, Esther, Ed.

    Section 1203 of the Education Amendments of 1978 mandated the undertaking of studies concerning the adequate financing of elementary and secondary education in the 1980s. Created to carry out this mandate, the School Finance Project established as one of its goals reporting to Congress on issues implicit in funding educational adequacy. Several…

  9. Pregnant x-ray technologist: providing adequate radiation safety for the fetus

    International Nuclear Information System (INIS)

    Caprio, M.L. Jr.

    1980-01-01

    The human embryo-fetus is highly radiosensitive and must be protected from excessive exposure to ionizing radiation. The maximum permissible dose equivalent for the developing embryo-fetus is set at 0.5 rem per year - the MPD level for members of the general public. Methods by which supervisory personnel can limit the fetal dose incurred by the occupational exposure of the mother are presented. It is recommended that supervisory personnel attempt to limit occupational exposure to the current non-occupational MPD levels for all x-ray technologists, thereby, insuring that the fetal dose limits are not surpassed and providing an added safety factor for personnel by keeping exposures as low as reasonably achievable

  10. Providing adequate economic incentives for bioenergies with CO2 capture and geological storage

    International Nuclear Information System (INIS)

    Ricci, Olivia

    2012-01-01

    Knowing that carbon capture and storage (CCS) could play an important role in reducing emissions, it is important to have a good understanding of this role and the importance of environmental policies to support carbon capture and geological storage from bioenergies (BECCS). To date CCS technologies are not deployed on a commercial level, and policy instruments should be used to provide incentives to firms to use these technologies to reduce pollution. The aim of this paper is to compare the cost-efficiency of several incentive-based instruments (a fossil fuel tax, an emissions tax, a cap and trade system, and a subsidy on captured emissions) needed to spur the adoption of CCS and BECCS, using a dynamic general equilibrium model. This type of model has become the standard for assessing economy-wide impacts of environmental and technological policies. The study shows that BECCS will be deployed only if a specific subsidy per unit of biomass emissions captured with a CCS technology is available. We show also that the two most cost-efficient instruments for achieving a given emissions reduction target are a specific subsidy that rewards captured emissions and a carbon tax whose revenues are recycled to subsidize BECCS. - Highlights: ► We investigate the suitability of economic instruments to support CCS and BECCS. ► We model CCS and BECCS in a dynamic general equilibrium model. ► We compare the cost-efficiency of economic instruments to reduce emissions. ► A subsidy that rewards biomass captured emissions is appropriate to encourage BECCS. ► A carbon tax whose revenues are recycled to subsidize BECCS is cost-efficient.

  11. Do clinical examination gloves provide adequate electrical insulation for safe hands-on defibrillation? I: Resistive properties of nitrile gloves.

    Science.gov (United States)

    Deakin, Charles D; Lee-Shrewsbury, Victoria; Hogg, Kitwani; Petley, Graham W

    2013-07-01

    Uninterrupted chest compressions are a key factor in determining resuscitation success. Interruptions to chest compression are often associated with defibrillation, particularly the need to stand clear from the patient during defibrillation. It has been suggested that clinical examination gloves may provide adequate electrical resistance to enable safe hands-on defibrillation in order to minimise interruptions. We therefore examined whether commonly used nitrile clinical examination gloves provide adequate resistance to current flow to enable safe hands-on defibrillation. Clinical examination gloves (Kimberly Clark KC300 Sterling nitrile) worn by members of hospital cardiac arrest teams were collected immediately following termination of resuscitation. To determine the level of protection afforded by visually intact gloves, electrical resistance across the glove was measured by applying a DC voltage across the glove and measuring subsequent resistance. Forty new unused gloves (control) were compared with 28 clinical (non-CPR) gloves and 128 clinical (CPR) gloves. One glove in each group had a visible tear and was excluded from analysis. Control gloves had a minimum resistance of 120 kΩ (median 190 kΩ) compared with 60 kΩ in clinical gloves (both CPR (median 140 kΩ) and non-CPR groups (median 160 kΩ)). Nitrile clinical examination gloves do not provide adequate electrical insulation for the rescuer to safely undertake 'hands-on' defibrillation and when exposed to the physical forces of external chest compression, even greater resistive degradation occurs. Further work is required to identify gloves suitable for safe use for 'hands-on' defibrillation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Study to Determine Adequate Margins in Radiotherapy Planning for Esophageal Carcinoma by Detailing Patterns of Recurrence After Definitive Chemoradiotherapy

    International Nuclear Information System (INIS)

    Button, Michael R.; Morgan, Carys A.; Croydon, Elizabeth S.; Roberts, S. Ashley; Crosby, Thomas D.L.

    2009-01-01

    Purpose: To ascertain the adequacy of radiotherapy (RT) margins by studying the relapse patterns after definitive chemoradiotherapy for carcinoma of the esophagus. Methods and Materials: We performed a retrospective study assessing the first site of disease relapse after definitive chemoradiotherapy that included four 3-weekly cycles of cisplatin and continuous infusion 5-fluorouracil, with conformal RT (50 Gy in 25 fractions) concurrent with Cycles 3 and 4. The RT planning target volume was the endoscopic ultrasonography/computed tomography-defined gross tumor volume with 1.5-cm lateral and 3-cm superoinferior margins. Results: A total of 145 patients were included. Their average age was 65.4 years, 45% had adenocarcinoma, 61% had lower third esophageal tumors, and 75% had Stage III-IVA disease. After RT, of 142 patients, 85 (60%) had evidence of relapse at a median follow-up of 18 months. The relapse was local (within the RT field) in 55; distant (metastatic) in 13, and a combination of local and distant in 14. The local relapse rates were not influenced by tumor stage, lymph node status, or disease length. Three patients developed a relapse in regions adjacent to the RT fields; however, it is unlikely that larger field margins would have been clinically acceptable or effective in these cases. The median overall survival was 15 months. Conclusion: The gross tumor volume-planning target volume margins in this study appeared adequate. Future efforts to improve outcomes using definitive chemoradiotherapy should be directed toward reducing the high rates of in-field and distant relapses

  13. Perioperative antibiotics for surgical site infection in pancreaticoduodenectomy: does the SCIP-approved regimen provide adequate coverage?

    Science.gov (United States)

    Donald, Graham W; Sunjaya, Dharma; Lu, Xuyang; Chen, Formosa; Clerkin, Barbara; Eibl, Guido; Li, Gang; Tomlinson, James S; Donahue, Timothy R; Reber, Howard A; Hines, Oscar J

    2013-08-01

    The Joint Commission Surgical Care Improvement Project (SCIP) includes performance measures aimed at reducing surgical site infections (SSI). One measure defines approved perioperative antibiotics for general operative procedures. However, there may be a subset of procedures not adequately covered with the use of approved antibiotics. We hypothesized that piperacillin-tazobactam is a more appropriate perioperative antibiotic for pancreaticoduodenectomy (PD). In collaboration with hospital epidemiology and the Division of Infectious Diseases, we retrospectively reviewed records of 34 patients undergoing PD between March and May 2008 who received SCIP-approved perioperative antibiotics and calculated the SSI rate. After changing our perioperative antibiotic to piperacillin-tazobactam, we prospectively reviewed PDs performed between June 2008 and March 2009 and compared the SSI rates before and after the change. For 34 patients from March through May 2008, the SSI rate for PD was 32.4 per 100 cases. Common organisms from wound cultures were Enterobacter and Enterococcus (50.0% and 41.7%, respectively), and these were cefoxitin resistant. From June 2008 through March 2009, 106 PDs were performed. During this period, the SSI rate was 6.6 per 100 surgeries, 80% lower than during March through May 2008 (relative risk, 0.204; 95% confidence interval [CI], 0.086-0.485; P = .0004). Use of piperacillin-tazobactam as a perioperative antibiotic in PD may reduce SSI compared with the use of SCIP-approved antibiotics. Continued evaluation of SCIP performance measures in relationship to patient outcomes is integral to sustained quality improvement. Copyright © 2013 Mosby, Inc. All rights reserved.

  14. The influence of nutritional supplement drinks on providing adequate calorie and protein intake in older adults with dementia.

    Science.gov (United States)

    Allen, V; Methven, L; Gosney, M

    2013-09-01

    Investigate the impact of the provision of ONS on protein and energy intake from food and ability to meet protein and calorie requirements in people with dementia. After consent by proxy was obtained, participants took part in a cross over study comparing oral intake on an intervention day to an adjacent control day. The study occurred in Nursing homes and hospitalised settings. Older adults with dementia over the age of 65 were recruited. 26 participants (aged 83.9+/-8.4years, MMSE 13.08+/-8.13) took part. Intervention (if any): On the intervention day nutritional supplement drinks were provided three times. Each drink provided 283.3+/-41.8 Kcal of energy and 13.8+/-4.7g of protein. Supplements were removed approximately 1 hour before meals were served and weighed waste (g) was obtained. Intake of food consumed was determined on intervention and control days using the quartile method (none, quarter, half, three quarters, all) for each meal component. More people achieved their energy and protein requirements with the supplement drink intervention with no sufficient impact on habitual food consumption. Findings from these 26 participants with dementia indicate that supplement drinks may be beneficial in reducing the prevalence of malnutrition within the group as more people meet their nutritional requirements. As the provision of supplement drinks is also demonstrated to have an additive effect to consumption of habitual foods these can be used alongside other measures to also improve oral intake.

  15. Study of the bismuth oxide concentration required to provide Portland cement with adequate radiopacity for endodontic use.

    Science.gov (United States)

    Bueno, Carlos Eduardo da Silveira; Zeferino, Eduardo Gregatto; Manhães, Luiz Roberto Coutinho; Rocha, Daniel Guimarães Pedro; Cunha, Rodrigo Sanches; De Martin, Alexandre Sigrist

    2009-01-01

    The purpose of this study was to determine the ideal concentration of bismuth oxide in white Portland cement to provide it with sufficient radiopacity for use as an endodontic material (ADA specification #57). 2-mm thick standardized test specimens of white MTA and of white Portland cement, as controls, and of white Portland cement with the experimental addition of 5%, 10%, 15%, 20%, 25% or 30% of bismuth oxide were radiographed and compared with various thicknesses of pure aluminum, using optic density to determine the observed grayscale levels of radiopacity in a scale ranging from 0 to 255. The data was submitted to ANOVA (pcement with 0%, 5%, 10%, 15%, 20%, 25% and 30% of bismuth oxide presented mean readings of 63.3, 95.7, 110.7, 142.7, 151.3, 161.0 and 180.0 respectively. MTA presented a mean reading of 157.3. The readings of MTA and white Portland cement with 15% bismuth oxide did not differ significantly from the reading observed for a thickness of 4 mm of aluminum (145.3), which is considered ideal for a test specimen by ADA specification #57 (2 mm above the thickness of the test specimen). White MTA and white Portland cement with 15% bismuth oxide presented the radiopacity required for an endodontic cement.

  16. DO FINANCIAL STATEMENTS PROVIDE ADEQUATE INFORMATION ABOUT THE CAPITALIZATION OF COSTS RELATED TO INTANGIBLE ASSETS?: AN EMPIRICAL RESEARCH ON ITALIAN LISTED COMPANIES

    Directory of Open Access Journals (Sweden)

    Stefania Vignini

    2015-11-01

    Full Text Available The aim of our research is to verify if Italian listed companies financial statements provide adequate information about the capitalization of costs related to intangible assets and if the information provided are reliable. Moreover, we investigated if they merely comply with law or provide additional information on cost capitalization and reveal if internal control systems (especially managerial accounting systems or other information systems are applied to support the measurement process and the cost control, thus guaranteeing the verifiability and representational faithfulness of the information disclosed. This paper is an empirical analysis and is concerned to investigate the financial statements of 250 Italian listed companies.

  17. Undernutrition among children under 5 years of age in Yemen: Role of adequate childcare provided by adults under conditions of food insecurity.

    Science.gov (United States)

    Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi

    2016-01-01

    Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen.

  18. Healthcare workers' behaviors and personal determinants associated with providing adequate sexual and reproductive healthcare services in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Jonas, Kim; Crutzen, Rik; van den Borne, Bart; Reddy, Priscilla

    2017-03-13

    Healthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services. A systematic review of literature was conducted to identify studies focusing on healthcare workers' behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015). Five databases were searched until 30th October 2015, using a search strategy that was adapted based on the technical requirements of each specific database. Articles were independently screened for eligibility by two researchers. Of the 125-screened full-text articles, 35 studies met all the inclusion criteria. Negative behaviours and attitudes of healthcare workers, as well as other personal determinants, such as poor knowledge and skills of SRH services, and related factors, like availability of essential drugs and equipment are associated with provision of inadequate SRH services. Some healthcare workers still have negative attitudes towards young people using contraceptives and are more likely to limit access to and utilization of SRH by adolescents especially. Knowledge of and implementation of specific SRH components are below optimum levels according to the WHO recommended guidelines. Healthcare workers' negative behaviours and attitudes are unlikely to encourage women in general to access and utilize SRH services, but more specifically young women. Knowledge of SRH services, including basic emergency obstetric care (EmOC) is insufficient among healthcare workers in SSA. A protocol for this systematic review was registered with PROSPERO and the registration number is: CRD42015017509 .

  19. A dynamic case definition is warranted for adequate notification in an extended epidemic setting: the Dutch Q fever outbreak 2007-2009 as exemplar.

    Science.gov (United States)

    Jaramillo-Gutierrez, G; Wegdam-Blans, M C; ter Schegget, R; Korbeeck, J M; van Aken, R; Bijlmer, H A; Tjhie, J H; Koopmans, M P

    2013-10-10

    Q fever is a notifiable disease in the Netherlands:laboratories are obliged to notify possible cases to the Municipal Health Services. These services then try to reconfirm cases with additional clinical and epidemiological data and provide anonymised reports to the national case register of notifiable diseases. Since the start of the 2007–2009 Dutch Q fever outbreak,notification rules remained unchanged, despite new laboratory insights and altered epidemiology. In this study, we retrospectively analysed how these changes influenced the proportion of laboratory-defined acute Q fever cases (confirmed, probable and possible)that were included in the national case register, during(2009) and after the outbreak (2010 and 2011).The number of laboratory-defined cases notified to the Municipal Health Services was 377 in 2009, 96 in 2010 and 50 in 2011. Of these, 186 (49.3%) in 2009, 12(12.5%) in 2010 and 9 (18.0%) in 2011 were confirmed as acute infection by laboratory interpretation. The proportion of laboratory-defined acute Q fever cases that was reconfirmed by the Municipal Health Services and that were included in the national case register decreased from 90% in 2009, to 22% and 24% in 2010 and 2011, respectively. The decrease was observed in all categories of cases, including those considered to be confirmed by laboratory criteria. Continued use ofa pre-outbreak case definition led to over-reporting of cases to the Municipal Health Services in the post-epidemic years. Therefore we recommend dynamic laboratory notification rules, by reviewing case definitions periodically in an ongoing epidemic, as in the Dutch Q fever outbreak.

  20. The New York Adequacy Study: "Determining the Cost of Providing All Children in New York an Adequate Education." Volume 1: Final Report [and] Volume 2: Technical Appendices

    Science.gov (United States)

    Chambers, Jay G.; Parrish, Thomas B.; Levin, Jesse D.; Smith, James R.; Guthrie, James W.; Seder, Rich C.; Taylor, Lori

    2004-01-01

    What is the cost of providing all New York public school students a full opportunity to meet the Regents Learning Standards? This report presents the results of a fifteen-month project undertaken jointly by American Institutes for Research (AIR) and Management Analysis and Planning, Inc. (MAP) to answer this question. This is a "costing…

  1. Clear Purpose...Complete Commitment. A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs 1996-2000.

    Science.gov (United States)

    Jaques, Thomas F.

    This document provides the 5-year (1996-2000) library plan for public libraries in Louisiana. It identifies specific inadequacies in public library services, resources, facilities, and personnel. It identifies the people who are to be served, and reveals the geographical, sociological, economic, and educational barriers to the expanded use of…

  2. Utility of providing a concussion definition in the assessment of concussion history in former NFL players.

    Science.gov (United States)

    Alosco, Michael L; Jarnagin, Johnny; Tripodis, Yorghos; Martin, Brett; Chaisson, Christine; Baugh, Christine M; Torres, Alcy; Nowinski, Christopher J; Cantu, Robert C; Stern, Robert A

    2017-01-01

    Former National Football League (NFL) players' working knowledge of concussion has not yet been evaluated, despite this population being a major clinical research target due to the association between repetitive head impacts (RHI) and long-term clinical impairments. This study examined former NFL players' understanding of the current concussion definition, and the association between number of concussions with clinical function. 95 former NFL players (mean age = 55.29; mean NFL year = 8.10) self-reported number of concussions before being provided with a concussion definition and after being read a modern definition of concussion. Subjects reported number of concussions with loss of consciousness (LOC). Principal Component Analysis of a battery of tests generated behaviour/mood, psychomotor speed/executive function, and verbal and visual memory factor scores. Post-definition number of concussions (median = 50) was five times the pre-definition (median = 10; p football played, with specific effects for depressive symptoms and impulsivity. LOC did not account for variance beyond number of concussions. Practitioners and clinical researchers should provide a definition of concussion in the assessment of concussion history in former football players to facilitate accuracy and standardization.

  3. Defining the economic essence of definition «providing efficiency»

    OpenAIRE

    Kovalchyk, Olena Arnoldivna

    2011-01-01

    In paper the main approaches to defining the economic essence of the category of «efficiency» is analyzed. The existing conceptual approach to the term «providing» is investigated. The own point of view on the interpretation of definition «providing efficiency» is given.

  4. Self-reported concussion history: impact of providing a definition of concussion

    Directory of Open Access Journals (Sweden)

    Robbins CA

    2014-05-01

    Full Text Available Clifford A Robbins,1 Daniel H Daneshvar,1,2 John D Picano,1,3 Brandon E Gavett,1,4 Christine M Baugh,1,2 David O Riley,1 Christopher J Nowinski,1,2,5 Ann C McKee,1,2,6–8 Robert C Cantu,1,5,9,10 Robert A Stern1,2,8,91Center for the Study of Traumatic Encephalopathy, 2Department of Neurology, Boston University School of Medicine, Boston, MA, USA; 3School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA; 4Department of Psychology, University of Colorado, Colorado Springs, CO, USA; 5Sports Legacy Institute, Waltham MA, USA; 6United States Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA; 7Department of Pathology, 8Alzheimer's Disease Center, 9Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA; 10Department of Neurosurgery, Emerson Hospital, Concord, MA, USABackground: In recent years, the understanding of concussion has evolved in the research and medical communities to include more subtle and transient symptoms. The accepted definition of concussion in these communities has reflected this change. However, it is unclear whether this shift is also reflected in the understanding of the athletic community.What is known about the subject: Self-reported concussion history is an inaccurate assessment of someone's lifetime exposure to concussive brain trauma. However, unfortunately, in many cases it is the only available tool.Hypothesis/purpose: We hypothesize that athletes' self-reported concussion histories will be significantly greater after reading them the current definition of concussion, relative to the reporting when no definition was provided. An increase from baseline to post-definition response will suggest that athletes are unaware of the currently accepted medical definition.Study design: Cross-sectional study of 472 current and former athletes.Methods: Investigators conducted structured telephone interviews with current and former athletes between January

  5. Nuclear Facility Isotopic Content (NFIC) Waste Management System to provide input for safety envelope definition

    International Nuclear Information System (INIS)

    Genser, J.R.

    1992-01-01

    The Westinghouse Savannah River Company (WSRC) is aggressively applying environmental remediation and radioactive waste management activities at the US Department of Energy's Savannah River Site (SRS) to ensure compliance with today's challenging governmental laws and regulatory requirements. This report discusses a computer-based Nuclear Facility Isotopic Content (NFIC) Waste Management System developed to provide input for the safety envelope definition and assessment of site-wide facilities. Information was formulated describing the SRS ''Nuclear Facilities'' and their respective bounding inventories of nuclear materials and radioactive waste using the NFIC Waste Management System

  6. Funding an 'Adequate' Education.

    Science.gov (United States)

    Guthrie, James W.

    1983-01-01

    The U.S. political process has been used to define an "adequate" education, in terms of resources, procedures, content, or outcomes. The marketplace also allows individuals to define adequacy through various voucher arrangements. Both mechanisms should be used, based on whether public or private interests are paramount in a particular…

  7. Improving Providers' Role Definitions to Decrease Overcrowding and Improve In-Hospital Cardiac Arrest Response.

    Science.gov (United States)

    Leary, Marion; Schweickert, William; Neefe, Stacie; Tsypenyuk, Boris; Falk, Scott Austin; Holena, Daniel N

    2016-07-01

    How nontechnical factors such as inadequate role definition and overcrowding affect outcomes of in-hospital cardiac arrest (IHCA) is unknown. Using a bundled intervention, we sought to improve providers' role definitions and decrease overcrowding during IHCA events. To determine if a bundled intervention consisting of a nurse/physician leadership dyad, visual cues for provider roles, and a "role check" would lead to reductions in crowding and improve perceptions of communication and team leadership. Baseline data on the number and type of IHCA providers were collected. Providers were asked to complete a postevent survey rating communication and leadership. A bundled intervention was then introduced. Data were then obtained for the subsequent IHCA events. Twenty ICHA events were captured before and 34 after the intervention. The number of physicians present at pulse checks 2 (median [interquartile range]: 6 [5-8] before vs 5 [3-6] after, P = .02) and 3 (7 [5-9] vs 4 [4-5], P = .004) decreased significantly after the intervention. The overall number of providers at the third pulse check (18 [14-22] before vs 14 [12-16] after, P = .04) also decreased after the intervention. On a 10-point Likert scale, ratings of communication (8 [7-8]) and physician leadership (8 [7-9]) did not differ significantly from before to after the intervention. Both the physician leads (90%) and patients' primary nurses (97%) were able to identify clear nurse leaders. A bundled intervention targeted at improving IHCA response led to a decrease in overcrowding at ICHA events without substantial changes in the perceptions of communication or physician leadership. ©2016 American Association of Critical-Care Nurses.

  8. Quasi-adequate semigroups

    International Nuclear Information System (INIS)

    El-Qallali, A.

    1987-11-01

    The least fundamental adequate good congruence on an arbitrary type W semigroup S is described as well as the largest superabundant full subsemigroup of S and the largest full subsemigroup of S which is a band of cancellative monoids. Weak type W semigroups are defined by replacing the idempotent-connected property in type W by one of its consequences and a structure theorem is obtained for such semigroups. (author). 12 refs

  9. Decision support for the definition of wind turbine systems adequacy to site specificities and weak electrical networks; Aide a la decision pour la definition d'un systeme eolien, adequation au site et a un reseau faible

    Energy Technology Data Exchange (ETDEWEB)

    Arbaoui, A

    2006-10-15

    A decision support system for the definition of wind turbine systems is developed by taking into account the wind and site characteristics, the wind turbine components and the electrical network properties close to the site. The approach is based on functional analysis, on the investigation of the functional fluxes and on the definition of a model suitable for supporting decision at the preliminary stages of wind turbine design. The complete set of solutions derived from the model is determined using a Constraint Satisfaction Problem solver. The intrinsic capability of the model to support decision is derived from the investigation of the model parsimony, precision, exactness and specialization. The model takes into account performance criteria resulting from knowledge of manufacturers, distributors and investors. These criteria are used to discriminate design alternatives. Design alternatives correspond to choices of site (wind, electric network) and wind turbine architectures (related to 7 design variables). Performance criteria are the cost of electric kWh, the amount of energy being produced and the discounted total cost of the project. Electric network connection to wind turbines is taken into account through slow variations of the voltage and Flickers phenomenon. First, the maximal rate of penetration of the wind turbine energy production is determined. Next, two design alternatives have been investigated to improve wind turbine system integration in electric distribution networks. These alternatives are a reactive power control system and an inertial energy storage system. Inertial storage systems seem to be more expensive than reactive power control systems for this type of application. The influence of site specificities on decision making process has been established through three different sites (a Mediterranean site and two sites located in northern Europe). Profits relative to the cost of kWh appear to be high for Mediterranean sites. Most of the

  10. Decision support for the definition of wind turbine systems adequacy to site specificities and weak electrical networks; Aide a la decision pour la definition d'un systeme eolien, adequation au site et a un reseau faible

    Energy Technology Data Exchange (ETDEWEB)

    Arbaoui, A

    2006-10-15

    A decision support system for the definition of wind turbine systems is developed by taking into account the wind and site characteristics, the wind turbine components and the electrical network properties close to the site. The approach is based on functional analysis, on the investigation of the functional fluxes and on the definition of a model suitable for supporting decision at the preliminary stages of wind turbine design. The complete set of solutions derived from the model is determined using a Constraint Satisfaction Problem solver. The intrinsic capability of the model to support decision is derived from the investigation of the model parsimony, precision, exactness and specialization. The model takes into account performance criteria resulting from knowledge of manufacturers, distributors and investors. These criteria are used to discriminate design alternatives. Design alternatives correspond to choices of site (wind, electric network) and wind turbine architectures (related to 7 design variables). Performance criteria are the cost of electric kWh, the amount of energy being produced and the discounted total cost of the project. Electric network connection to wind turbines is taken into account through slow variations of the voltage and Flickers phenomenon. First, the maximal rate of penetration of the wind turbine energy production is determined. Next, two design alternatives have been investigated to improve wind turbine system integration in electric distribution networks. These alternatives are a reactive power control system and an inertial energy storage system. Inertial storage systems seem to be more expensive than reactive power control systems for this type of application. The influence of site specificities on decision making process has been established through three different sites (a Mediterranean site and two sites located in northern Europe). Profits relative to the cost of kWh appear to be high for Mediterranean sites. Most of the

  11. Caregiver Coaching Strategies for Early Intervention Providers: Moving toward Operational Definitions

    Science.gov (United States)

    Friedman, Mollie; Woods, Juliann; Salisbury, Christine

    2012-01-01

    Early intervention (EI) providers increasingly coach and collaborate with caregivers to strengthen and support caregiver-child interactions. The EI providers learning to coach other adults benefit from knowing what, exactly, they should do to support caregivers. This article serves two purposes. First, it proposes an operationally defined,…

  12. Identification, definition and quantification of goods and services provided by marine biodiversity: implications for the ecosystem approach.

    Science.gov (United States)

    Beaumont, N J; Austen, M C; Atkins, J P; Burdon, D; Degraer, S; Dentinho, T P; Derous, S; Holm, P; Horton, T; van Ierland, E; Marboe, A H; Starkey, D J; Townsend, M; Zarzycki, T

    2007-03-01

    This paper identifies and defines ecosystem goods and services provided by marine biodiversity. Case studies have been used to provide an insight into the practical issues associated with the assessment of marine ecosystem goods and services at specific locations. The aim of this research was to validate the definitions of goods and services, and to identify knowledge gaps and likely difficulties of quantifying the goods and services. A validated theoretical framework for the assessment of goods and services is detailed, and examples of the goods and services at a variety of case study areas are documented. These results will enable future assessments of marine ecosystem goods and services. It is concluded that the utilisation of this goods and services approach has the capacity to play a fundamental role in the Ecosystem Approach, by enabling the pressures and demands of society, the economy and the environment to be integrated into environmental management.

  13. Do British travel agents provide adequate health advice for travellers?

    Science.gov (United States)

    Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D

    2000-01-01

    Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised. PMID:10954940

  14. Adequate supervision for children and adolescents.

    Science.gov (United States)

    Anderst, James; Moffatt, Mary

    2014-11-01

    Primary care providers (PCPs) have the opportunity to improve child health and well-being by addressing supervision issues before an injury or exposure has occurred and/or after an injury or exposure has occurred. Appropriate anticipatory guidance on supervision at well-child visits can improve supervision of children, and may prevent future harm. Adequate supervision varies based on the child's development and maturity, and the risks in the child's environment. Consideration should be given to issues as wide ranging as swimming pools, falls, dating violence, and social media. By considering the likelihood of harm and the severity of the potential harm, caregivers may provide adequate supervision by minimizing risks to the child while still allowing the child to take "small" risks as needed for healthy development. Caregivers should initially focus on direct (visual, auditory, and proximity) supervision of the young child. Gradually, supervision needs to be adjusted as the child develops, emphasizing a safe environment and safe social interactions, with graduated independence. PCPs may foster adequate supervision by providing concrete guidance to caregivers. In addition to preventing injury, supervision includes fostering a safe, stable, and nurturing relationship with every child. PCPs should be familiar with age/developmentally based supervision risks, adequate supervision based on those risks, characteristics of neglectful supervision based on age/development, and ways to encourage appropriate supervision throughout childhood. Copyright 2014, SLACK Incorporated.

  15. Contemporary group estimates adjusted for climatic effects provide a finer definition of the unknown environmental challenges experienced by growing pigs.

    Science.gov (United States)

    Guy, S Z Y; Li, L; Thomson, P C; Hermesch, S

    2017-12-01

    Environmental descriptors derived from mean performances of contemporary groups (CGs) are assumed to capture any known and unknown environmental challenges. The objective of this paper was to obtain a finer definition of the unknown challenges, by adjusting CG estimates for the known climatic effects of monthly maximum air temperature (MaxT), minimum air temperature (MinT) and monthly rainfall (Rain). As the unknown component could include infection challenges, these refined descriptors may help to better model varying responses of sire progeny to environmental infection challenges for the definition of disease resilience. Data were recorded from 1999 to 2013 at a piggery in south-east Queensland, Australia (n = 31,230). Firstly, CG estimates of average daily gain (ADG) and backfat (BF) were adjusted for MaxT, MinT and Rain, which were fitted as splines. In the models used to derive CG estimates for ADG, MaxT and MinT were significant variables. The models that contained these significant climatic variables had CG estimates with a lower variance compared to models without significant climatic variables. Variance component estimates were similar across all models, suggesting that these significant climatic variables accounted for some known environmental variation captured in CG estimates. No climatic variables were significant in the models used to derive the CG estimates for BF. These CG estimates were used to categorize environments. There was no observable sire by environment interaction (Sire×E) for ADG when using the environmental descriptors based on CG estimates on BF. For the environmental descriptors based on CG estimates of ADG, there was significant Sire×E only when MinT was included in the model (p = .01). Therefore, this new definition of the environment, preadjusted by MinT, increased the ability to detect Sire×E. While the unknown challenges captured in refined CG estimates need verification for infection challenges, this may provide a

  16. Is prophetic discourse adequate to address global economic justice?

    African Journals Online (AJOL)

    Test

    2011-02-15

    Feb 15, 2011 ... of moral discourse adequately addresses issues of economic injustice. ... plays an indispensable role in addressing issues of global economic justice, but ...... governance in their business practices, to provide a tool for a.

  17. The Effectiveness of Clinician Education on the Adequate ...

    African Journals Online (AJOL)

    information to make their input in the patient's management.[1]. Some errors in ... to insufficient, and/or illegible clinical information provided ... Adequate Completion of Laboratory Test Request. Forms at a ..... the system prior to the posttest.

  18. Identification, definition and quantification of goods and services provided by marine biodiversity: Implications for the ecosystem approach

    NARCIS (Netherlands)

    Beaumont, N.J.; Austen, M.C.; Atkins, J.P.; Burdon, D.; Degraer, S.; Dentinho, T.P.; Serous, S.; Holm, P.; Horton, T.; Ierland, van E.C.; Marboe, A.H.; Starkey, D.J.; Townsend, M.; Zarzycki, T.

    2007-01-01

    This paper identifies and defines ecosystem goods and services provided by marine biodiversity. Case studies have been used to provide an insight into the practical issues associated with the assessment of marine ecosystem goods and services at specific locations. The aim of this research was to

  19. Development of a validated clinical case definition of generalized tonic-clonic seizures for use by community-based health care providers.

    Science.gov (United States)

    Anand, Krishnan; Jain, Satish; Paul, Eldho; Srivastava, Achal; Sahariah, Sirazul A; Kapoor, Suresh K

    2005-05-01

    To develop and test a clinical case definition for identification of generalized tonic-clonic seizures (GTCSs) by community-based health care providers. To identify symptoms that can help identify GTCSs, patients with history of a jerky movements or rigidity in any part of the body ever in life were recruited from three sites: the community, secondary care hospital, and tertiary care hospital. These patients were administered a 14-item structured interview schedule focusing on the circumstances surrounding the seizure. Subsequently, a neurologist examined each patient and, based on available investigations, classified them as GTCS or non-GTCS cases. A logistic regression analysis was performed to select symptoms that were to be used for case definition of GTCSs. Validity parameters for the case definition at different cutoff points were calculated in another set of subjects. In total, 339 patients were enrolled in the first phase of the study. The tertiary care hospital contributed the maximal number of GTCS cases, whereas cases of non-GTCS were mainly from the community. At the end of phase I, the questionnaire was shortened from 14 to eight questions based on statistical association and clinical judgment. After phase II, which was conducted among 170 subjects, three variables were found to be significantly related to the presence of GTCSs by logistic regression: absence of stress (13.1; 4.1-41.3), presence of frothing (13.7; 4.0-47.3), and occurrence in sleep (8.3; 2.0-34.9). As a case definition using only three variables did not provide sufficient specificity, three more variables were added based on univariate analysis of the data (incontinence during the episode and unconsciousness) and review of literature (injury during episode). A case definition consisting of giving one point to an affirmative answer for each of the six questions was tested. At a cutoff point of four, sensitivity was 56.9 (47.4-66.0) and specificity, 96.3 (86.2-99.4). Among the 197 GTCS

  20. Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States.

    Science.gov (United States)

    Philbin, Morgan M; Tanner, Amanda E; Ma, Alice; Chambers, Brittany D; Ware, Samuella; Kinnard, Elizabeth N; Hussen, Sophia A; Lee, Sonia; Fortenberry, J Dennis

    2017-10-01

    It is important for both individual- and population-level health that HIV-infected individuals progress through the Care Continuum. However, HIV-infected youth frequently disengage from care during transition from pediatric/adolescent to adult care; only 50% remain in adult care after 1 year. Understanding how providers define and approach a successful healthcare transition can improve the delivery of HIV-related services during critical years of HIV treatment. We conducted 58 staff interviews across 14 Adolescent Trials Network clinics (n = 30) and 20 adult clinics (n = 28). We used the constant comparative method to examine how providers defined and approached youths' successful transition. Providers identified four components critical to successful transition: (1) clinical outcomes (e.g., medication adherence and viral suppression); (2) youth knowing how to complete treatment-related activities (e.g., refilling prescriptions and making appointments); (3) youth taking responsibility for treatment-related activities and their overall health (e.g., "when they stop reaching out to the adolescent [clinic] to solve all their problems."); and (4) youth feeling a connection and trust toward the adult clinic (e.g., "they feel safe here"), with some providers even prioritizing connectedness over clinical outcomes (e.g., "Even if they're not taking meds but are connected [to care], …that's a success."). The identification of key components of successful transition can guide focused interventions and resources to improve youth maintenance in the HIV Care Continuum as they transition to adult care. Identifying what facilitates successful transitions, and the gaps that interventions can target, will help to ensure HIV-infected youth remain healthy across their lifespan.

  1. Global Peak in Atmospheric Radiocarbon Provides a Potential Definition for the Onset of the Anthropocene Epoch in 1965.

    Science.gov (United States)

    Turney, Chris S M; Palmer, Jonathan; Maslin, Mark A; Hogg, Alan; Fogwill, Christopher J; Southon, John; Fenwick, Pavla; Helle, Gerhard; Wilmshurst, Janet M; McGlone, Matt; Bronk Ramsey, Christopher; Thomas, Zoë; Lipson, Mathew; Beaven, Brent; Jones, Richard T; Andrews, Oliver; Hua, Quan

    2018-02-19

    Anthropogenic activity is now recognised as having profoundly and permanently altered the Earth system, suggesting we have entered a human-dominated geological epoch, the 'Anthropocene'. To formally define the onset of the Anthropocene, a synchronous global signature within geological-forming materials is required. Here we report a series of precisely-dated tree-ring records from Campbell Island (Southern Ocean) that capture peak atmospheric radiocarbon ( 14 C) resulting from Northern Hemisphere-dominated thermonuclear bomb tests during the 1950s and 1960s. The only alien tree on the island, a Sitka spruce (Picea sitchensis), allows us to seasonally-resolve Southern Hemisphere atmospheric 14 C, demonstrating the 'bomb peak' in this remote and pristine location occurred in the last-quarter of 1965 (October-December), coincident with the broader changes associated with the post-World War II 'Great Acceleration' in industrial capacity and consumption. Our findings provide a precisely-resolved potential Global Stratotype Section and Point (GSSP) or 'golden spike', marking the onset of the Anthropocene Epoch.

  2. Definition of Terms Used in Limitation of Treatment and Providing Palliative Care at the End of Life: The Indian Council of Medical Research Commission Report

    Science.gov (United States)

    Salins, Naveen; Gursahani, Roop; Mathur, Roli; Iyer, Shivakumar; Macaden, Stanley; Simha, Nagesh; Mani, Raj Kumar; Rajagopal, M. R.

    2018-01-01

    Background: Indian hospitals, in general, lack policies on the limitation of inappropriate life-sustaining interventions at the end of life. To facilitate discussion, preparation of guidelines and framing of laws, terminologies relating to the treatment limitation, and providing palliative care at the end-of-life care (EOLC) need to be defined and brought up to date. Methodology: This consensus document on terminologies and definitions of terminologies was prepared under the aegis of the Indian Council of Medical Research. The consensus statement was created using Nominal Group and Delphi Method. Results: Twenty-five definitions related to the limitations of treatment and providing palliative care at the end of life were created by reviewing existing international documents and suitably modifying it to the Indian sociocultural context by achieving national consensus. Twenty-five terminologies defined within the scope of this document are (1) terminal illness, (2) actively dying, (3) life-sustaining treatment, (4) potentially inappropriate treatment, (5) cardiopulmonary resuscitation (CPR), (6) do not attempt CPR, (7) withholding life-sustaining treatment, (8) withdrawing life-sustaining treatment, (9) euthanasia (10) active shortening of the dying process, (11) physician-assisted suicide, (12) palliative care, (13) EOLC, (14) palliative sedation, (15) double effect, (16) death, (17) best interests, (18) health-care decision-making capacity, (19) shared decision-making, (20) advance directives, (21) surrogates, (22) autonomy, (23) beneficence, (24) nonmaleficence, and (25) justice.

  3. Is frozen embryo transfer better for mothers and babies? Can cumulative meta-analysis provide a definitive answer?

    Science.gov (United States)

    Maheshwari, Abha; Pandey, Shilpi; Amalraj Raja, Edwin; Shetty, Ashalatha; Hamilton, Mark; Bhattacharya, Siladitya

    2018-01-01

    and magnitude of effect for these outcomes have remained virtually unchanged over time while the degree of precision has improved with the addition of data from newer studies. The results of this cumulative meta-analysis confirm that the decreased risks of small for gestational age, low birth weight and preterm delivery and increased risks of large for gestational age and high birth weight associated with pregnancies conceived from frozen embryos have been consistent in terms of direction and magnitude of effect over several years, with increasing precision around the point estimates. Replication in a number of different populations has provided external validity for the results, for outcomes of birth weight and preterm delivery. Meanwhile, caution should be exercised about embarking on a policy of electively freezing all embryos in IVF as there are increased risks for large for gestational age babies and hypertensive disorders of pregnancy. Therefore, elective freezing should ideally be undertaken in specific cases such as ovarian hyperstimulation syndrome, fertility preservation or in the context of randomised trials. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  4. Real Time Investments with Adequate Portfolio Theory

    Directory of Open Access Journals (Sweden)

    Alina Kvietkauskienė

    2015-02-01

    Full Text Available The objective of this paper is to identify investment decision makingschemes using the adequate portfolio model. This approach can be employed to project investment in stocks, using the opportunities offered by the markets and investor intelligence. It was decided to use adequate portfolio theory for investment decision making, simulation of financial markets, and optimisation of utility function. The main conclusion of article suggests investigating return on individual portfolio level. Real investment is a way to make sure of the soundness of applicable strategies.

  5. Perception of Mothers on Adequate Nutrition

    Directory of Open Access Journals (Sweden)

    Darshini Valoo

    2017-03-01

    Full Text Available Background: Malnutrition in children less than 5 years old persists around the world. In West Java and one of the districts of West Java (Sumedang, the prevalence of malnutrition is about 18.5% and 15.8% respectively. Numerous factors can lead to child malnutrition. Difficulties in availability, accessibility, acceptability and quality of food can be contributing factors. A good perception of mother on adequate nutrition can improve children’s nutritional status. This study was conducted to study the perception of mothers with children 2 to 5 years old on adequate nutrition. Methods: Most of the respondents had good perception on the aspect of adequate nutrition. Results showed perception on availability was 83.8%, physical accessibility was 97.1%, economical accessibility was 98.6%, information accessibility was 84.8% and acceptability was 81.0%. However, perception of respondents on good quality nutrition for the main meal and additional food was still poor. Moreover, there are taboos for eating shrimp and watermelon. Additionally, children were given snacks in large amount. Results: There was a strong correlation between mid-upper arm muscle area/size and muscular strength (correlation cooefficient 0.746. Moreover, the higher the Body Mass Index, the stronger the muscle strength was to some point. If the BMI was more than 25 kg/m2, this findings did not occurred. Conclusions: This study reveals that the perception of mothers on good quality food is poor regardless the good results on availibility, accesibility and acceptability.

  6. How adequate policies can push renewables

    International Nuclear Information System (INIS)

    Goldemberg, J.; Coelho, S.T.; Lucon, Oswaldo

    2004-01-01

    The growing interest in the establishment of a minimum share of renewable sources in the world energy matrix, after the Johannesburg's World Summit for Sustainable Development (WSSD), has raised the question about the means for such new technologies to compete with the traditional ones. The Brazilian experience in the last 25 years with ethanol as a replacement for gasoline can illustrate this possibility. Moreover, recent policies introduced by the Federal government for a minimum share of new renewable sources - wind, modern biomass and small hydro - in the Brazilian electricity matrix reinforces the country's commitment to utilize adequate policies for achieving sustainable development

  7. Iron absorption from adequate Filipinos meals

    International Nuclear Information System (INIS)

    Trinidad, T.P.; Madriaga, J.R.; Valdez, D.H.; Cruz, E.M.; Mallillin, A.C.; Sison, C.C.; Kuizon, M.D.

    1989-01-01

    Iron absorption from adequate Filipino meals representing the three major island groups of the Philippines (Luzon, Visayas, and Mindanao) was studied using double isotope extrinsic tag method. Mean iron absorption of the one-day meal for Metro Manila was 6.6 +- 1.26%. Central Visayas, 6.3 +- 1.15% and Southern Mindanao, 6.4 +- 1.19%. Comparison between meals (breakfast, lunch, dinner) for each region as well as one-day meal for the three regions showed no significant differences (P>0.01). Correlation tests done between iron absorption and the following iron enhancers: ascorbic acid, amount of fish, meat or poultry; and inhibitors: phytic acid and tannic acid, did not give significant results. The overall average of 6.4 +- 1.20% may be used as the iron absorption level from an adequate Filipino meal. This value can be considered as one of the bases for arriving at recommended dietary allowances for iron among Filipinos instead of the 10% iron absorption assumed in 1976. (Auth.). 21 refs.; 3 tabs.; 3 annexes

  8. Iron absorption from adequate Filipino meals

    International Nuclear Information System (INIS)

    Trinidad, T.P.; Madriaga, J.R.; Valdez, D.H.; Cruz, E.M.; Mallillin, A.C.; Sison, C.C.; Kuizon, M.D.

    1991-01-01

    Iron absorption from adequate Filipino meals representing the three major island groups of the Philippines (Luzon, Visayas and Mindanao) was studied using double isotope extrinsic tag method. Mean iron absorption of the one-day meal for Metro Manila was 6.6 ± 1.26%, Central Visayas, 6.3 ± 1.15% and Southern Mindanao, 6.4 ± 1.19%. Comparison between meals (breakfast, lunch, dinner) for each region as well as one-day meal for the three regions showed no significant differences (P > .01). Correlation tests done between iron absorption and the following iron enhancers: ascorbic acid, amount of fish, meat or poultry and inhibitors: phytic acid and tannic acid did not give significant results. The overall bar x of 6.4 ± 1.20% may be used as the non-heme iron absorption level from an adequate Filipino meal. This value can be considered as one of the bases for arriving at recommended dietary allowances for iron among Filipinos instead of the 10% iron absorption assumed in 1976

  9. Do Online Bicycle Routing Portals Adequately Address Prevalent Safety Concerns?

    Directory of Open Access Journals (Sweden)

    Martin Loidl

    2018-03-01

    Full Text Available Safety concerns are among the most prevalent deterrents for bicycling. The provision of adequate bicycling infrastructure is considered as one of the most efficient means to increase cycling safety. However, limited public funding does not always allow agencies to implement cycling infrastructure improvements at the desirable level. Thus, bicycle trip planners can at least partly alleviate the lack of adequate infrastructure by recommending optimal routes in terms of safety. The presented study provides a systematic review of 35 bicycle routing applications and analyses to which degree they promote safe bicycling. The results show that most trip planners lack corresponding routing options and therefore do not sufficiently address safety concerns of bicyclists. Based on these findings, we developed recommendations on how to better address bicycling safety in routing portals. We suggest employing current communication technology and analysis to consider safety concerns more explicitly.

  10. Depression in nursing homes: ensuring adequate treatment.

    Science.gov (United States)

    Llewellyn-Jones, Robert H; Snowdon, John

    2007-01-01

    Studies have shown a high prevalence of depressive disorders among nursing home residents around the world. Various losses in old age may precipitate depression, and physical illness and disability are major factors that contribute to the development and persistence of depressive disorders. Demoralization (existential distress) is common. Recognition of what a nursing home resident has lost is often a key to developing plans for management. The prognosis for recovery from depression is worse for patients who face an ongoing distressing situation or physical condition. For ongoing loss-related distress, including sadness about loss of health, it is important for patients to ventilate feelings, and to either re-acquire what is lost or to grieve and then adapt to the new situation. For major depression with melancholia, psychotic depression and bipolar disorders, biological treatments are of prime importance. Non-melancholic major depression is best treated with a combination of antidepressants and psychosocial therapies, the latter being particularly indicated when the depression has been precipitated by stressful and depressing events or situations. Psychosocial and environmental interventions are important in all types of depression and may prove more effective than the use of antidepressants for milder disorders. There has been a welcome increase in the recognition of depression in nursing homes and in the prescription of newer antidepressants, but the published evidence to date does not allow definitive recommendations regarding which antidepressants to use in this setting. Outcome research is needed to assess antidepressant efficacy and to better plan multifaceted treatment strategies for depressions of varying types and aetiologies among nursing home residents.

  11. Statistics Canada's Definition and Classification of Postsecondary and Adult Education Providers in Canada. Culture, Tourism and the Centre for Education Statistics. Research Paper. Catalogue no. 81-595-M No. 071

    Science.gov (United States)

    Orton, Larry

    2009-01-01

    This document outlines the definitions and the typology now used by Statistics Canada's Centre for Education Statistics to identify, classify and delineate the universities, colleges and other providers of postsecondary and adult education in Canada for which basic enrollments, graduates, professors and finance statistics are produced. These new…

  12. A review of the literature and discussion: establishing a consensus for the definition of post-mastectomy pain syndrome to provide a standardized clinical and research approach.

    Science.gov (United States)

    Brackstone, Murial

    2016-09-01

    Chronic pain presents a management challenge for physicians and patients alike, and post-mastectomy pain is no exception. In this issue, Waltho and Rockwell present a review of post-mastectomy pain syndrome (PMPS) and propose a standard definition that should allow future studies to be comparable. The proposed definition of "post-breast surgery pain syndrome" includes pain after any type of breast surgery that is of at least moderate intensity and comprises neuropathic qualities, that is present in the ipsilateral breast/chest/arm, that lasts longer than 6 months and is present at least half the time. Further work is needed to clarify whether this pain syndrome is in fact driven by neuralgia resulting from the axillary dissection component of breast cancer surgery.

  13. Much Ado About the New Definitions of Sepsis

    Directory of Open Access Journals (Sweden)

    Copotoiu Sanda-Maria

    2016-04-01

    Full Text Available Following the publication of the new definition of sepsis (Sepsis-3, a plethora of articles have been published in medical journals. Recognizing the epidemiological importance of the previous definitions, first issued in 1992 (Sepsis-1, and subsequently revised in 2001 (Sepsis-2, the most recent opinion emphasizes the failure “to provide adequate groups of patients with homogenous aetiologies, presentations and outcomes”, and blamed one of the causes “for the failure of several randomized controlled trials (RCTs, that tested the efficacy of adjuvant sepsis therapies”. This review summarizes the recent advances in sepsis definition.

  14. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Science.gov (United States)

    2010-01-01

    ... veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... adequate veterinary care. (a) Each research facility shall have an attending veterinarian who shall provide adequate veterinary care to its animals in compliance with this section: (1) Each research facility shall...

  15. Does Military Culture Adequately Prepare Senior Leaders to Provide Clear Objective, and Useful Strategic Advice?

    Science.gov (United States)

    2012-05-17

    relegate South Vietnamese forces to the fight against the Viet Cong in lieu of training and employing them in the fight against the existential threat...counter insurgencies in foreign countries that are ostensibly of minimal threat to the existential being of the United States. Since insurgent threats to...profound difference between the will to understand for purposes of coexistence and humanistic enlargement of horizons, and the will to dominate for

  16. Electrocautery device does not provide adequate pulmonary vessel sealing in transumbilical anatomic pulmonary lobectomy.

    Science.gov (United States)

    Liu, Hung-Ping; Chu, Yen; Wu, Yi-Cheng; Hsieh, Ming-Ju; Liu, Chieng-Ying; Chen, Tzu-Ping; Chao, Yin-Kai; Wu, Ching-Yang; Yeh, Chi-Ju; Ko, Po-Jen; Liu, Yun-Hen

    2016-05-01

    Safe pulmonary vessel sealing device plays a crucial role in anatomic lung resection. In 2014, we reported high rates of massive bleeding complications during transumbilical lobectomy in a canine model due to difficulty in managing the pulmonary vessel with an endostapler. In this animal survival series, we aimed to evaluate the outcome of pulmonary vessel sealing with an electrocautery device to simplify the transumbilical thoracic surgery. Under general anesthesia, a 3-cm longitudinal incision was made over the umbilicus. Under video guidance, a bronchoscope was inserted through the incision for exploration. The diaphragmatic wound was created with an electrocautery knife and used as the entrance into the thoracic cavity. Using the transumbilical technique, anatomic lobectomy was performed with electrosurgical devices and endoscopic vascular staplers in 15 canines. Transumbilical endoscopic anatomic lobectomy was successfully completed in 12 of the 15 animals. Intraoperative bleeding developed in three animals during pulmonary hilum dissection, where one animal was killed due to hemodynamic instability and the other two animals required thoracotomy to complete the operation. There were five delayed bleeding and surgical mortality cases caused by inadequate vessel sealing by electrosurgical devices. Postmortem examination confirmed correct transumbilical lobectomy in the twelve animals that survived the operations. Transumbilical anatomic lobectomy is technically feasible in a canine model; however, the electrosurgical devices were not effective in sealing the pulmonary vessel in the current canine model.

  17. Three Canted Radiator Panels to Provide Adequate Cooling for Instruments on Slewing Spacecraft in LEO

    Science.gov (United States)

    Choi, Michael K.

    2012-01-01

    Certain free-flying spacecraft in low Earth orbit (LEO) or payloads on the International Space Station (ISS) are required to slew to point the telescopes at targets. Instrument detectors and electronics require cooling. Traditionally a planar thermal radiator is used. The temperature of such a radiator varies significantly when the spacecraft slews because its view factors to space vary significantly. Also for payloads on the ISS, solar impingement on the radiator is possible. These thermal adversities could lead to inadequate cooling for the instrument. This paper presents a novel thermal design concept that utilizes three canted radiator panels to mitigate this problem. It increases the overall radiator view factor to cold space and reduces the overall solar or albedo flux absorbed per unit area of the radiator.

