WorldWideScience

Sample records for provide adequate estimates

  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. 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

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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.

  9. Does limited data availability prevent adequate water use estimates on farm scale?

    Science.gov (United States)

    Kayatz, Benjamin; Kuster, Benjamin; Percy, Barbara; Hillier, Jonathan; Freese, Dirk; Wattenbach, Martin

    2015-04-01

    Increasing food production for a growing world population and at the same time mitigating climate change as well as adapting to its consequences is one of the key global challenges. Therefore producing crops with fewer resources such as water and fertilizers and less emissions of greenhouse gases is an important question that has to be answered on farm scale. The cool farm tool (CFT) is a farm scale emission calculator and was developed in 2010 to help farmers to reduce their carbon footprint. In order to adapt to future climate change an easy to use and at the same time robust water footprinting tool is needed for the CFT to take a more holistic approach on environmental sustainability. However data on farm level is often scarce. We investigated the effect of limited data on actual evapotranspiration using the FAO56 standard to assess the quality of farm water footprint estimates. Calculations are based on various agricultural sites from the Fluxnet database and estimates are compared to eddy covariance measurements. Results show that higher data availability is not directly linked to more accurate estimates of actual evapotranspiration. Estimates based only on temperature and relative humidity are still able to reproduce daily patterns. However cumulative values over one growing season show a considerable offset to eddy covariance observations for all data input levels. Finding the optimum between data requirements and an accuracy that fulfills farmer needs is crucial. Engagement of farmers and using a global network as the Fluxnet database will help to achieve this goal.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Estimation and Prediction of Avoidable Health Care Costs of Cardiovascular Diseases and Type 2 Diabetes Through Adequate Dairy Food Consumption: A Systematic Review and Micro Simulation Modeling Study.

    Science.gov (United States)

    Javanbakht, Mehdi; Jamshidi, Ahmad Reza; Baradaran, Hamid Reza; Mohammadi, Zahra; Mashayekhi, Atefeh; Shokraneh, Farhad; Rezai Hamami, Mohsen; Yazdani Bakhsh, Raziyeh; Shabaninejad, Hossien; Delavari, Sajad; Tehrani, Arash

    2018-05-01

    Recent evidence from prospective cohort studies show a relationship between consumption of dairy foods and cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM). This association highlights the importance of dairy foods consumption in prevention of these diseases and also reduction of associated healthcare costs. The aim of this study was to estimate avoidable healthcare costs of CVD and T2D through adequate dairy foods consumption in Iran. This was a multistage modelling study. We conducted a systematic literature review in PubMed and EMBASE to identify any association between incidence of CVD and T2DM and dairy foods intake, and also associated relative risks. We obtained age- and sex-specific dairy foods consumption level and healthcare expenditures from national surveys and studies. Patient level simulation Markov models were constructed to predict the disease incidence, patient population size and associated healthcare costs for current and optimal dairy foods consumption at different time horizons (1, 5, 10 and 20 years). All parameters including costs and transition probabilities were defined as statistical distributions in the models, and all analyses were conducted by accounting for first and second order uncertainty. The systematic review results indicated that dairy foods consumption was inversely associated with incidence of T2DM, coronary heart disease (CHD) and stroke. We estimated that the introduction of a diet containing 3 servings of dairy foods per day may produce a $0.43 saving in annual per capita healthcare costs in Iran in the first year due to saving in cost of CVD and T2DM treatment. The estimated savings in per capita healthcare costs were $8.42, $39.97 and $190.25 in 5, 10 and 20-years' time, respectively. Corresponding total aggregated avoidable costs for the entire Iranian population within the study time horizons were $33.83, $661.31, $3,138.21 and $14,934.63 million, respectively. Our analysis demonstrated that increasing

  17. 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 .

  18. 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…

  19. 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…

  20. Estimating the Cost of Providing Foundational Public Health Services.

    Science.gov (United States)

    Mamaril, Cezar Brian C; Mays, Glen P; Branham, Douglas Keith; Bekemeier, Betty; Marlowe, Justin; Timsina, Lava

    2017-12-28

    To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. © Health Research and Educational Trust.

  1. Gender differences in pension wealth: estimates using provider data.

    Science.gov (United States)

    Johnson, R W; Sambamoorthi, U; Crystal, S

    1999-06-01

    Information from pension providers was examined to investigate gender differences in pension wealth at midlife. For full-time wage and salary workers approaching retirement age who had pension coverage, median pension wealth on the current job was 76% greater for men than women. Differences in wages, years of job tenure, and industry between men and women accounted for most of the gender gap in pension wealth on the current job. Less than one third of the wealth difference could not be explained by gender differences in education, demographics, or job characteristics. The less-advantaged employment situation of working women currently in midlife carries over into worse retirement income prospects. However, the gender gap in pensions is likely to narrow in the future as married women's employment experiences increasingly resemble those of men.

  2. 49 CFR 375.409 - May household goods brokers provide estimates?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false May household goods brokers provide estimates? 375... Estimating Charges § 375.409 May household goods brokers provide estimates? A household goods broker must not... there is a written agreement between the broker and you, the carrier, adopting the broker's estimate as...

  3. Can genetic estimators provide robust estimates of the effective number of breeders in small populations?

    Directory of Open Access Journals (Sweden)

    Marion Hoehn

    Full Text Available The effective population size (N(e is proportional to the loss of genetic diversity and the rate of inbreeding, and its accurate estimation is crucial for the monitoring of small populations. Here, we integrate temporal studies of the gecko Oedura reticulata, to compare genetic and demographic estimators of N(e. Because geckos have overlapping generations, our goal was to demographically estimate N(bI, the inbreeding effective number of breeders and to calculate the N(bI/N(a ratio (N(a =number of adults for four populations. Demographically estimated N(bI ranged from 1 to 65 individuals. The mean reduction in the effective number of breeders relative to census size (N(bI/N(a was 0.1 to 1.1. We identified the variance in reproductive success as the most important variable contributing to reduction of this ratio. We used four methods to estimate the genetic based inbreeding effective number of breeders N(bI(gen and the variance effective populations size N(eV(gen estimates from the genotype data. Two of these methods - a temporal moment-based (MBT and a likelihood-based approach (TM3 require at least two samples in time, while the other two were single-sample estimators - the linkage disequilibrium method with bias correction LDNe and the program ONeSAMP. The genetic based estimates were fairly similar across methods and also similar to the demographic estimates excluding those estimates, in which upper confidence interval boundaries were uninformative. For example, LDNe and ONeSAMP estimates ranged from 14-55 and 24-48 individuals, respectively. However, temporal methods suffered from a large variation in confidence intervals and concerns about the prior information. We conclude that the single-sample estimators are an acceptable short-cut to estimate N(bI for species such as geckos and will be of great importance for the monitoring of species in fragmented landscapes.

  4. 國民中學適足教育經費:臺灣偏遠與非偏遠地區學校的比較 Estimating Adequate Funding to Meet Performance Standards for Junior High School Students: Adequate Funding Comparisons Between Rural and Non-Rural Schools in Taiwan

    Directory of Open Access Journals (Sweden)

    張良丞 Liang-Cheng Zhang

    2016-09-01

    Full Text Available 臺灣學生近年來在國際大型測驗表現亮眼,但如進一步檢視學校所處地區,即可明顯看出臺灣存在巨大的城鄉差距問題:偏遠地區與大城市相比,不僅數學表現較差,且出現各校數學差距相對較大的情況。不足的教育經費可能是導致此差距的原因之一,本研究因此以成本函數法來估算偏遠與非偏遠地區學校達成預期學生學業成就所需的適足經費,並以國中基測數學基礎級、平均數、精熟級來作為適足分數,以估算不同程度所需的適足經費,結果發現,無論何種適足分數,偏遠地區所需的每生適足經費皆比非偏遠地區為高,且超過半數以上的偏遠學校未達適足經費水準。本研究亦根據研究結果,提出改進建議。 Although the mathematical ability of Taiwanese students is ranked high according to the Programme for International Student Assessment (PISA, Taiwan faces the problem of a gap in test scores between rural students and their non-rural counterparts, with the latter group scoring higher on average. Inadequate funding is a possible reason for this discrepancy. Therefore, this paper uses the cost function approach to compare adequate funding requirements between rural and non-rural schools. The adequate funding estimates are calculated based on the different levels of mathematics scores in the Basic Competence Test (basic, average, and proficient. The results showed that rural schools require more per student funding than do non-rural schools, irrespective of the use of score levels as references. A greater portion of rural schools were shown to operate under inadequate per student funding compared with non-rural schools. This paper provides further evidence of the urgency of increased investment in rural schools.

  5. 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…

  6. 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

  7. Do group-specific equations provide the best estimates of stature?

    Science.gov (United States)

    Albanese, John; Osley, Stephanie E; Tuck, Andrew

    2016-04-01

    An estimate of stature can be used by a forensic anthropologist with the preliminary identification of an unknown individual when human skeletal remains are recovered. Fordisc is a computer application that can be used to estimate stature; like many other methods it requires the user to assign an unknown individual to a specific group defined by sex, race/ancestry, and century of birth before an equation is applied. The assumption is that a group-specific equation controls for group differences and should provide the best results most often. In this paper we assess the utility and benefits of using group-specific equations to estimate stature using Fordisc. Using the maximum length of the humerus and the maximum length of the femur from individuals with documented stature, we address the question: Do sex-, race/ancestry- and century-specific stature equations provide the best results when estimating stature? The data for our sample of 19th Century White males (n=28) were entered into Fordisc and stature was estimated using 22 different equation options for a total of 616 trials: 19th and 20th Century Black males, 19th and 20th Century Black females, 19th and 20th Century White females, 19th and 20th Century White males, 19th and 20th Century any, and 20th Century Hispanic males. The equations were assessed for utility in any one case (how many times the estimated range bracketed the documented stature) and in aggregate using 1-way ANOVA and other approaches. This group-specific equation that should have provided the best results was outperformed by several other equations for both the femur and humerus. These results suggest that group-specific equations do not provide better results for estimating stature while at the same time are more difficult to apply because an unknown must be allocated to a given group before stature can be estimated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Software project estimation the fundamentals for providing high quality information to decision makers

    CERN Document Server

    Abran, Alain

    2015-01-01

    Software projects are often late and over-budget and this leads to major problems for software customers. Clearly, there is a serious issue in estimating a realistic, software project budget. Furthermore, generic estimation models cannot be trusted to provide credible estimates for projects as complex as software projects. This book presents a number of examples using data collected over the years from various organizations building software. It also presents an overview of the non-for-profit organization, which collects data on software projects, the International Software Benchmarking Stan

  9. A microbial clock provides an accurate estimate of the postmortem interval in a mouse model system

    Science.gov (United States)

    Metcalf, Jessica L; Wegener Parfrey, Laura; Gonzalez, Antonio; Lauber, Christian L; Knights, Dan; Ackermann, Gail; Humphrey, Gregory C; Gebert, Matthew J; Van Treuren, Will; Berg-Lyons, Donna; Keepers, Kyle; Guo, Yan; Bullard, James; Fierer, Noah; Carter, David O; Knight, Rob

    2013-01-01

    Establishing the time since death is critical in every death investigation, yet existing techniques are susceptible to a range of errors and biases. For example, forensic entomology is widely used to assess the postmortem interval (PMI), but errors can range from days to months. Microbes may provide a novel method for estimating PMI that avoids many of these limitations. Here we show that postmortem microbial community changes are dramatic, measurable, and repeatable in a mouse model system, allowing PMI to be estimated within approximately 3 days over 48 days. Our results provide a detailed understanding of bacterial and microbial eukaryotic ecology within a decomposing corpse system and suggest that microbial community data can be developed into a forensic tool for estimating PMI. DOI: http://dx.doi.org/10.7554/eLife.01104.001 PMID:24137541

  10. Estimated Nutritive Value of Low-Price Model Lunch Sets Provided to Garment Workers in Cambodia

    Directory of Open Access Journals (Sweden)

    Jan Makurat

    2017-07-01

    Full Text Available Background: The establishment of staff canteens is expected to improve the nutritional situation of Cambodian garment workers. The objective of this study is to assess the nutritive value of low-price model lunch sets provided at a garment factory in Phnom Penh, Cambodia. Methods: Exemplary lunch sets were served to female workers through a temporary canteen at a garment factory in Phnom Penh. Dish samples were collected repeatedly to examine mean serving sizes of individual ingredients. Food composition tables and NutriSurvey software were used to assess mean amounts and contributions to recommended dietary allowances (RDAs or adequate intake of energy, macronutrients, dietary fiber, vitamin C (VitC, iron, vitamin A (VitA, folate and vitamin B12 (VitB12. Results: On average, lunch sets provided roughly one third of RDA or adequate intake of energy, carbohydrates, fat and dietary fiber. Contribution to RDA of protein was high (46% RDA. The sets contained a high mean share of VitC (159% RDA, VitA (66% RDA, and folate (44% RDA, but were low in VitB12 (29% RDA and iron (20% RDA. Conclusions: Overall, lunches satisfied recommendations of caloric content and macronutrient composition. Sets on average contained a beneficial amount of VitC, VitA and folate. Adjustments are needed for a higher iron content. Alternative iron-rich foods are expected to be better suited, compared to increasing portions of costly meat/fish components. Lunch provision at Cambodian garment factories holds the potential to improve food security of workers, approximately at costs of <1 USD/person/day at large scale. Data on quantitative total dietary intake as well as physical activity among workers are needed to further optimize the concept of staff canteens.

  11. Estimates of economic burden of providing inpatient care in childhood rotavirus gastroenteritis from Malaysia.

    Science.gov (United States)

    Lee, Way Seah; Poo, Muhammad Izzuddin; Nagaraj, Shyamala

    2007-12-01

    To estimate the cost of an episode of inpatient care and the economic burden of hospitalisation for childhood rotavirus gastroenteritis (GE) in Malaysia. A 12-month prospective, hospital-based study on children less than 14 years of age with rotavirus GE, admitted to University of Malaya Medical Centre, Kuala Lumpur, was conducted in 2002. Data on human resource expenditure, costs of investigations, treatment and consumables were collected. Published estimates on rotavirus disease incidence in Malaysia were searched. Economic burden of hospital care for rotavirus GE in Malaysia was estimated by multiplying the cost of each episode of hospital admission for rotavirus GE with national rotavirus incidence in Malaysia. In 2002, the per capita health expenditure by Malaysian Government was US$71.47. Rotavirus was positive in 85 (22%) of the 393 patients with acute GE admitted during the study period. The median cost of providing inpatient care for an episode of rotavirus GE was US$211.91 (range US$68.50-880.60). The estimated average cases of children hospitalised for rotavirus GE in Malaysia (1999-2000) was 8571 annually. The financial burden of providing inpatient care for rotavirus GE in Malaysian children was estimated to be US$1.8 million (range US$0.6 million-7.5 million) annually. The cost of providing inpatient care for childhood rotavirus GE in Malaysia was estimated to be US$1.8 million annually. The financial burden of rotavirus disease would be higher if cost of outpatient visits, non-medical and societal costs are included.

  12. Psychological impact of providing women with personalised 10-year breast cancer risk estimates.

    Science.gov (United States)

    French, David P; Southworth, Jake; Howell, Anthony; Harvie, Michelle; Stavrinos, Paula; Watterson, Donna; Sampson, Sarah; Evans, D Gareth; Donnelly, Louise S

    2018-05-08

    The Predicting Risk of Cancer at Screening (PROCAS) study estimated 10-year breast cancer risk for 53,596 women attending NHS Breast Screening Programme. The present study, nested within the PROCAS study, aimed to assess the psychological impact of receiving breast cancer risk estimates, based on: (a) the Tyrer-Cuzick (T-C) algorithm including breast density or (b) T-C including breast density plus single-nucleotide polymorphisms (SNPs), versus (c) comparison women awaiting results. A sample of 2138 women from the PROCAS study was stratified by testing groups: T-C only, T-C(+SNPs) and comparison women; and by 10-year risk estimates received: 'moderate' (5-7.99%), 'average' (2-4.99%) or 'below average' (<1.99%) risk. Postal questionnaires were returned by 765 (36%) women. Overall state anxiety and cancer worry were low, and similar for women in T-C only and T-C(+SNPs) groups. Women in both T-C only and T-C(+SNPs) groups showed lower-state anxiety but slightly higher cancer worry than comparison women awaiting results. Risk information had no consistent effects on intentions to change behaviour. Most women were satisfied with information provided. There was considerable variation in understanding. No major harms of providing women with 10-year breast cancer risk estimates were detected. Research to establish the feasibility of risk-stratified breast screening is warranted.

  13. Can administrative health utilisation data provide an accurate diabetes prevalence estimate for a geographical region?

    Science.gov (United States)

    Chan, Wing Cheuk; Papaconstantinou, Dean; Lee, Mildred; Telfer, Kendra; Jo, Emmanuel; Drury, Paul L; Tobias, Martin

    2018-05-01

    To validate the New Zealand Ministry of Health (MoH) Virtual Diabetes Register (VDR) using longitudinal laboratory results and to develop an improved algorithm for estimating diabetes prevalence at a population level. The assigned diabetes status of individuals based on the 2014 version of the MoH VDR is compared to the diabetes status based on the laboratory results stored in the Auckland regional laboratory result repository (TestSafe) using the New Zealand diabetes diagnostic criteria. The existing VDR algorithm is refined by reviewing the sensitivity and positive predictive value of the each of the VDR algorithm rules individually and as a combination. The diabetes prevalence estimate based on the original 2014 MoH VDR was 17% higher (n = 108,505) than the corresponding TestSafe prevalence estimate (n = 92,707). Compared to the diabetes prevalence based on TestSafe, the original VDR has a sensitivity of 89%, specificity of 96%, positive predictive value of 76% and negative predictive value of 98%. The modified VDR algorithm has improved the positive predictive value by 6.1% and the specificity by 1.4% with modest reductions in sensitivity of 2.2% and negative predictive value of 0.3%. At an aggregated level the overall diabetes prevalence estimated by the modified VDR is 5.7% higher than the corresponding estimate based on TestSafe. The Ministry of Health Virtual Diabetes Register algorithm has been refined to provide a more accurate diabetes prevalence estimate at a population level. The comparison highlights the potential value of a national population long term condition register constructed from both laboratory results and administrative data. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Providing low-budget estimations of carbon sequestration and greenhouse gas emissions in agricultural wetlands

    International Nuclear Information System (INIS)

    Lloyd, Colin R; Rebelo, Lisa-Maria; Max Finlayson, C

    2013-01-01

    The conversion of wetlands to agriculture through drainage and flooding, and the burning of wetland areas for agriculture have important implications for greenhouse gas (GHG) production and changing carbon stocks. However, the estimation of net GHG changes from mitigation practices in agricultural wetlands is complex compared to dryland crops. Agricultural wetlands have more complicated carbon and nitrogen cycles with both above- and below-ground processes and export of carbon via vertical and horizontal movement of water through the wetland. This letter reviews current research methodologies in estimating greenhouse gas production and provides guidance on the provision of robust estimates of carbon sequestration and greenhouse gas emissions in agricultural wetlands through the use of low cost reliable and sustainable measurement, modelling and remote sensing applications. The guidance is highly applicable to, and aimed at, wetlands such as those in the tropics and sub-tropics, where complex research infrastructure may not exist, or agricultural wetlands located in remote regions, where frequent visits by monitoring scientists prove difficult. In conclusion, the proposed measurement-modelling approach provides guidance on an affordable solution for mitigation and for investigating the consequences of wetland agricultural practice on GHG production, ecological resilience and possible changes to agricultural yields, variety choice and farming practice. (letter)

  15. Novel serologic biomarkers provide accurate estimates of recent Plasmodium falciparum exposure for individuals and communities.

    Science.gov (United States)

    Helb, Danica A; Tetteh, Kevin K A; Felgner, Philip L; Skinner, Jeff; Hubbard, Alan; Arinaitwe, Emmanuel; Mayanja-Kizza, Harriet; Ssewanyana, Isaac; Kamya, Moses R; Beeson, James G; Tappero, Jordan; Smith, David L; Crompton, Peter D; Rosenthal, Philip J; Dorsey, Grant; Drakeley, Christopher J; Greenhouse, Bryan

    2015-08-11

    Tools to reliably measure Plasmodium falciparum (Pf) exposure in individuals and communities are needed to guide and evaluate malaria control interventions. Serologic assays can potentially produce precise exposure estimates at low cost; however, current approaches based on responses to a few characterized antigens are not designed to estimate exposure in individuals. Pf-specific antibody responses differ by antigen, suggesting that selection of antigens with defined kinetic profiles will improve estimates of Pf exposure. To identify novel serologic biomarkers of malaria exposure, we evaluated responses to 856 Pf antigens by protein microarray in 186 Ugandan children, for whom detailed Pf exposure data were available. Using data-adaptive statistical methods, we identified combinations of antibody responses that maximized information on an individual's recent exposure. Responses to three novel Pf antigens accurately classified whether an individual had been infected within the last 30, 90, or 365 d (cross-validated area under the curve = 0.86-0.93), whereas responses to six antigens accurately estimated an individual's malaria incidence in the prior year. Cross-validated incidence predictions for individuals in different communities provided accurate stratification of exposure between populations and suggest that precise estimates of community exposure can be obtained from sampling a small subset of that community. In addition, serologic incidence predictions from cross-sectional samples characterized heterogeneity within a community similarly to 1 y of continuous passive surveillance. Development of simple ELISA-based assays derived from the successful selection strategy outlined here offers the potential to generate rich epidemiologic surveillance data that will be widely accessible to malaria control programs.

  16. Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

    Science.gov (United States)

    Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L

    2015-01-01

    Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

  17. Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

    Directory of Open Access Journals (Sweden)

    Annie Haakenstad

    Full Text Available Faith-based organizations (FBOs have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH channeled through these organizations.Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs.In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs.Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

  18. Estimating the Development Assistance for Health Provided to Faith-Based Organizations, 1990–2013

    Science.gov (United States)

    Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L.

    2015-01-01

    Background Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Material and Methods Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. Results In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund’s contributions to NGOs. In 2011, the Gates Foundation’s contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Conclusion Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health. PMID:26042731

  19. Does public health system provide adequate financial risk protection to its clients? Out of pocket expenditure on inpatient care at secondary level public health institutions: Causes and determinants in an eastern Indian state.

    Science.gov (United States)

    Rout, Sarit Kumar; Choudhury, Sarmistha

    2018-02-09

    This study is undertaken to estimate the out of pocket expenditure (OOPE) for various diseases and its determinants at secondary level public health facilities in Odisha. A cross-sectional survey was conducted among the inpatients utilising secondary level public health facilities in the 2 districts of Odisha. More than 80% of the inpatients were selected conveniently, and data on OOPE and socioeconomic status of patients were collected. The OOPE was estimated separately on surgery, nonsurgery, and child birth conditions. Ordinary least square regression models were developed to explain the factors determining OOPE. The mean OOPE for the secondary care facility was Indian National Rupee 3136.14, (95% CI: 2869.08-3403.19), of which, Indian National Rupee 1622.79 (95% CI: 1462.70-1782.89) was on medicine constituting 79% of total medical expenditure. The mean OOPE on surgery was highest followed by nonsurgery and child birth conditions. The OOPE is mainly influenced by caste and educational status of patients as revealed by the regression results. With increase in social status, the OOPE increases and the results are statistically significant. This evidence should be used to design financial strategies to reduce OOPE at secondary care public health facilities, which is largely due to medicine, diagnostic services, and transport expenditure. Efforts should be made to protect the interest of the poor, who utilise public health facility in a low resource setting in India. Copyright © 2018 John Wiley & Sons, Ltd.

  20. Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan.

    Science.gov (United States)

    Chughtai, A A; Qadeer, E; Khan, W; Hadi, H; Memon, I A

    2013-03-01

    To improve involvement of the private sector in the national tuberculosis (TB) programme in Pakistan various public-private mix projects were set up between 2004 and 2009. A retrospective analysis of data was made to study 6 different public-private mix models for TB control in Pakistan and estimate the contribution of the various private providers to TB case notification and treatment outcome. The number of TB cases notified through the private sector increased significantly from 77 cases in 2004 to 37,656 in 2009. Among the models, the nongovernmental organization model made the greatest contribution to case notification (58.3%), followed by the hospital-based model (18.9%). Treatment success was highest for the district-led model (94.1%) and lowest for the hospital-based model (74.2%). The private sector made an important contribution to the national data through the various public-private mix projects. Issues of sustainability and the lack of treatment supporters are discussed as reasons for lack of success of some projects.

  1. 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

  2. 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.

  3. Accuracy of the visual estimation method as a predictor of food intake in Alzheimer's patients provided with different types of food.

    Science.gov (United States)

    Amano, Nobuko; Nakamura, Tomiyo

    2018-02-01

    The visual estimation method is commonly used in hospitals and other care facilities to evaluate food intake through estimation of plate waste. In Japan, no previous studies have investigated the validity and reliability of this method under the routine conditions of a hospital setting. The present study aimed to evaluate the validity and reliability of the visual estimation method, in long-term inpatients with different levels of eating disability caused by Alzheimer's disease. The patients were provided different therapeutic diets presented in various food types. This study was performed between February and April 2013, and 82 patients with Alzheimer's disease were included. Plate waste was evaluated for the 3 main daily meals, for a total of 21 days, 7 consecutive days during each of the 3 months, originating a total of 4851 meals, from which 3984 were included. Plate waste was measured by the nurses through the visual estimation method, and by the hospital's registered dietitians through the actual measurement method. The actual measurement method was first validated to serve as a reference, and the level of agreement between both methods was then determined. The month, time of day, type of food provided, and patients' physical characteristics were considered for analysis. For the 3984 meals included in the analysis, the level of agreement between the measurement methods was 78.4%. Disagreement of measurements consisted of 3.8% of underestimation and 17.8% of overestimation. Cronbach's α (0.60, P visual estimation method was within the acceptable range. The visual estimation method was found to be a valid and reliable method for estimating food intake in patients with different levels of eating impairment. The successful implementation and use of the method depends upon adequate training and motivation of the nurses and care staff involved. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  4. A Dynamical Model of Pitch Memory Provides an Improved Basis for Implied Harmony Estimation

    Science.gov (United States)

    Kim, Ji Chul

    2017-01-01

    Tonal melody can imply vertical harmony through a sequence of tones. Current methods for automatic chord estimation commonly use chroma-based features extracted from audio signals. However, the implied harmony of unaccompanied melodies can be difficult to estimate on the basis of chroma content in the presence of frequent nonchord tones. Here we present a novel approach to automatic chord estimation based on the human perception of pitch sequences. We use cohesion and inhibition between pitches in auditory short-term memory to differentiate chord tones and nonchord tones in tonal melodies. We model short-term pitch memory as a gradient frequency neural network, which is a biologically realistic model of auditory neural processing. The model is a dynamical system consisting of a network of tonotopically tuned nonlinear oscillators driven by audio signals. The oscillators interact with each other through nonlinear resonance and lateral inhibition, and the pattern of oscillatory traces emerging from the interactions is taken as a measure of pitch salience. We test the model with a collection of unaccompanied tonal melodies to evaluate it as a feature extractor for chord estimation. We show that chord tones are selectively enhanced in the response of the model, thereby increasing the accuracy of implied harmony estimation. We also find that, like other existing features for chord estimation, the performance of the model can be improved by using segmented input signals. We discuss possible ways to expand the present model into a full chord estimation system within the dynamical systems framework. PMID:28522983

  5. A Dynamical Model of Pitch Memory Provides an Improved Basis for Implied Harmony Estimation.

    Science.gov (United States)

    Kim, Ji Chul

    2017-01-01

    Tonal melody can imply vertical harmony through a sequence of tones. Current methods for automatic chord estimation commonly use chroma-based features extracted from audio signals. However, the implied harmony of unaccompanied melodies can be difficult to estimate on the basis of chroma content in the presence of frequent nonchord tones. Here we present a novel approach to automatic chord estimation based on the human perception of pitch sequences. We use cohesion and inhibition between pitches in auditory short-term memory to differentiate chord tones and nonchord tones in tonal melodies. We model short-term pitch memory as a gradient frequency neural network, which is a biologically realistic model of auditory neural processing. The model is a dynamical system consisting of a network of tonotopically tuned nonlinear oscillators driven by audio signals. The oscillators interact with each other through nonlinear resonance and lateral inhibition, and the pattern of oscillatory traces emerging from the interactions is taken as a measure of pitch salience. We test the model with a collection of unaccompanied tonal melodies to evaluate it as a feature extractor for chord estimation. We show that chord tones are selectively enhanced in the response of the model, thereby increasing the accuracy of implied harmony estimation. We also find that, like other existing features for chord estimation, the performance of the model can be improved by using segmented input signals. We discuss possible ways to expand the present model into a full chord estimation system within the dynamical systems framework.

  6. A Dynamical Model of Pitch Memory Provides an Improved Basis for Implied Harmony Estimation

    Directory of Open Access Journals (Sweden)

    Ji Chul Kim

    2017-05-01

    Full Text Available Tonal melody can imply vertical harmony through a sequence of tones. Current methods for automatic chord estimation commonly use chroma-based features extracted from audio signals. However, the implied harmony of unaccompanied melodies can be difficult to estimate on the basis of chroma content in the presence of frequent nonchord tones. Here we present a novel approach to automatic chord estimation based on the human perception of pitch sequences. We use cohesion and inhibition between pitches in auditory short-term memory to differentiate chord tones and nonchord tones in tonal melodies. We model short-term pitch memory as a gradient frequency neural network, which is a biologically realistic model of auditory neural processing. The model is a dynamical system consisting of a network of tonotopically tuned nonlinear oscillators driven by audio signals. The oscillators interact with each other through nonlinear resonance and lateral inhibition, and the pattern of oscillatory traces emerging from the interactions is taken as a measure of pitch salience. We test the model with a collection of unaccompanied tonal melodies to evaluate it as a feature extractor for chord estimation. We show that chord tones are selectively enhanced in the response of the model, thereby increasing the accuracy of implied harmony estimation. We also find that, like other existing features for chord estimation, the performance of the model can be improved by using segmented input signals. We discuss possible ways to expand the present model into a full chord estimation system within the dynamical systems framework.

