Sexual health communication between cancer survivors and providers: how frequently does it occur and which providers are preferred?

Science.gov (United States)

Sporn, Nora J; Smith, Kelly B; Pirl, William F; Lennes, Inga T; Hyland, Kelly A; Park, Elyse R

2015-09-01

Sexual health concerns in cancer survivors are often unaddressed by providers. Study objectives were to assess cancer survivors' reported rates of communication with oncology providers about sexual health, preference for such communication with their oncology or primary care providers (PCPs), and factors associated with these communication rates and preferences. Sixty-six patients attending a cancer survivorship clinic were asked how often their oncologist addressed and initiated discussion about sexual functioning and whether they wanted their oncologist or PCP to ask about their sexual health. We also assessed whether various sociodemographic characteristics and levels of depression, anxiety, and sexual satisfaction were associated with survivors' sexual health communication rates and preferences. 41% of patients wanted their oncologist to ask about sexual health and 58% of patients wanted their PCP to ask about sexual health. Over 90% of patients reported that their oncologist infrequently addressed sexual health concerns and that their oncologist was unlikely to initiate such discussions. Education level influenced whether patients wanted their oncologist to ask about sexual health. Age, education level, and insurance type influenced whether patients wanted their PCP to ask about sexual health. Levels of depression, anxiety, and sexual satisfaction were not associated with communication rates or preferences. Patients attending a survivorship clinic reported infrequent communication about sexual health with their oncology providers, despite wanting their providers to ask about sexual health concerns. Copyright © 2014 John Wiley & Sons, Ltd.

Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety.

Science.gov (United States)

Ulrey, K L; Amason, P

2001-01-01

Cultural diversity is becoming increasingly more important in the workplace. This is particularly true in health care organizations facing demographic shifts in the patients served and their families. This study serves to aid the development of intercultural communication training programs for health care providers by examining how cultural sensitivity and effective intercultural communication, besides helping patients, personally benefit health care providers by reducing their stress. Effective intercultural communication and cultural sensitivity were found to be related. Health care providers' levels of intercultural anxiety also were found to correlate with effective intercultural communication.

Provider Communication Regarding Psychosocial Factors Predicts Pain Beliefs in Parent and Child

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Sood, Erica; Pinder, Wendy; Pendley, Jennifer S.; Fisher, Alicia O.; Wali, Prateek D.; del Rosario, Fernando

2017-01-01

Objective To examine the role of provider communication about psychosocial causes of abdominal pain and recommendations for psychosocial intervention during a gastroenterology clinic visit in predicting families’ causal beliefs and perceptions of treatment acceptability. Method Participants were 57 children with a diagnosed or suspected abdominal pain-related functional gastrointestinal disorder (FGID) presenting for an outpatient gastroenterology follow-up visit and their accompanying parent. Children and parents completed questionnaires assessing child anxiety and abdominal pain severity, recall of provider communication about causes of abdominal pain and recommendations for intervention, their own causal beliefs about pain, and perceived acceptability of cognitive behavioral therapy (CBT) and standard medical treatment (SMT) after reading descriptions of each treatment. Providers completed a questionnaire assessing their perceptions and communication about the causes of the child’s abdominal pain and perceived acceptability of CBT. Results Provider communication about psychosocial causes and interventions was reported infrequently by parents, children, and providers. Parents rated psychosocial causes for abdominal pain as less likely than physical causes, and children and parents rated CBT as less acceptable than SMT. Parents’ recall of provider communication about psychosocial causes was associated with their own causal beliefs about pain and their perceived acceptability of CBT. Children’s and parents’ recall of provider recommendations for psychosocial intervention was associated with their perceived acceptability of CBT. Conclusion Results highlight the importance of provider communication about psychosocial contributors to abdominal pain and psychosocial interventions for children with FGIDs. Medical and mental health providers can partner to deliver care to children with FGIDs using a biopsychosocial approach. PMID:27035693

Patient-provider communication over social media: perspectives of adolescents with psychiatric illness.

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van Rensburg, Samuel H; Klingensmith, Katherine; McLaughlin, Paige; Qayyum, Zheala; van Schalkwyk, Gerrit I

2016-02-01

Social media is an increasingly dominant platform for communication, especially among adolescents. Statements from professional bodies and a growing body of empirical evidence support a role for social media in improving provider-patient interactions. In psychiatry, particular concerns exist about the suitability of this style of communication. Very limited data are available exploring how patients would like to incorporate social media into their communication with their psychiatric providers. We conducted a qualitative study with 20 adolescents attending the Yale Psychiatric Hospital Intensive Outpatient Programme. Interviews were analysed using inductive thematic analysis. Participants highlighted how social media could allow for constant access to a mental health provider, provide a less anxiety-provoking mode of communication, and allow for them to be monitored in a more on-going fashion. However, participants also identified many potential risks associated with these applications, including the potential for anxiety if a provider was not able to respond immediately, and a sense that online interactions would be less rich overall. Our findings suggest that adolescents are open to the idea of communicating with mental health providers over social media and are able to describe a number of instances where this could be of value. The risks participants described, as well as concerns raised by existing literature, indicate the need for further work and protocol development in order for social media to be a feasible tool for communication between providers and adolescents with psychiatric illness. © 2015 John Wiley & Sons Ltd.

Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers.

Science.gov (United States)

Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C

2013-11-04

Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs

Clinical social networking--a new revolution in provider communication and delivery of clinical information across providers of care?

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Kolowitz, Brian J; Lauro, Gonzalo Romero; Venturella, James; Georgiev, Veliyan; Barone, Michael; Deible, Christopher; Shrestha, Rasu

2014-04-01

The adoption of social media technologies appears to enhance clinical outcomes through improved communications as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). The ability of providers to more effectively, directly, and rapidly communicate among themselves as well as with patients should strengthen collaboration and treatment as reported by Bacigalupe (Fam Syst Heal 29(1):1-14, 2011). This paper is a case study in one organization's development of an internally designed and developed social technology solution termed "Unite." The Unite system combines social technologies' features including push notifications, messaging, community groups, and user lists with clinical workflow and applications to construct dynamic provider networks, simplify communications, and facilitate clinical workflow optimization. Modeling Unite as a social technology may ease adoption barriers. Developing a social network that is integrated with healthcare information systems in the clinical space opens the doors to capturing and studying the way in which providers communicate. The Unite system appears to have the potential to breaking down existing communication paradigms. With Unite, a rich set of usage data tied to clinical events may unravel alternative networks that can be leveraged to advance patient care.

Emergent dynamics of Cucker-Smale particles under the effects of random communication and incompressible fluids

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Ha, Seung-Yeal; Xiao, Qinghua; Zhang, Xiongtao

2018-04-01

We study the dynamics of infinitely many Cucker-Smale (C-S) flocking particles under the interplay of random communication and incompressible fluids. For the dynamics of an ensemble of flocking particles, we use the kinetic Cucker-Smale-Fokker-Planck (CS-FP) equation with a degenerate diffusion, whereas for the fluid component, we use the incompressible Navier-Stokes (N-S) equations. These two subsystems are coupled via the drag force. For this coupled model, we present the global existence of weak and strong solutions in Rd (d = 2 , 3). Under the extra regularity assumptions of the initial data, the unique solvability of strong solutions is also established in R2. In a large coupling regime and periodic spatial domain T2 : =R2 /Z2, we show that the velocities of C-S particles and fluids are asymptotically aligned to two constant velocities which may be different.

Communication strategies and accommodations utilized by health care providers with hearing loss: a pilot study.

Science.gov (United States)

Trotter, Alanna R; Matt, Susan B; Wojnara, Danuta

2014-03-01

Poor communication between health care providers and patients may negatively impact patient outcomes, and enhancing communication is one way to improve outcomes. Effective communication is particularly important for health care providers who have hearing loss. The authors found that a systematic survey of the communication strategies and experiences of health care providers with hearing loss had not yet been conducted. In this pilot study, 32 health care professionals with hearing loss were recruited via the Association of Medical Professionals With Hearing Losses and were asked to complete a 28-question survey. Health care providers with hearing loss already employ strategies that all health care providers are encouraged to use in order to enhance patient–provider communication, and survey participants have found the strategies to be effective. The communication techniques and assistive technologies used by individuals with hearing loss seem to be effective: All participants reported feeling able to communicate effectively with patients at least most of the time. More research is needed to determine if use of these communication techniques has similar results for health care providers without hearing loss.

Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight.

Science.gov (United States)

Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L

2017-06-01

To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers

Science.gov (United States)

2013-01-01

Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff

Interrelation between Patient Satisfaction and Patient-Provider Communication in Diabetes Management

Directory of Open Access Journals (Sweden)

Ayse Basak Cinar

2014-01-01

Full Text Available The present study aims to assess how patient satisfaction with medical provider-patient communication can affect oral health, diabetes, and psychobehavioural measures among type 2 diabetes (T2DM patients. It is part of a prospective intervention study among randomly selected T2DM patients, in Turkey. The data analyzed were Community Periodontal Need Index (CPI, HbA1c, patient satisfaction with communication, and psychobehavioural variables. Data was collected initially and at the end of the intervention. The participants were allocated to either health coaching (HC or health education (HE. At baseline, there were no statistical differences between the HC and the HE groups on any of the measures (P>0.05. Patients in both the HC and the HE groups had low satisfaction with communication. At postintervention, the increase in patient satisfaction with communication in the HC group was significantly higher than that in the HE group (P=0.001. Principal component analysis revealed that patient satisfaction with communication shared the same cluster with clinical measures (CPI and HbA1c and quality of life in the HC group. In conclusion, the present study showed, to our knowledge for the first time, that overall patient satisfaction with medical care provider-patient communication, empowered by HC approach, was interrelated with well-being of T2DM patients, in terms of psychobehavioural and clinical measures.