  18. Nuclear waste disposal: achieving adequate financing - special study

    International Nuclear Information System (INIS)

    Quasebarth, M.V.

    1984-01-01

    An analysis by the Congressional Budget Office (CBO) evaluates whether the current one mill fee now charged to nuclear-electricity consumers will adequately finance the waste disposal program. The CBO found that, if the fee is adjusted annually for inflation, it should provide enough revenues to cover all program costs under all nuclear growth forecasts. If the fee is unchanged, however, the fees will be inadequate if inflation exceeds 3% annually. The report suggests two alternatives for fee revision, but makes no recommendations. The alternatives are to increase the fee only at specific intervals or to automatically adjust the fee through indexation. The report examines the effect of delaying the program, cost overruns, and alternative inflation rate and interest rate assumptions. 3 figures, 12 tables

  19. Development of the Verona coding definitions of emotional sequences to code health providers' responses (VR-CoDES-P) to patient cues and concerns

    NARCIS (Netherlands)

    del Piccolo, Lidia; de Haes, Hanneke; Heaven, Cathy; Jansen, Jesse; Verheul, William; Bensing, Jozien; Bergvik, Svein; Deveugele, Myriam; Eide, Hilde; Fletcher, Ian; Goss, Claudia; Humphris, Gerry; Kim, Young-Mi; Langewitz, Wolf; Mazzi, Maria Angela; Mjaaland, Trond; Moretti, Francesca; Nübling, Matthias; Rimondini, Michela; Salmon, Peter; Sibbern, Tonje; Skre, Ingunn; van Dulmen, Sandra; Wissow, Larry; Young, Bridget; Zandbelt, Linda; Zimmermann, Christa; Finset, Arnstein

    2011-01-01

    Objective: To present a method to classify health provider responses to patient cues and concerns according to the VR-CoDES-CC (Del Piccolo et al. (2009) [2] and Zimmermann et al. (submitted for publication) [3]). The system permits sequence analysis and a detailed description of how providers

  20. Development of the Verona coding definitions of emotional sequences to code health providers' responses (VR-CoDES-P) to patient cues and concerns.

    NARCIS (Netherlands)

    Piccolo, L. del; Haes, H. de; Heaven, C.; Jansen, J.; Verheul, W.; Bensing, J.; Bergvik, S.; Deveugele, M.; Eide, H.; Fletcher, I.; Goss, C.; Humphris, G.; Young-Mi, K.; Langewitz, W.; Mazzi, M.A.; Mjaaland, T.; Moretti, F.; Nübling, M.; Rimondini, M.; Salmon, P.; Sibbern, T.; Skre, I.; Dulmen, S. van; Wissow, L.; Young, B.; Zandbelt, L.; Zimmermann, C.; Finset, A.

    2011-01-01

    Objective: To present a method to classify health provider responses to patient cues and concerns according to the VR-CoDES-CC (Del Piccolo et al. (2009) [2] and Zimmermann et al. (submitted for publication) [3]). The system permits sequence analysis and a detailed description of how providers

  1. 40 CFR 716.25 - Adequate file search.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the required...

  2. 9 CFR 305.3 - Sanitation and adequate facilities.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.3 Sanitation and adequate facilities. Inspection shall not be inaugurated if an...

  3. 13 CFR 108.200 - Adequate capital for NMVC Companies.

    Science.gov (United States)

    2010-01-01

    ... VENTURE CAPITAL (âNMVCâ) PROGRAM Qualifications for the NMVC Program Capitalizing A Nmvc Company § 108.200 Adequate capital for NMVC Companies. You must meet the requirements of §§ 108.200-108.230 in order to... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Adequate capital for NMVC...

  4. ENSURING ADEQUATE SAFETY WHEN USING HYDROGEN AS A FUEL

    Energy Technology Data Exchange (ETDEWEB)

    Coutts, D

    2007-01-22

    Demonstration projects using hydrogen as a fuel are becoming very common. Often these projects rely on project-specific risk evaluations to support project safety decisions. This is necessary because regulations, codes, and standards (hereafter referred to as standards) are just being developed. This paper will review some of the approaches being used in these evolving standards, and techniques which demonstration projects can implement to bridge the gap between current requirements and stakeholder desires. Many of the evolving standards for hydrogen-fuel use performance-based language, which establishes minimum performance and safety objectives, as compared with prescriptive-based language that prescribes specific design solutions. This is being done for several reasons including: (1) concern that establishing specific design solutions too early will stifle invention, (2) sparse performance data necessary to support selection of design approaches, and (3) a risk-adverse public which is unwilling to accept losses that were incurred in developing previous prescriptive design standards. The evolving standards often contain words such as: ''The manufacturer shall implement the measures and provide the information necessary to minimize the risk of endangering a person's safety or health''. This typically implies that the manufacturer or project manager must produce and document an acceptable level of risk. If accomplished using comprehensive and systematic process the demonstration project risk assessment can ease the transition to widespread commercialization. An approach to adequately evaluate and document the safety risk will be presented.

  5. High-resolution, time-resolved MRA provides superior definition of lower-extremity arterial segments compared to 2D time-of-flight imaging.

    Science.gov (United States)

    Thornton, F J; Du, J; Suleiman, S A; Dieter, R; Tefera, G; Pillai, K R; Korosec, F R; Mistretta, C A; Grist, T M

    2006-08-01

    To evaluate a novel time-resolved contrast-enhanced (CE) projection reconstruction (PR) magnetic resonance angiography (MRA) method for identifying potential bypass graft target vessels in patients with Class II-IV peripheral vascular disease. Twenty patients (M:F = 15:5, mean age = 58 years, range = 48-83 years), were recruited from routine MRA referrals. All imaging was performed on a 1.5 T MRI system with fast gradients (Signa LX; GE Healthcare, Waukesha, WI). Images were acquired with a novel technique that combined undersampled PR with a time-resolved acquisition to yield an MRA method with high temporal and spatial resolution. The method is called PR hyper time-resolved imaging of contrast kinetics (PR-hyperTRICKS). Quantitative and qualitative analyses were used to compare two-dimensional (2D) time-of-flight (TOF) and PR-hyperTRICKS in 13 arterial segments per lower extremity. Statistical analysis was performed with the Wilcoxon signed-rank test. Fifteen percent (77/517) of the vessels were scored as missing or nondiagnostic with 2D TOF, but were scored as diagnostic with PR-hyperTRICKS. Image quality was superior with PR-hyperTRICKS vs. 2D TOF (on a four-point scale, mean rank = 3.3 +/- 1.2 vs. 2.9 +/- 1.2, P < 0.0001). PR-hyperTRICKS produced images with high contrast-to-noise ratios (CNR) and high spatial and temporal resolution. 2D TOF images were of inferior quality due to moderate spatial resolution, inferior CNR, greater flow-related artifacts, and absence of temporal resolution. PR-hyperTRICKS provides superior preoperative assessment of lower limb ischemia compared to 2D TOF.

  6. Region 6: Texas Austin Adequate Letter (11/23/2016)

    Science.gov (United States)

    EPA letter approves the Motor Vehicle Emissions Budgets contained in the latest revision to Dallas/Fort Worth 2008 8-hour Ozone State Implementation Plan, finding them adequate for transportation conformity purposes to be announced in the Federal Register.

  7. The iodized salt programme in Bangalore, India provides adequate iodine intakes in pregnant women and more-than-adequate iodine intakes in their children

    NARCIS (Netherlands)

    Jaiswal, N.; Boonstra, A.; Sharma, S.K.; Srinivasan, K.; Zimmerman, M.B.

    2015-01-01

    Objective To compare the iodine status of pregnant women and their children who were sharing all meals in Bangalore, India. Design A cross-sectional study evaluating demographic characteristics, household salt iodine concentration and salt usage patterns, urinary iodine concentrations (UIC) in women

  8. [Phenomenology of craving: from differentiation to adequate therapy].

    Science.gov (United States)

    Mendelevich, V D

    2010-01-01

    The author analyzes a phenomenon of addiction from the psychological/psychiatric position and differentiates it from psychopathological disorders, including parabulia, hyperbulia, paraphylia, commonly used for the definition of drive disorders. It has been concluded that addition is a specific complex of clinical symptoms which is not similar to other drive disorders. To avoid diagnostic and therapeutic errors, the author suggests to revise definitions by assigning the biological sense to the conception of addiction within psychoactive substance dependence and sexual addiction, some forms of eating dependence and to use the definition of paraaddictive drives in cases of over-valued drives (gambling, Internet dependence, fanaticism etc).

  9. Arabidopsis: an adequate model for dicot root systems?

    Directory of Open Access Journals (Sweden)

    Richard W Zobel

    2016-02-01

    Full Text Available The Arabidopsis root system is frequently considered to have only three classes of root: primary, lateral, and adventitious. Research with other plant species has suggested up to 8 different developmental/functional classes of root for a given plant root system. If Arabidopsis has only three classes of root, it may not be an adequate model for eudicot plant root systems. Recent research, however, can be interpreted to suggest that pre-flowering Arabidopsis does have at least five (5 of these classes of root. This then suggests that Arabidopsis root research can be considered an adequate model for eudicot plant root systems.

  10. Comparability and Reliability Considerations of Adequate Yearly Progress

    Science.gov (United States)

    Maier, Kimberly S.; Maiti, Tapabrata; Dass, Sarat C.; Lim, Chae Young

    2012-01-01

    The purpose of this study is to develop an estimate of Adequate Yearly Progress (AYP) that will allow for reliable and valid comparisons among student subgroups, schools, and districts. A shrinkage-type estimator of AYP using the Bayesian framework is described. Using simulated data, the performance of the Bayes estimator will be compared to…

  11. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Science.gov (United States)

    2010-01-01

    ... the security and privacy of personal data. (4) The disposal and disposition of identifiable personal... contained in a system of records are adequately trained to protect the security and privacy of such records....114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114...

  12. 4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

    Science.gov (United States)

    2010-01-01

    ... identifiable personal data and automated systems shall be adequately trained in the security and privacy of... the security and privacy of such records. (5) The disposal and destruction of identifiable personal....14 Section 200.14 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200...

  13. Need for Adequate Funding in the Administration of Secondary ...

    African Journals Online (AJOL)

    Funding is considered all over the world as the life wire that propels the educational sector towards achieving her objectives. The paper focuses on the need for adequate funding of secondary education in Nigeria. Emphases were laid on the alternative sources of funding for secondary schools as well as the consequences ...

  14. Is the Marketing Concept Adequate for Continuing Education?

    Science.gov (United States)

    Rittenburg, Terri L.

    1984-01-01

    Because educators have a social responsibility to those they teach, the marketing concept may not be adequate as a philosophy for continuing education. In attempting to broaden the audience for continuing education, educators should consider a societal marketing concept to meet the needs of the educationally disadvantaged. (SK)

  15. How Much and What Kind? Identifying an Adequate Technology Infrastructure for Early Childhood Education. Policy Brief

    Science.gov (United States)

    Daugherty, Lindsay; Dossani, Rafiq; Johnson, Erin-Elizabeth; Wright, Cameron

    2014-01-01

    To realize the potential benefits of technology use in early childhood education (ECE), and to ensure that technology can help to address the digital divide, providers, families of young children, and young children themselves must have access to an adequate technology infrastructure. The goals for technology use in ECE that a technology…

  16. 33 CFR 155.4050 - Ensuring that the salvors and marine firefighters are adequate.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Ensuring that the salvors and marine firefighters are adequate. 155.4050 Section 155.4050 Navigation and Navigable Waters COAST GUARD..., water turbidity, water depth, sea state and temperature extremes). (13) Resource provider has the...

  17. Minimal Adequate Model of Unemployment Duration in the Post-Crisis Czech Republic

    Directory of Open Access Journals (Sweden)

    Adam Čabla

    2016-03-01

    Full Text Available Unemployment is one of the leading economic problems in a developed world. The aim of this paper is to identify the differences in unemployment duration in different strata in the post-crisis Czech Republic via building a minimal adequate model, and to quantify the differences. Data from Labour Force Surveys are used and since they are interval censored in nature, proper metodology must be used. The minimal adequate model is built through the accelerated failure time modelling, maximum likelihood estimates and likelihood ratio tests. Variables at the beginning are sex, marital status, age, education, municipality size and number of persons in a household, containing altogether 29 model parameters. The minimal adequate model contains 5 parameters and differences are found between men and women, the youngest category and the rest and the university educated and the rest. The estimated expected values, variances, medians, modes and 90th percentiles are provided for all subgroups.

  18. Physiological aspect walking and Nordic walking as adequate kinetic activities.

    OpenAIRE

    BENEŠ, Václav

    2010-01-01

    This bachelor thesis on the topic of The Physiological Aspect of Walking and Nordic Walking as an adequate physical activity focuses on chosen physiological changes of an organism during a five-month training cycle. In the theoretical part I describe the physiological changes of organism during a regularly repeated strain, and also the technique of walking, Nordic walking and health benefits of these activities are defined here. The research part of the thesis describes the measurement method...

  19. 12 CFR 1206.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Banking FEDERAL HOUSING FINANCE AGENCY ORGANIZATION AND OPERATIONS ASSESSMENTS § 1206.2 Definitions. As used in this part: Act means the Federal Housing Finance Regulatory Reform Act of 2008. Adequately capitalized means the adequately capitalized capital classification under 12 U.S.C. 1364 and related...

  20. A student's perspective: are medical students adequately trained in BLS?

    Directory of Open Access Journals (Sweden)

    Oyewole T

    2016-11-01

    Full Text Available Tobi Oyewole,1 Folashade Oyewole2 1University of Liverpool – The School of Medicine, Liverpool, 2Imperial College London, London, UK We read with great interest the article by Lami et al regarding improving basic life support (BLS training for medical students.1 We agree that BLS skills are vital for junior doctors. The days of trial by fire have long gone away, and junior doctors and medical students need to feel that they are adequately trained to handle emergency situations they may face in hospital.  Read the original article

  1. Radiographic appearances following adequate transfusion in. beta. -thalassaemia

    Energy Technology Data Exchange (ETDEWEB)

    Scutellari, P.N.; Orzincolo, C.; Bagni, B.; Franceschini, F.

    1989-01-01

    The main lesions of the skull and hand, observed in a group of hypertransfused ..beta..-thalassaemic patients, are compared with a control group of low-transfused patients. Bony abnormalities reflect the relationship between proliferating bone marrow and bone cortex, and hypertransfusion therapy will prevent development of lesions only if established early in life. If this is done, the diploe in the skull may become normal, overgrowth of facial bones is moderate, pneumatisation of the paranasal sinuses is not completely prevented, and the 'hair-brush' pattern may disappear completely. A normal appearance of the hand in adequately treated patients differentiates between prepubertal patients and adults.

  2. 22 CFR 513.105 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (GRANTS) General § 513.105 Definitions. The following definitions apply to this part: Adequate evidence. Information sufficient to support the reasonable belief... designated by the agency head. Indictment. Indictment for a criminal offense. An information or other filing...

  3. Barriers to adequate prenatal care utilization in American Samoa

    Science.gov (United States)

    Hawley, Nicola L; Brown, Carolyn; Nu’usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

    2013-01-01

    Objective To describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Methods Using data from prenatal clinic records, women (n=692) were categorized according to the Adequacy of Prenatal Care Utilization Index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way Analysis of Variance (ANOVA) and independent samples t-tests. Results Between 2001 and 2008 85.4% of women received inadequate prenatal care. Parity (P=0.02), maternal unemployment (P=0.03), and both parents being unemployed (P=0.03) were negatively associated with the timing of prenatal care initation. Giving birth in 2007–2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 versus 25.12 weeks; Pprenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007–2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population. PMID:24045912

  4. [The human right to adequate food: an urban vision].

    Science.gov (United States)

    Casemiro, Juliana Pereira; Valla, Victor Vincent; Guimarães, Maria Beatriz Lisboa

    2010-07-01

    The human right to adequate food is comprehended in two dimensions: being free of hunger and denutrition and having access to an adequate food. The urban context, in which the possession of food is done primarily through merchandising because of its strong consuming appealing, became a big challenge to debate this topic in poor districts today. Here we combine considerations of a qualitative study carried out in São João de Meriti, Rio de Janeiro State, joining leaders from Pastoral da Criança in focal group sessions. The unemployment, the sub-employment and the difficulty in reaching the public health system, the social assistance and basic sanitation were presented as the major obstacles to bring into effect the human right to food. It was possible to determine that, among the strategies to fight the poverty and hunger, a big highlight is the establishment of mutual help mechanisms. The social support, generosity and religiousness were presented as the most important categories among the thoughts of the leaders. Facing a reality in which poverty and hunger appear as something inherent or become a mechanism of change during elections, the issue of the clienteles appears as a huge concern and challenge for those leaders.

  5. Quantifying dose to the reconstructed breast: Can we adequately treat?

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Eugene; Marsh, Robin B.; Griffith, Kent A.; Moran, Jean M. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Pierce, Lori J., E-mail: ljpierce@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2013-04-01

    To evaluate how immediate reconstruction (IR) impacts postmastectomy radiotherapy (PMRT) dose distributions to the reconstructed breast (RB), internal mammary nodes (IMN), heart, and lungs using quantifiable dosimetric end points. 3D conformal plans were developed for 20 IR patients, 10 autologous reconstruction (AR), and 10 expander-implant (EI) reconstruction. For each reconstruction type, 5 right- and 5 left-sided reconstructions were selected. Two plans were created for each patient, 1 with RB coverage alone and 1 with RB + IMN coverage. Left-sided EI plans without IMN coverage had higher heart Dmean than left-sided AR plans (2.97 and 0.84 Gy, p = 0.03). Otherwise, results did not vary by reconstruction type and all remaining metrics were evaluated using a combined AR and EI dataset. RB coverage was adequate regardless of laterality or IMN coverage (Dmean 50.61 Gy, D95 45.76 Gy). When included, IMN Dmean and D95 were 49.57 and 40.96 Gy, respectively. Mean heart doses increased with left-sided treatment plans and IMN inclusion. Right-sided treatment plans and IMN inclusion increased mean lung V{sub 20}. Using standard field arrangements and 3D planning, we observed excellent coverage of the RB and IMN, regardless of laterality or reconstruction type. Our results demonstrate that adequate doses can be delivered to the RB with or without IMN coverage.

  6. Is prophetic discourse adequate to address global economic justice?

    Directory of Open Access Journals (Sweden)

    Piet J. Naudé

    2011-04-01

    Full Text Available This article outlined key features of prophetic discourse and investigated whether this form of moral discourse adequately addresses issues of economic injustice. It is shown that the strength of prophetic discourse is its ability to denounce instances of injustice whilst at the same time announcing a God-willed alternative future. The ‘preferential option for the poor’ in Latin American liberation theologies is treated as a case study of the influence of prophetic discourse in contexts of perceived economic injustice. Also the core weaknesses of prophetic discourse are investigated, specifically its incomplete moral argument, weak moral analyses, silence on transition measures, and its inability to take a positive stance on reforms in the system from which itself benefits. In the final section it is concluded that prophetic discourse plays an indispensable role in addressing issues of global economic justice, but – taken by itself – it is not an adequate form of moral discourse to address concrete matters of justice.

  7. Presentations provided

    Energy Technology Data Exchange (ETDEWEB)

    Hashemian, H; Beverly, D [Analysis and Measurement Services Corp., Knoxville, TN (United States)

    1999-12-31

    The following topics covered in detail at the workshop included: temperature instrumentation; pressure instrumentation; in-situ calibration and response time testing of RTDs and pressure transmitters; on-line performance monitoring and preventive maintenance of critical equipment; automated measurement of critical parameters; nuclear power plant infrastructure, management and Quality Assurance issues and recent developments for WWER and RBMK reactors. Conclusions drawn were: aging can adversely affect the performance of nuclear plant pressure transmitters; current testing interval of once in every fuel cycle is adequate for aging management; in-situ response time measurements and on-line calibration testing methods have been developed and validated for nuclear plant pressure transmitters; NUREG/CR-5851 should be taken into account for details of aging research on pressure transmitters

  8. Presentations provided

    International Nuclear Information System (INIS)

    Hashemian, H.; Beverly, D.

    1998-01-01

    The following topics covered in detail at the workshop included: temperature instrumentation; pressure instrumentation; in-situ calibration and response time testing of RTDs and pressure transmitters; on-line performance monitoring and preventive maintenance of critical equipment; automated measurement of critical parameters; nuclear power plant infrastructure, management and Quality Assurance issues and recent developments for WWER and RBMK reactors. Conclusions drawn were: aging can adversely affect the performance of nuclear plant pressure transmitters; current testing interval of once in every fuel cycle is adequate for aging management; in-situ response time measurements and on-line calibration testing methods have been developed and validated for nuclear plant pressure transmitters; NUREG/CR-5851 should be taken into account for details of aging research on pressure transmitters

  9. Post-breast surgery pain syndrome: establishing a consensus for the definition of post-mastectomy pain syndrome to provide a standardized clinical and research approach - a review of the literature and discussion.

    Science.gov (United States)

    Waltho, Daniel; Rockwell, Gloria

    2016-09-01

    Post-mastectomy pain syndrome (PMPS) is a frequent complication of breast surgery. There is currently no standard definition for this chronic pain syndrome. The purpose of this review was to establish a consensus for defining PMPS by identifying the various elements included in the definitions and how they vary across the literature, determining how these definitions affect the methodological components therein, and proposing a definition that appropriately encompasses all of the appropriate elements. We searched PubMed to retrieve all studies and case reports on PMPS, and we analyzed definitions of PMPS, inclusion/exclusion criteria, and methods of measuring PMPS. Twenty-three studies were included in this review. We identified 7 independent domains for defining PMPS: surgical breast procedure, neuropathic nature, pain of at least moderate intensity, protracted duration, frequent symptoms, appropriate location of the symptoms and exacerbation with movement. These domains were used with varying frequency. Inclusion/exclusion criteria and methods for assessing PMPS also varied markedly. To prevent future discrepancies in both the clinical and research settings, we propose a new and complete definition based on the results of our review: PMPS is pain that occurs after any breast surgery; is of at least moderate severity; possesses neuropathic qualities; is located in the ipsilateral breast/chest wall, axilla, and/or arm; lasts at least 6 months; occurs at least 50% of the time; and may be exacerbated by movements of the shoulder girdle.

  10. Comparison of biochemical failure definitions for permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Kuban, Deborah A.; Levy, Larry B.; Potters, Louis; Beyer, David C.; Blasko, John C.; Moran, Brian J.; Ciezki, Jay P.; Zietman, Anthony L.; Zelefsky, Michael J.; Pisansky, Thomas M.; Elshaikh, Mohamed; Horwitz, Eric M.

    2006-01-01

    Purpose: To assess prostate-specific antigen (PSA) failure definitions for patients with Stage T1-T2 prostate cancer treated by permanent prostate brachytherapy. Methods and Materials: A total of 2,693 patients treated with radioisotopic implant as solitary treatment for T1-T2 prostatic adenocarcinoma were studied. All patients had a pretreatment PSA, were treated at least 5 years before analysis, 1988 to 1998, and did not receive hormonal therapy before recurrence. Multiple PSA failure definitions were tested for their ability to predict clinical failure. Results: Definitions which determined failure by a certain increment of PSA rise above the lowest PSA level to date (nadir + x ng/mL) were more sensitive and specific than failure definitions based on PSA doubling time or a certain number of PSA rises. The sensitivity and specificity for the nadir + 2 definition were 72% and 83%, vs. 51% and 81% for 3 PSA rises. The surgical type definitions (PSA exceeding an absolute value) could match this sensitivity and specificity but only when failure was defined as exceeding a PSA level in the 1-3 ng/mL range and only when patients were allowed adequate time to nadir. When failure definitions were compared by time varying covariate regression analysis, nadir + 2 ng/mL retained the best fit. Conclusions: For patients treated by permanent radioisotopic implant for prostate cancer, the definition nadir + 2 ng/mL provides the best surrogate for failure throughout the entire follow-up period, similar to patients treated by external beam radiotherapy. Therefore, the same PSA failure definition could be used for both modalities. For brachytherapy patients with long-term follow-up, at least 6 years, defining failure as exceeding an absolute PSA level in the 0.5 ng/mL range may be reasonable

  11. Calculation of the Cost of an Adequate Education in Kentucky: A Professional Judgment Approach

    Directory of Open Access Journals (Sweden)

    Deborah A. Verstegen

    2004-02-01

    Full Text Available What is an adequate education and how much does it cost? In 1989, Kentucky’s State Supreme Court found the entire system of education unconstitutional-“all of its parts and parcels”. The Court called for all children to have access to an adequate education, one that is uniform and has as its goal the development of seven capacities, including: (i “sufficient oral and written communication skills to enable students to function in a complex and rapidly changing civilization . . . .and (vii sufficient levels of academic or vocational skills to enable public school students to compete favorably with their counterparts in surrounding states, in academics or in the job market”. Now, over a decade later, key questions remain regarding whether these objectives have been fulfilled. This research is designed to calculate the cost of an adequate education by aligning resources to State standards, laws and objectives, using a professional judgment approach. Seven focus groups were convened for this purpose and the scholarly literature was reviewed to provide multiple inputs into study findings. The study produced a per pupil base cost for each of three prototype school districts and an total statewide cost, with the funding gap between existing revenue and the revenue needed for current operations of $1.097 billion per year (2001-02. Additional key resource requirements needed to achieve an adequate education, identified by professional judgment panels, include: (1 extending the school year for students and teachers, (2 adding voluntary half-day preschool for three and four year olds, and (3 raising teacher salaries. This increases the funding gap to $1.23 billion and suggests that significant new funding is required over time if the Commonwealth of Kentucky is to provide an adequate and equitable education of high quality for all children and youth as directed by the State Supreme Court.

  12. DoD Actions Were Not Adequate to Reduce Improper Travel Payments

    Science.gov (United States)

    2016-03-10

    vouchers in near real time and identifies duplicate or incorrect payments. DoD Components developed corrective actions that did not include steps to...causes of improper payments. In addition, many of the payment errors were not preventable through real - time or post-payment automated validation checks...H 1 0 , 2 0 1 6 Report No. DODIG-2016-060 DoD Actions Were Not Adequate to Reduce Improper Travel Payments Mission Our mission is to provide

  13. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  14. Bloqueio seletivo dos nervos supraescapular e axilar promove analgesia satisfatória e menor grau de bloqueio motor: comparação com o bloqueio interescalênico El bloqueo selectivo de los nervios supraescapular y axilar promueve una analgesia satisfactoria y un menor grado de bloqueo motor: comparación con el bloqueo interescalénico Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block: comparison with interscalene block

    Directory of Open Access Journals (Sweden)

    Patrícia Falcão Pitombo

    2013-02-01

    and axillary nerve blocks in shoulder arthroscopy using the interscalene approach to brachial plexus blockade. METHODS: According to the technique used, sixty-eight patients were allocated into two groups: interscalene group (IG, n = 34 and selective group (SG, n = 34, with neurostimulation approach used for both techniques. After appropriate motor response, IG received 30 mL of 0.33% levobupivacaine in 50% enantiomeric excess with adrenalin 1:200,000. After motor response of suprascapular and axillary nerves, SG received 15 mL of the same substance on each nerve. General anesthesia was then administered. Variables assessed were time to perform the blocks, analgesia, opioid consumption, motor block, cardiovascular stability, patient satisfaction and acceptability. RESULTS: Time for interscalene blockade was significantly shorter than for selective blockade. Analgesia was significantly higher in the immediate postoperative period in IG and in the late postoperative period in SG. Morphine consumption was significantly higher in the first hour in SG. Motor block was significantly lower in SG. There was no difference between groups regarding cardiocirculatory stability and patient satisfaction and acceptability. Failure occurred in IG (1 and SG (2. CONCLUSIONS: Both techniques are safe, effective, and with the same degree of satisfaction and acceptability. The selective blockade of both nerves showed satisfactory analgesia, with the advantage of providing motor block restricted to the shoulder.

  15. Hydroxyapatite clay for gap filling and adequate bone ingrowth.

    Science.gov (United States)

    Maruyama, M; Terayama, K; Ito, M; Takei, T; Kitagawa, E

    1995-03-01

    In uncemented total hip arthroplasty, a complete filling of the gap between femoral prosthesis and the host bone is difficult and defects would remain, because the anatomy of the reamed intramedullary canal cannot fit the prosthesis. Therefore, it seems practical to fill the gap with a clay containing hydroxyapatite (HA), which has an osteoconductive character. The clay (HA clay) is made by mixing HA granules (size 0.1 mm or more) having a homogeneous pore distribution and a porosity of 35-48 vol%, and a viscous substance such as a saline solution of sodium alginate (SSSA). In the first experiment, the ratio of HA granules and sodium alginate in SSSA is set for the same handling properties of HA clay and polymethylmethacrylate bone cement (standard viscosity) before hardening. As a result, the ratio is set for 55 wt% of HA in the clay and 12.5 wt% of sodium alginate in SSSA (i.e., HA:sodium alginate:saline solution = 9.8:1:7). In the second study, the gap between the femoral stem and bone model is completely filled with HA clay. However, the gap is not filled only with HA granules or HA granules mixed with saline solution. In the third animal experiment, using an unloaded model, histology shows that HA clay has an osteoconductive property bridging the gap between the implant and the cortical bone without any adverse reaction. HA clay is considered a useful biomaterial to fill the gap with adequate bone ingrowth.

  16. Improving access to adequate pain management in Taiwan.

    Science.gov (United States)

    Scholten, Willem

    2015-06-01

    There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring access for medical and scientific purposes while preventing diversion, harmful use and dependence. Furthermore, international law requires that countries ensure access to opioid analgesics for medical and scientific purposes. There is evidence that opioid analgesics for chronic pain are not associated with a major risk for developing dependence. Barriers for access can be classified in the categories of overly restrictive laws and regulations; insufficient medical training on pain management and problems related to assessment of medical needs; attitudes like an excessive fear for dependence or diversion; and economic and logistical problems. The GOPI project found many examples of such barriers in Asia. Access to opioid medicines in Taiwan can be improved by analysing the national situation and drafting a plan. The WHO policy guidelines Ensuring Balance in National Policies on Controlled Substances can be helpful for achieving this purpose, as well as international guidelines for pain treatment. Copyright © 2015. Published by Elsevier B.V.

  17. Monitoring the eye lens: which dose quantity is adequate?

    International Nuclear Information System (INIS)

    Behrens, R; Dietze, G

    2010-01-01

    Recent epidemiological studies suggest a rather low dose threshold (below 0.5 Gy) for the induction of a cataract of the eye lens. Some other studies even assume that there is no threshold at all. Therefore, protection measures have to be optimized and current dose limits for the eye lens may be reduced in the future. The question of which personal dose equivalent quantity is appropriate for monitoring the dose to the eye lens arises from this situation. While in many countries dosemeters calibrated in terms of the dose equivalent quantity H p (0.07) have been seen as being adequate for monitoring the dose to the eye lens, this might be questionable in the case of reduced dose limits and, thus, it may become necessary to use the dose equivalent quantity H p (3) for this purpose. To discuss this question, the dose conversion coefficients for the equivalent dose of the eye lens (in the following eye lens dose) were determined for realistic photon and beta radiation fields and compared with the values of the corresponding conversion coefficients for the different operational quantities. The values obtained lead to the following conclusions: in radiation fields where most of the dose comes from photons, especially x-rays, it is appropriate to use dosemeters calibrated in terms of H p (0.07) on a slab phantom, while in other radiation fields (dominated by beta radiation or unknown contributions of photon and beta radiation) dosemeters calibrated in terms of H p (3) on a slab phantom should be used. As an alternative, dosemeters calibrated in terms of H p (0.07) on a slab phantom could also be used; however, in radiation fields containing beta radiation with the end point energy near 1 MeV, an overestimation of the eye lens dose by up to a factor of 550 is possible.

  18. Are we telling the diabetic patients adequately about foot care

    International Nuclear Information System (INIS)

    Ali, R.; Din, M.J.U.; Jadoon, R.J.; Farooq, U.; Alam, M.A.; Qureshi, A.; Shah, S.U.

    2016-01-01

    Background: Diabetes mellitus affects more than 285 million people worldwide. The prevalence is expected to rise to 439 million by the year 2030. Diabetic foot ulcers precede 84 percentage of non-traumatic amputations in diabetics. One lower limb is lost every 30 seconds around the world because of diabetic foot ulceration. Apart from being lengthy, the treatment of diabetic foot is also very expensive. There is very limited emphasis on foot care in diabetic patients. Even in developed countries patients feel that they do not have adequate knowledge about foot care. This study was conducted to find out how much information is imparted by doctors to diabetic patients about foot care. Methods: This cross-sectional study was conducted in admitted patients of the Department of Medicine, DHQ Hospital, Abbottabad from May 2014 to June 2015. 139 diabetic patients more than 25 years of age were included by non-probability consecutive sampling. Results: The mean age was 57.17 ( percentage 11.1) years. 35.3 percentage of patients were male and 64.7 percentage were female. The mean duration of diabetes in patients was 8.3 (±6) years. Only 36.7 percentage of patients said that their doctor told them about foot care. Less than 40 percentage of patients knew that they should daily inspect their feet, wash them with gentle warm water, and dry them afterwards. Only 25.2 percentage of the participants knew how to manage corns or calluses on feet. 66.5 percentage of patients knew that they should not walk bare foot. Overall, 63 percentage of our patients had less than 50 percentage knowledge of the 11 points regarding foot care that the investigators asked them. Conclusion: Diabetic foot problems are the one of the costliest, most disabling and disheartening complication of diabetes mellitus. Doctors are not properly telling diabetic patients about foot care. There is a deficiency of knowledge among the diabetic patients regarding foot care. (author)

  19. Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ)-Themed Literature for Teens: Are School Libraries Providing Adequate Collections?

    Science.gov (United States)

    Hughes-Hassell, Sandra; Overberg, Elizabeth; Harris, Shannon

    2013-01-01

    The purpose of this study was to determine if young adults have access through school libraries to LGBTQ-themed literature. The library collections in 125 high schools in one Southern U.S. state were examined for the inclusion of LGBTQ-themed fiction, nonfiction, and biographies, including a core collection of 21 recommended titles. Results showed…

  20. Use of Flumazenil to Provide Adequate Recovery Time Post-Midazolom Infusion in a General Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    MOJTABA MOJTAHEDZADEH

    1999-08-01

    Full Text Available Sedation permits patients to tolerate the various treatment modalities to which they are subjected. However it may sometimes cause prolonged sedation in critically ill patients. Flumazenil, a benzo¬diazepine antagonist, reverses midazolam-induced sedation and amnesia. We prospectively designed a double-blind randomized study to evaluate the effects of flumazenil on thirty (30 Iranian General Intensive Care Unit (ICU patients. They were requiring mechanical ventilation for more than 12 hours and they were sedated by midazolam infusions. Sedation levels were measured hourly during the infusion, at the end of the infusion, and at 5, 15, 30, 60, and 120 min after cessation of the mida¬zolam infusion. Reversal of sedation was observed in all patients who received flumazenil, and re-sedation occurred in seven of these patients. Reversal was not seen in any of the patients who receiv-ed placebo.

  1. Kidney transplantation fails to provide adequate growth in children with chronic kidney disease born small for gestational age.

    Science.gov (United States)

    Franke, Doris; Steffens, Rena; Thomas, Lena; Pavičić, Leo; Ahlenstiel, Thurid; Pape, Lars; Gellermann, Jutta; Müller, Dominik; Querfeld, Uwe; Haffner, Dieter; Živičnjak, Miroslav

    2017-03-01

    Children with chronic kidney disease are frequently born small for gestational age (SGA) and prone to disproportionately short stature. It is unclear how SGA affects growth after kidney transplantation (KTx). Linear growth (height, sitting height, and leg length) was prospectively investigated in a cohort of 322 pediatric KTx recipients, with a mean follow-up of 4.9 years. Sitting height index (ratio of sitting height to total body height) was used to assess body proportions. Predictors of growth outcome in KTx patients with (n = 94) and without (n = 228) an SGA history were evaluated by the use of linear mixed-effects models. Mean z-scores for all linear body dimensions were lower in SGA compared with non-SGA patients (p deficit and degree of body disproportion (p growth during childhood. Pubertal trunk growth was diminished in SGA patients, and the pubertal growth spurt of legs was delayed in both groups, resulting in further impairment of adult height, which was more frequently reduced in SGA than in non-SGA patients (50 % vs 18 %, p growth hormone treatment in the pre-transplant period, preemptive KTx, transplant function, and control of metabolic acidosis were the only potentially modifiable correlates of post-transplant growth in SGA groups. By contrast, living related KTx, steroid exposure, and degree of anemia proved to be correlates in non-SGA only. In children born SGA, growth outcome after KTx is significantly more impaired and affected by different clinical parameters compared with non-SGA patients.

  2. Definition of drug-resistant epilepsy: is it evidence based?

    Science.gov (United States)

    Wiebe, Samuel

    2013-05-01

    Clinical case definitions are the cornerstone of clinical communication and of clinical and epidemiologic research. The ramifications of establishing a case definition are extensive, including potentially large changes in epidemiologic estimates of frequency, and decisions for clinical management. Yet, defining a condition entails numerous challenges such as defining the scope and purpose, incorporating the strongest evidence base with clinical expertise, accounting for patients' values, and considering impact on care. The clinical case definition of drug-resistant epilepsy, in addition, must address what constitutes an adequate intervention for an individual drug, what are the outcomes of relevance, what period of observation is sufficient to determine success or failure, how many medications should be tried, whether seizure frequency should play a role, and what is the role of side effects and tolerability. On the other hand, the principles of evidence-based medicine (EBM) aim at providing a systematic approach to incorporating the best available evidence into the process of clinical decision for individual patients. The case definition of drug-resistant epilepsy proposed by the the International League Against Epilepsy (ILAE) in 2009 is evaluated in terms of the principles of EBM as well as the stated goals of the authors of the definition. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

  3. LD Definition.

    Science.gov (United States)

    Learning Disability Quarterly, 1987

    1987-01-01

    The position paper (1981) of the National Joint Committee on Learning Disabilities presents a revised definition of learning disabilities and identifies issues and concerns (such as the limitation to children and the exclusion clause) associated with the definition included in P.L. 94-142, the Education for All Handicapped Children Act. (DB)

  4. The Alchemy of "Costing Out" an Adequate Education

    Science.gov (United States)

    Hanushek, Eric A.

    2006-01-01

    In response to the rapid rise in court cases related to the adequacy of school funding, a variety of alternative methods have been developed to provide an analytical base about the necessary expenditure on schools. These approaches have been titled to give an aura of a thoughtful and solid scientific basis: the professional judgment model, the…

  5. Choosing the Adequate Level of Graded Readers--Preliminary Study

    Science.gov (United States)

    Prtljaga, Jelena; Palinkaševic, Radmila; Brkic, Jovana

    2015-01-01

    Graded readers have been used as second language teaching material since the end of the Second World War. They are an important source of simplified material which provides comprehensible input on all levels. It is of crucial importance for a successful usage of graded readers in the classroom and in studies which focus on graded readers, that an…

  6. Goal Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Laurent, Alexis; Owsianiak, Mikołaj

    2018-01-01

    The goal definition is the first phase of an LCA and determines the purpose of a study in detail. This chapter teaches how to perform the six aspects of a goal definition: (1) Intended applications of the results, (2) Limitations due to methodological choices, (3) Decision context and reasons...... for carrying out the study, (4) Target audience , (5) Comparative studies to be disclosed to the public and (6) Commissioner of the study and other influential actors. The instructions address both the conduct and reporting of a goal definition and are largely based on the ILCD guidance document (EC...

  7. Scope Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Owsianiak, Mikołaj; Laurent, Alexis

    2018-01-01

    The scope definition is the second phase of an LCA. It determines what product systems are to be assessed and how this assessment should take place. This chapter teaches how to perform a scope definition. First, important terminology and key concepts of LCA are introduced. Then, the nine items...... making up a scope definition are elaborately explained: (1) Deliverables. (2) Object of assessment, (3) LCI modelling framework and handling of multifunctional processes, (4) System boundaries and completeness requirements, (5) Representativeness of LCI data, (6) Preparing the basis for the impact...... assessment, (7) Special requirements for system comparisons, (8) Critical review needs and (9) Planning reporting of results. The instructions relate both to the performance and reporting of a scope definition and are largely based on ILCD....

  8. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

    Directory of Open Access Journals (Sweden)

    Menizibeya Osain Welcome

    2011-01-01

    Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine

  9. Do clinicians receive adequate training to identify trafficked persons? A scoping review of NHS Foundation Trusts.

    Science.gov (United States)

    Thompson, Charles Dr; Mahay, Arun; Stuckler, David; Steele, Sarah

    2017-09-01

    We investigate whether physicians in secondary care in the English NHS receive adequate training to recognise and appropriately refer for services those persons suspected to be victims of human trafficking. Freedom of Information requests were sent to the 105 England's NHS Trusts delivering acute care in England. NHS Trusts providing secondary care in England. English NHS Trusts. We requested data about the training provided on human trafficking to clinicians, including the nature, delivery, and format of any education, and any planned training. A total of 89.5% of the 105 Trusts responded. Of these Trusts, 69% provide education to physicians on human trafficking, and a further 6% provide training but did not specify who received it. The majority of Trusts providing training did so within wider safeguarding provision (91%). Only one trust reported that it provides stand-alone training on trafficking to all its staff, including physicians. Within training offered by Trusts, 54% observed best practice providing training on the clinical indicators of trafficking, while 16% referenced the National Referral Mechanism. Amongst those not providing training, 39% of Trusts report provision is in development. Our results find that 25% of NHS Foundation Trusts appear to lack training for physicians around human trafficking. It is also of concern that of the Trusts who currently do not provide training, only 39% are developing training or planning to do so. There is an urgent need to review and update the scope of available training and bring it into alignment with current legislation.

  10. Improving Land Dry Farmer Capacity Toward Adequate Food Security

    Directory of Open Access Journals (Sweden)

    Sitti Aminah

    2015-09-01

    Full Text Available Land dry farmers have not enrolled in supporting food security. Most of the farmer are the peasants with low capacity to produce food. The purpose of the research is to formulate policy recommendation to increase capacity of the peasants for support food security. The data were collected using following techniques: questionnaire, interview and focus group discussion. The data were analyzed using descriptive statistics and structural equation modelling (SEM. The research results showed that the peasant characteristics and the peasants capacity are within low category, influencing the level of food security. The Government are expected actively to increase the peasant’s capacity by optimizing efforts: providing extension and training in participatory ways; increasing role of facilitator and researcher in empowerment process, increasing the peasants’ access to production input, credit facilities and wider markets, give incentive to the peasants so that they can do double working, as well as increasing coordination between government institutions and stakeholder.

  11. Chronic Disease Management Programmes: an adequate response to patients’ needs?

    Science.gov (United States)

    Rijken, Mieke; Bekkema, Nienke; Boeckxstaens, Pauline; Schellevis, François G.; De Maeseneer, Jan M.; Groenewegen, Peter P.

    2012-01-01

    Abstract Background  Inspired by American examples, several European countries are now developing disease management programmes (DMPs) to improve the quality of care for patients with chronic diseases. Recently, questions have been raised whether the disease management approach is appropriate to respond to patient‐defined needs. Objective  In this article we consider the responsiveness of current European DMPs to patients’ needs defined in terms of multimorbidity, functional and participation problems, and self‐management. Method  Information about existing DMPs was derived from a survey among country‐experts. In addition, we made use of international scientific literature. Results  Most European DMPs do not have a solid answer yet to the problem of multimorbidity. Methods of linking DMPs, building extra modules to deal with the most prevalent comorbidities and integration of case management principles are introduced. Rehabilitation, psychosocial and reintegration support are not included in all DMPs, and the involvement of the social environment of the patient is uncommon. Interventions tailored to the needs of specific social or cultural patient groups are mostly not available. Few DMPs provide access to individualized patient information to strengthen self‐management, including active engagement in decision making. Conclusion  To further improve the responsiveness of DMPs to patients’ needs, we suggest to monitor ‘patient relevant outcomes’ that might be based on the ICF‐model. To address the needs of patients with multimorbidity, we propose a generic comprehensive model, embedded in primary care. A goal‐oriented approach provides the opportunity to prioritize goals that really matter to patients. PMID:22712877

  12. Home care: from adequate funding to integration of services.

    Science.gov (United States)

    Hébert, Réjean

    2009-01-01

    With the aging of the population, the healthcare system needs to shift from the actual hospital-centred system developed in the past century for dealing with acute diseases and a young population toward a home-centred system, more appropriate for serving older people with chronic diseases. Funding of home care should not only be significantly increased but also be managed differently. We propose the introduction of an autonomy support benefit (ASB) to cover costs related to disabilities, irrespective of living environment, and to set up a public universal autonomy insurance program that will cover the ASB. This insurance should be at least partly capitalized to provide for the aging of the population and to ensure intergenerational equity. Also, since the home is a much more complicated service-delivery environment than the hospital, these services must be coordinated and integrated. The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA) is a coordination-type model of integration that was implemented and evaluated in three areas (one urban and two rural) in and around Sherbrooke, Quebec. A four-year longitudinal quasi-experimental study with over 1,500 participants demonstrated its efficiency in improving system effectiveness at no extra cost.

  13. Are hotspots of evolutionary potential adequately protected in southern California?

    Science.gov (United States)

    Vandergast, A.G.; Bohonak, A.J.; Hathaway, S.A.; Boys, J.; Fisher, R.N.

    2008-01-01

    Reserves are often designed to protect rare habitats, or "typical" exemplars of ecoregions and geomorphic provinces. This approach focuses on current patterns of organismal and ecosystem-level biodiversity, but typically ignores the evolutionary processes that control the gain and loss of biodiversity at these and other levels (e.g., genetic, ecological). In order to include evolutionary processes in conservation planning efforts, their spatial components must first be identified and mapped. We describe a GIS-based approach for explicitly mapping patterns of genetic divergence and diversity for multiple species (a "multi-species genetic landscape"). Using this approach, we analyzed mitochondrial DNA datasets from 21 vertebrate and invertebrate species in southern California to identify areas with common phylogeographic breaks and high intrapopulation diversity. The result is an evolutionary framework for southern California within which patterns of genetic diversity can be analyzed in the context of historical processes, future evolutionary potential and current reserve design. Our multi-species genetic landscapes pinpoint six hotspots where interpopulation genetic divergence is consistently high, five evolutionary hotspots within which genetic connectivity is high, and three hotspots where intrapopulation genetic diversity is high. These 14 hotspots can be grouped into eight geographic areas, of which five largely are unprotected at this time. The multi-species genetic landscape approach may provide an avenue to readily incorporate measures of evolutionary process into GIS-based systematic conservation assessment and land-use planning.

  14. Are the current Australian sun exposure guidelines effective in maintaining adequate levels of 25-hydroxyvitamin D?

    Science.gov (United States)

    Kimlin, Michael; Sun, Jiandong; Sinclair, Craig; Heward, Sue; Hill, Jane; Dunstone, Kimberley; Brodie, Alison

    2016-01-01

    An adequate vitamin D status, as measured by serum 25-hydroxyvitamin D (25(OH)D) concentration, is important in humans for maintenance of healthy bones and muscle function. Serum 25(OH)D concentration was assessed in participants from Melbourne, Australia (37.81S, 144.96E), who were provided with the current Australian guidelines on sun exposure for 25(OH)D adequacy (25(OH)D ≥50 nmol/L). Participants were interviewed in February (summer, n=104) and August (winter, n=99) of 2013. Serum 25(OH)D concentration was examined as a function of measures of sun exposure and sun protection habits with control of key characteristics such as dietary intake of vitamin D, body mass index (BMI) and skin colour, that may modify this relationship. The mean 25(OH)D concentration in participants who complied with the current sun exposure guidelines was 67.3 nmol/L in summer and 41.9 nmol/L in winter. At the end of the study, 69.3% of participants who complied with the summer sun exposure guidelines were 25(OH)D adequate, while only 27.6% of participants who complied with the winter sun exposure guidelines were 25(OH)D adequate at the end of the study. The results suggest that the current Australian guidelines for sun exposure for 25(OH)D adequacy are effective for most in summer and ineffective for most in winter. This article is part of a Special Issue entitled '17th Vitamin D Workshop'. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. HSQC-1,n-ADEQUATE: a new approach to long-range 13C-13C correlation by covariance processing.

    Science.gov (United States)

    Martin, Gary E; Hilton, Bruce D; Willcott, M Robert; Blinov, Kirill A

    2011-10-01

    Long-range, two-dimensional heteronuclear shift correlation NMR methods play a pivotal role in the assembly of novel molecular structures. The well-established GHMBC method is a high-sensitivity mainstay technique, affording connectivity information via (n)J(CH) coupling pathways. Unfortunately, there is no simple way of determining the value of n and hence no way of differentiating two-bond from three- and occasionally four-bond correlations. Three-bond correlations, however, generally predominate. Recent work has shown that the unsymmetrical indirect covariance or generalized indirect covariance processing of multiplicity edited GHSQC and 1,1-ADEQUATE spectra provides high-sensitivity access to a (13)C-(13) C connectivity map in the form of an HSQC-1,1-ADEQUATE spectrum. Covariance processing of these data allows the 1,1-ADEQUATE connectivity information to be exploited with the inherent sensitivity of the GHSQC spectrum rather than the intrinsically lower sensitivity of the 1,1-ADEQUATE spectrum itself. Data acquisition times and/or sample size can be substantially reduced when covariance processing is to be employed. In an extension of that work, 1,n-ADEQUATE spectra can likewise be subjected to covariance processing to afford high-sensitivity access to the equivalent of (4)J(CH) GHMBC connectivity information. The method is illustrated using strychnine as a model compound. Copyright © 2011 John Wiley & Sons, Ltd.

  16. 40 CFR 195.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... PROFICIENCY PROGRAMS General Provisions § 195.2 Definitions. Definitions in 15 U.S.C. 2602 and 2662 apply to... exam means the exam which evaluates individuals who provide radon measurement services in a residential...

  17. Enhancing entrepreneurship development in Bosnia and Herzegovina through adequate governmental financial support

    Directory of Open Access Journals (Sweden)

    Bahrija Umihanić

    2016-06-01

    Full Text Available Entrepreneurship and SME sector is extremely important for general economic development in Bosnia and Herzegovina. In order to enhance further development of the SME sector adequate sources of financing for businesses need to be available and accessible. Entrepreneurs and owners of small and medium businesses in Bosnia and Herzegovina are facing certain challenges in obtaining finances. The issue of accessing sources of finance for SMEs in this country has remained problematic for years. Many relevant studies worldwide emphasise the importance of adequate sources of financing entrepreneurship and SME development. However, a variety of factors influence financing of SMEs depending on the region, economic development, development of financial markets etc. In this paper the authors are addressing the problem of financing SMEs focusing on the governmental support, with emphasis on Bosnia and Herzegovina. The main aim of the paper is to provide an answer to the question whether the government support in Bosnia and Herzegovina enables SMEs to access initial financing, needed for their entrepreneurial activity. The paper presents results of an empirical research conducted among managers of SMEs in Bosnia and Herzegovina in regards to availability and adequacy of financial products for these businesses. The results indicate that entrepreneurs in B&H rarely use government funds as a source of financing business activities, which is mostly caused by insufficient funds and inefficient government procedures.

  18. Incentives for an adequate, economic and reliable Swiss transmission grid. Final version

    International Nuclear Information System (INIS)

    Twomey, P.; Neuhoff, K.; Newbery, D.