  7. Integrating field plots, lidar, and landsat time series to provide temporally consistent annual estimates of biomass from 1990 to present

    Science.gov (United States)

    Warren B. Cohen; Hans-Erik Andersen; Sean P. Healey; Gretchen G. Moisen; Todd A. Schroeder; Christopher W. Woodall; Grant M. Domke; Zhiqiang Yang; Robert E. Kennedy; Stephen V. Stehman; Curtis Woodcock; Jim Vogelmann; Zhe Zhu; Chengquan. Huang

    2015-01-01

    We are developing a system that provides temporally consistent biomass estimates for national greenhouse gas inventory reporting to the United Nations Framework Convention on Climate Change. Our model-assisted estimation framework relies on remote sensing to scale from plot measurements to lidar strip samples, to Landsat time series-based maps. As a demonstration, new...

  8. 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…

  9. Estimating the cost of skin cancer detection by dermatology providers in a large health care system.

    Science.gov (United States)

    Matsumoto, Martha; Secrest, Aaron; Anderson, Alyce; Saul, Melissa I; Ho, Jonhan; Kirkwood, John M; Ferris, Laura K

    2018-04-01

    Data on the cost and efficiency of skin cancer detection through total body skin examination are scarce. To determine the number needed to screen (NNS) and biopsy (NNB) and cost per skin cancer diagnosed in a large dermatology practice in patients undergoing total body skin examination. This is a retrospective observational study. During 2011-2015, a total of 20,270 patients underwent 33,647 visits for total body skin examination; 9956 lesion biopsies were performed yielding 2763 skin cancers, including 155 melanomas. The NNS to detect 1 skin cancer was 12.2 (95% confidence interval [CI] 11.7-12.6) and 1 melanoma was 215 (95% CI 185-252). The NNB to detect 1 skin cancer was 3.0 (95% CI 2.9-3.1) and 1 melanoma was 27.8 (95% CI 23.3-33.3). In a multivariable model for NNS, age and personal history of melanoma were significant factors. Age switched from a protective factor to a risk factor at 51 years of age. The estimated cost per melanoma detected was $32,594 (95% CI $27,326-$37,475). Data are from a single health care system and based on physician coding. Melanoma detection through total body skin examination is most efficient in patients ≥50 years of age and those with a personal history of melanoma. Our findings will be helpful in modeling the cost effectiveness of melanoma screening by dermatologists. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. Order Quantity Distributions: Estimating an Adequate Aggregation Horizon

    Directory of Open Access Journals (Sweden)

    Eriksen Poul Svante

    2016-09-01

    Full Text Available In this paper an investigation into the demand, faced by a company in the form of customer orders, is performed both from an explorative numerical and analytical perspective. The aim of the research is to establish the behavior of customer orders in first-come-first-serve (FCFS systems and the impact of order quantity variation on the planning environment. A discussion of assumptions regarding demand from various planning and control perspectives underlines that most planning methods are based on the assumption that demand in the form of customer orders are independently identically distributed and stem from symmetrical distributions. To investigate and illustrate the need to aggregate demand to live up to these assumptions, a simple methodological framework to investigate the validity of the assumptions and for analyzing the behavior of orders is developed. The paper also presents an analytical approach to identify the aggregation horizon needed to achieve a stable demand. Furthermore, a case study application of the presented framework is presented and concluded on.

  15. Logistic quantile regression provides improved estimates for bounded avian counts: A case study of California Spotted Owl fledgling production

    Science.gov (United States)

    Cade, Brian S.; Noon, Barry R.; Scherer, Rick D.; Keane, John J.

    2017-01-01

    Counts of avian fledglings, nestlings, or clutch size that are bounded below by zero and above by some small integer form a discrete random variable distribution that is not approximated well by conventional parametric count distributions such as the Poisson or negative binomial. We developed a logistic quantile regression model to provide estimates of the empirical conditional distribution of a bounded discrete random variable. The logistic quantile regression model requires that counts are randomly jittered to a continuous random variable, logit transformed to bound them between specified lower and upper values, then estimated in conventional linear quantile regression, repeating the 3 steps and averaging estimates. Back-transformation to the original discrete scale relies on the fact that quantiles are equivariant to monotonic transformations. We demonstrate this statistical procedure by modeling 20 years of California Spotted Owl fledgling production (0−3 per territory) on the Lassen National Forest, California, USA, as related to climate, demographic, and landscape habitat characteristics at territories. Spotted Owl fledgling counts increased nonlinearly with decreasing precipitation in the early nesting period, in the winter prior to nesting, and in the prior growing season; with increasing minimum temperatures in the early nesting period; with adult compared to subadult parents; when there was no fledgling production in the prior year; and when percentage of the landscape surrounding nesting sites (202 ha) with trees ≥25 m height increased. Changes in production were primarily driven by changes in the proportion of territories with 2 or 3 fledglings. Average variances of the discrete cumulative distributions of the estimated fledgling counts indicated that temporal changes in climate and parent age class explained 18% of the annual variance in owl fledgling production, which was 34% of the total variance. Prior fledgling production explained as much of

  16. Size-specific dose estimate (SSDE) provides a simple method to calculate organ dose for pediatric CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Bria M.; Brady, Samuel L., E-mail: samuel.brady@stjude.org; Kaufman, Robert A. [Department of Radiological Sciences, St Jude Children' s Research Hospital, Memphis, Tennessee 38105 (United States); Mirro, Amy E. [Department of Biomedical Engineering, Washington University, St Louis, Missouri 63130 (United States)

    2014-07-15

    previously published pediatric patient doses that accounted for patient size in their dose calculation, and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusions: For organs fully covered within the scan volume, the average correlation of SSDE and organ absolute dose was found to be better than ±10%. In addition, this study provides a complete list of organ dose correlation factors (CF{sub SSDE}{sup organ}) for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE.

  17. Digital photography provides a fast, reliable, and noninvasive method to estimate anthocyanin pigment concentration in reproductive and vegetative plant tissues.

    Science.gov (United States)

    Del Valle, José C; Gallardo-López, Antonio; Buide, Mª Luisa; Whittall, Justen B; Narbona, Eduardo

    2018-03-01

    Anthocyanin pigments have become a model trait for evolutionary ecology as they often provide adaptive benefits for plants. Anthocyanins have been traditionally quantified biochemically or more recently using spectral reflectance. However, both methods require destructive sampling and can be labor intensive and challenging with small samples. Recent advances in digital photography and image processing make it the method of choice for measuring color in the wild. Here, we use digital images as a quick, noninvasive method to estimate relative anthocyanin concentrations in species exhibiting color variation. Using a consumer-level digital camera and a free image processing toolbox, we extracted RGB values from digital images to generate color indices. We tested petals, stems, pedicels, and calyces of six species, which contain different types of anthocyanin pigments and exhibit different pigmentation patterns. Color indices were assessed by their correlation to biochemically determined anthocyanin concentrations. For comparison, we also calculated color indices from spectral reflectance and tested the correlation with anthocyanin concentration. Indices perform differently depending on the nature of the color variation. For both digital images and spectral reflectance, the most accurate estimates of anthocyanin concentration emerge from anthocyanin content-chroma ratio, anthocyanin content-chroma basic, and strength of green indices. Color indices derived from both digital images and spectral reflectance strongly correlate with biochemically determined anthocyanin concentration; however, the estimates from digital images performed better than spectral reflectance in terms of r 2 and normalized root-mean-square error. This was particularly noticeable in a species with striped petals, but in the case of striped calyces, both methods showed a comparable relationship with anthocyanin concentration. Using digital images brings new opportunities to accurately quantify the

  18. Seeing the Forest through the Trees: Citizen Scientists Provide Critical Data to Refine Aboveground Carbon Estimates in Restored Riparian Forests

    Science.gov (United States)

    Viers, J. H.

    2013-12-01

    Integrating citizen scientists into ecological informatics research can be difficult due to limited opportunities for meaningful engagement given vast data streams. This is particularly true for analysis of remotely sensed data, which are increasingly being used to quantify ecosystem services over space and time, and to understand how land uses deliver differing values to humans and thus inform choices about future human actions. Carbon storage and sequestration are such ecosystem services, and recent environmental policy advances in California (i.e., AB 32) have resulted in a nascent carbon market that is helping fuel the restoration of riparian forests in agricultural landscapes. Methods to inventory and monitor aboveground carbon for market accounting are increasingly relying on hyperspatial remotely sensed data, particularly the use of light detection and ranging (LiDAR) technologies, to estimate biomass. Because airborne discrete return LiDAR can inexpensively capture vegetation structural differences at high spatial resolution ( 1000 ha), its use is rapidly increasing, resulting in vast stores of point cloud and derived surface raster data. While established algorithms can quantify forest canopy structure efficiently, the highly complex nature of native riparian forests can result in highly uncertain estimates of biomass due to differences in composition (e.g., species richness, age class) and structure (e.g., stem density). This study presents the comparative results of standing carbon estimates refined with field data collected by citizen scientists at three different sites, each capturing a range of agricultural, remnant forest, and restored forest cover types. These citizen science data resolve uncertainty in composition and structure, and improve allometric scaling models of biomass and thus estimates of aboveground carbon. Results indicate that agricultural land and horticulturally restored riparian forests store similar amounts of aboveground carbon

  19. Training anesthesiology residents in providing anesthesia for awake craniotomy: learning curves and estimate of needed case load.

    Science.gov (United States)

    Bilotta, Federico; Titi, Luca; Lanni, Fabiana; Stazi, Elisabetta; Rosa, Giovanni

    2013-08-01

    To measure the learning curves of residents in anesthesiology in providing anesthesia for awake craniotomy, and to estimate the case load needed to achieve a "good-excellent" level of competence. Prospective study. Operating room of a university hospital. 7 volunteer residents in anesthesiology. Residents underwent a dedicated training program of clinical characteristics of anesthesia for awake craniotomy. The program was divided into three tasks: local anesthesia, sedation-analgesia, and intraoperative hemodynamic management. The learning curve for each resident for each task was recorded over 10 procedures. Quantitative assessment of the individual's ability was based on the resident's self-assessment score and the attending anesthesiologist's judgment, and rated by modified 12 mm Likert scale, reported ability score visual analog scale (VAS). This ability VAS score ranged from 1 to 12 (ie, very poor, mild, moderate, sufficient, good, excellent). The number of requests for advice also was recorded (ie, resident requests for practical help and theoretical notions to accomplish the procedures). Each task had a specific learning rate; the number of procedures necessary to achieve "good-excellent" ability with confidence, as determined by the recorded results, were 10 procedures for local anesthesia, 15 to 25 procedures for sedation-analgesia, and 20 to 30 procedures for intraoperative hemodynamic management. Awake craniotomy is an approach used increasingly in neuroanesthesia. A dedicated training program based on learning specific tasks and building confidence with essential features provides "good-excellent" ability. © 2013 Elsevier Inc. All rights reserved.

  20. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    Science.gov (United States)

    Khader, A. I.; Rosenberg, D. E.; McKee, M.

    2013-05-01

    Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs

  1. The health system burden of chronic disease care: an estimation of provider costs of selected chronic diseases in Uganda.

    Science.gov (United States)

    Settumba, Stella Nalukwago; Sweeney, Sedona; Seeley, Janet; Biraro, Samuel; Mutungi, Gerald; Munderi, Paula; Grosskurth, Heiner; Vassall, Anna

    2015-06-01

    To explore the chronic disease services in Uganda: their level of utilisation, the total service costs and unit costs per visit. Full financial and economic cost data were collected from 12 facilities in two districts, from the provider's perspective. A combination of ingredients-based and step-down allocation costing approaches was used. The diseases under study were diabetes, hypertension, chronic obstructive pulmonary disease (COPD), epilepsy and HIV infection. Data were collected through a review of facility records, direct observation and structured interviews with health workers. Provision of chronic care services was concentrated at higher-level facilities. Excluding drugs, the total costs for NCD care fell below 2% of total facility costs. Unit costs per visit varied widely, both across different levels of the health system, and between facilities of the same level. This variability was driven by differences in clinical and drug prescribing practices. Most patients reported directly to higher-level facilities, bypassing nearby peripheral facilities. NCD services in Uganda are underfunded particularly at peripheral facilities. There is a need to estimate the budget impact of improving NCD care and to standardise treatment guidelines. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  2. 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.

  3. Store turnover as a predictor of food and beverage provider turnover and associated dietary intake estimates in very remote Indigenous communities.

    Science.gov (United States)

    Wycherley, Thomas; Ferguson, Megan; O'Dea, Kerin; McMahon, Emma; Liberato, Selma; Brimblecombe, Julie

    2016-12-01

    Determine how very-remote Indigenous community (RIC) food and beverage (F&B) turnover quantities and associated dietary intake estimates derived from only stores, compare with values derived from all community F&B providers. F&B turnover quantity and associated dietary intake estimates (energy, micro/macronutrients and major contributing food types) were derived from 12-months transaction data of all F&B providers in three RICs (NT, Australia). F&B turnover quantities and dietary intake estimates from only stores (plus only the primary store in multiple-store communities) were expressed as a proportion of complete F&B provider turnover values. Food types and macronutrient distribution (%E) estimates were quantitatively compared. Combined stores F&B turnover accounted for the majority of F&B quantity (98.1%) and absolute dietary intake estimates (energy [97.8%], macronutrients [≥96.7%] and micronutrients [≥83.8%]). Macronutrient distribution estimates from combined stores and only the primary store closely aligned complete provider estimates (≤0.9% absolute). Food types were similar using combined stores, primary store or complete provider turnover. Evaluating combined stores F&B turnover represents an efficient method to estimate total F&B turnover quantity and associated dietary intake in RICs. In multiple-store communities, evaluating only primary store F&B turnover provides an efficient estimate of macronutrient distribution and major food types. © 2016 Public Health Association of Australia.

  4. Water, sanitation and hygiene interventions for acute childhood diarrhea: a systematic review to provide estimates for the Lives Saved Tool.

    Science.gov (United States)

    Darvesh, Nazia; Das, Jai K; Vaivada, Tyler; Gaffey, Michelle F; Rasanathan, Kumanan; Bhutta, Zulfiqar A

    2017-11-07

    In the Sustainable Development Goals (SDGs) era, there is growing recognition of the responsibilities of non-health sectors in improving the health of children. Interventions to improve access to clean water, sanitation facilities, and hygiene behaviours (WASH) represent key opportunities to improve child health and well-being by preventing the spread of infectious diseases and improving nutritional status. We conducted a systematic review of studies evaluating the effects of WASH interventions on childhood diarrhea in children 0-5 years old. Searches were run up to September 2016. We screened the titles and abstracts of retrieved articles, followed by screening of the full-text reports of relevant studies. We abstracted study characteristics and quantitative data, and assessed study quality. Meta-analyses were performed for similar intervention and outcome pairs. Pooled analyses showed diarrhea risk reductions from the following interventions: point-of-use water filtration (pooled risk ratio (RR): 0.47, 95% confidence interval (CI): 0.36-0.62), point-of-use water disinfection (pooled RR: 0.69, 95% CI: 0.60-0.79), and hygiene education with soap provision (pooled RR: 0.73, 95% CI: 0.57-0.94). Quality ratings were low or very low for most studies, and heterogeneity was high in pooled analyses. Improvements to the water supply and water disinfection at source did not show significant effects on diarrhea risk, nor did the one eligible study examining the effect of latrine construction. Various WASH interventions show diarrhea risk reductions between 27% and 53% in children 0-5 years old, depending on intervention type, providing ample evidence to support the scale-up of WASH in low and middle-income countries (LMICs). Due to the overall low quality of the evidence and high heterogeneity, further research is required to accurately estimate the magnitude of the effects of these interventions in different contexts.

  5. Field data provide estimates of effective permeability, fracture spacing, well drainage area and incremental production in gas shales

    KAUST Repository

    Eftekhari, Behzad; Marder, M.; Patzek, Tadeusz

    2018-01-01

    the external unstimulated reservoir. This allows us to estimate for the first time the effective permeability of the unstimulated shale and the spacing of fractures in the stimulated region. From an analysis of wells in the Barnett shale, we find

  6. Effects on the estimated cause-specific mortality fraction of providing physician reviewers with different formats of verbal autopsy data

    Directory of Open Access Journals (Sweden)

    Chow Clara

    2011-08-01

    a cause of death did not substantively influence the pattern of mortality estimated. Substantially abbreviated and simplified verbal autopsy questionnaires might provide robust information about high-level mortality patterns.

  7. Simplifying ART cohort monitoring: Can pharmacy stocks provide accurate estimates of patients retained on antiretroviral therapy in Malawi?

    Directory of Open Access Journals (Sweden)

    Tweya Hannock

    2012-07-01

    Full Text Available Abstract Background Routine monitoring of patients on antiretroviral therapy (ART is crucial for measuring program success and accurate drug forecasting. However, compiling data from patient registers to measure retention in ART is labour-intensive. To address this challenge, we conducted a pilot study in Malawi to assess whether patient ART retention could be determined using pharmacy records as compared to estimates of retention based on standardized paper- or electronic based cohort reports. Methods Twelve ART facilities were included in the study: six used paper-based registers and six used electronic data systems. One ART facility implemented an electronic data system in quarter three and was included as a paper-based system facility in quarter two only. Routine patient retention cohort reports, paper or electronic, were collected from facilities for both quarter two [April–June] and quarter three [July–September], 2010. Pharmacy stock data were also collected from the 12 ART facilities over the same period. Numbers of ART continuation bottles recorded on pharmacy stock cards at the beginning and end of each quarter were documented. These pharmacy data were used to calculate the total bottles dispensed to patients in each quarter with intent to estimate the number of patients retained on ART. Information for time required to determine ART retention was gathered through interviews with clinicians tasked with compiling the data. Results Among ART clinics with paper-based systems, three of six facilities in quarter two and four of five facilities in quarter three had similar numbers of patients retained on ART comparing cohort reports to pharmacy stock records. In ART clinics with electronic systems, five of six facilities in quarter two and five of seven facilities in quarter three had similar numbers of patients retained on ART when comparing retention numbers from electronically generated cohort reports to pharmacy stock records. Among

  8. 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.

  9. 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

  10. 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

  11. 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

  12. Field data provide estimates of effective permeability, fracture spacing, well drainage area and incremental production in gas shales

    KAUST Repository

    Eftekhari, Behzad

    2018-05-23

    About half of US natural gas comes from gas shales. It is valuable to study field production well by well. We present a field data-driven solution for long-term shale gas production from a horizontal, hydrofractured well far from other wells and reservoir boundaries. Our approach is a hybrid between an unstructured big-data approach and physics-based models. We extend a previous two-parameter scaling theory of shale gas production by adding a third parameter that incorporates gas inflow from the external unstimulated reservoir. This allows us to estimate for the first time the effective permeability of the unstimulated shale and the spacing of fractures in the stimulated region. From an analysis of wells in the Barnett shale, we find that on average stimulation fractures are spaced every 20 m, and the effective permeability of the unstimulated region is 100 nanodarcy. We estimate that over 30 years on production the Barnett wells will produce on average about 20% more gas because of inflow from the outside of the stimulated volume. There is a clear tradeoff between production rate and ultimate recovery in shale gas development. In particular, our work has strong implications for well spacing in infill drilling programs.

  13. Derelict fishing line provides a useful proxy for estimating levels of non-compliance with no-take marine reserves.

    Directory of Open Access Journals (Sweden)

    David H Williamson

    Full Text Available No-take marine reserves (NTMRs are increasingly being established to conserve or restore biodiversity and to enhance the sustainability of fisheries. Although effectively designed and protected NTMR networks can yield conservation and fishery benefits, reserve effects often fail to manifest in systems where there are high levels of non-compliance by fishers (poaching. Obtaining reliable estimates of NTMR non-compliance can be expensive and logistically challenging, particularly in areas with limited or non-existent resources for conducting surveillance and enforcement. Here we assess the utility of density estimates and re-accumulation rates of derelict (lost and abandoned fishing line as a proxy for fishing effort and NTMR non-compliance on fringing coral reefs in three island groups of the Great Barrier Reef Marine Park (GBRMP, Australia. Densities of derelict fishing line were consistently lower on reefs within old (>20 year NTMRs than on non-NTMR reefs (significantly in the Palm and Whitsunday Islands, whereas line densities did not differ significantly between reefs in new NTMRs (5 years of protection and non-NTMR reefs. A manipulative experiment in which derelict fishing lines were removed from a subset of the monitoring sites demonstrated that lines re-accumulated on NTMR reefs at approximately one third (32.4% of the rate observed on non-NTMR reefs over a thirty-two month period. Although these inshore NTMRs have long been considered some of the best protected within the GBRMP, evidence presented here suggests that the level of non-compliance with NTMR regulations is higher than previously assumed.

  14. 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.

  15. Comparison of NIS and NHIS/NIPRCS vaccination coverage estimates. National Immunization Survey. National Health Interview Survey/National Immunization Provider Record Check Study.

    Science.gov (United States)

    Bartlett, D L; Ezzati-Rice, T M; Stokley, S; Zhao, Z

    2001-05-01

    The National Immunization Survey (NIS) and the National Health Interview Survey (NHIS) produce national coverage estimates for children aged 19 months to 35 months. The NIS is a cost-effective, random-digit-dialing telephone survey that produces national and state-level vaccination coverage estimates. The National Immunization Provider Record Check Study (NIPRCS) is conducted in conjunction with the annual NHIS, which is a face-to-face household survey. As the NIS is a telephone survey, potential coverage bias exists as the survey excludes children living in nontelephone households. To assess the validity of estimates of vaccine coverage from the NIS, we compared 1995 and 1996 NIS national estimates with results from the NHIS/NIPRCS for the same years. Both the NIS and the NHIS/NIPRCS produce similar results. The NHIS/NIPRCS supports the findings of the NIS.

  16. Logistic quantile regression provides improved estimates for bounded avian counts: a case study of California Spotted Owl fledgling production

    Science.gov (United States)

    Brian S. Cade; Barry R. Noon; Rick D. Scherer; John J. Keane

    2017-01-01

    Counts of avian fledglings, nestlings, or clutch size that are bounded below by zero and above by some small integer form a discrete random variable distribution that is not approximated well by conventional parametric count distributions such as the Poisson or negative binomial. We developed a logistic quantile regression model to provide estimates of the empirical...

  17. Patch testing in Australia: Is it adequate?

    Science.gov (United States)

    Tizi, Stephanie; Nixon, Rosemary L

    2016-08-01

    Patch testing (PT) is essential for making the diagnosis of allergic contact dermatitis (ACD). However, the extent of PT undertaken by Australian dermatologists is unknown. The objectives of this study were to determine the rate and type of PT in Australia, the perceived obstacles to PT, and to explore the exposure to PT in dermatology training. Data were collected on private PT (analysing Medicare item numbers) and public hospital-based PT (estimated via verbal reports). An online survey on PT was sent to Fellows of the Australasian College of Dermatologists. It was found that total PT numbers, combining Medicare item number and public hospital data, were below the suggested optimum in all states and in Australia overall. Of the 173 respondents to the survey, 61% reported they patch tested and 78% reported they referred for PT. TrueTest was the most commonly used PT system, although it is known to be inadequate. Dermatologists who PT as registrars were significantly more likely to PT as consultants (P value = 0.0029). Cost, expertise required and staffing were considered major obstacles to performing PT. Accessibility and cost to the patient were common obstacles to referral. The combination of suboptimal PT rates and inadequate PT means that patients are missing out on being diagnosed with ACD in Australia. Increasing the exposure of registrars to PT, supporting specialised centres, the development of the Australian Baseline Series and the Contact Allergen Bank will, it is hoped, improve the rates of comprehensive PT in Australia. © 2015 The Australasian College of Dermatologists.

  18. 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...

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

    International Nuclear Information System (INIS)

    Moore, B; Brady, S; Kaufman, R; Mirro, A

    2014-01-01

    Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE

  5. MO-E-17A-04: Size-Specific Dose Estimate (SSDE) Provides a Simple Method to Calculate Organ Dose for Pediatric CT Examinations

    Energy Technology Data Exchange (ETDEWEB)

    Moore, B; Brady, S; Kaufman, R [St Jude Children' s Research Hospital, Memphis, TN (United States); Mirro, A [Washington University, St. Louis, MO (United States)

    2014-06-15

    Purpose: Investigate the correlation of SSDE with organ dose in a pediatric population. Methods: Four anthropomorphic phantoms, representing a range of pediatric body habitus, were scanned with MOSFET dosimeters placed at 23 organ locations to determine absolute organ dosimetry. Phantom organ dosimetry was divided by phantom SSDE to determine correlation between organ dose and SSDE. Correlation factors were then multiplied by patient SSDE to estimate patient organ dose. Patient demographics consisted of 352 chest and 241 abdominopelvic CT examinations, 22 ± 15 kg (range 5−55 kg) mean weight, and 6 ± 5 years (range 4 mon to 23 years) mean age. Patient organ dose estimates were compared to published pediatric Monte Carlo study results. Results: Phantom effective diameters were matched with patient population effective diameters to within 4 cm. 23 organ correlation factors were determined in the chest and abdominopelvic region across nine pediatric weight subcategories. For organs fully covered by the scan volume, correlation in the chest (average 1.1; range 0.7−1.4) and abdominopelvic (average 0.9; range 0.7−1.3) was near unity. For organs that extended beyond the scan volume (i.e., skin, bone marrow, and bone surface), correlation was determined to be poor (average 0.3; range: 0.1−0.4) for both the chest and abdominopelvic regions, respectively. Pediatric organ dosimetry was compared to published values and was found to agree in the chest to better than an average of 5% (27.6/26.2) and in the abdominopelvic region to better than 2% (73.4/75.0). Conclusion: Average correlation of SSDE and organ dosimetry was found to be better than ± 10% for fully covered organs within the scan volume. This study provides a list of organ dose correlation factors for the chest and abdominopelvic regions, and describes a simple methodology to estimate individual pediatric patient organ dose based on patient SSDE.

  6. 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...

  7. 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...

  8. 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...

  9. Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

    Science.gov (United States)

    Baldini, Christopher G; Culley, Eric J

    2011-01-01

    A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. Quantifying the Impact of Natural Immunity on Rotavirus Vaccine Efficacy Estimates: A Clinical Trial in Dhaka, Bangladesh (PROVIDE) and a Simulation Study.

    Science.gov (United States)

    Rogawski, Elizabeth T; Platts-Mills, James A; Colgate, E Ross; Haque, Rashidul; Zaman, K; Petri, William A; Kirkpatrick, Beth D

    2018-03-05

    The low efficacy of rotavirus vaccines in clinical trials performed in low-resource settings may be partially explained by acquired immunity from natural exposure, especially in settings with high disease incidence. In a clinical trial of monovalent rotavirus vaccine in Bangladesh, we compared the original per-protocol efficacy estimate to efficacy derived from a recurrent events survival model in which children were considered naturally exposed and potentially immune after their first rotavirus diarrhea (RVD) episode. We then simulated trial cohorts to estimate the expected impact of prior exposure on efficacy estimates for varying rotavirus incidence rates and vaccine efficacies. Accounting for natural immunity increased the per-protocol vaccine efficacy estimate against severe RVD from 63.1% (95% confidence interval [CI], 33.0%-79.7%) to 70.2% (95% CI, 44.5%-84.0%) in the postvaccination period, and original year 2 efficacy was underestimated by 14%. The simulations demonstrated that this expected impact increases linearly with RVD incidence, will be greatest for vaccine efficacies near 50%, and can reach 20% in settings with high incidence and low efficacy. High rotavirus incidence leads to predictably lower vaccine efficacy estimates due to the acquisition of natural immunity in unvaccinated children, and this phenomenon should be considered when comparing efficacy estimates across settings. NCT01375647.

  15. 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.

  16. Rapid exposure and loss estimates for the May 12, 2008 Mw 7.9 Wenchuan earthquake provided by the U.S. Geological Survey's PAGER system

    Science.gov (United States)

    Earle, P.S.; Wald, D.J.; Allen, T.I.; Jaiswal, K.S.; Porter, K.A.; Hearne, M.G.

    2008-01-01

    One half-hour after the May 12th Mw 7.9 Wenchuan, China earthquake, the U.S. Geological Survey’s Prompt Assessment of Global Earthquakes for Response (PAGER) system distributed an automatically generated alert stating that 1.2 million people were exposed to severe-to-extreme shaking (Modified Mercalli Intensity VIII or greater). It was immediately clear that a large-scale disaster had occurred. These alerts were widely distributed and referenced by the major media outlets and used by governments, scientific, and relief agencies to guide their responses. The PAGER alerts and Web pages included predictive ShakeMaps showing estimates of ground shaking, maps of population density, and a list of estimated intensities at impacted cities. Manual, revised alerts were issued in the following hours that included the dimensions of the fault rupture. Within a half-day, PAGER’s estimates of the population exposed to strong shaking levels stabilized at 5.2 million people. A coordinated research effort is underway to extend PAGER’s capability to include estimates of the number of casualties. We are pursuing loss models that will allow PAGER the flexibility to use detailed inventory and engineering results in regions where these data are available while also calculating loss estimates in regions where little is known about the type and strength of the built infrastructure. Prototype PAGER fatality estimates are currently implemented and can be manually triggered. In the hours following the Wenchuan earthquake, these models predicted fatalities in the tens of thousands.