Anti-Smoking Communication to Preadolescents with and without a Cancer Diagnosis: Parents and Healthcare Providers as Important Communicators.

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Throckmorton-Belzer, Leslee; Tyc, Vida L; Robinson, Leslie A; Klosky, James L; Lensing, Shelly; Booth, Andrea K

2009-10-01

A cancer diagnosis does not prevent smoking among pediatric oncology patients, and anti-smoking communications among parents and health care providers have been proposed as influencing smoking outcomes in this group. Anti-smoking communications were compared among 93 preadolescents with cancer and 402 controls. After adjusting for demographics and covariates, preadolescents with cancer were less likely than control participants to report receipt of anti-smoking messages from physicians and parents, and recalled more messages >/= 4 months post-diagnosis as compared to 1-3 months. Should anti-tobacco communications prove to influence smoking outcomes, parents and physicians may be uniquely positioned to provide smoking prevention interventions to these patients.

Parent Preferences for Communicating With Their Adolescent's Provider Using New Technologies.

Science.gov (United States)

Rand, Cynthia M; Blumkin, Aaron; Vincelli, Phyllis; Katsetos, Viki; Szilagyi, Peter G

2015-09-01

Because adolescents make few health care visits, we assessed the views of parents of adolescents on various means to communicate with their adolescents' physicians about vaccine reminders and appointments, medication refills and test results-including phone, mail, e-mail, text messages, and personal health records (PHRs). We performed a cross-sectional survey of 400 parents of adolescents presenting to four pediatric offices (two urban, two suburban) in Rochester, NY in 2011 before vaccine reminders occurring in these practices. Roughly half of parents (60% urban, 52% suburban, p = .11) were accepting of teens receiving their own vaccine reminders. Urban parents preferred communicating with the provider via telephone, whereas suburban parents preferred e-mail for most issues and a PHR for receipt of test results. In adjusted analyses, being younger was associated with preferring text message vaccine reminders (41 to parent was associated with preferring e-mail reminders (aRR = 1.6, p parents are ready for electronic (text message, e-mail, PHR) communications for their adolescents' health care and that a parent age and socioeconomic divide exists. Providing options in the means in which parents communicate with an adolescent's provider is ideal. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research.

Science.gov (United States)

Hemsley, Bronwyn; Balandin, Susan

2014-12-01

Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.

Fluid-cooled heat sink for use in cooling various devices

Science.gov (United States)

Bharathan, Desikan; Bennion, Kevin; Kelly, Kenneth; Narumanchi, Sreekant

2017-09-12

The disclosure provides a fluid-cooled heat sink having a heat transfer base, a shroud, and a plurality of heat transfer fins in thermal communication with the heat transfer base and the shroud, where the heat transfer base, heat transfer fins, and the shroud form a central fluid channel through which a forced or free cooling fluid may flow. The heat transfer pins are arranged around the central fluid channel with a flow space provided between adjacent pins, allowing for some portion of the central fluid channel flow to divert through the flow space. The arrangement reduces the pressure drop of the flow through the fins, optimizes average heat transfer coefficients, reduces contact and fin-pin resistances, and reduces the physical footprint of the heat sink in an operating environment.

Communication Challenges: A Qualitative Look at the Relationship Between Pediatric Hospitalists and Primary Care Providers.

Science.gov (United States)

Solan, Lauren G; Sherman, Susan N; DeBlasio, Dominick; Simmons, Jeffrey M

2016-07-01

Primary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determine ways to improve communication and remove barriers by eliciting the perspectives of pediatric PCPs and hospitalists. Using qualitative methods, 2 sets of focus groups were held: 1) mix of local PCPs serving diverse populations, and 2) hospitalists from a free-standing, pediatric institution. The open-ended, semistructured question guides included questions about communication experiences, patient care responsibilities, and suggestions for improvement. Using inductive thematic analysis, investigators coded the transcripts, and resolved differences through consensus. Six PCP (n = 27) and 3 hospitalist (n = 15) focus groups were held. Fifty-six percent of PCPs and 14% of hospitalists had been practicing for >10 years. Five major themes were identified: problematic aspects of communication, perceptions of provider roles, push-pull, postdischarge responsibilities/care, and proposed solutions. Aspects of communication included specific problem areas with verbal and written communication. Perceptions of provider roles highlighted the issue of PCPs feeling devalued. Push-pull described conflicting expectations about a counterpart's role and responsibilities. Postdischarge responsibilities/care addressed unclear responsibilities related to patient follow-up. Proposed solutions were suggested for ways to improve communication. Deficiencies in communication hinder successful collaboration and can cause tension between providers in inpatient and outpatient settings. Understanding specific issues that contribute to poor communication like perceptions about provider roles is critical to improving relationships and facilitating combined efforts to improve patient care