    2006-11-01

    This comprehensive final report for the Swiss Federal Office of Energy (SFOE) discusses incentives necessary for the implementation of an adequate, economic and reliable Swiss electricity transmission grid. As Switzerland moves towards a more liberalised and competitive electricity market, an essential task of policy makers will be to ensure that incentives are in place for the construction, maintenance and operation of adequate, economic and reliable transmission infrastructure. As well as continuing to serve the domestic market, the location of Switzerland at the centre of Europe also means that policy should embrace opportunities in servicing the developing European Internal Market by providing transit and other services. Topics discussed include the economic evaluation of transmission investment proposals, regulated transmission investment, investments in transmission lines by power merchants, power auctions and congestion management as well as inter-TSO compensation mechanisms. European regulations and practice are discussed as are access questions and transmission charges. Developments in interconnection management and harmonisation are examined. The particular characteristics of the Swiss energy system, its prices and its legal frameworks are discussed. Cross-border trading and security of supply are also discussed

  19. Incentives for an adequate, economic and reliable Swiss transmission grid. Final version

    Energy Technology Data Exchange (ETDEWEB)

    Twomey, P.; Neuhoff, K.; Newbery, D.

    2006-11-15

    This comprehensive final report for the Swiss Federal Office of Energy (SFOE) discusses incentives necessary for the implementation of an adequate, economic and reliable Swiss electricity transmission grid. As Switzerland moves towards a more liberalised and competitive electricity market, an essential task of policy makers will be to ensure that incentives are in place for the construction, maintenance and operation of adequate, economic and reliable transmission infrastructure. As well as continuing to serve the domestic market, the location of Switzerland at the centre of Europe also means that policy should embrace opportunities in servicing the developing European Internal Market by providing transit and other services. Topics discussed include the economic evaluation of transmission investment proposals, regulated transmission investment, investments in transmission lines by power merchants, power auctions and congestion management as well as inter-TSO compensation mechanisms. European regulations and practice are discussed as are access questions and transmission charges. Developments in interconnection management and harmonisation are examined. The particular characteristics of the Swiss energy system, its prices and its legal frameworks are discussed. Cross-border trading and security of supply are also discussed

  20. 42 CFR 51.2 - Definitions.

    Science.gov (United States)

    2010-10-01

    ..., newspaper articles, telephone calls (including anonymous calls) from any source alleging abuse or neglect of... appropriate individual program or treatment plan (including a discharge plan); provide adequate nutrition...

  1. 30 CFR 20.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... MINING PRODUCTS ELECTRIC MINE LAMPS OTHER THAN STANDARD CAP LAMPS § 20.2 Definitions. (a) Adequate... its lamp has been adjudged satisfactory under the requirements of this part. (c) Explosion-proof... or discharge of flame and without ignition of surrounding explosive methane-air mixtures. (d...

  2. 12 CFR 722.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Definitions. 722.2 Section 722.2 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS APPRAISALS § 722.2... appraiser setting forth an opinion as to the market value of an adequately-described property as of a...

  3. 12 CFR 1410.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... particular loan constitutes an independent credit risk and such determination is adequately documented in the... Banking FARM CREDIT SYSTEM INSURANCE CORPORATION PREMIUMS § 1410.2 Definitions. (a) Act means the Farm Credit Act of 1971, as amended. (b) Average principal outstanding means the average annual principal...

  4. Do clinicians receive adequate training to identify trafficked persons? A scoping review of NHS Foundation Trusts

    Science.gov (United States)

    Mahay, Arun; Stuckler, David; Steele, Sarah

    2017-01-01

    Objective We investigate whether physicians in secondary care in the English NHS receive adequate training to recognise and appropriately refer for services those persons suspected to be victims of human trafficking. Design Freedom of Information requests were sent to the 105 England’s NHS Trusts delivering acute care in England. Setting NHS Trusts providing secondary care in England. Participants English NHS Trusts. Main outcome measures We requested data about the training provided on human trafficking to clinicians, including the nature, delivery, and format of any education, and any planned training. Results A total of 89.5% of the 105 Trusts responded. Of these Trusts, 69% provide education to physicians on human trafficking, and a further 6% provide training but did not specify who received it. The majority of Trusts providing training did so within wider safeguarding provision (91%). Only one trust reported that it provides stand-alone training on trafficking to all its staff, including physicians. Within training offered by Trusts, 54% observed best practice providing training on the clinical indicators of trafficking, while 16% referenced the National Referral Mechanism. Amongst those not providing training, 39% of Trusts report provision is in development. Conclusions Our results find that 25% of NHS Foundation Trusts appear to lack training for physicians around human trafficking. It is also of concern that of the Trusts who currently do not provide training, only 39% are developing training or planning to do so. There is an urgent need to review and update the scope of available training and bring it into alignment with current legislation. PMID:28904806

  5. Quality Investing – Industry versus Academic Definitions

    NARCIS (Netherlands)

    G.S. Kyosev (Georgi); M.X. Hanauer (Matthias); J.J. Huij (Joop); S.D. Lansdorp (Simon)

    2016-01-01

    textabstractIn this study we provide an overview of common quality definitions that are currently used in the industry and those used in academic studies, and we outline the differences between these definitions. We show that there is a large dispersion in the definitions that are used for the

  6. 44 CFR 71.2 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... as by a private sector insurance company under the Write Your Own Program as authorized by 44 CFR... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Definitions. 71.2 Section 71... LEGISLATION § 71.2 Definitions. (a) Except as otherwise provided in this part, the definitions set forth in...

  7. Assuring Adequate Health Insurance for Children With Special Health Care Needs: Progress From 2001 to 2009-2010.

    Science.gov (United States)

    Ghandour, Reem M; Comeau, Meg; Tobias, Carol; Dworetzky, Beth; Hamershock, Rose; Honberg, Lynda; Mann, Marie Y; Bachman, Sara S

    2015-01-01

    To report on coverage and adequacy of health insurance for children with special health care needs (CSHCN) in 2009-2010 and assess changes since 2001. Data were from the National Survey of Children with Special Health Care Needs (NS-CSHCN), a random-digit telephone survey with 40,243 (2009-2010) and 38,866 (2001) completed interviews. Consistency and adequacy of insurance was measured by: 1) coverage status, 2) gaps in coverage, 3) coverage of needed services, 4) reasonableness of uncovered costs, and 5) ability to see needed providers, as reported by parents. Bivariate and multivariable analyses were conducted to assess factors associated with adequate insurance coverage in 2009-2010. Unadjusted and adjusted prevalence estimates were examined to identify changes in the type of insurance coverage and the proportion of CSHCN with adequate coverage by insurance type. The proportion of CSHCN with private coverage decreased from 64.7% to 50.7% between 2001 and 2009-2010, while public coverage increased from 21.7% to 34.7%; the proportion of CSHCN without any insurance declined from 5.2% to 3.5%. The proportion of CSHCN with adequate coverage varied over time and by insurance type: among privately covered CSHCN, the proportion with adequate coverage declined (62.6% to 59.6%), while among publicly covered CSHCN, the proportion with adequate insurance increased (63.0% to 70.7%). Publicly insured CSHCN experienced improvements in each of the 3 adequacy components. There has been a continued shift from private to public coverage, which is more affordable, offers benefits that are more likely to meet CSHCN needs, and allowed CSHCN to see necessary providers. Published by Elsevier Inc.

  8. When one is not enough: prevalence and characteristics of homes not adequately protected by smoke alarms.

    Science.gov (United States)

    Peek-Asa, C; Allareddy, V; Yang, J; Taylor, C; Lundell, J; Zwerling, C

    2005-12-01

    The National Fire Protection Association (NFPA) has specific recommendations about the number, location, and type of smoke alarms that are needed to provide maximum protection for a household. No previous studies have examined whether or not homes are completely protected according to these guidelines. The authors describe the prevalence and home characteristics associated with compliance to recommendations for smoke alarm installation by the NFPA. Data are from the baseline on-site survey of a randomized trial to measure smoke alarm effectiveness. The trial was housed in a longitudinal cohort study in a rural Iowa county. Of 1005 homes invited, 691 (68.8%) participated. Information about smoke alarm type, placement, and function, as well as home and occupant characteristics, was collected through an on-site household survey. Although 86.0% of homes had at least one smoke alarm, only 22.3% of homes (approximately one in five) were adequately protected according to NFPA guidelines. Fourteen percent of homes had no functioning smoke alarms. More than half of the homes with smoke alarms did not have enough of them or had installed them incorrectly, and 42.4% of homes with alarms had at least one alarm that did not operate. Homes with at least one high school graduate were nearly four times more likely to be fully protected. Homes that had multiple levels, a basement, or were cluttered or poorly cleaned were significantly less likely to be fully protected. These findings indicate that consumers may not be knowledgeable about the number of alarms they need or how to properly install them. Occupants are also not adequately maintaining the alarms that are installed.

  9. Maintaining Adequate Carbon Dioxide Washout for an Advanced Extravehicular Mobility Unit

    Science.gov (United States)

    Chullen, Cinda; Navarro, Moses; Conger, Bruce; Korona, Adam; McMillin, Summer; Norcross, Jason; Swickrath, Mike

    2013-01-01

    Over the past several years, NASA has realized tremendous progress in technology development that is aimed at the production of an Advanced Extravehicular Mobility Unit (AEMU). Of the many functions provided by the spacesuit and portable life support subsystem within the AEMU, delivering breathing gas to the astronaut along with removing the carbon dioxide (CO2) remains one of the most important environmental functions that the AEMU can control. Carbon dioxide washout is the capability of the ventilation flow in the spacesuit helmet to provide low concentrations of CO2 to the crew member to meet breathing requirements. CO2 washout performance is a critical parameter needed to ensure proper and sufficient designs in a spacesuit and in vehicle applications such as sleep stations and hygiene compartments. Human testing to fully evaluate and validate CO2 washout performance is necessary but also expensive due to the levied safety requirements. Moreover, correlation of math models becomes challenging because of human variability and movement. To supplement human CO2 washout testing, a breathing capability will be integrated into a suited manikin test apparatus to provide a safe, lower cost, stable, easily modeled alternative to human testing. Additionally, this configuration provides NASA Johnson Space Center (JSC) the capability to evaluate CO2 washout under off-nominal conditions that would otherwise be unsafe for human testing or difficult due to fatigue of a test subject. Testing has been under way in-house at JSC and analysis has been initiated to evaluate whether the technology provides sufficient performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an extravehicular activity. This paper will review recent CO2 washout testing and analysis activities, testing planned in-house with a spacesuit simulator, and the associated analytical work

  10. The enforceability of the human right to adequate food : a comparative study

    NARCIS (Netherlands)

    mr.dr. Bart F.W. Wernaart

    2013-01-01

    While the right to adequate food is often discussed in the context of developing countries, especially in situations where access to adequate food is a problem on a larger scale, this book focusses on the right to food in two Western countries in which theoretically the circumstances allow this

  11. Study Concerning Exercising an Adequate Professional Reasoning in Developing the Evaluation and Audit

    Directory of Open Access Journals (Sweden)

    Vârteiu Daniel Petru

    2017-01-01

    Even though there are regulations which clearly specify the way in which an evaluation process, respectively an adequate audit process must take place, for a good management of encountered situations and difficulties, the evaluator, respectively the auditor must exercise an adequate professional reasoning.

  12. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Science.gov (United States)

    2010-01-01

    ... veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT... and Adequate Veterinary Care § 2.40 Attending veterinarian and adequate veterinary care (dealers and... veterinary care to its animals in compliance with this section. (1) Each dealer and exhibitor shall employ an...

  13. Cognitive Attributes of Adequate and Inadequate Responders to Reading Intervention in Middle School

    Science.gov (United States)

    Miciak, Jeremy; Stuebing, Karla K.; Vaughn, Sharon; Roberts, Greg; Barth, Amy E.; Fletcher, Jack M.

    2014-01-01

    No studies have investigated the cognitive attributes of middle school students who are adequate and inadequate responders to Tier 2 reading intervention. We compared students in Grades 6 and 7 representing groups of adequate responders (n = 77) and inadequate responders who fell below criteria in (a) comprehension (n = 54); (b) fluency (n = 45);…

  14. NUKEM adjusts price definitions

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    This article is the October-November 1994 market report, providing trading volume and prices in the Uranium market. During this period, there were five deals in the spot concentrates market, five deals in the medium and long-term market, one deal in the conversion market, and two deals in the enrichment market. Restricted prices strengthened while unrestricted prices held steady. Price re-definitions were also announced

  15. XMPP The Definitive Guide

    CERN Document Server

    Saint-Andre, Peter; Smith, Kevin

    2009-01-01

    This practical book provides everything you need to know about the Extensible Messaging and Presence Protocol (XMPP) -- the open technology for real-time communication used in instant messaging, Voice over IP, real-time collaboration, social networking, microblogging, lightweight middleware, cloud computing, and more. XMPP: The Definitive Guide walks you through the thought processes and design decisions involved in building a complete XMPP-enabled application, and adding real-time interfaces to existing applications.

  16. Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia.

    Science.gov (United States)

    Semba, Richard D; de Pee, Saskia; Hess, Sonja Y; Sun, Kai; Sari, Mayang; Bloem, Martin W

    2008-02-01

    Salt iodization is the main strategy for reducing iodine deficiency disorders worldwide. Characteristics of families not using iodized salt need to be known to expand coverage. The objective was to determine whether families who do not use iodized salt have a higher prevalence of child malnutrition and mortality and to identify factors associated with not using iodized salt. Use of adequately iodized salt (>or =30 ppm), measured by rapid test kits, was assessed between January 1999 and September 2003 in 145 522 and 445 546 families in urban slums and rural areas, respectively, in Indonesia. Adequately iodized salt was used by 66.6% and 67.2% of families from urban slums and rural areas, respectively. Among families who used adequately iodized salt, mortality in neonates, infants, and children aged urban slums; among families who did not use adequately iodized salt, the respective values were 4.2% compared with 6.3%, 7.1% compared with 11.2%, and 8.5% compared with 13.3% (P rural areas. Families not using adequately iodized salt were more likely to have children who were stunted, underweight, and wasted. In multivariate analyses that controlled for potential confounders, low maternal education was the strongest factor associated with not using adequately iodized salt. In Indonesia, nonuse of adequately iodized salt is associated with a higher prevalence of child malnutrition and mortality in neonates, infants, and children aged <5 y. Stronger efforts are needed to expand salt iodization in Indonesia.

  17. [Neonatal ABO incompatibility underlies a potentially severe hemolytic disease of the newborn and requires adequate care].

    Science.gov (United States)

    Senterre, T; Minon, J-M; Rigo, J

    2011-03-01

    ABO allo-immunization is the most frequent hemolytic disease of the newborn and ABO incompatibility is present in 15-25 % of pregnancies. True ABO alloimmunization occurs in approximately one out of 150 births. Intensity is generally lower than in RhD allo-immunization. We report on three cases showing that ABO allo-immunization can lead to severe hemolytic disease of the newborn with potentially threatening hyperbilirubinemia and complications. Early diagnosis and adequate care are necessary to prevent complications in ABO incompatibility. A direct antiglobulin test is the cornerstone of diagnosis and should be performed at birth on cord blood sampling in all group infants born to O mothers, especially if of African origin. Risk factor analysis and attentive clinical monitoring during the first days of life are essential. Vigilance is even more important for infants discharged before the age of 72 h. Every newborn should be assessed for the risk of developing severe hyperbilirubinemia and should be examined by a qualified healthcare professional in the first days of life. Treatment depends on the total serum bilirubin level, which may increase very rapidly in the first 48 h of life in cases of hemolytic disease of the newborn. Phototherapy and, in severe cases, exchange transfusion are used to prevent hyperbilirubinemia encephalopathy. Intravenous immunoglobulins are used to reduce exchange transfusion. Treatments of severe hemolytic disease of the newborn should be provided and performed by trained personnel in neonatal intensive care units. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  18. Gulf War Illnesses: DOD's Conclusions about U.S. Troops' Exposure Cannot Be Adequately Supported

    National Research Council Canada - National Science Library

    Rhodes, Keith

    2004-01-01

    ... (MOD) conclusions about troops' exposure. The GAO found that DoD's and MOD's conclusions about troops' exposure to CW agents, based on DoD and CIA plume modeling, cannot be adequately supported...

  19. Region 10: Idaho Northern Ada County Adequate Letter (6/21/2013)

    Science.gov (United States)

    EPA approves motor vehicle emissions budget in the Northern Ada County PM10 State Implementation Plan, Maintenance Plan: Ten-Year Update for PM10 national ambient air quality standard, adequate for transportation conformity purposes.

  20. Cognitive Attributes of Adequate and Inadequate Responders to Reading Intervention in Middle School

    OpenAIRE

    Miciak, Jeremy; Stuebing, Karla K.; Vaughn, Sharon; Roberts, Greg; Barth, Amy Elizabeth; Fletcher, Jack M.

    2014-01-01

    No studies have investigated the cognitive attributes of middle school students who are adequate and inadequate responders to Tier 2 reading intervention. We compared students in Grades 6 and 7 representing groups of adequate responders (n = 77) and inadequate responders who fell below criteria in (a) comprehension (n = 54); (b) fluency (n = 45); and (c) decoding, fluency, and comprehension (DFC; n = 45). These students received measures of phonological awareness, listening comprehension, rap...

  1. Critical reflections on the currently leading definition of sustainable employability.

    Science.gov (United States)

    Fleuren, Bram Bi; de Grip, Andries; Jansen, Nicole Wh; Kant, Imjert; Zijlstra, Fred Rh

    2016-06-01

    Sustainable employability (SE) is an important topic as it deals with employees' abilities to function adequately at work and in the labor market throughout their working lives. However, until now there has been only one attempt to define SE in the international literature (1). This first definition is a valuable contribution to the field as it rightfully describes SE as a multidimensional concept, recognizes the importance of both employee and work characteristics, and acknowledges the inherently longitudinal nature of SE. Despite these merits, we argue that this definition of SE has some serious omissions that are important in capturing SE comprehensively. Specifically, we argue that the definition could be improved in various ways, namely, it should: (i) clarify which aspects of employment constitute someone's SE; (ii) not counterintuitively treat SE as a characteristic of both the job and the employee simultaneously; (iii) not be based on the insufficiently tested assumption that achieving value in work inherently leads to SE; (iv) be formulated in a way that SE can also apply to unemployed individuals; and (v) adequately specify how the inherently longitudinal dimension of SE should be addressed. We would like to contribute to the discussion by providing guidelines for a new adjusted definition of SE that could facilitate further research on this important concept and its determinants. Introduction SE is a topic of vital importance to individual employees, organizations and society alike. It generally refers to employees' capacities to function in work throughout their working life. As participation in work is important for individuals, organizations, and society as a whole, individuals' ability to function in work is essential. For individuals, work provides meaning, financial security as well as social contacts. Organizations need productive employees to survive. Also from a societal perspective, it is important that as many people as possible participate in

  2. Definition of containment issues

    International Nuclear Information System (INIS)

    Walker, D.H.

    1982-01-01

    Public Law 96-567 Nuclear Safety Research, Development and Demonstration Act of 1980, directed the US Department of Energy (DOE) to provide an accelerated and coordinated program for developing practical generic improvements that would enhance the capability for safe, reliable and economical operation of Light Water Nuclear Reactor Power Stations. The DOE approach to defining such a program will consist of two phases, (1) definition of program requirements and (2) implementation of the program plan. This paper summarizes the results of the program definition phase for the containment integrity function. The definition phase effort was carried out by two groups of knowledgeable technical experts from the nuclear industry, one of which addressed containment integrity. Tabulated in the paper are the issues identified by the working groups and their associated priorities. Also tabulated are those high priority issues for which ongoing programs do not appear to provide sufficient information to resolve the issue. The results of this review show that existing programs to a great extent address existing issues in a manner such that the issues should be resolved by the programs

  3. Integrated security system definition

    International Nuclear Information System (INIS)

    Campbell, G.K.; Hall, J.R. II

    1985-01-01

    The objectives of an integrated security system are to detect intruders and unauthorized activities with a high degree of reliability and the to deter and delay them until effective response/engagement can be accomplished. Definition of an effective integrated security system requires proper application of a system engineering methodology. This paper summarizes a methodology and describes its application to the problem of integrated security system definition. This process includes requirements identification and analysis, allocation of identified system requirements to the subsystem level and provides a basis for identification of synergistic subsystem elements and for synthesis into an integrated system. The paper discusses how this is accomplished, emphasizing at each step how system integration and subsystem synergism is considered. The paper concludes with the product of the process: implementation of an integrated security system

  4. Ensuring Adequate Health and Safety Information for Decision Makers during Large-Scale Chemical Releases

    Science.gov (United States)

    Petropoulos, Z.; Clavin, C.; Zuckerman, B.

    2015-12-01

    The 2014 4-Methylcyclohexanemethanol (MCHM) spill in the Elk River of West Virginia highlighted existing gaps in emergency planning for, and response to, large-scale chemical releases in the United States. The Emergency Planning and Community Right-to-Know Act requires that facilities with hazardous substances provide Material Safety Data Sheets (MSDSs), which contain health and safety information on the hazardous substances. The MSDS produced by Eastman Chemical Company, the manufacturer of MCHM, listed "no data available" for various human toxicity subcategories, such as reproductive toxicity and carcinogenicity. As a result of incomplete toxicity data, the public and media received conflicting messages on the safety of the contaminated water from government officials, industry, and the public health community. Two days after the governor lifted the ban on water use, the health department partially retracted the ban by warning pregnant women to continue avoiding the contaminated water, which the Centers for Disease Control and Prevention deemed safe three weeks later. The response in West Virginia represents a failure in risk communication and calls to question if government officials have sufficient information to support evidence-based decisions during future incidents. Research capabilities, like the National Science Foundation RAPID funding, can provide a solution to some of the data gaps, such as information on environmental fate in the case of the MCHM spill. In order to inform policy discussions on this issue, a methodology for assessing the outcomes of RAPID and similar National Institutes of Health grants in the context of emergency response is employed to examine the efficacy of research-based capabilities in enhancing public health decision making capacity. The results of this assessment highlight potential roles rapid scientific research can fill in ensuring adequate health and safety data is readily available for decision makers during large

  5. A traumatic central cord syndrome occurring after adequate decompression for cervical spondylosis: biomechanics of injury: case report.

    Science.gov (United States)

    Dickerman, Rob D; Lefkowitz, Michael; Epstein, Joseph A

    2005-10-15

    Case report with review of the literature. To present the first case of a central cord syndrome occurring after adequate decompression, and review the mechanics of the cervical spinal cord injury and postoperative biomechanical and anatomic changes occurring after cervical decompressive laminectomy. Cervical spondylosis is a common pathoanatomic occurrence in the elderly population and is thought to be one of the primary causes for a central cord syndrome. Decompressive laminectomy with or without fusion has been a primary treatment for spondylotic disease and is thought to be protective against further injury. To our knowledge, there are no cases of a central cord syndrome occurring after adequate decompression reported in the literature. Case study with extensive review of the literature. The patient underwent C3-C7 cervical laminectomy without complications. After surgery, the patient's spasticity and gait difficulties improved. She was discharged to inpatient rehabilitation for further treatment of upper extremity weakness. The patient fell in the rehabilitation center, with a central cord syndrome despite adequate decompression of her spinal canal. The patient was treated conservatively for the central cord and had minimal improvement. Decompressive laminectomy provides an immediate decompressive effect on the spinal cord as seen by the dorsal migration of the cord, however, the biomechanics of the cervical spine after decompressive laminectomy remain uncertain. This case supports the ongoing research and need for more intensive research on postoperative cervical spine biomechanics, including decompressive laminectomies, decompressive laminectomy and fusion, and laminoplasty.

  6. Prediction of Adequate Prenatal Care Utilization Based on the Extended Parallel Process Model.

    Science.gov (United States)

    Hajian, Sepideh; Imani, Fatemeh; Riazi, Hedyeh; Salmani, Fatemeh

    2017-10-01

    Pregnancy complications are one of the major public health concerns. One of the main causes of preventable complications is the absence of or inadequate provision of prenatal care. The present study was conducted to investigate whether Extended Parallel Process Model's constructs can predict the utilization of prenatal care services. The present longitudinal prospective study was conducted on 192 pregnant women selected through the multi-stage sampling of health facilities in Qeshm, Hormozgan province, from April to June 2015. Participants were followed up from the first half of pregnancy until their childbirth to assess adequate or inadequate/non-utilization of prenatal care services. Data were collected using the structured Risk Behavior Diagnosis Scale. The analysis of the data was carried out in SPSS-22 using one-way ANOVA, linear regression and logistic regression analysis. The level of significance was set at 0.05. Totally, 178 pregnant women with a mean age of 25.31±5.42 completed the study. Perceived self-efficacy (OR=25.23; Pprenatal care. Husband's occupation in the labor market (OR=0.43; P=0.02), unwanted pregnancy (OR=0.352; Pcare for the minors or elderly at home (OR=0.35; P=0.045) were associated with lower odds of receiving prenatal care. The model showed that when perceived efficacy of the prenatal care services overcame the perceived threat, the likelihood of prenatal care usage will increase. This study identified some modifiable factors associated with prenatal care usage by women, providing key targets for appropriate clinical interventions.

  7. The Goal of Adequate Nutrition: Can It Be Made Affordable, Sustainable, and Universal?

    Directory of Open Access Journals (Sweden)

    Ian McFarlane

    2016-11-01

    Full Text Available Until about 1900, large proportions of the world population endured hunger and poverty. The 20th century saw world population increase from 1.6 to 6.1 billion, accompanied and to some extent made possible by rapid improvements in health standards and food supply, with associated advances in agricultural and nutrition sciences. In this paper, I use the application of linear programming (LP in preparation of rations for farm animals to illustrate a method of calculating the lowest cost of a human diet selected from locally available food items, constrained to provide recommended levels of food energy and nutrients; then, to find a realistic minimum cost, I apply the further constraint that the main sources of food energy in the costed diet are weighted in proportion to the actual reported consumption of food items in that area. Worldwide variations in dietary preferences raise the issue as to the sustainability of popular dietary regimes, and the paper reviews the factors associated with satisfying requirements for adequate nutrition within those regimes. The ultimate physical constraints on food supply are described, together with the ways in which climate change may affect those constraints. During the 20th century, food supply increased sufficiently in most areas to keep pace with the rapid increase in world population. Many challenges will need to be overcome if food supply is to continue to meet demand, and those challenges are made more severe by rising expectations of quality of life in the developing world, as well as by the impacts of climate change on agriculture and aquaculture.

  8. Development of adequate meteorological monitoring standards for safety analysis of nuclear facilities

    International Nuclear Information System (INIS)

    Alp, E.; Lewis, P.J.

    1985-09-01

    The aim of this report is to identify what constitutes adequate meteorological information for airborne dispersion calculations in case of releases from nuclear facilities during 'normal operation', 'design postulated accidents', and 'emergency situations'. The models used for estimating downwind dispersion are reviewed, including short-range simple terrain, short-range complex terrain and medium to long range models with emphasis on Lagrangian models. The meteorogolical input parameters required for running these models are identified. The methods by which these parameters may be obtained from raw meteorological data are then considered. Emphasis is placed on well-tried and recommended methods rather than those which are currently being developed and lack long-term field tests. The meteorological data required to calculate the parameters that are in turn input to dispersion calculation methods can be obtained mainly from tower measurements. Recommended tower height is 50 m, with two levels of instruments (10 and 50 m) for wind speed, wind direction and temperature. Data for precipitation and solar radiation, that may be required under certain conditions and for special calculations, may be estimated from nearby representative weather stations (if available). For simple terrain, a single tower is sufficient. For complex terrain, such as coastal regions, two towers are desirable for accurate characterization of the turbulence regime in the vicinity of a release site. The report provides the necessary accuracy specifications for instruments required for the meteorological measurements. Data monitoring and recording, maintenance, quality control and assurance are also discussed. Error propagation analyses are recommended to determine the full implications of instrument accuracies on the accuracy of dispersion model predictions. 82 refs

  9. Importance of adequate exercise in the detection of coronary heart disease by radionuclide ventriculography

    International Nuclear Information System (INIS)

    Brady, T.J.; Thrall, J.H.; Lo, K.; Pitt, B.

    1980-01-01

    Rest and exercise radionuclide ventriculograms were obtained on 77 symptomatic patients without prior documented coronary artery disease (CAD). Coronary artery disease was present by angiograms in 48. Radionuclide ventriculography (RNV) was abnormal in 41 patients (overall sensitivity 85%). In 29 patients with normal coronary arteries, RNV was normal in 24 (specificity 83%). To determine if the exercise level affects sensitivity, the studies were graded for adequacy of exercise. It was considered adequate if patients developed (a) chest pain, or (b) ST segment depression of at least 1 mm, or (c) if they achieved a pressure rate product greater than 250. Among the 48 patients with coronary artery disease, 35 achieved adequate exercise. Thirty-three had an abnormal RNV (sensitivity 94%). In 13 patients who failed to achieve adequate exercise, RNV was abnormal in eight (sensitivity of only 62%). Some patients with coronary artery disease may have a normal ventricular response at inadequate levels of stress

  10. 5 CFR 9901.404 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... providing feedback, developing performance and addressing poor performance, and rating and rewarding... setting and communicating employee performance expectations, monitoring performance and providing feedback... (NSPS) Performance Management § 9901.404 Definitions. In this subpart— Appraisal means the review and...

  11. Cassandra the definitive guide

    CERN Document Server

    Hewitt, Eben

    2011-01-01

    What could you do with data if scalability wasn't a problem? With this hands-on guide, you'll learn how Apache Cassandra handles hundreds of terabytes of data while remaining highly available across multiple data centers -- capabilities that have attracted Facebook, Twitter, and other data-intensive companies. Cassandra: The Definitive Guide provides the technical details and practical examples you need to assess this database management system and put it to work in a production environment. Author Eben Hewitt demonstrates the advantages of Cassandra's nonrelational design, and pays special

  12. Contemporary jewelry definitions

    Directory of Open Access Journals (Sweden)

    Marlon Aparecido Mercaldi

    2016-12-01

    Full Text Available Contemporary jewelry terminology is open to many criticism and weaknesses as it is confronted with the classic definition of jewelry and also often attached to the historical widespread idea of adornment and jewelry to modernity. Therefore one of the this article issues is to approach about what it is contemporary jewelry and how it can be defined. Thus, we present the topics related to the jewel discussion in contemporary times that are organized into a set of assumptions and approaches that help us provide an overview about the contemporary jewelry.

  13. The definition of alcoholism.

    Science.gov (United States)

    Madden, J S

    1993-11-01

    Formulations of alcohol dependence are continuously refreshed, in line with changing concepts and altered needs. Two new descriptions have been prepared: the revised WHO criteria for substance use disorders and an educative definition of alcoholism. The major sets of diagnostic criteria provided by WHO and by the American Psychiatric Association are moving closer together but have not solved all the semantic problems. More refined assessments are also available to quicken fulfillment of the long-awaited hope that treatments can be matched to patients.

  14. Is the world supply of omega-3 fatty acids adequate for optimal human nutrition?

    Science.gov (United States)

    Salem, Norman; Eggersdorfer, Manfred

    2015-03-01

    To delineate the available sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for human consumption and to determine if the available supply is capable of supplying the nutrient levels recommended by expert bodies. There are converging opinions among experts, professional organizations and health professionals that a recommendation for a daily individual consumption of 500 mg of EPA/DHA would provide health benefits, and this translates to an annual human consumption of 1.3 million metric tons. Current human consumption of EPA/DHA is estimated to be only a small fraction of this amount and many people may suffer from suboptimal health as a result of low intake. EPA and DHA originate in the phytoplankton and are made available in the human food chain mainly through fish and other seafood. The fish catch is not elastic and in fact has long since reached a plateau. Aquaculture has grown rapidly, but most of the fish oil produced is currently being used to support aquaculture feed and so this would appear to limit aquaculture growth - or at least the growth in availability of fish sources of EPA/DHA. Vegetable oil-derived alpha-linolenic acid, though relatively plentiful, is converted only at a trace level in humans to DHA and not very efficiently to EPA, and so cannot fill this gap. Microbial EPA/DHA production can in the future be increased, although this oil is likely to remain more expensive than fish oil. Plant sources of EPA and DHA have now been produced in the laboratory via transgenic means and will eventually clear regulatory hurdles for commercialization, but societal acceptance remains in question. The purpose of this review is to discuss the various sources of omega-3 fatty acids within the context of the potential world demand for these nutrients. In summary, it is concluded that fish and vegetable oil sources will not be adequate to meet future needs, but that algal oil and terrestrial plants modified genetically to produce EPA and DHA

  15. Pharmaceutical care: the PCNE definition 2013.

    Science.gov (United States)

    Allemann, Samuel S; van Mil, J W Foppe; Botermann, Lea; Berger, Karin; Griese, Nina; Hersberger, Kurt E

    2014-06-01

    Twenty-three years after Hepler and Strand published their well-known definition of Pharmaceutical Care (PhC), confusion remains about what the term includes and how to differentiate it from other terms. The board of the Pharmaceutical Care Network Europe (PCNE) felt the need to redefine PhC and to answer the question: "What is Pharmaceutical Care in 2013". The aims of this paper were to review existing definitions of PhC and to describe the process of developing a redefined definition. A literature search was conducted in the MEDLINE database (1964-January 2013). Keywords included "Pharmaceutical Care", "Medication (Therapy) Management", "Medicine Management", and "Pharmacist Care" in the title or abstract together with the term "defin*". To ease comparison between definitions, we developed a standardised syntax to paraphrase the definitions. During a dedicated meeting, a moderated discussion about the definition of PhC was organised. The initial literature search produced 186 hits, with eight unique PhC definitions. Hand searching identified a further 11 unique definitions. These 19 definitions were paraphrased using the standardised syntax (provider, recipient, subject, outcome, activities). Fourteen members of PCNE and 10 additional experts attended the moderated discussion. Working groups of increasing size developed intermediate definitions, which had similarities and differences to those retrieved in the literature search. At the end of the session, participants reached a consensus on a "PCNE definition of Pharmaceutical Care" reading: "Pharmaceutical Care is the pharmacist's contribution to the care of individuals in order to optimize medicines use and improve health outcomes". It was possible to paraphrase definitions of PhC using a standardised syntax focusing on the provider, recipient, subject, outcomes, and activities included in PhC practice. During a one-day workshop, experts in PhC research agreed on a definition, intended to be applicable for the

  16. Protecting the Home and Adequate Housing - Living in a Caravan or Trailer as a Human Right

    NARCIS (Netherlands)

    Donders, Y.

    2016-01-01

    Many Roma, gypsies and travellers live in caravans or trailers, sometimes in together trailer parks or camps. This article analyses how this specific lifestyle connected to their housing is protected under the various regimes and provisions of international human rights law. Home and adequate

  17. Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

    Science.gov (United States)

    Godrich, Stephanie L; Lo, Johnny; Davies, Christina R; Darby, Jill; Devine, Amanda

    2017-01-03

    Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD) (i.e., food availability, access, and utilisation dimensions) and adequate vegetable consumption among children living in regional and remote Western Australia (WA). Caregiver-child dyads ( n = 256) living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23). A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria ( p ≤ 0.20) for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed ( p = 0.007), promotion ( p = 0.017), location of food outlets ( p = 0.027), and price ( p = 0.043). Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned) are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

  18. 12 CFR 1229.5 - Capital distributions for adequately capitalized Banks.

    Science.gov (United States)

    2010-01-01

    ... capitalized Banks. 1229.5 Section 1229.5 Banks and Banking FEDERAL HOUSING FINANCE AGENCY ENTITY REGULATIONS CAPITAL CLASSIFICATIONS AND PROMPT CORRECTIVE ACTION Federal Home Loan Banks § 1229.5 Capital... classification of adequately capitalized. A Bank may not make a capital distribution if such distribution would...

  19. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets

    DEFF Research Database (Denmark)

    Parlesak, A.; Tetens, Inge; Dejgård Jensen, Jørgen

    2016-01-01

    Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent ...

  20. Towards 31Mg-β-NMR resonance linewidths adequate for applications in magnesium chemistry

    DEFF Research Database (Denmark)

    Stachura, M.; McFadden, R. M. L.; Chatzichristos, A.

    2017-01-01

    The span of most chemical shifts recorded in conventional 25Mg-NMR spectroscopy is ~ 100 ppm. Accordingly, linewidths of ~ 10 ppm or better are desirable to achieve adequate resolution for applications in chemistry. Here we present first high-field 31Mg- β-NMR measurements of 31Mg+ ions implanted...

  1. Long-Term Recurrent Subarachnoid Hemorrhage After Adequate Coiling Versus Clipping of Ruptured Intracranial Aneurysms

    NARCIS (Netherlands)

    Schaafsma, Joanna D.; Sprengers, Marieke E.; van Rooij, Willem Jan; Sluzewski, Menno; Majoie, Charles B. L. M.; Wermer, Marieke J. H.; Rinkel, Gabriel J. E.

    Background and Purpose-Coiling is increasingly used as treatment for intracranial aneurysms. Despite its favorable short-term outcome, concerns exist about long-term reopening and inherent risk of recurrent subarachnoid hemorrhage (SAH). We hypothesized a higher risk for recurrent SAH after adequate

  2. 76 FR 51041 - Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop

    Science.gov (United States)

    2011-08-17

    ...] Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop AGENCY: Food and... Donors.'' The purpose of this public workshop is to discuss blood donor hemoglobin and hematocrit qualification standards in the United States, its impact on donor safety and blood availability, and potential...

  3. Maintaining adequate nutrient supply - Principles, decision-support tools, and best management practices [Chapter 6

    Science.gov (United States)

    Robert B. Harrison; Douglas A. Maguire; Deborah Page-Dumroese

    2011-01-01

    Maintaining adequate nutrient supply to maintain or enhance tree vigor and forest growth requires conservation of topsoil and soil organic matter. Sometimes nutrient amendments are also required to supplement inherent nutrient-pool limitations or replenish nutrients removed in harvested material. The goal is to maintain the productive potential of the soil and, when...

  4. Global Uranium And Thorium Resources: Are They Adequate To Satisfy Demand Over The Next Half Century?

    Science.gov (United States)

    Lambert, I. B.

    2012-04-01

    This presentation will consider the adequacy of global uranium and thorium resources to meet realistic nuclear power demand scenarios over the next half century. It is presented on behalf of, and based on evaluations by, the Uranium Group - a joint initiative of the OECD Nuclear Energy Agency and the International Atomic Energy Agency, of which the author is a Vice Chair. The Uranium Group produces a biennial report on Uranium Resources, Production and Demand based on information from some 40 countries involved in the nuclear fuel cycle, which also briefly reviews thorium resources. Uranium: In 2008, world production of uranium amounted to almost 44,000 tonnes (tU). This supplied approximately three-quarters of world reactor requirements (approx. 59,000 tU), the remainder being met by previously mined uranium (so-called secondary sources). Information on availability of secondary sources - which include uranium from excess inventories, dismantling nuclear warheads, tails and spent fuel reprocessing - is incomplete, but such sources are expected to decrease in market importance after 2013. In 2008, the total world Reasonably Assured plus Inferred Resources of uranium (recoverable at less than 130/kgU) amounted to 5.4 million tonnes. In addition, it is clear that there are vast amounts of uranium recoverable at higher costs in known deposits, plus many as yet undiscovered deposits. The Uranium Group has concluded that the uranium resource base is more than adequate to meet projected high-case requirements for nuclear power for at least half a century. This conclusion does not assume increasing replacement of uranium by fuels from reprocessing current reactor wastes, or by thorium, nor greater reactor efficiencies, which are likely to ameliorate future uranium demand. However, progressively increasing quantities of uranium will need to be mined, against a backdrop of the relatively small number of producing facilities around the world, geopolitical uncertainties and

  5. Subjects with molecularly defined familial hypercholesterolemia or familial defective apoB-100 are not being adequately treated.

    Directory of Open Access Journals (Sweden)

    Trond P Leren

    2011-02-01

    Full Text Available To study whether subjects with a molecular genetic diagnosis of familial hypercholesterolemia (FH or familial defective apoB-100 (FDB are being adequately treated.A questionnaire regarding medical history was sent to 2611 subjects who had been provided with a molecular genetic diagnosis of FH or FDB, and a blood sample was obtained for lipid measurements.956 (36.6% of the 2611 subjects participated. The mean age for starting lipid-lowering therapy was 33.4 (±12.1 years. Among those below 18 years of age, only 20.4% were on lipid-lowering drugs, whereas 89.1% of those aged 18 and above were on lipid-lowering drugs. The mean levels of total serum cholesterol and LDL-cholesterol were 5.7 (±1.5 mmol/l and 3.9 (±1.3 mmol/l, respectively. Among those who were on lipid-lowering drugs, 29.0% and 12.2% had levels of LDL cholesterol below 3.0 mmol/l and 2.6 mmol/l, respectively. Only 47.3% of the 956 subjects were considered as being adequately treated largely due to a failure to titrate their drug regimens. From the use of cholesterol-years score, lipid-lowering therapy must start before the age of 20 in order to prevent the subjects from contracting premature coronary heart disease.The majority of FH/FDB subjects are being diagnosed late in life and are not being adequately treated. In order to prevent them from contracting premature coronary heart disease, it is key that levels of LDL cholesterol are normalized from a young age and that sufficient doses of lipid-lowering drugs are being used.

  6. Adequate Consultation And Dialogue With Local Community Unlocking The Untapped Potential For Peace And Development Evidences From South Omo Zone

    Directory of Open Access Journals (Sweden)

    Mohammed Yimer

    2017-10-01

    Full Text Available The paper argues that adequate consultation and public wide dialogues at the grass root level are the two potential entry points in times of development interventions. This will foster peace among the nearby people and led a foundation for the subsequent development. The study was undertaken to examine whether the agro-pastoral communities of South Omo zone were jeopardized as a result of the Omo Kuraz Sugar development project or not. It also targeted whether there was adequate consultation with the local people at the earliest days of the project. Adopting Ethnographic design the study accompanied by primary data collected through participant observation focus group discussion and key informant interview indicated that there were attempts to consult the indigenous people though not adequate. It also indicated that despite the absence of compensation for the local displaced people due to their mobile life the people were not endangered as a result of the project. This project as a development project that is established at the communal land of the agro-pastoralists is providing training for the nearby people to hire them in its various offices. Far from the claims of the various oversees institutions propounded as if the agro-pastoral communities were miserably suffered from such a project the people consider it as if it is their own project. The study implied that South Omo zone is a counter example of how local level consultation and a wide range of dialogue are indispensable preconditions to foster peace and development in many pastoral and agro-pastoral areas of the country.

  7. Training Manual for Elements of Interface Definition and Control

    Science.gov (United States)

    Lalli, Vincent R. (Editor); Kastner, Robert E. (Editor); Hartt, Henry N. (Editor)

    1997-01-01

    The primary thrust of this manual is to ensure that the format and information needed to control interfaces between equipment are clear and understandable. The emphasis is on controlling the engineering design of the interface and not on the functional performance requirements of the system or the internal workings of the interfacing equipment. Interface control should take place, with rare exception, at the interfacing elements and no further. There are two essential sections of the manual. Chapter 2, Principles of Interface Control, discusses how interfaces are defined. It describes different types of interfaces to be considered and recommends a format for the documentation necessary for adequate interface control. Chapter 3, The Process: Through the Design Phases, provides tailored guidance for interface definition and control. This manual can be used to improve planned or existing interface control processes during system design and development. It can also be used to refresh and update the corporate knowledge base. The information presented herein will reduce the amount of paper and data required in interface definition and control processes by as much as 50 percent and will shorten the time required to prepare an interface control document. It also highlights the essential technical parameters that ensure that flight subsystems will indeed fit together and function as intended after assembly and checkout.

  8. Definition of Nonequilibrium Entropy of General Systems

    OpenAIRE

    Mei, Xiaochun

    1999-01-01

    The definition of nonequilibrium entropy is provided for the general nonequilibrium processes by connecting thermodynamics with statistical physics, and the principle of entropy increment in the nonequilibrium processes is also proved in the paper. The result shows that the definition of nonequilibrium entropy is not unique.

  9. Emotion-Related Regulation: Sharpening the Definition

    Science.gov (United States)

    Eisenberg, Nancy; Spinrad, Tracy L.

    2004-01-01

    Cole, Martin, and Dennis (this issue) considered many important conceptual and methodological issues in their discussion of emotion regulation. Although it may be necessary to develop an integrated definition of the construct of emotion regulation, the definition provided in the Cole et al. article is too encompassing. It is important to…

  10. 12 CFR 952.1 - Definitions.

    Science.gov (United States)

    2010-01-01

    .... Targeted community lending means providing financing for economic development projects for targeted... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Definitions. 952.1 Section 952.1 Banks and... INVESTMENT CASH ADVANCE PROGRAMS § 952.1 Definitions. As used in this part: Champion Community means a...

  11. 13 CFR 120.10 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Provider is an entity that contracts with a Lender or CDC to perform management, marketing, legal or other... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Definitions. 120.10 Section 120.10 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Definitions § 120.10...

  12. 7 CFR 652.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ..., unless specified otherwise: Approved list means the list of individuals, private sector entities, or... 7 Agriculture 6 2010-01-01 2010-01-01 false Definitions. 652.2 Section 652.2 Agriculture... AGRICULTURE SUPPORT ACTIVITIES TECHNICAL SERVICE PROVIDER ASSISTANCE General Provisions § 652.2 Definitions...

  13. 46 CFR 71.50-1 - Definitions relating to hull examinations.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Definitions relating to hull examinations. 71.50-1... INSPECTION AND CERTIFICATION Drydocking § 71.50-1 Definitions relating to hull examinations. As used in this part— Adequate hull protection system means a method of protecting the vessel's hull from corrosion. It...

  14. Preliminary definition of improvement in juvenile arthritis.

    Science.gov (United States)

    Giannini, E H; Ruperto, N; Ravelli, A; Lovell, D J; Felson, D T; Martini, A

    1997-07-01

    standardize the conduct and reporting of clinical trials, and should help practitioners decide if a child with JA has responded adequately to therapy. We are in the process of prospectively validating this definition and several others that scored highly.

  15. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Science.gov (United States)

    2010-10-01

    ... this section, on the accrual method of accounting. (3) For governmental institutions that use a cash basis of accounting, cost data developed on this basis is acceptable. However, only depreciation on... definitions and accounting, statistics, and reporting practices that are widely accepted in the health care...

  16. NASA Technology Readiness Level Definitions

    Science.gov (United States)

    Mcnamara, Karen M.

    2012-01-01

    This presentation will cover the basic Technology Readiness Level (TRL) definitions used by the National Aeronautics and Space Administration (NASA) and their specific wording. We will discuss how they are used in the NASA Project Life Cycle and their effectiveness in practice. We'll also discuss the recent efforts by the International Standards Organization (ISO) to develop a broadly acceptable set of TRL definitions for the international space community and some of the issues brought to light. This information will provide input for further discussion of the use of the TRL scale in manufacturing.

  17. Which Food Security Determinants Predict Adequate Vegetable Consumption among Rural Western Australian Children?

    Directory of Open Access Journals (Sweden)

    Stephanie L. Godrich

    2017-01-01

    Full Text Available Improving the suboptimal vegetable consumption among the majority of Australian children is imperative in reducing chronic disease risk. The objective of this research was to determine whether there was a relationship between food security determinants (FSD (i.e., food availability, access, and utilisation dimensions and adequate vegetable consumption among children living in regional and remote Western Australia (WA. Caregiver-child dyads (n = 256 living in non-metropolitan/rural WA completed cross-sectional surveys that included questions on FSD, demographics and usual vegetable intake. A total of 187 dyads were included in analyses, which included descriptive and logistic regression analyses via IBM SPSS (version 23. A total of 13.4% of children in this sample had adequate vegetable intake. FSD that met inclusion criteria (p ≤ 0.20 for multivariable regression analyses included price; promotion; quality; location of food outlets; variety of vegetable types; financial resources; and transport to outlets. After adjustment for potential demographic confounders, the FSD that predicted adequate vegetable consumption were, variety of vegetable types consumed (p = 0.007, promotion (p = 0.017, location of food outlets (p = 0.027, and price (p = 0.043. Food retail outlets should ensure that adequate varieties of vegetable types (i.e., fresh, frozen, tinned are available, vegetable messages should be promoted through food retail outlets and in community settings, towns should include a range of vegetable purchasing options, increase their reliance on a local food supply and increase transport options to enable affordable vegetable purchasing.

  18. Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

    Directory of Open Access Journals (Sweden)

    Bumpers Harvey L

    2011-05-01

    Full Text Available Abstract Background Although evaluation of at least 12 lymph nodes (LNs is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs. Methods To evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected. Results For patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91, but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64, examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87 and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26 decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p Conclusions Thus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

  19. Implementation of selective prevention for cardiometabolic diseases; are Dutch general practices adequately prepared?

    Science.gov (United States)

    Stol, Daphne M; Hollander, Monika; Nielen, Markus M J; Badenbroek, Ilse F; Schellevis, François G; de Wit, Niek J

    2018-03-01

    Current guidelines acknowledge the need for cardiometabolic disease (CMD) prevention and recommend five-yearly screening of a targeted population. In recent years programs for selective CMD-prevention have been developed, but implementation is challenging. The question arises if general practices are adequately prepared. Therefore, the aim of this study is to assess the organizational preparedness of Dutch general practices and the facilitators and barriers for performing CMD-prevention in practices currently implementing selective CMD-prevention. Observational study. Dutch primary care. General practices. Organizational characteristics. General practices implementing selective CMD-prevention are more often organized as a group practice (49% vs. 19%, p = .000) and are better organized regarding chronic disease management compared to reference practices. They are motivated for performing CMD-prevention and can be considered as 'frontrunners' of Dutch general practices with respect to their practice organization. The most important reported barriers are a limited availability of staff (59%) and inadequate funding (41%). The organizational infrastructure of Dutch general practices is considered adequate for performing most steps of selective CMD-prevention. Implementation of prevention programs including easily accessible lifestyle interventions needs attention. All stakeholders involved share the responsibility to realize structural funding for programmed CMD-prevention. Aforementioned conditions should be taken into account with respect to future implementation of selective CMD-prevention. Key Points   There is need for adequate CMD prevention. Little is known about the organization of selective CMD prevention in general practices.   • The organizational infrastructure of Dutch general practices is adequate for performing most steps of selective CMD prevention.   • Implementation of selective CMD prevention programs including easily accessible

  20. The adequate rocuronium dose required for complete block of the adductor muscles of the thigh.

    Science.gov (United States)

    Fujimoto, M; Kawano, K; Yamamoto, T

    2018-03-01

    Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced. Rocuronium, 0.15 mg/kg, was repeatedly administered intravenously. The adequate rocuronium dose required for complete block of the thigh muscles, defined as the cumulative dose of rocuronium administered until that time, and its correlation with the first twitch response of the adductor pollicis muscle on train-of-four stimulation after initial rocuronium administration was analyzed. The rocuronium dose found adequate for complete block of the thigh muscles was 0.30 mg/kg in seven patients and 0.45 mg/kg in the remaining four patients, which did not correlate with the first twitch response. At the time of complete block of the thigh muscles, the neuromuscular blockade level of the adductor pollicis muscle varied greatly, although the level was never more profound than a post-tetanic count of 1. Although the response of the adductor pollicis muscle to rocuronium cannot be used to determine the adequate rocuronium dose required for complete block of the thigh muscles, intense blockade, with maintenance of post-tetanic count at ≤ 1 in the adductor pollicis muscle is essential to prevent the obturator jerk. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Does Current Army Physical Fitness Training Doctrine Adequately Prepare Soldiers for War?

    Science.gov (United States)

    2010-06-11

    longer 7 adequate to sustain the activity. Anaerobic activities include sprinting, soccer , and basketball. Balance: The ability to maintain...deep muscles, and joint articulations. The common push-up requires the interaction of 21 different muscles to execute one repetition. The overhead press...aerobically break down glycogen, carbohydrates , and fats to produce energy. The more regularly the individual conducts cardio-respiratory training

  2. Median Urinary Iodine Concentrations Are Indicative of Adequate Iodine Status among Women of Reproductive Age in Prey Veng, Cambodia.