  17. 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...

  18. 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...

  19. 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 ...

  20. 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)

  1. 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

  2. Quantitative estimation of cholinesterase-specific drug metabolism of carbamate inhibitors provided by the analysis of the area under the inhibition-time curve.

    Science.gov (United States)

    Zhou, Huimin; Xiao, Qiaoling; Tan, Wen; Zhan, Yiyi; Pistolozzi, Marco

    2017-09-10

    Several molecules containing carbamate groups are metabolized by cholinesterases. This metabolism includes a time-dependent catalytic step which temporary inhibits the enzymes. In this paper we demonstrate that the analysis of the area under the inhibition versus time curve (AUIC) can be used to obtain a quantitative estimation of the amount of carbamate metabolized by the enzyme. (R)-bambuterol monocarbamate and plasma butyrylcholinesterase were used as model carbamate-cholinesterase system. The inhibition of different concentrations of the enzyme was monitored for 5h upon incubation with different concentrations of carbamate and the resulting AUICs were analyzed. The amount of carbamate metabolized could be estimated with cholinesterases in a selected compartment in which the cholinesterase is confined (e.g. in vitro solutions, tissues or body fluids), either in vitro or in vivo. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Statistical modelling and RCS detrending methods provide similar estimates of long-term trend in radial growth of common beech in north-eastern France

    OpenAIRE

    Bontemps , Jean-Daniel; Esper , Jan

    2011-01-01

    International audience; Dendrochronological methods have greatly contributed to the documentation of past long-term trends in forest growth. These methods primarily focus on the high-frequency signals of tree ring chronologies. They require the removal of the ageing trend in tree growth, known as 'standardisation' or 'detrending', as a prerequisite to the estimation of such trends. Because the approach is sequential, it may however absorb part of the low-frequency historical signal. In this s...

  4. 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…

  5. 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...

  6. 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...

  7. Pilot-scale data provide enhanced estimates of the life cycle energy and emissions profile of algae biofuels produced via hydrothermal liquefaction.

    Science.gov (United States)

    Liu, Xiaowei; Saydah, Benjamin; Eranki, Pragnya; Colosi, Lisa M; Greg Mitchell, B; Rhodes, James; Clarens, Andres F

    2013-11-01

    Life cycle assessment (LCA) has been used widely to estimate the environmental implications of deploying algae-to-energy systems even though no full-scale facilities have yet to be built. Here, data from a pilot-scale facility using hydrothermal liquefaction (HTL) is used to estimate the life cycle profiles at full scale. Three scenarios (lab-, pilot-, and full-scale) were defined to understand how development in the industry could impact its life cycle burdens. HTL-derived algae fuels were found to have lower greenhouse gas (GHG) emissions than petroleum fuels. Algae-derived gasoline had significantly lower GHG emissions than corn ethanol. Most algae-based fuels have an energy return on investment between 1 and 3, which is lower than petroleum biofuels. Sensitivity analyses reveal several areas in which improvements by algae bioenergy companies (e.g., biocrude yields, nutrient recycle) and by supporting industries (e.g., CO2 supply chains) could reduce the burdens of the industry. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. 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.

  9. The Need to Provide for Security in Old Age in Hierarchy of Needs-An Estimation of Its Ranking within the Polish Population

    Science.gov (United States)

    Roszkiewicz, Malgorzata

    2004-01-01

    The results of studies conducted in the last 5 years in Poland formed the basis for the assumption that amongst many needs an individual or a Polish household seeks to satisfy, the need to provide for security in old age takes a prominent position. Determining the position of this need among other needs as defined in Schrab's classification…

  10. 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

  11. 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.

  12. 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

  13. [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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. Using laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) to characterize copper, zinc and mercury along grizzly bear hair providing estimate of diet

    Energy Technology Data Exchange (ETDEWEB)

    Noël, Marie, E-mail: marie.noel@stantec.com [Stantec Consulting Ltd. 2042 Mills Road, Unit 11, Sidney BC V8L 4X2 (Canada); Christensen, Jennie R., E-mail: jennie.christensen@stantec.com [Stantec Consulting Ltd. 2042 Mills Road, Unit 11, Sidney BC V8L 4X2 (Canada); Spence, Jody, E-mail: jodys@uvic.ca [School of Earth and Ocean Sciences, Bob Wright Centre A405, University of Victoria, PO BOX 3065 STN CSC, Victoria, BC V8W 3V6 (Canada); Robbins, Charles T., E-mail: ctrobbins@wsu.edu [School of the Environment and School of Biological Sciences, Washington State University, Pullman, WA 99164-4236 (United States)

    2015-10-01

    We enhanced an existing technique, laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS), to function as a non-lethal tool in the temporal characterization of trace element exposure in wild mammals. Mercury (Hg), copper (Cu), cadmium (Cd), lead (Pb), iron (Fe) and zinc (Zn) were analyzed along the hair of captive and wild grizzly bears (Ursus arctos horribilis). Laser parameters were optimized (consecutive 2000 μm line scans along the middle line of the hair at a speed of 50 μm/s; spot size = 30 μm) for consistent ablation of the hair. A pressed pellet of reference material DOLT-2 and sulfur were used as external and internal standards, respectively. Our newly adapted method passed the quality control tests with strong correlations between trace element concentrations obtained using LA-ICP-MS and those obtained with regular solution-ICP-MS (r{sup 2} = 0.92, 0.98, 0.63, 0.57, 0.99 and 0.90 for Hg, Fe, Cu, Zn, Cd and Pb, respectively). Cross-correlation analyses revealed good reproducibility between trace element patterns obtained from hair collected from the same bear. One exception was Cd for which external contamination was observed resulting in poor reproducibility. In order to validate the method, we used LA-ICP-MS on the hair of five captive grizzly bears fed known and varying amounts of cutthroat trout over a period of 33 days. Trace element patterns along the hair revealed strong Hg, Cu and Zn signals coinciding with fish consumption. Accordingly, significant correlations between Hg, Cu, and Zn in the hair and Hg, Cu, and Zn intake were evident and we were able to develop accumulation models for each of these elements. While the use of LA-ICP-MS for the monitoring of trace elements in wildlife is in its infancy, this study highlights the robustness and applicability of this newly adapted method. - Highlights: • LA-ICP-MS provides temporal trace metal exposure information for wild grizzly bears. • Cu and Zn temporal exposures provide

  19. Using laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) to characterize copper, zinc and mercury along grizzly bear hair providing estimate of diet

    International Nuclear Information System (INIS)

    Noël, Marie; Christensen, Jennie R.; Spence, Jody; Robbins, Charles T.

    2015-01-01

    We enhanced an existing technique, laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS), to function as a non-lethal tool in the temporal characterization of trace element exposure in wild mammals. Mercury (Hg), copper (Cu), cadmium (Cd), lead (Pb), iron (Fe) and zinc (Zn) were analyzed along the hair of captive and wild grizzly bears (Ursus arctos horribilis). Laser parameters were optimized (consecutive 2000 μm line scans along the middle line of the hair at a speed of 50 μm/s; spot size = 30 μm) for consistent ablation of the hair. A pressed pellet of reference material DOLT-2 and sulfur were used as external and internal standards, respectively. Our newly adapted method passed the quality control tests with strong correlations between trace element concentrations obtained using LA-ICP-MS and those obtained with regular solution-ICP-MS (r 2 = 0.92, 0.98, 0.63, 0.57, 0.99 and 0.90 for Hg, Fe, Cu, Zn, Cd and Pb, respectively). Cross-correlation analyses revealed good reproducibility between trace element patterns obtained from hair collected from the same bear. One exception was Cd for which external contamination was observed resulting in poor reproducibility. In order to validate the method, we used LA-ICP-MS on the hair of five captive grizzly bears fed known and varying amounts of cutthroat trout over a period of 33 days. Trace element patterns along the hair revealed strong Hg, Cu and Zn signals coinciding with fish consumption. Accordingly, significant correlations between Hg, Cu, and Zn in the hair and Hg, Cu, and Zn intake were evident and we were able to develop accumulation models for each of these elements. While the use of LA-ICP-MS for the monitoring of trace elements in wildlife is in its infancy, this study highlights the robustness and applicability of this newly adapted method. - Highlights: • LA-ICP-MS provides temporal trace metal exposure information for wild grizzly bears. • Cu and Zn temporal exposures provide

  20. 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.

  1. 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

  2. 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...

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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)

  9. 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…

  10. 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.

  11. 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.

  12. 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

    strong opposition to growth of nuclear power in a number of quarters - it is vital that the market provides incentives for exploration and development of environmentally sustainable mining operations. Thorium: World Reasonably Assured plus Inferred Resources of thorium are estimated at over 2.2 million tonnes, in hard rock and heavy mineral sand deposits. At least double this amount is considered to occur in as yet undiscovered thorium deposits. Currently, demand for thorium is insignificant, but even a major shift to thorium-fueled reactors would not make significant inroads into the huge resource base over the next half century.

  13. 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…

  14. 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…

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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

  7. Magnetic Resonance Imaging Provides Added Value to the Prostate Cancer Prevention Trial Risk Calculator for Patients With Estimated Risk of High-grade Prostate Cancer Less Than or Equal to 10.

    Science.gov (United States)

    Kim, Eric H; Weaver, John K; Shetty, Anup S; Vetter, Joel M; Andriole, Gerald L; Strope, Seth A

    2017-04-01

    To determine the added value of prostate magnetic resonance imaging (MRI) to the Prostate Cancer Prevention Trial risk calculator. Between January 2012 and December 2015, 339 patients underwent prostate MRI prior to biopsy at our institution. MRI was considered positive if there was at least 1 Prostate Imaging Reporting and Data System 4 or 5 MRI suspicious region. Logistic regression was used to develop 2 models: biopsy outcome as a function of the (1) Prostate Cancer Prevention Trial risk calculator alone and (2) combined with MRI findings. When including all patients, the Prostate Cancer Prevention Trial with and without MRI models performed similarly (area under the curve [AUC] = 0.74 and 0.78, P = .06). When restricting the cohort to patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%, the model with MRI outperformed the Prostate Cancer Prevention Trial alone model (AUC = 0.69 and 0.60, P = .01). Within this cohort of patients, there was no significant difference in discrimination between models for those with previous negative biopsy (AUC = 0.61 vs 0.63, P = .76), whereas there was a significant improvement in discrimination with the MRI model for biopsy-naïve patients (AUC = 0.72 vs 0.60, P = .01). The use of prostate MRI in addition to the Prostate Cancer Prevention Trial risk calculator provides a significant improvement in clinical risk discrimination for patients with estimated risk of high-grade (Gleason ≥7) prostate cancer ≤10%. Prebiopsy prostate MRI should be strongly considered for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  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. 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.

  15. 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.

  16. [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.

  17. 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...

  18. 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.

  19. 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...

  20. Estimation of nuclear power plant aircraft hazards

    International Nuclear Information System (INIS)

    Gottlieb, P.

    1978-01-01

    The standard procedures for estimating aircraft risk to nuclear power plants provide a conservative estimate, which is adequate for most sites, which are not close to airports or heavily traveled air corridors. For those sites which are close to facilities handling large numbers of aircraft movements (airports or corridors), a more precise estimate of aircraft impact frequency can be obtained as a function of aircraft size. In many instances the very large commercial aircraft can be shown to have an acceptably small impact frequency, while the very small general aviation aircraft will not produce sufficiently serious impact to impair the safety-related functions. This paper examines the in between aircraft: primarily twin-engine, used for business, pleasure, and air taxi operations. For this group of aircraft the total impact frequency was found to be approximately once in one million years, the threshold above which further consideration of specific safety-related consequences would be required

  1. 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

  2. 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.

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

    International Nuclear Information System (INIS)

    Heery Mary

    2006-08-01

    Since the introduction of the workplace ban on smoking in March, 2004 radon is the most significant factor for lung cancer in the workplace in Ireland. Radon is a natural radioactive invisible gas which accounts for over 60% of the total radiation dose received in Ireland. It has been classified as a Group One carcinogen by the World Health Organisation and is the second most important risk factor for lung cancer worldwide, after tobacco smoking. Lung cancer is the most common type of cancer causing death in Ireland. The Radiological Protection Institute of Ireland estimate that there are approximately 200 deaths per year in Ireland linked to radon. The aim of this study was to determine if the health of Irish workers was being protected from the effects of radon gas. Indoor workplaces in Sligo and Ballina, two towns in High Radon Areas were surveyed, to assess awareness of, and compliance with the legislation governing radon in the workplace. The results show that of employers surveyed: at least 50% did not know that their workplace was located in a High Radon Areas, 43% were not aware of the legislation governing radon in the workplace, 48% had not identified radon as a hazard to health and safety, 64% had not included radon in the workplace Safety Statement and 58% had not carried out a measurement for radon. The results also show that: awareness and compliance was higher in Public Sector workplaces than in Private Sector workplaces, it was higher among larger employers with an international profile than among smaller local employers, employers knew where to go to for advice and guidance on carrying out radon surveys in the workplace, advice on radon was not readily available from State bodies like the Health and Safety Authority, Local Authorities and the Health Service Executive. In conclusion, more than half of all employers surveyed were failing to comply with legislation governing radon in the workplace, yet no employer in either town had ever been

  4. 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.

  5. 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.

  6. Quantifying Uncertainty in Soil Volume Estimates

    International Nuclear Information System (INIS)

    Roos, A.D.; Hays, D.C.; Johnson, R.L.; Durham, L.A.; Winters, M.

    2009-01-01

    Proper planning and design for remediating contaminated environmental media require an adequate understanding of the types of contaminants and the lateral and vertical extent of contamination. In the case of contaminated soils, this generally takes the form of volume estimates that are prepared as part of a Feasibility Study for Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) sites and/or as part of the remedial design. These estimates are typically single values representing what is believed to be the most likely volume of contaminated soil present at the site. These single-value estimates, however, do not convey the level of confidence associated with the estimates. Unfortunately, the experience has been that pre-remediation soil volume estimates often significantly underestimate the actual volume of contaminated soils that are encountered during the course of remediation. This underestimation has significant implications, both technically (e.g., inappropriate remedial designs) and programmatically (e.g., establishing technically defensible budget and schedule baselines). Argonne National Laboratory (Argonne) has developed a joint Bayesian/geostatistical methodology for estimating contaminated soil volumes based on sampling results, that also provides upper and lower probabilistic bounds on those volumes. This paper evaluates the performance of this method in a retrospective study that compares volume estimates derived using this technique with actual excavated soil volumes for select Formerly Utilized Sites Remedial Action Program (FUSRAP) Maywood properties that have completed remedial action by the U.S. Army Corps of Engineers (USACE) New York District. (authors)

  7. 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

  8. Dietary vitamin A intakes of Filipino elders with adequate or low liver vitamin A concentrations as assessed by the deuterated-retinol-dilution method: implications for dietary requirements.

    Science.gov (United States)

    Ribaya-Mercado, Judy D; Solon, Florentino S; Fermin, Liza S; Perfecto, Christine S; Solon, Juan Antonio A; Dolnikowski, Gregory G; Russell, Robert M

    2004-04-01

    The vitamin A requirements of elderly humans have not been studied. In a cross-sectional study of 60-88-y-old men (n = 31) and women (n = 31) in rural Philippines, we assessed the dietary intakes of elders with adequate (> or = 0.07 micromol/g) or low (value for elders. The mean (+/- SD) vitamin A intakes of the men and women with adequate vitamin A in liver were 135 +/- 86 and 134 +/- 104 microg retinol activity equivalents (RAE)/d, respectively; intakes of the men and women with low vitamin A in liver were 75 +/- 53 and 60 +/- 27 microg RAE/d, respectively. Total-body vitamin A or liver vitamin A but not serum retinol correlated with dietary RAE, preformed vitamin A, beta-carotene, fat, and protein. An estimated acceptable or sufficient dietary vitamin A intake associated with adequate liver vitamin A concentrations in elders is 6.45 microg RAE/kg body wt; for a reference 76-kg man and a 61-kg woman, these values are approximately 500 and 400 microg RAE/d, respectively. The dietary vitamin A intakes of elders with adequate or low liver vitamin A concentrations as estimated by use of the deuterated-retinol-dilution technique are useful for assessing vitamin A requirements.

  9. 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

  10. 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.

  11. 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...

  12. 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 ...

  13. 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...

  14. 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

  15. 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...

  16. 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…

  17. 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...

  18. Guam Medical Staffing Plan Needs Improvement to Ensure Eligible Beneficiaries Will Have Adequate Access to Health Care

    Science.gov (United States)

    2012-05-16

    Podiatry • Gastroenterology • Pediatric Psychology • Pediatric Psychiatry • Cardio Thoracic Surgery NMW estimated that USNH Guam will deliver...considered using circuit rider programs for neurology and podiatry . Circuit rider programs provide limited access to specialty care because providers...are: Neurology, Neurosurgery, Cardiology, Cardio Thoracic Surgery, NICU, Podiatry , Gastroenterology; Pediatric Psychiatry, and Pediatric Psychology

  19. 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.

  20. 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.

  1. Aboveground Forest Biomass Estimation with Landsat and LiDAR Data and Uncertainty Analysis of the Estimates

    Directory of Open Access Journals (Sweden)

    Dengsheng Lu

    2012-01-01

    Full Text Available Landsat Thematic mapper (TM image has long been the dominate data source, and recently LiDAR has offered an important new structural data stream for forest biomass estimations. On the other hand, forest biomass uncertainty analysis research has only recently obtained sufficient attention due to the difficulty in collecting reference data. This paper provides a brief overview of current forest biomass estimation methods using both TM and LiDAR data. A case study is then presented that demonstrates the forest biomass estimation methods and uncertainty analysis. Results indicate that Landsat TM data can provide adequate biomass estimates for secondary succession but are not suitable for mature forest biomass estimates due to data saturation problems. LiDAR can overcome TM’s shortcoming providing better biomass estimation performance but has not been extensively applied in practice due to data availability constraints. The uncertainty analysis indicates that various sources affect the performance of forest biomass/carbon estimation. With that said, the clear dominate sources of uncertainty are the variation of input sample plot data and data saturation problem related to optical sensors. A possible solution to increasing the confidence in forest biomass estimates is to integrate the strengths of multisensor data.

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Estimations of actual availability

    International Nuclear Information System (INIS)

    Molan, M.; Molan, G.

    2001-01-01

    Adaptation of working environment (social, organizational, physical and physical) should assure higher level of workers' availability and consequently higher level of workers' performance. A special theoretical model for description of connections between environmental factors, human availability and performance was developed and validated. The central part of the model is evaluations of human actual availability in the real working situation or fitness for duties self-estimation. The model was tested in different working environments. On the numerous (2000) workers, standardized values and critical limits for an availability questionnaire were defined. Standardized method was used in identification of the most important impact of environmental factors. Identified problems were eliminated by investments in the organization in modification of selection and training procedures in humanization of working .environment. For workers with behavioural and health problems individual consultancy was offered. The described method is a tool for identification of impacts. In combination with behavioural analyses and mathematical analyses of connections, it offers possibilities to keep adequate level of human availability and fitness for duty in each real working situation. The model should be a tool for achieving adequate level of nuclear safety by keeping the adequate level of workers' availability and fitness for duty. For each individual worker possibility for estimation of level of actual fitness for duty is possible. Effects of prolonged work and additional tasks should be evaluated. Evaluations of health status effects and ageing are possible on the individual level. (author)

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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)

  1. 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)

  2. 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...

  3. 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.

  4. 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.)

  5. 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.

  6. 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)

  7. Temporal rainfall estimation using input data reduction and model inversion

    Science.gov (United States)

    Wright, A. J.; Vrugt, J. A.; Walker, J. P.; Pauwels, V. R. N.

    2016-12-01

    Floods are devastating natural hazards. To provide accurate, precise and timely flood forecasts there is a need to understand the uncertainties associated with temporal rainfall and model parameters. The estimation of temporal rainfall and model parameter distributions from streamflow observations in complex dynamic catchments adds skill to current areal rainfall estimation methods, allows for the uncertainty of rainfall input to be considered when estimating model parameters and provides the ability to estimate rainfall from poorly gauged catchments. Current methods to estimate temporal rainfall distributions from streamflow are unable to adequately explain and invert complex non-linear hydrologic systems. This study uses the Discrete Wavelet Transform (DWT) to reduce rainfall dimensionality for the catchment of Warwick, Queensland, Australia. The reduction of rainfall to DWT coefficients allows the input rainfall time series to be simultaneously estimated along with model parameters. The estimation process is conducted using multi-chain Markov chain Monte Carlo simulation with the DREAMZS algorithm. The use of a likelihood function that considers both rainfall and streamflow error allows for model parameter and temporal rainfall distributions to be estimated. Estimation of the wavelet approximation coefficients of lower order decomposition structures was able to estimate the most realistic temporal rainfall distributions. These rainfall estimates were all able to simulate streamflow that was superior to the results of a traditional calibration approach. It is shown that the choice of wavelet has a considerable impact on the robustness of the inversion. The results demonstrate that streamflow data contains sufficient information to estimate temporal rainfall and model parameter distributions. The extent and variance of rainfall time series that are able to simulate streamflow that is superior to that simulated by a traditional calibration approach is a

  8. The Design Model of Multilevel Estimation Means for Students’ Competence Assessment at Technical Higher School

    Directory of Open Access Journals (Sweden)

    O. F. Shikhova

    2012-01-01

    Full Text Available The paper considers the research findings aimed at the developing the new quality testing technique for students assessment at Technical Higher School. The model of multilevel estimation means is provided for diagnosing the level of general cultural and professional competences of students doing a bachelor degree in technological fields. The model implies the integrative character of specialists training - the combination of both the psycho-pedagogic (invariable and engineering (variable components, as well as the qualimetric approach substantiating the system of students competence estimation and providing the most adequate assessment means. The principles of designing the multilevel estimation means are defined along with the methodology approaches to their implementation. For the reasonable selection of estimation means, the system of quality criteria is proposed by the authors, being based on the group expert assessment. The research findings can be used for designing the competence-oriented estimation means. 

  9. 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.

  10. 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.

  11. 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...

  12. Electrical estimating methods

    CERN Document Server

    Del Pico, Wayne J

    2014-01-01

    Simplify the estimating process with the latest data, materials, and practices Electrical Estimating Methods, Fourth Edition is a comprehensive guide to estimating electrical costs, with data provided by leading construction database RS Means. The book covers the materials and processes encountered by the modern contractor, and provides all the information professionals need to make the most precise estimate. The fourth edition has been updated to reflect the changing materials, techniques, and practices in the field, and provides the most recent Means cost data available. The complexity of el

  13. 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)

  14. 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...

  15. 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)

  16. 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.

  17. 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

  18. 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.

  19. Estimating Body Related Soft Biometric Traits in Video Frames

    Directory of Open Access Journals (Sweden)

    Olasimbo Ayodeji Arigbabu

    2014-01-01

    Full Text Available Soft biometrics can be used as a prescreening filter, either by using single trait or by combining several traits to aid the performance of recognition systems in an unobtrusive way. In many practical visual surveillance scenarios, facial information becomes difficult to be effectively constructed due to several varying challenges. However, from distance the visual appearance of an object can be efficiently inferred, thereby providing the possibility of estimating body related information. This paper presents an approach for estimating body related soft biometrics; specifically we propose a new approach based on body measurement and artificial neural network for predicting body weight of subjects and incorporate the existing technique on single view metrology for height estimation in videos with low frame rate. Our evaluation on 1120 frame sets of 80 subjects from a newly compiled dataset shows that the mentioned soft biometric information of human subjects can be adequately predicted from set of frames.

  20. 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...

  1. Parameter Estimation

    DEFF Research Database (Denmark)

    Sales-Cruz, Mauricio; Heitzig, Martina; Cameron, Ian

    2011-01-01

    of optimisation techniques coupled with dynamic solution of the underlying model. Linear and nonlinear approaches to parameter estimation are investigated. There is also the application of maximum likelihood principles in the estimation of parameters, as well as the use of orthogonal collocation to generate a set......In this chapter the importance of parameter estimation in model development is illustrated through various applications related to reaction systems. In particular, rate constants in a reaction system are obtained through parameter estimation methods. These approaches often require the application...... of algebraic equations as the basis for parameter estimation.These approaches are illustrated using estimations of kinetic constants from reaction system models....

  2. Estimating and Forecasting Generalized Fractional Long Memory Stochastic Volatility Models

    Directory of Open Access Journals (Sweden)

    Shelton Peiris

    2017-12-01

    Full Text Available This paper considers a flexible class of time series models generated by Gegenbauer polynomials incorporating the long memory in stochastic volatility (SV components in order to develop the General Long Memory SV (GLMSV model. We examine the corresponding statistical properties of this model, discuss the spectral likelihood estimation and investigate the finite sample properties via Monte Carlo experiments. We provide empirical evidence by applying the GLMSV model to three exchange rate return series and conjecture that the results of out-of-sample forecasts adequately confirm the use of GLMSV model in certain financial applications.

  3. 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

  4. 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.

  5. In Few Words: Linguistic Gap but Adequate Narrative Structure in Preschool Bilingual Children

    Science.gov (United States)

    Bonifacci, Paola; Barbieri, Margherita; Tomassini, Marta; Roch, Maja

    2018-01-01

    The aim of this study was to compare linguistic and narrative skills of monolingual and bilingual preschoolers and to estimate linguistic predictors of the macro-structural level of narratives. A battery of linguistic measures in Italian was administered to sixty-four Monolinguals and sixty-four Early Bilinguals; it included Vocabulary,…

  6. Sky luminance research imperative for adequate ciontrol of temporary supplementary artificial lighting installations

    NARCIS (Netherlands)

    Rutten, A.J.F.

    1994-01-01

    The energy consumption in Dutch office buildings can be cut considerably if daylight is used as task lighting. A conservative estimate gives a potential saving of 46% on the electricity costs for artificial lighting. The problem of photo-electric control of artificial lighting supplementing the

  7. 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.

  8. 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.)

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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)

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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...

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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)

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. IDC reengineering Phase 2 & 3 US industry standard cost estimate summary

    Energy Technology Data Exchange (ETDEWEB)

    Harris, James M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Huelskamp, Robert M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-01-01

    Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, using a commercial software cost estimation tool calibrated to US industry performance parameters. This is not a cost estimate for Sandia to perform the project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can neither commence nor continue unless adequate funding has been accepted and certified by DOE.

  16. 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...

  17. 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...

  18. Overconfidence in Interval Estimates

    Science.gov (United States)

    Soll, Jack B.; Klayman, Joshua

    2004-01-01

    Judges were asked to make numerical estimates (e.g., "In what year was the first flight of a hot air balloon?"). Judges provided high and low estimates such that they were X% sure that the correct answer lay between them. They exhibited substantial overconfidence: The correct answer fell inside their intervals much less than X% of the time. This…

  19. Ecosystem services provided by bats.

    Science.gov (United States)

    Kunz, Thomas H; Braun de Torrez, Elizabeth; Bauer, Dana; Lobova, Tatyana; Fleming, Theodore H

    2011-03-01

    Ecosystem services are the benefits obtained from the environment that increase human well-being. Economic valuation is conducted by measuring the human welfare gains or losses that result from changes in the provision of ecosystem services. Bats have long been postulated to play important roles in arthropod suppression, seed dispersal, and pollination; however, only recently have these ecosystem services begun to be thoroughly evaluated. Here, we review the available literature on the ecological and economic impact of ecosystem services provided by bats. We describe dietary preferences, foraging behaviors, adaptations, and phylogenetic histories of insectivorous, frugivorous, and nectarivorous bats worldwide in the context of their respective ecosystem services. For each trophic ensemble, we discuss the consequences of these ecological interactions on both natural and agricultural systems. Throughout this review, we highlight the research needed to fully determine the ecosystem services in question. Finally, we provide a comprehensive overview of economic valuation of ecosystem services. Unfortunately, few studies estimating the economic value of ecosystem services provided by bats have been conducted to date; however, we outline a framework that could be used in future studies to more fully address this question. Consumptive goods provided by bats, such as food and guano, are often exchanged in markets where the market price indicates an economic value. Nonmarket valuation methods can be used to estimate the economic value of nonconsumptive services, including inputs to agricultural production and recreational activities. Information on the ecological and economic value of ecosystem services provided by bats can be used to inform decisions regarding where and when to protect or restore bat populations and associated habitats, as well as to improve public perception of bats. © 2011 New York Academy of Sciences.

  20. [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.

  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. 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.)

  3. 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.)

  4. 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...

  5. Adaptive Spectral Doppler Estimation

    DEFF Research Database (Denmark)

    Gran, Fredrik; Jakobsson, Andreas; Jensen, Jørgen Arendt

    2009-01-01

    . The methods can also provide better quality of the estimated power spectral density (PSD) of the blood signal. Adaptive spectral estimation techniques are known to pro- vide good spectral resolution and contrast even when the ob- servation window is very short. The 2 adaptive techniques are tested......In this paper, 2 adaptive spectral estimation techniques are analyzed for spectral Doppler ultrasound. The purpose is to minimize the observation window needed to estimate the spectrogram to provide a better temporal resolution and gain more flexibility when designing the data acquisition sequence...... and compared with the averaged periodogram (Welch’s method). The blood power spectral capon (BPC) method is based on a standard minimum variance technique adapted to account for both averaging over slow-time and depth. The blood amplitude and phase estimation technique (BAPES) is based on finding a set...

  6. 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...

  7. 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

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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...

  13. 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.

  14. 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...

  15. 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...

  16. 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...

  17. "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…

  18. 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.

  19. 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...

  20. 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

  1. 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.