Patients' Perspectives of Oral Healthcare Providers' Communication: Considering the Impact of Message Source and Content.

Science.gov (United States)

Fico, Ashley E; Lagoe, Carolyn

2018-08-01

This study explores patients' perceptions of positive and negative communication experiences with dentists and dental hygienists using a sample of 267 individuals who reported having a general dental provider. Patients' oral health literacy, dental mistrust, use of dental health services, anxiety, and provider satisfaction are examined on the basis of reported communication experiences in the dental context. When comparing participants who had or had not experienced positive communication with a dentist, individuals with positive experiences demonstrated significantly higher levels of oral health literacy and provider satisfaction, as well as lower levels of dental mistrust. Participants who had experienced negative communication with a dentist reported significantly higher levels of anxiety and dental mistrust, as well as greater likelihood of ever leaving a dental practice, as compared to those without negative communication experiences. By contrast, positive and negative communication experiences with hygienists had limited impact on patient outcomes. Information derived from this investigation can be used by dental providers to guide communicative actions with patients, as well as by scholars to enhance existing theoretical explanations of the function of communication in dentistry.

Fluid-driven reciprocating apparatus and valving for controlling same

Science.gov (United States)

Whitehead, John C.; Toews, Hans G.

1993-01-01

A control valve assembly for alternately actuating a pair of fluid-driven free-piston devices by using fluid pressure communication therebetween. Each control valve is switched by a pressure signal depending on the state of its counterpart's piston. The communication logic is arranged to provide overlap of the forward strokes of the pistons, so that at least one of the pair will always be pressurized. Thus, uninterrupted pumping of liquid is made possible from a pair of free-piston pumps. In addition, the speed and frequency of piston stroking is entirely dependent on the mechanical power load applied. In the case of a pair of pumps, this enables liquid delivery at a substantially constant pressure over the full range of flow rates, from zero to maximum flow. One embodiment of the invention utilized two pairs of fluid-driven free-piston devices whereby a bipropellant liquid propulsion system may be operated, so as to provide continuous flow of both fuel and oxidizer liquids when used in rocket applications, for example.

The Association of Perceived Provider-Patient Communication and Relationship Quality with Colorectal Cancer Screening

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Underhill, Meghan L.; Kiviniemi, Marc T.

2012-01-01

Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…

Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.

Science.gov (United States)

Jesus, Tiago Silva; Silva, Isabel Lopes

2016-04-01

There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

"Are you still driving?" Metasynthesis of patient preferences for communication with health care providers.

Science.gov (United States)

Betz, Marian E; Scott, Kenneth; Jones, Jacqueline; Diguiseppi, Carolyn

2016-05-18

The aim of this study was to synthesize published qualitative studies to identify older adults' preferences for communication about driving with health care providers. Health care providers play a key role in addressing driving safety and driving retirement with older adults, but conversations about driving can be difficult. Guides exist for family members and providers, but to date less is known about the types of communication and messages older drivers want from their health care providers. A qualitative metasynthesis of studies published on or before October 10, 2014, in databases (PubMed, CINAHL, PsycINFO, and Web of Science) and grey literature was performed. Twenty-two published studies representing 518 older adult drivers met the following inclusion criteria: the study (1) was about driving; (2) involved older drivers; (3) was qualitative (rather than quantitative or mixed methods); and (4) contained information on older drivers' perspectives about communication with health care providers. We identified 5 major themes regarding older adults' communication preferences: (1) driving discussions are emotionally charged; (2) context matters; (3) providers are trusted and viewed as authority figures; (4) communication should occur over a period of time rather than suddenly; and (5) older adults desire agency in the decision to stop driving. Various stakeholders involved in older driver safety should consider older drivers' perspectives regarding discussions about driving. Health care providers can respect and empower older drivers-and support their family members-through tactful communication about driving safety and mobility transitions during the life course.

Self lubricating fluid bearings

International Nuclear Information System (INIS)

Kapich, D.D.