    Science.gov (United States)

    Karakochuk, Crystal D; Michaux, Kristina D; Chai, Tze L; Chan, Benny B; Whitfield, Kyly C; Barr, Susan I; McLean, Judy; Talukder, Aminuzzaman; Hou, Kroeun; Ly, Sokhoing; Green, Tim J

    2016-03-03

    Iodine deficiency disorders are estimated to affect over 1.9 million people worldwide. Iodine deficiency is especially serious for women during pregnancy and lactation because of the negative consequences for both mother and infant. The aim of this cross-sectional study was to determine the median urinary iodine concentration (UIC) as a population-level indicator of iodine status among rural women farmers of reproductive age (18-45 years) in the province of Prey Veng, Cambodia. A total of 450 women provided a spot morning urine sample in 2012. Of those women, 93% (n = 420) were non-pregnant and 7% (n = 30) were pregnant at the time of collection. UIC was quantified using the Sandell-Kolthoff reaction with modifications. The median UIC of non-pregnant (139 μg/L) and pregnant women (157 μg/L) were indicative of adequate iodine status using the WHO/UNICEF/ICCIDD epidemiological criteria for both groups (median UIC between 100-199 and 150-249 μg/L, respectively). We conclude that non-pregnant and pregnant women in rural Prey Veng, Cambodia had adequate iodine status based on single spot morning urine samples collected in 2012. More research is warranted to investigate iodine status among larger and more representative populations of women in Cambodia, especially in light of recent policy changes to the national program for universal salt iodization.

  3. Biodiversity of the Great Barrier Reef—how adequately is it protected?

    Directory of Open Access Journals (Sweden)

    Zoe T. Richards

    2018-05-01

    Full Text Available Background The Great Barrier Reef (GBR is the world’s most iconic coral reef ecosystem, recognised internationally as a World Heritage Area of outstanding significance. Safeguarding the biodiversity of this universally important reef is a core legislative objective; however, ongoing cumulative impacts including widespread coral bleaching and other detrimental impacts have heightened conservation concerns for the future of the GBR. Methods Here we review the literature to report on processes threatening species on the GBR, the status of marine biodiversity, and evaluate the extent of species-level monitoring and reporting. We assess how many species are listed as threatened at a global scale and explore whether these same species are protected under national threatened species legislation. We conclude this review by providing future directions for protecting potentially endangered elements of biodiversity within the GBR. Results Most of the threats identified to be harming the diversity of marine life on the GBR over the last two–three decades remain to be effectively addressed and many are worsening. The inherent resilience of this globally significant coral reef ecosystem has been seriously compromised and various elements of the biological diversity for which it is renowned may be at risk of silent extinction. We show at least 136 of the 12,000+ animal species known to occur on the GBR (approximately 20% of the 700 species assessed by the IUCN occur in elevated categories of threat (Critically Endangered, Endangered or Vulnerable at a global scale. Despite the wider background level of threat for these 136 species, only 23 of them are listed as threatened under regional or national legislation. Discussion To adequately protect the biodiversity values of the GBR, it may be necessary to conduct further targeted species-level monitoring and reporting to complement ecosystem management approaches. Conducting a vigorous value of information

  4. Self-esteem, social support, and satisfaction differences in women with adequate and inadequate prenatal care.

    Science.gov (United States)

    Higgins, P; Murray, M L; Williams, E M

    1994-03-01

    This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.

  5. The impact of urban gardens on adequate and healthy food: a systematic review.

    Science.gov (United States)

    Garcia, Mariana T; Ribeiro, Silvana M; Germani, Ana Claudia Camargo Gonçalves; Bógus, Cláudia M

    2018-02-01

    To examine the impacts on food and nutrition-related outcomes resulting from participation in urban gardens, especially on healthy food practices, healthy food access, and healthy food beliefs, knowledge and attitudes. The systematic review identified studies by searching the PubMed, ERIC, LILACS, Web of Science and Embase databases. An assessment of quality and bias risk of the studies was carried out and a narrative summary was produced. Studies published as original articles in peer-reviewed scientific journals in English, Spanish or Portuguese between 2005 and 2015 were included. The studies included were based on data from adult participants in urban gardens. Twenty-four studies were initially selected based on the eligibility criteria, twelve of which were included. There was important heterogeneity of settings, population and assessment methods. Assessment of quality and bias risk of the studies revealed the need for greater methodological rigour. Most studies investigated community gardens and employed a qualitative approach. The following were reported: greater fruit and vegetable consumption, better access to healthy foods, greater valuing of cooking, harvest sharing with family and friends, enhanced importance of organic production, and valuing of adequate and healthy food. Thematic patterns related to adequate and healthy food associated with participation in urban gardens were identified, revealing a positive impact on practices of adequate and healthy food and mainly on food perceptions.

  6. Current strategies for the restoration of adequate lordosis during lumbar fusion

    Science.gov (United States)

    Barrey, Cédric; Darnis, Alice

    2015-01-01

    Not restoring the adequate lumbar lordosis during lumbar fusion surgery may result in mechanical low back pain, sagittal unbalance and adjacent segment degeneration. The objective of this work is to describe the current strategies and concepts for restoration of adequate lordosis during fusion surgery. Theoretical lordosis can be evaluated from the measurement of the pelvic incidence and from the analysis of spatial organization of the lumbar spine with 2/3 of the lordosis given by the L4-S1 segment and 85% by the L3-S1 segment. Technical aspects involve patient positioning on the operating table, release maneuvers, type of instrumentation used (rod, screw-rod connection, interbody cages), surgical sequence and the overall surgical strategy. Spinal osteotomies may be required in case of fixed kyphotic spine. AP combined surgery is particularly efficient in restoring lordosis at L5-S1 level and should be recommended. Finally, not one but several strategies may be used to achieve the need for restoration of adequate lordosis during fusion surgery. PMID:25621216

  7. Developing a model for the adequate description of electronic communication in hospitals.

    Science.gov (United States)

    Saboor, Samrend; Ammenwerth, Elske

    2011-01-01

    Adequate information and communication systems (ICT) can help to improve the communication in hospitals. Changes to the ICT-infrastructure of hospitals must be planed carefully. In order to support a comprehensive planning, we presented a classification of 81 common errors of the electronic communication on the MIE 2008 congress. Our objective now was to develop a data model that defines specific requirements for an adequate description of electronic communication processes We first applied the method of explicating qualitative content analysis on the error categorization in order to determine the essential process details. After this, we applied the method of subsuming qualitative content analysis on the results of the first step. A data model for the adequate description of electronic communication. This model comprises 61 entities and 91 relationships. The data model comprises and organizes all details that are necessary for the detection of the respective errors. It can be for either used to extend the capabilities of existing modeling methods or as a basis for the development of a new approach.

  8. Evaluation of the condensation potential of hydrocarbon fluids in the national gas pipeline system; establishing of adequate operational schemes

    International Nuclear Information System (INIS)

    Pineda Gomez, Cesar Augusto; Arenas Mantilla, Oscar Armando; Santos Santos, Nicolas

    2007-01-01

    For transporting industry of natural gas by pipeline systems, it's vital to guarantee the integrity of their lines, in order to decrease operational costs and prevent accidents that may damaging against people's safety, the environment or the infrastructure itself. in this paper it's presented the principal compounds from o technical study about principal net and its distribution branches to municipalities of the National System Transport of Natural Gas pointed by the Colombian Natural Gas Company - ECOGAS, (specifically the Cusiana - Porvenir - La Belleza, La Belleza - Cogua, La Belleza - Vasconia, Vasconia - Neiva and Vasconia - Cali gas lines, (see Figure 1). The principal objective is evaluate the possible condensation of hydrocarbons fluids inside gas lines, due to compositional characteristics of the gas, the different topographical conditions along the gas line route and the actual and future operational conditions to be implemented in the system. The evaluation performed over this gas streams, generates transcendental information in the creation of safe operational limits that minimizing the existence of obstacle problems and damages over pipeline systems and process equipment, due to the presence of liquid hydrocarbons inside these flow lines. This article has been prepared in four sections in order to guarantee easy access to each one of the steps involved in the study. Section one presents the compositional and thermodynamic analysis of feeding gas streams; in section two, its presented the required information for modeling gas lines with definition of the gas pipeline numerical simulation model in stable state; section three presents the sensitivity analysis for gas variation upon loading gas composition at the inlet point of the system, variation of the operational conditions (flow, pressure and gas temperature) and environment temperatures for the different inlet points (branches) with verification of compliance of the Unique Transport Regulation

  9. Clear Purpose...Complete Commitment: A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs, 1992-1996.

    Science.gov (United States)

    Jaques, Thomas F.

    This report identifies specific inadequacies in Louisiana public library services, resources, facilities, and personnel. It also identifies the people who are to be served, and reveals the geographical, sociological, economic, and educational barriers to the expanded use of libraries. Finally, it presents specific goals and objectives as part of…

  10. Clear Purpose...Complete Commitment: A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs, 1995-1999.

    Science.gov (United States)

    Jaques, Thomas F.

    This document presents the five year library plan for public libraries in Louisiana. It identifies the specific inadequacies in public library services, resources, facilities, and personnel; identifies the people who are to be served; reveals the geographical, sociological, economic, and educational barriers to the expanded use of libraries; and…

  11. Clear Purpose...Complete Commitment: A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs, 1993-1997.

    Science.gov (United States)

    Jaques, Thomas F.

    This long range plan, which was prepared in compliance with the Library Services and Construction Act (LSCA), begins with an overview of the library public and the state library agency in Louisiana. Identification of needs and action plans are presented in the following goal areas: (1) improving state library administration; (2) extending services…

  12. Clear Purpose...Complete Commitment. A Long-Range Program To Provide Louisianians with Library and Information Services Adequate to Their Needs, 1990/91-1995.

    Science.gov (United States)

    Jaques, Thomas F.

    This long-range library program for the state of Louisiana identifies specific inadequacies in public library services, resources, facilities, and personnel. It identifies the people who are to be served, and reveals geographical, socioeconomic, and educational barriers to the expanded use of libraries. Finally, it presents specific goals and…

  13. Three finned press-fit cup: Does its initial fixation strength provide an adequate stability? Clinical midterm results of 685 implants

    Directory of Open Access Journals (Sweden)

    Rocco Romeo

    2016-01-01

    Full Text Available Introduction: One of the major causes of loosening of cementless acetabular cup implants is insufficient initial stability. A technical proposal to decrease the risk of suboptimal first stability is a circumferential finned design of the cup. This design aims to improve periacetabular bone contact and prevent rotational micromotion of the cup when optimal press-fit cannot be obtained. Materials and Methods: We retrospectively reviewed a group of 712 consecutive patients who underwent total hip arthroplasty from June 2006 to June 2014. In all patients, a titanium cup, characterized by three anti-rotational circumferential fins at the superior pole, was implanted. Results: Five hundred and ninety-two patients, for a total of 685 hips, were evaluated at a mean follow-up of 58 months (range 12-96 months. At 1-year follow-up, the average score increased to 82.90 (range 100-70 and at the final follow-up (58 months, range 12-96 months, it was 80.12 (range 100-66. In 22 cases (3%, screws to obtain a secure primary stability of the cup were used. Nineteen complications (2.6% needing revision surgery were observed. Survivorship at 10 years was 98.7% (95% confidence interval [CI], 98.7-99.7% with revision for aseptic cup loosening as an endpoint and 96.7% (95% CI, 98.3-95.1% with revision for all causes of revision as the second endpoint. Discussion: In our group of patients, we did not observe the cases of very early cup loosening. The only two-cup revision, do to loosening of osteolysis, was observed 26 and 32 months before surgery. Conclusion: Our very low rate of additional screws represents an indirect sign of finned cup first stability. Three-finned cup design clinically confirmed to improve initial cup stability.

  14. South African medical students’ perceptions and knowledge about antibiotic resistance and appropriate prescribing: Are we providing adequate training to future prescribers?

    Directory of Open Access Journals (Sweden)

    Sean Wasserman,

    2017-05-01

    Full Text Available Background. Education of medical students has been identified by the World Health Organization as an important aspect of antibiotic resistance (ABR containment. Surveys from high-income countries consistently reveal that medical students recognise the importance of antibiotic prescribing knowledge, but feel inadequately prepared and require more education on how to make antibiotic choices. The attitudes and knowledge of South African (SA medical students regarding ABR and antibiotic prescribing have never been evaluated. Objective. To evaluate SA medical students’ perceptions, attitudes and knowledge about antibiotic use and resistance, and the perceived quality of education relating to antibiotics and infection. Methods. This was a cross-sectional survey of final-year students at three medical schools, using a 26-item self-administered questionnaire. The questionnaires recorded basic demographic information, perceptions about antibiotic use and ABR, sources, quality, and usefulness of current education about antibiotic use, and questions to evaluate knowledge. Hard-copy surveys were administered during whole-class lectures. Results. A total of 289 of 567 (51% students completed the survey. Ninety-two percent agreed that antibiotics are overused and 87% agreed that resistance is a significant problem in SA – higher proportions than those who thought that antibiotic overuse (63% and resistance (61% are problems in the hospitals where they had worked (p<0.001. Most reported that they would appreciate more education on appropriate use of antibiotics (95%. Only 33% felt confident to prescribe antibiotics, with similar proportions across institutions. Overall, prescribing confidence was associated with the use of antibiotic prescribing guidelines (p=0.003, familiarity with antibiotic stewardship (p=0.012, and more frequent contact with infectious diseases specialists (p<0.001. There was an overall mean correct score of 50% on the knowledge questionnaire, with significant differences between institutions. Students who used antibiotic prescribing guidelines and found their education more useful scored higher on knowledge questionnaires. Conclusion. There are low levels of confidence with regard to antibiotic prescribing among final-year medical students in SA, and most students would like more education in this area. Perceptions that ABR is less of a problem in their local setting may contribute to inappropriate prescribing behaviours. Differences exist between medical schools in knowledge about antibiotic use, with suboptimal scores across institutions. The introduction and use of antibiotic prescribing guidelines and greater contact with specialists in antibiotic prescribing may improve prescribing behaviours.

  15. Vaccines provided by family physicians.

    Science.gov (United States)

    Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F

    2010-01-01

    This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.

  16. Severe Chronic Upper Airway Disease (SCUAD) in children. Definition issues and requirements.

    Science.gov (United States)

    Karatzanis, A; Kalogjera, L; Scadding, G; Velegrakis, S; Kawauchi, H; Cingi, C; Prokopakis, E

    2015-07-01

    Upper airway diseases are extremely common, and a significant proportion of patients are not adequately controlled by contemporary treatment algorithms. The term SCUAD (Severe Chronic Upper Airway Disease) has been previously introduced to describe such cases. However, this term has not been adequately focused on children. This study aims to address the necessity of the term, as well as further details specifically for children. For this purpose, a review was performed of the current literature, with specific focus on issues regarding SCUAD in children. Paediatric SCUAD represents a heterogeneous group of patients and has significant clinical and socioeconomic implications. Relevant literature is generally lacking and questions regarding definition and pathogenesis remain unanswered. Accurate definition and acknowledgement of paediatric SCUAD cases may lead to better design of future clinical and molecular research protocols. This may provide improved understanding of the underlying disease processes, more accurate data regarding socioeconomic burden, and, above all, more successful treatment and prevention strategies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Early procalcitonin kinetics and adequate empiric antibiotic therapy in critically ill

    OpenAIRE

    Dr. Trásy Domonkos

    2017-01-01

    Sepsis has become a major health economic issue, with more patients dying in hospitals due to sepsis related complications compared to breast and colorectal cancer together. Despite extensive research in order to improve outcome in sepsis over the last few decades, results of large multicenter studies were by-and-large very disappointing. This fiasco can be explained by several factors, but one of the most important reasons is the uncertain definition of sepsis resulting in very heterogeneous...

  18. 48 CFR 247.301-70 - Definition.

    Science.gov (United States)

    2010-10-01

    ... Definition. “Integrated logistics managers” or “third-party logistics providers” means providers of multiple logistics services. Some examples of logistics services are the management of transportation, demand...

  19. 7 CFR 1427.3 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... they conflict with definitions in this section. Adjusted spot price means the spot price adjusted to... to CCC; and (5) Providing loan, loan deficiency payment, and accounting data to CCC for statistical...

  20. Common SIDS and SUID Terms and Definitions

    Science.gov (United States)

    ... media links Common SIDS and SUID Terms and Definitions Page Content Health care providers and others may ... NICHD Home Accessibility NICHD Contact Disclaimer NICHD Accounts: Facebook Twitter Pinterest YouTube NIH...Turning Discovery Into Health ® ...

  1. WHO SHOULD OWN THE DEFINITION OF PERSONALITY

    NARCIS (Netherlands)

    HOFSTEE, WKB

    The averaged judgment of knowledgeable others provides the best available point of reference both for the definition of personality structure in general and for assessing someone's personality in particular. Self-judgments, as in personality questionnaires, are intrinsically deficient because

  2. Definitions of Idioms in Preadolescents, Adolescents, and Adults

    Science.gov (United States)

    Chan, Yen-Ling; Marinellie, Sally A.

    2008-01-01

    The purpose of this study was to expand the current literature on word definitions by focusing on definitions of idioms provided by several age groups. Preadolescents, young adolescents, older adolescents, and adults wrote definitions for 10 frequently used idioms and also rated their familiarity with the idiomatic expressions. Participants'…

  3. Establishing adequate conditions for mercury determination in environmental samples by INAA

    International Nuclear Information System (INIS)

    Perez, Caroline; Santos, Eliane C.; Saiki, Mitiko

    2017-01-01

    Mercury (Hg) is a toxic element released into the environment mainly by anthropic activities. Consequently, the improvement for Hg determination in environmental samples is of great interest. Instrumental Neutron Activation Analysis (INAA) is considered an adequate method to determine several elements. However, Hg determination by INAA is often hampered by its volatility, which causes losses. The aim of this study was to establish adequate irradiation conditions for Hg determination in environmental samples by INAA. The following parameters were evaluated: irradiation time, container for irradiation and spectral gamma ray interferences. For the study, aliquots of certified reference materials (CRMs) and tree bark samples were irradiated together with Hg synthetic standard at the IEA-R1 nuclear research reactor. Gamma ray activities of 1 97 Hg and 203 Hg were measured in a spectrometer coupled to a HGe detector. Results obtained indicated that polyethylene capsules or envelopes can be used as container for sample irradiation and the Hg impurities in these containers were negligible. Irradiation time of one hour was adequate for Hg determination and in long irradiations of 8 h problems of spectral interference of 198 Au and 75 Se were observed. In addition, Hg loss during the irradiation of 1 h and after irradiation was not observed. Quality control of Hg results, obtained in the CRMs analyses using one hour of irradiation, indicated good precision and accuracy with |Z score| < 2. The experimental conditions established in this study were applied to tree bark samples. Detection limits for Hg of these analyses were between 0.14 and 1.9 μg g -1 . (author)

  4. Establishing adequate conditions for mercury determination in environmental samples by INAA

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Caroline; Santos, Eliane C.; Saiki, Mitiko, E-mail: caroline.perez@usp.br [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN-SP), São Paulo, SP (Brazil)

    2017-07-01

    Mercury (Hg) is a toxic element released into the environment mainly by anthropic activities. Consequently, the improvement for Hg determination in environmental samples is of great interest. Instrumental Neutron Activation Analysis (INAA) is considered an adequate method to determine several elements. However, Hg determination by INAA is often hampered by its volatility, which causes losses. The aim of this study was to establish adequate irradiation conditions for Hg determination in environmental samples by INAA. The following parameters were evaluated: irradiation time, container for irradiation and spectral gamma ray interferences. For the study, aliquots of certified reference materials (CRMs) and tree bark samples were irradiated together with Hg synthetic standard at the IEA-R1 nuclear research reactor. Gamma ray activities of 1{sup 97}Hg and {sup 203}Hg were measured in a spectrometer coupled to a HGe detector. Results obtained indicated that polyethylene capsules or envelopes can be used as container for sample irradiation and the Hg impurities in these containers were negligible. Irradiation time of one hour was adequate for Hg determination and in long irradiations of 8 h problems of spectral interference of {sup 198}Au and {sup 75}Se were observed. In addition, Hg loss during the irradiation of 1 h and after irradiation was not observed. Quality control of Hg results, obtained in the CRMs analyses using one hour of irradiation, indicated good precision and accuracy with |Z score| < 2. The experimental conditions established in this study were applied to tree bark samples. Detection limits for Hg of these analyses were between 0.14 and 1.9 μg g{sup -1}. (author)

  5. Are individual transferable quotas an adequate solution to overfishing and overcapacity? Evidence from Danish fisheries

    DEFF Research Database (Denmark)

    Merayo Garcia, Eugenia; Nielsen, Rasmus; Hoff, Ayoe

    2018-01-01

    Individual Transferable Quotas stand in large parts of the fisheries economic literature as the panacea that solves all problems of overfishing and overcapacity of world´s fisheries. However, they are also criticized by a number of authors based on their negative social effects. Individual...... in local fishing communities compared to the national average was found. The Danish experience proves that Individual Transferable Quotas can be an adequate solution with regards to overfishing and overcapacity with also positive effects on the environment due to reduced fuel consumption and fishing...

  6. Towards {sup 31}Mg-β-NMR resonance linewidths adequate for applications in magnesium chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Stachura, M., E-mail: mstachura@triumf.ca [TRIUMF (Canada); McFadden, R. M. L. [University of British Columbia, Chemistry Department (Canada); Chatzichristos, A.; Dehn, M. H. [University of British Columbia, Department of Physics and Astronomy (Canada); Gottberg, A. [TRIUMF (Canada); Hemmingsen, L. [Københavns Universitet Universitetsparken 5, Kemisk Institut (Denmark); Jancso, A. [University of Szeged, Department of Inorganic and Analytical Chemistry (Hungary); Karner, V. L. [University of British Columbia, Chemistry Department (Canada); Kiefl, R. F. [University of British Columbia, Department of Physics and Astronomy (Canada); Larsen, F. H. [Københavns Universitet Rolighedsvej 26, Institut for Fødevarevidenskab (Denmark); Lassen, J.; Levy, C. D. P.; Li, R. [TRIUMF (Canada); MacFarlane, W. A. [University of British Columbia, Chemistry Department (Canada); Morris, G. D. [TRIUMF (Canada); Pallada, S. [CERN (Switzerland); Pearson, M. R. [TRIUMF (Canada); Szunyogh, D.; Thulstrup, P. W. [Københavns Universitet Universitetsparken 5, Kemisk Institut (Denmark); Voss, A. [University of Jyväskylä, Department of Physics (Finland)

    2017-11-15

    The span of most chemical shifts recorded in conventional {sup 25}Mg-NMR spectroscopy is ~ 100 ppm. Accordingly, linewidths of ~ 10 ppm or better are desirable to achieve adequate resolution for applications in chemistry. Here we present first high-field {sup 31}Mg- β-NMR measurements of {sup 31}Mg{sup +} ions implanted into a MgO single crystal carried out at the ISAC facility at TRIUMF. The resonances recorded at 2.5 T and 3.5 T show strong linewidth dependency on the applied RF power, ranging from ~ 419 ppm for the highest RF power down to ~ 48 ppm for the lowest one.

  7. Search for adequate quality standards for neutron radiography of nuclear fuel

    International Nuclear Information System (INIS)

    Domanus, J.C.

    1983-01-01

    Unlike in other fields of industrial radiography, where standard methods and procedures are used to control the quality of the radiographic image, no such standard exists for neutron radiography of nuclear fuel. To fill that gap it was felt that standardization work ought to be started in that field, too. Accordingly in 1979 an Euratom Neutron Radiography Working Group was constituted, which initiated standardization work in the field of neutron radiography of nuclear fuel. Finding adequate standards for image quality of neutron radiographs and checking the accuracy of dimension measurements from them were given first priority. (Auth.)

  8. Towards a universal definition of competitive intelligence

    OpenAIRE

    Rene Pellissier; Tshilidzi E. Nenzhelele

    2013-01-01

    Background: Enterprises face intense competition caused by globalisation. Consequently, enterprises look for tools that provide a competitive advantage. Competitive intelligence (CI) provides a competitive advantage to enterprises of all sizes. There are many definitions of CI but no universally accepted one. Objectives: The purpose of this research is to review the current literature on CI with the aim of identifying and analysing CI definitions to establish the commonalities and differen...

  9. Appropriate definition of the scale parameter Λ in quantum chromodynamics

    International Nuclear Information System (INIS)

    Monsay, E.; Rosenzweig, C.

    1981-01-01

    Even after we have chosen a specific definition of the quantum-chromodynamic coupling constant (e.g., modified minimal subtraction or momentum-space subtraction) we are free to choose a definition of Λ when we expand the coupling constant in powers of (lnQ 2 /Λ 2 ) -1 . We discuss in detail a particular definition suggested by Abbott and argue that this definition does seem to provide an attractive means of fixing Λ

  10. Can Earth Materials BE Adequately Covered in a - or Two-Semester Course?

    Science.gov (United States)

    Hefferan, K. P.; O'Brien, J.

    2007-12-01

    Traditional geology programs offer courses in mineralogy, optical mineralogy, igneous petrology, metamorphic petrology, sedimentology and economic geology. At many universities this suite of mineralogy/petrology courses has been supplanted by a one-semester or two-semester Earth Materials course. This interactive poster poses five questions to faculty and students related to the means by which Earth Materials can be delivered: 1) Available online syllabi demonstrate a wide variation in the topics addressed in Earth Materials courses; is there a standard core of key topics that must be covered and in what level of detail? 2) Can a one-semester or two- semester Earth Materials course adequately cover these topics? 3) Excellent textbooks exist in both mineralogy and in petrology; what textbooks, if any, adequately encompass Earth Materials? 4) How has the online environment changed the way in which we use textbooks in the classroom? 5) Given the evolution of geology programs, higher education and the global economy in the past twenty years, what additional changes can be anticipated with respect to delivery and demand of Earth Materials topics? Answers-- or at least related discussions-- to these questions are encouraged via verbal dialogue among participants and/or by comments written on the poster. Our goal is to solicit faculty, student and industry feedback to create a textbook, curricula and online materials that support an Earth Materials course.

  11. Response of cotton genotypes to boron under-b-adequate conditions

    International Nuclear Information System (INIS)

    Shah, J. A.; Sial, M. A.; Hassan, Z. U.; Rajpar, I.

    2015-01-01

    Balanced boron (B) application is well-known to enhance the cotton production; however, the narrow range between B-deficiency and toxicity levels makes it difficult to manage. Cotton genotypes extensively differ in their response to B requirements. The adequate dose of B for one genotype may be insufficient or even toxic to other genotype. The effects of boron (B) on seed cotton yield and its various yield associated traits were studied on 10 cotton genotypes of Pakistan. The pot studies were undertaken to categorize cotton genotypes using B-deficient (control) and B-adequate (2.0 kg B ha-1) levels arranged in CRD with four repeats. The results indicated that the seed cotton yield, yield attributes and B-uptake of genotypes were comparatively decreased in B-deficient stressed treatment. Genotype NIA-Ufaq exhibited wide range of adaptation and ranked as efficient-responsive, as it produced higher seed cotton yield under both B-regimes. SAU-2 and CIM-506 were highly-efficient and remaining all genotypes were medium-efficient. Genotype Sindh-1 produced low seed cotton yield under B deficient condition and ranked as low-efficient. B-efficient cotton genotypes can be grown in B deficient soils without B application. (author)

  12. The importance of adequate follow-up in defining treatment success after external beam irradiation for prostate cancer

    International Nuclear Information System (INIS)

    Vicini, Frank A.; Kestin, Larry L.; Martinez, Alvaro A.

    1999-01-01

    median follow-up of 3 years for this cohort (range: 1 to 5 years). This process was repeated five times for five random samples of seven cohorts each. Biochemical failure was calculated according to the Consensus Panel definition. Results: In the first analysis, significantly different rates of biochemical control (varying by 6-21%) were calculated for the same actuarial year chosen for analysis depending only upon the length of follow-up used. For example, the 3-year actuarial rate of biochemical control (BC) varied from 71% when calculated with 3 years of follow-up versus 50.4% with 7 years (p < 0.01). These differences in actuarial rates of BC were observed in all subsets of patients analyzed (e.g., PSA < 10, Gleason ≤ 6, n = 132, p < 0.001; PSA < 10, Gleason ≥ 7, n = 33, p = 0.03; PSA ≥ 10, Gleason ≤ 6, n = 109, p < 0.001; and PSA ≥ 10, Gleason ≥ 7, n = 72, p = 0.002). The absolute magnitude of the difference in actuarial rates of BC was greatest during years 2 (range 18-30%), 3 (range 16-25%), and 4 (range 15-24%) after treatment. In the second analysis using median PSA follow-ups (as defined above), statistically significant differences in actuarial rates of BC were again observed. For example, the 3-year actuarial rate of BC varied from 74.8% with a median follow-up of 2 years versus 49.2% with a median follow-up of 6 years. These dramatic differences in BC were still observed beyond 5 years. Conclusion: When the ASTRO Consensus Panel definition of BF is used to calculate treatment success with external beam RT for prostate cancer, adequate follow-up is critical. Depending upon the length of time after treatment, significantly different rates of BC (varying by 15% to 30%) can be calculated for the same time interval chosen for analysis. These results suggest that data should only be reported if the length of follow-up extends at least beyond the time point at which actuarial results are examined for the majority of patients

  13. Strongly anisotropic thermal conductivity and adequate breathability of bilayered films for heat management of on-skin electronics

    Science.gov (United States)

    Zhou, Tianle; Wei, Hao; Tan, Huaping; Wang, Xin; Zeng, Haibo; Liu, Xiaoheng; Nagao, Shijo; Koga, Hirotaka; Nogi, Masaya; Sugahara, Tohru; Suganuma, Katsuaki

    2018-07-01

    Thin-film wearable electronics are required to be directly laminated on to human skin for reliable, sensitive bio-sensing but with minimal irritation to the user after long-time use. Excellent heat management films with strongly anisotropic thermal conductivity (K) and adequate breathability are increasingly desirable for shielding the skin from heating while allowing the skin to breathe properly. Here, interfacial self-assembly of a graphene oxide (GO) film covering an ambient-dried bacterial cellulose aerogel (AD-BCA) film followed by laser reduction was proposed to prepare laser-reduced GO (L-rGO)/AD-BCA bilayered films. The AD-BCA substrate provides low cross-plane K (K ⊥  ≈  0.052 W mK‑1), high breathability, and high compressive and tensile resistance by ‘partially’ inheriting the pore structure from bacterial cellulose (BC) gel. The introduction of an upper L-rGO film, which is only 0.31 wt% content, dramatically increases the in-plane K (K // ) from 0.3 W mK‑1 in AD-BCA to 10.72 W mK‑1 owing to the highly in-plane oriented, continuous, uniform assembling geometry of the GO film; while K ⊥ decreases to a lower value of 0.033 W mK‑1, mainly owing to the air pockets between L-rGO multilayers caused by the laser reduction. The bilayered films achieve a K // /K ⊥ of 325, which is substantially larger even than that of graphite and similar polymer composites. They permit high transmission rates for water vapor (416.78 g/m2/day, >204 g/m2/day of normal skin) and O2 (449.35 cm3/m2/day). The combination of strongly anisotropic thermal conductivity and adequate breathability facilitates applications in heat management in on-skin electronics.

  14. Impact of a cost constraint on nutritionally adequate food choices for French women: an analysis by linear programming.

    Science.gov (United States)

    Darmon, Nicole; Ferguson, Elaine L; Briend, André

    2006-01-01

    To predict, for French women, the impact of a cost constraint on the food choices required to provide a nutritionally adequate diet. Isocaloric daily diets fulfilling both palatability and nutritional constraints were modeled in linear programming, using different cost constraint levels. For each modeled diet, total departure from an observed French population's average food group pattern ("mean observed diet") was minimized. To achieve the nutritional recommendations without a cost constraint, the modeled diet provided more energy from fish, fresh fruits and green vegetables and less energy from animal fats and cheese than the "mean observed diet." Introducing and strengthening a cost constraint decreased the energy provided by meat, fresh vegetables, fresh fruits, vegetable fat, and yogurts and increased the energy from processed meat, eggs, offal, and milk. For the lowest cost diet (ie, 3.18 euros/d), marked changes from the "mean observed diet" were required, including a marked reduction in the amount of energy from fresh fruits (-85%) and green vegetables (-70%), and an increase in the amount of energy from nuts, dried fruits, roots, legumes, and fruit juices. Nutrition education for low-income French women must emphasize these affordable food choices.

  15. Therapy Provider Phase Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...

  16. Definition of Videogames

    Directory of Open Access Journals (Sweden)

    Grant Tavinor

    2008-01-01

    Full Text Available Can videogames be defined? The new field of games studies has generated three somewhat competing models of videogaming that characterize games as new forms of gaming, narratives, and interactive fictions. When treated as necessary and sufficient condition definitions, however, each of the three approaches fails to pick out all and only videogames. In this paper I argue that looking more closely at the formal qualities of definition helps to set out the range of definitional options open to the games theorist. A disjunctive definition of videogaming seems the most appropriate of these definitional options. The disjunctive definition I offer here is motivated by the observation that there is more than one characteristic way of being a videogame.

  17. [Stress-ECG is adequate to detect myocardial ischemia: when are additional diagnostic tests needed?].

    Science.gov (United States)

    Baer, F M

    2007-09-01

    The stress-ECG is the most often adopted and most cost effective initial diagnostic test for the assessment of myocardial ischemia in patients with suspected coronary artery disease (CAD). Prerequisites for the diagnostic usefullness of stress-ECG are a clearly interpretable ST-segment, ability to reach the predicted work load, an intermediate pretest probability for CAD ranging between 10% and 90% and the absence of any contraindications for dynamic exercise. Because of the limited diagnostic sensitivity of about 70%, and a high percentage of patients, who are unable to exercise, a negative stress ECG can definitely not exclude hemodynamically significant CAD. Therefore, stress imaging techniques like myocardial scintigraphy, stress-echocardiography and stress magnetic resonance imaging play a major role in the stepwise diagnostic work-up of patients with suspected CAD. These stress imaging techniques are basically interchangeable since no method is definitely superior to one of the others. However, each method has its specific pros and cons and inherent contraindications. Therefore the choice of the stress imaging method and the form of stress applied should be based on the individual patients characteristics to gain optimal image quality and diagnostic accuracy. Moreover, the decision for one method should take the local availability and institutional expertise of diagnostic centers into account. Although partly substituted by stress imaging techniques the stress-ECG still remains the workhorse for a stepwise diagnostic work-up of patients with suspected CAD.

  18. Precise femtosecond laser ablation of dental hard tissue: preliminary investigation on adequate laser parameters

    International Nuclear Information System (INIS)

    Hikov, Todor; Pecheva, Emilia; Petrov, Todor; Montgomery, Paul; Antoni, Frederic; Leong-Hoi, Audrey

    2017-01-01

    This work aims at evaluating the possibility of introducing state-of-the-art commercial femtosecond laser system in restorative dentistry by maintaining well-known benefits of lasers for caries removal, but also in overcoming disadvantages such as thermal damage of irradiated substrate. Femtosecond ablation of dental hard tissue is investigated by changing the irradiation parameters (pulsed laser energy, scanning speed and pulse repetition rate), assessed for enamel and dentin. The femtosecond laser system used in this work may be suitable for cavity preparation in dentin and enamel, due to the expected effective ablation and low temperature increase when using ultra short laser pulses. If adequate laser parameters are selected, this system seems to be promising for promoting a laser-assisted, minimally invasive approach in restorative dentistry. (paper)

  19. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets

    DEFF Research Database (Denmark)

    Parlesak, A.; Tetens, Inge; Dejgård Jensen, Jørgen

    2016-01-01

    Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent...... both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear...... in each of the resulting five baskets was increased through limiting the relative share of individual foods. The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6). The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8). The baskets with the greater...

  20. Europe's gas consumption and imports to increase with adequate low cost supplies

    International Nuclear Information System (INIS)

    Odell, P.R.

    1997-01-01

    Gas in Europe has always been sold above its long-run supply price. Lower prices, however, still permit profitable indigeneous supply expansion. As further reductions in production and transport costs from technological advances are expected, this will continue based on the exploitation of large proven and probable reserves. By 2025, indigeneous output will be 60% up on 1995. Nevertheless, an average 2.2%/annum growth in gas demand will increase import dependence from 130 to 320 BCM over this period. Future international oil prices indicate gas-equivalent border values adequate to secure profitable supply from a range of external sources, leading to continuing competition for markets and the diversification of imports. (9 tables; 31 references). (author)

  1. The classification of explosion-proof protected induction motor into adequate temperature and efficiency class

    Science.gov (United States)

    Brinovar, Iztok; Srpčič, Gregor; Seme, Sebastijan; Štumberger, Bojan; Hadžiselimović, Miralem

    2017-07-01

    This article deals with the classification of explosion-proof protected induction motors, which are used in hazardous areas, into adequate temperature and efficiency class. Hazardous areas are defined as locations with a potentially explosive atmosphere where explosion may occur due to present of flammable gasses, liquids or combustible dusts (industrial plants, mines, etc.). Electric motors and electrical equipment used in such locations must be specially designed and tested to prevent electrical initiation of explosion due to high surface temperature and arcing contacts. This article presents the basic tests of three-phase explosion-proof protected induction motor with special emphasis on the measuring system and temperature rise test. All the measurements were performed with high-accuracy instrumentation and accessory equipment and carried out at the Institute of energy technology in the Electric machines and drives laboratory and Applied electrical engineering laboratory.

  2. Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? A questionnaire-based study

    Science.gov (United States)

    Osman, Houssam; Parikh, Janak; Patel, Shirali; Jeyarajah, D Rohan

    2015-01-01

    Background The present study was conducted to assess the preparedness of hepatopancreatobiliary (HPB) fellows upon entering fellowship, identify challenges encountered by HPB fellows during the initial part of their HPB training, and identify potential solutions to these challenges that can be applied during residency training. Methods A questionnaire was distributed to all HPB fellows in accredited HPB fellowship programmes in two consecutive academic years (n = 42). Reponses were then analysed. Results A total of 19 (45%) fellows responded. Prior to their fellowship, 10 (53%) were in surgical residency and the rest were in other surgical fellowships or surgical practice. Thirteen (68%) were graduates of university-based residency programmes. All fellows felt comfortable in performing basic laparoscopic procedures independently at the completion of residency and less comfortable in performing advanced laparoscopy. Eight (42%) fellows cited a combination of inadequate case volume and lack of autonomy during residency as the reasons for this lack of comfort. Thirteen (68%) identified inadequate preoperative workup and management as their biggest fear upon entering practice after general surgery training. A total of 17 (89%) fellows felt they were adequately prepared to enter HPB fellowship. Extra rotations in transplant, vascular or minimally invasive surgery were believed to be most helpful in preparing general surgery residents pursing HPB fellowships. Conclusions Overall, HPB fellows felt themselves to be adequately prepared for fellowship. Advanced laparoscopic procedures and the perioperative management of complex patients are two of the challenges facing HPB fellows. General surgery residents who plan to pursue an HPB fellowship may benefit from spending extra rotations on certain subspecialties. Focus on perioperative workup and management should be an integral part of residency and fellowship training. PMID:25387852

  3. Use of Linear Programming to Develop Cost-Minimized Nutritionally Adequate Health Promoting Food Baskets.

    Science.gov (United States)

    Parlesak, Alexandr; Tetens, Inge; Dejgård Jensen, Jørgen; Smed, Sinne; Gabrijelčič Blenkuš, Mojca; Rayner, Mike; Darmon, Nicole; Robertson, Aileen

    2016-01-01

    Food-Based Dietary Guidelines (FBDGs) are developed to promote healthier eating patterns, but increasing food prices may make healthy eating less affordable. The aim of this study was to design a range of cost-minimized nutritionally adequate health-promoting food baskets (FBs) that help prevent both micronutrient inadequacy and diet-related non-communicable diseases at lowest cost. Average prices for 312 foods were collected within the Greater Copenhagen area. The cost and nutrient content of five different cost-minimized FBs for a family of four were calculated per day using linear programming. The FBs were defined using five different constraints: cultural acceptability (CA), or dietary guidelines (DG), or nutrient recommendations (N), or cultural acceptability and nutrient recommendations (CAN), or dietary guidelines and nutrient recommendations (DGN). The variety and number of foods in each of the resulting five baskets was increased through limiting the relative share of individual foods. The one-day version of N contained only 12 foods at the minimum cost of DKK 27 (€ 3.6). The CA, DG, and DGN were about twice of this and the CAN cost ~DKK 81 (€ 10.8). The baskets with the greater variety of foods contained from 70 (CAN) to 134 (DGN) foods and cost between DKK 60 (€ 8.1, N) and DKK 125 (€ 16.8, DGN). Ensuring that the food baskets cover both dietary guidelines and nutrient recommendations doubled the cost while cultural acceptability (CAN) tripled it. Use of linear programming facilitates the generation of low-cost food baskets that are nutritionally adequate, health promoting, and culturally acceptable.

  4. Local confinement and bedridden in the context of boundedness - The development of a conceptual definition based on an integrative review

    Science.gov (United States)

    Schirghuber, Johannes; Schrems, Berta

    2018-04-01

    Background: Local confinement and bedridden are important phenomena in nursing care. Nevertheless, conceptual definitions and appropriate nursing diagnoses are missing in the current nursing classification systems. Aim: The aim is to provide the basis for a conceptual definition. To this end, the current state of the German and English usage of the terms local confinement and bedridden are presented. At the same time, definitions of English-language terms, which are internationally widely recognized, are elaborated. Additionally, phenomena associated with local confinement and bedridden are recorded and delimited of each other. Method: The identification of the German and English conceptual usage takes place through an integrative literature review covering the period from 1990 to 2016. Results: There are a variety of English-language terms of location confinement and bedridden. The concepts of homebound, wheelchairbound and bedridden form of local confinement and bedridden most extensively. Instability, immobility is connected as cause and inactivity as a consequence. In contrast to this is bedrest, which is ordered and temporally limited. Conclusions: Local confinement and bedridden are to be viewed through the definition of boundedness. The antecedents (instability, immobility) must be diagnosed to derive adequate interventions to avoid or alleviate the consequences.

  5. TRANSWRAP II: problem definition manual

    International Nuclear Information System (INIS)

    Knittle, D.E.

    1981-02-01

    The TRANSWRAP II computer code, written in Fortran IV and described in this Problem Definition Manual, was developed to analytically predict the magnitude of pressure pulses of large scale sodium-wate reactions in LMFBR secondary systems. It is currently being used for the Clinch River Breeder Reactor Program. The code provides the options, flexibility and features necessary to consider any system configuration. The code methodology has been validated with the aid of extensive sodium-water reaction test programs

  6. The definition of kernel Oz

    OpenAIRE

    Smolka, Gert

    1994-01-01

    Oz is a concurrent language providing for functional, object-oriented, and constraint programming. This paper defines Kernel Oz, a semantically complete sublanguage of Oz. It was an important design requirement that Oz be definable by reduction to a lean kernel language. The definition of Kernel Oz introduces three essential abstractions: the Oz universe, the Oz calculus, and the actor model. The Oz universe is a first-order structure defining the values and constraints Oz computes with. The ...

  7. 21 CFR 740.10 - Labeling of cosmetic products for which adequate substantiation of safety has not been obtained.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Labeling of cosmetic products for which adequate..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS COSMETIC PRODUCT WARNING STATEMENTS Warning Statements § 740.10 Labeling of cosmetic products for which adequate substantiation of safety has not been...

  8. Definitions of deafblindness and congenital deafblindness

    DEFF Research Database (Denmark)

    Ask Larsen, Flemming; Damen, Saskia

    2014-01-01

    in determining eligibility of the studies were encountered due to heterogeneity in definitions and inclusion criteria used in the articles. The present systematic review aims to provide both an overview of this terminological and methodological heterogeneity and suggestions for better future research practices....... A systematic review of definitions used in (N = 30) studies employing psychological assessment of people with CDB served as a sample of the scientific literature on DB and CDB. Absent or heterogeneous definitions and inclusion criteria regarding both DB and CDB are evident in the sample. Fifty percent...

  9. Definition of postprandial lipaemia

    DEFF Research Database (Denmark)

    Kolovou, Genovefa D; Mikhailidis, Dimitri P; Nordestgaard, Børge G

    2011-01-01

    At the present time, there is no widely agreed definition of postprandial lipaemia (PPL). This lack of a shared definition limits the identification and treatment of patients with exaggerated PPL as well as the evaluation of potential therapeutic agents. PPL is a complex syndrome characterized by...

  10. Productivity of Stream Definitions

    NARCIS (Netherlands)

    Endrullis, Jörg; Grabmayer, Clemens; Hendriks, Dimitri; Isihara, Ariya; Klop, Jan

    2007-01-01

    We give an algorithm for deciding productivity of a large and natural class of recursive stream definitions. A stream definition is called ‘productive’ if it can be evaluated continuously in such a way that a uniquely determined stream is obtained as the limit. Whereas productivity is undecidable

  11. Productivity of stream definitions

    NARCIS (Netherlands)

    Endrullis, J.; Grabmayer, C.A.; Hendriks, D.; Isihara, A.; Klop, J.W.

    2008-01-01

    We give an algorithm for deciding productivity of a large and natural class of recursive stream definitions. A stream definition is called ‘productive’ if it can be evaluated continually in such a way that a uniquely determined stream in constructor normal form is obtained as the limit. Whereas

  12. Engineering Definitional Interpreters

    DEFF Research Database (Denmark)

    Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

    2013-01-01

    A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We imp...

  13. Dynamics of Situation Definition

    Science.gov (United States)

    Park, Dongseop; Moro, Yuji

    2006-01-01

    Situation definition is the process and product of actors' interpretive activities toward a given situation. By reviewing a number of psychological studies conducted in experimental settings, we found that the studies have only explicated a part of the situation definition process and have neglected its dynamic aspects. We need to focus on the…

  14. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

    Science.gov (United States)

    Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

    2015-01-01

    High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time. © 2014 International Society for Diseases of the Esophagus.

  15. Defending definitions of life.

    Science.gov (United States)

    Mix, Lucas John

    2015-01-01

    Over the past 10 years, it has become unpopular to talk about definitions of life, under the assumption that attempts at a precise definition are counterproductive. Recent attempts have failed to meet strict philosophical criteria for definitions and have failed to reach consensus. I argue that provisional definitions are necessary for clear communications. Our current knowledge of biology justifies a number of universal claims about the category of life. Whether or not "life" represents a natural category, it maps to a number of important, observable processes. Given the importance of those processes and the extent of our knowledge, plural explicit definitions of life (and related categories) will be necessary for progress in astrobiology and origin-of-life studies as well as biology in general. I propose concrete categories related to, but not necessarily coextensive with, life for clear communication and hypothesis formation: Woese life, Darwin life, Haldane life.

  16. Definitional Arguments in Children’s Speech

    Directory of Open Access Journals (Sweden)

    Rebecca Schar

    2017-07-01

    Full Text Available Based on the debate on children’s ability to produce argumentative discourse in different edu­cational settings, this paper provides further support for the fact that small children are able to support their opinions with arguments. In particular, the paper makes a case in point on children’s appeal to definitional loci, when supporting their standpoints. The analysis of their reasoning’s implicit components shows how children apply different definitional arguments.

  17. Adequate sleep among adolescents is positively associated with health status and health-related behaviors

    Directory of Open Access Journals (Sweden)

    Jeng Yi-Jong

    2006-03-01

    Full Text Available Abstract Background Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6–8 hours per night regularly is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was to examine the relationship between AS during schooldays and excessive body weight, frequency of visiting doctors and health-related behaviors among Taiwanese adolescents. Methods A cross-sectional study design, categorical and multivariate data analyses were used. The hypotheses investigated were: high frequency of AS is positively associated with lack of obesity and less frequent visits to doctors; and high frequency AS is positively associated with health-related behavior. Results A total of 656 boys (53.2% and girls (46.8%, ranging in age from 13–18 years were studied between January and June 2004. Three hundred and fifty seven subjects (54% reported that they slept less than the suggested 6–8 hours on schooldays. A significant negative association was found between low sleep and of the following health-related behaviors: (1 life appreciation; (2 taking responsibility for health; (3 adopting healthy diet; (4 effective stress management; (5 regular exercise; and (6 total AHP score. High frequency AS was associated with low frequencies of obesity after potential confounding factors were controlled. Junior high school adolescents reported significantly higher frequencies of AS than high school participants. Gender, family structure, home location and frequency of television watching or computer use were not significantly associated with AS. Conclusion These findings support the proposition that AS is associated with good health status and high-frequency adoption of health-related behavior. Furthermore, these findings suggest that inadequate

  18. Medical service provider networks.

    Science.gov (United States)

    Mougeot, Michel; Naegelen, Florence

    2018-05-17

    In many countries, health insurers or health plans choose to contract either with any willing providers or with preferred providers. We compare these mechanisms when two medical services are imperfect substitutes in demand and are supplied by two different firms. In both cases, the reimbursement is higher when patients select the in-network provider(s). We show that these mechanisms yield lower prices, lower providers' and insurer's profits, and lower expense than in the uniform-reimbursement case. Whatever the degree of product differentiation, a not-for-profit insurer should prefer selective contracting and select a reimbursement such that the out-of-pocket expense is null. Although all providers join the network under any-willing-provider contracting in the absence of third-party payment, an asymmetric equilibrium may exist when this billing arrangement is implemented. Copyright © 2018 John Wiley & Sons, Ltd.

  19. The definition of cross polarization

    DEFF Research Database (Denmark)

    Ludwig, Arthur

    1973-01-01

    There are at least three different definitions of cross polarization used in the literature. The alternative definitions are discussed with respect to several applications, and the definition which corresponds to one standard measurement practice is proposed as the best choice....

  20. Choosing an adequate design and analysis in cross-cultural personality research

    Directory of Open Access Journals (Sweden)

    Jia He

    2017-02-01

    Full Text Available The flourishing of cross-cultural personality research requires a keen eye for rigorous methodology in such research. With decades of experience in cross-cultural research methods, we have come to appreciate that methodological aspects of such studies are critical for obtaining valid findings. Ill-designed or -conducted studies may produce results that are difficult to interpret. A careful design and analysis can help to deal with various methodological problems in cross-cultural personality studies. Drawing on the extensive knowledge that has been accumulated in cross-cultural and personality research in the past decades, we describe a framework of bias and equivalence that enables the choice of adequate research methods and the avoidance of pitfalls that endanger valid conclusions in cross-cultural personality research. Specifically, we focus on sampling issues, test adaptations, and the combination of emic and etic approaches in this short review article. We encourage researchers to use the tools and experience that are available to considerably enlarge our insights in cross-cultural differences and similarities in personality research.

  1. Are breast biopsies adequately funded? A process cost and revenue analysis

    International Nuclear Information System (INIS)

    Hahn, M.; Fischbach, E.; Fehm, T.

    2011-01-01

    Purpose: The objective of the study was to determine whether the various breast biopsy procedures specified in the S 3 guidelines are sensibly represented within the current German health system as considered from a cost evaluation perspective. Materials and Methods: This prospectively designed multicenter study analyzed 221 breast biopsies at 7 institutions from 04/2006 to 01/2007. Core needle biopsies, vacuum-assisted biopsies and surgical open biopsies under sonographic or mammographic guidance were evaluated. During an analysis of process costs, the individual process steps were recorded in diagrammatic form and assigned to the true consumption of resources. The actual resource consumption costs were entered. A process-related breakeven analysis was conducted to check whether the reimbursement of individual biopsy types covers the costs. Results: Only sonographically guided core needle biopsy and surgical open biopsy are adequately reimbursed in the current German health system. All other breast biopsies indicate a negative profit margin. The principal reasons for underfunding are found in the area of reimbursement of investment and non-personnel costs. Conclusion: The reimbursement of breast biopsies must be improved in order to guarantee nationwide care of the population using the breast biopsy methods recommended in the S 3 guidelines and to avoid disincentives with respect to breast biopsy indications. (orig.)