  2. 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.

  3. ROLE OF DIETARY DIVERSITY IN ENSURING ADEQUATE HAEMATOLOGICAL STATUS DURING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Mahama Saaka, Abdulai Abdul Rauf

    2015-10-01

    Full Text Available Introduction: Though nutrition is a key input to blood formation, little is known about the extent maternal dietary quality contributes to the haematological status of pregnant women in Northern Region of Ghana. Objective: The aim of this study was to assess the independent contribution of dietary diversity to haematological status of pregnant women whilst controlling for potential confounding factors including malarial infection. Methods: A cross-sectional study design was used on a sample of 307 pregnant women in their third trimester. A structured questionnaire was used to collect socio-demographic characteristics, obstetric and dietary data related to anaemia. Overall dietary quality was assessed using the dietary diversity score. Haemoglobin concentration (Hb was measured using portable HemoCueR Hb 301 system. Predictors of anaemia were estimated using multiple linear regression analysis. Results: The mean Hb was 10.8±1.4 g/dl and prevalence of anaemia (Hb < 11.0 g/dl was 46.3 %. High dietary diversity score [Beta coefficient (β, = 0.141 p < 0.001], multi-gravidity (β=0.205 and high composite score for ANC content (β= 0.201 were associated with a decreased risk of anaemia in the third trimester of pregnancy. Conclusion: The findings suggest the need to strengthen interventions that focus on improving the consumption of diversified foods particularly during pregnancy.

  4. Understanding of morphometric features for adequate water resource management in arid environments

    Science.gov (United States)

    Elhag, Mohamed; Galal, Hanaa K.; Alsubaie, Haneen

    2017-08-01

    Hydrological characteristics such as topographic parameters, drainage attributes, and land use/land cover patterns are essential to evaluate the water resource management of a watershed area. In the current study, delineation of a watershed and calculation of morphometric characteristics were undertaken using the ASTER global digital elevation model (GDEM). The drainage density of the basin was estimated to be very high, which indicates that the watershed possesses highly permeable soils and low to medium relief. The stream order of the area ranges from first to sixth order, showing a semi-dendritic and radial drainage pattern that indicates heterogeneity in textural characteristics, and it is influenced by structural characteristics in the study area. The bifurcation ratio (Rb) of the basin ranges from 2.0 to 4.42, and the mean bifurcation ratio is 3.84 in the entire study area, which signifies that the drainage pattern of the entire basin is controlled much more by the lithological and geological structure. The elongation ratio is 0.14, which indicates that the shape of the basin has a narrow and elongated shape. A land use/land cover map was generated by using a Landsat-8 image acquired on 10 August 2015 and classified to distinguish mainly the alluvial deposit from the mountainous rock.

  5. Understanding of morphometric features for adequate water resource management in arid environments

    Directory of Open Access Journals (Sweden)

    M. Elhag

    2017-08-01

    Full Text Available Hydrological characteristics such as topographic parameters, drainage attributes, and land use/land cover patterns are essential to evaluate the water resource management of a watershed area. In the current study, delineation of a watershed and calculation of morphometric characteristics were undertaken using the ASTER global digital elevation model (GDEM. The drainage density of the basin was estimated to be very high, which indicates that the watershed possesses highly permeable soils and low to medium relief. The stream order of the area ranges from first to sixth order, showing a semi-dendritic and radial drainage pattern that indicates heterogeneity in textural characteristics, and it is influenced by structural characteristics in the study area. The bifurcation ratio (Rb of the basin ranges from 2.0 to 4.42, and the mean bifurcation ratio is 3.84 in the entire study area, which signifies that the drainage pattern of the entire basin is controlled much more by the lithological and geological structure. The elongation ratio is 0.14, which indicates that the shape of the basin has a narrow and elongated shape. A land use/land cover map was generated by using a Landsat-8 image acquired on 10 August 2015 and classified to distinguish mainly the alluvial deposit from the mountainous rock.

  6. [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

  7. 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.

  8. 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.

  9. 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.

  10. [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.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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

  16. Aerial estimation of the size of gull breeding colonies

    Science.gov (United States)

    Kadlec, J.A.; Drury, W.H.

    1968-01-01

    Counts on photographs and visual estimates of the numbers of territorial gulls are usually reliable indicators of the number of gull nests, but single visual estimates are not adequate to measure the number of nests in individual colonies. To properly interpret gull counts requires that several islands with known numbers of nests be photographed to establish the ratio of gulls to nests applicable for a given local census. Visual estimates are adequate to determine total breeding gull numbers by regions. Neither visual estimates nor photography will reliably detect annual changes of less than about 2.5 percent.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. The impact of advances in human molecular biology on radiation genetic risk estimation in man

    International Nuclear Information System (INIS)

    Sankaranarayanan, K.

    1996-01-01

    This paper provides an overview of the conceptual framework, the data base, methods and assumptions used thus far to assess the genetic risks of exposure of human populations to ionising radiation. These are then re-examined in the contemporary context of the rapidly expanding knowledge of the molecular biology of human mendelian diseases. This re-examination reveals that (i) many of the assumptions used thus far in radiation genetic risk estimation may not be fully valid and (ii) the current genetic risk estimates are probably conservative, but provide an adequate margin of safety for radiological protection. The view is expressed that further advances in the field of genetic risk estimation will be largely driven by advances in the molecular biology of human genetic diseases. (author). 37 refs., 5 tabs

  3. Bayesian phylogenetic estimation of fossil ages.

    Science.gov (United States)

    Drummond, Alexei J; Stadler, Tanja

    2016-07-19

    Recent advances have allowed for both morphological fossil evidence and molecular sequences to be integrated into a single combined inference of divergence dates under the rule of Bayesian probability. In particular, the fossilized birth-death tree prior and the Lewis-Mk model of discrete morphological evolution allow for the estimation of both divergence times and phylogenetic relationships between fossil and extant taxa. We exploit this statistical framework to investigate the internal consistency of these models by producing phylogenetic estimates of the age of each fossil in turn, within two rich and well-characterized datasets of fossil and extant species (penguins and canids). We find that the estimation accuracy of fossil ages is generally high with credible intervals seldom excluding the true age and median relative error in the two datasets of 5.7% and 13.2%, respectively. The median relative standard error (RSD) was 9.2% and 7.2%, respectively, suggesting good precision, although with some outliers. In fact, in the two datasets we analyse, the phylogenetic estimate of fossil age is on average less than 2 Myr from the mid-point age of the geological strata from which it was excavated. The high level of internal consistency found in our analyses suggests that the Bayesian statistical model employed is an adequate fit for both the geological and morphological data, and provides evidence from real data that the framework used can accurately model the evolution of discrete morphological traits coded from fossil and extant taxa. We anticipate that this approach will have diverse applications beyond divergence time dating, including dating fossils that are temporally unconstrained, testing of the 'morphological clock', and for uncovering potential model misspecification and/or data errors when controversial phylogenetic hypotheses are obtained based on combined divergence dating analyses.This article is part of the themed issue 'Dating species divergences using

  4. Algorithm of the managing systems state estimation

    Directory of Open Access Journals (Sweden)

    Skubilin M. D.

    2010-02-01

    Full Text Available The possibility of an electronic estimation of automatic and automated managing systems state is analyzed. An estimation of a current state (functional readiness of technical equipment and person-operator as integrated system allows to take operatively adequate measures on an exception and-or minimisation of consequences of system’s transition in a supernumerary state. The offered method is universal enough and can be recommended for normalisation of situations on transport, mainly in aircraft.

  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. 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

  7. 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...

  8. 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

  9. 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…

  10. 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

  11. 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

  12. IDC Reengineering Phase 2 & 3 Rough Order of Magnitude (ROM) Cost Estimate Summary (Leveraged NDC Case).

    Energy Technology Data Exchange (ETDEWEB)

    Harris, James M.; Prescott, Ryan; Dawson, Jericah M.; Huelskamp, Robert M.

    2014-11-01

    Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, based on leveraging a fully funded, Sandia executed NDC Modernization project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can neither commence nor continue unless adequate funding has been accepted and certified by DOE.

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Budget estimates. Fiscal year 1998

    International Nuclear Information System (INIS)

    1997-02-01

    The U.S. Congress has determined that the safe use of nuclear materials for peaceful purposes is a legitimate and important national goal. It has entrusted the Nuclear Regulatory Commission (NRC) with the primary Federal responsibility for achieving that goal. The NRC's mission, therefore, is to regulate the Nation's civilian use of byproduct, source, and special nuclear materials to ensure adequate protection of public health and safety, to promote the common defense and security, and to protect the environment. The NRC's FY 1998 budget requests new budget authority of $481,300,000 to be funded by two appropriations - one is the NRC's Salaraies and Expenses appropriation for $476,500,000, and the other is NRC's Office of Inspector General appropriation for $4,800,000. Of the funds appropriated to the NRC's Salaries and Expenses, $17,000,000, shall be derived from the Nuclear Waste Fund and $2,000,000 shall be derived from general funds. The proposed FY 1998 appropriation legislation would also exempt the $2,000,000 for regulatory reviews and other assistance provided to the Department of Energy from the requirement that the NRC collect 100 percent of its budget from fees. The sums appropriated to the NRC's Salaries and Expenses and NRC's Office of Inspector General shall be reduced by the amount of revenues received during FY 1998 from licensing fees, inspection services, and other services and collections, so as to result in a final FY 1998 appropriation for the NRC of an estimated $19,000,000 - the amount appropriated from the Nuclear Waste Fund and from general funds. Revenues derived from enforcement actions shall be deposited to miscellaneous receipts of the Treasury

  1. Budget estimates. Fiscal year 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    The U.S. Congress has determined that the safe use of nuclear materials for peaceful purposes is a legitimate and important national goal. It has entrusted the Nuclear Regulatory Commission (NRC) with the primary Federal responsibility for achieving that goal. The NRC`s mission, therefore, is to regulate the Nation`s civilian use of byproduct, source, and special nuclear materials to ensure adequate protection of public health and safety, to promote the common defense and security, and to protect the environment. The NRC`s FY 1998 budget requests new budget authority of $481,300,000 to be funded by two appropriations - one is the NRC`s Salaraies and Expenses appropriation for $476,500,000, and the other is NRC`s Office of Inspector General appropriation for $4,800,000. Of the funds appropriated to the NRC`s Salaries and Expenses, $17,000,000, shall be derived from the Nuclear Waste Fund and $2,000,000 shall be derived from general funds. The proposed FY 1998 appropriation legislation would also exempt the $2,000,000 for regulatory reviews and other assistance provided to the Department of Energy from the requirement that the NRC collect 100 percent of its budget from fees. The sums appropriated to the NRC`s Salaries and Expenses and NRC`s Office of Inspector General shall be reduced by the amount of revenues received during FY 1998 from licensing fees, inspection services, and other services and collections, so as to result in a final FY 1998 appropriation for the NRC of an estimated $19,000,000 - the amount appropriated from the Nuclear Waste Fund and from general funds. Revenues derived from enforcement actions shall be deposited to miscellaneous receipts of the Treasury.

  2. 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.

  3. Coherence in quantum estimation

    Science.gov (United States)

    Giorda, Paolo; Allegra, Michele

    2018-01-01

    The geometry of quantum states provides a unifying framework for estimation processes based on quantum probes, and it establishes the ultimate bounds of the achievable precision. We show a relation between the statistical distance between infinitesimally close quantum states and the second order variation of the coherence of the optimal measurement basis with respect to the state of the probe. In quantum phase estimation protocols, this leads to propose coherence as the relevant resource that one has to engineer and control to optimize the estimation precision. Furthermore, the main object of the theory i.e. the symmetric logarithmic derivative, in many cases allows one to identify a proper factorization of the whole Hilbert space in two subsystems. The factorization allows one to discuss the role of coherence versus correlations in estimation protocols; to show how certain estimation processes can be completely or effectively described within a single-qubit subsystem; and to derive lower bounds for the scaling of the estimation precision with the number of probes used. We illustrate how the framework works for both noiseless and noisy estimation procedures, in particular those based on multi-qubit GHZ-states. Finally we succinctly analyze estimation protocols based on zero-temperature critical behavior. We identify the coherence that is at the heart of their efficiency, and we show how it exhibits the non-analyticities and scaling behavior proper of a large class of quantum phase transitions.

  4. 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

  5. Estimation of temperature distribution in a reactor shield

    International Nuclear Information System (INIS)

    Agarwal, R.A.; Goverdhan, P.; Gupta, S.K.

    1989-01-01

    Shielding is provided in a nuclear reactor to absorb the radiations emanating from the core. The energy of these radiations appear in the form of heat. Concrete which is commonly used as a shielding material in nuclear power plants must be able to withstand the temperatures and temperature gradients appearing in the shield due to this heat. High temperatures lead to dehydration of the concrete and in turn reduce the shielding effectiveness of the material. Adequate cooling needs to be provided in these shields in order to limit the maximum temperature. This paper describes a method to estimate steady state and transient temperature distribution in reactor shields. The results due to loss of coolant in the coolant tubes have been studied and presented in the paper. (author). 5 figs

  6. 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

  7. 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...

  8. Approaches to estimating decommissioning costs

    International Nuclear Information System (INIS)

    Smith, R.I.

    1990-07-01

    The chronological development of methodology for estimating the cost of nuclear reactor power station decommissioning is traced from the mid-1970s through 1990. Three techniques for developing decommissioning cost estimates are described. The two viable techniques are compared by examining estimates developed for the same nuclear power station using both methods. The comparison shows that the differences between the estimates are due largely to differing assumptions regarding the size of the utility and operating contractor overhead staffs. It is concluded that the two methods provide bounding estimates on a range of manageable costs, and provide reasonable bases for the utility rate adjustments necessary to pay for future decommissioning costs. 6 refs

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. Fractional cointegration rank estimation

    DEFF Research Database (Denmark)

    Lasak, Katarzyna; Velasco, Carlos

    the parameters of the model under the null hypothesis of the cointegration rank r = 1, 2, ..., p-1. This step provides consistent estimates of the cointegration degree, the cointegration vectors, the speed of adjustment to the equilibrium parameters and the common trends. In the second step we carry out a sup......-likelihood ratio test of no-cointegration on the estimated p - r common trends that are not cointegrated under the null. The cointegration degree is re-estimated in the second step to allow for new cointegration relationships with different memory. We augment the error correction model in the second step...... to control for stochastic trend estimation effects from the first step. The critical values of the tests proposed depend only on the number of common trends under the null, p - r, and on the interval of the cointegration degrees b allowed, but not on the true cointegration degree b0. Hence, no additional...

  15. Providing global WLCG transfer monitoring

    International Nuclear Information System (INIS)

    Andreeva, J; Dieguez Arias, D; Campana, S; Keeble, O; Magini, N; Molnar, Z; Ro, G; Saiz, P; Salichos, M; Tuckett, D; Flix, J; Oleynik, D; Petrosyan, A; Uzhinsky, A; Wildish, T

    2012-01-01

    The WLCG[1] Transfers Dashboard is a monitoring system which aims to provide a global view of WLCG data transfers and to reduce redundancy in monitoring tasks performed by the LHC experiments. The system is designed to work transparently across LHC experiments and across the various technologies used for data transfer. Currently each LHC experiment monitors data transfers via experiment-specific systems but the overall cross-experiment picture is missing. Even for data transfers handled by FTS, which is used by 3 LHC experiments, monitoring tasks such as aggregation of FTS transfer statistics or estimation of transfer latencies are performed by every experiment separately. These tasks could be performed once, centrally, and then served to all experiments via a well-defined set of APIs. In the design and development of the new system, experience accumulated by the LHC experiments in the data management monitoring area is taken into account and a considerable part of the code of the ATLAS DDM Dashboard is being re-used. The paper describes the architecture of the Global Transfer monitoring system, the implementation of its components and the first prototype.

  16. Estimation of spectral kurtosis

    Science.gov (United States)

    Sutawanir

    2017-03-01

    Rolling bearings are the most important elements in rotating machinery. Bearing frequently fall out of service for various reasons: heavy loads, unsuitable lubrications, ineffective sealing. Bearing faults may cause a decrease in performance. Analysis of bearing vibration signals has attracted attention in the field of monitoring and fault diagnosis. Bearing vibration signals give rich information for early detection of bearing failures. Spectral kurtosis, SK, is a parameter in frequency domain indicating how the impulsiveness of a signal varies with frequency. Faults in rolling bearings give rise to a series of short impulse responses as the rolling elements strike faults, SK potentially useful for determining frequency bands dominated by bearing fault signals. SK can provide a measure of the distance of the analyzed bearings from a healthy one. SK provides additional information given by the power spectral density (psd). This paper aims to explore the estimation of spectral kurtosis using short time Fourier transform known as spectrogram. The estimation of SK is similar to the estimation of psd. The estimation falls in model-free estimation and plug-in estimator. Some numerical studies using simulations are discussed to support the methodology. Spectral kurtosis of some stationary signals are analytically obtained and used in simulation study. Kurtosis of time domain has been a popular tool for detecting non-normality. Spectral kurtosis is an extension of kurtosis in frequency domain. The relationship between time domain and frequency domain analysis is establish through power spectrum-autocovariance Fourier transform. Fourier transform is the main tool for estimation in frequency domain. The power spectral density is estimated through periodogram. In this paper, the short time Fourier transform of the spectral kurtosis is reviewed, a bearing fault (inner ring and outer ring) is simulated. The bearing response, power spectrum, and spectral kurtosis are plotted to

  17. 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

  18. 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.)

  19. 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.

  20. 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, ...

  1. Informing Estimates of Program Effects for Studies of Mathematics Professional Development Using Teacher Content Knowledge Outcomes.

    Science.gov (United States)

    Phelps, Geoffrey; Kelcey, Benjamin; Jones, Nathan; Liu, Shuangshuang

    2016-10-03

    Mathematics professional development is widely offered, typically with the goal of improving teachers' content knowledge, the quality of teaching, and ultimately students' achievement. Recently, new assessments focused on mathematical knowledge for teaching (MKT) have been developed to assist in the evaluation and improvement of mathematics professional development. This study presents empirical estimates of average program change in MKT and its variation with the goal of supporting the design of experimental trials that are adequately powered to detect a specified program effect. The study drew on a large database representing five different assessments of MKT and collectively 326 professional development programs and 9,365 teachers. Results from cross-classified hierarchical growth models found that standardized average change estimates across the five assessments ranged from a low of 0.16 standard deviations (SDs) to a high of 0.26 SDs. Power analyses using the estimated pre- and posttest change estimates indicated that hundreds of teachers are needed to detect changes in knowledge at the lower end of the distribution. Even studies powered to detect effects at the higher end of the distribution will require substantial resources to conduct rigorous experimental trials. Empirical benchmarks that describe average program change and its variation provide a useful preliminary resource for interpreting the relative magnitude of effect sizes associated with professional development programs and for designing adequately powered trials. © The Author(s) 2016.

  2. Cost Estimation and Control for Flight Systems

    Science.gov (United States)

    Hammond, Walter E.; Vanhook, Michael E. (Technical Monitor)

    2002-01-01

    Good program management practices, cost analysis, cost estimation, and cost control for aerospace flight systems are interrelated and depend upon each other. The best cost control process cannot overcome poor design or poor systems trades that lead to the wrong approach. The project needs robust Technical, Schedule, Cost, Risk, and Cost Risk practices before it can incorporate adequate Cost Control. Cost analysis both precedes and follows cost estimation -- the two are closely coupled with each other and with Risk analysis. Parametric cost estimating relationships and computerized models are most often used. NASA has learned some valuable lessons in controlling cost problems, and recommends use of a summary Project Manager's checklist as shown here.

  3. Predictive framework for estimating exposure of birds to pharmaceuticals.

    Science.gov (United States)

    Bean, Thomas G; Arnold, Kathryn E; Lane, Julie M; Bergström, Ed; Thomas-Oates, Jane; Rattner, Barnett A; Boxall, Alistair B A

    2017-09-01

    We present and evaluate a framework for estimating concentrations of pharmaceuticals over time in wildlife feeding at wastewater treatment plants (WWTPs). The framework is composed of a series of predictive steps involving the estimation of pharmaceutical concentration in wastewater, accumulation into wildlife food items, and uptake by wildlife with subsequent distribution into, and elimination from, tissues. Because many pharmacokinetic parameters for wildlife are unavailable for the majority of drugs in use, a read-across approach was employed using either rodent or human data on absorption, distribution, metabolism, and excretion. Comparison of the different steps in the framework against experimental data for the scenario where birds are feeding on a WWTP contaminated with fluoxetine showed that estimated concentrations in wastewater treatment works were lower than measured concentrations; concentrations in food could be reasonably estimated if experimental bioaccumulation data are available; and read-across from rodent data worked better than human to bird read-across. The framework provides adequate predictions of plasma concentrations and of elimination behavior in birds but yields poor predictions of distribution in tissues. The approach holds promise, but it is important that we improve our understanding of the physiological similarities and differences between wild birds and domesticated laboratory mammals used in pharmaceutical efficacy/safety trials, so that the wealth of data available can be applied more effectively in ecological risk assessments. Environ Toxicol Chem 2017;36:2335-2344. © 2017 SETAC. © 2017 SETAC.

  4. Negative binomial models for abundance estimation of multiple closed populations

    Science.gov (United States)

    Boyce, Mark S.; MacKenzie, Darry I.; Manly, Bryan F.J.; Haroldson, Mark A.; Moody, David W.

    2001-01-01

    Counts of uniquely identified individuals in a population offer opportunities to estimate abundance. However, for various reasons such counts may be burdened by heterogeneity in the probability of being detected. Theoretical arguments and empirical evidence demonstrate that the negative binomial distribution (NBD) is a useful characterization for counts from biological populations with heterogeneity. We propose a method that focuses on estimating multiple populations by simultaneously using a suite of models derived from the NBD. We used this approach to estimate the number of female grizzly bears (Ursus arctos) with cubs-of-the-year in the Yellowstone ecosystem, for each year, 1986-1998. Akaike's Information Criteria (AIC) indicated that a negative binomial model with a constant level of heterogeneity across all years was best for characterizing the sighting frequencies of female grizzly bears. A lack-of-fit test indicated the model adequately described the collected data. Bootstrap techniques were used to estimate standard errors and 95% confidence intervals. We provide a Monte Carlo technique, which confirms that the Yellowstone ecosystem grizzly bear population increased during the period 1986-1998.

  5. Predictive framework for estimating exposure of birds to pharmaceuticals

    Science.gov (United States)

    Bean, Thomas G.; Arnold, Kathryn E.; Lane, Julie M.; Bergström, Ed; Thomas-Oates, Jane; Rattner, Barnett A.; Boxall, Allistair B.A.

    2017-01-01

    We present and evaluate a framework for estimating concentrations of pharmaceuticals over time in wildlife feeding at wastewater treatment plants (WWTPs). The framework is composed of a series of predictive steps involving the estimation of pharmaceutical concentration in wastewater, accumulation into wildlife food items, and uptake by wildlife with subsequent distribution into, and elimination from, tissues. Because many pharmacokinetic parameters for wildlife are unavailable for the majority of drugs in use, a read-across approach was employed using either rodent or human data on absorption, distribution, metabolism, and excretion. Comparison of the different steps in the framework against experimental data for the scenario where birds are feeding on a WWTP contaminated with fluoxetine showed that estimated concentrations in wastewater treatment works were lower than measured concentrations; concentrations in food could be reasonably estimated if experimental bioaccumulation data are available; and read-across from rodent data worked better than human to bird read-across. The framework provides adequate predictions of plasma concentrations and of elimination behavior in birds but yields poor predictions of distribution in tissues. The approach holds promise, but it is important that we improve our understanding of the physiological similarities and differences between wild birds and domesticated laboratory mammals used in pharmaceutical efficacy/safety trials, so that the wealth of data available can be applied more effectively in ecological risk assessments.

  6. Estimating Utility

    DEFF Research Database (Denmark)

    Arndt, Channing; Simler, Kenneth R.

    2010-01-01

    A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes a......, with the current approach tending to systematically overestimate (underestimate) poverty in urban (rural) zones.......A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes...... an information-theoretic approach to estimating cost-of-basic-needs (CBN) poverty lines that are utility consistent. Applications to date illustrate that utility-consistent poverty measurements derived from the proposed approach and those derived from current CBN best practices often differ substantially...

  7. The content of African diets is adequate to achieve optimal efficacy with fixed-dose artemether-lumefantrine: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Sagara Issaka

    2008-11-01

    Full Text Available Abstract A fixed-dose combination of artemether-lumefantrine (AL, Coartem® has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat. As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat. African diets are typically based on a carbohydrate staple (starchy root vegetables, fruit [plantain] or cereals supplemented by soups, relishes and sauces derived from vegetables, pulses, nuts or fish. The most important sources of dietary fat in African countries are oil crops (e.g. peanuts, soya beans and cooking oils as red palm, peanut, coconut and sesame oils. Total fat intake in the majority of subSaharan countries is estimated to be in the range 30–60 g/person/day across the whole population (average 43 g/person/day. Breast-feeding of infants up to two years of age is standard, with one study estimating a fat intake of 15–30 g fat/day from breast milk up to the age of 18 months. Weaning foods typically contain low levels of fat, and the transition from breast milk to complete weaning is associated with a marked reduction in dietary fat. Nevertheless, fat intake >10 g/day has been reported in young children post-weaning. A randomized trial in Uganda reported no difference in the efficacy of AL between patients receiving supervised meals with a fixed fat content (~23 g fat or taking AL unsupervised, suggesting that fat intake at home was sufficient for optimal efficacy. Moreover, randomized trials in African children aged 5–59 months have shown similar high cure

  8. Estimating the Break-Even Price for Forest Protection in Central Kalimantan

    OpenAIRE

    Yamamoto, Yuki; Takeuchi, Kenji

    2011-01-01

    This paper estimates the break-even price in Central Kalimantan province, Indonesia and evaluates the effectiveness of a REDD+ mechanism in this area. On the basis of data collected through a field survey, we found that the break-even price is $17.14 per ton of carbon or $4.68 per ton of carbon dioxide. The figure can be even lower when we take the peat thickness of the area into account. Our analysis shows that the current level of carbon price can provide adequate compensation for Indonesia...

  9. The cost for meeting SLA dependability requirements; implications for customers and providers

    International Nuclear Information System (INIS)

    Følstad, Eirik L.; Helvik, Bjarne E.

    2016-01-01

    A Service Level Agreement (SLA) describes the service, the service-level objectives (SLOs), the price the customer should pay and the compensation if the SLOs are not met. There is a trade-off for the provider between the costs for improving the deployed service quality vs. probability of paying compensation. We propose how to estimate the provider's optimal service deployment. We show that the optimal deployed service quality is dependent on the SLOs, deployment cost, compensation and observation interval. A service deployment based on cost optimization results in targeted dependability objective values that are significantly better than stated in the SLOs. The proposed approach provides valuable insight for an aggregator, who buys services from other providers, to negotiate adequate SLOs, price and compensation from the providers to make a valuable offer for its own customers. - Highlights: • SLA with availability, number of failures, down time criteria and observation period. • Analysis of compound service delivery in the SLA context by a semi-Markov model. • SLA non-conformance risk dependent on the inherent/steady state system parameters. • Cost optimal service operation under non-conformance penalties (the safety margin).

  10. 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.

  11. Reducing stress and fuel consumption providing road information

    Directory of Open Access Journals (Sweden)

    Víctor CORCOBA MAGAÑA

    2014-12-01

    Full Text Available In this paper, we propose a solution to reduce the stress level of the driver, minimize fuel consumption and improve safety. The system analyzes the driving style and the driver’s workload during the trip while driving. If it discovers an area where the stress increases and the driving style is not appropriate from the point of view of energy efficiency and safety for a particular driver, the location of this area is saved in a shared database. On the other hand, the implemented solution warns a particular user when approaching a region where the driving is difficult (high fuel consumption and stress using the shared database based on previous recorded knowledge of similar drivers in that area. In this case, the proposal provides an optimal deceleration profile if the vehicle speed is not adequate. Therefore, he or she may adjust the vehicle speed with both a positive impact on the driver workload and fuel consumption. The Data Envelopment Analysis algorithm is used to estimate the efficiency of driving and the driver’s workload in in each area. We employ this method because there is no preconceived form on the data in order to calculate the efficiency and stress level. A validation experiment has been conducted using both a driving simulator and a real environment with 12 participants who made 168 driving tests. The system reduced the slowdowns (38%, heart rate (4.70%, and fuel consumption (12.41% in the real environment. The proposed solution is implemented on Android mobile devices and does not require the installation of infrastructure on the road. It can be installed on any model of vehicle.

  12. Generalized estimating equations

    CERN Document Server

    Hardin, James W

    2002-01-01

    Although powerful and flexible, the method of generalized linear models (GLM) is limited in its ability to accurately deal with longitudinal and clustered data. Developed specifically to accommodate these data types, the method of Generalized Estimating Equations (GEE) extends the GLM algorithm to accommodate the correlated data encountered in health research, social science, biology, and other related fields.Generalized Estimating Equations provides the first complete treatment of GEE methodology in all of its variations. After introducing the subject and reviewing GLM, the authors examine th

  13. Estimation of LOCA break size using cascaded Fuzzy neural networks

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Geon Pil; Yoo, Kwae Hwan; Back, Ju Hyun; Na, Man Gyun [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of)

    2017-04-15

    Operators of nuclear power plants may not be equipped with sufficient information during a loss-of-coolant accident (LOCA), which can be fatal, or they may not have sufficient time to analyze the information they do have, even if this information is adequate. It is not easy to predict the progression of LOCAs in nuclear power plants. Therefore, accurate information on the LOCA break position and size should be provided to efficiently manage the accident. In this paper, the LOCA break size is predicted using a cascaded fuzzy neural network (CFNN) model. The input data of the CFNN model are the time-integrated values of each measurement signal for an initial short-time interval after a reactor scram. The training of the CFNN model is accomplished by a hybrid method combined with a genetic algorithm and a least squares method. As a result, LOCA break size is estimated exactly by the proposed CFNN model.