1980-01-01

The invention concerns self lubricating fluid bearings, which are used in a shaft sealed system extending two regions. These regions contain fluids, which have to be isolated. A first seal is fluid tight for the first region between the carter shaft and the shaft. The second seal is fluid tight between the carter and the shaft, it communicates with the second region. The first fluid region is the environment surrounding the shaft carter. The second fluid region is a part of a nuclear reactor which contains the cooling fluid. The shaft is conceived to drive a reactor circulating and cooling fluid [fr

Influence of Provider Communication on Women's Delivery Expectations and Birth Experience Appraisal: A Qualitative Study.

Science.gov (United States)

Ledford, Christy J W; Canzona, Mollie Rose; Womack, Jasmyne J; Hodge, Joshua A

2016-07-01

Although current research suggests that patient-provider prenatal communication and expectation-setting affects women's outcomes, more needs to be understood about the kinds of communication experiences that shape women's expectations, the nature of expectations that women hold, and how those expectations influence their appraisal of labor and delivery. The goal of this study is to draw connections between provider communication, birth experience expectations, and birth experience appraisals. Recently delivered mothers (n=36) were recruited at a mid-Atlantic community hospital. Using a grounded theory approach, interviews were systematically analyzed to uncover how participants perceived provider communication during their prenatal care, how participants described their expectations of the birth experience, and how expectations affected appraisals of the experience. Mothers recognize providers' use of patient-centered communication in messages of empowerment, emotional support, explanation, decision making, and elicitation. Findings posit that it is the inflexibility or flexibility of expectations that may determine mothers' appraisals of the birth experience. Mothers continue to rely on providers as partners in health care. Through patient-centered communication, providers can help mothers develop flexible expectations of the birth experience, which in turn can result in positive appraisals of delivery.

Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows.

Science.gov (United States)

Jain, Parul; Slater, Michael D

2013-01-01

Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed.

The coupling of fluids, dynamics, and controls on advanced architecture computers

Science.gov (United States)

Atwood, Christopher

1995-01-01

This grant provided for the demonstration of coupled controls, body dynamics, and fluids computations in a workstation cluster environment; and an investigation of the impact of peer-peer communication on flow solver performance and robustness. The findings of these investigations were documented in the conference articles.The attached publication, 'Towards Distributed Fluids/Controls Simulations', documents the solution and scaling of the coupled Navier-Stokes, Euler rigid-body dynamics, and state feedback control equations for a two-dimensional canard-wing. The poor scaling shown was due to serialized grid connectivity computation and Ethernet bandwidth limits. The scaling of a peer-to-peer communication flow code on an IBM SP-2 was also shown. The scaling of the code on the switched fabric-linked nodes was good, with a 2.4 percent loss due to communication of intergrid boundary point information. The code performance on 30 worker nodes was 1.7 (mu)s/point/iteration, or a factor of three over a Cray C-90 head. The attached paper, 'Nonlinear Fluid Computations in a Distributed Environment', documents the effect of several computational rate enhancing methods on convergence. For the cases shown, the highest throughput was achieved using boundary updates at each step, with the manager process performing communication tasks only. Constrained domain decomposition of the implicit fluid equations did not degrade the convergence rate or final solution. The scaling of a coupled body/fluid dynamics problem on an Ethernet-linked cluster was also shown.

Adolescent Perspectives on Patient-Provider Sexual Health Communication: A Qualitative Study.

Science.gov (United States)

Hoopes, Andrea J; Benson, Samantha K; Howard, Heather B; Morrison, Diane M; Ko, Linda K; Shafii, Taraneh

2017-10-01

Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews. Interviews explored participants' past experiences with medical providers and their preferences regarding provider characteristics and communication strategies. Interviews revealed that (1) individual patient dynamics and (2) patient-provider interaction dynamics shape the experience during a sexual health visit. Individual patient dynamics included evolving level of maturity, autonomy, and sexual experience. Patient-provider interaction dynamics were shaped by adolescents' perceptions of providers as sources of health information who distribute valued sexual health supplies like contraception and condoms. Participant concerns about provider judgment, power differential, and lack of confidentiality also emerged as important themes. Adolescents demonstrate diverse and evolving needs for sexual health care and interactions with clinicians as they navigate sexual and emotional development.

Pediatric primary care providers' perspectives regarding hospital discharge communication: a mixed methods analysis.