  2. A test of the cerebellar hypothesis of dyslexia in adequate and inadequate responders to reading intervention.

    Science.gov (United States)

    Barth, Amy E; Denton, Carolyn A; Stuebing, Karla K; Fletcher, Jack M; Cirino, Paul T; Francis, David J; Vaughn, Sharon

    2010-05-01

    The cerebellar hypothesis of dyslexia posits that cerebellar deficits are associated with reading disabilities and may explain why some individuals with reading disabilities fail to respond to reading interventions. We tested these hypotheses in a sample of children who participated in a grade 1 reading intervention study (n = 174) and a group of typically achieving children (n = 62). At posttest, children were classified as adequately responding to the intervention (n = 82), inadequately responding with decoding and fluency deficits (n = 36), or inadequately responding with only fluency deficits (n = 56). Based on the Bead Threading and Postural Stability subtests from the Dyslexia Screening Test-Junior, we found little evidence that assessments of cerebellar functions were associated with academic performance or responder status. In addition, we did not find evidence supporting the hypothesis that cerebellar deficits are more prominent for poor readers with "specific" reading disabilities (i.e., with discrepancies relative to IQ) than for poor readers with reading scores consistent with IQ. In contrast, measures of phonological awareness, rapid naming, and vocabulary were strongly associated with responder status and academic outcomes. These results add to accumulating evidence that fails to associate cerebellar functions with reading difficulties.

  3. Adequate nutrition status important for bone mineral density improvement in a patient with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Nakamura Y

    2018-05-01

    Full Text Available Yukio Nakamura,1,2 Mikio Kamimura,3 Hidefumi Koiwai,4 Hiroyuki Kato1 1Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; 2Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, Japan; 3Center of Osteoporosis and Spinal Disorders, Kamimura Orthopedic Clinic, Matsumoto, Japan; 4Koiwai Orthopedic Clinic, Komoro, Japan Abstract: Low bone mineral density (BMD is one of the most frequent complications of anorexia nervosa (AN. We report the clinical outcomes of a female patient with severe AN, whose chest had become deformed due to thoracic fracture. Lumbar BMD was 0.358 g/cm2 (T-score = −6.3, and total hip BMD was 0.411 g/cm2 (T-score = −4.4. Active vitamin D increased these parameters by 81.0% and 57.4%, respectively, but a drop in her nutrition status afterward resulted in a sharp decrease in BMD values. These findings suggest that adequate nutrient intake is essential for effective osteoporosis treatment in patients with AN. Keywords: anorexia nervosa, bone mineral density, daily teriparatide, osteoporosis

  4. Improved ASTM G72 Test Method for Ensuring Adequate Fuel-to-Oxidizer Ratios

    Science.gov (United States)

    Juarez, Alfredo; Harper, Susana Tapia

    2016-01-01

    The ASTM G72/G72M-15 Standard Test Method for Autogenous Ignition Temperature of Liquids and Solids in a High-Pressure Oxygen-Enriched Environment is currently used to evaluate materials for the ignition susceptibility driven by exposure to external heat in an enriched oxygen environment. Testing performed on highly volatile liquids such as cleaning solvents has proven problematic due to inconsistent test results (non-ignitions). Non-ignition results can be misinterpreted as favorable oxygen compatibility, although they are more likely associated with inadequate fuel-to-oxidizer ratios. Forced evaporation during purging and inadequate sample size were identified as two potential causes for inadequate available sample material during testing. In an effort to maintain adequate fuel-to-oxidizer ratios within the reaction vessel during test, several parameters were considered, including sample size, pretest sample chilling, pretest purging, and test pressure. Tests on a variety of solvents exhibiting a range of volatilities are presented in this paper. A proposed improvement to the standard test protocol as a result of this evaluation is also presented. Execution of the final proposed improved test protocol outlines an incremental step method of determining optimal conditions using increased sample sizes while considering test system safety limits. The proposed improved test method increases confidence in results obtained by utilizing the ASTM G72 autogenous ignition temperature test method and can aid in the oxygen compatibility assessment of highly volatile liquids and other conditions that may lead to false non-ignition results.

  5. Adequate irradiation of the internal jugular lymph node chain: technical considerations

    International Nuclear Information System (INIS)

    Aref, Amr; Gross, Martin; Fontanesi, James; Devi, Syamala; Kopel, Christine; Thornton, Dale

    1997-01-01

    Purpose: This research aimed to study the anatomic relationship between the internal jugular vein with the surrounding internal jugular lymph node chain and the underlying bony anatomical structures which are commonly used as landmarks for radiation therapy planning. Methods and Materials: Twelve patients with carcinoma of the head and neck region were studied prospectively. Using our three-dimensional planning system, a beam's-eye view of the internal jugular vein was projected onto a lateral and anterior simulation film. Quantitative measurements were made in every case of the anatomic relationship between the internal jugular vein and the posterior border of the cervical vertebrae and sagittal midline. Results: The distance between the posterior border of the internal jugular vein and the posterior border of the cervical vertebrae ranged between 0 and 2.5 cm. The distances between the sagittal midline and the medial border of the internal jugular veins ranged between 2 and 4 cm. Conclusion: To ensure adequate irradiation of the internal jugular lymph nodes, the posterior border of the lateral radiation therapy upper-neck fields should be placed at least 1 cm posterior to the posterior aspect of the cervical vertebrae. The midline block used in the lower neck anterior field should not exceed 2 cm in width

  6. GENERIC APPROACH IN CHOICE OF ADEQUATE METHODOLOGY FOR THE ASSESSMENT OF IT INVESTMENTS

    Directory of Open Access Journals (Sweden)

    Melita Kozina

    2012-07-01

    Full Text Available Investments into information technology (IT, (hereinafter: IT investments havereached very high figures, which are still continually on the rise. IT potentials are being usedin an increasing number of ways. Various company managers have different approaches tothis issue. A large number of methods/models for the assessment of IT investments isavailable, so the question is posed of how to choose the adequate assessment category. Thesaid reasons have initiated a need for defining the generic approach in the choice ofadequate methodology for the assessment of IT investments, which was indeed the goal ofthis paper. General ideas to this approach stem from the fact that each IT investment has itspurpose and belongs to a certain type of IT investment (decision-making aspect whichdemands its relevant methodology for assessing IT investments. Two groups of demands(conditions have been defined in choosing relevant methodology. The first group pertains tomethodology analysis and determination of its compatibility with characteristics of thedefined decision-making aspect. The second group of conditions pertains to methodologyanalysis with respect to its possibilities (abilities of integrating quantity, quality and riskfactors of IT decision. Conducted field research shows that the assessment of IT investmentshas been done mainly using simpler methods/models and their combinations, and is focusedon quantity aspects of IT values.

  7. First adequately-known quadrupedal sirenian from Eurasia (Eocene, Bay of Biscay, Huesca, northeastern Spain).

    Science.gov (United States)

    Díaz-Berenguer, Ester; Badiola, Ainara; Moreno-Azanza, Miguel; Canudo, José Ignacio

    2018-03-23

    Sirenians are the only extant herbivorous mammals fully adapted to an aquatic lifestyle. They originated in Africa during the Paleocene from an undetermined clade of afrotherian mammals, and by the end of the Eocene they were widely distributed across the tropical latitudes. Here we introduce Sobrarbesiren cardieli gen. et sp. nov. It is the first adequately-known quadrupedal sirenian from Eurasia and the oldest record of this clade from western Europe. Fossils have been recovered from the middle Lutetian (SBZ15) site of Castejón de Sobrarbe-41 (Huesca, Spain), and comprise many cranial and postcranial remains, including pelvic girdle and hind limb bones, from at least six sirenian individuals of different ontogenetic stages. Sobrarbesiren shows a suite of characters previously considered synapomorphies of different clades of derived sirenians, such as the presence of the processus retroversus of the squamosal and the pterygoid fossa, combined with ancestral characters such as the presence of an alisphenoid canal, a permanent P5, at least two sacral vertebrae, a primitive pelvis and functional femora and fibulae. Sobrarbesiren is recovered as the sister taxon of Dugongidae and represents a transitional stage of adaptation to aquatic life between the amphibious quadrupedal prorastomids and the aquatic quadrupedal protosirenids.

  8. Proposal for a advanced PWR core with adequate characteristics for passive safety concept

    International Nuclear Information System (INIS)

    Perrotta, Jose Augusto

    1999-01-01

    This work presents a discussion upon the suitable from an advanced PWR core, classified by the EPRI as 'Passive PWR' (advanced reactor with passive safety concept to power plants with less than 600 MW electrical power). The discussion upon the type of core is based on nuclear fuel engineering concepts. Discussion is made on type of fuel materials, structural materials, geometric shapes and manufacturing process that are suitable to produce fuel assemblies which give good performance for this type of reactors. The analysis is guided by the EPRI requirements for Advanced Light Water Reactor (ALWR). By means of comparison, the analysis were done to Angra 1 (old type of 600 MWe PWR class), and the design of the Westinghouse Advanced PWR-AP600. It was verified as a conclusion of this work that the modern PWR fuels are suitable for advanced PWR's Nevertheless, this work presents a technical alternative to this kind of fuel, still using UO 2 as fuel, but changing its cylindrical form of pellets and pin type fuel element to plane shape pallets and plate type fuel element. This is not a novelty fuel, since it was used in the 50's at Shippingport Reactor and as an advanced version by CEA of France in the 70's. In this work it is proposed a new mechanical assembly design for this fuel, which can give adequate safety and operational performance to the core of a 'Passive PWR'. (author)

  9. Aurally-adequate time-frequency analysis for scattered sound in auditoria

    Science.gov (United States)

    Norris, Molly K.; Xiang, Ning; Kleiner, Mendel

    2005-04-01

    The goal of this work was to apply an aurally-adequate time-frequency analysis technique to the analysis of sound scattering effects in auditoria. Time-frequency representations were developed as a motivated effort that takes into account binaural hearing, with a specific implementation of interaural cross-correlation process. A model of the human auditory system was implemented in the MATLAB platform based on two previous models [A. Härmä and K. Palomäki, HUTear, Espoo, Finland; and M. A. Akeroyd, A. Binaural Cross-correlogram Toolbox for MATLAB (2001), University of Sussex, Brighton]. These stages include proper frequency selectivity, the conversion of the mechanical motion of the basilar membrane to neural impulses, and binaural hearing effects. The model was then used in the analysis of room impulse responses with varying scattering characteristics. This paper discusses the analysis results using simulated and measured room impulse responses. [Work supported by the Frank H. and Eva B. Buck Foundation.

  10. The Comprehension Problems of Children with Poor Reading Comprehension despite Adequate Decoding: A Meta-Analysis.

    Science.gov (United States)

    Spencer, Mercedes; Wagner, Richard K

    2018-06-01

    The purpose of this meta-analysis was to examine the comprehension problems of children who have a specific reading comprehension deficit (SCD), which is characterized by poor reading comprehension despite adequate decoding. The meta-analysis included 86 studies of children with SCD who were assessed in reading comprehension and oral language (vocabulary, listening comprehension, storytelling ability, and semantic and syntactic knowledge). Results indicated that children with SCD had deficits in oral language ( d = -0.78, 95% CI [-0.89, -0.68], but these deficits were not as severe as their deficit in reading comprehension ( d = -2.78, 95% CI [-3.01, -2.54]). When compared to reading comprehension age-matched normal readers, the oral language skills of the two groups were comparable ( d = 0.32, 95% CI [-0.49, 1.14]), which suggests that the oral language weaknesses of children with SCD represent a developmental delay rather than developmental deviance. Theoretical and practical implications of these findings are discussed.

  11. Engaging service providers in improving industry performance

    International Nuclear Information System (INIS)

    Oberth, R.

    2012-01-01

    Effective task leadership is the key to achieving results in the nuclear industry and in most other industries. One of the themes of this conference is to discuss how the nuclear industry can undertake Issue-Identification and Definition as a means of 'identifying what needs attention' and then 'defining what needs to be done to make that happen'. I will explore this theme from the perspective of the 'Service Provider' - which by the definition of this conference includes everyone not within an operating utility - meaning 'those involved in everything from inspection and repair to research and plant architecture' - basically the member companies of my association, OCI. Our members take the definition of the roles and responsibilities of the 'Service Provider' community very seriously. In the context of this discussion a key utility function is the early definition of requirements and expectations of Service Providers in supplying to these requirements. Let's explore for a moment the Service Provider role and perspective. Service Providers are by nature pro-active - they seek ways to engage with utilities (and tier one vendors) to solve problems and achieve good outcomes. They come to industry conferences like this one to learn about upcoming utility programs and supply opportunities and how they can improve performance. Service Providers particularly want to hear senior utility people comment on emerging issues even those at the very early identification stage. Some Clarification of Roles is in Order - as that is the focus of this conference: 'Issue-Identification and Definition'. 'Issue-Identification' is the utility's job - it is the utility's role to identify as early as possible 'what needs attention and what their needs and expectations are'. This takes place before service provider engagement. 'Issue-Definition' is more challenging. It means 'determining and prioritizing what needs to be done to deal with the situation at hand'. This typically involves

  12. Mastering IDEAScript the definitive guide

    CERN Document Server

    Mueller, John Paul

    2011-01-01

    With approximately 44,000 users in the U.S. and Canada, as well as 42,000 in Europe, IDEA software has become a leading provider of data analysis software for use by auditors and accountants. Written to provide users with a quick access guide for optimal use of IDEAScript, Mastering IDEAScript: The Definitive Guide is IDEA's official guide to mastering IDEAScript, covering essential topics such as Introducing IDEAScript, Understanding the Basics of IDEAScript Editor, Designing Structured Applications, Understanding IDEA Databases and much more. For auditors, accountants and controllers.

  13. Team errors: definition and taxonomy

    International Nuclear Information System (INIS)

    Sasou, Kunihide; Reason, James

    1999-01-01

    In error analysis or error management, the focus is usually upon individuals who have made errors. In large complex systems, however, most people work in teams or groups. Considering this working environment, insufficient emphasis has been given to 'team errors'. This paper discusses the definition of team errors and its taxonomy. These notions are also applied to events that have occurred in the nuclear power industry, aviation industry and shipping industry. The paper also discusses the relations between team errors and Performance Shaping Factors (PSFs). As a result, the proposed definition and taxonomy are found to be useful in categorizing team errors. The analysis also reveals that deficiencies in communication, resource/task management, excessive authority gradient, excessive professional courtesy will cause team errors. Handling human errors as team errors provides an opportunity to reduce human errors

  14. Statin intolerance - a question of definition.

    Science.gov (United States)

    Algharably, Engi Abdel-Hady; Filler, Iris; Rosenfeld, Stephanie; Grabowski, Katja; Kreutz, Reinhold

    2017-01-01

    Statin therapy is the backbone of pharmacologic therapy for low-density lipoproteins cholesterol lowering and plays a pivotal role in cardiovascular disease prevention. Statin intolerance is understood as the inability to continue using a statin to reduce individual cardiovascular risk sufficiently, due to the development of symptoms or laboratory abnormalities attributable to the initiation or dose escalation of a statin. Muscle symptoms are the most common side effects observed. Areas covered: The main aim of this article is to present a review on published definitions of statin intolerance. In addition, a brief review on clinical aspects and risk factors of statin intolerance is provided and features for a common definition for statin intolerance are suggested. Expert opinion: A definition of statin intolerance by major drug regulatory agencies is not available. In clinical studies, different definitions are chosen and results are not comparable; different medical associations do not agree on one common definition. There is an unmet need to establish a common definition of statin intolerance to ensure an appropriate clinical use of this important drug class. Further work is required to develop a consensus definition on statin intolerance that could have significant positive impact on both research and clinical management.

  15. Detailed NMR, Including 1,1-ADEQUATE, and Anticancer Studies of Compounds from the Echinoderm Colobometra perspinosa

    Directory of Open Access Journals (Sweden)

    Catherine H. Liptrot

    2009-11-01

    Full Text Available From the dichloromethane/methanol extract of the crinoid Colobometra perspinosa, collected south east of Richards Island (Bedara, Family Islands, Central Great Barrier Reef, Australia, 3-(1'-hydroxypropyl-1,6,8-trihydroxy-9,10-anthraquinone [one of the two stereoisomers of rhodoptilometrin, (1], 3-propyl-1,6,8-trihydroxy-9,10-anthraquinone (3, 2-[(phenylacetylamino]ethanesulfonic acid (4, and 4-hydroxybutanoic acid (5 were isolated. Comparison of 1H- and 13C-NMR data for rhodoptilometrin (1 with those reported in the literature showed significant differences for some resonances associated with rings A and C. In an attempt to provide accurately assigned 1H- and 13C-NMR data, as well as to confirm the structure of 1, a thorough NMR investigation of this compound was undertaken. Measurements included: concentration dependent 13C, 1D selective NOE, HSQC, HMBC and 1,1-ADEQUATE. The NMR data for 4 and 5 are reported here for the first time, as is their occurrence from the marine environment. The in vitro anticancer activity of the original extract was found to be associated with 1, 3 and 5.

  16. Providing free autopoweroff plugs

    DEFF Research Database (Denmark)

    Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

    2012-01-01

    Experimental evidence of the effect of providing households with cheap energy saving technology is sparse. We present results from a field experiment in which autopoweroff plugs were provided free of charge to randomly selected households. We use propensity score matching to find treatment effects...

  17. Fair Balance and Adequate Provision in Direct-to-Consumer Prescription Drug Online Banner Advertisements: A Content Analysis

    Science.gov (United States)

    2016-01-01

    none displayed negative images when presenting risks facts. When benefit facts were being presented, 7% (5/68) showed only positive images. No ads showed negative images when the benefit facts were being presented. Conclusions In the face of ambiguous regulatory guidelines for online banner promotion, drug companies appear to make an attempt to adapt to regulatory guidelines designed for traditional media. However, banner ads use various techniques of presentation to present the advertised drug in the best possible light. The FDA should formalize requirements that drug companies provide a brief summary and include multiple forms of adequate provision in banner ads. PMID:26892749

  18. Fair Balance and Adequate Provision in Direct-to-Consumer Prescription Drug Online Banner Advertisements: A Content Analysis.

    Science.gov (United States)

    Adams, Crystal

    2016-02-18

    facts. When benefit facts were being presented, 7% (5/68) showed only positive images. No ads showed negative images when the benefit facts were being presented. In the face of ambiguous regulatory guidelines for online banner promotion, drug companies appear to make an attempt to adapt to regulatory guidelines designed for traditional media. However, banner ads use various techniques of presentation to present the advertised drug in the best possible light. The FDA should formalize requirements that drug companies provide a brief summary and include multiple forms of adequate provision in banner ads.

  19. Emotional Experiences of Obese Women with Adequate Gestational Weight Variation: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Débora Bicudo Faria-Schützer

    Full Text Available As a result of the growth of the obese population, the number of obese women of fertile age has increased in the last few years. Obesity in pregnancy is related to greater levels of anxiety, depression and physical harm. However, pregnancy is an opportune moment for the intervention of health care professionals to address obesity. The objective of this study was to describe how obese pregnant women emotionally experience success in adequate weight control.Using a qualitative design that seeks to understand content in the field of health, the sample of subjects was deliberated, with thirteen obese pregnant women selected to participate in an individual interview. Data was analysed by inductive content analysis and includes complete transcription of the interviews, re-readings using suspended attention, categorization in discussion topics and the qualitative and inductive analysis of the content. The analysis revealed four categories, three of which show the trajectory of body care that obese women experience during pregnancy: 1 The obese pregnant woman starts to think about her body;2 The challenge of the diet for the obese pregnant woman; 3 The relation of the obese pregnant woman with the team of antenatal professionals. The fourth category reveals the origin of the motivation for the change: 4 The potentializing factors for change: the motivation of the obese woman while pregnant.During pregnancy, obese women are more in touch with themselves and with their emotional conflicts. Through the transformations of their bodies, women can start a more refined self-care process and experience of the body-mind unit. The fear for their own and their baby's life, due to the risks posed by obesity, appears to be a great potentializing factor for change. The relationship with the professionals of the health care team plays an important role in the motivational support of the obese pregnant woman.

  20. Do Foley Catheters Adequately Drain the Bladder? Evidence from CT Imaging Studies

    Directory of Open Access Journals (Sweden)

    Svetlana Avulova

    2015-06-01

    Full Text Available ABSTRACTIntroduction:The Foley catheter has been widely assumed to be an effective means of draining the bladder. However, recent studies have brought into question its efficacy. The objective of our study is to further assess the adequacy of Foley catheter for complete drainage of the bladder.Materials and Methods:Consecutive catheterized patients were identified from a retrospective review of contrast enhanced and non-contrast enhanced computed tomo-graphic (CT abdomen and pelvis studies completed from 7/1/2011-6/30/2012. Residual urine volume (RUV was measured using 5mm axial CT sections as follows: The length (L and width (W of the bladder in the section with the greatest cross sectional area was combined with bladder height (H as determined by multiplanar reformatted images in order to calculate RUV by applying the formula for the volume (V of a sphere in a cube: V=(ϖ/6*(L*W*H.Results:RUVs of 167 (mean age 67 consecutively catheterized men (n=72 and women (n=95 identified by CT abdomen and pelvis studies were calculated. The mean RUV was 13.2 mL (range: 0.0 mL-859.1 mL, standard deviation: 75.9 mL, margin of error at 95% confidence:11.6 mL. Four (2.4% catheterized patients had RUVs of >50 mL, two of whom had an improperly placed catheter tip noted on their CT-reports.Conclusions:Previous studies have shown that up to 43% of catheterized patients had a RUV greater than 50 mL, suggesting inadequacy of bladder drainage via the Foley catheter. Our study indicated that the vast majority of patients with Foley catheters (97.6%, had adequately drained bladders with volumes of

  1. Emotional Experiences of Obese Women with Adequate Gestational Weight Variation: A Qualitative Study

    Science.gov (United States)

    Faria-Schützer, Débora Bicudo; Surita, Fernanda Garanhani de Castro; Alves, Vera Lucia Pereira; Vieira, Carla Maria; Turato, Egberto Ribeiro

    2015-01-01

    Background As a result of the growth of the obese population, the number of obese women of fertile age has increased in the last few years. Obesity in pregnancy is related to greater levels of anxiety, depression and physical harm. However, pregnancy is an opportune moment for the intervention of health care professionals to address obesity. The objective of this study was to describe how obese pregnant women emotionally experience success in adequate weight control. Methods and Findings Using a qualitative design that seeks to understand content in the field of health, the sample of subjects was deliberated, with thirteen obese pregnant women selected to participate in an individual interview. Data was analysed by inductive content analysis and includes complete transcription of the interviews, re-readings using suspended attention, categorization in discussion topics and the qualitative and inductive analysis of the content. The analysis revealed four categories, three of which show the trajectory of body care that obese women experience during pregnancy: 1) The obese pregnant woman starts to think about her body;2) The challenge of the diet for the obese pregnant woman; 3) The relation of the obese pregnant woman with the team of antenatal professionals. The fourth category reveals the origin of the motivation for the change: 4) The potentializing factors for change: the motivation of the obese woman while pregnant. Conclusions During pregnancy, obese women are more in touch with themselves and with their emotional conflicts. Through the transformations of their bodies, women can start a more refined self-care process and experience of the body-mind unit. The fear for their own and their baby's life, due to the risks posed by obesity, appears to be a great potentializing factor for change. The relationship with the professionals of the health care team plays an important role in the motivational support of the obese pregnant woman. PMID:26529600

  2. Pakistan: the new target of terrorism. Are Karachi's emergency medical response systems adequately prepared?

    Science.gov (United States)

    Siddiqui, Muhammad Ahmed; Jawad, Ahmed; Minhas, Saeed; Ansari, Asma; Siddiqui, Afrah; Mehtab, Sana

    2009-07-01

    To assess the efficacy and preparedness of the pre-hospital and hospital emergency medical systems and post graduate trainees in the city to deal with a massive terrorist strike. A cross-sectional survey of postgraduate trainees was conducted at Jinnah Postgraduate Medical Center and Civil Hospital Karachi from 21st July 2007 to 24th July 2007, to evaluate the preparedness and self identified deficiencies of doctors involved in massive trauma casualty management. To assess the pre-hospital care in Karachi, structured telephonic interviews were conducted of administrators of two private run charity based ambulance services. Out of the 90 respondents questioned regarding a self assessment of their training, only 3 (3.3%) of them were confident about their management of bomb blast victims. Eighty-seven (96.6%) of the respondents felt they required some further training (44.4%) or comprehensive training (52.2%). No simulated drills or courses had been conducted for disaster management in the emergency department of the surveyed Hospitals. Most of the ambulance drivers had no paramedic training. Ambulances are equipped with a stretcher and an oxygen cylinder only. No resuscitation measures are available in the ambulances. With an increasing number of terrorist attacks in the country, massive influx of casualties in a relatively short time span has become a regular feature of the Pakistani hospital system. Lack of adequate training at pre-hospital and in hospital levels may translate into increasing morbidities and mortalities. It is imperative that training of junior doctors and paramedical staff be conducted regularly and an effective regional communication base established for efficient interdepartmental coordination.

  3. Do Foley catheters adequately drain the bladder? Evidence from CT imaging studies

    Energy Technology Data Exchange (ETDEWEB)

    Avulova, Svetlana; Li, Valery J.; Khusid, Johnathan A. [Department of Urology, SUNY Downstate College of Medicine, Brooklyn, NY (United States); Choi, Woo S. [Radiology, SUNY Downstate College of Medicine, Brooklyn, NY (United States); Weiss, Jeffrey P., E-mail: johnathan.khusid@downstate.edu [Department of Urology, Weill Cornell Medical College, New York, NY (United States)

    2015-05-15

    Introduction: The Foley catheter has been widely assumed to be an effective means of draining the bladder. However, recent studies have brought into question its efficacy. The objective of our study is to further assess the adequacy of Foley catheter for complete drainage of the bladder. Materials and Methods: Consecutive catheterized patients were identified from a retrospective review of contrast enhanced and non-contrast enhanced computed tomographic (CT) abdomen and pelvis studies completed from 7/1/2011-6/30/2012. Residual urine volume (RUV) was measured using 5mm axial CT sections as follows: The length (L) and width (W) of the bladder in the section with the greatest cross sectional area was combined with bladder height (H) as determined by multiplanar reformatted images in order to calculate RUV by applying the formula for the volume (V) of a sphere in a cube:V=(π/6)⁎L⁎W⁎H). Results: RUVs of 167 (mean age 67) consecutively catheterized men (n=72) and women (n=95) identified by CT abdomen and pelvis studies were calculated. The mean RUV was 13.2 mL (range: 0.0 mL-859.1 mL, standard deviation: 75.9 mL, margin of error at 95% confidence:11.6 mL). Four (2.4%) catheterized patients had RUVs of >50 mL, two of whom had an improperly placed catheter tip noted on their CT-reports. Conclusions: Previous studies have shown that up to 43% of catheterized patients had a RUV greater than 50 mL, suggesting inadequacy of bladder drainage via the Foley catheter. Our study indicated that the vast majority of patients with Foley catheters (97.6%), had adequately drained bladders with volumes of <50 mL. (author)

  4. Capillary PO2 does not adequately reflect arterial PO2 in hypoxemic COPD patients.

    Science.gov (United States)

    Magnet, Friederike Sophie; Majorski, Daniel Sebastian; Callegari, Jens; Schwarz, Sarah Bettina; Schmoor, Claudia; Windisch, Wolfram; Storre, Jan Hendrik

    2017-01-01

    To compare arterial (P a O 2 ) with capillary (P c O 2 ) partial pressure of oxygen in hypoxemic COPD patients because capillary blood gas analysis (CBG) is increasingly being used as an alternative to arterial blood gas analysis (ABG) in a non-intensive care unit setting, although the agreement between P c O 2 and P a O 2 has not been evaluated in hypoxemic COPD patients. Bland-Altman comparison of P a O 2 and P c O 2 served as the primary outcome parameter if P c O 2 values were ≤60 mmHg and the secondary outcome parameter if P c O 2 values were ≤55 mmHg. Pain associated with the measurements was assessed using a 100-mm visual analog scale. One hundred and two P a O 2 /P c O 2 measurement pairs were obtained. For P c O 2 values ≤60 mmHg, the mean difference between P a O 2 and P c O 2 was 5.99±6.05 mmHg (limits of agreement: -5.88 to 17.85 mmHg). For P c O 2 values ≤55 mmHg (n=73), the mean difference was 5.33±5.52 mmHg (limits of agreement: -5.48 to 16.15 mmHg). If P a O 2 ≤55 (≤60) mmHg was set as the cut-off value, in 20.6% (30.4%) of all patients, long-term oxygen therapy have been unnecessarily prescribed if only P c O 2 would have been assessed. ABG was rated as more painful compared with CBG. P c O 2 does not adequately reflect P a O 2 in hypoxemic COPD patients, which can lead to a relevant number of unnecessary long-term oxygen therapy prescriptions.

  5. Defining an adequate sample of earlywood vessels for retrospective injury detection in diffuse-porous species.

    Directory of Open Access Journals (Sweden)

    Estelle Arbellay

    Full Text Available Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospective injury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L. Moench and downy birch (Betula pubescens Ehrh. were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii identifying an adequate sample of earlywood vessels (number and intra-ring location of cells attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospective injury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding.

  6. Spirulina does not decrease muscle damage nor oxdidative stress in cycling athletes with adequate nutritional status

    Directory of Open Access Journals (Sweden)

    G.A.M. Franca

    2010-12-01

    Full Text Available The objective of this study was to assess the effect of Spirulina maxima on oxidative stress and muscle damage in cycling athletes subjected to high volume and intensity of training. Eighteen male athletes were randomly divided into an experimental group (n=11 with age 27.8±3.5 and placebo (n=7 with age 34.3±2.3 in a double-blind fashion. They carried out a protocol of Spirulina dietary supplementation (7.5 g/day of placebo for four weeks and maintained their trainings during this period. A nutritional anamnesis was performed and blood tests were done to determine pre and post levels of creatine kinase (CK, lactic dehydrogenase (LHD, superoxide dismutase (SOD and malondialdehyde (MDA. The supplemented and placebo groups performed the same volume training, has adequate macronutrients and antioxidant vitamins ingestion before study, as well as initial CK, LDH, SOD and MDA levels. Supplementation did not promote a significant alteration in CK levels on supplemented group (158.4±16.3 for 140.0±16.6 U/l, p>0.05, LDH (420±13.2 for 394.9±27.9 UI/l, p>0.05, MDA (2.8±0.2 for 2.9±0.4 nmol/ml, p>0.05, nor an increase in the SOD (7.3±0.6 for 7.0±0.6 U/mg Hb, p>0.05. We conclude that administration of Spirulina does not interfere in the magnitude of muscle damage nor in antioxidant status of cycling athletes that practice intense training.

  7. Adequate plasma drug concentrations suggest that amoxicillin can be administered by continuous infusion using elastomeric pumps.

    Science.gov (United States)

    Arensdorff, Lyne; Boillat-Blanco, Noémie; Decosterd, Laurent; Buclin, Thierry; de Vallière, Serge

    2017-09-01

    Elastomeric pumps can be useful for the administration of antibiotics in the outpatient setting. To determine amoxicillin degradation in elastomeric pumps, as well as the effectiveness of amoxicillin treatment administered by elastomeric pumps. Antibiotic degradation was measured in elastomeric pumps filled with 6 g of amoxicillin in 240 mL of NaCl 0.9% by drawing samples at 12 h intervals when stored in the fridge for 48 h and when worn around the waist for 24 h. Subsequently nine patients were treated with continuous infusions of 8 or 12 g of amoxicillin per day. Plasma amoxicillin concentrations were measured on each visit to the outpatient parenteral antibiotic therapy unit. Clinical outcome was verified 3 months after the end of treatment. Amoxicillin degradation in elastomeric pumps reached 10% after 48 h in the fridge and an additional 30% when worn around the waist for 24 h. Mean plasma drug concentrations achieved with 12 g of amoxicillin per day were 18.5 mg/L (95% CI 13.5-23.5), which is largely above the MIC of amoxicillin-susceptible bacteria. Nine patients treated for various complicated infections were cured and had no unexpected adverse effects. Adequate plasma drug concentrations and favourable clinical outcomes suggest that amoxicillin can be administered by continuous infusion using elastomeric pumps. This treatment modality does not fulfil formal requirements regarding pharmaceutical stability, but the resulting safety impact in patients is probably limited. Therapeutic drug monitoring and a close clinical follow-up are recommended if this route of administration is chosen. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Report: EPA Has Adequate Controls to Manage Advice From Science and Research Federal Advisory Committees, but Transparency Could Be Improved

    Science.gov (United States)

    Report #17-P-0124, March 13, 2017. Science plays an integral role in the EPA's mission. The EPA has an adequate system of controls to manage recommendations from its science and research federal advisory committees.

  9. Do people know adequately about leptospirosis? A knowledge assessment survey in post-outbreak situation in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Suneth B Agampodi

    2010-01-01

    Conclusions: Although there is not adequate information on MDD prevalence in some areas of Iran, the overall current preva-lence of MDD in the country is high and females are at the greater risk of disease.

  10. Definitions of fuel poverty: Implications for policy

    International Nuclear Information System (INIS)

    Moore, Richard

    2012-01-01

    This paper outlines why the definition of fuel poverty is important in policy formulation and describes how the Government's current definitions evolved from the original concept. It discusses the determination of income and fuel costs and the possibilities for a relative and common European measure. It examines problems inherent in assessing fuel costs as a percentage of income and puts forward the arguments for a ‘budget standard’ approach. The paper illustrates how the size of the problem depends on the definition and chosen threshold and suggests advantages for a rating scale. It illustrates how the income composition and thresholds also govern the distribution of the target populations and the relative importance of the main causal factors, and examines the consequent policy implications. It explores the definition of vulnerable households and the importance of severity and questions whether the UK fuel poverty strategy is targeted at households least able to afford their fuel costs (as the name implies) or primarily those at risk from excess winter and summer mortality and morbidity. Finally, after examining the role of supplementary indicators, it looks at the opportunities for changing the definition and comments on the Government review of the definition and targets. - Highlights: ► There are major failings in the existing official definitions of fuel poverty. ► expressing fuel costs as a percentage of income is a poor indicator of fuel poverty. ► A budget standard approach provides a more consistent, meaningful and fairer measure. ► The scale and nature of the problem changes dramatically with different definitions. ► The definition is crucial to the mix of policies and allocation of resources required.

  11. Selection of the initial conditions in the tunneling time definition

    International Nuclear Information System (INIS)

    Zajchenko, A.K.

    2004-01-01

    The necessity of changing of the initial conditions in the Olkhovsky - Recami definition of the tunneling time is justified. The new initial conditions are proposed which adequately taking into account the irreversibility of the wave packets spreading. The expression for the tunneling time with the new initial conditions is reduced to the form which is convenient for the performing and controlling the accuracy of calculations

  12. Credential Service Provider (CSP)

    Data.gov (United States)

    Department of Veterans Affairs — Provides a VA operated Level 1 and Level 2 credential for individuals who require access to VA applications, yet cannot obtain a credential from another VA accepted...

  13. MAX Provider Characteristics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MAX Provider Characteristics (PC) File Implementation Report describes the design, implementation, and results of the MAXPC prototype, which was based on three...

  14. Genomic definition of species

    Energy Technology Data Exchange (ETDEWEB)

    Crkvenjakov, R.; Drmanac, R.

    1991-07-01

    The subject of this paper is the definition of species based on the assumption that genome is the fundamental level for the origin and maintenance of biological diversity. For this view to be logically consistent it is necessary to assume the existence and operation of the new law which we call genome law. For this reason the genome law is included in the explanation of species phenomenon presented here even if its precise formulation and elaboration are left for the future. The intellectual underpinnings of this definition can be traced to Goldschmidt. We wish to explore some philosophical aspects of the definition of species in terms of the genome. The point of proposing the definition on these grounds is that any real advance in evolutionary theory has to be correct in both its philosophy and its science.

  15. Definition of successful defibrillation

    NARCIS (Netherlands)

    Koster, Rudolph W.; Walker, Robert G.; van Alem, Anouk P.

    2006-01-01

    OBJECTIVES: The definition of defibrillation shock "success" endorsed by the International Liaison Committee on Resuscitation since the publication of Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiac Care has been removal of ventricular fibrillation at 5 secs after shock

  16. 42 CFR 456.51 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... institution for mental disease, as defined in § 440.10; (2) [Reserved] (3) Services provided in specialty hospitals and (b) Exclude services provided in mental hospitals. Utilization control requirements for mental... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals § 456.51 Definitions. As used in this...

  17. 45 CFR 1386.19 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... treatment plan (including a discharge plan); provide adequate nutrition, clothing, or health care to an..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON DEVELOPMENTAL DISABILITIES, DEVELOPMENTAL... formal or informal, written or oral, received by the system including media accounts, newspaper articles...

  18. Is the Health of Irish Workers adequately protected from the effects Radon Gas?

    International Nuclear Information System (INIS)

    Heery Mary

    2006-08-01

    prosecuted for failing to comply with this legislation. Hence, the health of Irish workers is not being adequately protected from the effects of this silent killer, radon gas

  19. [The challenge of adequate reimbursement for the seriously injured patient in the German DRG system].

    Science.gov (United States)

    Franz, D; Lefering, R; Siebert, H; Windolf, J; Roeder, N; Mahlke, L

    2013-02-01

    ability to obtain adequate case allocations for highly complex and heterogeneous cases. Specific modifications of the G-DRG structures could increase the appropriateness of case allocation of critically injured patients. Additional consideration of the ISS clinical data must be further evaluated. Data-based analysis is an essential prerequisite for a constructive development of the G-DRG system and a necessary tool for the active participation of medical societies in this process. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Hidden Curriculum: An Analytical Definition

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Andarvazh

    2018-03-01

    Full Text Available Background: The concept of hidden curriculum was first used by Philip Jackson in 1968, and Hafferty brought this concept to the medical education. Many of the subjects that medical students learn are attributed to this curriculum. So far several definitions have been presented for the hidden curriculum, which on the one hand made this concept richer, and on the other hand, led to confusion and ambiguity.This paper tries to provide a clear and comprehensive definition of it.Methods: In this study, concept analysis of McKenna method was used. Using keywords and searching in the databases, 561 English and 26 Persian references related to the concept was found, then by limitingthe research scope, 125 abstracts and by finding more relevant references, 55 articles were fully studied.Results: After analyzing the definitions by McKenna method, the hidden curriculum is defined as follows: The hidden curriculum is a hidden, powerful, intrinsic in organizational structure and culture and sometimes contradictory message, conveyed implicitly and tacitly in the learning environment by structural and human factors and its contents includes cultural habits and customs, norms, values, belief systems, attitudes, skills, desires and behavioral and social expectations can have a positive or negative effect, unplanned, neither planners nor teachers, nor learners are aware of it. The ultimate consequence of the hidden curriculum includes reproducing the existing class structure, socialization, and familiarizing learners for transmission and joining the professional world.Conclusion: Based on the concept analysis, we arrived at an analytical definition of the hidden curriculum that could be useful for further studies in this area.Keywords: CONCEPT ANALYSIS, HIDDEN CURRICULUM, MCKENNA’S METHOD

  1. Provider software buyer's guide.

    Science.gov (United States)

    1994-03-01

    To help long term care providers find new ways to improve quality of care and efficiency, Provider magazine presents the fourth annual listing of software firms marketing computer programs for all areas of nursing facility operations. On the following five pages, more than 80 software firms display their wares, with programs such as minimum data set and care planning, dietary, accounting and financials, case mix, and medication administration records. The guide also charts compatible hardware, integration ability, telephone numbers, company contacts, and easy-to-use reader service numbers.

  2. Exploring Mathematical Definition Construction Processes

    Science.gov (United States)

    Ouvrier-Buffet, Cecile

    2006-01-01

    The definition of "definition" cannot be taken for granted. The problem has been treated from various angles in different journals. Among other questions raised on the subject we find: the notions of "concept definition" and "concept image", conceptions of mathematical definitions, redefinitions, and from a more axiomatic point of view, how to…

  3. Health Care Provider Value Chain

    OpenAIRE

    Kawczynski , Lukasz; Taisch , Marco

    2009-01-01

    International audience; In every society there is a need for an efficient health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers a complex way of looking at the value within the health care sector. The proposal of the value chain model is anticipated with a value stream mapping activities and experts interviews. Proposed model offers consistent...

  4. What HERA may provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes [DESY, Hamburg (Germany); De Roeck, Albert [CERN, Genf (Switzerland); Bartles, Jochen [Univ. Hamburg (DE). Institut fuer Theoretische Physik II] (and others)

    2008-09-15

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  5. What HERA may provide?

    International Nuclear Information System (INIS)

    Jung, Hannes; De Roeck, Albert; Bartles, Jochen

    2008-09-01

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  6. Provider of Services File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...

  7. 40 CFR 280.92 - Definition of terms.

    Science.gov (United States)

    2010-07-01

    ... than monetary compensation that provides a motivation for the guarantor to provide a guarantee... include intangibles such as goodwill and rights to patents or royalties. For purposes of this definition...

  8. Considering the Definition of Addiction

    Science.gov (United States)

    Sussman, Steve; Sussman, Alan N.

    2011-01-01

    The definition of addiction is explored. Elements of addiction derived from a literature search that uncovered 52 studies include: (a) engagement in the behavior to achieve appetitive effects, (b) preoccupation with the behavior, (c) temporary satiation, (d) loss of control, and (e) suffering negative consequences. Differences from compulsions are suggested. While there is some debate on what is intended by the elements of addictive behavior, we conclude that these five constituents provide a reasonable understanding of what is intended by the concept. Conceptual challenges for future research are mentioned. PMID:22073026

  9. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    2015-01-01

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...... process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....... of the services, such as sequential or reciprocal task activities, influence the development of different types of capabilities. We study five cases of offshore-outsourced knowledge-intensive business services that are distinguished according to their reciprocal or sequential task activities in their production...

  10. Providing x-rays

    International Nuclear Information System (INIS)

    Mallozzi, P.J.; Epstein, H.M.

    1985-01-01

    This invention provides an apparatus for providing x-rays to an object that may be in an ordinary environment such as air at approximately atmospheric pressure. The apparatus comprises: means (typically a laser beam) for directing energy onto a target to produce x-rays of a selected spectrum and intensity at the target; a fluid-tight enclosure around the target; means for maintaining the pressure in the first enclosure substantially below atmospheric pressure; a fluid-tight second enclosure adjoining the first enclosure, the common wall portion having an opening large enough to permit x-rays to pass through but small enough to allow the pressure reducing means to evacuate gas from the first enclosure at least as fast as it enters through the opening; the second enclosure filled with a gas that is highly transparent to x-rays; the wall of the second enclosure to which the x-rays travel having a portion that is highly transparent to x-rays (usually a beryllium or plastic foil), so that the object to which the x-rays are to be provided may be located outside the second enclosure and adjacent thereto and thus receive the x-rays substantially unimpeded by air or other intervening matter. The apparatus is particularly suited to obtaining EXAFS (extended x-ray fine structure spectroscopy) data on a material

  11. Why healthcare providers merge.

    Science.gov (United States)

    Postma, Jeroen; Roos, Anne-Fleur

    2016-04-01

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities.

  12. PROVIDING WOMEN, KEPT MEN

    Science.gov (United States)

    Mojola, Sanyu A

    2014-01-01

    This paper draws on ethnographic and interview based fieldwork to explore accounts of intimate relationships between widowed women and poor young men that emerged in the wake of economic crisis and a devastating HIV epidemic among the Luo ethnic group in Western Kenya. I show how the cooptation of widow inheritance practices in the wake of an overwhelming number of widows as well as economic crisis resulted in widows becoming providing women and poor young men becoming kept men. I illustrate how widows in this setting, by performing a set of practices central to what it meant to be a man in this society – pursuing and providing for their partners - were effectively doing masculinity. I will also show how young men, rather than being feminized by being kept, deployed other sets of practices to prove their masculinity and live in a manner congruent with cultural ideals. I argue that ultimately, women’s practice of masculinity in large part seemed to serve patriarchal ends. It not only facilitated the fulfillment of patriarchal expectations of femininity – to being inherited – but also served, in the end, to provide a material base for young men’s deployment of legitimizing and culturally valued sets of masculine practice. PMID:25489121

  13. Predictors of Timely Prenatal Care Initiation and Adequate Utilization in a Sample of Late Adolescent Texas Latinas.

    Science.gov (United States)

    Torres, Rosamar; Kehoe, Priscilla; Heilemann, MarySue V

    2018-03-01

    Little is known of late adolescent Texas Latinas' prenatal care perceptions or how these perceptions predict timely prenatal care initiation or adequate utilization. Hence, the purpose of this study is to describe and compare these perceptions between participants with timely versus late prenatal care initiation and adequate, intermediate, and inadequate prenatal care utilization; and to determine predictors of timely prenatal care initiation and adequate utilization. Fifty-four postpartum Latinas were recruited through social media. Eligibility criteria were 18 to 21 years old, Texas-born, primiparous, uncomplicated pregnancy/delivery, and English literate. Prenatal care perceptions were measured with the Revised Better Babies Survey and Access Barriers to Care Index. Participants had favorable views of prenatal care benefits; however, not living with the baby's father predicted inadequate prenatal care, Wald χ 2 (1) = 4.93, p = .026. Perceived benefits of timely and adequate prenatal care predicted timely prenatal care initiation, χ 2 (1) = 7.47, p = .006. Self-reported depression during pregnancy predicted timely entry into prenatal care, χ 2 (1) = 4.73, p = .03. Participants' positive prenatal care perceptions did not predict adequate prenatal care utilization, indicating that barriers serve as powerful obstacles in late adolescent Texas Latinas.

  14. Evidenced-based, practical food portion sizes for preschool children and how they fit into a well balanced, nutritionally adequate diet.

    Science.gov (United States)

    More, J A; Emmett, P M

    2015-04-01

    Healthy eating guidelines for 1-4-year-old children are available but evidence-based portion sizes have not been specified. Parents and early-years providers are concerned about under- or over-feeding young children. The present study aimed to report detailed information about appropriate average portion size ranges and suggest a practical food plan for feeding preschool children, providing adequate nutrient intakes within energy requirements. Two sources of information were used to obtain an appropriate portion size range for the types of foods normally eaten by this age group. Median portions of a variety of foods were combined into a food plan fulfilling healthy eating guidelines regarding the number of servings from each food group. The nutrient and energy content of the plan was assessed and compared with recommended adequate nutrient intakes and percentage energy contributions from macronutrients. UK children, aged 1-4 years, taking part in Avon Longitudinal Study of Parents and Children and National Diet and Nutrition Survey, were used in the present study. Portion size ranges were developed for 164 foods. The theoretical food plan using foods with high to medium nutrient density was shown to provide an adequate intake of all nutrients, except vitamin D, for which there are very few food sources. These practical food portion size ranges could be used both in early years settings and in advice to parents. The food plan emphasises the need to include a variety of nutrient-dense foods if a balanced diet is to be achieved for preschool children. © 2014 The British Dietetic Association Ltd.

  15. 21 CFR 514.117 - Adequate and well-controlled studies.

    Science.gov (United States)

    2010-04-01

    ... for purposes of section 512 of the Federal Food, Drug, and Cosmetic Act (the act) (21 U.S.C. 360b... and well-controlled study should provide sufficient details of study design, conduct, and analysis to... limited to, the manufacture, processing, packaging, holding, and labeling of the new animal drug such that...

  16. Factors supporting an adequate sizing of internal audit departments in the public sector

    Directory of Open Access Journals (Sweden)

    Elena Doina DASCĂLU

    2016-06-01

    By identifying the factors considered critical for the sizing of the internal audit departments, which have no equivalent (counterpart in the factors provided for in the current normative framework in Romania, the article contributes to the clarification of issues related to sizing models and procedures in the field.

  17. 75 FR 69648 - Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers

    Science.gov (United States)

    2010-11-15

    ... interpretative posture weakens the safety structure the rule is designed to hold firmly in place. 10 CFR Part 830... Basis Documents, and notes that the Safety Basis Approval Authority may prescribe interim controls and... managers ``are expected to carefully evaluate situations that fall short of expectations and only provide...

  18. 75 FR 74022 - Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers

    Science.gov (United States)

    2010-11-30

    ... posture weakens the safety structure the rule is designed to hold firmly in place. 10 CFR Part 830 imposes... Basis Documents, and notes that the Safety Basis Approval Authority may prescribe interim controls and... managers ``are expected to carefully evaluate situations that fall short of expectations and only provide...

  19. 42 CFR 413.24 - Adequate cost data and cost finding.

    Science.gov (United States)

    2010-10-01

    ... qualified health clinic, community mental health center, or end-stage renal disease facility. (ii) Effective..., rural health clinics, Federally qualified health centers, and community mental health centers, a... qualified health centers, and community mental health centers, a provider must submit a hard copy of a...

  20. "Standards" on the Bench: Do Standards for Technological Literacy Render an Adequate Image of Technology?

    Science.gov (United States)

    Nia, Mahdi G.; de Vries, Marc J.

    2016-01-01

    The technological literacy of students has recently become one of the primary goals of education in countries such as the USA, England, New Zealand, Australia, and so forth. However the question here is whether these educations--their long-term policy documents as well as the standards they provide in particular--address sufficient learning about…

  1. How Adequate is your CV? Analyzing French CVs with ReaderBench

    NARCIS (Netherlands)

    Gutu, Gabriel; Dascalu, Mihai; Trausan-Matu, Stefan; Lepoivre, Olivier

    2017-01-01

    This study is aimed at presenting a new ReaderBench-based tool built to support candidates in increasing the quality of their CV for a job opening. Both the visual quality and the textual content are considered while also providing an overview and corresponding feedback for the entire CV.

  2. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Science.gov (United States)

    2010-07-01

    ... Federal agency. (a) Certain biological control agents. (1) Except as provided by paragraphs (a)(3) and (a)(4) of this section, all biological control agents are exempt from FIFRA requirements. (2) If the Agency determines that an individual biological control agent or class of biological control agents is no...

  3. Providing Compassion through Flow

    Directory of Open Access Journals (Sweden)

    Lydia Royeen

    2015-07-01

    Full Text Available Meg Kral, MS, OTR/L, CLT, is the cover artist for the Summer 2015 issue of The Open Journal of Occupational Therapy. Her untitled piece of art is an oil painting and is a re-creation of a photograph taken while on vacation. Meg is currently supervisor of outpatient services at Rush University Medical Center. She is lymphedema certified and has a specific interest in breast cancer lymphedema. Art and occupational therapy serve similar purposes for Meg: both provide a sense of flow. She values the outcomes, whether it is a piece of art or improved functional status

  4. Self-Reports of Student Cheating: Does a Definition of Cheating Matter?

    Science.gov (United States)

    Burrus, Robert T.; McGoldrick, KimMarie; Schuhmann, Peter W.