  14. 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.

  15. Young People's Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment.

    Directory of Open Access Journals (Sweden)

    Christine Michaels-Igbokwe

    Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.

  16. Importance of adequate local spatiotemporal transmission measures in malaria cohort studies: application to the relation between placental malaria and first malaria infection in infants.

    Science.gov (United States)

    Le Port, Agnès; Cottrell, Gilles; Chandre, Fabrice; Cot, Michel; Massougbodji, Achille; Garcia, André

    2013-07-01

    According to several studies, infants whose mothers had a malaria-infected placenta (MIP) at delivery are at increased risk of a first malaria infection. Immune tolerance caused by intrauterine contact with the parasite could explain this phenomenon, but it is also known that infants who are highly exposed to Anopheles mosquitoes infected with Plasmodium are at greater risk of contracting malaria. Consequently, local malaria transmission must be taken into account to demonstrate the immune tolerance hypothesis. From data collected between 2007 and 2010 on 545 infants followed from birth to age 18 months in southern Benin, we compared estimates of the effect of MIP on time to first malaria infection obtained through different Cox models. In these models, MIP was adjusted for either 1) "village-like" time-independent exposure variables or 2) spatiotemporal exposure prediction derived from local climatic, environmental, and behavioral factors. Only the use of exposure prediction improved the model's goodness of fit (Bayesian Information Criterion) and led to clear conclusions regarding the effect of placental infection, whereas the models using the village-like variables were less successful than the univariate model. This demonstrated clearly the benefit of adequately taking transmission into account in cohort studies of malaria.

  17. Thermodynamic estimation: Ionic materials

    International Nuclear Information System (INIS)

    Glasser, Leslie

    2013-01-01

    Thermodynamics establishes equilibrium relations among thermodynamic parameters (“properties”) and delineates the effects of variation of the thermodynamic functions (typically temperature and pressure) on those parameters. However, classical thermodynamics does not provide values for the necessary thermodynamic properties, which must be established by extra-thermodynamic means such as experiment, theoretical calculation, or empirical estimation. While many values may be found in the numerous collected tables in the literature, these are necessarily incomplete because either the experimental measurements have not been made or the materials may be hypothetical. The current paper presents a number of simple and relible estimation methods for thermodynamic properties, principally for ionic materials. The results may also be used as a check for obvious errors in published values. The estimation methods described are typically based on addition of properties of individual ions, or sums of properties of neutral ion groups (such as “double” salts, in the Simple Salt Approximation), or based upon correlations such as with formula unit volumes (Volume-Based Thermodynamics). - Graphical abstract: Thermodynamic properties of ionic materials may be readily estimated by summation of the properties of individual ions, by summation of the properties of ‘double salts’, and by correlation with formula volume. Such estimates may fill gaps in the literature, and may also be used as checks of published values. This simplicity arises from exploitation of the fact that repulsive energy terms are of short range and very similar across materials, while coulombic interactions provide a very large component of the attractive energy in ionic systems. Display Omitted - Highlights: • Estimation methods for thermodynamic properties of ionic materials are introduced. • Methods are based on summation of single ions, multiple salts, and correlations. • Heat capacity, entropy

  18. 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

  19. 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.

  20. Estimating the financial resources needed for local public health departments in Minnesota: a multimethod approach.

    Science.gov (United States)

    Riley, William; Briggs, Jill; McCullough, Mac

    2011-01-01

    This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. For each of the methods, we selected a panel to represent a profile of Minnesota health departments. The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.

  1. Drought impacts and resilience on crops via evapotranspiration estimations

    Science.gov (United States)

    Timmermans, Joris; Asadollahi Dolatabad, Saeid

    2015-04-01

    Currently, the global needs for food and water is at a critical level. It has been estimated that 12.5 % of the global population suffers from malnutrition and 768 million people still do not have access to clean drinking water. This need is increasing because of population growth but also by climate change. Changes in precipitation patterns will result either in flooding or droughts. Consequently availability, usability and affordability of water is becoming challenge and efficient use of water and water management is becoming more important, particularly during severe drought events. Drought monitoring for agricultural purposes is very hard. While meteorological drought can accurately be monitored using precipitation only, estimating agricultural drought is more difficult. This is because agricultural drought is dependent on the meteorological drought, the impacts on the vegetation, and the resilience of the crops. As such not only precipitation estimates are required but also evapotranspiration at plant/plot scale. Evapotranspiration (ET) describes the amount of water evaporated from soil and vegetation. As 65% of precipitation is lost by ET, drought severity is highly linked with this variable. In drought research, the precise quantification of ET and its spatio-temporal variability is therefore essential. In this view, remote sensing based models to estimate ET, such as SEBAL and SEBS, are of high value. However the resolution of current evapotranspiration products are not good enough for monitoring the impact of the droughts on the specific crops. This limitation originates because plot scales are in general smaller than the resolution of the available satellite ET products. As such remote sensing estimates of evapotranspiration are always a combination of different land surface types and cannot be used for plant health and drought resilience studies. The goal of this research is therefore to enable adequate resolutions of daily evapotranspiration estimates

  2. Efficient, Differentially Private Point Estimators

    OpenAIRE

    Smith, Adam

    2008-01-01

    Differential privacy is a recent notion of privacy for statistical databases that provides rigorous, meaningful confidentiality guarantees, even in the presence of an attacker with access to arbitrary side information. We show that for a large class of parametric probability models, one can construct a differentially private estimator whose distribution converges to that of the maximum likelihood estimator. In particular, it is efficient and asymptotically unbiased. This result provides (furt...

  3. Variance estimation for generalized Cavalieri estimators

    OpenAIRE

    Johanna Ziegel; Eva B. Vedel Jensen; Karl-Anton Dorph-Petersen

    2011-01-01

    The precision of stereological estimators based on systematic sampling is of great practical importance. This paper presents methods of data-based variance estimation for generalized Cavalieri estimators where errors in sampling positions may occur. Variance estimators are derived under perturbed systematic sampling, systematic sampling with cumulative errors and systematic sampling with random dropouts. Copyright 2011, Oxford University Press.

  4. Growth Estimators and Confidence Intervals for the Mean of Negative Binomial Random Variables with Unknown Dispersion

    Directory of Open Access Journals (Sweden)

    David Shilane

    2013-01-01

    Full Text Available The negative binomial distribution becomes highly skewed under extreme dispersion. Even at moderately large sample sizes, the sample mean exhibits a heavy right tail. The standard normal approximation often does not provide adequate inferences about the data's expected value in this setting. In previous work, we have examined alternative methods of generating confidence intervals for the expected value. These methods were based upon Gamma and Chi Square approximations or tail probability bounds such as Bernstein's inequality. We now propose growth estimators of the negative binomial mean. Under high dispersion, zero values are likely to be overrepresented in the data. A growth estimator constructs a normal-style confidence interval by effectively removing a small, predetermined number of zeros from the data. We propose growth estimators based upon multiplicative adjustments of the sample mean and direct removal of zeros from the sample. These methods do not require estimating the nuisance dispersion parameter. We will demonstrate that the growth estimators' confidence intervals provide improved coverage over a wide range of parameter values and asymptotically converge to the sample mean. Interestingly, the proposed methods succeed despite adding both bias and variance to the normal approximation.

  5. 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 ...

  6. 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

  7. 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

  8. 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!

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. Evaluation of overall setup accuracy and adequate setup margins in pelvic image-guided radiotherapy: Comparison of the male and female patients

    International Nuclear Information System (INIS)

    Laaksomaa, Marko; Kapanen, Mika; Tulijoki, Tapio; Peltola, Seppo; Hyödynmaa, Simo; Kellokumpu-Lehtinen, Pirkko-Liisa

    2014-01-01

    We evaluated adequate setup margins for the radiotherapy (RT) of pelvic tumors based on overall position errors of bony landmarks. We also estimated the difference in setup accuracy between the male and female patients. Finally, we compared the patient rotation for 2 immobilization devices. The study cohort included consecutive 64 male and 64 female patients. Altogether, 1794 orthogonal setup images were analyzed. Observer-related deviation in image matching and the effect of patient rotation were explicitly determined. Overall systematic and random errors were calculated in 3 orthogonal directions. Anisotropic setup margins were evaluated based on residual errors after weekly image guidance. The van Herk formula was used to calculate the margins. Overall, 100 patients were immobilized with a house-made device. The patient rotation was compared against 28 patients immobilized with CIVCO's Kneefix and Feetfix. We found that the usually applied isotropic setup margin of 8 mm covered all the uncertainties related to patient setup for most RT treatments of the pelvis. However, margins of even 10.3 mm were needed for the female patients with very large pelvic target volumes centered either in the symphysis or in the sacrum containing both of these structures. This was because the effect of rotation (p ≤ 0.02) and the observer variation in image matching (p ≤ 0.04) were significantly larger for the female patients than for the male patients. Even with daily image guidance, the required margins remained larger for the women. Patient rotations were largest about the lateral axes. The difference between the required margins was only 1 mm for the 2 immobilization devices. The largest component of overall systematic position error came from patient rotation. This emphasizes the need for rotation correction. Overall, larger position errors and setup margins were observed for the female patients with pelvic cancer than for the male patients

  14. 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.

  15. 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.)

  16. SYSTEM ORGANIZATION OF MATERIAL PROVIDING OF BUILDING

    Directory of Open Access Journals (Sweden)

    A. V. Rаdkеvich

    2014-04-01

    Full Text Available Purpose. Development of scientific-methodical bases to the design of rational management of material streams in the field of building providing taking into account intersystem connections with the enterprises of building industry. Methodology. The analysis of last few years of functioning of building industry in Ukraine allows distinguishing a number of problems that negatively influence the steady development of building, as the component of the state economics system. Therefore the research of existent organization methods of the system of building objects providing with material resources is extremely necessary. In connection with this the article justifies the use of method of hierarchies analysis (Saati method for finding the optimal task solution of fixing the enterprises of building industry after building objects. Findings. Results give an opportunity to guidance of building organization to estimate and choose advantageous suppliers - enterprises of building industry, to conduct their rating, estimation taking into account basic descriptions, such as: quality, price, reliability of deliveries, specialization, financial status etc. Originality. On the basis of Saati method the methodologies of organization are improved, planning and managements of the reliable system of providing of building necessary material resources that meet the technological requirements of implementation of building and installation works. Practical value. Contribution to the decisions of many intricate organizational problems that are accompanied by the problems of development of building, provided due to organization of the reliable system of purchase of material resources.

  17. State estimation for a hexapod robot

    CSIR Research Space (South Africa)

    Lubbe, Estelle

    2015-09-01

    Full Text Available This paper introduces a state estimation methodology for a hexapod robot that makes use of proprioceptive sensors and a kinematic model of the robot. The methodology focuses on providing reliable full pose state estimation for a commercially...

  18. Velocity Estimate Following Air Data System Failure

    National Research Council Canada - National Science Library

    McLaren, Scott A

    2008-01-01

    .... A velocity estimator (VEST) algorithm was developed to combine the inertial and wind velocities to provide an estimate of the aircraft's current true velocity to be used for command path gain scheduling and for display in the cockpit...

  19. 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

  20. Accuracy of height estimation and tidal volume setting using anthropometric formulas in an ICU Caucasian population.

    Science.gov (United States)

    L'her, Erwan; Martin-Babau, Jérôme; Lellouche, François

    2016-12-01

    Knowledge of patients' height is essential for daily practice in the intensive care unit. However, actual height measurements are unavailable on a daily routine in the ICU and measured height in the supine position and/or visual estimates may lack consistency. Clinicians do need simple and rapid methods to estimate the patients' height, especially in short height and/or obese patients. The objectives of the study were to evaluate several anthropometric formulas for height estimation on healthy volunteers and to test whether several of these estimates will help tidal volume setting in ICU patients. This was a prospective, observational study in a medical intensive care unit of a university hospital. During the first phase of the study, eight limb measurements were performed on 60 healthy volunteers and 18 height estimation formulas were tested. During the second phase, four height estimates were performed on 60 consecutive ICU patients under mechanical ventilation. In the 60 healthy volunteers, actual height was well correlated with the gold standard, measured height in the erect position. Correlation was low between actual and calculated height, using the hand's length and width, the index, or the foot equations. The Chumlea method and its simplified version, performed in the supine position, provided adequate estimates. In the 60 ICU patients, calculated height using the simplified Chumlea method was well correlated with measured height (r = 0.78; ∂ ventilation, alternative anthropometric methods to obtain patient's height based on lower leg and on forearm measurements could be useful to facilitate the application of protective mechanical ventilation in a Caucasian ICU population. The simplified Chumlea method is easy to achieve in a bed-ridden patient and provides accurate height estimates, with a low bias.

  1. 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.

  2. [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.

  3. 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)

  4. 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.

  5. Estimation of morbidity effects

    International Nuclear Information System (INIS)

    Ostro, B.

    1994-01-01

    Many researchers have related exposure to ambient air pollution to respiratory morbidity. To be included in this review and analysis, however, several criteria had to be met. First, a careful study design and a methodology that generated quantitative dose-response estimates were required. Therefore, there was a focus on time-series regression analyses relating daily incidence of morbidity to air pollution in a single city or metropolitan area. Studies that used weekly or monthly average concentrations or that involved particulate measurements in poorly characterized metropolitan areas (e.g., one monitor representing a large region) were not included in this review. Second, studies that minimized confounding ad omitted variables were included. For example, research that compared two cities or regions and characterized them as 'high' and 'low' pollution area were not included because of potential confounding by other factors in the respective areas. Third, concern for the effects of seasonality and weather had to be demonstrated. This could be accomplished by either stratifying and analyzing the data by season, by examining the independent effects of temperature and humidity, and/or by correcting the model for possible autocorrelation. A fourth criterion for study inclusion was that the study had to include a reasonably complete analysis of the data. Such analysis would include an careful exploration of the primary hypothesis as well as possible examination of te robustness and sensitivity of the results to alternative functional forms, specifications, and influential data points. When studies reported the results of these alternative analyses, the quantitative estimates that were judged as most representative of the overall findings were those that were summarized in this paper. Finally, for inclusion in the review of particulate matter, the study had to provide a measure of particle concentration that could be converted into PM10, particulate matter below 10

  6. 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 ...

  7. 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.

  8. 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.

  9. 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

  10. The feasibility of producing adequate feedstock for year–round cellulosic ethanol production in an intensive agricultural fuelshed

    Science.gov (United States)

    Uden, Daniel R.; Mitchell, Rob B.; Allen, Craig R.; Guan, Qingfeng; McCoy, Tim D.

    2013-01-01

    To date, cellulosic ethanol production has not been commercialized in the United States. However, government mandates aimed at increasing second-generation biofuel production could spur exploratory development in the cellulosic ethanol industry. We conducted an in-depth analysis of the fuelshed surrounding a starch-based ethanol plant near York, Nebraska that has the potential for cellulosic ethanol production. To assess the feasibility of supplying adequate biomass for year-round cellulosic ethanol production from residual maize (Zea mays) stover and bioenergy switchgrass (Panicum virgatum) within a 40-km road network service area of the existing ethanol plant, we identified ∼14,000 ha of marginally productive cropland within the service area suitable for conversion from annual rowcrops to switchgrass and ∼132,000 ha of maize-enrolled cropland from which maize stover could be collected. Annual maize stover and switchgrass biomass supplies within the 40-km service area could range between 429,000 and 752,000 metric tons (mT). Approximately 140–250 million liters (l) of cellulosic ethanol could be produced, rivaling the current 208 million l annual starch-based ethanol production capacity of the plant. We conclude that sufficient quantities of biomass could be produced from maize stover and switchgrass near the plant to support year-round cellulosic ethanol production at current feedstock yields, sustainable removal rates and bioconversion efficiencies. Modifying existing starch-based ethanol plants in intensive agricultural fuelsheds could increase ethanol output, return marginally productive cropland to perennial vegetation, and remove maize stover from productive cropland to meet feedstock demand.

  11. Comparison of single questions and brief questionnaire with longer validated food frequency questionnaire to assess adequate fruit and vegetable intake.

    Science.gov (United States)

    Cook, Amelia; Roberts, Kia; O'Leary, Fiona; Allman-Farinelli, Margaret Anne

    2015-01-01

    The aim of this study was to determine if a single question (SQ) for fruit and a SQ or five-item questionnaire for vegetable consumption (VFQ) could replace a longer food frequency questionnaire (FFQ) to screen for inadequate versus adequate intakes in populations. Participants (109) completed three test screeners: fruit SQ, vegetable SQ, and a five-item VFQ followed by the reference 74-item FFQ (version 2 of the Dietary Questionnaire for Epidemiological Studies [DQESv2]) including 13 fruit and 25 vegetable items. The five-item VFQ asked about intake of salad vegetables, cooked vegetables, white potatoes, legumes, and vegetable juice. The screeners were compared with the reference (DQESv2 FFQ) for sensitivity, specificity, and positive and negative predictive powers (PPV, NPV) to detect intakes of two or more servings of fruit and three or more servings of vegetables. Relative validity was examined using Bland-Altman statistics. The fruit SQ showed a PPV of 56% and an NPV of 83%. The PPV for the vegetable SQ was 30% and the NPV was 89%. For the five-item VFQ, the PPV was 39% and the NPV was 85%. Bland-Altman plots and linear regression equations showed that although the screener showed good agreement for fruit (unstandardized b1 coefficient = 0.04) for vegetable intake the difference between methods increased at higher intake levels (unstandardized b1 coefficients = -0.3 for the SQ, b1 = -0.6 for five-item VFQ). The fruit SQ and the five-item VFQ are suitable replacements for longer FFQs to detect inadequate intake and assess population mean but not individual intakes. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. 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

    (Reglamento Unico de Transporte - RUT) established by CREG (CREG, 1999); section four presents the recommended set up of adequate work schemes required lo guarantee the non-existence of hydrocarbon fluid due condensation in the evaluated system

  13. Twice-monthly administration of a lower dose of epoetin beta pegol can maintain adequate hemoglobin levels in hemodialysis patients.

    Science.gov (United States)

    Morikami, Yuki; Fujimori, Akira; Okada, Shioko; Kumei, Mai; Mizobuchi, Noriko; Sakai, Makoto

    2015-04-01

    Epoetin beta pegol is a continuous erythropoietin receptor activator (CERA) with a long half-life. Although CERA has been shown to maintain adequate hemoglobin (Hb) levels at prolonged dosing intervals, the optimal dosing schedule remains unclear. We therefore compared the efficacy of maintaining hemoglobin levels with administration of twice-monthly CERA (TWICE) versus once-monthly CERA (ONCE). Twenty hemodialysis patients receiving epoetin beta (EPO) were enrolled in this crossover study. Patients were assigned to either the TWICE or the ONCE group based on matching Hb levels and EPO doses. After 6 months of treatment, the CERA dosage was interchanged between the groups and the study was continued for an additional 6 months. The effect of the different regimens on iron metabolism was also assessed during the first 6 months of the study. Hb levels significantly increased in the TWICE group, allowing for a reduction in CERA dosage, while the dose of CERA required to maintain Hb levels in the ONCE group remained unchanged. After the interchange, a decrease in Hb levels with incremental increase in CERA dosage was observed in the TWICE→ONCE group, with the opposite effect observed in the ONCE→TWICE group. Although increases in ferritin and hepcidin-25 levels in the ONCE group were noted at one month, they disappeared at 6 months. Although Hb levels were maintained in both the ONCE and TWICE groups, a twice-monthly administration was advantageous, as it required a lower dose of CERA. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.

  14. How Can the U.S. Military Avoid Another 9/15?: An Analysis of the Inability of U.S. Military Leaders to Provide an Adequate Strategy for Responding to the 9/11 Attacks

    Science.gov (United States)

    2007-12-01

    bombing campaign 6-Apr-72 23-Oct-72 I 195 Operation Pocket Money Military aerial mining of Haiphong harbor 9-May-72 23-Oct-72 I 196 Operation...197 Operation Endsweep Military counter-mine measure to remove mines dropped during Operation Pocket Money North Vietnam 27-Jan-72 27-Jul-73 I 198

  15. The Swiss lodized Salt Program Provides Adequate Iodine for School Children and Pregnant Women, but Weaning Infants Not Receiving Iodine-Containing Complementary Foods as well as Their Mothers Are Iodine Deficient

    NARCIS (Netherlands)

    Andersson, M.; Aeberli, I.; Wüst, N.; Piacenza, A.M.; Bucher, T.; Henschen, I.; Haldimann, M.; Zimmermann, M.B.

    2010-01-01

    Background: If children and pregnant women in the population are iodine sufficient, it is generally assumed infants are also sufficient. But weaning infants may be at risk of iodine deficiency because iodized salt contributes little dietary iodine during this period. To fill this gap, iodine

  16. Evaluation of species richness estimators based on quantitative performance measures and sensitivity to patchiness and sample grain size

    Science.gov (United States)

    Willie, Jacob; Petre, Charles-Albert; Tagg, Nikki; Lens, Luc

    2012-11-01

    Data from forest herbaceous plants in a site of known species richness in Cameroon were used to test the performance of rarefaction and eight species richness estimators (ACE, ICE, Chao1, Chao2, Jack1, Jack2, Bootstrap and MM). Bias, accuracy, precision and sensitivity to patchiness and sample grain size were the evaluation criteria. An evaluation of the effects of sampling effort and patchiness on diversity estimation is also provided. Stems were identified and counted in linear series of 1-m2 contiguous square plots distributed in six habitat types. Initially, 500 plots were sampled in each habitat type. The sampling process was monitored using rarefaction and a set of richness estimator curves. Curves from the first dataset suggested adequate sampling in riparian forest only. Additional plots ranging from 523 to 2143 were subsequently added in the undersampled habitats until most of the curves stabilized. Jack1 and ICE, the non-parametric richness estimators, performed better, being more accurate and less sensitive to patchiness and sample grain size, and significantly reducing biases that could not be detected by rarefaction and other estimators. This study confirms the usefulness of non-parametric incidence-based estimators, and recommends Jack1 or ICE alongside rarefaction while describing taxon richness and comparing results across areas sampled using similar or different grain sizes. As patchiness varied across habitat types, accurate estimations of diversity did not require the same number of plots. The number of samples needed to fully capture diversity is not necessarily the same across habitats, and can only be known when taxon sampling curves have indicated adequate sampling. Differences in observed species richness between habitats were generally due to differences in patchiness, except between two habitats where they resulted from differences in abundance. We suggest that communities should first be sampled thoroughly using appropriate taxon sampling

  17. Mitigating Provider Uncertainty in Service Provision Contracts

    Science.gov (United States)

    Smith, Chris; van Moorsel, Aad

    Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

  18. Estimating Subjective Probabilities

    DEFF Research Database (Denmark)

    Andersen, Steffen; Fountain, John; Harrison, Glenn W.

    2014-01-01

    either construct elicitation mechanisms that control for risk aversion, or construct elicitation mechanisms which undertake 'calibrating adjustments' to elicited reports. We illustrate how the joint estimation of risk attitudes and subjective probabilities can provide the calibration adjustments...... that theory calls for. We illustrate this approach using data from a controlled experiment with real monetary consequences to the subjects. This allows the observer to make inferences about the latent subjective probability, under virtually any well-specified model of choice under subjective risk, while still...

  19. Mixtures Estimation and Applications

    CERN Document Server

    Mengersen, Kerrie; Titterington, Mike

    2011-01-01

    This book uses the EM (expectation maximization) algorithm to simultaneously estimate the missing data and unknown parameter(s) associated with a data set. The parameters describe the component distributions of the mixture; the distributions may be continuous or discrete. The editors provide a complete account of the applications, mathematical structure and statistical analysis of finite mixture distributions along with MCMC computational methods, together with a range of detailed discussions covering the applications of the methods and features chapters from the leading experts on the subject

  20. Medicare Referring Provider DMEPOS PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset, which is part of CMSs Medicare Provider Utilization and Payment Data, details information on Durable Medical Equipment, Prosthetics, Orthotics and...

  1. Lodging Update: Providence, Rhode Island

    Directory of Open Access Journals (Sweden)

    Ragel Roginsky

    2013-04-01

    Full Text Available Each quarter, Pinnacle Advisory Group prepares an analysis of the New England lodging industry, which provides a regional summary and then focuses in depth on a particular market. These reviews look at recent and proposed supply changes, factors affecting demand and growth rates, and the effects of interactions between such supply and demand trends. In this issue, the authors spotlight the lodging market in Providence, Rhode Island.

  2. How should we best estimate the mean recency duration for the BED method?

    Directory of Open Access Journals (Sweden)

    John Hargrove

    Full Text Available BED estimates of HIV incidence from cross-sectional surveys are obtained by restricting, to fixed time T, the period over which incidence is estimated. The appropriate mean recency duration (Ω(T then refers to the time where BED optical density (OD is less than a pre-set cut-off C, given the patient has been HIV positive for at most time T. Five methods, tested using data for postpartum women in Zimbabwe, provided similar estimates of Ω(T for C = 0.8: i The ratio (r/s of the number of BED-recent infections to all seroconversions over T = 365 days: 192 days [95% CI 168-216]. ii Linear mixed modeling (LMM: 191 days [95% CI 174-208]. iii Non-linear mixed modeling (NLMM: 196 days [95% CrI 188-204]. iv Survival analysis (SA: 192 days [95% CI 168-216]. Graphical analysis: 193 days. NLMM estimates of Ω(T--based on a biologically more appropriate functional relationship than LMM--resulted in best fits to OD data, the smallest variance in estimates of VT, and best correspondence between BED and follow-up estimates of HIV incidence, for the same subjects over the same time period. SA and NLMM produced very similar estimates of Ω(T but the coefficient of variation of the former was .3 times as high. The r/s method requires uniformly distributed seroconversion events but is useful if data are available only from a single follow-up. The graphical method produces the most variable results, involves unsound methodology and should not be used to provide estimates of Ω(T. False-recent rates increased as a quadratic function of C: for incidence estimation C should thus be chosen as small as possible, consistent with an adequate resultant number of recent cases, and accurate estimation of Ω(T. Inaccuracies in the estimation of Ω(T should not now provide an impediment to incidence estimation.

  3. On the estimation of the degree of regression polynomial

    International Nuclear Information System (INIS)

    Toeroek, Cs.

    1997-01-01

    The mathematical functions most commonly used to model curvature in plots are polynomials. Generally, the higher the degree of the polynomial, the more complex is the trend that its graph can represent. We propose a new statistical-graphical approach based on the discrete projective transformation (DPT) to estimating the degree of polynomial that adequately describes the trend in the plot

  4. On Modal Parameter Estimates from Ambient Vibration Tests

    DEFF Research Database (Denmark)

    Agneni, A.; Brincker, Rune; Coppotelli, B.

    2004-01-01

    Modal parameter estimates from ambient vibration testing are turning into the preferred technique when one is interested in systems under actual loadings and operational conditions. Moreover, with this approach, expensive devices to excite the structure are not needed, since it can be adequately...

  5. Qualitative Robustness in Estimation

    Directory of Open Access Journals (Sweden)

    Mohammed Nasser

    2012-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Times New Roman","serif";} Qualitative robustness, influence function, and breakdown point are three main concepts to judge an estimator from the viewpoint of robust estimation. It is important as well as interesting to study relation among them. This article attempts to present the concept of qualitative robustness as forwarded by first proponents and its later development. It illustrates intricacies of qualitative robustness and its relation with consistency, and also tries to remove commonly believed misunderstandings about relation between influence function and qualitative robustness citing some examples from literature and providing a new counter-example. At the end it places a useful finite and a simulated version of   qualitative robustness index (QRI. In order to assess the performance of the proposed measures, we have compared fifteen estimators of correlation coefficient using simulated as well as real data sets.

  6. A hierarchical estimator development for estimation of tire-road friction coefficient.

    Science.gov (United States)

    Zhang, Xudong; Göhlich, Dietmar

    2017-01-01

    The effect of vehicle active safety systems is subject to the friction force arising from the contact of tires and the road surface. Therefore, an adequate knowledge of the tire-road friction coefficient is of great importance to achieve a good performance of these control systems. This paper presents a tire-road friction coefficient estimation method for an advanced vehicle configuration, four-motorized-wheel electric vehicles, in which the longitudinal tire force is easily obtained. A hierarchical structure is adopted for the proposed estimation design. An upper estimator is developed based on unscented Kalman filter to estimate vehicle state information, while a hybrid estimation method is applied as the lower estimator to identify the tire-road friction coefficient using general regression neural network (GRNN) and Bayes' theorem. GRNN aims at detecting road friction coefficient under small excitations, which are the most common situations in daily driving. GRNN is able to accurately create a mapping from input parameters to the friction coefficient, avoiding storing an entire complex tire model. As for large excitations, the estimation algorithm is based on Bayes' theorem and a simplified "magic formula" tire model. The integrated estimation method is established by the combination of the above-mentioned estimators. Finally, the simulations based on a high-fidelity CarSim vehicle model are carried out on different road surfaces and driving maneuvers to verify the effectiveness of the proposed estimation method.