Science.gov (United States)

Leyenaar, JoAnna K; Bergert, Lora; Mallory, Leah A; Engel, Richard; Rassbach, Caroline; Shen, Mark; Woehrlen, Tess; Cooperberg, David; Coghlin, Daniel

2015-01-01

Effective communication between inpatient and outpatient providers may mitigate risks of adverse events associated with hospital discharge. However, there is an absence of pediatric literature defining effective discharge communication strategies at both freestanding children's hospitals and general hospitals. The objectives of this study were to assess associations between pediatric primary care providers' (PCPs) reported receipt of discharge communication and referral hospital type, and to describe PCPs' perspectives regarding effective discharge communication and areas for improvement. We administered a questionnaire to PCPs referring to 16 pediatric hospital medicine programs nationally. Multivariable models were developed to assess associations between referral hospital type and receipt and completeness of discharge communication. Open-ended questions asked respondents to describe effective strategies and areas requiring improvement regarding discharge communication. Conventional qualitative content analysis was performed to identify emergent themes. Responses were received from 201 PCPs, for a response rate of 63%. Although there were no differences between referral hospital type and PCP-reported receipt of discharge communication (relative risk 1.61, 95% confidence interval 0.97-2.67), PCPs referring to general hospitals more frequently reported completeness of discharge communication relative to those referring to freestanding children's hospitals (relative risk 1.78, 95% confidence interval 1.26-2.51). Analysis of free text responses yielded 4 major themes: 1) structured discharge communication, 2) direct personal communication, 3) reliability and timeliness of communication, and 4) communication for effective postdischarge care. This study highlights potential differences in the experiences of PCPs referring to general hospitals and freestanding children's hospitals, and presents valuable contextual data for future quality improvement initiatives

Facilitating communication about sexual health between aging women and their health care providers.

Science.gov (United States)

Hughes, Anne K; Lewinson, Terri D W

2015-04-01

Many women experience changes in sexual health as they age, and discussing these changes with health care providers is an essential component of optimal health management. The purpose of this study was to understand aging women's perspectives about communicating with providers about sexual health. We used the integrative model of behavioral prediction as a theoretical lens to explore women's attitudes, perceived norms, and perceived self-efficacy that promote or inhibit the likelihood of communicating about sexual health. In this theory-based qualitative study, we interviewed 28 community-dwelling older women in the Midwestern United States. Through thematic analysis, we identified both positive and negative attitudes about communicating with providers. Women seemed most inclined to discuss sexual health if they perceived that important patient-provider conditions, such as trust and rapport, were in place. Despite situational obstacles and perceived norms, these women held strong beliefs about their abilities to discuss sexual health topics with providers. © The Author(s) 2014.

The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication.

Science.gov (United States)

Klarica, Marijan; Radoš, Milan; Erceg, Gorislav; Petošić, Antonio; Jurjević, Ivana; Orešković, Darko

2014-01-01

Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF) pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension.

The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication.

Directory of Open Access Journals (Sweden)

Marijan Klarica

Full Text Available Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension.

Communication about sexual health with breast cancer survivors: Variation among patient and provider perspectives.

Science.gov (United States)

Canzona, Mollie Rose; Garcia, David; Fisher, Carla L; Raleigh, Meghan; Kalish, Virginia; Ledford, Christy J W

2016-11-01

Breast cancer survivors experience a range of sexual health (SH) issues. Communication problems between patient and provider can prevent survivors from pursuing SH goals and can negatively influence biopsychosocial outcomes. The primary aims of this study were to identify provider communication behaviors that facilitate or impede clinical interactions regarding SH (according to survivors and providers) and to highlight discrepancies that affect care. Forty breast cancer survivors and forty health care providers from a variety of specialties participated in semi-structured interviews informed by the Critical Incident Technique. Transcripts were thematically analyzed using the constant comparative method. Survivors and providers discussed the importance of honoring individual patient needs and conveying compassionate messages. However, accounts varied significantly regarding the appropriate timing and method of initiating SH discussions and the helpfulness of certain support behaviors and linguistic devices. Provider and survivor accounts of what constitutes helpful and unhelpful provider communication behaviors when discussing SH concerns are misaligned in nuanced and meaningful ways. These discrepancies reveal potential areas for educational intervention. SH discussions require providers to examine assumptions about patients' communication preferences and information needs. Patients may benefit from frank yet sensitive discussions earlier in the cancer continuum. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Research and Practice Communications Between Oral Health Providers and Prenatal Health Providers: A Bibliometric Analysis.