    2007-01-01

    The authors examine student cheating based on implicit and explicit definitions of cheating. Prior to being provided a definition of cheating, students reported whether they had cheated. Students were then provided a definition of cheating and asked to rereport their cheating behaviors. Results indicate that students do not understand what…

  5. Definitions of solid and hazardous wastes

    International Nuclear Information System (INIS)

    1992-08-01

    This guidance document explains the definitions of solid and hazardous waste under the Resource Conservation and Recovery Act (RCRA). The definitions are presented in flowchart form to provide the reader with a method of utilizing applicable regulations to determine whether or not a material meets the definition of a solid or hazardous waste. A narrative adjacent to each step of the flowchart elaborates on the specific subject and clarifies the role of the step. The text also contains cross references to other parts of this document for further clarification. The information is provided in terms of a decision-making process. The flowcharts and accompanying text include all major information from the RCRA regulations found in Title 40 of the Code of Federal Regulations, Part 261 (40 CFR Part 261). In some cases, regulatory language has been supplemented with language from EPA rulemaking preambles

  6. High-Definition Medicine.

    Science.gov (United States)

    Torkamani, Ali; Andersen, Kristian G; Steinhubl, Steven R; Topol, Eric J

    2017-08-24

    The foundation for a new era of data-driven medicine has been set by recent technological advances that enable the assessment and management of human health at an unprecedented level of resolution-what we refer to as high-definition medicine. Our ability to assess human health in high definition is enabled, in part, by advances in DNA sequencing, physiological and environmental monitoring, advanced imaging, and behavioral tracking. Our ability to understand and act upon these observations at equally high precision is driven by advances in genome editing, cellular reprogramming, tissue engineering, and information technologies, especially artificial intelligence. In this review, we will examine the core disciplines that enable high-definition medicine and project how these technologies will alter the future of medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. ITER definition phase

    International Nuclear Information System (INIS)

    1989-01-01

    The International Thermonuclear Experimental Reactor (ITER) is envisioned as a fusion device which would demonstrate the scientific and technological feasibility of fusion power. As a first step towards achieving this goal, the European Community, Japan, the Soviet Union, and the United States of America have entered into joint conceptual design activities under the auspices of the International Atomic Energy Agency. A brief summary of the Definition Phase of ITER activities is contained in this report. Included in this report are the background, objectives, organization, definition phase activities, and research and development plan of this endeavor in international scientific collaboration. A more extended technical summary is contained in the two-volume report, ''ITER Concept Definition,'' IAEA/ITER/DS/3. 2 figs, 2 tabs

  8. Factors Affecting the Presence of Adequately Iodized Salt at Home in Wolaita, Southern Ethiopia: Community Based Study.

    Science.gov (United States)

    Kumma, Wondimagegn Paulos; Haji, Yusuf; Abdurahmen, Junayde; Mehretie Adinew, Yohannes

    2018-01-01

    Universal use of iodized salt is a simple and inexpensive method to prevent and eliminate iodine deficiency disorders like mental retardation. However, little is known about the level of adequately iodized salt consumption in the study area. Therefore, the study was aimed at assessing the proportion of households having adequately iodized salt and associated factors in Wolaita Sodo town and its peripheries, Southern Ethiopia. A cross-sectional study was conducted from May 10 to 20, 2016, in 441 households in Sodo town and its peripheries. Samples were selected using the systematic sampling technique. An iodometric titration method (AOAC, 2000) was used to analyze the iodine content of the salt samples. Data entry and analysis were done using Epi Info version 3.5.1 and SPSS version 16, respectively. The female to male ratio of the respondents was 219. The mean age of the respondents was 30.2 (±7.3 SD). The proportion of households having adequately iodized salt was 37.7%, with 95% CI of 33.2% to 42.2%. Not exposing salt to sunlight with [OR: 3.75; 95% CI: 2.14, 6.57], higher monthly income [OR: 3.71; 95% CI: 1.97-7.01], and formal education of respondents with [OR: 1.75; 95% CI: 1.14, 2.70] were found associated with the presence of adequately iodized salt at home. This study revealed low levels of households having adequately iodized salt in Wolaita Sodo town and its peripheries. The evidence here shows that there is a need to increase the supply of adequately iodized salt to meet the goal for monitoring progress towards sustainable elimination of IDD.

  9. Factors Affecting the Presence of Adequately Iodized Salt at Home in Wolaita, Southern Ethiopia: Community Based Study

    Directory of Open Access Journals (Sweden)

    Wondimagegn Paulos Kumma

    2018-01-01

    Full Text Available Background. Universal use of iodized salt is a simple and inexpensive method to prevent and eliminate iodine deficiency disorders like mental retardation. However, little is known about the level of adequately iodized salt consumption in the study area. Therefore, the study was aimed at assessing the proportion of households having adequately iodized salt and associated factors in Wolaita Sodo town and its peripheries, Southern Ethiopia. Methods. A cross-sectional study was conducted from May 10 to 20, 2016, in 441 households in Sodo town and its peripheries. Samples were selected using the systematic sampling technique. An iodometric titration method (AOAC, 2000 was used to analyze the iodine content of the salt samples. Data entry and analysis were done using Epi Info version 3.5.1 and SPSS version 16, respectively. Result. The female to male ratio of the respondents was 219. The mean age of the respondents was 30.2 (±7.3 SD. The proportion of households having adequately iodized salt was 37.7%, with 95% CI of 33.2% to 42.2%. Not exposing salt to sunlight with [OR: 3.75; 95% CI: 2.14, 6.57], higher monthly income [OR: 3.71; 95% CI: 1.97–7.01], and formal education of respondents with [OR: 1.75; 95% CI: 1.14, 2.70] were found associated with the presence of adequately iodized salt at home. Conclusion. This study revealed low levels of households having adequately iodized salt in Wolaita Sodo town and its peripheries. The evidence here shows that there is a need to increase the supply of adequately iodized salt to meet the goal for monitoring progress towards sustainable elimination of IDD.

  10. [Functional restoration--it depends on an adequate mixture of treatment].

    Science.gov (United States)

    Pfingsten, M

    2001-12-01

    impairment as well as physical variables (mobility, strength) have limited predictive value. Return to work and pain reduction are much better predicted by length of absence from work, application for pension, and the patients' disability in daily-life activities. In the last five years another important variable of success has been identified: avoidance behavior has been suspected to be a major contributor to the initiation and maintenance of chronic low back pain. The perpetuation of avoidance behavior beyond normal healing time subsequently leads to negative consequences such as "disuse syndrome", which is associated with physical deconditioning, sick role behavior, psychosocial withdrawal and negative affect. Accordingly, fear-avoidance beliefs were strongly related to absenteeism from work due to back pain and were the best predictors of therapy outcome in 300 acute low back pain patients. In a prospective study on 87 patients with chronic low back pain (CLBP) we demonstrated that fear-avoidance beliefs were the strongest predictors of return to work after a functional restoration treatment program. Although nonspecific mechanisms such as emotional disturbance, helplessness, pain anticipation, disability, and job circumstances could be identified as influencing the chronic pain process, we have to remember that long-lasting experience of pain is usually a very individual process in which several conditions may work together in a unique combination. Treatment procedures must consider this variability by focusing on general mechanisms, as well as on individual conditions and deficits. FR treatment strongly depends on behavioral principles that rule the whole therapeutic process: Adequate information is necessary to overcome unhelpful beliefs; information has to be related to the patients' daily experiences and their mental capability to understand them. Pacing, goal-setting, graded exposure with exercise quotas and permanent feedback as well as contingent motivation

  11. Interdisciplinary care for adequate adherence totreatment in patients with lupus nephritis

    Directory of Open Access Journals (Sweden)

    Gladys Gaviria-García

    2016-02-01

    Full Text Available The review is based on the contribution that each discipline should provide the patient for a holistic care, which include medical assessment, monitoring and counselling as emotional support, assessment and nutritional monitoring as a key element in core requirements, physical activity that optimize the quality of life, social activities that can enter the individual in active groups, follow-up by nurses to the fulfillment of the ordered drug treatment, car care and orientation education to the family. The novelty of this proposal is to basically carry out care of the interdisciplinary team for treatment adherence. This review concluded that patients with lupus nephritis (NL treated after assessment and follow-up holistic, such as system monitoring and adherence to the treatment of comprehensive care, provides better quality of life, and minimizes the risks of complication of the patient, avoiding recurrent hospitalizations.

  12. The Pedagogical Performance Of The Judge In The Search For A Fair Trial And An Adequate Provision: Judicial Role

    Directory of Open Access Journals (Sweden)

    Elaine Harzheim Macedo

    2017-02-01

    Full Text Available This work analyzes the possibility of pedagogical performance of the judge in the search for a fair trial and adequate process. Using deductive methodology, starts with the duties and powers of the judge to assess the possibility of inducing practices based on the good faith by applying bad faith litigation and determination of initial amendment. The judge can be an agent that helps in the implementation of fair trial and adequate provision and should not remain inert in relation to clear violations of fundamental procedural rights. This activity should not generalise situations, being based on the analysis of specific cases.

  13. Developmental origins of metabolic disorders: The need for biomarker candidates and therapeutic targets from adequate preclinical models

    Directory of Open Access Journals (Sweden)

    Antonio Gonzalez-Bulnes

    2016-03-01

    Full Text Available The investigation on obesity and associated disorders have changed from an scenario in which genome drove the phenotype to a dynamic setup in which prenatal and early-postnatal conditions are determinant. However, research in human beings is difficult due to confounding factors (lifestyle and socioeconomic heterogeneity plus ethical issues. Hence, there is currently an intensive effort for developing adequate preclinical models, aiming for an adequate combination of basic studies in rodent models and specific preclinical studies in large animals. The results of these research strategies may increase the identification and development of contrasted biomarkers and therapeutic targets.

  14. [The pregnant employee in anaesthesia and intensive care - An evidence-based approach to designing adequate workplaces].

    Science.gov (United States)

    Röher, Katharina; Göpfert, Matthias S

    2015-07-01

    In the light of a rising percentage of women among employees in anaesthesia and intensive care designing adequate workplaces for pregnant employees plays an increasingly important role. Here it is necessary to align the varied interests of the pregnant employee, fellow employees and the employer, where the legal requirements of the Maternity Protection Act ("Mutterschutzgesetz") form the statutory framework. This review describes how adequate workplaces for pregnant employees in anaesthesia and intensive care can be established considering the scientific evidence on the subject. © Georg Thieme Verlag Stuttgart · New York.

  15. Maintenance of exercise training benefits is associated with adequate milk and dairy products intake in elderly hypertensive subjects following detraining.

    Science.gov (United States)

    Moraes, Wilson Max Almeida Monteiro de; Santos, Neucilane Silveira Dos; Aguiar, Larissa Pereira; Sousa, Luís Gustavo Oliveira de

    2017-01-01

    To investigate whether maintenance of exercise training benefits is associated with adequate milk and dairy products intake in hypertensive elderly subjects after detraining. Twenty-eight elderly hypertensive patients with optimal clinical treatment underwent 16 weeks of multicomponent exercise training program followed by 6 weeks of detraining, and were classified according to milk and dairy products intake as low milk (exercise training, there was a significant reduction (pexercise training benefits related to pressure levels, lower extremity strength and aerobic capacity, is associated with adequate milk and dairy products intake in hypertensive elderly subjects following 6 weeks of detraining.

  16. Development of a large-area Multigap RPC with adequate spatial resolution for muon tomography

    Science.gov (United States)

    Wang, J.; Wang, Y.; Wang, X.; Zeng, M.; Xie, B.; Han, D.; Lyu, P.; Wang, F.; Li, Y.

    2016-11-01

    We study the performance of a large-area 2-D Multigap Resistive Plate Chamber (MRPC) designed for muon tomography with high spatial resolution. An efficiency up to 98% and a spatial resolution of around 270 μ m are obtained in cosmic ray and X-ray tests. The performance of the MRPC is also investigated for two working gases: standard gas and pure Freon. The result shows that the MRPC working in pure Freon can provide higher efficiency and better spatial resolution.

  17. Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data

    NARCIS (Netherlands)

    Waldinger, Marcel D.; Zwinderman, Aeilko H.; Olivier, Berend; Schweitzer, Dave H.

    2005-01-01

    Introduction. Consensus on a definition of premature ejaculation has not yet been reached because of debates based on subjective authority opinions and nonstandardized assessment methods to measure ejaculation time and ejaculation control. Aim. To provide a definition for lifelong premature

  18. Prebiotics: why definitions matter

    Science.gov (United States)

    Hutkins, Robert W; Krumbeck, Janina A; Bindels, Laure B; Cani, Patrice D; Fahey, George; Goh, Yong Jun; Hamaker, Bruce; Martens, Eric C; Mills, David A; Rastal, Robert A; Vaughan, Elaine; Sanders, Mary Ellen

    2015-01-01

    The prebiotic concept was introduced twenty years ago, and despite several revisions to the original definition, the scientific community has continued to debate what it means to be a prebiotic. How prebiotics are defined is important not only for the scientific community, but also for regulatory agencies, the food industry, consumers and healthcare professionals. Recent developments in community-wide sequencing and glycomics have revealed that more complex interactions occur between putative prebiotic substrates and the gut microbiota than previously considered. A consensus among scientists on the most appropriate definition of a prebiotic is necessary to enable continued use of the term. PMID:26431716

  19. Energy providers: customer expectations

    International Nuclear Information System (INIS)

    Pridham, N.F.

    1997-01-01

    The deregulation of the gas and electric power industries, and how it will impact on customer service and pricing rates was discussed. This paper described the present situation, reviewed core competencies, and outlined future expectations. The bottom line is that major energy consumers are very conscious of energy costs and go to great lengths to keep them under control. At the same time, solutions proposed to reduce energy costs must benefit all classes of consumers, be they industrial, commercial, institutional or residential. Deregulation and competition at an accelerated pace is the most likely answer. This may be forced by external forces such as foreign energy providers who are eager to enter the Canadian energy market. It is also likely that the competition and convergence between gas and electricity is just the beginning, and may well be overshadowed by other deregulated industries as they determine their core competencies

  20. Exploring barriers to and enablers of adequate healthcare for Indigenous Australian prisoners with cancer: a scoping review drawing on evidence from Australia, Canada and the United States.

    Science.gov (United States)

    Olds, Jessica; Reilly, Rachel; Yerrell, Paul; Stajic, Janet; Micklem, Jasmine; Morey, Kim; Brown, Alex

    International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group. This scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation. Eight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons' concern with security versus the need for timely access to medical care. Findings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians' over-burden of cancer mortality and over-representation in the prison system, further research is needed to

  1. Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94

    International Nuclear Information System (INIS)

    Fietkau, Rainer; Roedel, Claus; Hohenberger, Werner; Raab, Rudolf; Hess, Clemens; Liersch, Torsten; Becker, Heinz; Wittekind, Christian; Hutter, Matthias; Hager, Eva; Karstens, Johann; Ewald, Hermann; Christen, Norbert; Jagoditsch, Michael; Martus, Peter; Sauer, Rolf

    2007-01-01

    Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, and delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% ± 7.8%; inadequate RT, 21.2% ± 5.6%; adequate RT, 6.8% ± 1.4%; p = 0.0001) and DFS (no RT, 55.1% ± 9.1%; inadequate RT, 57.4% ± 6.3%; adequate RT, 69.1% ± 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage and age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender

  2. Developing syndrome definitions based on consensus and current use

    Science.gov (United States)

    Dowling, John N; Baer, Atar; Buckeridge, David L; Cochrane, Dennis; Conway, Michael A; Elkin, Peter; Espino, Jeremy; Gunn, Julia E; Hales, Craig M; Hutwagner, Lori; Keller, Mikaela; Larson, Catherine; Noe, Rebecca; Okhmatovskaia, Anya; Olson, Karen; Paladini, Marc; Scholer, Matthew; Sniegoski, Carol; Thompson, David; Lober, Bill

    2010-01-01

    Objective Standardized surveillance syndromes do not exist but would facilitate sharing data among surveillance systems and comparing the accuracy of existing systems. The objective of this study was to create reference syndrome definitions from a consensus of investigators who currently have or are building syndromic surveillance systems. Design Clinical condition–syndrome pairs were catalogued for 10 surveillance systems across the United States and the representatives of these systems were brought together for a workshop to discuss consensus syndrome definitions. Results Consensus syndrome definitions were generated for the four syndromes monitored by the majority of the 10 participating surveillance systems: Respiratory, gastrointestinal, constitutional, and influenza-like illness (ILI). An important element in coming to consensus quickly was the development of a sensitive and specific definition for respiratory and gastrointestinal syndromes. After the workshop, the definitions were refined and supplemented with keywords and regular expressions, the keywords were mapped to standard vocabularies, and a web ontology language (OWL) ontology was created. Limitations The consensus definitions have not yet been validated through implementation. Conclusion The consensus definitions provide an explicit description of the current state-of-the-art syndromes used in automated surveillance, which can subsequently be systematically evaluated against real data to improve the definitions. The method for creating consensus definitions could be applied to other domains that have diverse existing definitions. PMID:20819870

  3. What HERA May Provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes; /DESY; De Roeck, Albert; /CERN; Bartels, Jochen; /Hamburg U., Inst. Theor. Phys. II; Behnke, Olaf; Blumlein, Johannes; /DESY; Brodsky, Stanley; /SLAC /Durham U., IPPP; Cooper-Sarkar, Amanda; /Oxford U.; Deak, Michal; /DESY; Devenish, Robin; /Oxford U.; Diehl, Markus; /DESY; Gehrmann, Thomas; /Zurich U.; Grindhammer, Guenter; /Munich, Max Planck Inst.; Gustafson, Gosta; /CERN /Lund U., Dept. Theor. Phys.; Khoze, Valery; /Durham U., IPPP; Knutsson, Albert; /DESY; Klein, Max; /Liverpool U.; Krauss, Frank; /Durham U., IPPP; Kutak, Krzysztof; /DESY; Laenen, Eric; /NIKHEF, Amsterdam; Lonnblad, Leif; /Lund U., Dept. Theor. Phys.; Motyka, Leszek; /Hamburg U., Inst. Theor. Phys. II /Birmingham U. /Southern Methodist U. /DESY /Piemonte Orientale U., Novara /CERN /Paris, LPTHE /Hamburg U. /Penn State U.

    2011-11-10

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. The HERA accelerator and the HERA experiments H1, HERMES and ZEUS stopped running in the end of June 2007. This was after 15 years of very successful operation since the first collisions in 1992. A total luminosity of {approx} 500 pb{sup -1} has been accumulated by each of the collider experiments H1 and ZEUS. During the years the increasingly better understood and upgraded detectors and HERA accelerator have contributed significantly to this success. The physics program remains in full swing and plenty of new results were presented at DIS08 which are approaching the anticipated final precision, fulfilling and exceeding the physics plans and the previsions of the upgrade program. Most of the analyses presented at DIS08 were still based on the so called HERA I data sample, i.e. data taken until 2000, before the shutdown for the luminosity upgrade. This sample has an integrated luminosity of {approx} 100 pb{sup -1}, and the four times larger statistics sample from HERA II is still in the process of being analyzed.

  4. Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review

    Directory of Open Access Journals (Sweden)

    Littauer SL

    2017-12-01

    Full Text Available Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up telephone calls and to highlight the main areas of chronic-disease management where these models have been applied. Studies within the areas of hypertension, diabetes, asthma, anticoagulation and depression were identified, but only two randomized controlled trials with adequate sample size demonstrating the positive impact of telemonitoring combined with pharmacist care in hypertension were identified. The evidence for the impact of pharmacist-based telemedicine models is sparse and weak, with the studies conducted presenting serious threats to internal and external validity. Therefore, no definitive conclusions about the impact of pharmacist-led telemedicine models can be made at this time. In the Unites States, the increasing shortage of primary care providers and specialists represents an opportunity for pharmacists to assume a more prominent role managing patients with chronic disease in the ambulatory care setting. However, lack of reimbursement may pose a barrier to the provision of care by pharmacists using telemedicine.

  5. First aid facilities in the school settings: Are schools able to manage adequately?

    Science.gov (United States)

    Qureshi, Farhan Muhammad; Khalid, Nadia; Nigah-E-Mumtaz, Seema; Assad, Tahira; Noreen, Khola

    2018-01-01

    Children spend most of their time in schools and are vulnerable to injuries and mild ailments, hence requiring first-aid care. School teacher can provide immediate first-aid care in the absence of any health professional. This study assesses first-aid facilities within school premises and assessment of teachers on first aid training. A cross sectional study was conducted from July-December 2017, participants were full time school teachers of both public and private sectors at both primary and secondary levels, having a minimum of one year experience. Questionnaire was filled on one to one basis by taking oral interview. Out of 209 teachers, 72.7% were from private sector. Stomachache was the most common medical incident (82.29%) requiring first-aid care in schools. First aid box was available in all schools but its contents were not satisfactory. Sick bay was not found in any school. 68.42% of teachers were not trained in first-aid management because of lack of opportunity, however 56% were willing to enroll in any first aid training and majority (91.38%) considered it essential for their professional life. First aid facilities at various schools of Karachi and availability of trained teachers who can provide first aid care is unsatisfactory.

  6. Exotic plant species receive adequate pollinator service despite variable integration into plant-pollinator networks.

    Science.gov (United States)

    Thompson, Amibeth H; Knight, Tiffany M

    2018-05-01

    Both exotic and native plant species rely on insect pollinators for reproductive success, and yet few studies have evaluated whether and how exotic plant species receive services from native pollinators for successful reproduction in their introduced range. Plant species are expected to successfully reproduce in their exotic range if they have low reliance on animal pollinators or if they successfully integrate themselves into resident plant-pollinator networks. Here, we quantify the breeding system, network integration, and pollen limitation for ten focal exotic plant species in North America. Most exotic plant species relied on animal pollinators for reproduction, and these species varied in their network integration. However, plant reproduction was limited by pollen receipt for only one plant species. Our results demonstrate that even poorly integrated exotic plant species can still have high pollination service and high reproductive success. The comprehensive framework considered here provides a method to consider the contribution of plant breeding systems and the pollinator community to pollen limitation, and can be applied to future studies to provide a more synthetic understanding of the factors that determine reproductive success of exotic plant species.

  7. Ultraviolet and short wavelength visible light exposure: why ultraviolet protection alone is not adequate.

    Science.gov (United States)

    Reichow, Alan W; Citek, Karl; Edlich, Richard F

    2006-01-01

    The danger of exposure to ultraviolet (UV) radiation in both the natural environment and artificial occupational settings has long been recognized by national and international standards committees and worker safety agencies. There is an increasing body of literature that suggests that protection from UV exposure is not enough. Unprotected exposure to the short wavelengths of the visible spectrum, termed the "blue light hazard", is gaining acceptance as a true risk to long-term visual health. Global standards and experts in the field are now warning that those individuals who spend considerable time outdoors should seek sun filter eyewear with high impact resistant lenses that provide 100% UV filtration, high levels of blue light filtration, and full visual field lens/frame coverage as provided by high wrap eyewear. The Skin Cancer Foundation has endorsed certain sunglasses as "product[s]...effective [as] UV filter[s] for the eyes and surrounding skin". However, such endorsement does not necessarily mean that the eyewear meets all the protective needs for outdoor use. There are several brands that offer products with such protective characteristics. Performance sun eyewear by Nike Vision, available in both corrective and plano (nonprescription) forms, is one such brand incorporating these protective features.

  8. Elaborating a coherent and adequate financial structure for a post Kyoto framework

    International Nuclear Information System (INIS)

    Bassi, A M; Magnoni, S

    2009-01-01

    The present paper reviews the international climate change financial framework and aims at providing insights on its future post-2012 development. This study offers an overview of the good attributes and distortions of the current regime, while investigating the work currently done by many countries and international organisation, in proposing unique and original financial schemes for a post-Kyoto agreement. The objective is to define potential strengths and shortcomings of the current (or projected) financial regime, and put this in relation with the creation of an improved new financing scheme, that could transfer sufficient resources from North to South in an efficient, transparent and participatory way. Indeed, international climate change negotiations are now working in this direction, and the regular submissions from Parties and civil society to the UNFCCC's AWG-LCA witness the desire of governments and organisations to achieve an innovative climate change agreement that could overcome existing weaknesses in the global financial structure, while providing nations with suitable tools to handle the adverse consequences of climatic modifications. The paper will additionally focus on the role of CDM and credit-based mechanisms in a new future financial framework, in consideration of needed improvements in the current international credit system and country visions and AWG-LCA submissions.

  9. A Systems Definition of Educational Technology in Society

    Science.gov (United States)

    Luppicini, Rocci

    2005-01-01

    Conceptual development in the field of Educational Technology provides crucial theoretical grounding for ongoing research and practice. This essay draws from theoretical developments both within and external to the field of Educational Technology to articulate a systems definition of Educational Technology in Society. A systems definition of…

  10. Definitional Ceremonies: Integrating Community into Multicultural Counseling Sessions

    Science.gov (United States)

    Bitter, James Robert; Robertson, Patricia E.; Roig, Grace; Disqueact, J. Graham

    2004-01-01

    Definitional Ceremonies are used as a forum for integrating members of diverse cultures into multicultural counseling sessions. The authors provide a philosophical foundation, implementation process, and excerpts from a typescript of a recent definitional ceremony involving a women and her mother, both recently in the United States from Panama.

  11. 26 CFR 53.4943-10 - Business enterprise; definition.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Business enterprise; definition. 53.4943-10...) MISCELLANEOUS EXCISE TAXES (CONTINUED) FOUNDATION AND SIMILAR EXCISE TAXES Taxes on Excess Business Holdings § 53.4943-10 Business enterprise; definition. (a) In general. (1) Except as provided in paragraph (b...

  12. 24 CFR 241.830 - Definition of default.

    Science.gov (United States)

    2010-04-01

    ... SUPPLEMENTARY FINANCING FOR INSURED PROJECT MORTGAGES Contract Rights and Obligations-Multifamily Projects... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Definition of default. 241.830... § 241.830 Definition of default. (a) If the borrower fails to make any payments due under or provided to...

  13. Dictionary of terms and definitions used in radiation protection technology

    International Nuclear Information System (INIS)

    1975-01-01

    The dictionary contains terms and definitions used in radiation protection technology. This document is developed by the Section of CMEA Secretariat on peaceful atomic energy application on the basis of materials provided by member states. The dictionary contains versions of terms and definitions in the languages of member states. Total number of terms is 94. (I.T.)

  14. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven

    2014-01-01

    OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset...

  15. COPD: Definition and Phenotypes

    DEFF Research Database (Denmark)

    Vestbo, J.

    2014-01-01

    particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients. The evolution of this definition and the diagnostic criteria currently in use are discussed. COPD is increasingly divided in subgroups or phenotypes based on specific features and association...

  16. Center of buoyancy definition

    International Nuclear Information System (INIS)

    Sandberg, V.

    1988-12-01

    The center of buoyancy of an arbitrary shaped body is defined in analogy to the center of gravity. The definitions of the buoyant force and center of buoyancy in terms of integrals over the area of the body are converted to volume integrals and shown to have simple intuitive interpretations

  17. VSCE technology definition study

    Science.gov (United States)

    Howlett, R. A.; Hunt, R. B.

    1979-01-01

    Refined design definition of the variable stream control engine (VSCE) concept for advanced supersonic transports is presented. Operating and performance features of the VSCE are discussed, including the engine components, thrust specific fuel consumption, weight, noise, and emission system. A preliminary engine design is presented.

  18. The definition of sarcopenia

    NARCIS (Netherlands)

    Bijlsma, Astrid Y.

    2013-01-01

    Sarcopenia in old age has been associated with a higher mortality, poor physical functioning, poor outcome of surgery and higher drug toxicity. There is no general consensus on the definition of sarcopenia. The aim of the research presented in this thesis was to assess the implications of the use of

  19. Subjective poverty line definitions

    NARCIS (Netherlands)

    J. Flik; B.M.S. van Praag (Bernard)

    1991-01-01

    textabstractIn this paper we will deal with definitions of subjective poverty lines. To measure a poverty threshold value in terms of household income, which separates the poor from the non-poor, we take into account the opinions of all people in society. Three subjective methods will be discussed

  20. Definition of Professional Development

    Science.gov (United States)

    Learning Forward, 2015

    2015-01-01

    President Obama signed into law the Every Student Succeeds Act, the reauthorization of the Elementary and Secondary Education Act, on December 10, 2015. "Learning Forward's focus in this new law is its improved definition of professional learning," said Stephanie Hirsh, executive director of Learning Forward. "We've long advocated…

  1. Definition of Entity Authentication

    DEFF Research Database (Denmark)

    Ahmed, Naveed; Jensen, Christian D.

    2010-01-01

    Authentication is considered a pre-requisite for communication security, but the definition of authentication is generally not agreed upon. Many attacks on authentication protocols are the result of misunderstanding of the goals of authentication. This state of affairs indicate limitations in the...

  2. Are forestation, bio-char and landfilled biomass adequate offsets for the climate effects of burning fossil fuels?

    NARCIS (Netherlands)

    Reijnders, L.

    2009-01-01

    Forestation and landfilling purpose-grown biomass are not adequate offsets for the CO2 emission from burning fossil fuels. Their permanence is insufficiently guaranteed and landfilling purpose-grown biomass may even be counterproductive. As to permanence, bio-char may do better than forests or

  3. 21 CFR 1.283 - What happens to food that is imported or offered for import without adequate prior notice?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false What happens to food that is imported or offered for import without adequate prior notice? 1.283 Section 1.283 Food and Drugs FOOD AND DRUG... Imported Food Consequences § 1.283 What happens to food that is imported or offered for import without...

  4. Fed up with the right to food? : The Netherlands' policies and practices regarding the human right to adequate food

    NARCIS (Netherlands)

    Hospes, O.; Meulen, van der B.M.J.

    2009-01-01

    There is no one in this world who would deny the importance of access to adequate food for every human being. In fact, access to food has been declared a human right in 1948 with the Universal Declaration of Human Rights. In spite of the right to food to be more than half a century old, many are not

  5. The Comprehension Problems for Second-Language Learners with Poor Reading Comprehension Despite Adequate Decoding: A Meta-Analysis

    Science.gov (United States)

    Spencer, Mercedes; Wagner, Richard K.

    2017-01-01

    We conducted a meta-analysis of 16 existing studies to examine the nature of the comprehension problems for children who were second-language learners with poor reading comprehension despite adequate decoding. Results indicated that these children had deficits in oral language (d = -0.80), but these deficits were not as severe as their reading…

  6. Lack of adequate sun protection for children with oculocutaneous albinism in South Africa

    Science.gov (United States)

    Lund, Patricia M; Taylor, Julie S

    2008-01-01

    Background Childhood is a high risk time for ultraviolet induced skin damage as this age group has more time and opportunity to be outdoors in the sun. Children in Africa with the inherited condition oculocutaneous albinism (OCA) are especially vulnerable due to their lack of protective melanin. They are highly susceptible to developing skin lesions that have both cosmetic and health complications, with a high risk of developing skin cancers. The study aimed to explore the adequacy of sun protection strategies of children with albinism in order to inform future provision. Methods Community based participatory research methods were employed to investigate sun protection strategies in 90 pupils with OCA (40 female and 50 male) boarding at a special school educating pupils with visual impairment in a rural area of northern South Africa. Hats worn and sunscreen preparations used were examined during semi-structured face to face interviews conducted in small peer groups. The resident nurse interpreted if necessary and provided additional information on monitoring and treatment of skin lesions. Results Participants with albinism in this study were exposed to high levels of ultraviolet radiation throughout the year and showed skin damage despite wearing protective head gear. All except one pupil possessed at least one hat, with a mean brim width of 5.4 cm. Gender differences in sun avoidance behaviour were documented, with females seeking shade during recreational periods and males playing soccer outside. Although 38% of pupils were using a sunscreen with a sun protection factor (SPF) rating, only 12% had government sponsored tubes of SPF15 cream. Government sponsored sunscreen preparations were only provided if actively sought, involving time consuming trips to regional hospitals, with inadequate availability and insufficient supply. Conclusion Children with albinism living away from home in rural areas appear to have inadequate sun protection strategies. Changes in

  7. Lack of adequate sun protection for children with oculocutaneous albinism in South Africa

    Directory of Open Access Journals (Sweden)

    Taylor Julie S

    2008-06-01

    Full Text Available Abstract Background Childhood is a high risk time for ultraviolet induced skin damage as this age group has more time and opportunity to be outdoors in the sun. Children in Africa with the inherited condition oculocutaneous albinism (OCA are especially vulnerable due to their lack of protective melanin. They are highly susceptible to developing skin lesions that have both cosmetic and health complications, with a high risk of developing skin cancers. The study aimed to explore the adequacy of sun protection strategies of children with albinism in order to inform future provision. Methods Community based participatory research methods were employed to investigate sun protection strategies in 90 pupils with OCA (40 female and 50 male boarding at a special school educating pupils with visual impairment in a rural area of northern South Africa. Hats worn and sunscreen preparations used were examined during semi-structured face to face interviews conducted in small peer groups. The resident nurse interpreted if necessary and provided additional information on monitoring and treatment of skin lesions. Results Participants with albinism in this study were exposed to high levels of ultraviolet radiation throughout the year and showed skin damage despite wearing protective head gear. All except one pupil possessed at least one hat, with a mean brim width of 5.4 cm. Gender differences in sun avoidance behaviour were documented, with females seeking shade during recreational periods and males playing soccer outside. Although 38% of pupils were using a sunscreen with a sun protection factor (SPF rating, only 12% had government sponsored tubes of SPF15 cream. Government sponsored sunscreen preparations were only provided if actively sought, involving time consuming trips to regional hospitals, with inadequate availability and insufficient supply. Conclusion Children with albinism living away from home in rural areas appear to have inadequate sun protection

  8. 25 CFR 39.1001 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... an in some cases providing administrative direction to one or more off-reservation boarding schools... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Administrative Cost Formula § 39.1001 Definitions. (a) Agency Education Office means a field office of the Office...

  9. 48 CFR 28.001 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... proposal under a negotiated acquisition. See the definition of “offer” at 2.101. Bidder means any entity... within the period specified for acceptance and (2) will execute a written contract and furnish required... required by law to all persons supplying labor or material in the prosecution of the work provided for in...

  10. 40 CFR 133.101 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS SECONDARY TREATMENT REGULATION § 133.101 Definitions. Terms used in this part are defined as follows: (a) 7-day average. The... pond is used as the principal process, and (3) The treatment works provide significant biological...

  11. 21 CFR 146.3 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... CONSUMPTION CANNED FRUIT JUICES General Provisions § 146.3 Definitions. For the purposes of this part: (a) The... hydrolyzed starch. (c) The term dried glucose sirup means the product obtained by drying glucose sirup. (d... following: Unless otherwise provided in a standard, a lot of canned fruits shall be deemed in compliance for...

  12. An international definition for "nursing home"

    NARCIS (Netherlands)

    Sanford, A.M.; Orrell, M.; Tolson, D.; Abbatecola, A.M.; Arai, H.; Bauer, J.M.; Cruz-Jentoft, A.J.; Dong, B.; Ga, H.; Goel, A.; Hajjar, R.; Holmerova, I.; Katz, P.R.; Koopmans, R.T.; Rolland, Y.; Visvanathan, R.; Woo, J.; Morley, J.E.; Vellas, B.

    2015-01-01

    There is much ambiguity regarding the term "nursing home" in the international literature. The definition of a nursing home and the type of assistance provided in a nursing home is quite varied by country. The International Association of Gerontology and Geriatrics and AMDA foundation developed a

  13. 29 CFR 29.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ..., as provided for in the criteria described in § 29.3(g) and (h). Quality assurance assessment means a... technical assistance; conducting reviews for compliance with 29 CFR parts 29 and 30 and quality assurance... of Labor LABOR STANDARDS FOR THE REGISTRATION OF APPRENTICESHIP PROGRAMS § 29.2 Definitions...

  14. 5 CFR 351.203 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... for a position covered by a wage-board or similar wage-determining procedure, such as provided in the definition of representative rate for Federal Wage System positions in 5 CFR 532.401 of this chapter; (3) For... low priority program or to a vacant position. [51 FR 319, Jan. 3, 1986, as amended at 58 FR 65533, Dec...

  15. 18 CFR 358.3 - Definitions.

    Science.gov (United States)

    2010-04-01

    ...; and natural gas transportation, storage, exchange, backhaul, or displacement service provided pursuant... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Definitions. 358.3 Section 358.3 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT...

  16. 16 CFR 1407.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... GENERATORS: REQUIREMENTS TO PROVIDE PERFORMANCE AND TECHNICAL DATA BY LABELING § 1407.2 Definitions. (a) The... portable generator is an internal combustion engine-driven electric generator rated no higher than 15..., and may have alternating- or direct-current (DC) sections for supplying energy to battery charging...

  17. 10 CFR 430.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Definitions. For purposes of this part, words shall be defined as provided for in section 321 of the Act and... top, the heat transfer surfaces on refrigerant and air sides (flat tubes vs. grooved tubes, fin shapes... convert incoming broadcast signals into color television pictures and associated sound. Compact...

  18. 48 CFR 873.102 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... SUPPLEMENTARY REGULATIONS SIMPLIFIED ACQUISITION PROCEDURES FOR HEALTH-CARE RESOURCES 873.102 Definitions...-care providers include health-care plans and insurers and any organizations, institutions, or other entities or individuals who furnish health-care resources. (38 U.S.C. 8153) Health-care resource includes...

  19. 49 CFR 1300.1 - Scope; definitions.

    Science.gov (United States)

    2010-10-01

    ... CHANGE OF RATES AND OTHER SERVICE TERMS FOR RAIL COMMON CARRIAGE § 1300.1 Scope; definitions. (a) The provisions of this part address the requirements imposed on rail carriers by 49 U.S.C. 11101(b), 11101(c... apply to any common carriage transportation or service provided by a rail carrier subject to the...

  20. 19 CFR 191.2 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... under the provision for the substitution of finished petroleum derivatives, § 313(p), as amended (19 U.S... identified for purposes of direct identification drawback by use of the accounting methods provided for in... (CONTINUED) DRAWBACK General Provisions § 191.2 Definitions. For the purposes of this part: (a) Abstract...

  1. 7 CFR 1540.21 - Definition.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Definition. 1540.21 Section 1540.21 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF... cut flowers provided for in items 192.17, 192.18, and 192.21 of the TSUS; and (f) Concentrated citrus...

  2. 7 CFR 1540.41 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Definitions. 1540.41 Section 1540.41 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF... fresh cut flowers provided for in chapter 6 of the Harmonized Tariff Schedule (HTS); (2) Fresh or...

  3. 16 CFR 1211.22 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... definitions shall apply to this subpart: (a) Private labeler means an owner of a brand or trademark which is used on an operator subject to the standard and which is not the brand or trademark of the manufacturer of the operator, provided the owner of the brand or trademark caused or authorized the operator to be...

  4. 14 CFR 271.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS GUIDELINES FOR SUBSIDIZING AIR CARRIERS PROVIDING ESSENTIAL AIR TRANSPORTATION § 271.2 Definitions... compensation under Subchapter II of Chapter 417 of the Statute. Essential air service is that air...

  5. 13 CFR 120.701 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... businesses and which provides marketing, management, and technical assistance to its borrowers. It may be: (1... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Definitions. 120.701 Section 120.701 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Microloan Program...

  6. 29 CFR 801.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Definitions. 801.2 Section 801.2 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE.... 2001-2009). (b) (1) The term commerce has the meaning provided in section 3(b) of the Fair Labor...

  7. 31 CFR 31.201 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... agency agreement between a private sector entity and the Treasury for services under the TARP, other than... Stabilization Act of 2008. Key individual means an individual providing services to a private sector entity who... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Definitions. 31.201 Section 31.201...

  8. 44 CFR 206.221 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... buildings, structures, equipment, or systems used to provide emergency services, such as fire protection... Definitions. (a) Educational institution means: (1) Any elementary school as defined by section 801(c) of the Elementary and Secondary Education Act of 1965; or (2) Any secondary school as defined by section 801(h) of...

  9. 30 CFR 75.201 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.201 Definitions. Automated temporary roof support (ATRS) system. A device to provide temporary roof support from a location where the equipment operator is protected from roof falls. Pillar recovery. Any reduction in pillar size during retreat mining. ...

  10. 33 CFR 335.7 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... in the littoral transport process. Emergency means a situation which would result in an unacceptable... transport interstate or foreign commerce. A more complete definition is provided in 33 CFR part 329. For the... technology, and logistics in light of overall project purposes. Statement of Findings (SOF) means a...

  11. Department of Energy's safety and health program for enrichment plant workers is not adequately implemented

    International Nuclear Information System (INIS)

    Staats, E.B.

    1980-01-01

    The Department of Energy's (DOE's) program to protect the safety and health of employees at its contractor-operated uranium enrichment plants has not been fully implemented by DOE's Oak Ridge Operations Office. Appraisals and inspections of plant conditions are not as frequent and/or as thorough as required. Instead of independently investigating employee complaints, DOE has delegated this responsibility to the contractor. It is recommended that the Secretary of Energy make sure that Oak Ridge properly conducts inspections and appraisals and investigates and follows up on all employee complaints. He should also take steps to provide increased independence and objectivity in the Oak Ridge Operations Office's safety and health program. Furthermore, the Congress should authorize the Secretary of Energy to institute a program of non-reimbursable penalties and fines for violations of safety and health standards and procedures

  12. HIV and Pregnancy Intentions: Do Services Adequately Respond to Women's Needs?

    Science.gov (United States)

    Firestone, Rebecca; MacCarthy, Sarah; Ferguson, Laura

    2008-01-01

    Too little is known about how an HIV diagnosis and access to care and treatment affect women's childbearing intentions. As access to antiretroviral therapy improves, greater numbers of HIV-positive women are living longer, healthier lives, and many want to have children. Effectively supporting women's reproductive decisionmaking in the context of HIV requires understanding how pregnancy, reproduction, and HIV intersect and asking questions that bridge the biomedical and social sciences. Considering women to be at the center of decisions on health policy and service delivery can help provide an appropriate constellation of services. A clear research agenda is needed to create a more coordinated approach to policies and programs supporting the pregnancy intentions of women with HIV. PMID:18703432

  13. DOE'S award fees at Rocky Flats do not adequately reflect ES and H problems

    International Nuclear Information System (INIS)

    1989-10-01

    Despite the persistance of significant environmental, safety, and health problems at the Rocky Flats plant, it's contractor has received substantial monetary awards from the Department of Energy for operating the plant. During fiscal years 1986 through 1988, approximately $26.8 million was received in award fees - about 84 percent of the total award fees that were available under the contract with DOE. This report identified a number of problems that raise concerns about how the award process is being administered: significant ES and H deficiencies have been downplayed in the evaluation process; the process has placed more emphasis on production rather than on ES and H performance; and the evaluations have not been reviewed by DOE headquarters organizations that have important roles in the conduct of activities. This report recommends that DOE restructure its award fee process to provide a clear understanding to its contractors what they will be losing in award fees for certain types of ES and H problems

  14. Are community-level financial data adequate to assess population health investments?

    Science.gov (United States)

    Casper, Tim; Kindig, David A

    2012-01-01

    The variation in health outcomes among communities results largely from different levels of financial and nonfinancial policy investments over time; these natural experiments should offer investment and policy guidance for a business model on population health. However, little such guidance exists. We examined the availability of data in a sample of Wisconsin counties for expenditures in selected categories of health care, public health, human services, income support, job development, and education. We found, as predicted by the National Committee on Vital and Health Statistics in 2002, that availability is often limited by the challenges of difficulty in locating useable data, a lack of resources among public agencies to upgrade information technology systems for making data more usable and accessible to the public, and a lack of enterprise-wide coordination and geographic detail in data collection efforts. These challenges must be overcome to provide policy-relevant information for optimal population health resource allocation.

  15. Are Australian smokers with mental illness receiving adequate smoking cessation and harm reduction information?

    Science.gov (United States)

    Sharma-Kumar, Ratika; Meurk, Carla; Ford, Pauline; Beere, Diana; Gartner, Coral

    2018-05-02

    Provision of smoking cessation support in the form of advice and information is central to increasing quit rates, including among people with mental illness (MI), who have 3-5 times higher odds of smoking than those without MI. This study investigated the extent and perceived utility of quit smoking advice and information available to Australian smokers with MI through face-to-face, semi-structured, in-depth interviews with 29 current smokers with MI. Qualitative analysis identified four major sources of quit smoking advice and information: (i) mental health practitioners; (ii) Quitline; (iii) social networks; and (iv) Internet and media. All identified sources, including formal sources (mental health practitioners and Quitline), were perceived as providing inadequate information about quitting smoking, particularly regarding optimal usage of nicotine replacement therapy (NRT). Social networks emerged as a substantial source of quit smoking advice and information, especially for nontraditional methods such as vaping. Participants showed high interest in receiving support from peer-led smoking cessation groups. A minority of participants reported that they had received quit smoking information from Internet and media; this was largely restricted to negative reports about e-cigarettes and short advertisements for nicotine replacement therapy. Our findings suggest that more can be done to provide smokers with MI with practical smoking cessation advice and support. Comprehensive information resources tailored for smokers with MI should be developed and disseminated via multiple pathways. We also recommend a number of policy and practice reforms to promote smoking cessation among those with MI. © 2018 Australian College of Mental Health Nurses Inc.

  16. Dispersion stability of nanoparticles in ecotoxicological investigations: the need for adequate measurement tools

    Energy Technology Data Exchange (ETDEWEB)

    Tantra, Ratna, E-mail: ratna.tantra@npl.co.uk; Jing Shingheng; Pichaimuthu, Sivaraman K. [National Physical Laboratory (United Kingdom); Walker, Nicholas [University of Exeter, School of Biosciences (United Kingdom); Noble, James [National Physical Laboratory (United Kingdom); Hackley, Vincent A. [National Institute of Standards and Technology (United States)

    2011-09-15

    One of the main challenges in nanoecotoxicological investigations is in the selection of the most suitable measurement methods and protocols for nanoparticle characterisation. Several parameters have been identified as being important as they govern nanotoxicological activity, with some parameters being better defined than others. For example, as a parameter, there is some ambiguity as to how to measure dispersion stability in the context of ecotoxicological investigations; indeed, there is disagreement over which are the best methods to measure nanoparticle dispersion stability. The purpose of this article is to use various commercially available tools to measure dispersion stability and to understand the information given by each tool. In this study, CeO{sub 2} was dispersed in two different types of media: de-ionised water and electrolyte-containing fish medium. The DLS mean particle size of freshly dispersed sample in DI water was {approx}200 nm in diameter. A visual sedimentation experiment showed that nanoparticle dispersion made in the fish medium was less stable compared to corresponding dispersion in de-ionised water. Stability of these dispersions was monitored using various techniques, for a period of 3 days. Our findings have shown that dispersion stability can be suitably assessed by monitoring: (a) surface charge, (b) sedimentation events and (c) presence of agglomerates, through time. The majority of techniques employed here (zeta potential, particle size via DLS, fluorescence and UV-Vis spectroscopy and SEM) were shown to provide useful, complementary information on dispersion stability. Nanoparticle Tracking Analysis (NTA) provides useful, quantitative information on the concentration of nanoparticles in suspension, but is limited by its inability to accurately track the motion of large agglomerates found in the fish medium.

  17. Dispersion stability of nanoparticles in ecotoxicological investigations: the need for adequate measurement tools

    International Nuclear Information System (INIS)

    Tantra, Ratna; Jing Shingheng; Pichaimuthu, Sivaraman K.; Walker, Nicholas; Noble, James; Hackley, Vincent A.

    2011-01-01

    One of the main challenges in nanoecotoxicological investigations is in the selection of the most suitable measurement methods and protocols for nanoparticle characterisation. Several parameters have been identified as being important as they govern nanotoxicological activity, with some parameters being better defined than others. For example, as a parameter, there is some ambiguity as to how to measure dispersion stability in the context of ecotoxicological investigations; indeed, there is disagreement over which are the best methods to measure nanoparticle dispersion stability. The purpose of this article is to use various commercially available tools to measure dispersion stability and to understand the information given by each tool. In this study, CeO 2 was dispersed in two different types of media: de-ionised water and electrolyte-containing fish medium. The DLS mean particle size of freshly dispersed sample in DI water was ∼200 nm in diameter. A visual sedimentation experiment showed that nanoparticle dispersion made in the fish medium was less stable compared to corresponding dispersion in de-ionised water. Stability of these dispersions was monitored using various techniques, for a period of 3 days. Our findings have shown that dispersion stability can be suitably assessed by monitoring: (a) surface charge, (b) sedimentation events and (c) presence of agglomerates, through time. The majority of techniques employed here (zeta potential, particle size via DLS, fluorescence and UV–Vis spectroscopy and SEM) were shown to provide useful, complementary information on dispersion stability. Nanoparticle Tracking Analysis (NTA) provides useful, quantitative information on the concentration of nanoparticles in suspension, but is limited by its inability to accurately track the motion of large agglomerates found in the fish medium.

  18. Building a Definition of Irritability From Academic Definitions and Lay Descriptions.

    Science.gov (United States)

    Barata, Paula C; Holtzman, Susan; Cunningham, Shannon; O'Connor, Brian P; Stewart, Donna E

    2016-04-08

    The current work builds a definition of irritability from both academic definitions and lay perspectives. In Study 1, a quantitative content analysis of academic definitions resulted in eight main content categories (i.e., behaviour, emotion or affect, cognition, physiological, qualifiers, irritant, stability or endurance, and other). In Study 2, a community sample of 39 adults participated in qualitative interviews. A deductive thematic analysis resulted in two main themes. The first main theme dealt with how participants positioned irritability in relation to other negative states. The second dealt with how participants constructed irritability as both a loss of control and as an experience that should be controlled. The discussion integrates the findings of both studies and provides a concise, but comprehensive definition.

  19. Definitions of Health Terms: Minerals

    Science.gov (United States)

    ... gov/definitions/mineralsdefinitions.html Definitions of Health Terms : Minerals To use the sharing features on this page, ... National Institutes of Health, Office of Dietary Supplements Minerals Minerals are those elements on the earth and ...

  20. Adopting adequate leaching requirement for practical response models of basil to salinity

    Science.gov (United States)

    Babazadeh, Hossein; Tabrizi, Mahdi Sarai; Darvishi, Hossein Hassanpour

    2016-07-01

    Several mathematical models are being used for assessing plant response to salinity of the root zone. Objectives of this study included quantifying the yield salinity threshold value of basil plants to irrigation water salinity and investigating the possibilities of using irrigation water salinity instead of saturated extract salinity in the available mathematical models for estimating yield. To achieve the above objectives, an extensive greenhouse experiment was conducted with 13 irrigation water salinity levels, namely 1.175 dS m-1 (control treatment) and 1.8 to 10 dS m-1. The result indicated that, among these models, the modified discount model (one of the most famous root water uptake model which is based on statistics) produced more accurate results in simulating the basil yield reduction function using irrigation water salinities. Overall the statistical model of Steppuhn et al. on the modified discount model and the math-empirical model of van Genuchten and Hoffman provided the best results. In general, all of the statistical models produced very similar results and their results were better than math-empirical models. It was also concluded that if enough leaching was present, there was no significant difference between the soil salinity saturated extract models and the models using irrigation water salinity.

  1. Juvenile idiopathic arthritis and athletic participation: are we adequately preparing for sports integration?

    Science.gov (United States)

    Taxter, Alysha; Foss, Kim Barber; Melson, Paula; Ford, Kevin R; Shaffer, Michael; Myer, Gregory D

    2012-09-01

    Children with juvenile idiopathic arthritis (JIA) now have well-controlled disease due to improved therapies and management strategies. Children with JIA are more active than in the past and often participate in dynamic, high-loading sports. Standard measures of disease control include examination findings, laboratory values, and patient-directed surveys. However, these standards do not address the subtle deficits in biomechanics and neuromuscular control, which could place affected joints at higher risk for injury. Currently, there are limited evidence-based guidelines to structure conditioning recommendations as to the fitness and mechanics needed to provide safe integration into sports in this population; therefore, tools that objectively measure function with high accuracy and precision may be warranted. Previous work using 3-dimensional motion analysis demonstrated usefulness in guiding physical therapy treatment to correct these deficits. The use of a multidisciplinary team, including physical therapy, rheumatology, and sports medicine, is crucial for preparing these children to return to play. We suggest that the child transition into a sport preparatory-conditioning program to address any underlying deficits. A pediatric exercise specialist who is sensitive to the needs of this population can work with a physical therapist to then appropriately integrate the child safely into sport. Encouraging an active lifestyle is vital to the management of JIA and does not worsen the symptoms associated with childhood arthritis.