  7. A hierarchical estimator development for estimation of tire-road friction coefficient.

    Directory of Open Access Journals (Sweden)

    Xudong Zhang

    Full Text Available The effect of vehicle active safety systems is subject to the friction force arising from the contact of tires and the road surface. Therefore, an adequate knowledge of the tire-road friction coefficient is of great importance to achieve a good performance of these control systems. This paper presents a tire-road friction coefficient estimation method for an advanced vehicle configuration, four-motorized-wheel electric vehicles, in which the longitudinal tire force is easily obtained. A hierarchical structure is adopted for the proposed estimation design. An upper estimator is developed based on unscented Kalman filter to estimate vehicle state information, while a hybrid estimation method is applied as the lower estimator to identify the tire-road friction coefficient using general regression neural network (GRNN and Bayes' theorem. GRNN aims at detecting road friction coefficient under small excitations, which are the most common situations in daily driving. GRNN is able to accurately create a mapping from input parameters to the friction coefficient, avoiding storing an entire complex tire model. As for large excitations, the estimation algorithm is based on Bayes' theorem and a simplified "magic formula" tire model. The integrated estimation method is established by the combination of the above-mentioned estimators. Finally, the simulations based on a high-fidelity CarSim vehicle model are carried out on different road surfaces and driving maneuvers to verify the effectiveness of the proposed estimation method.

  8. Laser cost experience and estimation

    International Nuclear Information System (INIS)

    Shofner, F.M.; Hoglund, R.L.

    1977-01-01

    This report addresses the question of estimating the capital and operating costs for LIS (Laser Isotope Separation) lasers, which have performance requirements well beyond the state of mature art. This question is seen with different perspectives by political leaders, ERDA administrators, scientists, and engineers concerned with reducing LIS to economically successful commercial practice, on a timely basis. Accordingly, this report attempts to provide ''ballpark'' estimators for capital and operating costs and useful design and operating information for lasers based on mature technology, and their LIS analogs. It is written very basically and is intended to respond about equally to the perspectives of administrators, scientists, and engineers. Its major contributions are establishing the current, mature, industrialized laser track record (including capital and operating cost estimators, reliability, types of application, etc.) and, especially, evolution of generalized estimating procedures for capital and operating cost estimators for new laser design

  9. Artificial neural networks in the estimation of monthly capacity factors of WECS in Taiwan

    International Nuclear Information System (INIS)

    Tu, Y.-L.; Chang, T.-J.; Hsieh, C.-I; Shih, J.-Y.

    2010-01-01

    Measured wind speed and power output time series with 10-min resolution at Jhongtun wind power station and 30-min resolution at Mailiao station have been used to estimate monthly energy output by artificial neural networks (ANNs) over a period spanned between 2002 and 2006. The widely used back propagation algorithm is used in the network. The available database of these two stations is divided into two parts - data from Year 2002 to Year 2005 is for training and Year 2006 data is used for the validation of training results. For the purpose of investigating the adequate training length of ANN simulations, four training periods (Year 2002-2005, 2003-2005, 2004-2005 and 2005) together with four training intervals (yearly, half-yearly, seasonal, and monthly) are input into the ANN model to estimate monthly capacity factors of the two stations at Year 2006 and compared with the measured data. The results show that ANN is an efficient tool for estimating wind power production. A training length with 12 months can provide satisfactory estimation of monthly capacity factors in both of the stations. Moreover, the half-yearly training interval, which is derived from the real wind characteristics in Taiwan, gives the best estimation of monthly capacity factors compared to other training intervals.

  10. State energy data report 1994: Consumption estimates

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    This document provides annual time series estimates of State-level energy consumption by major economic sector. The estimates are developed in the State Energy Data System (SEDS), operated by EIA. SEDS provides State energy consumption estimates to members of Congress, Federal and State agencies, and the general public, and provides the historical series needed for EIA`s energy models. Division is made for each energy type and end use sector. Nuclear electric power is included.

  11. State energy data report 1994: Consumption estimates

    International Nuclear Information System (INIS)

    1996-10-01

    This document provides annual time series estimates of State-level energy consumption by major economic sector. The estimates are developed in the State Energy Data System (SEDS), operated by EIA. SEDS provides State energy consumption estimates to members of Congress, Federal and State agencies, and the general public, and provides the historical series needed for EIA's energy models. Division is made for each energy type and end use sector. Nuclear electric power is included

  12. Practical estimate of gradient nonlinearity for implementation of apparent diffusion coefficient bias correction.

    Science.gov (United States)

    Malkyarenko, Dariya I; Chenevert, Thomas L

    2014-12-01

    To describe an efficient procedure to empirically characterize gradient nonlinearity and correct for the corresponding apparent diffusion coefficient (ADC) bias on a clinical magnetic resonance imaging (MRI) scanner. Spatial nonlinearity scalars for individual gradient coils along superior and right directions were estimated via diffusion measurements of an isotropicic e-water phantom. Digital nonlinearity model from an independent scanner, described in the literature, was rescaled by system-specific scalars to approximate 3D bias correction maps. Correction efficacy was assessed by comparison to unbiased ADC values measured at isocenter. Empirically estimated nonlinearity scalars were confirmed by geometric distortion measurements of a regular grid phantom. The applied nonlinearity correction for arbitrarily oriented diffusion gradients reduced ADC bias from 20% down to 2% at clinically relevant offsets both for isotropic and anisotropic media. Identical performance was achieved using either corrected diffusion-weighted imaging (DWI) intensities or corrected b-values for each direction in brain and ice-water. Direction-average trace image correction was adequate only for isotropic medium. Empiric scalar adjustment of an independent gradient nonlinearity model adequately described DWI bias for a clinical scanner. Observed efficiency of implemented ADC bias correction quantitatively agreed with previous theoretical predictions and numerical simulations. The described procedure provides an independent benchmark for nonlinearity bias correction of clinical MRI scanners.

  13. Estimated water requirements for gold heap-leach operations

    Science.gov (United States)

    Bleiwas, Donald I.

    2012-01-01

    This report provides a perspective on the amount of water necessary for conventional gold heap-leach operations. Water is required for drilling and dust suppression during mining, for agglomeration and as leachate during ore processing, to support the workforce (requires water in potable form and for sanitation), for minesite reclamation, and to compensate for water lost to evaporation and leakage. Maintaining an adequate water balance is especially critical in areas where surface and groundwater are difficult to acquire because of unfavorable climatic conditions [arid conditions and (or) a high evaporation rate]; where there is competition with other uses, such as for agriculture, industry, and use by municipalities; and where compliance with regulatory requirements may restrict water usage. Estimating the water consumption of heap-leach operations requires an understanding of the heap-leach process itself. The task is fairly complex because, although they all share some common features, each gold heap-leach operation is unique. Also, estimating the water consumption requires a synthesis of several fields of science, including chemistry, ecology, geology, hydrology, and meteorology, as well as consideration of economic factors.

  14. On estimating the effective diffusive properties of hardened cement pastes

    International Nuclear Information System (INIS)

    Stora, E.; Bary, B.; Stora, E.; He, Qi-Chang

    2008-01-01

    The effective diffusion coefficients of hardened cement pastes can vary between a few orders of magnitude. The paper aims at building a homogenization model to estimate these macroscopic diffusivities and capture such strong variations. For this purpose, a three-scale description of the paste is proposed, relying mainly on the fact that the initial cement grains hydrate forming a complex microstructure with a multi-scale pore structure. In particular, porosity is found to be well connected at a fine scale. However, only a few homogenization schemes are shown to be adequate to account for such connectivity. Among them, the mixed composite spheres assemblage estimate (Stora, E., He, Q.-C., Bary, B.: J. Appl. Phys. 100(8), 084910, 2006a) seems to be the only one that always complies with rigorous bounds and is consequently employed to predict the effects of this fine porosity on the material effective diffusivities. The model proposed provides predictions in good agreement with experimental results and is consistent with the numerous measurements of critical pore diameters issued from mercury intrusion porosimetry tests. The evolution of the effective diffusivities of cement pastes subjected to leaching is also assessed by adopting a simplified scenario of the decalcification process. (authors)

  15. Ancillary Services Provided from DER

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.B.

    2005-12-21

    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  16. Ecosystem services provided by waterbirds.

    Science.gov (United States)

    Green, Andy J; Elmberg, Johan

    2014-02-01

    Ecosystem services are ecosystem processes that directly or indirectly benefit human well-being. There has been much recent literature identifying different services and the communities and species that provide them. This is a vital first step towards management and maintenance of these services. In this review, we specifically address the waterbirds, which play key functional roles in many aquatic ecosystems, including as predators, herbivores and vectors of seeds, invertebrates and nutrients, although these roles have often been overlooked. Waterbirds can maintain the diversity of other organisms, control pests, be effective bioindicators of ecological conditions, and act as sentinels of potential disease outbreaks. They also provide important provisioning (meat, feathers, eggs, etc.) and cultural services to both indigenous and westernized societies. We identify key gaps in the understanding of ecosystem services provided by waterbirds and areas for future research required to clarify their functional role in ecosystems and the services they provide. We consider how the economic value of these services could be calculated, giving some examples. Such valuation will provide powerful arguments for waterbird conservation. © 2013 The Authors. Biological Reviews © 2013 Cambridge Philosophical Society.

  17. 46 CFR 92.15-15 - Ventilation for crew quarters and, where provided, passenger spaces.

    Science.gov (United States)

    2010-10-01

    ..., unless it can be shown that a natural system will provide adequate ventilation. However, vessels which... 46 Shipping 4 2010-10-01 2010-10-01 false Ventilation for crew quarters and, where provided...) CARGO AND MISCELLANEOUS VESSELS CONSTRUCTION AND ARRANGEMENT Ventilation § 92.15-15 Ventilation for crew...

  18. The Efficacy of Private Sector Providers in Improving Public Educational Outcomes

    Science.gov (United States)

    Heinrich, Carolyn J.; Nisar, Hiren

    2013-01-01

    School districts required under No Child Left Behind (NCLB) to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in services. If the market does not drive out ineffective providers, students may not gain through SES participation.…

  19. OPPS Provider Summary for 30 Selected APC Groups - CY2011

    Data.gov (United States)

    U.S. Department of Health & Human Services — A provider level summary of Outpatient Prospective Payment System (OPPS) average estimated submitted charges and average Medicare Payments for 30 selected Ambulatory...

  20. Introduction to variance estimation

    CERN Document Server

    Wolter, Kirk M

    2007-01-01

    We live in the information age. Statistical surveys are used every day to determine or evaluate public policy and to make important business decisions. Correct methods for computing the precision of the survey data and for making inferences to the target population are absolutely essential to sound decision making. Now in its second edition, Introduction to Variance Estimation has for more than twenty years provided the definitive account of the theory and methods for correct precision calculations and inference, including examples of modern, complex surveys in which the methods have been used successfully. The book provides instruction on the methods that are vital to data-driven decision making in business, government, and academe. It will appeal to survey statisticians and other scientists engaged in the planning and conduct of survey research, and to those analyzing survey data and charged with extracting compelling information from such data. It will appeal to graduate students and university faculty who...

  1. Mental Health Insurance Parity and Provider Wages.

    Science.gov (United States)

    Golberstein, Ezra; Busch, Susan H

    2017-06-01

    Policymakers frequently mandate that employers or insurers provide insurance benefits deemed to be critical to individuals' well-being. However, in the presence of private market imperfections, mandates that increase demand for a service can lead to price increases for that service, without necessarily affecting the quantity being supplied. We test this idea empirically by looking at mental health parity mandates. This study evaluated whether implementation of parity laws was associated with changes in mental health provider wages. Quasi-experimental analysis of average wages by state and year for six mental health care-related occupations were considered: Clinical, Counseling, and School Psychologists; Substance Abuse and Behavioral Disorder Counselors; Marriage and Family Therapists; Mental Health Counselors; Mental Health and Substance Abuse Social Workers; and Psychiatrists. Data from 1999-2013 were used to estimate the association between the implementation of state mental health parity laws and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and average mental health provider wages. Mental health parity laws were associated with a significant increase in mental health care provider wages controlling for changes in mental health provider wages in states not exposed to parity (3.5 percent [95% CI: 0.3%, 6.6%]; pwages. Health insurance benefit expansions may lead to increased prices for health services when the private market that supplies the service is imperfect or constrained. In the context of mental health parity, this work suggests that part of the value of expanding insurance benefits for mental health coverage was captured by providers. Given historically low wage levels of mental health providers, this increase may be a first step in bringing mental health provider wages in line with parallel health professions, potentially reducing turnover rates and improving treatment quality.

  2. Estimating uncertainty in resolution tests

    CSIR Research Space (South Africa)

    Goncalves, DP

    2006-05-01

    Full Text Available frequencies yields a biased estimate, and we provide an improved estimator. An application illustrates how the results derived can be incorporated into a larger un- certainty analysis. ? 2006 Society of Photo-Optical Instrumentation Engineers. H20851DOI: 10....1117/1.2202914H20852 Subject terms: resolution testing; USAF 1951 test target; resolution uncertainity. Paper 050404R received May 20, 2005; revised manuscript received Sep. 2, 2005; accepted for publication Sep. 9, 2005; published online May 10, 2006. 1...

  3. Enstore with Chimera namespace provider

    International Nuclear Information System (INIS)

    Litvintsev, Dmitry; Moibenko, Alexander; Oleynik, Gene; Zalokar, Michael

    2012-01-01

    Enstore is a mass storage system developed by Fermilab that provides distributed access and management of data stored on tapes. It uses a namespace service, PNFS, developed by DESY to provide a filesystem-like view of the stored data. PNFS is a legacy product and is being replaced by a new implementation, called Chimera, which is also developed by DESY. Chimera offers multiple advantages over PNFS in terms of performance and functionality. The Enstore client component, encp, has been modified to work with Chimera, as well as with any other namespace provider. We performed high load end-to-end acceptance test of Enstore with the Chimera namespace. This paper describes the modifications to Enstore, the test procedure and the results of the acceptance testing.

  4. Dangertalk: Voices of abortion providers.

    Science.gov (United States)

    Martin, Lisa A; Hassinger, Jane A; Debbink, Michelle; Harris, Lisa H

    2017-07-01

    Researchers have described the difficulties of doing abortion work, including the psychosocial costs to individual providers. Some have discussed the self-censorship in which providers engage in to protect themselves and the pro-choice movement. However, few have examined the costs of this self-censorship to public discourse and social movements in the US. Using qualitative data collected during abortion providers' discussions of their work, we explore the tensions between their narratives and pro-choice discourse, and examine the types of stories that are routinely silenced - narratives we name "dangertalk". Using these data, we theorize about the ways in which giving voice to these tensions might transform current abortion discourse by disrupting false dichotomies and better reflecting the complex realities of abortion. We present a conceptual model for dangertalk in abortion discourse, connecting it to functions of dangertalk in social movements more broadly. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Procedure for estimating permanent total enclosure costs

    Energy Technology Data Exchange (ETDEWEB)

    Lukey, M E; Prasad, C; Toothman, D A; Kaplan, N

    1999-07-01

    Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use permanent total enclosures (PTEs). By definition, an enclosure which meets the US Environmental Protection Agency's five-point criteria is a PTE and has a capture efficiency of 100%. Since costs play an important role in regulatory development, in selection of control equipment, and in control technology evaluations for permitting purposes, EPA has developed a Control Cost Manual for estimating costs of various items of control equipment. EPA's Manual does not contain any methodology for estimating PTE costs. In order to assist environmental regulators and potential users of PTEs, a methodology for estimating PTE costs was developed under contract with EPA, by Pacific Environmental Services, Inc. (PES) and is the subject of this paper. The methodology for estimating PTE costs follows the approach used for other control devices in the Manual. It includes procedures for sizing various components of a PTE and for estimating capital as well as annual costs. It contains verification procedures for demonstrating compliance with EPA's five-point criteria. In addition, procedures are included to determine compliance with Occupational Safety and Health Administration (OSHA) standards. Meeting these standards is an important factor in properly designing PTEs. The methodology is encoded in Microsoft Exel spreadsheets to facilitate cost estimation and PTE verification. Examples are given throughout the methodology development and in the spreadsheets to illustrate the PTE design, verification, and cost estimation procedures.

  6. The need to estimate risks

    International Nuclear Information System (INIS)

    Pochin, E.E.

    1980-01-01

    In an increasing number of situations, it is becoming possible to obtain and compare numerical estimates of the biological risks involved in different alternative sources of action. In some cases these risks are similar in kind, as for example when the risk of including fatal cancer of the breast or stomach by x-ray screening of a population at risk, is compared with the risk of such cancers proving fatal if not detected by a screening programme. In other cases in which it is important to attempt a comparison, the risks are dissimilar in type, as when the safety of occupations involving exposure to radiation or chemical carcinogens is compared with that of occupations in which the major risks are from lung disease or from accidental injury and death. Similar problems of assessing the relative severity of unlike effects occur in any attempt to compare the total biological harm associated with a given output of electricity derived from different primary fuel sources, with its contributions both of occupation and of public harm. In none of these instances is the numerical frequency of harmful effects alone an adequate measure of total biological detriment, nor is such detriment the only factor which should influence decisions. Estimations of risk appear important however, since otherwise public health decisions are likely to be made on more arbitrary grounds, and public opinion will continue to be affected predominantly by the type rather than also by the size of risk. (author)

  7. EAMJ Provider April 10.indd

    African Journals Online (AJOL)

    2010-04-04

    Apr 4, 2010 ... from 14 to 30 days in studies done in Europe and. North America ... to confirmatory laboratory diagnostic test was 56.2 days (n=83, range 1 to 985 days, standard .... (9,10). In a population based study in German, Volker ... risk factors for provider delays (9). ... mammographic reliability for cancer diagnosis at.

  8. Device provides controlled gas leaks

    Science.gov (United States)

    Kami, S. K.; King, H. J.

    1968-01-01

    Modified palladium leak device provides a controlled release /leak/ of very small quantities of gas at low or medium pressures. It has no moving parts, requires less than 5 watts to operate, and is capable of releasing the gas either continuously or in pulses at adjustable flow rates.

  9. Twitter for travel medicine providers.

    Science.gov (United States)

    Mills, Deborah J; Kohl, Sarah E

    2016-03-01

    Travel medicine practitioners, perhaps more so than medical practitioners working in other areas of medicine, require a constant flow of information to stay up-to-date, and provide best practice information and care to their patients. Many travel medicine providers are unaware of the popularity and potential of the Twitter platform. Twitter use among our travellers, as well as by physicians and health providers, is growing exponentially. There is a rapidly expanding body of published literature on this information tool. This review provides a brief overview of the ways Twitter is being used by health practitioners, the advantages that are peculiar to Twitter as a platform of social media, and how the interested practitioner can get started. Some key points about the dark side of Twitter are highlighted, as well as the potential benefits of using Twitter as a way to disseminate accurate medical information to the public. This article will help readers develop an increased understanding of Twitter as a tool for extracting useful facts and insights from the ever increasing volume of health information. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  10. Vitamin D: dietary requirements and food fortification as a means of helping achieve adequate vitamin D status.

    Science.gov (United States)

    Cashman, Kevin D

    2015-04-01

    Vitamin D deficiency is evident in many parts of the globe, even in the sunnier regions, for a variety of reasons. Such deficiency contributes to risk of metabolic bone disease as well as potentially other non-skeletal chronic diseases in both early-life and later-life, and thus strategies for its prevention are of major public health importance. Dietary Reference Intervals (called Dietary Reference Intakes (DRI) and Dietary Reference Values (DRVs) in North America and Europe, respectively) for vitamin D have a key role in protecting against vitamin D deficiency in the population, and these have been re-evaluated in recent years on both sides of the Atlantic. The current DRI and DRVs for vitamin D and their basis will be overviewed in this review as well as some limitations that existed within the evidence-base and which contribute some degree of uncertainty to these new requirement estimates for vitamin D. The review will also compare current population intake estimates for children and adults in North America and Europe against the estimated average requirement (EAR) for vitamin D, as a benchmark of nutritional adequacy. While vitamin D supplementation has been suggested as a method of bridging the gap between current vitamin D intakes and new recommendations, the level of usage of vitamin D supplements in many countries as well as the vitamin D content of available supplements in these countries, appears to be low. The fortification of food with vitamin D has been suggested as a strategy for increasing intake with potentially the widest reach and impact in the population. The present review will highlight the need to re-evaluate current food fortification practices as well as consider new additional food-based approaches, such as biofortification of food with vitamin D, as a means of collectively tackling the low intakes of vitamin D within populations and the consequent high prevalence of low vitamin D status that are observed. This article is part of a Special

  11. Australia’s protected area network fails to adequately protect the world’s most threatened marine fishes

    Directory of Open Access Journals (Sweden)

    Karen R. Devitt

    2015-01-01

    Full Text Available In order to maintain ecosystems and biodiversity, Australia has long invested in the development of marine and terrestrial protected area networks. Within this land- and sea-scape, northern Australia represents a global population stronghold for four species of the world’s most threatened marine fish family, the sawfishes (family Pristidae. The distribution of sawfishes across northern Australia has previously only been coarsely estimated, and the adequacy of their representation in protected areas has not been evaluated. The calculated range of each species was intersected with Australia’s marine and terrestrial protected area datasets, and targets of 10% marine and 17% inland range protection were used to determine adequacy of sawfish range protection. Marine targets have been achieved for all species, but the inland range protection targets have not been met for any species. Results indicate that further protection of inland habitats is required in order to improve sawfish protection and habitat connectivity.

  12. Estimating uncertainty of data limited stock assessments

    DEFF Research Database (Denmark)

    Kokkalis, Alexandros; Eikeset, Anne Maria; Thygesen, Uffe Høgsbro

    2017-01-01

    -limited. Particular emphasis is put on providing uncertainty estimates of the data-limited assessment. We assess four cod stocks in the North-East Atlantic and compare our estimates of stock status (F/Fmsy) with the official assessments. The estimated stock status of all four cod stocks followed the established stock...

  13. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU per day on biochemical responses and the wellbeing of patients

    Directory of Open Access Journals (Sweden)

    Hu Amanda

    2004-07-01

    Full Text Available Abstract Background For adults, vitamin D intake of 100 mcg (4000 IU/day is physiologic and safe. The adequate intake (AI for older adults is 15 mcg (600 IU/day, but there has been no report focusing on use of this dose. Methods We compared effects of these doses on biochemical responses and sense of wellbeing in a blinded, randomized trial. In Study 1, 64 outpatients (recruited if summer 2001 25(OHD Results In Study 1, basal summer 25-hydroxyvitamin D [25(OHD] averaged 48 ± 9 (SD nmol/L. Supplementation for more than 6 months produced mean 25(OHD levels of 79 ± 30 nmol/L for the 15 mcg/day group, and 112 ± 41 nmol/L for the 100 mcg/day group. Both doses lowered plasma parathyroid hormone with no effect on plasma calcium. Between December and February, wellbeing score improved more for the 100-mcg/day group than for the lower-dosed group (1-tail Mann-Whitney p = 0.036. In Study 2, 25(OHD averaged 39 ± 9 nmol/L, and winter wellbeing scores improved with both doses of vitamin D (two-tail p Conclusion The highest AI for vitamin D brought summertime 25(OHD to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D3 in patients who needed additional vitamin D.

  14. Actions Needed to Ensure Scientific and Technical Information is Adequately Reviewed at Goddard Space Flight Center, Johnson Space Center, Langley Research Center, and Marshall Space Flight Center

    Science.gov (United States)

    2008-01-01

    This audit was initiated in response to a hotline complaint regarding the review, approval, and release of scientific and technical information (STI) at Johnson Space Center. The complainant alleged that Johnson personnel conducting export control reviews of STI were not fully qualified to conduct those reviews and that the reviews often did not occur until after the STI had been publicly released. NASA guidance requires that STI, defined as the results of basic and applied scientific, technical, and related engineering research and development, undergo certain reviews prior to being released outside of NASA or to audiences that include foreign nationals. The process includes technical, national security, export control, copyright, and trade secret (e.g., proprietary data) reviews. The review process was designed to preclude the inappropriate dissemination of sensitive information while ensuring that NASA complies with a requirement of the National Aeronautics and Space Act of 1958 (the Space Act)1 to provide for the widest practicable and appropriate dissemination of information resulting from NASA research activities. We focused our audit on evaluating the STI review process: specifically, determining whether the roles and responsibilities for the review, approval, and release of STI were adequately defined and documented in NASA and Center-level guidance and whether that guidance was effectively implemented at Goddard Space Flight Center, Johnson Space Center, Langley Research Center, and Marshall Space Flight Center. Johnson was included in the review because it was the source of the initial complaint, and Goddard, Langley, and Marshall were included because those Centers consistently produce significant amounts of STI.

  15. Management systems for service providers

    International Nuclear Information System (INIS)

    Bolokonya, Herbert Chiwalo

    2015-02-01

    In the field of radiation safety and protection there are a number of institutions that are involved in achieving different goals and strategies. These strategies and objectives are achieved based on a number of tools and systems, one of these tools and systems is the use of a management system. This study aimed at reviewing the management system concept for Technical Service Providers in the field of radiation safety and protection. The main focus was on personal monitoring services provided by personal dosimetry laboratories. A number of key issues were found to be prominent to make the management system efficient. These are laboratory accreditation, approval; having a customer driven operating criteria; and controlling of records and good reporting. (au)

  16. Providing solutions to engineering problems

    International Nuclear Information System (INIS)

    Connop, R.P.P.

    1991-01-01

    BNFL has acquired unique experience over a period of 40 years in specifying, designing and constructing spent fuel reprocessing and associated waste management plant. This experience is currently used to support a pound 5.5 billion capital investment programme. This paper reviews a number of engineering problems and their solutions to highlight BNFL experience in providing comprehensive specification, design and engineering and project management services. (author)

  17. Support Net for Frontline Providers

    Science.gov (United States)

    2016-03-01

    learning style , as well as treatment readiness (Proudfoot et al., 2011). Several channels of delivery include audio, video, email correspondence and...Provided Resources (1) o “Self assessment, resources were good.” Coaching (2) o “During this coaching period, I had a death of a parent , I did find the...Secondary Traumatic Stress Scale. Res Soc Work Pract. 2004; 14(1):27–35. 21. Pyevich CM, Newman E, Daleiden E. The relationship among cognitive

  18. Are the U.S. Navy’s Current Procedures for Responding to Homeland Defense and Security Tasking Adequately Designed?

    Science.gov (United States)

    2009-12-01

    Amphibious Transport Dock LSD Landing Ship Dock MACA Military Assistance to Civil Authorities MAD Magnetic Anomaly Detector MARFORNORTH Marine...as Military Assistance to Civil Authorities ( MACA ), is DoD support for domestic emergencies.38 DoD support includes anything from providing experts

  19. Pre-registration Nurse Education in Pharmacology: Is It Adequate for the Roles that Nurses Are Expected To Fulfill?

    Science.gov (United States)

    Morrison-Griffiths, Sally; Snowden, Michael A.; Pirmohamed, Munir

    2002-01-01

    According to responses from 33 of 52 nursing departments in England, 90% integrated pharmacology into curricula; 82% preferred that nurses teach it; 88% provided no training for lecturers. Lecture was the predominant teaching method. About one-fifth did not formally assess pharmacology knowledge. Students lacked math and science preparation for…

  20. Suggestions for an adequate risk communication - experiences based on German epidemiological studies on childhood cancer and neighbourhood to nuclear power plants

    International Nuclear Information System (INIS)

    Kaatsch, P.

    2006-01-01

    From the example of the German studies on childhood cancer in the vicinity of nuclear power plants general principles for adequate risk communication could be derived. It is particularly important to explain the complexity of the issue to the public in an adequate way, when dealing with topics of such an emotionally loaded nature. Some rules are required, when explaining the nature of risk to the layman, the press, politicians, or scientists from other fields. The main principle is to create a basis of trustfulness, whereupon results can be presented. In this contribution we derive general and proven specific recommendations for adequate risk communication on the basis of experiences made at the German Childhood Cancer Registry. (orig.)

  1. The APT program plan: Providing an assured tritium production capability

    International Nuclear Information System (INIS)

    Lisowski, P.W.; Anderson, J.L.; Bishop, W.P.; Boggs, B.; Hall, K.

    1996-01-01

    Tritium is a radioactive hydrogen isotope used in all U.S. nuclear weapons. Because the half-life of tritium is short, 12.3 yr, it must be periodically replenished. To provide a new source, the U.S. Department of Energy (DOE) is sponsoring conceptual design and engineering development and demonstration activities for a plant that will use a high-power proton linear accelerator to produce tritium and will go on-line no later than 2007. The APT project is in the process of completing the conceptual design for a tritium production plant. In addition, there are several important areas under engineering development and demonstration that will ensure an efficient, cost-effective plant design and provide an adequate margin of tritium production. Information provided from this work will be used by the DOE in its 1998 choice of production technology implementation

  2. Providing cleaner air to Canadians

    International Nuclear Information System (INIS)

    2001-02-01

    This booklet is designed to explain salient aspects of the Ozone Annex, negotiated and signed recently by Canada and the United States, in a joint effort to improve air quality in North America. By significantly reducing the transboundary flows of air pollutants that cause smog, the Ozone Annex will benefit some 16 million people in central and eastern Canada and provide an example for a future round of negotiations to address concerns of the millions of Canadians and Americans who live in the border area between British Columbia and Washington State. The brochure provide summaries of the Canadian and American commitments, focusing on transportation, monitoring and reporting. The Ozone Annex complements other air quality initiatives by the Government of Canada enacted under the Environmental Protection Act, 1999. These measures include regulations to reduce sulphur content to 30 parts per million by Jan 1, 2005; proposing to restrict toxic particulate matter (PM) to less than 10 microns; establishing daily smog forecasts in the Maritimes and committing to a national program built upon existing smog advisories and forecasts in Quebec, Ontario and British Columbia; and investing in more clean air research through the newly created Canadian Foundation for Climate and Atmospheric Sciences

  3. 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

  4. Radiation dose estimates for radiopharmaceuticals

    International Nuclear Information System (INIS)

    Stabin, M.G.; Stubbs, J.B.; Toohey, R.E.