Science.gov (United States)

Skvoretz, John; Dyer, Karen; Daley, Ellen; Debate, Rita; Vamos, Cheryl; Kline, Nolan; Thompson, Erika

2016-08-01

Objectives We aimed to examine scholarly collaboration between oral health and prenatal providers. Oral disease is a silent epidemic with significant public health implications for pregnant women. Evidence linking poor oral health during pregnancy to adverse pregnancy and birth outcomes requires oral health and prenatal providers to communicate on the prevention, treatment and co-management matters pertaining to oral health issues among their pregnant patients. The need for inter-professional collaboration is highlighted by guidelines co-endorsed by the American College of Obstetricians and Gynecologists and the American Dental Association, stressing the importance of oral health care during pregnancy. Methods To assess if interdisciplinary communication occurs between oral health and prenatal disciplines, we conducted a network analysis of research on pregnancy-related periodontal disease. Results Social Network analysis allowed us to identify communication patterns between communities of oral health and prenatal professionals via scientific journals. Analysis of networks of citations linking journals in different fields reveals a core-periphery pattern dominated by oral health journals with some participation from medicine journals. However, an analysis of dyadic ties of citation reveals statistically significant "inbreeding" tendencies in the citation patterns: both medical and oral health journals tend to cite their own kind at greater-than-chance levels. Conclusions Despite evidence suggesting that professional collaboration benefits patients' overall health, findings from this research imply that little collaboration occurs between these two professional groups. More collaboration may be useful in addressing women's oral-systemic health concerns that result in adverse pregnancy outcomes.

SPACEWAY: Providing affordable and versatile communication solutions

Science.gov (United States)

Fitzpatrick, E. J.

1995-08-01

By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.

Web-Based Tools for Text-Based Patient-Provider Communication in Chronic Conditions: Scoping Review.

Science.gov (United States)

Voruganti, Teja; Grunfeld, Eva; Makuwaza, Tutsirai; Bender, Jacqueline L

2017-10-27

Patients with chronic conditions require ongoing care which not only necessitates support from health care providers outside appointments but also self-management. Web-based tools for text-based patient-provider communication, such as secure messaging, allow for sharing of contextual information and personal narrative in a simple accessible medium, empowering patients and enabling their providers to address emerging care needs. The objectives of this study were to (1) conduct a systematic search of the published literature and the Internet for Web-based tools for text-based communication between patients and providers; (2) map tool characteristics, their intended use, contexts in which they were used, and by whom; (3) describe the nature of their evaluation; and (4) understand the terminology used to describe the tools. We conducted a scoping review using the MEDLINE (Medical Literature Analysis and Retrieval System Online) and EMBASE (Excerpta Medica Database) databases. We summarized information on the characteristics of the tools (structure, functions, and communication paradigm), intended use, context and users, evaluation (study design and outcomes), and terminology. We performed a parallel search of the Internet to compare with tools identified in the published literature. We identified 54 papers describing 47 unique tools from 13 countries studied in the context of 68 chronic health conditions. The majority of tools (77%, 36/47) had functions in addition to communication (eg, viewable care plan, symptom diary, or tracker). Eight tools (17%, 8/47) were described as allowing patients to communicate with the team or multiple health care providers. Most of the tools were intended to support communication regarding symptom reporting (49%, 23/47), and lifestyle or behavior modification (36%, 17/47). The type of health care providers who used tools to communicate with patients were predominantly allied health professionals of various disciplines (30%, 14

Providing Survivable Real-Time Communication Service for Distributed Mission Critical Systems

National Research Council Canada - National Science Library

Zhao, Wei; Bettati, Riccardo; Vaidya, Nitin

2005-01-01

This document is the final report for Providing Survivable Real-Time Communication Service for Distributed Mission Critical Systems, a Texas A AND M project funded through the DARPA Fault Tolerant Networks Program...

Anti-Smoking Communication to Preadolescents with and without a Cancer Diagnosis: Parents and Healthcare Providers as Important Communicators

OpenAIRE

Throckmorton-Belzer, Leslee; Tyc, Vida L.; Robinson, Leslie A.; Klosky, James L.; Lensing, Shelly; Booth, Andrea K.

2009-01-01

A cancer diagnosis does not prevent smoking among pediatric oncology patients, and anti-smoking communications among parents and health care providers have been proposed as influencing smoking outcomes in this group. Anti-smoking communications were compared among 93 preadolescents with cancer and 402 controls. After adjusting for demographics and covariates, preadolescents with cancer were less likely than control participants to report receipt of anti-smoking messages from physicians and pa...

Self-contained miniature electronics transceiver provides voice communication in hazardous environment

Science.gov (United States)

Cribb, H. E.

1970-01-01

Two-way wireless voice communications system is automatic, provides freedom of movement, allows for complete awareness of the environment, and does not present any additional hazards such as activation of electromagnetic sensitive devices.

Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer.