  2. Interprofessionals' definitions of moral resilience.

    Science.gov (United States)

    Holtz, Heidi; Heinze, Katherine; Rushton, Cynda

    2018-02-01

    To describe common characteristics and themes of the concept of moral resilience as reported by interprofessional clinicians in health care. Research has provided an abundance of data on moral distress with limited research to resolve and help negate the detrimental effects of moral distress. This reveals a critical need for research on how to mitigate the negative consequences of moral distress that plague nurses and other healthcare providers. One promising direction is to build resilience as an individual strategy concurrently with interventions to build a culture of ethical practice. Qualitative descriptive methods were used to analyse descriptive definitions provided by 184 interprofessional clinicians in health care attending educational programmes in various locations as well as a small group of 23 professionals with backgrounds such as chaplaincy and nonhealthcare providers. Three primary themes and three subthemes emerged from the data. The primary themes are integrity-personal and relational, and buoyancy. The subthemes are self-regulation, self-stewardship and moral efficacy. Individual healthcare providers and healthcare systems can use this research to help negate the detrimental effects of moral distress by finding ways to develop interventions to cultivate moral resilience. Moral resilience involves not only building and fostering the individual's capacity to navigate moral adversity but also developing systems that support a culture of ethical practice for healthcare providers. © 2017 John Wiley & Sons Ltd.

  3. The Adequate Corpus Luteum: miR-96 Promotes Luteal Cell Survival and Progesterone Production.

    Science.gov (United States)

    Mohammed, Bushra T; Sontakke, Sadanand D; Ioannidis, Jason; Duncan, W Colin; Donadeu, F Xavier

    2017-07-01

    Inadequate progesterone production from the corpus luteum is associated with pregnancy loss. Data available in model species suggest important roles of microRNAs (miRNAs) in luteal development and maintenance. To comprehensively investigate the involvement of miRNAs during the ovarian follicle-luteal transition. The effects of specific miRNAs on survival and steroid production by human luteinized granulosa cells (hLGCs) were tested using specific miRNA inhibitors. Candidate miRNAs were identified through microarray analyses of follicular and luteal tissues in a bovine model. An academic institution in the United Kingdom associated with a teaching hospital. hLGCs were obtained by standard transvaginal follicular-fluid aspiration from 35 women undergoing assisted conception. Inhibition of candidate miRNAs in vitro. Levels of miRNAs, mRNAs, FOXO1 protein, apoptosis, and steroids were measured in tissues and/or cultured cells. Two specific miRNA clusters, miR-183-96-182 and miR-212-132, were dramatically increased in luteal relative to follicular tissues. miR-96 and miR-132 were the most upregulated miRNAs within each cluster. Database analyses identified FOXO1 as a putative target of both these miRNAs. In cultured hLGCs, inhibition of miR-96 increased apoptosis and FOXO1 protein levels, and decreased progesterone production. These effects were prevented by small interfering RNA-mediated downregulation of FOXO1. In bovine luteal cells, miR-96 inhibition also led to increases in apoptosis and FOXO1 protein levels. miR-96 targets FOXO1 to regulate luteal development through effects on cell survival and steroid production. The miR-183-96-182 cluster could provide a novel target for the manipulation of luteal function. Copyright © 2017 Endocrine Society

  4. Function- and User-related Definitions in Online Dictionaries

    DEFF Research Database (Denmark)

    Nielsen, Sandro

    2011-01-01

    A study of the existing literature shows that definitions play an important part in dictionary use and making. The discussions primarily concern printed dictionaries and show that definitions are static in that only one definition should be provided for each meaning of a lemma or entry word, as a....... The important point is that each definition has been written with a specific function and user group in mind taking into account the needs of users in specific types of user situation.......A study of the existing literature shows that definitions play an important part in dictionary use and making. The discussions primarily concern printed dictionaries and show that definitions are static in that only one definition should be provided for each meaning of a lemma or entry word......, as argued in e.g. Jackson (2002: 86-100). However, online dictionaries provide lexicographers with the option of taking a more flexible approach to lexicographic definitions in an attempt to give the best possible help to users. The “one-size-fits-all” approach to dictionary making has its limits...

  5. On an elementary definition of visual saliency

    DEFF Research Database (Denmark)

    Loog, Marco

    2008-01-01

    Various approaches to computational modelling of bottom-up visual attention have been proposed in the past two decades. As part of this trend, researchers have studied ways to characterize the saliency map underlying many of these models. In more recent years, several definitions based on probabi......Various approaches to computational modelling of bottom-up visual attention have been proposed in the past two decades. As part of this trend, researchers have studied ways to characterize the saliency map underlying many of these models. In more recent years, several definitions based...... on probabilistic and information or decision theoretic considerations have been proposed. These provide experimentally successful, appealing, low-level, operational, and elementary definitions of visual saliency (see eg, Bruce, 2005 Neurocomputing 65 125 - 133). Here, I demonstrate that, in fact, all...

  6. Conceptualising Business Models: Definitions, Frameworks and Classifications

    Directory of Open Access Journals (Sweden)

    Erwin Fielt

    2013-12-01

    Full Text Available The business model concept is gaining traction in different disciplines but is still criticized for being fuzzy and vague and lacking consensus on its definition and compositional elements. In this paper we set out to advance our understanding of the business model concept by addressing three areas of foundational research: business model definitions, business model elements, and business model archetypes. We define a business model as a representation of the value logic of an organization in terms of how it creates and captures customer value. This abstract and generic definition is made more specific and operational by the compositional elements that need to address the customer, value proposition, organizational architecture (firm and network level and economics dimensions. Business model archetypes complement the definition and elements by providing a more concrete and empirical understanding of the business model concept. The main contributions of this paper are (1 explicitly including the customer value concept in the business model definition and focussing on value creation, (2 presenting four core dimensions that business model elements need to cover, (3 arguing for flexibility by adapting and extending business model elements to cater for different purposes and contexts (e.g. technology, innovation, strategy (4 stressing a more systematic approach to business model archetypes by using business model elements for their description, and (5 suggesting to use business model archetype research for the empirical exploration and testing of business model elements and their relationships.

  7. Nuclear technology terms and definitions

    International Nuclear Information System (INIS)

    1979-02-01

    The terms and definitions in this standard are part of the catalogue of definitions 'Nuclear technology, terms and definitions', in eight parts; they are the latest version of the standards and draft standards of DIN 25 401, part 10 to 19, published at irregular intervals until now. (orig.) [de

  8. Quantum computers: Definition and implementations

    International Nuclear Information System (INIS)

    Perez-Delgado, Carlos A.; Kok, Pieter

    2011-01-01

    The DiVincenzo criteria for implementing a quantum computer have been seminal in focusing both experimental and theoretical research in quantum-information processing. These criteria were formulated specifically for the circuit model of quantum computing. However, several new models for quantum computing (paradigms) have been proposed that do not seem to fit the criteria well. Therefore, the question is what are the general criteria for implementing quantum computers. To this end, a formal operational definition of a quantum computer is introduced. It is then shown that, according to this definition, a device is a quantum computer if it obeys the following criteria: Any quantum computer must consist of a quantum memory, with an additional structure that (1) facilitates a controlled quantum evolution of the quantum memory; (2) includes a method for information theoretic cooling of the memory; and (3) provides a readout mechanism for subsets of the quantum memory. The criteria are met when the device is scalable and operates fault tolerantly. We discuss various existing quantum computing paradigms and how they fit within this framework. Finally, we present a decision tree for selecting an avenue toward building a quantum computer. This is intended to help experimentalists determine the most natural paradigm given a particular physical implementation.

  9. Distribution definition of path integrals

    International Nuclear Information System (INIS)

    Kerler, W.

    1979-01-01

    By starting from quantum mechanics it turns out that a rather general definition of quantum functional integrals can be given which is based on distribution theory. It applies also to curved space and provides clear rules for non-linear transformations. The refinements necessary in usual definitions of path integrals are pointed out. Since the quantum nature requires special care with time sequences, it is not the classical phase space which occurs in the phase-space form of the path integral. Feynman's configuration-space form only applies to a highly specialized situation, and therefore is not a very advantageous starting point for general investigations. It is shown that the commonly used substitutions of variables do not properly account for quantum effects. The relation to the traditional ordering problem is clarified. The distribution formulation has allowed to treat constrained systems directly at the quantum level, to complete the path integral formulation of the equivalence theorem, and to define functional integrals also for space translation after the transition to fields. (orig.)

  10. ENHANCING ASSETS' PROTECTION THROUGH AN ADEQUATE MONITORING OF INTERNAL CONTROL SYSTEM BY INTERNAL AUDIT

    Directory of Open Access Journals (Sweden)

    Dan Eugen Cosmin

    2011-12-01

    Full Text Available The assets are established into a company as very important and strategic resources that are contributing at the creation of the needed premises to conduct the daily-basis activity and also to reach present and future planned objectives. Recent studies like COSO's Fraudulent Financial Reporting 1998-2007 have highlighted an increasing fraudulent activity against assets therefore the efforts of fighting against fraud must be supplemented in order to preserve the existence and value of those resources. Internal controls are processes implemented in order to give a reasonable assurance that the company will not become a fraud victim. Even so, a lot of internal controls are paying a heavy tribute to their lack of efficiency and update. Thus, for a correct functioning, internal controls must be monitored and assessed permanently in order to preserve their strength and ability to fulfill their mission. This approach will deliver more added value because rather than being corrected after they have already occurred, the frauds related with the assets will be prevented, detected and reported at a timely moment, thereby the incidence and value of those criminal activities will decrease significantly. Furthermore, because not only the process of monitoring is important but even the entity conducting this activity we believe that internal audit is the most appropriate to undertake this responsibility. Thus, through this material we opened a discussion about how important permanent monitored and updated internal controls are in order to assure a proper assets protection and why internal audit, rather than the management, should be the most eligible to undertake this responsibility. Also we provided some suggestions regarding the main activities that must be taken into consideration by an internal audit professional when is being involved in a monitoring process of internal control system. We do believe that this paper will be the starting point for new

  11. 48 CFR 52.216-29 - Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate...

    Science.gov (United States)

    2010-10-01

    ...-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate Price Competition. 52.216-29... Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price Competition (FEB 2007) (a) The... Time-and-Materials/Labor-Hour Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price...

  12. Controversy around the definition of waste

    CSIR Research Space (South Africa)

    Oelofse, Suzanna HH

    2009-11-20

    Full Text Available This paper presents the information concerning the definition of waste. Discussing the importance of the clear definition, ongoing debates, broad definition of waste, problems with the broad definition, interpretation, current waste management model...

  13. Toward a Definition of the Engineering Method.

    Science.gov (United States)

    Koen, Billy V.

    1988-01-01

    Describes a preliminary definition of engineering method as well as a definition and examples of engineering heuristics. After discussing some alternative definitions of the engineering method, a simplified definition of the engineering method is suggested. (YP)

  14. The Logic of Definition

    Science.gov (United States)

    2009-05-01

    Wittgenstein , in his Philosophical Investigations (1953), observed that, for many phenomena, there are no necessary conditions common to all members of... Wittgenstein 1953: §66, p.27e). Wittgenstein refers to these overlapping similarities as “family resemblances” (Ibid., §67, p.27e). Few, if any, of...that is, we may resort to stipulative definition). But this is not necessary for the concept to be usable. Indeed, as Wittgenstein says, sometimes

  15. Timing and adequate attendance of antenatal care visits among women in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available Although ANC services are increasingly available to women in low and middle-income countries, their inadequate use persists. This suggests a misalignment between aims of the services and maternal beliefs and circumstances. Owing to the dearth of studies examining the timing and adequacy of content of care, this current study aims to investigate the timing and frequency of ANC visits in Ethiopia.Data was obtained from the nationally representative 2011 Ethiopian Demographic and Health Survey (EDHS which used a two-stage cluster sampling design to provide estimates for the health and demographic variables of interest for the country. Our study focused on a sample of 10,896 women with history of at least one childbirth event. Percentages of timing and adequacy of ANC visits were conducted across the levels of selected factors. Variables which were associated at 5% significance level were examined in the multivariable logistic regression model for association between timing and frequency of ANC visits and the explanatory variables while controlling for covariates. Furthermore, we presented the approach to estimate marginal effects involving covariate-adjusted logistic regression with corresponding 95%CI of delayed initiation of ANC visits and inadequate ANC attendance. The method used involved predicted probabilities added up to a weighted average showing the covariate distribution in the population.Results indicate that 66.3% of women did not use ANC at first trimester and 22.3% had ANC less than 4 visits. The results of this study were unique in that the association between delayed ANC visits and adequacy of ANC visits were examined using multivariable logistic model and the marginal effects using predicted probabilities. Results revealed that older age interval has higher odds of inadequate ANC visits. More so, type of place of residence was associated with delayed initiation of ANC visits, with rural women having the higher odds of delayed

  16. Timing and adequate attendance of antenatal care visits among women in Ethiopia

    Science.gov (United States)

    Bishwajit, Ghose; Ekholuenetale, Michael; Shah, Vaibhav; Kadio, Bernard; Udenigwe, Ogochukwu

    2017-01-01

    Introduction Although ANC services are increasingly available to women in low and middle-income countries, their inadequate use persists. This suggests a misalignment between aims of the services and maternal beliefs and circumstances. Owing to the dearth of studies examining the timing and adequacy of content of care, this current study aims to investigate the timing and frequency of ANC visits in Ethiopia. Methods Data was obtained from the nationally representative 2011 Ethiopian Demographic and Health Survey (EDHS) which used a two-stage cluster sampling design to provide estimates for the health and demographic variables of interest for the country. Our study focused on a sample of 10,896 women with history of at least one childbirth event. Percentages of timing and adequacy of ANC visits were conducted across the levels of selected factors. Variables which were associated at 5% significance level were examined in the multivariable logistic regression model for association between timing and frequency of ANC visits and the explanatory variables while controlling for covariates. Furthermore, we presented the approach to estimate marginal effects involving covariate-adjusted logistic regression with corresponding 95%CI of delayed initiation of ANC visits and inadequate ANC attendance. The method used involved predicted probabilities added up to a weighted average showing the covariate distribution in the population. Results Results indicate that 66.3% of women did not use ANC at first trimester and 22.3% had ANC less than 4 visits. The results of this study were unique in that the association between delayed ANC visits and adequacy of ANC visits were examined using multivariable logistic model and the marginal effects using predicted probabilities. Results revealed that older age interval has higher odds of inadequate ANC visits. More so, type of place of residence was associated with delayed initiation of ANC visits, with rural women having the higher odds of

  17. Diet quality of Italian yogurt consumers: an application of the probability of adequate nutrient intake score (PANDiet).

    Science.gov (United States)

    Mistura, Lorenza; D'Addezio, Laura; Sette, Stefania; Piccinelli, Raffaela; Turrini, Aida

    2016-01-01

    The diet quality in yogurt consumers and non-consumers was evaluated by applying the probability of adequate nutrient intake (PANDiet) index to a sample of adults and elderly from the Italian food consumption survey INRAN SCAI 2005-06. Overall, yogurt consumers had a significantly higher mean intake of energy, calcium and percentage of energy from total sugars whereas the mean percentage of energy from total fat, saturated fatty acid and total carbohydrate were significantly (p yogurt consumers than in non-consumers, (60.58 ± 0.33 vs. 58.58 ± 0.19, p yogurt consumers. The items of calcium, potassium and riboflavin showed the major percentage variation between consumers and non-consumers. Yogurt consumers were more likely to have adequate intakes of vitamins and minerals, and a higher quality score of the diet.

  18. The Leap of a Provincial SME into the Global Market Using E-commerce: The Success of Adequate Planning

    Science.gov (United States)

    Sainz de Abajo, Beatriz; García Salcines, Enrique; Burón Fernández, F. Javier; López Coronado, Miguel; de Castro Lozano, Carlos

    The leap into the global market is not easy when it involves a provincial family business. This article demonstrates how adequate planning is fundamental in a small and medium-sized enterprise (SME) with the tight budget they have available to them, in order to be able to differentiate themselves in a highly competitive market, taking into accounts the benefits and risks involved. The Information Technology (IT) tools put in place will give the necessary support and allow for the possibility of increasing and improving the infrastructure as the company requires. An adequate strategy for the future to increases sales would be e-marketing techniques as well as the current promotions which contribute to diffusing the brand.

  19. The Audit Opinion of the DISA FY 2011 Working Capital Fund Financial Statements Was Not Adequately Supported

    Science.gov (United States)

    2013-04-26

    President’s Council on Integrity and Efficiency MD&A Management Discussion and Analysis MFR Memorandum for Record NoF Notification of...memorandums for record ( MFRs ) would have a material impact on the financial statements and ultimately Acuity’s opinion, • perform adequate completeness...the deficiencies identified by DISA in its FBWT MFRs would impact the reliability of the financial statements and ultimately Acuity’s opinion

  20. Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

    Science.gov (United States)

    Marović, Ivan; Hanak, Tomaš

    2017-10-01

    In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.

  1. Zinc content of selected tissues and taste perception in rats fed zinc deficient and zinc adequate rations

    International Nuclear Information System (INIS)

    Boeckner, L.S.; Kies, C.

    1986-01-01

    The objective of the study was to determine the effects of feeding zinc sufficient and zinc deficient rations on taste sensitivity and zinc contents of selected organs in rats. The 36 Sprague-Dawley male weanling rats were divided into 2 groups and fed zinc deficient or zinc adequate rations. The animals were subjected to 4 trial periods in which a choice of deionized distilled water or a solution of quinine sulfate at 1.28 x 10 -6 was given. A randomized schedule for rat sacrifice was used. No differences were found between zinc deficient and zinc adequate rats in taste preference aversion scores for quinine sulfate in the first three trial periods; however, in the last trial period rats in the zinc sufficient group drank somewhat less water containing quinine sulfate as a percentage of total water consumption than did rats fed the zinc deficient ration. Significantly higher zinc contents of kidney, brain and parotid salivary glands were seen in zinc adequate rats compared to zinc deficient rats at the end of the study. However, liver and tongue zinc levels were lower for both groups at the close of the study than were those of rats sacrificed at the beginning of the study

  2. Definitions of Exacerbations Does It Really Matter in Clinical Trials on COPD?

    NARCIS (Netherlands)

    Effing, Tanja W.; Kerstjens, Huib A. M.; Monninkhof, Evelyn M.; van der Valk, Paul D. L. P. M.; Wouters, Emiel F. M.; Postma, Dirkje S.; Zielhuis, Gerhard A.; van der Palen, Job

    Many definitions of COPD exacerbations are reported. The choice for a definition determines the number of exacerbations observed. However, the effect of different definitions on the effect sizes of randomized controlled trials is unclear. This article provides an overview of the large variation of

  3. Definitions of exacerbations: does it really matter in clinical trials on COPD?

    NARCIS (Netherlands)

    Effing-Tijdhof, T.W.; Kerstjens, H.A.; Monninkhof, E.M.; Valk, P.D.L.P.M. van der; Wouters, E.F.; Postma, D.S.; Zielhuis, G.A.; Palen, J.A.M. van der

    2009-01-01

    Many definitions of COPD exacerbations are reported. The choice for a definition determines the number of exacerbations observed. However, the effect of different definitions on the effect sizes of randomized controlled trials is unclear. This article provides an overview of the large variation of

  4. Adolescents' Definitions of Bullying: The Contribution of Age, Gender, and Experience of Bullying

    Science.gov (United States)

    Byrne, Hollie; Dooley, Barbara; Fitzgerald, Amanda; Dolphin, Louise

    2016-01-01

    The aim of the present research was to examine adolescents' definitions of bullying in a nationally representative sample of adolescents in Ireland. Definitions of bullying were examined according to age, gender, and bullying experiences. A sample of 4358 adolescents aged 12-19 years (M = 14.99 years, SD = 1.63) provided their definitions of…

  5. Workflow patterns the definitive guide

    CERN Document Server

    Russell, Nick; ter Hofstede, Arthur H M

    2016-01-01

    The study of business processes has emerged as a highly effective approach to coordinating an organization's complex service- and knowledge-based activities. The growing field of business process management (BPM) focuses on methods and tools for designing, enacting, and analyzing business processes. This volume offers a definitive guide to the use of patterns, which synthesize the wide range of approaches to modeling business processes. It provides a unique and comprehensive introduction to the well-known workflow patterns collection -- recurrent, generic constructs describing common business process modeling and execution scenarios, presented in the form of problem-solution dialectics. The underlying principles of the patterns approach ensure that they are independent of any specific enabling technology, representational formalism, or modeling approach, and thus broadly applicable across the business process modeling and business process technology domains. The authors, drawing on extensive research done by...

  6. Sponsorship in non-commercial clinical trials: definitions, challenges and the role of Good Clinical Practices guidelines.

    Science.gov (United States)

    Ravinetto, Raffaella; De Nys, Katelijne; Boelaert, Marleen; Diro, Ermias; Meintjes, Graeme; Adoke, Yeka; Tagbor, Harry; Casteels, Minne

    2015-12-30

    Non-commercial clinical research plays an increasingly essential role for global health. Multiple partners join in international consortia that operate under the limited timeframe of a specific funding period. One organisation (the sponsor) designs and carries out the trial in collaboration with research partners, and is ultimately responsible for the trial's scientific, ethical, regulatory and legal aspects, while another organization, generally in the North (the funder), provides the external funding and sets funding conditions. Even if external funding mechanisms are key for most non-commercial research, the dependence on an external funder's policies may heavily influence the choices of a sponsor. In addition, the competition for accessing the available external funds is great, and non-commercial sponsors may not be in a position to discuss or refuse standard conditions set by a funder. To see whether the current definitions adequately address the intricacies of sponsorship in externally-funded trials, we looked at how a "sponsor" of clinical trials is defined in selected international guidelines, with particular focus on international Good Clinical Practices codes, and in selected European and African regulations/legislations. Our limited analysis suggests that the sponsors definition from the 1995 WHO Good Clinical Practices code has been integrated as such into many legislations, guidelines and regulations, and that it is not adequate to cover today's reality of funding arrangements in global health, where the legal responsibility and the funding source are de facto split. In agreement with other groups, we suggest that the international Good Clinical Practices codes should be updated to reflect the reality of non-commercial clinical research. In particular, they should explicitly include the distinction between commercial and non-commercial sponsors, and provide guidance to non-commercial sponsors for negotiating with external funding agencies and other

  7. Are uranium reserves adequate?

    International Nuclear Information System (INIS)

    Anon.

    2006-01-01

    Against a backdrop of growing concerns about global warming and geopolitical pressures on fossil energies, especially natural gas and oil, interest in nuclear power has revived considerably. Conscious of its addiction to oil and reeling from a series of gigantic blackouts, the United States, in the words of its president, must 'aggressively move forward with the construction of nuclear power plants'. Some European countries have approved new power plant construction (Finland and France), while the more reserved ones (Belgium, Germany and Sweden) have begun to show a change in attitude. Asia, meanwhile, is host to the planet's largest number of potential nuclear construction projects in this first half of the 21. century. All these signs point to a sharp rise in uranium consumption, the basic fuel for these plants. But are there enough resources to support a nuclear revival on a planetary scale? The publication of the Red Book on uranium in late May 2006 was an opportunity for Thierry Dujardin, Deputy Director of Science and Development at the OECD's Nuclear Energy Agency, to take stock of resources. He gives his opinion in this paper

  8. Are current practices adequate

    International Nuclear Information System (INIS)

    Taylor, T.B.

    1975-01-01

    Events related to safeguards during the last year are reviewed. Present needs are a clear statement of safeguards objectives, more Federal funds, and design of facilities for easier safeguards. It is felt that effective safeguards can be implemented at relatively low overall cost to industry. C. Walske's presentation of the AIF position is strongly endorsed. (U.S.)

  9. Making ecological models adequate

    Science.gov (United States)

    Getz, Wayne M.; Marshall, Charles R.; Carlson, Colin J.; Giuggioli, Luca; Ryan, Sadie J.; Romañach, Stephanie; Boettiger, Carl; Chamberlain, Samuel D.; Larsen, Laurel; D'Odorico, Paolo; O'Sullivan, David

    2018-01-01

    Critical evaluation of the adequacy of ecological models is urgently needed to enhance their utility in developing theory and enabling environmental managers and policymakers to make informed decisions. Poorly supported management can have detrimental, costly or irreversible impacts on the environment and society. Here, we examine common issues in ecological modelling and suggest criteria for improving modelling frameworks. An appropriate level of process description is crucial to constructing the best possible model, given the available data and understanding of ecological structures. Model details unsupported by data typically lead to over parameterisation and poor model performance. Conversely, a lack of mechanistic details may limit a model's ability to predict ecological systems’ responses to management. Ecological studies that employ models should follow a set of model adequacy assessment protocols that include: asking a series of critical questions regarding state and control variable selection, the determinacy of data, and the sensitivity and validity of analyses. We also need to improve model elaboration, refinement and coarse graining procedures to better understand the relevancy and adequacy of our models and the role they play in advancing theory, improving hind and forecasting, and enabling problem solving and management.

  10. access to adequate housing

    African Journals Online (AJOL)

    Nicola Smit

    chauffeurs and restaurant/hotel workers approached the Development Action ..... 10 Ibid. 11 Budget speech by LN Sisulu, Minister of Housing, 28 May 2008, available at .... exorbitantly high property prices in the Cape Town CBD and environs, ...

  11. Integral definition of the logarithmic function and the derivative of the exponential function in calculus

    Science.gov (United States)

    Vaninsky, Alexander

    2015-04-01

    Defining the logarithmic function as a definite integral with a variable upper limit, an approach used by some popular calculus textbooks, is problematic. We discuss the disadvantages of such a definition and provide a way to fix the problem. We also consider a definition-based, rigorous derivation of the derivative of the exponential function that is easier, more intuitive, and complies with the standard definitions of the number e, the logarithmic, and the exponential functions.

  12. Variation in Definition of Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Rose, Louise; McGinlay, Michael; Amin, Reshma; Burns, Karen Ea; Connolly, Bronwen; Hart, Nicholas; Jouvet, Philippe; Katz, Sherri; Leasa, David; Mawdsley, Cathy; McAuley, Danny F; Schultz, Marcus J; Blackwood, Bronagh

    2017-10-01

    Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym. We screened 5,331 references, reviewed 539 full-text references, and excluded 120. Of the 419 studies (representing 38 countries) meeting inclusion criteria, 297 (71%) reported data on a heterogeneous subject cohort, and 66 (16%) included surgical subjects only (46 of those 66, 70% cardiac surgery). Other studies described COPD (16, 4%), trauma (22, 5%), neuromuscular (17, 4%), and sepsis (1, 0.2%) cohorts. A total of 741 terms were used to refer to the 419 study cohorts. The most common terms were: prolonged mechanical ventilation (253, 60%), admission to specialized unit (107, 26%), and long-term mechanical ventilation (79, 19%). Some authors (282, 67%) defined their cohorts based on duration of mechanical ventilation, with 154 studies (55%) using this as the sole criterion. We identified 37 different durations of ventilation ranging from 5 h to 1 y, with > 21 d being the most common (28 of 282, 7%). For studies describing a surgical cohort, minimum ventilation duration required for inclusion was ≥ 24 h for 20 of 66 studies (30%). More than half of all studies (237, 57%) did not provide a reason/rationale for definitional criteria used, with only 28 studies (7%) referring to a consensus definition. We conclude that substantial variation exists in the terminology and definitional criteria for cohorts of subjects receiving prolonged mechanical ventilation. Standardization of

  13. Primitive and definitive erythropoiesis in mammals

    Directory of Open Access Journals (Sweden)

    James ePalis

    2014-01-01

    Full Text Available Red blood cells (RBCs, which constitute the most abundant cell type in the body, come in two distinct flavors- primitive and definitive. Definitive RBCs in mammals circulate as smaller, anucleate cells during fetal and postnatal life, while primitive RBCs circulate transiently in the early embryo as large, nucleated cells before ultimately enucleating. Both cell types are formed from lineage-committed progenitors that generate a series of morphologically identifiable precursors that enucleate to form mature RBCs. While definitive erythroid precursors mature extravascularly in the fetal liver and postnatal marrow in association with macrophage cells, primitive erythroid precursors mature as a semi-synchronous cohort in the embryonic bloodstream. While the cytoskeletal network is critical for the maintenance of cell shape and the deformability of definitive RBCs, little is known about the components and function of the cytoskeleton in primitive erythroblasts. Erythropoietin (EPO is a critical regulator of late-stage definitive, but not primitive, erythroid progenitor survival. However, recent studies indicate that EPO regulates multiple aspects of terminal maturation of primitive murine and human erythroid precursors, including cell survival, proliferation, and the rate of terminal maturation. Primitive and definitive erythropoiesis share central transcriptional regulators, including Gata1 and Klf1, but are also characterized by the differential expression and function of other regulators, including myb, Sox6, and Bcl11A. Flow cytometry-based methodologies, developed to purify murine and human stage-specific erythroid precursors, have enabled comparative global gene expression studies and are providing new insights into the biology of erythroid maturation.

  14. What is compassion and how can we measure it? A review of definitions and measures.

    Science.gov (United States)

    Strauss, Clara; Lever Taylor, Billie; Gu, Jenny; Kuyken, Willem; Baer, Ruth; Jones, Fergal; Cavanagh, Kate

    2016-07-01

    The importance of compassion is widely recognized and it is receiving increasing research attention. Yet, there is lack of consensus on definition and a paucity of psychometrically robust measures of this construct. Without an agreed definition and adequate measures, we cannot study compassion, measure compassion or evaluate whether interventions designed to enhance compassion are effective. In response, this paper proposes a definition of compassion and offers a systematic review of self- and observer-rated measures. Following consolidation of existing definitions, we propose that compassion consists of five elements: recognizing suffering, understanding the universality of human suffering, feeling for the person suffering, tolerating uncomfortable feelings, and motivation to act/acting to alleviate suffering. Three databases were searched (Web of Science, PsycInfo, and Medline) and nine measures included and rated for quality. Quality ratings ranged from 2 to 7 out of 14 with low ratings due to poor internal consistency for subscales, insufficient evidence for factor structure and/or failure to examine floor/ceiling effects, test-retest reliability, and discriminant validity. We call our five-element definition, and if supported, the development of a measure of compassion based on this operational definition, and which demonstrates adequate psychometric properties. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. The Capability Threshold: Re-examining the Definition of the Middle Class in an Unequal Developing Country

    OpenAIRE

    Burger, Ronelle; McAravey, Camren; van der Berg, Servaas

    2015-01-01

    In a polarised and highly unequal country such as South Africa, it is unlikely that a definition of the middle class that is based on an income threshold will adequately capture the political and social meanings of being middle class. We therefore propose a multi-dimensional definition, rooted in the ideas of empowerment and capability, and find that the 'empowered middle class' has expanded significantly since 1993 also across vulnerable subgroups such as blacks, female-headed households and...

  16. Jenkins The Definitive Guide

    CERN Document Server

    Smart, John

    2011-01-01

    Streamline software development with Jenkins, the popular Java-based open source tool that has revolutionized the way teams think about Continuous Integration (CI). This complete guide shows you how to automate your build, integration, release, and deployment processes with Jenkins-and demonstrates how CI can save you time, money, and many headaches. Ideal for developers, software architects, and project managers, Jenkins: The Definitive Guide is both a CI tutorial and a comprehensive Jenkins reference. Through its wealth of best practices and real-world tips, you'll discover how easy it is

  17. Hadoop The Definitive Guide

    CERN Document Server

    White, Tom

    2009-01-01

    Hadoop: The Definitive Guide helps you harness the power of your data. Ideal for processing large datasets, the Apache Hadoop framework is an open source implementation of the MapReduce algorithm on which Google built its empire. This comprehensive resource demonstrates how to use Hadoop to build reliable, scalable, distributed systems: programmers will find details for analyzing large datasets, and administrators will learn how to set up and run Hadoop clusters. Complete with case studies that illustrate how Hadoop solves specific problems, this book helps you: Use the Hadoop Distributed

  18. Apache The Definitive Guide

    CERN Document Server

    Laurie, Ben

    2003-01-01

    Apache is far and away the most widely used web server platform in the world. This versatile server runs more than half of the world's existing web sites. Apache is both free and rock-solid, running more than 21 million web sites ranging from huge e-commerce operations to corporate intranets and smaller hobby sites. With this new third edition of Apache: The Definitive Guide, web administrators new to Apache will come up to speed quickly, and experienced administrators will find the logically organized, concise reference sections indispensable, and system programmers interested in customizin

  19. The definite article in Romance expletives and long weak definites

    Directory of Open Access Journals (Sweden)

    M.Teresa Espinal

    2017-03-01

    Full Text Available This paper focuses on some issues involving expletive articles and long weak definites in Romance (mainly Spanish, Brazilian Portuguese and Catalan, in comparison to DPs that elicit a strong reading. We show the similarities between expletive definites and long weak definites, and we argue for an analysis in common to other polarity items in terms of polarity sensitivity. We reach the conclusion that the definite article in Romance comes in two variants: the referentially unique variant (to be translated as the semantic 'iota 'operator and the polar variant, formally characterized with an abstract [+σ] feature, that encodes a weak bound reading (to be semantically translated by an existential operator.

  20. The HEALTHGRAIN definition of ‘whole grain’

    Science.gov (United States)

    van der Kamp, Jan Willem; Poutanen, Kaisa; Seal, Chris J.; Richardson, David P.

    2014-01-01

    Most cereal products, like white bread, pasta, and biscuits, are based on flour after removal of bran and germ, the two parts of grain kernels containing most of the dietary fibre and other bioactive components. In the past decade, consumers have been rediscovering whole grain-based products and the number of wholegrain products has increased rapidly. In most countries in Europe and worldwide, however, no legally endorsed definition of wholegrain flour and products exists. Current definitions are often incomplete, lacking descriptions of the included grains and the permitted flour manufacturing processes. The consortium of the HEALTHGRAIN EU project (FP6-514008, 2005–2010) identified the need for developing a definition of whole grain with the following scope: 1) more comprehensive than current definitions in most EU countries; 2) one definition for Europe – when possible equal to definitions outside Europe; 3) reflecting current industrial practices for production of flours and consumer products; 4) useful in the context of nutritional guidelines and for labelling purposes. The definition was developed in a range of discussion meetings and consultations and was launched in 2010 at the end of the HEALTHGRAIN project. The grains included are specified: a wide range of cereal grains from the Poaceae family, and the pseudo-cereals amaranth, buckwheat, quinoa, and wild rice. The definition also describes manufacturing processes allowed for producing wholegrain flours. This paper compares the HEALTHGRAIN definition with previous definitions, provides more comprehensive explanations than in the definition itself regarding the inclusion of specific grains, and sets out the permitted flour manufacturing processes. PMID:24505218

  1. Informative providing of processes of development on industrial enterprises

    OpenAIRE

    Kalinichenko, L.

    2010-01-01

    Information is definite by the basic resource of activity of enterprises. Suggestion in relation to the selection of informative subsystems of strategic, tactical, operative management is borne. The list of indexes in relation to estimation of the informative providing of functional processes of enterprise is offered.

  2. Quality Perception within Corporate E-Learning Providers in Catalonia

    Science.gov (United States)

    Sangra, Albert; Fernandez-Michels, Pedro

    2011-01-01

    Purpose: The paper seeks to describe the Catalan corporate e-learning providers from the perspective of quality perception, quality assessment and quality control. Design/methodology/approach: A literature review reveals key aspects of the definition of quality in e-learning. The results of the review constitute the basis for exploratory research…

  3. Are forestation, bio-char and landfilled biomass adequate offsets for the climate effects of burning fossil fuels?

    International Nuclear Information System (INIS)

    Reijnders, L.

    2009-01-01

    Forestation and landfilling purpose-grown biomass are not adequate offsets for the CO 2 emission from burning fossil fuels. Their permanence is insufficiently guaranteed and landfilling purpose-grown biomass may even be counterproductive. As to permanence, bio-char may do better than forests or landfilled biomass, but there are major uncertainties about net greenhouse gas emissions linked to the bio-char life cycle, which necessitate suspension of judgement about the adequacy of bio-char addition to soils as an offset for CO 2 emissions from burning fossil fuels.

  4. Definition of IGRT

    International Nuclear Information System (INIS)

    Lief, Eugene

    2008-01-01

    Two definitions of image-guided radiation therapy (IGRT) are cited: 'Frequent imaging in the treatment room during a course of radiotherapy to guide the treatment process' and 'Any use of planar imaging, volumetric imaging or volumetric cine imaging, marker localization, marker tracking, patient surface imaging or patient surface tracking to improve the precision of radiation-therapy delivery'. Also cited are the sentences 'IGRT refers broadly to treatment delivery using modern imaging methods, such as CT, MRI, PET and Ultrasound, in target and non-target structures and in RT definition, design and delivery...' and 'IGRT includes, but is not limited to, 3DCRT, IMRT: stereotactic radiosurgery, stereotactic RT, and brachytherapy...'. Purposes include: Precise patient positioning; Automatic localization of bony structures or implanted fiducial markers; Imaging and positioning of soft tissue tumors and critical structures; Margin reduction and healthy organ sparing; and Delivering the desired dose distribution. On the negative side are the following factors: Physics staffing at treatment delivery Longer treatment times: 1 min. arm deployment, setup for scan, 1 min. gantry rotation - volume image acquisition, 30 sec. reconstruction (depends on resolution), 30 sec. load CT and CB into registration; Registration: from few sec. to few min.; Feasible if the number of treatments is low. The history of IGRT is mentioned, instrumentation is described using ample photographs, and many applications are shown. (P.A.)

  5. LDR structural experiment definition

    Science.gov (United States)

    Russell, R. A.

    1988-01-01

    A system study to develop the definition of a structural flight experiment for a large precision segmented reflector on the Space Station was accomplished by the Boeing Aerospace Company for NASA's Langley Research Center. The objective of the study was to use a Large Deployable Reflector (LDR) baseline configuration as the basis for focusing an experiment definition, so that the resulting accommodation requirements and interface constraints could be used as part of the mission requirements data base for Space Station. The primary objectives of the first experiment are to construct the primary mirror support truss and to determine its structural and thermal characteristics. Addition of an optical bench, thermal shield and primary mirror segments, and alignment of the optical components, would occur on a second experiment. The structure would then be moved to the payload point system for pointing, optical control, and scientific optical measurement for a third experiment. Experiment 1 will deploy the primary support truss while it is attached to the instrument module structure. The ability to adjust the mirror attachment points and to attach several dummy primary mirror segments with a robotic system will also be demonstrated. Experiment 2 will be achieved by adding new components and equipment to experiment one. Experiment 3 will demonstrate advanced control strategies, active adjustment of the primary mirror alignment, and technologies associated with optical sensing.

  6. LDR structural experiment definition

    Science.gov (United States)

    Russell, Richard A.; Gates, Richard M.

    1988-01-01

    A study was performed to develop the definition of a structural flight experiment for a large precision segmented reflector that would utilize the Space Station. The objective of the study was to use the Large Deployable Reflector (LDR) baseline configuration for focusing on experiment definition activity which would identify the Space Station accommodation requirements and interface constraints. Results of the study defined three Space Station based experiments to demonstrate the technologies needed for an LDR type structure. The basic experiment configurations are the same as the JPL baseline except that the primary mirror truss is 10 meters in diameter instead of 20. The primary objectives of the first experiment are to construct the primary mirror support truss and to determine its structural and thermal characteristics. Addition of the optical bench, thermal shield and primary mirror segments and alignment of the optical components occur on the second experiment. The structure will then be moved to the payload pointing system for pointing, optical control and scientific optical measurement for the third experiment.

  7. Clinical case definition for the diagnosis of acute intussusception.

    Science.gov (United States)

    Bines, Julie E; Ivanoff, Bernard; Justice, Frances; Mulholland, Kim

    2004-11-01

    Because of the reported association between intussusception and a rotavirus vaccine, future clinical trials of rotavirus vaccines will need to include intussusception surveillance in the evaluation of vaccine safety. The aim of this study is to develop and validate a clinical case definition for the diagnosis of acute intussusception. A clinical case definition for the diagnosis of acute intussusception was developed by analysis of an extensive literature review that defined the clinical presentation of intussusception in 70 developed and developing countries. The clinical case definition was then assessed for sensitivity and specificity using a retrospective chart review of hospital admissions. Sensitivity of the clinical case definition was assessed in children diagnosed with intussusception over a 6.5-year period. Specificity was assessed in patients aged clinical case definition accurately identified 185 of 191 assessable cases as "probable" intussusception and six cases as "possible" intussusception (sensitivity, 97%). No case of radiologic or surgically proven intussusception failed to be identified by the clinical case definition. The specificity of the definition in correctly identifying patients who did not have intussusception ranged from 87% to 91%. The clinical case definition for intussusception may assist in the prompt identification of patients with intussusception and may provide an important tool for the future trials of enteric vaccines.

  8. Lattice cell diffusion coefficients. Definitions and comparisons

    International Nuclear Information System (INIS)

    Hughes, R.P.

    1980-01-01

    Definitions of equivalent diffusion coefficients for regular lattices of heterogeneous cells have been given by several authors. The paper begins by reviewing these different definitions and the unification of their derivation. This unification makes clear how accurately each definition (together with appropriate cross-section definitions to preserve the eigenvalue) represents the individual reaction rates within the cell. The approach can be extended to include asymmetric cells and whereas before, the buckling describing the macroscopic flux shape was real, here it is found to be complex. A neutron ''drift'' coefficient as well as a diffusion coefficient is necessary to produce the macroscopic flux shape. The numerical calculation of the various different diffusion coefficients requires the solutions of equations similar to the ordinary transport equation for an infinite lattice. Traditional reactor physics codes are not sufficiently flexible to solve these equations in general. However, calculations in certain simple cases are presented and the theoretical results quantified. In difficult geometries, Monte Carlo techniques can be used to calculate an effective diffusion coefficient. These methods relate to those already described provided that correlation effects between different generations of neutrons are included. Again, these effects are quantified in certain simple cases. (author)

  9. Towards a universal definition of competitive intelligence

    Directory of Open Access Journals (Sweden)

    Rene Pellissier

    2013-10-01

    Objectives: The purpose of this research is to review the current literature on CI with the aim of identifying and analysing CI definitions to establish the commonalities and differences, to propose a universal and comprehensive definition of CI and to set the borders of CI for common understanding amongst CI stakeholders. Method: The study was qualitative in nature and content analysis was conducted on all identified sources establishing and analysing CI definitions. To identify relevant literature, academic databases and search engines were used. A review of references in related studies led to more relevant sources, the references of which were further reviewed and analysed. Keywords ‘competitive intelligence’, ‘marketing intelligence’ and ‘business intelligence’ were used in search engines to find relevant sources. To ensure reliability, only peer-reviewed articles were used. Results: The majority of scholars define CI as a process and acknowledge that CI is collected from the internal and external or competitive environment. They also outline the goals of CI, which are to help in decision-making and provide a competitive advantage. Conclusion: The proposed definition outlines the process, purpose, source, deliverables, beneficiaries, benefit, ethicality and legality of CI, sets out the borders of CI and ensures a common understanding amongst CI stakeholders.

  10. Duration of untreated psychosis: a proposition regarding treatment definition.

    Science.gov (United States)

    Polari, Andrea; Lavoie, Suzie; Sarrasin, Pascale; Pellanda, Veronica; Cotton, Sue; Conus, Philippe

    2011-11-01

    Duration of untreated psychosis (DUP) refers to the time elapsing between psychosis onset and treatment initiation. Despite a certain degree of consensus regarding the definition of psychosis onset, the definition of treatment commencement varies greatly between studies and DUP may be underestimated due to lack of agreement. In the present study, three sets of criteria to define the end of the untreated period were applied in a first-episode psychosis cohort to assess the impact of the choice of definition on DUP estimation. The DUP of 117 patients admitted in the Treatment and Early Intervention in Psychosis Program Psychosis in Lausanne was measured using the following sets of criteria to define treatment onset: (i) initiation of antipsychotic medication; (ii) entry into a specialized programme; and (iii) entry into a specialized programme and adequate medication with a good compliance. DUP varied greatly according to definitions, the most restrictive criteria leading to the longest DUP (median DUP1=2.2 months, DUP2=7.4 months and DUP3=13.6 months). A percentage of 19.7 of the patients who did not meet these restrictive criteria had poorer premorbid functioning and were more likely to use cannabis. Longer DUP3 was associated with poorer premorbid functioning and with younger age at onset of psychosis. These results underline the need for a unique and standardized definition of the end of DUP. We suggest that the most restrictive definition of treatment should be used when using the DUP concept in future research. © 2011 Blackwell Publishing Asia Pty Ltd.

  11. Concept definition for space station technology development experiments. Experiment definition, task 2

    Science.gov (United States)

    1986-01-01

    The second task of a study with the overall objective of providing a conceptual definition of the Technology Development Mission Experiments proposed by LaRC on space station is discussed. During this task, the information (goals, objectives, and experiment functional description) assembled on a previous task was translated into the actual experiment definition. Although still of a preliminary nature, aspects such as: environment, sensors, data acquisition, communications, handling, control telemetry requirements, crew activities, etc., were addressed. Sketches, diagrams, block diagrams, and timeline analyses of crew activities are included where appropriate.

  12. Serum albumin-adjusted glycated albumin is an adequate indicator of glycemic control in patients with Cushing's syndrome.

    Science.gov (United States)

    Kitamura, Tetsuhiro; Otsuki, Michio; Tamada, Daisuke; Tabuchi, Yukiko; Mukai, Kosuke; Morita, Shinya; Kasayama, Soji; Bando, Yukihiro; Shimomura, Iichiro; Koga, Masafumi

    2014-12-01

    We recently reported that glycated albumin (GA) in patients with Cushing's syndrome is low. In the present study, we examined whether serum albumin (SA)-adjusted GA (SAaGA) is an adequate indicator of glycemic control in patients with Cushing's syndrome. We studied 26 patients with Cushing's syndrome (13 patients without diabetes and 13 patients with diabetes). Twenty six non-diabetic subjects and 26 patients with type 2 diabetes mellitus matched for age, sex and BMI were used as the controls. SAaGA was calculated using the regression formula between SA and GA in non-diabetic patients with Cushing's syndrome and non-diabetic subjects. SA showed a significant correlation with GA in non-diabetic patients with Cushing's syndrome and non-diabetic subjects. GA, but not SAaGA, in non-diabetic patients with Cushing's syndrome was significantly lower than that in the non-diabetic controls. Furthermore, the GA/HbA1c ratio, but not the SAaGA/HbA1c ratio, in diabetic patients with Cushing's syndrome was significantly lower than that in the diabetic controls. The measured GA in the patients with Cushing's syndrome was significantly lower than the estimated GA, but there was no difference between SAaGA and the estimated GA. The present findings suggest that SAaGA is an adequate indicator of the glycemic control in patients with Cushing's syndrome. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  13. Exercise prescription for the older population: The interactions between physical activity, sedentary time, and adequate nutrition in maintaining musculoskeletal health.

    Science.gov (United States)

    Shad, Brandon J; Wallis, Gareth; van Loon, Luc J C; Thompson, Janice L

    2016-11-01

    Regular physical activity (PA) promotes musculoskeletal health in older adults. However, the majority of older individuals do not meet current PA guidelines and are also highly sedentary. Emerging evidence indicates that large amounts of sedentary time accelerate the loss of skeletal muscle mass (i.e., sarcopenia) and physical function with advancing age. However, current PA recommendations for sedentary time are non-specific (i.e., keep sedentary time to a minimum). Research indicates that physical inactivity and large amounts of sedentary time accelerate sarcopenic muscle loss by inducing skeletal muscle 'anabolic resistance'. These findings suggest a critical interaction between engaging in 'sufficient' levels of PA, minimising sedentary time, and consuming 'adequate' nutrition to promote optimal musculoskeletal health in older adults. However, current PA recommendations do not take into account the important role that nutrition plays in ensuring older adults can maximise the benefits from the PA in which they engage. The aim of this narrative review is: (1) to briefly summarise the evidence used to inform current public health recommendations for PA and sedentary time in older adults; and (2) to discuss the presence of 'anabolic resistance' in older adults, highlighting the importance of regular PA and minimising sedentary behaviour. It is imperative that the synergy between PA, minimising sedentary behaviour and adequate nutrition is integrated into future PA guidelines to promote optimal musculoskeletal health and metabolic responses in the growing ageing population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Data governance for health care providers.

    Science.gov (United States)

    Andronis, Katerina; Moysey, Kevin

    2013-01-01

    Data governance is characterised from broader definitions of governance. These characteristics are then mapped to a framework that provides a practical representation of the concepts. This representation is further developed with operating models and roles. Several information related scenarios covering both clinical and non-clinical domains are considered in information terms and then related back to the data governance framework. This assists the reader in understanding how data governance would help address the issues or achieve a better outcome. These elements together enable the reader to gain an understanding of the data governance framework and how it applies in practice. Finally, some practical advice is offered for establishing and operating data governance as well as approaches for justifying the investment.

  15. Bullying by Definition: An Examination of Definitional Components of Bullying

    Science.gov (United States)

    Goldsmid, Susan; Howie, Pauline

    2014-01-01

    Lack of definitional consensus remains an important unresolved issue within bullying research. This study examined the ability of definitional variables to predict overall level of victimisation (distress, power inequity, and provocation as predictors) and bullying (intention to harm, power inequity, and provocation as predictors) in 246…

  16. Healthcare service quality: towards a broad definition.

    Science.gov (United States)

    Mosadeghrad, Ali Mohammad

    2013-01-01

    The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

  17. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Science.gov (United States)

    2010-10-01

    ..., widespread fires, discharge of toxic gases, widespread power failures, industrial explosions, civil disorders... of programming providing emergency information. (a) Definitions. (1) For purposes of this section, the definitions in §§ 79.1 and 79.3 apply. (2) Emergency information. Information, about a current...

  18. The Environmental Management Project Manager's Handbook for improved project definition

    International Nuclear Information System (INIS)

    1995-02-01

    The United States Department of Energy (DOE) is committed to providing high quality products that satisfy customer needs and are the associated with this goal, DOE personnel must possess the knowledge, skills, and abilities to ensure successful job performance. In addition, there must be recognition that the greatest obstacle to proper project performance is inadequate project definition. Without strong project definition, DOE environmental management efforts are vulnerable to fragmented solutions, duplication of effort, and wastes resources. The primary means of ensuring environmental management projects meet cost and schedule milestones is through a structured and graded approach to project definition, which is the focus of this handbook

  19. Definition af primitiver

    DEFF Research Database (Denmark)

    Christensen, Morten

    1997-01-01

    Når et elektrisk system skal opstilles på arrayform, er det vigtig først at lave en række fornuftige modeller for de primitiver, der indgår i netværket. Disse modeller skal muligvis revideres, når man begynder at sammensætte dem til et netværk, men laver man opstillingen grundigt på et tidligt...... tidspunkt, kan der spares meget tid senere, hvor det er besværligt at definerer primitiverne helt om.I denne rapport er de primitiver, der skal bruges til Sydkrafts net gennemgået. Der er taget stilling til hver enkelt tilstand for de forskellige primitiver. Dette er gjort for at få en definition, som er...

  20. Viruses, definitions and reality

    Directory of Open Access Journals (Sweden)

    Libia Herrero-Uribe

    2011-09-01

    Full Text Available Viruses are known to be abundant, ubiquitous, and to play a very important role in the health and evolution of life organisms. However, most biologists have considered them as entities separate from the realm of life and acting merely as mechanical artifacts that can exchange genes between different organisms. This article reviews some definitions of life organisms to determine if viruses adjust to them, and additionally, considers new discoveries to challenge the present definition of viruses. Definitions of life organisms have been revised in order to validate how viruses fit into them. Viral factories are discussed since these mini-organelles are a good example of the complexity of viral infection, not as a mechanical usurpation of cell structures, but as a driving force leading to the reorganization and modification of cell structures by viral and cell enzymes. New discoveries such as the Mimivirus, its virophage and viruses that produce filamentous tails when outside of their host cell, have stimulated the scientific community to analyze the current definition of viruses. One way to be free for innovation is to learn from life, without rigid mental structures or tied to the past, in order to understand in an integrated view the new discoveries that will be unfolded in future research. Life processes must be looked from the complexity and trans-disciplinarity perspective that includes and accepts the temporality of the active processes of life organisms, their interdependency and interrelation among them and their environment. New insights must be found to redefine life organisms, especially viruses, which still are defined using the same concepts and knowledge of the fifties. Rev. Biol. Trop. 59 (3: 993-998. Epub 2011 September 01.Los virus son abundantes, ubicuos, y juegan un papel muy importante en la salud y en la evolución de los organismos vivos. Sin embargo, la mayoría de los biólogos los siguen considerado como entidades separadas

  1. Consciousness: function and definition.

    Science.gov (United States)

    Niedermeyer, E

    1994-07-01

    The term "consciousness" plays an enormous role in the clinical assessment of patients and also in psychophysiological considerations. It has often been said that consciousness is a term that defies definition. This lack of definability, however, might be more apparent than real. In the multitude of facets, three main components can be singled out: a) vigilance, b) mental contents and c) selective attention. Vigilance, not to be equated with consciousness, is most amenable to electrophysiological studies. The stages of sleep have fairly well standardized EEG correlates, unlike the comatose states. The overflowing wealth of mental contents is constantly adjusted to momentary needs by the mechanism of selective attention. Awareness is a subcomponent and differs from both vigilance and consciousness. Emotionality is particularly important among the variety of further subcomponents. The time factor must be taken into account in order to understand the dynamics and fluctuations of consciousness.