    1996-04-01

    Tables of radiation dose estimates based on the Cristy-Eckerman adult male phantom are provided for a number of radiopharmaceuticals commonly used in nuclear medicine. Radiation dose estimates are listed for all major source organs, and several other organs of interest. The dose estimates were calculated using the MIRD Technique as implemented in the MIRDOSE3 computer code, developed by the Oak Ridge Institute for Science and Education, Radiation Internal Dose Information Center. In this code, residence times for source organs are used with decay data from the MIRD Radionuclide Data and Decay Schemes to produce estimates of radiation dose to organs of standardized phantoms representing individuals of different ages. The adult male phantom of the Cristy-Eckerman phantom series is different from the MIRD 5, or Reference Man phantom in several aspects, the most important of which is the difference in the masses and absorbed fractions for the active (red) marrow. The absorbed fractions for flow energy photons striking the marrow are also different. Other minor differences exist, but are not likely to significantly affect dose estimates calculated with the two phantoms. Assumptions which support each of the dose estimates appears at the bottom of the table of estimates for a given radiopharmaceutical. In most cases, the model kinetics or organ residence times are explicitly given. The results presented here can easily be extended to include other radiopharmaceuticals or phantoms

  5. Risk estimation using probability machines

    Science.gov (United States)

    2014-01-01

    Background Logistic regression has been the de facto, and often the only, model used in the description and analysis of relationships between a binary outcome and observed features. It is widely used to obtain the conditional probabilities of the outcome given predictors, as well as predictor effect size estimates using conditional odds ratios. Results We show how statistical learning machines for binary outcomes, provably consistent for the nonparametric regression problem, can be used to provide both consistent conditional probability estimation and conditional effect size estimates. Effect size estimates from learning machines leverage our understanding of counterfactual arguments central to the interpretation of such estimates. We show that, if the data generating model is logistic, we can recover accurate probability predictions and effect size estimates with nearly the same efficiency as a correct logistic model, both for main effects and interactions. We also propose a method using learning machines to scan for possible interaction effects quickly and efficiently. Simulations using random forest probability machines are presented. Conclusions The models we propose make no assumptions about the data structure, and capture the patterns in the data by just specifying the predictors involved and not any particular model structure. So they do not run the same risks of model mis-specification and the resultant estimation biases as a logistic model. This methodology, which we call a “risk machine”, will share properties from the statistical machine that it is derived from. PMID:24581306

  6. Boundary methods for mode estimation

    Science.gov (United States)

    Pierson, William E., Jr.; Ulug, Batuhan; Ahalt, Stanley C.

    1999-08-01

    This paper investigates the use of Boundary Methods (BMs), a collection of tools used for distribution analysis, as a method for estimating the number of modes associated with a given data set. Model order information of this type is required by several pattern recognition applications. The BM technique provides a novel approach to this parameter estimation problem and is comparable in terms of both accuracy and computations to other popular mode estimation techniques currently found in the literature and automatic target recognition applications. This paper explains the methodology used in the BM approach to mode estimation. Also, this paper quickly reviews other common mode estimation techniques and describes the empirical investigation used to explore the relationship of the BM technique to other mode estimation techniques. Specifically, the accuracy and computational efficiency of the BM technique are compared quantitatively to the a mixture of Gaussian (MOG) approach and a k-means approach to model order estimation. The stopping criteria of the MOG and k-means techniques is the Akaike Information Criteria (AIC).

  7. Is the support that dental registrants in difficulty receive from postgraduate dental teams and other sources adequate?

    Science.gov (United States)

    Pearce, M; Agius, S J; Macfarlane, J; Taylor, N

    2017-05-26

    Objective The aim of this research was to investigate the views of dental registrants in difficulty (DRiDS) on the support they received from postgraduate dental teams (PgDT) in Health Education England (HEE) and other sources. These data were complemented by the views of those appointed from the PgDT to support them on the service they provide.Method Qualitative data were collected by recording one-to-one semi structured telephone interviews, lasting approximately 30 minutes, with registrants in difficulty and supporters purposefully sampled from across England and Wales. Recordings were transcribed and the interview data analysed for recurring discourses and themes using thematic framework analysis.Setting and subjects All regional leads for DRiDs services in PgDT across the UK were asked to invite the DRiDs they were in contact with and the supporters they had appointed to contact the research team. Attempts were made to contact all who returned consent forms and six DRiDs and 11 supporters were eventually interviewed.Results Overall the DRiDs thought that the PgDT were very helpful. They were in many cases the only source of expert support and advice, particularly with regard to developing a personal development plan and collecting evidence about their practice to present to the regulator. There was a good match between the qualities that DRiDs wanted their supporters to have and the strengths supporters felt they brought to the role. The DRiDs had mixed views about the support provided by their indemnifiers and could not identify any other organisations that provided support once conditions had been imposed. Some had the support of peers; but both DRiDs and supporters felt there was a need for further support in addition to the educational support provided by PgDT and legal support provided by the indemnifier.Conclusion The DRiDS regarded the PgDT as their primary source of support and, in general, were very satisfied with the character and competence of the

  8. Providing Southern Perspectives on CSR

    DEFF Research Database (Denmark)

    Jeppesen, Søren; Kothuis, Bas

    The article seeks to contribute to the SMEs and CSR literature in developing countries by providing; a) a ‘Southern’ SME perspective, which includes the voices of managers and workers, b) a perspective of CSR, which opens up to informal CSR practices that SMEs undertake, and c) an analysis...... of the key institutional issues affecting the CSR practices of SMEs. It presents perceptions of CSR practices among 21 SMEs in the garment industry in South Africa, based on 40 interviews with managers and 19 interviews with workers through the use of qualitative and quantitative interview frameworks....... It highlights a high degree of similarities between managers and workers, though knowledge of (cognitive level) the concept ‘CSR’ differ considerably. Informal practices are widespread and of key importance to the SMEs, expressed by managers and workers alike. History, industry and manager-workers relations...

  9. Wind Turbine Providing Grid Support

    DEFF Research Database (Denmark)

    2011-01-01

    changing the operation of the wind turbine to a more efficient working point.; When the rotational speed of the rotor reaches a minimum value, the wind turbine enters a recovery period to re-accelerate the rotor to the nominal rotational speed while further contributing to the stability of the electrical......A variable speed wind turbine is arranged to provide additional electrical power to counteract non-periodic disturbances in an electrical grid. A controller monitors events indicating a need to increase the electrical output power from the wind turbine to the electrical grid. The controller...... is arranged to control the wind turbine as follows: after an indicating event has been detected, the wind turbine enters an overproduction period in which the electrical output power is increased, wherein the additional electrical output power is taken from kinetic energy stored in the rotor and without...

  10. Providers perspective and geographic and institutional factors associated with family planning counseling.

    Science.gov (United States)

    de la Vara-Salazar, Elvia; Suárez-López, Leticia; Rivera, Leonor; Lazcano-Ponce, Eduardo

    2018-06-01

    Family planning (FP) counseling is an essential activity to prevent unplanned pregnancies and allow a fulfilling sex life. We defined adequate counseling in FP as the counseling given to women and men of reproductive age that provided complete information about use, application, effectiveness, side effects, and contraindications. Two objectives are proposed in this study. First, we seek to analyze geographic and institutional factors associated with FP counseling in primary and secondary healthcare facilities in Mexico. Second, we seek to identify the cultural barriers that providers perceive as a limitation of the clients so that they can come to request information related to FP and that are associated with FP counseling. This cross-sectional study uses a complex, probabilistic, stratified sampling design representative at national level by institution, region and rural-urban areas. We collected 16,829 provider questionnaires at healthcare facilities. Bivariate and logistic regression analyses were performed. Providers in rural areas had a greater possibility of offering adequate counseling (OR = 2.98; 95%CI 1.18-7.53). Providers in the northern region of the country were more likely to provide adequate counseling (OR = 5.37; 95% CI 1.91-15.12). Providers whom perceive religion as a limitation for clients to come to request information about FP are less likely to provide adequate counseling (OR = 0.37; 95% CI 0.15-0.88). Physical space exclusively for the provision of FP counseling and the availability of manuals were not associated with adequate counseling. There is a need to address the social and cultural influences on the quality of counseling in these healthcare facilities. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Is knowledge translation adequate? A quality assurance study of staging investigations in early stage breast cancer patients.

    Science.gov (United States)

    Han, Dolly; Hogeveen, Sophie; Sweet Goldstein, Miriam; George, Ralph; Brezden-Masley, Christine; Hoch, Jeffrey; Haq, Rashida; Simmons, Christine E

    2012-02-01

    After primary surgery, patients diagnosed with early stage breast cancer undergo radiological investigations based on pathologic stage of disease to rule out distant metastases. Published guidelines can aid clinicians in determining which tests are appropriate based on stage of disease. We wished to assess the consistency of radiological staging in an academic community oncology setting with standard guidelines and to determine the overall impact of non-adherence to these guidelines. A retrospective cohort study was conducted for new breast cancer patients seen at a single institution between January 2009 and April 2010. Patients were included if initial diagnosis and primary surgery was at this institution. Pathologic stage and radiological tests completed were recorded. A literature review was performed and the results were compared with those from this study to determine overall adherence rates. Subsequently, a cost analysis was performed to determine the financial impact at this centre. 231 patients met eligibility criteria for inclusion in this study. A large proportion of patients were over-staged with 129 patients (55%) undergoing unnecessary investigations according to guidelines. Specifically, 59% of stage I patients and 58% of stage II patients were over-investigated. Distant metastases at the time of diagnosis were found in three patients, all of whom had stage III disease (1.3%). The literature reviewed revealed similar non-adherence rates in other centres. The estimated cost of such non-adherence is in the range of $78 (CDN) per new early stage breast cancer patient seen at this centre. This oncology centre has a low adherence to practice guidelines for staging investigations in breast cancer patients, with 55% of patients undergoing unnecessary tests. Very few patients had metastases at diagnosis, and all had pathological stage III disease. Efforts may need to focus on improving knowledge translation across clinical oncology settings to increase

  12. Adequate vitamin D status is associated with the reduced odds of prevalent diabetic retinopathy in African Americans and Caucasians.

    Science.gov (United States)

    Millen, Amy E; Sahli, Michelle W; Nie, Jing; LaMonte, Michael J; Lutsey, Pamela L; Klein, Barbara E K; Mares, Julie A; Meyers, Kirstin J; Andrews, Christopher A; Klein, Ronald

    2016-09-01

    Vitamin D status has been hypothesized to protect against development of diabetic retinopathy via its anti-inflammatory and anti-angiogenic properties. Additionally, in vitro and in vivo studies suggest vitamin D favorably influences blood pressure and blood glucose control, strong risk factors for diabetic retinopathy. We examined the association between vitamin D status and prevalent diabetic retinopathy in participants with diabetes from a population-based cohort. Among participants in the Atherosclerosis Risk in Communities (ARIC) study with diabetes at visit 3 (1993-1995), 1339 (906 Caucasians, 433 African Americans) had serum 25-hydroxyvitamin (25[OH]D) concentrations assessed at visit 2 (1989-1992) and nonmydriatic retinal photographs taken at visit 3. Dietary intake of vitamin D was assessed at visit 1 (1987-1989). Logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for diabetic retinopathy by categories of season-adjusted 25(OH)D (diabetes. We further adjusted for HBA1c and hypertension to examine if 25(OH)D influenced diabetic retinopathy via its effects on either glycemic control or blood pressure. ORs (95 % CIs) for retinopathy, adjusted for race and duration, were 0.77 (0.45-1.32), 0.64 (0.37-1.10), and 0.39 (0.20-0.75), p for trend = 0.001, for participants with 25(OH)D of 30-retinopathy. 25(OH)D concentrations ≥75 nmol/L were associated with lower odds of any retinopathy assessed 3 years later. We speculate this may be due in part to vitamin D's influence on blood glucose control.

  13. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  14. General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients – is cultural competence adequately considered?

    Science.gov (United States)

    2014-01-01

    Background General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. Methods A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Results Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar’s generic communication and consultation skills, only 72% referred to culture or to the patient’s Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. Conclusions The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise

  15. General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients - is cultural competence adequately considered?

    Science.gov (United States)

    Abbott, Penelope; Reath, Jennifer; Gordon, Elaine; Dave, Darshana; Harnden, Chris; Hu, Wendy; Kozianski, Emma; Carriage, Cris

    2014-08-13

    General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar's generic communication and consultation skills, only 72% referred to culture or to the patient's Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the

  16. Fallout radiation protection provided by transportation vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Burson, Z.G.

    1972-10-20

    Fallout radiation protection factors (PF's) were estimated for a variety of civilian transportation vehicles using measurements of the natural terrain radiation as a source. The PF values are below 2 in light vehicles, truck beds, or trailers; from 2.5 to 3 in the cabs of heavy trucks and in a railway guard car; and from 3.0 to 3.5 in the engineer's seat of heavy locomotives. This information can be useful in planning the possible movement of personnel from or through areas contaminated either by a wartime incident or a peacetime accident. The information may also be useful for studying the reduction of exposure to the natural terrestrial radiation environment provided by vehicles.

  17. Moving Horizon Estimation and Control

    DEFF Research Database (Denmark)

    Jørgensen, John Bagterp

    successful and applied methodology beyond PID-control for control of industrial processes. The main contribution of this thesis is introduction and definition of the extended linear quadratic optimal control problem for solution of numerical problems arising in moving horizon estimation and control...... problems. Chapter 1 motivates moving horizon estimation and control as a paradigm for control of industrial processes. It introduces the extended linear quadratic control problem and discusses its central role in moving horizon estimation and control. Introduction, application and efficient solution....... It provides an algorithm for computation of the maximal output admissible set for linear model predictive control. Appendix D provides results concerning linear regression. Appendix E discuss prediction error methods for identification of linear models tailored for model predictive control....

  18. Food and nutritional security requires adequate protein as well as energy, delivered from whole-year crop production.

    Science.gov (United States)

    Coles, Graeme D; Wratten, Stephen D; Porter, John R

    2016-01-01

    Human food security requires the production of sufficient quantities of both high-quality protein and dietary energy. In a series of case-studies from New Zealand, we show that while production of food ingredients from crops on arable land can meet human dietary energy requirements effectively, requirements for high-quality protein are met more efficiently by animal production from such land. We present a model that can be used to assess dietary energy and quality-corrected protein production from various crop and crop/animal production systems, and demonstrate its utility. We extend our analysis with an accompanying economic analysis of commercially-available, pre-prepared or simply-cooked foods that can be produced from our case-study crop and animal products. We calculate the per-person, per-day cost of both quality-corrected protein and dietary energy as provided in the processed foods. We conclude that mixed dairy/cropping systems provide the greatest quantity of high-quality protein per unit price to the consumer, have the highest food energy production and can support the dietary requirements of the highest number of people, when assessed as all-year-round production systems. Global food and nutritional security will largely be an outcome of national or regional agroeconomies addressing their own food needs. We hope that our model will be used for similar analyses of food production systems in other countries, agroecological zones and economies.

  19. Estimating the Effective Sample Size of Tree Topologies from Bayesian Phylogenetic Analyses

    Science.gov (United States)

    Lanfear, Robert; Hua, Xia; Warren, Dan L.

    2016-01-01

    Bayesian phylogenetic analyses estimate posterior distributions of phylogenetic tree topologies and other parameters using Markov chain Monte Carlo (MCMC) methods. Before making inferences from these distributions, it is important to assess their adequacy. To this end, the effective sample size (ESS) estimates how many truly independent samples of a given parameter the output of the MCMC represents. The ESS of a parameter is frequently much lower than the number of samples taken from the MCMC because sequential samples from the chain can be non-independent due to autocorrelation. Typically, phylogeneticists use a rule of thumb that the ESS of all parameters should be greater than 200. However, we have no method to calculate an ESS of tree topology samples, despite the fact that the tree topology is often the parameter of primary interest and is almost always central to the estimation of other parameters. That is, we lack a method to determine whether we have adequately sampled one of the most important parameters in our analyses. In this study, we address this problem by developing methods to estimate the ESS for tree topologies. We combine these methods with two new diagnostic plots for assessing posterior samples of tree topologies, and compare their performance on simulated and empirical data sets. Combined, the methods we present provide new ways to assess the mixing and convergence of phylogenetic tree topologies in Bayesian MCMC analyses. PMID:27435794

  20. Improvement of Hyperemic Myocardial Oxygen Extraction Fraction Estimation By A Diffusion Prepared Sequence

    Science.gov (United States)

    McCommis, Kyle S.; Koktzoglou, Ioannis; Zhang, Haosen; Goldstein, Thomas A.; Northrup, Benjamin E.; Li, Debiao; Gropler, Robert J.; Zheng, Jie

    2010-01-01

    Myocardial oxygen extraction fraction (OEF) during hyperemia can be estimated using a double-inversion-recovery (DIR) prepared T2-weighted black-blood sequence. Severe irregular ECG-triggering due to elevated heart rate and/or arrhythmias may render it difficult to adequately suppress the flowing left ventricle blood signal and thus potentially cause errors in the estimates of myocardial OEF. Thus, the goal of this study was to evaluate another black-blood technique, a diffusion-weighted (DW)-prepared TSE sequence for its ability to determine regional myocardial OEF during hyperemia. Control dogs and dogs with acute coronary artery stenosis were imaged with both the DIR- and DW-prepared TSE sequences at rest and during either dipyridamole or dobutamine hyperemia. Validation of MRI OEF estimates was performed using blood sampling from the artery and coronary sinus in control dogs. The two methods showed comparable correlations with blood sampling results (R2 = 0.9). Similar OEF estimations for all dogs were observed except for the group of dogs with severe coronary stenosis during dobutamine stress. In these dogs, the DW method provided more physiologically reasonable OEF (hyperemic OEF = 0.75 ± 0.08 vs resting OEF of 0.6) than the DIR method (hyperemic OEF = 0.56 ± 0.10). DW-preparation may be a valuable alternative for more accurate oxygenation measurements during irregular ECG-triggering. PMID:20512871

  1. Environmental standards provide competitive advantage

    International Nuclear Information System (INIS)

    Chynoweth, E.; Kirshner, E.

    1993-01-01

    Quality organizations are breaking new ground with the development of international standards for environmental management. These promise to provide the platform for chemical companies wanting to establish their environmental credibility with a global audience. open-quotes It will be similar to auditing our customers to ISO 9000 close-quote, says the environmental manager for a European chemical firm. open-quote We will only want to deal with people who have got their environmental act together. And we'll be in a better competitive positions close-quote. The International Organization for Standardization (ISO;Geneva) has set up a taskforce to develop an environmental management standard, which is expected to be completed by the mid-1990s. Observers think the ISO standard will draw heavily on the British Standard Institute's (BSI;London) environmental management standard, BS7750, which will likely be the first system adopted in the world. Published last year, BS7750 has been extensively piloted in the UK (CW, Sept. 30, 1992, p. 62) and is now set to be revised before being offically adopted by BSI. The UK's Chemical Industries Association (CIA;London) is anxious to prevent a proliferation of standards, and its report on BS7750 pilot projects calls for an approach integrating quality, environment, and health and safety. But standard setters, including ISO, appear to be moving in the opposite direction. In the US, the American national Standards Institute (ANSI;Washington) has started work on an environmental management standard

  2. Computerized provider order entry systems.

    Science.gov (United States)

    2001-01-01

    Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use.

  3. [Estimates of the availability of energy and protein by province for the period 1985-2000].

    Science.gov (United States)

    Jus'at, I; Idrus, D

    1984-06-01

    An attempt is made to estimate the availability of adequate per capita food supplies and protein in the provinces of Indonesia over the period 1985 to 2000. The estimates are based on official population projections. Variations in food supply by province are discussed. (summary in ENG)

  4. Surface BRDF estimation from an aircraft compared to MODIS and ground estimates at the Southern Great Plains site

    Energy Technology Data Exchange (ETDEWEB)

    Knobelspiesse, Kirk D.; Cairns, Brian; Schmid, Beat; Roman, Miguel O.; Schaaf, Crystal B.

    2008-10-21

    The surface spectral albedo is an important component of climate models since it determines the amount of incident solar radiation that is absorbed by the ground. The albedo can be highly heterogeneous, both in space and time, and thus adequate measurement and modeling is challenging. One source of measurements that constrain the surface albedo are satellite instruments that observe the Earth, such as the Moderate Resolution Imaging Spectroradiometer (MODIS). Satellites estimate the surface bidirectional reflectance distribution function (BRDF) by correcting top of the atmosphere (TOA) radiances for atmospheric effects and accumulating observations at a variety of viewing geometries. The BRDF can then be used to determine the albedo that is required in climate modeling. Other measurements that provide a more direct constraint on surface albedo are those made by upward and downward looking radiometers at the ground. One product in particular, the Best Estimate Radiation Flux (BEFLUX) value added product of the Department of Energy’s Atmospheric Radiation Measurement (ARM) Program at the Southern Great Plains Central Facility (SGP CF) in central Oklahoma, has been used to evaluate the quality of the albedo products derived from MODIS BRDF estimates. These comparisons have highlighted discrepancies between the energy absorbed at the surface that is calculated from the BEFLUX products and that is predicted from the MODIS BRDF product. This paper attempts to investigate these discrepancies by using data from an airborne scanning radiometer, the Research Scanning Polarimeter (RSP) that was flown at low altitude in the vicinity of the SGP CF site during the Aerosol Lidar Validation Experiment (ALIVE) in September of 2005. The RSP is a polarimeter that scans in the direction of the aircraft ground track, and can thus estimate the BRDF in a period of seconds, rather than the days required by MODIS to accumulate enough viewing angles. Atmospheric correction is aided by the

  5. Estimation of Leak Rate from the Emergency Pump Well in L-Area Complex Basin

    International Nuclear Information System (INIS)

    Duncan, A

    2005-01-01

    This report provides an estimate of the leak rate from the emergency pump well in L-basin that is to be expected during an off-normal event. This estimate is based on expected shrinkage of the engineered grout (i.e., controlled low strength material) used to fill the emergency pump well and the header pipes that provide the dominant leak path from the basin to the lower levels of the L-Area Complex. The estimate will be used to provide input into the operating safety basis to ensure that the water level in the basin will remain above a certain minimum level. The minimum basin water level is specified to ensure adequate shielding for personnel and maintain the ''as low as reasonably achievable'' concept of radiological exposure. The need for the leak rate estimation is the existence of a gap between the fill material and the header pipes, which penetrate the basin wall and would be the primary leak path in the event of a breach in those pipes. The gap between the pipe and fill material was estimated based on a full scale demonstration pour that was performed and examined. Leak tests were performed on full scale pipes as a part of this examination. Leak rates were measured to be on the order of 0.01 gallons/minute for completely filled pipe (vertically positioned) and 0.25 gallons/minute for partially filled pipe (horizontally positioned). This measurement was for water at 16 feet head pressure and with minimal corrosion or biofilm present. The effect of the grout fill on the inside surface biofilm of the pipes is the subject of a previous memorandum

  6. Nurse education and willingness to provide spiritual care.

    Science.gov (United States)

    Wu, Li-Fen; Tseng, Hui-Chen; Liao, Yu-Chen

    2016-03-01

    Spiritual care is a critical part of holistic care, and nurses require adequate preparation to address the spiritual needs of patients. However, nurses' willingness to provide such care has rarely been reported. Hence, nurses' education, and knowledge of spiritual care, as well as their willingness to provide it require further study. A convenience sample of 200 nurses participated in the study. Quantitative data were collected using a 21-item Spiritual Care Needs Inventory (content validity index=.87; Cronbach's alpha=.96). The majority of participants were female (96.5%, n=193) between 21 and 59years old (mean=35.1years). Moreover, the majority of participants had a Bachelor's degree (74.0%, n=148) and 1-36years of clinical experience (mean=12.13years). Regarding religious beliefs, 63 (31.5%) had no religious belief, and 93 (46.5%) did not engage in any religious activity. Overall, the nurses were willing to provide spiritual care, although only 25 (12.5%) felt that they had received adequate education. The findings of this study indicate the need for further educational preparation in spiritual care for nurses. Specifically, additional teaching materials are required that are more directly related to spiritual care. Greater emphasis should be placed on different subject areas in school-based education, continuing education, and self-learning education according to the needs of nurses. Since spiritual care education needs policy support, in-depth discussions should take place regarding the approach and cultural environment for providing spiritual care in future nursing courses. Moreover, further studies should investigate barriers in providing spiritual nursing care to patients and whether they are the results of a lack of relevant knowledge or other factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Intelligence, Academic Self-Concept, and Information Literacy: The Role of Adequate Perceptions of Academic Ability in the Acquisition of Knowledge about Information Searching

    Science.gov (United States)

    Rosman, Tom; Mayer, Anne-Kathrin; Krampen, Günter

    2015-01-01

    Introduction: The present paper argues that adequate self-perceptions of academic ability are essential for students' realization of their intellectual potential, thereby fostering learning of complex skills, e.g., information-seeking skills. Thus, academic self-concept should moderate the relationship between intelligence and information…

  8. Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities

    Science.gov (United States)

    Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

    2013-01-01

    Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

  9. Migration and access to maternal healthcare: determinants of adequate antenatal care and institutional delivery among socio-economically disadvantaged migrants in Delhi, India.

    Science.gov (United States)

    Kusuma, Yadlapalli S; Kumari, Rita; Kaushal, Sonia

    2013-10-01

    To identify the determinants of adequate antenatal care (ANC) utilisation and institutional deliveries among socio-economically disadvantaged migrants living in Delhi, India. In a cross-sectional survey, 809 rural-urban migrant mothers with a child aged below 2 years were interviewed with a pretested questionnaire. Data on receiving antenatal, delivery and post-natal services, migration history and other social, demographic and income were collected. Recent migrants used the services significantly less than settled migrants. ANC was adequate only among 37% (35% of recent migrant women and 39% of settled migrants). Multinomial regression revealed that being a recent migrant, multiparous, illiterate and married to an unskilled worker were significant risk factors for receiving inadequate ANC. Around 53% of deliveries took place at home. ANC seeking has a strong influence on place of delivery: 70% of births to women who received inadequate ANC were at home. Women who are educated, had their first delivery after the age of 20 years and received adequate ANC were more likely to deliver their child in hospital. Post-natal care is grossly neglected among these groups. Migrant women, particularly recent migrants, are at the risk of not receiving adequate maternal healthcare. Because migration is a continuing phenomenon, measures to mitigate disadvantage due to migration need to be taken in the healthcare system. © 2013 John Wiley & Sons Ltd.

  10. The yield of adequate and conclusive fine-needle aspiration results in thyroid nodules is uniform across functional and goiter types.

    Science.gov (United States)

    Liel, Y

    1999-01-01

    Relatively little is known about the cytological characteristics of hyperfunctioning (hot) thyroid nodules. Concern has been expressed that fine-needle aspiration (FNA) identifies hot nodules as follicular tumors or indeterminate, and as a consequence patients could be unnecessarily referred for surgery. Between 1979 and 1996, thyroid FNA was performed on 829 patients. Result of thyroid scan was available in 326; 69 (21%) patients had hot, and 257 (79%) had warm or cold thyroid nodules. Nodules in each of these major groups were divided into 2 subgroups: clinically solitary nodules and dominant nodules in multinodular goiters (MNG). The frequencies of adequate versus inadequate FNA samples, and of conclusive versus indeterminate FNA results were determined separately for each of the groups and subgroups. In addition, patients with hot nodules and overt hyperthyroidism were identified and evaluated separately. Bivariate analyses were performed for the frequency of adequate versus inadequate smears and conclusive versus indeterminate results between hot, toxic, and cold-warm nodules, and between solitary nodules and MNG. The frequency of adequate aspirations and conclusive results in the various groups and subgroups was found to be statistically indistinguishable. In conclusion, the yield of adequate samples and the rate of conclusive results of FNA in thyroid nodules is similar, irrespective of the functional state or of goiter presentation. Hot thyroid nodules do not seem to produce an increase in the rate of inadequate or indeterminate FNA results, and therefore, do not affect the overall performance of thyroid FNA.

  11. Multispacecraft current estimates at swarm

    DEFF Research Database (Denmark)

    Dunlop, M. W.; Yang, Y.-Y.; Yang, J.-Y.

    2015-01-01

    During the first several months of the three-spacecraft Swarm mission all three spacecraft camerepeatedly into close alignment, providing an ideal opportunity for validating the proposed dual-spacecraftmethod for estimating current density from the Swarm magnetic field data. Two of the Swarm...

  12. Software Cost-Estimation Model

    Science.gov (United States)

    Tausworthe, R. C.

    1985-01-01

    Software Cost Estimation Model SOFTCOST provides automated resource and schedule model for software development. Combines several cost models found in open literature into one comprehensive set of algorithms. Compensates for nearly fifty implementation factors relative to size of task, inherited baseline, organizational and system environment and difficulty of task.

  13. Providing value in ambulatory anesthesia.

    Science.gov (United States)

    Fosnot, Caroline D; Fleisher, Lee A; Keogh, John

    2015-12-01

    colonoscopies. With this projected increase in the demand for anesthesia services nationwide comes the analysis of its financial feasibility. Some early data looking at endoscopist-administered sedation conclude that it offers higher patient satisfaction, there were less adverse effects than anesthesiologist-administered sedation, and is economically advantageous. This and future retrospective studies will help to guide healthcare policymakers and physicians to come to a conclusion about providing ambulatory services for these millions of patients. Ambulatory anesthesia's popularity continues to rise and anesthetic techniques will continue to morph and adapt to the needs of patients seeking ambulatory surgery. Alterations in already existing medications are promising as these modifications allow for quicker recovery from anesthesia or minimization of the already known undesirable side-effects. PONV, pain, obstructive sleep apnea, and chronic comorbidities (hypertension, cardiac disease, and diabetes mellitus) are perioperative concerns in ambulatory settings as more patients are safely being treated in ambulatory settings. Regional anesthesia stands out as a modality that has multiple advantages to general anesthesia, providing a minimal recovery period and a decrease in postanesthesia care unit stay. The implementation of the Affordable Healthcare Act specifically affects ambulatory settings as the demand and need for patients to have screening procedures with anesthesia. The question remains what the best strategy is to meet the needs of our future patients while preserving economically feasibility within an already strained healthcare system.