  2. Two definitions for genders

    Science.gov (United States)

    Shin, Philip

    2011-10-01

    By my definition, man and woman are the same fact to say. So man and woman have the same thinkings and same existence. But when I say again for man and woman, they are different for sex as the two different persons. They are different each two persons. As an example, by quantum, sex and color is different (the same existence and also different kind with quantum way-push and pull at the same time), also they are the same as they are our ID (hormones) and also dream matter. The same way, I hope we go to heaven and god will say you are the truth like it to be after the end of the world. I wish man and woman are different as it is more fun.

  3. Definition of containment failure

    International Nuclear Information System (INIS)

    Cybulskis, P.

    1982-01-01

    Core meltdown accidents of the types considered in probabilistic risk assessments (PRA's) have been predicted to lead to pressures that will challenge the integrity of containment structures. Review of a number of PRA's indicates considerable variation in the predicted probability of containment failure as a function of pressure. Since the results of PRA's are sensitive to the prediction of the occurrence and the timing of containment failure, better understanding of realistic containment capabilities and a more consistent approach to the definition of containment failure pressures are required. Additionally, since the size and location of the failure can also significantly influence the prediction of reactor accident risk, further understanding of likely failure modes is required. The thresholds and modes of containment failure may not be independent

  4. Examination of the roles and capacities of duty bearers responsible for protecting the human rights to adequate food, nutritional health and wellbeing in Ugandan children's homes.

    Science.gov (United States)

    Olafsen, Monica; Rukooko, Archangel Byaruhanga; Iversen, Per Ole; Andreassen, Bård A

    2018-04-17

    The majority of Ugandan children face vulnerability and malnutrition. As a State Party to international human rights treaties, Uganda has legal obligations of guaranteeing the fundamental rights and the best interest of the nation's children. Despite being protected under international and national law, Uganda is not providing adequate child protection, including safeguarding children's food security. Numerous privately owned and unregulated children's homes face this problem. The overall aim of the study was to examine to what extent children's homes' operations are consistent with the right to adequate food, nutritional health and wellbeing of children. We performed a qualitative role- and capacity analysis of duty bearers with human rights duties towards children living in children's homes. We studied three groups of duty bearers: caretakers working in private children's homes, State actors working in government and its institutions, and non-State actors working in civil society organizations. A human rights based approach guided all aspects of the study. An analysis of the roles, performance and capacities of duty bearers was employed, with individual face-to-face structured qualitative in-depth interviews, self-administered structured questionnaires, and a structured observational study, as well as a desk review of relevant literature. The State of Uganda's efforts to respect and realize its obligations towards children living in children's homes is inadequate. There are numerous capacity gaps among the duty bearers, and the concepts of human rights and the best interest of the child are not well understood among the duty bearers. The efforts of the State of Uganda to realize its human rights obligations towards children in children's homes are lacking in important areas. Hence the State does not fulfill its minimum obligations under the International Covenant on Economic, Social and Cultural Rights to ensure all children freedom from hunger. There is a need

  5. 16 CFR 316.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... or general partnership, corporation, or other business entity. (i) The definition of the term... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Definitions. 316.2 Section 316.2 Commercial... Definitions. (a) The definition of the term “affirmative consent” is the same as the definition of that term...

  6. The Rhode Island Life Saving Score (RILSS)--a proposed life-saving definition for EMS and emergency medicine.

    Science.gov (United States)

    Williams, Kenneth A; Sullivan, Francis M

    2013-12-03

    Emergency Medical Services (EMS) and Emergency Medicine staff are often described as life-saving providers, but there is no generally accepted objective definition of a life saved by these providers. Therefore, a proposed definition is described. Development of this definition began with conceptual rules, followed by a survey of physician EMS medical directors, and then by the development of a tool to implement the definition, and measure its validity and reliability through a review of 100 critical care transport EMS patient charts.

  7. Knowledge, attitudes, and practice of travelers' diarrhea management among frontline providers.

    Science.gov (United States)

    Hayat, Aatif M; Tribble, David R; Sanders, John W; Faix, Dennis J; Shiau, Danny; Armstrong, Adam W; Riddle, Mark S

    2011-01-01

    Many studies have found acute gastrointestinal infections to be among the most likely reason for clinic visits among forward deployed soldiers and are considered a significant contributor to morbidity in this population. This occurs despite the controlled food and water distribution systems under which military populations operate. Furthermore, recent studies have indicated that providers often fail to appropriately identify and treat the typical causes of these infections. To adequately address this issue, an assessment of gaps in knowledge, practice, and management of acute diarrhea in deployed troops was conducted. A multiple-choice survey was developed by clinical researchers with expertise in travelers' diarrhea (TD) and provided to a convenience sample of clinical providers with a broad range of training and operational experience. The survey evaluated provider's knowledge of TD along with their ability to identify etiologies of various syndromic categories of acute gastrointestinal infections. Providers were also queried on selection of treatment approaches to a variety of clinical-based scenarios. A total of 117 respondents completed the survey. Most were aware of the standard definition of TD (77%); however, their knowledge about the epidemiology was lower, with less than 24% correctly answering questions on etiology of diarrhea, and 31% believing that a viral pathogen was the primary cause of watery diarrhea during deployment. Evaluation of scenario-based responses showed that 64% of providers chose not to use antibiotics to treat moderate TD. Furthermore, 19% of providers felt that severe inflammatory diarrhea was best treated with hydration only while 25% felt hydration was the therapy of choice for dysentery. Across all provider types, three practitioner characteristics appeared to be related to better scores on responses to the nine management scenarios: having a Doctor of Medicine or Doctor of Osteopathy degree, greater knowledge of TD epidemiology

  8. Automating generation of textual class definitions from OWL to English.

    Science.gov (United States)

    Stevens, Robert; Malone, James; Williams, Sandra; Power, Richard; Third, Allan

    2011-05-17

    Text definitions for entities within bio-ontologies are a cornerstone of the effort to gain a consensus in understanding and usage of those ontologies. Writing these definitions is, however, a considerable effort and there is often a lag between specification of the main part of an ontology (logical descriptions and definitions of entities) and the development of the text-based definitions. The goal of natural language generation (NLG) from ontologies is to take the logical description of entities and generate fluent natural language. The application described here uses NLG to automatically provide text-based definitions from an ontology that has logical descriptions of its entities, so avoiding the bottleneck of authoring these definitions by hand. To produce the descriptions, the program collects all the axioms relating to a given entity, groups them according to common structure, realises each group through an English sentence, and assembles the resulting sentences into a paragraph, to form as 'coherent' a text as possible without human intervention. Sentence generation is accomplished using a generic grammar based on logical patterns in OWL, together with a lexicon for realising atomic entities. We have tested our output for the Experimental Factor Ontology (EFO) using a simple survey strategy to explore the fluency of the generated text and how well it conveys the underlying axiomatisation. Two rounds of survey and improvement show that overall the generated English definitions are found to convey the intended meaning of the axiomatisation in a satisfactory manner. The surveys also suggested that one form of generated English will not be universally liked; that intrusion of too much 'formal ontology' was not liked; and that too much explicit exposure of OWL semantics was also not liked. Our prototype tools can generate reasonable paragraphs of English text that can act as definitions. The definitions were found acceptable by our survey and, as a result, the

  9. Quasicrystals: A matter of definition

    OpenAIRE

    Lifshitz, Ron

    2003-01-01

    It is argued that the prevailing definition of quasicrystals, requiring them to contain an axis of symmetry that is forbidden in periodic crystals, is inadequate. This definition is too restrictive in that it excludes an important and interesting collection of structures that exhibit all the well-known properties of quasicrystals without possessing any forbidden symmetries.

  10. Nuclear engineering terms and definitions

    International Nuclear Information System (INIS)

    1981-01-01

    The most important nuclear engineering's terms and definitions are given in this standard. The definitions take into account the Austrian Regulations for Radiation Protection, for and pertinent ISO and DIN-Standards as also the OENORM A7006 and OENORM A6601. (M.T.)

  11. On the definition of 'chaos'

    International Nuclear Information System (INIS)

    Kolesov, Andrei Yu; Rozov, Nikolai Kh

    2009-01-01

    A new definition of a chaotic invariant set is given for a continuous semiflow in a metric space. It generalizes the well-known definition due to Devaney and allows one to take into account a special feature occurring in the non-compact infinite-dimensional case: so-called turbulent chaos. The paper consists of two sections. The first contains several well-known facts from chaotic dynamics, together with new definitions and results. The second presents a concrete example demonstrating that our definition of chaos is meaningful. Namely, an infinite-dimensional system of ordinary differential equations is investigated having an attractor that is chaotic in the sense of the new definition but not in the sense of Devaney or Knudsen. Bibliography: 65 titles.

  12. Automatic and manual segmentation of healthy retinas using high-definition optical coherence tomography.

    Science.gov (United States)

    Golbaz, Isabelle; Ahlers, Christian; Goesseringer, Nina; Stock, Geraldine; Geitzenauer, Wolfgang; Prünte, Christian; Schmidt-Erfurth, Ursula Margarethe

    2011-03-01

    This study compared automatic- and manual segmentation modalities in the retina of healthy eyes using high-definition optical coherence tomography (HD-OCT). Twenty retinas in 20 healthy individuals were examined using an HD-OCT system (Carl Zeiss Meditec, Inc.). Three-dimensional imaging was performed with an axial resolution of 6 μm at a maximum scanning speed of 25,000 A-scans/second. Volumes of 6 × 6 × 2 mm were scanned. Scans were analysed using a matlab-based algorithm and a manual segmentation software system (3D-Doctor). The volume values calculated by the two methods were compared. Statistical analysis revealed a high correlation between automatic and manual modes of segmentation. The automatic mode of measuring retinal volume and the corresponding three-dimensional images provided similar results to the manual segmentation procedure. Both methods were able to visualize retinal and subretinal features accurately. This study compared two methods of assessing retinal volume using HD-OCT scans in healthy retinas. Both methods were able to provide realistic volumetric data when applied to raster scan sets. Manual segmentation methods represent an adequate tool with which to control automated processes and to identify clinically relevant structures, whereas automatic procedures will be needed to obtain data in larger patient populations. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

  13. Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Ratna B Basak

    2011-01-01

    Full Text Available A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.

  14. Double Shell Tank (DST) Process Waste Sampling Subsystem Definition Report

    International Nuclear Information System (INIS)

    RASMUSSEN, J.H.

    2000-01-01

    This report defines the Double-Shell Tank (DST) Process Waste Sampling Subsystem (PWSS). This subsystem definition report fully describes and identifies the system boundaries of the PWSS. This definition provides a basis for developing functional, performance, and test requirements (i.e., subsystem specification), as necessary, for the PWSS. The resultant PWSS specification will include the sampling requirements to support the transfer of waste from the DSTs to the Privatization Contractor during Phase 1 of Waste Feed Delivery

  15. Definition of aggressive periodontitis in periodontal research. A systematic review

    DEFF Research Database (Denmark)

    Ramírez, Valeria; Hach, Maria; López, Rodrigo

    2018-01-01

    . Consequently, considerable variation in the understanding of aggressive periodontitis can be anticipated. AIM: To systematically asses, the definitions of aggressive periodontitis reported in original periodontal research. METHODS: A systematic review of original research on aggressive periodontitis published.......7% of the publications no information is provided as to how the cases were defined. Many combinations of criteria for case definition were found. CONCLUSIONS: This study revealed significant heterogeneity in the understanding and use of the term aggressive periodontitis in original research and poor documentation...

  16. En face view of the mitral valve: definition and acquisition.

    Science.gov (United States)

    Mahmood, Feroze; Warraich, Haider Javed; Shahul, Sajid; Qazi, Aisha; Swaminathan, Madhav; Mackensen, G Burkhard; Panzica, Peter; Maslow, Andrew

    2012-10-01

    A 3-dimensional echocardiographic view of the mitral valve, called the "en face" or "surgical view," presents a view of the mitral valve similar to that seen by the surgeon from a left atrial perspective. Although the anatomical landmarks of this view are well defined, no comprehensive echocardiographic definition has been presented. After reviewing the literature, we provide a definition of the left atrial and left ventricular en face views of the mitral valve. Techniques used to acquire this view are also discussed.

  17. The Definitive Guide to CentOS

    CERN Document Server

    Membrey, P; Angenendt, R

    2009-01-01

    CentOS is just like Red Hat, but without the price tag and with the virtuous license. When belts have to be tightened, we want to read about an OS with all the features of a commercial Linux variety, but without the pain. The Definitive Guide to CentOS is the first definitive reference for CentOS and focuses on CentOS alone, the workhorse Linux distro, that does the heavy lifting in small and medium-size enterprises without drawing too much attention to itself. *Provides tutorial and hands-on learning but is also designed to be used as a reference*Bases all examples on real-world tasks that re

  18. Definition of tolerable soil erosion values

    Directory of Open Access Journals (Sweden)

    G. Sparovek

    1997-09-01

    Full Text Available Although the criteria for defining erosion tolerance are well established, the limits generally used are not consistent with natural, economical and technological conditions. Rates greater than soil formation can be accepted only until a minimum of soil depth is reached, provided that they are not associated with environmental hazard or productivity losses. A sequence of equations is presented to calculate erosion tolerance rates through time. The selection of equation parameters permits the definition of erosion tolerance rates in agreement with environmental, social and technical needs. The soil depth change that is related to irreversible soil degradation can be calculated. The definition of soil erosion tolerance according to these equations can be used as a guideline for sustainable land use planning and is compatible with expert systems.

  19. Formal Definition of Measures for BPMN Models

    Science.gov (United States)

    Reynoso, Luis; Rolón, Elvira; Genero, Marcela; García, Félix; Ruiz, Francisco; Piattini, Mario

    Business process models are currently attaining more relevance, and more attention is therefore being paid to their quality. This situation led us to define a set of measures for the understandability of BPMN models, which is shown in a previous work. We focus on understandability since a model must be well understood before any changes are made to it. These measures were originally informally defined in natural language. As is well known, natural language is ambiguous and may lead to misunderstandings and a misinterpretation of the concepts captured by a measure and the way in which the measure value is obtained. This has motivated us to provide the formal definition of the proposed measures using OCL (Object Constraint Language) upon the BPMN (Business Process Modeling Notation) metamodel presented in this paper. The main advantages and lessons learned (which were obtained both from the current work and from previous works carried out in relation to the formal definition of other measures) are also summarized.

  20. Donor's understanding of the definition of sex as applied to predonation screening questions.

    Science.gov (United States)

    O'Brien, S F; Ram, S S; Yi, Q-L; Goldman, M

    2008-05-01

    Predonation screening questions about sexual risk factors should provide an extra layer of safety from recently acquired infections that may be too early to be detected by testing. Donors are required to read a definition of sex as it applies to predonation screening questions each time they come to donate, but how well donors apply such definitions has not been evaluated. We aimed to determine how donors define sex when answering screening questions. In total, 1297 whole blood donors were asked in a private interview to select from a list of sexual activities which ones they believed were being asked about in sexual background questions. Donors' definitions were coded as under-inclusive, correct or over-inclusive in relation to the blood services' definition. Qualitative interviews were carried out with 21 donors to understand reasoning behind definitions. Most donors had an over-inclusive definition (58.7%) or the correct definition (31.9%). Of the 9.4% of donors who had an under-inclusive definition, 95% included both vaginal and anal sex, but not oral sex. About 9% in each group were first-time donors (P > 0.05) who had never read the definition. The qualitative interviews indicated that donors reason their definition based on their own concept of transmissible disease risk. Donors apply a range of definitions of sex when answering questions about their sexual background. This may be due to different concepts of risk activities, and required reading of the definition has little impact.

  1. What Is Real-World Data? A Review of Definitions Based on Literature and Stakeholder Interviews.

    Science.gov (United States)

    Makady, Amr; de Boer, Anthonius; Hillege, Hans; Klungel, Olaf; Goettsch, Wim

    Despite increasing recognition of the value of real-world data (RWD), consensus on the definition of RWD is lacking. To review definitions publicly available for RWD to shed light on similarities and differences between them. A literature review and stakeholder interviews were used to compile data from eight groups of stakeholders. Data from documents and interviews were subjected to coding analysis. Definitions identified were classified into four categories: 1) data collected in a non-randomized controlled trial setting, 2) data collected in a non-interventional/non-controlled setting, 3) data collected in a non-experimental setting, and 4) others (i.e., data that do not fit into the other three categories). The frequency of definitions identified per category was recorded. Fifty-three documents and 20 interviews were assessed. Thirty-eight definitions were identified: 20 out of 38 definitions (53%) were category 1 definitions, 9 (24%) were category 2 definitions, 5 (13%) were category 3 definitions, and 4 (11%) were category 4 definitions. Differences were identified between, and within, definition categories. For example, opinions differed on the aspects of intervention with which non-interventional/non-controlled settings should abide. No definitions were provided in two interviews or identified in 33 documents. Most of the definitions defined RWD as data collected in a non-randomized controlled trial setting. A considerable number of definitions, however, diverged from this concept. Moreover, a significant number of authors and stakeholders did not have an official, institutional definition for RWD. Persisting variability in stakeholder definitions of RWD may lead to disparities among different stakeholders when discussing RWD use in decision making. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  2. Consensus Based Definition of Growth Restriction in the Newborn.

    Science.gov (United States)

    Beune, Irene M; Bloomfield, Frank H; Ganzevoort, Wessel; Embleton, Nicholas D; Rozance, Paul J; van Wassenaer-Leemhuis, Aleid G; Wynia, Klaske; Gordijn, Sanne J

    2018-05-01

    To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight definition for growth restriction in the newborn. This definition recognizes that infants with birth weights 10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Tacit definitions of informal caregiving.

    Science.gov (United States)

    Wrubel, J; Richards, T A; Folkman, S; Acree, M C

    2001-01-01

    This study describes three tacit definitions of informal caregiving and explores the extent to which differences in these tacit definitions explain variation in caregivers' negative mood over time. There is a growing need to understand the sources of stress and gratification for informal caregivers. Tacit definitions of informal caregiving refer to caregivers' understanding of what caregiving entails. These definitions are tacit because they arise from caregivers' taken-for-granted understanding rather than formally articulated positions concerning caregiving. A random sample of 60 men, all of whom were caregiving partners of men with acquired immunodeficiency syndrome (AIDS), was drawn from a larger cohort of 253 participants in the University of California San Francisco (UCSF) Coping Project (1990-1997). The caregivers were assessed bimonthly for 2 years with procedures that included a semi-structured interview focusing on a recent stressful event involving caregiving, and quantitative measures of well-being. Interpretive phenomenological case studies of the narrative accounts of the 60 caregivers produced three tacit definitions of caregiving - engagement, conflict and distance. These three tacit definitions were distinguished by differences in learning about caregiving, involvement in health care decisions, caregiving activities and reported sources of stress. The three groups differed on measures of dyadic adjustment, depression, anger and anxiety. Better understanding of caregivers' tacit definitions can facilitate and enhance effective support and interventions for caregivers.

  4. European Mixed Forests: definition and research perspectives

    Directory of Open Access Journals (Sweden)

    Andres Bravo-Oviedo

    2014-12-01

    Full Text Available Aim of study: We aim at (i developing a reference definition of mixed forests in order to harmonize comparative research in mixed forests and (ii review the research perspectives in mixed forests.Area of study: The definition is developed in Europe but can be tested worldwide.Material and Methods: Review of existent definitions of mixed forests based and literature review encompassing dynamics, management and economic valuation of mixed forests.Main results: A mixed forest is defined as a forest unit, excluding linear formations, where at least two tree species coexist at any developmental stage, sharing common resources (light, water, and/or soil nutrients. The presence of each of the component species is normally quantified as a proportion of the number of stems or of basal area, although volume, biomass or canopy cover as well as proportions by occupied stand area may be used for specific objectives. A variety of structures and patterns of mixtures can occur, and the interactions between the component species and their relative proportions may change over time.The research perspectives identified are (i species interactions and responses to hazards, (ii the concept of maximum density in mixed forests, (iii conversion of monocultures to mixed-species forest and (iv economic valuation of ecosystem services provided by mixed forests.Research highlights: The definition is considered a high-level one which encompasses previous attempts to define mixed forests. Current fields of research indicate that gradient studies, experimental design approaches, and model simulations are key topics providing new research opportunities.Keywords: COST Action; EuMIXFOR; mixed-species forests; admixtures of species.

  5. "Profession": a working definition for medical educators.

    Science.gov (United States)

    Cruess, Sylvia R; Johnston, Sharon; Cruess, Richard L

    2004-01-01

    To provide a working definition of professionalism for medical educators. Thus far, the literature has not provided a concise and inclusive definition of the word profession. There appears to be a need for one as a basis for teaching the cognitive aspects of the subject and for evaluating behaviors characteristic of professionals. Furthermore, a knowledge of the meaning of the word is important as it serves as the basis of the contract between medicine and society, and hence, of the obligations required of medicine to sustain the contract. A definition is proposed based on the Oxford English Dictionary and the literature on the subject. It is suggested that this can be useful to medical educators with responsibilities for teaching about the professions, professional responsibilities, and professional behavior. The proposed definition is as follows: Profession: An occupation whose core element is work based upon the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning or the practice of an art founded upon it is used in the service of others. Its members are governed by codes of ethics and profess a commitment to competence, integrity and morality, altruism, and the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in return grants the profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice and the privilege of self-regulation. Professions and their members are accountable to those served and to society.

  6. Historical centres: changing definitions

    Directory of Open Access Journals (Sweden)

    Roberta Lazzarotti

    2014-02-01

    Full Text Available Since the end of the Second World War, the architectural and planning culture has been showing a fluctuating attention to the theme of historical centres and their enhancement. First of all this uneven progress explains the difficulty to reach a homogeneous definition and this is still lacking. During a long phase of this period, the historical parts of the town were considered as objects to be preserved in an integral way, as urban monuments. This is mostly due to the high symbolic value of these settlements, that represent fundamental landmarks. Identity building and empowerment of local communities are indispensable conditions for any development programme, especially in the case of centres or other historic environments at risk of abandonment. The progressive evolution of this concept brings awareness of the impossibility of separating – either in analytical or in planning terms ­ historical centres from their urban and territorial contexts, which are linked by mutual, deep relationships. This article attempts to retrace the steps signaled by the publication of international documents and conventions, from the Charter of Gubbio (1960 to the Charter of Krakow and the European Landscape Convention (2000; they obviously represent particular points of view, not exhaustive of the richness of the positions in the debate, but extremely significant in terms of diffusion and consensus.

  7. Towards a definition of life.

    Science.gov (United States)

    Macklem, Peter T; Seely, Andrew

    2010-01-01

    This article offers a new definition of life as a "self-contained, self-regulating, self-organizing, self-reproducing, interconnected, open thermodynamic network of component parts which performs work, existing in a complex regime which combines stability and adaptability in the phase transition between order and chaos, as a plant, animal, fungus, or microbe." Open thermodynamic networks, which create and maintain order and are used by all organisms to perform work, import energy from and export entropy into the environment. Intra- and extracellular interconnected networks also confer order. Although life obeys the laws of physics and chemistry, the design of living organisms is not determined by these laws, but by Darwinian selection of the fittest designs. Over a short range of normalized energy consumption, open thermodynamic systems change from deeply ordered to chaotic, and life is found in this phase transition, where a dynamic balance between stability and adaptability allows for homeokinesis. Organisms and cells move within the phase transition with changes in metabolic rate. Seeds, spores and cryo-preserved tissue are well within the ordered regime, while health probably cannot be maintained with displacements into the chaotic regime. Understanding life in these terms may provide new insights into what constitutes health and lead to new theories of disease.

  8. Preferred Provider Organization (PPO) Plans

    Science.gov (United States)

    ... Find & compare doctors, hospitals, & other providers Preferred Provider Organization (PPO) Plans How PPO Plans Work A Medicare ... extra for these benefits. Related Resources Health Maintenance Organization (HMO) Private Fee-for-Service (PFFS) Special Needs ...

  9. The two-layer geochemical structure of modern biogeochemical provinces and its significance for spatially adequate ecological evaluations and decisions

    Science.gov (United States)

    Korobova, Elena; Romanov, Sergey

    2014-05-01

    Contamination of the environment has reached such a scale that ecogeochemical situation in any area can be interpreted now as a result of the combined effect of natural and anthropogenic factors. The areas that appear uncomfortable for a long stay can have natural and anthropogenic genesis, but the spatial structure of such biogeochemical provinces is in any case formed of a combination of natural and technogenic fields of chemical elements. Features of structural organization and the difference in factors and specific time of their formation allow their separation on one hand and help in identification of areas with different ecological risks due to overlay of the two structures on the other. Geochemistry of soil cover reflects the long-term result of the naturally balanced biogeochemical cycles, therefore the soil geochemical maps of the undisturbed areas may serve the basis for evaluation of the natural geochemical background with due regard to the main factors of geochemical differentiation in biosphere. Purposeful and incidental technogenic concentrations and dispersions of chemical elements of specific (mainly mono- or polycentric) structure are also fixed in soils that serve as secondary sources of contamination of the vegetation cover and local food chains. Overlay of the two structures forms specific heterogeneity of modern biogeochemical provinces with different risk for particular groups of people, animals and plants adapted to specific natural geochemical background within particular concentration interval. The developed approach is believed to be helpful for biogeochemical regionalizing of modern biosphere (noosphere) and for spatially adequate ecogeochemical evaluation of the environment and landuse decisions. It allows production of a set of applied geochemical maps such as: 1) health risk due to chemical elements deficiency and technogenic contamination accounting of possible additive effects; 2) adequate soil fertilization and melioration with due

  10. Canada's Compassionate Care Benefit: is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

    Science.gov (United States)

    Williams, Allison M; Eby, Jeanette A; Crooks, Valorie A; Stajduhar, Kelli; Giesbrecht, Melissa; Vuksan, Mirjana; Cohen, S Robin; Brazil, Kevin; Allan, Diane

    2011-05-18

    An increasingly significant public health issue in Canada, and elsewhere throughout the developed world, pertains to the provision of adequate palliative/end-of-life (P/EOL) care. Informal caregivers who take on the responsibility of providing P/EOL care often experience negative physical, mental, emotional, social and economic consequences. In this article, we specifically examine how Canada's Compassionate Care Benefit (CCB)--a contributory benefits social program aimed at informal P/EOL caregivers--operates as a public health response in sustaining informal caregivers providing P/EOL care, and whether or not it adequately addresses known aspects of caregiver burden that are addressed within the population health promotion (PHP) model. As part of a national evaluation of Canada's Compassionate Care Benefit, 57 telephone interviews were conducted with Canadian informal P/EOL caregivers in 5 different provinces, pertaining to the strengths and weaknesses of the CCB and the general caregiving experience. Interview data was coded with Nvivo software and emerging themes were identified by the research team, with such findings published elsewhere. The purpose of the present analysis was identified after comparing the findings to the literature specific to caregiver burden and public health, after which data was analyzed using the PHP model as a guiding framework. Informal caregivers spoke to several of the determinants of health outlined in the PHP model that are implicated in their burden experience: gender, income and social status, working conditions, health and social services, social support network, and personal health practises and coping strategies. They recognized the need for improving the CCB to better address these determinants. This study, from the perspective of family caregivers, demonstrates that the CCB is not living up to its full potential in sustaining informal P/EOL caregivers. Effort is required to transform the CCB so that it may fulfill the

  11. Would it provide Free Education?

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Would it provide Free Education? Would it provide Free Education? Would it provide Compulsory Education? Would it guarantee education of equitable quality? Would it prevent discrimination? Would it stop schools that promote inequality & discrimination? NO! NO!

  12. Involving regional expertise in nationwide modeling for adequate prediction of climate change effects on different demands for fresh water

    Science.gov (United States)

    de Lange, W. J.

    2014-05-01

    Wim J. de Lange, Geert F. Prinsen, Jacco H. Hoogewoud, Ab A Veldhuizen, Joachim Hunink, Erik F.W. Ruijgh, Timo Kroon Nationwide modeling aims to produce a balanced distribution of climate change effects (e.g. harm on crops) and possible compensation (e.g. volume fresh water) based on consistent calculation. The present work is based on the Netherlands Hydrological Instrument (NHI, www.nhi.nu), which is a national, integrated, hydrological model that simulates distribution, flow and storage of all water in the surface water and groundwater systems. The instrument is developed to assess the impact on water use on land-surface (sprinkling crops, drinking water) and in surface water (navigation, cooling). The regional expertise involved in the development of NHI come from all parties involved in the use, production and management of water, such as waterboards, drinking water supply companies, provinces, ngo's, and so on. Adequate prediction implies that the model computes changes in the order of magnitude that is relevant to the effects. In scenarios related to drought, adequate prediction applies to the water demand and the hydrological effects during average, dry, very dry and extremely dry periods. The NHI acts as a part of the so-called Deltamodel (www.deltamodel.nl), which aims to predict effects and compensating measures of climate change both on safety against flooding and on water shortage during drought. To assess the effects, a limited number of well-defined scenarios is used within the Deltamodel. The effects on demand of fresh water consist of an increase of the demand e.g. for surface water level control to prevent dike burst, for flushing salt in ditches, for sprinkling of crops, for preserving wet nature and so on. Many of the effects are dealt with by regional and local parties. Therefore, these parties have large interest in the outcome of the scenario analyses. They are participating in the assessment of the NHI previous to the start of the analyses

  13. Healthcare Costs Associated with an Adequate Intake of Sugars, Salt and Saturated Fat in Germany: A Health Econometrical Analysis.

    Directory of Open Access Journals (Sweden)

    Toni Meier

    Full Text Available Non-communicable diseases (NCDs represent not only the major driver for quality-restricted and lost life years; NCDs and their related medical treatment costs also pose a substantial economic burden on healthcare and intra-generational tax distribution systems. The main objective of this study was therefore to quantify the economic burden of unbalanced nutrition in Germany--in particular the effects of an excessive consumption of fat, salt and sugar--and to examine different reduction scenarios on this basis. In this study, the avoidable direct cost savings in the German healthcare system attributable to an adequate intake of saturated fatty acids (SFA, salt and sugar (mono- & disaccharides, MDS were calculated. To this end, disease-specific healthcare cost data from the official Federal Health Monitoring for the years 2002-2008 and disease-related risk factors, obtained by thoroughly searching the literature, were used. A total of 22 clinical endpoints with 48 risk-outcome pairs were considered. Direct healthcare costs attributable to an unbalanced intake of fat, salt and sugar are calculated to be 16.8 billion EUR (CI95%: 6.3-24.1 billion EUR in the year 2008, which represents 7% (CI95% 2%-10% of the total treatment costs in Germany (254 billion EUR. This is equal to 205 EUR per person annually. The excessive consumption of sugar poses the highest burden, at 8.6 billion EUR (CI95%: 3.0-12.1; salt ranks 2nd at 5.3 billion EUR (CI95%: 3.2-7.3 and saturated fat ranks 3rd at 2.9 billion EUR (CI95%: 32 million-4.7 billion. Predicted direct healthcare cost savings by means of a balanced intake of sugars, salt and saturated fat are substantial. However, as this study solely considered direct medical treatment costs regarding an adequate consumption of fat, salt and sugars, the actual societal and economic gains, resulting both from direct and indirect cost savings, may easily exceed 16.8 billion EUR.

  14. Healthcare Costs Associated with an Adequate Intake of Sugars, Salt and Saturated Fat in Germany: A Health Econometrical Analysis.

    Science.gov (United States)

    Meier, Toni; Senftleben, Karolin; Deumelandt, Peter; Christen, Olaf; Riedel, Katja; Langer, Martin

    2015-01-01

    Non-communicable diseases (NCDs) represent not only the major driver for quality-restricted and lost life years; NCDs and their related medical treatment costs also pose a substantial economic burden on healthcare and intra-generational tax distribution systems. The main objective of this study was therefore to quantify the economic burden of unbalanced nutrition in Germany--in particular the effects of an excessive consumption of fat, salt and sugar--and to examine different reduction scenarios on this basis. In this study, the avoidable direct cost savings in the German healthcare system attributable to an adequate intake of saturated fatty acids (SFA), salt and sugar (mono- & disaccharides, MDS) were calculated. To this end, disease-specific healthcare cost data from the official Federal Health Monitoring for the years 2002-2008 and disease-related risk factors, obtained by thoroughly searching the literature, were used. A total of 22 clinical endpoints with 48 risk-outcome pairs were considered. Direct healthcare costs attributable to an unbalanced intake of fat, salt and sugar are calculated to be 16.8 billion EUR (CI95%: 6.3-24.1 billion EUR) in the year 2008, which represents 7% (CI95% 2%-10%) of the total treatment costs in Germany (254 billion EUR). This is equal to 205 EUR per person annually. The excessive consumption of sugar poses the highest burden, at 8.6 billion EUR (CI95%: 3.0-12.1); salt ranks 2nd at 5.3 billion EUR (CI95%: 3.2-7.3) and saturated fat ranks 3rd at 2.9 billion EUR (CI95%: 32 million-4.7 billion). Predicted direct healthcare cost savings by means of a balanced intake of sugars, salt and saturated fat are substantial. However, as this study solely considered direct medical treatment costs regarding an adequate consumption of fat, salt and sugars, the actual societal and economic gains, resulting both from direct and indirect cost savings, may easily exceed 16.8 billion EUR.

  15. Providing safe surgery for neonates in sub-Saharan Africa.

    Science.gov (United States)

    Ameh, Emmanuel A; Ameh, Nkeiruka

    2003-07-01

    Advances in neonatal intensive care, total parenteral nutrition and improvements in technology have led to a greatly improved outcome of neonatal surgery in developed countries. In many parts of sub-Saharan Africa, however, neonatal surgery continues to pose wide-ranging challenges. Delivery outside hospital, delayed referral, poor transportation, and lack of appropriate personnel and facilities continue to contribute to increased morbidity and mortality in neonates, particularly under emergency situations. Antenatal supervision and hospital delivery needs to be encouraged in our communities. Adequate attention needs to be paid to providing appropriate facilities for neonatal transport and support and training of appropriate staff for neonatal surgery. Neonates with surgical problems should be adequately resuscitated before referral where necessary but surgery should not be unduly delayed. Major neonatal surgery should as much as possible be performed by those trained to operate on neonates. Appropriate research and international collaboration is necessary to improve neonatal surgical care in the environment.

  16. Adequate trust avails, mistaken trust matters: on the moral responsibility of doctors as proxies for patients' trust in biobank research.

    Science.gov (United States)

    Johnsson, Linus; Helgesson, Gert; Hansson, Mats G; Eriksson, Stefan

    2013-11-01

    In Sweden, most patients are recruited into biobank research by non-researcher doctors. Patients' trust in doctors may therefore be important to their willingness to participate. We suggest a model of trust that makes sense of such transitions of trust between domains and distinguishes adequate trust from mistaken trust. The unique position of doctors implies, we argue, a Kantian imperfect duty to compensate for patients' mistaken trust. There are at least three kinds of mistaken trust, each of which requires a different set of countermeasures. First, trust is mistaken when necessary competence is lacking; the competence must be developed or the illusion dispelled. Second, trust is irrational whenever the patient is mistaken about his actual reasons for trusting. Care must therefore be taken to support the patient's reasoning and moral agency. Third, some patients inappropriately trust doctors to recommend only research that will benefit them directly. Such trust should be counteracted by nurturing a culture where patients expect to be asked occasionally to contribute to the common good. © 2012 John Wiley & Sons Ltd.

  17. Are breast biopsies adequately funded? A process cost and revenue analysis; Ist die Mammabiopsie ausreichend finanziert? Eine Prozesskosten und Erloesbetrachtung

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, M.; Fischbach, E.; Fehm, T. [Universitaetsklinikum Tuebingen (DE). Dept. of Obstetrics and Gynecology] (and others)

    2011-04-15

    Purpose: The objective of the study was to determine whether the various breast biopsy procedures specified in the S 3 guidelines are sensibly represented within the current German health system as considered from a cost evaluation perspective. Materials and Methods: This prospectively designed multicenter study analyzed 221 breast biopsies at 7 institutions from 04/2006 to 01/2007. Core needle biopsies, vacuum-assisted biopsies and surgical open biopsies under sonographic or mammographic guidance were evaluated. During an analysis of process costs, the individual process steps were recorded in diagrammatic form and assigned to the true consumption of resources. The actual resource consumption costs were entered. A process-related breakeven analysis was conducted to check whether the reimbursement of individual biopsy types covers the costs. Results: Only sonographically guided core needle biopsy and surgical open biopsy are adequately reimbursed in the current German health system. All other breast biopsies indicate a negative profit margin. The principal reasons for underfunding are found in the area of reimbursement of investment and non-personnel costs. Conclusion: The reimbursement of breast biopsies must be improved in order to guarantee nationwide care of the population using the breast biopsy methods recommended in the S 3 guidelines and to avoid disincentives with respect to breast biopsy indications. (orig.)

  18. Radiation protection. Terms and definitions

    Energy Technology Data Exchange (ETDEWEB)

    1981-04-01

    An alphabetical list in German is given of all terms and definitions important to radiation protection under consideration of all Austrian laws concerning this subject scope as also pertinent standards of ISO, DIN and OENORM.

  19. Definition and Facts for Constipation

    Science.gov (United States)

    ... Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Definition & Facts for Constipation What is constipation? Constipation is ... and Treatment. New York, NY: Springer Science and Business Media; 2014. May 2018 Share Previous: Constipation Next: ...

  20. Hotspots Definition Study

    International Nuclear Information System (INIS)

    De Pater, F.; Brinkman, S.; Schellekens, E.

    2010-03-01

    In the Dutch research programme Climate changes Spatial Planning (CcSP) many scientific projects are carried out. They often take a multidisciplinary approach to the climate issue. However, more attention needed to be given to embedding the programme into practice. Therefore, the board decided to start a hotspot programme. A hotspot was defined as a pilot project in a sector, place or region in which spatial planning and climate change play an important role in the physical shape and land use of the area and where conflicts of interest are found between these and other factors. The hotspot programme started with a definition study. This report is the result of this study. The goal of the study was to identify, describe and evaluate possible hotspots. In two workshops with policy-makers from national and regional governments, consultancy firms and nature conservation organizations, a large number of potential hotspots were identified. Fifteen were selected after the workshops took place and described in detail. The selection was done using a set of conditional criteria, criteria that all had to be met. Two potential hotspots were withdrawn after the selection. Since the Board of the CcSP programme expressed its interest in financing six to seven hotspots, a prioritization was made, using prioritizing criteria. Also the potential hotspots were assessed looking at regional distribution, thematic coverage and target groups. After this assessment and an analysis of the hotspots taking some other factors into account (eg. some hotspots were very similar or one could easily be incorporated in another one) five hotspots were selected: Kampen, Biesbosch-Haringvliet, Zuidplaspolder, Delta Waters and Tilburg. Options to fill the last two places were: Grounds for Change, Noordoostpolder, Oude Vaart Valley and Arnhem/Nijmegen (KAN). For these remaining potential hotspots draft terms of reference were drawn as basis for a project proposals. These terms of reference are added to

  1. CERN result provides definite answer to one of nature's most subtle secrets

    CERN Multimedia

    CERN Press Office. Geneva

    2001-01-01

    At a seminar at CERN on 10 May the NA48 collaboration announced its final result on one of nature's best-kept secrets : direct Charge Parity (CP)-violation. This subtle effect explains nature's preference for matter over antimatter.

  2. Providing Operational Definitions to Quality Constructs for E-Learning in Higher Education

    Science.gov (United States)

    Usoro, Abel; Abiagam, Bridget

    2009-01-01

    New developments in information and communication technologies (ICT) to support learning have brought about increasing interest by both academic and non-academic institutions in e-learning. These developments in ICT are principally multimedia and the Internet with its World Wide Web. Interest in ICT supported learning is also fuelled by the…

  3. On the quantitative definition of risk

    International Nuclear Information System (INIS)

    Kaplan, S.; Garrick, B.J.

    1985-01-01

    The purpose of this paper is to provide some suggestions and contributions toward a uniform conceptual/linguistic framework for quantifying and making precise the notion of risk. The concepts and definitions the authors present in this connection have shown themselves to be sturdy and serviceable in practical application to a wide variety of risk situations. They have demonstrated in the courtroom and elsewhere the ability to improve communication and greatly diminish the confusion and controversy that often swirls around public decision making involving risk. They hope therefore with this paper to widen the understanding and adoption of this framework, and to that end adopt a leisurely and tutorial place. In particular, they carefully draw a distinction between ''probability'' and ''frequency.'' Then, using this distinction, they return to the idea of risk, and give a ''second-level'' definition (of risk which generalizes the first-level definition) and is large enough and flexible enough to include at least all the aspects and subtleties of risk that have been encountered in the authors' experience

  4. Probiotics: definition, scope and mechanisms of action.

    Science.gov (United States)

    Reid, Gregor

    2016-02-01

    For a subject area of science, medicine and commerce to be so recently defined and investigated, few can compare to probiotics for the controversy they have incited. Barely a paper is published without the use of a different definition, or challenging the most used one, or proposing a different nuance of it. The situation has become even more surreal with the European Food and Safety Authority banning the word probiotic for use on labels. The reiteration of the FAO/WHO definition by the world's leading group of probiotic experts, should provide relative consistency in the near future, but what are the causes of these aberrations? This review will discuss the rationale for the definition, and the scope of the subject area and why alternatives emerge. While mechanisms of action are not widely proven, in vitro and some in vivo experiments support several. Ultimately, the goal of any field or product is to be understood by lay people and experts alike. Probiotics have come a long way in 100 years since Metchnikoff and 10 years since their globalization, but their evolution is far from over. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. On variational definition of quantum entropy

    International Nuclear Information System (INIS)

    Belavkin, Roman V.

    2015-01-01

    Entropy of distribution P can be defined in at least three different ways: 1) as the expectation of the Kullback-Leibler (KL) divergence of P from elementary δ-measures (in this case, it is interpreted as expected surprise); 2) as a negative KL-divergence of some reference measure ν from the probability measure P; 3) as the supremum of Shannon’s mutual information taken over all channels such that P is the output probability, in which case it is dual of some transportation problem. In classical (i.e. commutative) probability, all three definitions lead to the same quantity, providing only different interpretations of entropy. In non-commutative (i.e. quantum) probability, however, these definitions are not equivalent. In particular, the third definition, where the supremum is taken over all entanglements of two quantum systems with P being the output state, leads to the quantity that can be twice the von Neumann entropy. It was proposed originally by V. Belavkin and Ohya [1] and called the proper quantum entropy, because it allows one to define quantum conditional entropy that is always non-negative. Here we extend these ideas to define also quantum counterpart of proper cross-entropy and cross-information. We also show inequality for the values of classical and quantum information

  6. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care.

    Science.gov (United States)

    Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B

    2017-01-01

    A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of

  7. Life sciences payload definition and integration study, task C and D. Volume 2: Payload definition, integration, and planning studies

    Science.gov (United States)

    1973-01-01

    The Life Sciences Payload Definition and Integration Study was composed of four major tasks. Tasks A and B, the laboratory definition phase, were the subject of prior NASA study. The laboratory definition phase included the establishment of research functions, equipment definitions, and conceptual baseline laboratory designs. These baseline laboratories were designated as Maxi-Nom, Mini-30, and Mini-7. The outputs of Tasks A and B were used by the NASA Life Sciences Payload Integration Team to establish guidelines for Tasks C and D, the laboratory integration phase of the study. A brief review of Tasks A and B is presented provide background continuity. The tasks C and D effort is the subject of this report. The Task C effort stressed the integration of the NASA selected laboratory designs with the shuttle sortie module. The Task D effort updated and developed costs that could be used by NASA for preliminary program planning.

  8. Exploring definitions of financial abuse in elderly Korean immigrants: the contribution of traditional cultural values.

    Science.gov (United States)

    Lee, Hee Yun; Lee, Sang E; Eaton, Charissa K

    2012-10-01

    The purpose of this study is to explore the cultural definitions of financial abuse from the perspective of 124 elderly Korean immigrants and to examine the role of traditional cultural values in their definitions by using a mixed methods approach. The qualitative analysis generated four themes relevant to definition of financial abuse. A binary logistic regression indicated that those with stronger cultural adherence to traditional values had higher odds of providing culture-based definitions of financial abuse. Education is needed for health professionals, social service providers, and adult protective workers to increase their understanding of culture-specific experiences of financial abuse among ethnic minority elders.

  9. Efficacy of S-flurbiprofen plaster in knee osteoarthritis treatment: Results from a phase III, randomized, active-controlled, adequate, and well-controlled trial.

    Science.gov (United States)

    Yataba, Ikuko; Otsuka, Noboru; Matsushita, Isao; Matsumoto, Hideo; Hoshino, Yuichi

    2017-01-01

    S-flurbiprofen plaster (SFPP) is a novel non-steroidal anti-inflammatory drug (NSAID) patch, intended for topical treatment for musculoskeletal diseases. This trial was conducted to examine the effectiveness of SFPP using active comparator, flurbiprofen (FP) patch, on knee osteoarthritis (OA) symptoms. This was a phase III, multi-center, randomized, adequate, and well-controlled trial, both investigators and patients were blinded to the assigned treatment. Enrolled 633 knee OA patients were treated with either SFPP or FP patch for two weeks. The primary endpoint was improvement in knee pain on rising from the chair as assessed by visual analogue scale (rVAS). Safety was evaluated through adverse events (AEs). The change in rVAS was 40.9 mm in SFPP group and 30.6 mm in FP patch group (p < 0.001). The incidence of drug-related AEs at the application site was 9.5% (32 AEs, 29 mild and 3 moderate) in SFPP and 1.6% in FP patch (p < 0.001). Withdrawals due to AE were five in SFPP and one in FP patch. The superiority of SFPP in efficacy was demonstrated. Most of AEs were mild and few AEs led to treatment discontinuation. Therefore, SFPP provides an additional option for knee OA therapy.

  10. [Analysis of the mainstreaming of the perspective of the Human Right to Adequate Food in the institutional design of the National School Nutrition Program].

    Science.gov (United States)

    de Siqueira, Renata Lopes; Cotta, Rosângela Minardi Mitre; Ribeiro, Rita de Cássia Lanes; Sperandio, Naiara; Priore, Sílvia Eloíza

    2014-01-01

    Being a signatory to international agreements that recognize the Human Right to Adequate Food (HRAF) and having enshrined this right into its Constitution, the Brazilian state imposes a duty to provide, protect and promote the HRAF. For this it is necessary to incorporate the principles of the HRAF into the process of planning and executing the actions of Food and Nutrition Security (FNS). The objective was to analyze the process of mainstreaming of the HRAF in the new institutional design of the National School Nutrition Program (NSNP). This is in line with the principles laid down in General Comment No 12 of the Guide for Policy Analysis and Public Programs and nutritional Food Security under the Perspective of Human Rights and the Organic Law on Food and Nutrition Security (OLFNS). The results show that the new regulatory framework of the NSNP indicates a paradigm shift that is characterized by a gradual decline in the perception of NSNP as policy of a welfare nature. Concomitantly, there is an increase in the concept of the benefit of school food as a right, with the caveat that the construction of a new regulatory framework, although essential, is not sufficient for full implementation of the HRAF.

  11. Open of chat rooms for discussing geological disposal issues and review of adequate approaches for offering the information using the internet

    International Nuclear Information System (INIS)

    Takizawa, Masayuki; Ito, Toshikazu; Yabuta, Naohiro; Yoshizawa, Nobuaki; Tsunoda, Hirokazu

    2001-03-01

    JNC is doing publicity work to let the technical reliability for geological disposal of high-level radioactive waste (HLW) comprehended widely. But the information about geological disposal of HLW itself and its technology has not been spread and recognized. It has been required to offer the opportunity to discuss the geological disposal and its technology as our own issue. Recently the internet, which has such characteristics as two-way, instant and open communication means, has become used on business and for pleasure commonly. So the opportunity for discussing the topics related to geological disposal of HLW has been offered on the internet web site so-called 'Internet Forum' by JNC since fiscal year 1999. 'Internet Forum' or an assembly of chat rooms is being run on the web server which is not operated by JNC in order to provide the place where discussion on the issue can be done as fairly and objectively as possible. In this report, the results of Internet Forum in fiscal year 2000 comparing with that in fiscal year 1999 were shown and the adequate approaches of operating 'Internet Forum' and offering the information about geological disposal of HLW were reviewed. (author)

  12. CATEGORICAL TOOL OF INNOVATIVE LABOR PROVIDING IN MODERN CONDITIONS

    OpenAIRE

    Chernoivanova, Anna

    2017-01-01

    The article aims to study theoretical foundations of providing innovative work in modern conditions based on systematizing categorical tools. As a result of the study we found out the innovative work features and singled it out among other related to it categories such as “creative work”, “intellectual work”, “labor management”; summarized theoretical propositions about the nature of innovation work and clarified its definition. Classification of innovative work was grounded. The features of ...

  13. Patient choice of providers in a preferred provider organization.

    Science.gov (United States)

    Wouters, A V; Hester, J

    1988-03-01

    This article is an analysis of patient choice of providers by the employees of the Security Pacific Bank of California and their dependents who have access to the Med Network Preferred Provider Organization (PPO). The empirical results show that not only is the PPO used by individuals who require relatively little medical care (as measured by predicted office visit charges) but that the PPO is most intensively used for low-risk services such as treatment for minor illness and preventive care. Also, the most likely Security Pacific Health Care beneficiary to use a PPO provider is a recently hired employee who lives in the south urban region, has a relatively low income, does not have supplemental insurance coverage, and is without previous attachments to non-PPO primary care providers. In order to maximize their ability to reduce plan paid benefits, insurers who contract with PPOs should focus on increasing PPO utilization among poorer health risks.

  14. Perspectives of addiction treatment providers

    African Journals Online (AJOL)

    Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the ...

  15. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  16. 42 CFR 1000.10 - General definitions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false General definitions. 1000.10 Section 1000.10 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS INTRODUCTION; GENERAL DEFINITIONS Definitions § 1000.10 General definitions. In this chapter...

  17. Dual, use-based definition of "system"

    CSIR Research Space (South Africa)

    Gonçalves, DP

    2015-09-01

    Full Text Available The standard definition (ISO 15288, 2008) of the concept of a system is not complete and is the definition of a closed system. Such a definition is inadequate for systems engineering. A use-based definition is proposed which spans the open...

  18. 15 CFR 922.81 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Definitions. 922.81 Section 922.81... Definitions. In addition to those definitions found at § 922.3, the following definitions apply to this... or otherwise manifesting intention not to undertake or to cease salvage efforts, or when the owner...

  19. 48 CFR 2402.101 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... GENERAL DEFINITIONS OF WORDS AND TERMS Definitions 2402.101 Definitions. Accounting Office means the Office of Accounting Operations within the Office of the Chief Financial Officer and includes that Office... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Definitions. 2402.101...

  20. Incentives and provider payment methods.

    Science.gov (United States)

    Barnum, H; Kutzin, J; Saxenian, H

    1995-01-01

    The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.