  14. The blood-stained flags of liberty – The struggle for adequate signs of identity in New Caledonia

    Directory of Open Access Journals (Sweden)

    Lindenmann, Peter

    2014-09-01

    Full Text Available The Nouméa treaty of 1998 that created the framework for the transition of New Caledonia from a French overseas territory towards emancipation provided also for the creation of new identity markers. Lacking a shared understanding of history and a common vision for the future, the process of adopting a flag was blocked for more than ten years. As an intermediate solution the flag of the Kanak independence movement is hoisted side by side to the French tricolour since 2010. While some loyalist parties continue to campaign for a common flag, pro-independence parties are waiting to descend the tricolour, and others would favor the status quo. The unresolved question of the right symbol is also a reflection of the uncertain political future as the referendum on independence looms.

  15. The utilization of orbital images as an adequate form of control of preserved areas. [Araguaia National Park, Brazil

    Science.gov (United States)

    Dejesusparada, N. (Principal Investigator); Dossantos, J. R.

    1981-01-01

    The synoptic view and the repetitive acquisition of LANDSAT imagery provide precise information, in real-time, for monitoring preserved areas based on spectral, temporal and spatial properties. The purpose of this study was to monitor, with the use of multispectral imagery, the systematic annual burning, which causes the degradation of ecosystems in the National Park of Araguaia. LANDSAT imagery of channel 5 (0.6 a 0.7 microns) and 7 (0.8 a 1.1 microns), at the scale of 1:250.000, were used to identify and delimit vegetation units and burned area, based on photointerpretation parameter of tonality. The results show that the gallery forest can be discriminated from the seasonally flooded 'campo cerrado', and that 4,14% of the study area was burned. Conclusions point out that the LANDSAT images can be used for the implementation of environmental protection in national parks.

  16. Providing Real Research Opoportunities to Undergraduates

    Science.gov (United States)

    Ragozzine, Darin

    2016-01-01

    The current approach to undergraduate education focuses on teaching classes which provide the foundational knowledge for more applied experiences such as scientific research. Like most programs, Florida Institute of Technology (Florida Tech or FIT) strongly encourages undergraduate research, but is dominated by content-focused courses (e.g., "Physical Mechanics"). Research-like experiences are generally offered through "lab" classes, but these are almost always reproductions of past experiments: contrived, formulaic, and lacking the "heart" of real (i.e., potentially publishable) scientific research. Real research opportunities 1) provide students with realistic insight into the actual scientific process; 2) excite students far more than end-of-chapter problems; 3) provide context for the importance of learning math, physics, and astrophysics concepts; and 4) allow unique research progress for well-chosen problems. I have provided real research opportunities as an "Exoplanet Lab" component of my Introduction to Space Science (SPS1020) class at Florida Tech, generally taken by first-year majors in our Physics, Astronomy & Astrophysics, Planetary Science, and Astrobiology degree programs. These labs are a hybrid between citizen science (e.g., PlanetHunters) and simultaneously mentoring ~60 undergraduates in similar small research projects. These projects focus on problems that can be understood in the context of the course, but which benefit from "crowdsourcing". Examples include: dividing up the known planetary systems and developing a classification scheme and organizing them into populations (Fall 2013); searching through folded light curves to discover new exoplanets missed by previous pipelines (Fall 2014); and fitting n-body models to all exoplanets with known Transit Timing Variations to estimate planet masses (Fall 2015). The students love the fact that they are doing real potentially publishable research: not many undergraduates can claim to have discovered

  17. The Nutritional Contribution of Foods and Beverages Provided by Government-Sponsored Day Care Centers in Guatemala.

    Science.gov (United States)

    Vossenaar, Marieke; Hernández, Liza; Montenegro-Bethancourt, Gabriela; Soto-Méndez, María José; Bermudez, Odilia I; Solomons, Noel W

    2015-09-01

    Meals served at government-run day care centers must be nutritionally adequate to ensure good health and proper development of preschool-aged children. They can provide a controlled opportunity to complement the daily diet of children in vulnerable populations. To determine the nutrient adequacy and leading food sources of nutrients provided by the diet served in government-sponsored day care centers. Estimated daily energy and nutrient intakes of a theoretical 40-day day care center menu were calculated, and the nutrient adequacy was assessed. Nutrient densities and critical nutrient densities of the menu were computed to identify nutrient inadequacies. Furthermore, main sources of nutrients were identified, and energy and nutrient distributions were examined by meal time. The menu provides approximately 90% of daily energy requirement and more than 100% of Recommended Nutrient Intakes (RNIs), with the exception of vitamin D and calcium. Sugar was the first leading source of energy, whereas milk was the first leading contributor of vitamin D. Within an environment of budgetary constraints, the Guatemalan government developed and advocated an exemplary menu offering for children in the vulnerable preschool period. We have demonstrated that, if prepared and served as planned, the items from the official, standard menu would supply most of the nutrients needed. High vitamin A intake related to the mandated national fortification program is a potential problem. From the analysis, it was found that vitamin D emerges as the most prominent candidate for a problem nutrient of deficient intake. © The Author(s) 2015.

  18. Anticoagulation Bridge Therapy in Patients with Atrial Fibrillation: Recent Updates Providing a Rebalance of Risk and Benefit.

    Science.gov (United States)

    Garwood, Candice L; Korkis, Bianca; Grande, Domenico; Hanni, Claudia; Morin, Amy; Moser, Lynette R

    2017-06-01

    In 2011 we reviewed clinical updates and controversies surrounding anticoagulation bridge therapy in patients with atrial fibrillation (AF). Since then, options for oral anticoagulation have expanded with the addition of four direct oral anticoagulant (DOAC) agents available in the United States. Nonetheless, vitamin K antagonist (VKA) therapy continues to be the treatment of choice for patients who are poor candidates for a DOAC and for whom bridge therapy remains a therapeutic dilemma. This literature review identifies evidence and guideline and consensus statements from the last 5 years to provide updated recommendations and insight into bridge therapy for patients using a VKA for AF. Since our last review, at least four major international guidelines have been updated plus a new consensus document addressing bridge therapy was released. Prospective trials and one randomized controlled trial have provided guidance for perioperative bridge therapy. The clinical trial data showed that bridging with heparin is associated with a significant bleeding risk compared with not bridging; furthermore, data suggested that actual perioperative thromboembolic risk may be lower than previously estimated. Notably, patients at high risk for stroke have not been adequately represented. These findings highlight the importance of assessing thrombosis and bleeding risk before making bridging decisions. Thrombosis and bleeding risk tools have emerged to facilitate this assessment and have been incorporated into guideline recommendations. Results from ongoing trials are expected to provide more guidance on safe and effective perioperative management approaches for patients at high risk for stroke. © 2017 Pharmacotherapy Publications, Inc.

  19. Sustaining the Higher Education Hub Model: The Challenge of Adequate Academic and Social Support Structures for International Students

    Directory of Open Access Journals (Sweden)

    Cameron Richards

    2011-11-01

    Full Text Available In recent years, the Education Hub (EH concept has perhaps become the single most important focus of higher education policy in most Asian countries. A particular Asian Education Hub model (e.g. Cheng, 2010 is now globally influential with its emphasis on how governments can harness direct as well as indirect economic benefits of a higher education system. Such a model aims to prepare students for employment in an emerging global economy and also to attract fee-paying international students in terms of education as not just a public good but a key and increasingly important area of national investment and economic development. In a related paper which focused on a comparison between distinct Malaysian and Singaporean versions of Asian EH l models developed over the last two decades (Richards, 2011c, we investigated the dangers as well as opportunities at stake. In this paper, we investigate the linked idea that sufficient academic and social support structures for supporting international as well as local students provide the crucial key to the factors of sustainability needed to support the various versions of the general strategy of Higher Education internationalisation.

  20. ‘Standards’ on the bench: Do Standards for technological literacy render an adequate image of technology?

    Directory of Open Access Journals (Sweden)

    Mahdi G. Nia

    2016-03-01

    Full Text Available 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 the nature of technology. This seems to be an important concern that through taking advantage of the philosophy of technology (the arena which affords a bountiful ground of various reflections on the nature of technology is intended to be discussed throughout this study. In the first place, the paper presents a relevant framework based upon Mitcham’s (1994 four-aspect account of technology, i.e., technology as objects, knowledge, activities, and volition. Then it categorizes the main relevant concepts and concerns put forward by many other philosophers of technology into this framework; this will yield a concrete model (tool to analyze any intended standard such as the above mentioned ones. Afterwards, to show how this model works, the well-known case of the USA – Standards for Technological Literacy (ITEA, 2007 – will be used as an example for inspection; the results will disclose the points where the current American case needs to be modified.

  1. Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey

    Directory of Open Access Journals (Sweden)

    A. Cornet

    2012-01-01

    Full Text Available Background/Aim. To evaluate the obstetrics and gynaecology residents' perspective of their training and experience in the management of perineal tears that occur during assisted vaginal delivery. We hypothesised that residents would perceive room for improvement in their knowledge of pelvic floor anatomy and the training received in tears repair. Design. Descriptive cross-sectional study. Population/Setting. Seventy-two major residents from all teaching hospitals in Catalonia. Methods. A questionnaire was designed to evaluate experience, perception of the training and supervision provided. Results. The questionnaire was sent to all residents (=72, receiving 46 responses (64%. The participants represented 15 out of the 16 teaching hospitals included in the study (94% of the hospitals represented. Approximately, 52% of residents were in their third year while 48% were in their fourth. The majority of them thought that their knowledge of pelvic floor anatomy was poor (62%, although 98% felt confident that they would know when an episiotomy was correctly indicated. The survey found that they lacked experience in the repair of major degree tears (70% had repaired fewer than ten, and most did not carry out followup procedures. Conclusion. The majority of them indicated that more training in this specific area is necessary (98%.

  2. 78 FR 48543 - Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per...

    Science.gov (United States)

    2013-08-08

    ... and engage with the community; (2) Facilitate reintegration with the community and provide services that may optimize reintegration such as life-skills education, recreational activities, and follow-up... relationships with family; (4) Ensure adequate supervision, including supervision of medication and monitoring...

  3. Guideline to Estimate Decommissioning Costs

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Taesik; Kim, Younggook; Oh, Jaeyoung [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    The primary objective of this work is to provide guidelines to estimate the decommissioning cost as well as the stakeholders with plausible information to understand the decommissioning activities in a reasonable manner, which eventually contribute to acquiring the public acceptance for the nuclear power industry. Although several cases of the decommissioning cost estimate have been made for a few commercial nuclear power plants, the different technical, site-specific and economic assumptions used make it difficult to interpret those cost estimates and compare them with that of a relevant plant. Trustworthy cost estimates are crucial to plan a safe and economic decommissioning project. The typical approach is to break down the decommissioning project into a series of discrete and measurable work activities. Although plant specific differences derived from the economic and technical assumptions make a licensee difficult to estimate reliable decommissioning costs, estimating decommissioning costs is the most crucial processes since it encompasses all the spectrum of activities from the planning to the final evaluation on whether a decommissioning project has successfully been preceded from the perspective of safety and economic points. Hence, it is clear that tenacious efforts should be needed to successfully perform the decommissioning project.

  4. [Effect of speech estimation on social anxiety].

    Science.gov (United States)

    Shirotsuki, Kentaro; Sasagawa, Satoko; Nomura, Shinobu

    2009-02-01

    This study investigates the effect of speech estimation on social anxiety to further understanding of this characteristic of Social Anxiety Disorder (SAD). In the first study, we developed the Speech Estimation Scale (SES) to assess negative estimation before giving a speech which has been reported to be the most fearful social situation in SAD. Undergraduate students (n = 306) completed a set of questionnaires, which consisted of the Short Fear of Negative Evaluation Scale (SFNE), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS), and the SES. Exploratory factor analysis showed an adequate one-factor structure with eight items. Further analysis indicated that the SES had good reliability and validity. In the second study, undergraduate students (n = 315) completed the SFNE, SIAS, SPS, SES, and the Self-reported Depression Scale (SDS). The results of path analysis showed that fear of negative evaluation from others (FNE) predicted social anxiety, and speech estimation mediated the relationship between FNE and social anxiety. These results suggest that speech estimation might maintain SAD symptoms, and could be used as a specific target for cognitive intervention in SAD.

  5. Within- and between-individual variation in energy and nutrient intake in Japanese adults: effect of age and sex differences on group size and number of records required for adequate dietary assessment.

    Science.gov (United States)

    Fukumoto, Azusa; Asakura, Keiko; Murakami, Kentaro; Sasaki, Satoshi; Okubo, Hitomi; Hirota, Naoko; Notsu, Akiko; Todoriki, Hidemi; Miura, Ayako; Fukui, Mitsuru; Date, Chigusa

    2013-01-01

    Information on within- and between-individual variation in energy and nutrient intake is critical for precisely estimating usual dietary intake; however, data from Japanese populations are limited. We used dietary records to examine within- and between-individual variation by age and sex in the intake of energy and 31 selected nutrients among Japanese adults. We also calculated the group size required to estimate mean intake for a group and number of days required both to rank individuals within a group and to assess an individual's usual intake, all with appropriate arbitrary precision. A group of Japanese women (younger: 30-49 years, n = 58; older: 50-69 years, n = 63) and men (younger: 30-49 years, n = 54; older: 50-76 years, n = 67) completed dietary records for 4 nonconsecutive days in each season (16 days in total). Coefficients of within-individual variation and between-individual variation were generally larger in the younger group than in the older group and in men as compared with women. The group size required to estimate a group's mean intake, and number of days required to assess an individual's usual intake, were generally larger for the younger group and for men. In general, a longer period was required to rank women and older adults. In a group of Japanese adults, coefficients of within-individual variation and between-individual variation, which were used to estimate the group size and number of records required for adequate dietary assessment, differed by age, sex, and nutrient.

  6. Cost Calculation Model for Logistics Service Providers

    Directory of Open Access Journals (Sweden)

    Zoltán Bokor

    2012-11-01

    Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly

  7. Variable Kernel Density Estimation

    OpenAIRE

    Terrell, George R.; Scott, David W.

    1992-01-01

    We investigate some of the possibilities for improvement of univariate and multivariate kernel density estimates by varying the window over the domain of estimation, pointwise and globally. Two general approaches are to vary the window width by the point of estimation and by point of the sample observation. The first possibility is shown to be of little efficacy in one variable. In particular, nearest-neighbor estimators in all versions perform poorly in one and two dimensions, but begin to b...

  8. Do special constables in London feel that they are adequately prepared to meet their first aid responsibilities? A qualitative study.

    Science.gov (United States)

    Chandan, Joht Singh; Meakin, Richard

    2016-01-29

    This study's aims were to explore the views of special constables in the London metropolitan police force concerning their obligations and skills as first aiders. The metropolitan police force provides police officers to act as first responders to emergency calls made by the public. Special constables act with the same powers and responsibility as police officers and are required to deal with incidents involving medical emergencies. West London Police Station. Fifteen special constables entered and completed the study. A qualitative study involving semistructured interviews, participant observation, and reflective work. The outcome measures were the themes derived from the 'thematic framework approach' to analysis. Four main themes were identified. (1) 'Our responsibility?'--Special constables felt they had a responsibility, but were unsure of the origin of this responsibility, with many feeling it stemmed from public expectation. (2) 'Confidence'--Special constables had mixed feelings regarding their confidence in first aid scenarios and many felt that more could be done to improve their confidence. (3) 'Training needs'--Many felt the current training system was lacking in several ways including regularity, teaching and content. (4) 'Personal first aid knowledge'--Special constables were disappointed with their past performances. Owing to the small size of this study, the conclusions are limited; however, if the findings are confirmed by larger studies, they suggest the need to improve the confidence of special constables in first aid situations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Is the HIV sentinel surveillance system adequate in China? Findings from an evaluation of the national HIV sentinel surveillance system

    Directory of Open Access Journals (Sweden)

    Marc Bulterys

    2012-11-01

    Full Text Available Background: An external evaluation was conducted to assess the performance of the national HIV sentinel surveillance system (HSS, identify operational challenges at national and local levels and provide recommendations for improvement.Methods: The United States Centers for Disease Control and Prevention’s (CDC Updated Guidelines for Evaluating Public Health Surveillance Systems were followed to assess the key attributes of HSS. Comprehensive assessment activities were conducted, including: using a detailed checklist to review surveillance guidelines, protocols and relevant documents; conducting self-administered, anonymous surveys with 286 local China CDC staff; and carrying out field observations in 32 sentinel sites in four provinces.Results: China has built an extensive HSS with 1888 sentinel sites to monitor HIV epidemic trends by population groups over time. The strengths of HSS lie in its flexibility, simplicity, usefulness and increase in coverage in locations and populations. With its rapid expansion in 2010, HSS faces challenges in maintaining acceptability, timeliness, data quality, representativeness and sustainability.Recommendations: Implementation of the national guidelines should be standardized by strengthening training, monitoring and supervision of all staff involved, including community-based organizations. National surveillance guidelines need to be revised to strengthen data quality and representativeness, particularly to include specific instructions on HIV testing result provision, collection of identifying information, sample size and sampling methods particularly for men who have sex with men (MSM, collection of refusal information, and data interpretation. Sustainability of China’s HSS could be strengthened by applying locally tailored surveillance strategies, strengthening coordination and cooperation among government agencies and ensuring financial and human resources.

  10. Fuel Burn Estimation Model

    Science.gov (United States)

    Chatterji, Gano

    2011-01-01

    Conclusions: Validated the fuel estimation procedure using flight test data. A good fuel model can be created if weight and fuel data are available. Error in assumed takeoff weight results in similar amount of error in the fuel estimate. Fuel estimation error bounds can be determined.

  11. Optimal fault signal estimation

    NARCIS (Netherlands)

    Stoorvogel, Antonie Arij; Niemann, H.H.; Saberi, A.; Sannuti, P.

    2002-01-01

    We consider here both fault identification and fault signal estimation. Regarding fault identification, we seek either exact or almost fault identification. On the other hand, regarding fault signal estimation, we seek either $H_2$ optimal, $H_2$ suboptimal or Hinfinity suboptimal estimation. By

  12. Indirect estimators in US federal programs

    CERN Document Server

    1996-01-01

    In 1991, a subcommittee of the Federal Committee on Statistical Methodology met to document the use of indirect estimators - that is, estimators which use data drawn from a domain or time different from the domain or time for which an estimate is required. This volume comprises the eight reports which describe the use of indirect estimators and they are based on case studies from a variety of federal programs. As a result, many researchers will find this book provides a valuable survey of how indirect estimators are used in practice and which addresses some of the pitfalls of these methods.

  13. Site characterization: a spatial estimation approach

    International Nuclear Information System (INIS)

    Candy, J.V.; Mao, N.

    1980-10-01

    In this report the application of spatial estimation techniques or kriging to groundwater aquifers and geological borehole data is considered. The adequacy of these techniques to reliably develop contour maps from various data sets is investigated. The estimator is developed theoretically in a simplified fashion using vector-matrix calculus. The practice of spatial estimation is discussed and the estimator is then applied to two groundwater aquifer systems and used also to investigate geological formations from borehole data. It is shown that the estimator can provide reasonable results when designed properly

  14. Bayesian estimation and tracking a practical guide

    CERN Document Server

    Haug, Anton J

    2012-01-01

    A practical approach to estimating and tracking dynamic systems in real-worl applications Much of the literature on performing estimation for non-Gaussian systems is short on practical methodology, while Gaussian methods often lack a cohesive derivation. Bayesian Estimation and Tracking addresses the gap in the field on both accounts, providing readers with a comprehensive overview of methods for estimating both linear and nonlinear dynamic systems driven by Gaussian and non-Gaussian noices. Featuring a unified approach to Bayesian estimation and tracking, the book emphasizes the derivation

  15. Estimating Discount Rates

    Directory of Open Access Journals (Sweden)

    Laurence Booth

    2015-04-01

    Full Text Available Discount rates are essential to applied finance, especially in setting prices for regulated utilities and valuing the liabilities of insurance companies and defined benefit pension plans. This paper reviews the basic building blocks for estimating discount rates. It also examines market risk premiums, as well as what constitutes a benchmark fair or required rate of return, in the aftermath of the financial crisis and the U.S. Federal Reserve’s bond-buying program. Some of the results are disconcerting. In Canada, utilities and pension regulators responded to the crash in different ways. Utilities regulators haven’t passed on the full impact of low interest rates, so that consumers face higher prices than they should whereas pension regulators have done the opposite, and forced some contributors to pay more. In both cases this is opposite to the desired effect of monetary policy which is to stimulate aggregate demand. A comprehensive survey of global finance professionals carried out last year provides some clues as to where adjustments are needed. In the U.S., the average equity market required return was estimated at 8.0 per cent; Canada’s is 7.40 per cent, due to the lower market risk premium and the lower risk-free rate. This paper adds a wealth of historic and survey data to conclude that the ideal base long-term interest rate used in risk premium models should be 4.0 per cent, producing an overall expected market return of 9-10.0 per cent. The same data indicate that allowed returns to utilities are currently too high, while the use of current bond yields in solvency valuations of pension plans and life insurers is unhelpful unless there is a realistic expectation that the plans will soon be terminated.

  16. Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role.

    Science.gov (United States)

    Cheng, Adam; Overly, Frank; Kessler, David; Nadkarni, Vinay M; Lin, Yiqun; Doan, Quynh; Duff, Jonathan P; Tofil, Nancy M; Bhanji, Farhan; Adler, Mark; Charnovich, Alex; Hunt, Elizabeth A; Brown, Linda L

    2015-02-01

    Many healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions. We conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm. Participants overestimated achieving adequate chest compression depth (mean difference range: 16.1-60.6%) and rate (range: 0.2-51%), and underestimated chest compression fraction (0.2-2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (pCPR quality was poor for chest compression depth (0-13%), rate (5-46%) and chest compression fraction (60-63%). Perception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p=0.043) when using real-time feedback. Healthcare providers' visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Reliability estimation for multiunit nuclear and fossil-fired industrial energy systems

    International Nuclear Information System (INIS)

    Sullivan, W.G.; Wilson, J.V.; Klepper, O.H.

    1977-01-01

    As petroleum-based fuels grow increasingly scarce and costly, nuclear energy may become an important alternative source of industrial energy. Initial applications would most likely include a mix of fossil-fired and nuclear sources of process energy. A means for determining the overall reliability of these mixed systems is a fundamental aspect of demonstrating their feasibility to potential industrial users. Reliability data from nuclear and fossil-fired plants are presented, and several methods of applying these data for calculating the reliability of reasonably complex industrial energy supply systems are given. Reliability estimates made under a number of simplifying assumptions indicate that multiple nuclear units or a combination of nuclear and fossil-fired plants could provide adequate reliability to meet industrial requirements for continuity of service

  18. A simple model to estimate the impact of sea-level rise on platform beaches

    Science.gov (United States)

    Taborda, Rui; Ribeiro, Mónica Afonso

    2015-04-01

    Estimates of future beach evolution in response to sea-level rise are needed to assess coastal vulnerability. A research gap is identified in providing adequate predictive methods to use for platform beaches. This work describes a simple model to evaluate the effects of sea-level rise on platform beaches that relies on the conservation of beach sand volume and assumes an invariant beach profile shape. In closed systems, when compared with the Inundation Model, results show larger retreats; the differences are higher for beaches with wide berms and when the shore platform develops at shallow depths. The application of the proposed model to Cascais (Portugal) beaches, using 21st century sea-level rise scenarios, shows that there will be a significant reduction in beach width.

  19. A neural flow estimator

    DEFF Research Database (Denmark)

    Jørgensen, Ivan Harald Holger; Bogason, Gudmundur; Bruun, Erik

    1995-01-01

    This paper proposes a new way to estimate the flow in a micromechanical flow channel. A neural network is used to estimate the delay of random temperature fluctuations induced in a fluid. The design and implementation of a hardware efficient neural flow estimator is described. The system...... is implemented using switched-current technique and is capable of estimating flow in the μl/s range. The neural estimator is built around a multiplierless neural network, containing 96 synaptic weights which are updated using the LMS1-algorithm. An experimental chip has been designed that operates at 5 V...

  20. Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys

    Science.gov (United States)

    Degenhardt, Louisa; Glantz, Meyer; Evans‐Lacko, Sara; Sadikova, Ekaterina; Sampson, Nancy; Thornicroft, Graham; Aguilar‐Gaxiola, Sergio; Al‐Hamzawi, Ali; Alonso, Jordi; Helena Andrade, Laura; Bruffaerts, Ronny; Bunting, Brendan; Bromet, Evelyn J.; Miguel Caldas de Almeida, José; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Maria Haro, Josep; Huang, Yueqin; Karam, Aimee; Karam, Elie G.; Kiejna, Andrzej; Lee, Sing; Lepine, Jean‐Pierre; Levinson, Daphna; Elena Medina‐Mora, Maria; Nakamura, Yosikazu; Navarro‐Mateu, Fernando; Pennell, Beth‐Ellen; Posada‐Villa, José; Scott, Kate; Stein, Dan J.; ten Have, Margreet; Torres, Yolanda; Zarkov, Zahari; Chatterji, Somnath; Kessler, Ronald C.; Adamowski, Tomasz; Aguilar‐Gaxiola, Sergio; Al‐Hamzawi, Ali; Al‐Kaisy, Mohammad; Alonso, Jordi; Altwaijri, Yasmin; Andrade, Laura Helena; Atwoli, Lukoye; Auerbach, Randy P.; Axinn, William G.; Benjet, Corina; Borges, Guilherme; Bromet, Evelyn J.; Bruffaerts, Ronny; Bunting, Brendan; Caldas de Almeida, José Miguel; Cardoso, Graça; Chardoul, Stephanie; Chatterji, Somnath; Filho, Alexandre Chiavegatto; Cia, Alfredo H.; Cuijpers, Pim; Degenhardt, Louisa; de Girolamo, Giovanni; de Graaf, Ron; de Jonge, Peter; Ebert, David D.; Evans‐Lacko, Sara; Fayyad, John; Florescu, Silvia; Galea, Sandro; Germine, Laura; Ghimire, Dirgha J.; Gilman, Stephen E.; Glantz, Meyer D.; Gluzman, Semyon; Gureje, Oye; Haro, Josep Maria; Harris, Meredith G.; He, Yanling; Hinkov, Hristo; Hu, Chi‐Yi; Huang, Yueqin; Karam, Aimee Nasser; Karam, Elie G.; Kawakami, Norito; Kessler, Ronald C.; Kiejna, Andrzej; Koenen, Karestan C.; Kovess‐Masfety, Viviane; Lara, Carmen; Lee, Sing; Lepine, Jean‐Pierre; Levav, Itzhak; Levinson, Daphna; Liu, Zhaorui; Martins, Silvia S.; McGrath, John J.; McLaughlin, Katie A.; Medina‐Mora, Maria Elena; Mneimneh, Zeina; Moskalewicz, Jacek; Navarro‐Mateu, Fernando; Nock, Matthew K.; O'Neill, Siobhan; Ormel, Johan; Pennell, Beth‐Ellen; Piazza, Marina; Piotrowski, Patryk; Posada‐Villa, José; Ruscio, Ayelet M.; Scott, Kate M.; Slade, Tim; Smoller, Jordan W.; Stagnaro, Juan Carlos; Stein, Dan J.; Street, Amy E.; Tachimori, Hisateru; ten Have, Margreet; Thornicroft, Graham; Torres, Yolanda; Vilagut, Gemma; Viana, Maria Carmen; Wells, Elisabeth; Williams, David R.; Williams, Michelle A.; Wojtyniak, Bogdan; Zaslavsky, Alan M.

    2017-01-01

    Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross‐nationally, making it difficult to know what is the baseline for that SDG target. Here we report data from the World Health Organization (WHO)'s World Mental Health Surveys (WMHS), based on representative community household surveys in 26 countries. We assessed the 12‐month prevalence of substance use disorders (alcohol or drug abuse/dependence); the proportion of people with these disorders who were aware that they needed treatment and who wished to receive care; the proportion of those seeking care who received it; and the proportion of such treatment that met minimal standards for treatment quality (“minimally adequate treatment”). Among the 70,880 participants, 2.6% met 12‐month criteria for substance use disorders; the prevalence was higher in upper‐middle income (3.3%) than in high‐income (2.6%) and low/lower‐middle income (2.0%) countries. Overall, 39.1% of those with 12‐month substance use disorders recognized a treatment need; this recognition was more common in high‐income (43.1%) than in upper‐middle (35.6%) and low/lower‐middle income (31.5%) countries. Among those who recognized treatment need, 61.3% made at least one visit to a service provider, and 29.5% of the latter received minimally adequate treatment exposure (35.3% in high, 20.3% in upper‐middle, and 8.6% in low/lower‐middle income countries). Overall, only 7.1% of those with past‐year substance use disorders received minimally adequate treatment: 10.3% in high income, 4.3% in upper‐middle income and 1.0% in low/lower‐middle income countries. These data suggest that only a small minority of people with substance use disorders receive even minimally adequate