Science.gov (United States)

Nyrop, Kirsten A; Deal, Allison M; Williams, Grant R; Guerard, Emily J; Pergolotti, Mackenzi; Muss, Hyman B

2016-02-01

National guidelines recommend that patients with a cancer diagnosis engage in regular physical activity to reduce cancer-related fatigue, maintain quality of life and physical function, and improve overall prognosis and survival. This study investigates oncology provider communications about physical activity during routine clinic visits with patients with early-stage breast, colon, or prostate cancer. This study used a retrospective chart review for documentation of inquiries or recommendations pertaining to physical activity in clinician notes and after-visit patient summaries. In a 1-month period, 55 oncology providers had 361 encounters (clinic visits) with early-stage cancer patients. Thirty-five percent of these encounters included a provider communication about "physical activity," "exercise," or "activity." Encounters with a medical oncologist resulted in a physical activity communication 55% of the time, whereas encounters with other clinician specialties did so 20% of the time (P communication increased with patient age (P communications was significantly higher (46%, 37%, and 58%, respectively) than the rate when the visit was during radiation treatment or surgery (6% and 19%, respectively; P communications during routine clinic visits; however, the frequency of physical activity communications varies among providers. Interventions are needed to remind and encourage all oncology providers to encourage their patients with early-stage cancer to be physically active. . © 2015 American Cancer Society.

Disparities in perceived patient-provider communication quality in the United States: Trends and correlates.

Science.gov (United States)

Spooner, Kiara K; Salemi, Jason L; Salihu, Hamisu M; Zoorob, Roger J

2016-05-01

This study aimed to describe disparities and temporal trends in the level of perceived patient-provider communication quality (PPPCQ) in the United States, and to identify sociodemographic and health-related factors associated with elements of PPPCQ. A cross-sectional analysis was conducted using nationally-representative data from the 2011-2013 iterations of the Health Information National Trends Survey (HINTS). Descriptive statistics, multivariable linear and logistic regression analyses were conducted to examine associations. PPPCQ scores, the composite measure of patients' ratings of communication quality, were positive overall (82.8; 95% CI: 82.1-83.5). However, less than half (42-46%) of respondents perceived that providers always addressed their feelings, spent enough time with them, or helped with feelings of uncertainty about their health. Older adults and those with a regular provider consistently had higher PPPCQ scores, while those with poorer perceived general health were consistently less likely to have positive perceptions of their providers' communication behaviors. Disparities in PPPCQ can be attributed to patients' age, race/ethnicity, educational attainment, employment status, income, healthcare access and general health. These findings may inform educational and policy efforts which aim to improve patient-provider communication, enhance the quality of care, and reduce health disparities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Humor as a Communication Strategy in Provider-Patient Communication in a Chronic Care Setting.

Science.gov (United States)

Schöpf, Andrea C; Martin, Gillian S; Keating, Mary A

2017-02-01

Humor is a potential communication strategy to accomplish various and potentially conflicting consultation goals. We investigated humor use and its reception in diabetes consultations by analyzing how and why humor emerges and its impact on the interaction. We did this by using an interactional sociolinguistics approach. We recorded 50 consultations in an Irish diabetes setting. Analysis of the humor events drew on framework analysis and on concepts from Conversation Analysis and pragmatics. The study also comprised interviews using tape-assisted recall. We identified 10 humor functions and two umbrella functions. A key finding is that most humor is relationship-protecting humor initiated by patients, that is, they voice serious messages and deal with emotional issues through humor. Our findings imply that patients' and providers' awareness of indirect communication strategies needs to be increased. We also recommend that researchers employ varied methods to adequately capture the interactive nature of humor.

Measuring patient-provider communication skills in Rwanda: Selection, adaptation and assessment of psychometric properties of the Communication Assessment Tool.

Science.gov (United States)

Cubaka, Vincent Kalumire; Schriver, Michael; Vedsted, Peter; Makoul, Gregory; Kallestrup, Per

2018-04-23

To identify, adapt and validate a measure for providers' communication and interpersonal skills in Rwanda. After selection, translation and piloting of the measure, structural validity, test-retest reliability, and differential item functioning were assessed. Identification and adaptation: The 14-item Communication Assessment Tool (CAT) was selected and adapted. Content validation found all items highly relevant in the local context except two, which were retained upon understanding the reasoning applied by patients. Eleven providers and 291 patients were involved in the field-testing. Confirmatory factor analysis showed a good fit for the original one factor model. Test-retest reliability assessment revealed a mean quadratic weighted Kappa = 0.81 (range: 0.69-0.89, N = 57). The average proportion of excellent scores was 15.7% (SD: 24.7, range: 9.9-21.8%, N = 180). Differential item functioning was not observed except for item 1, which focuses on greetings, for age groups (p = 0.02, N = 180). The Kinyarwanda version of CAT (K-CAT) is a reliable and valid patient-reported measure of providers' communication and interpersonal skills. K-CAT was validated on nurses and its use on other types of providers may require further validation. K-CAT is expected to be a valuable feedback tool for providers in practice and in training. Copyright © 2018 Elsevier B.V. All rights reserved.

Variation in patient-provider communication by patient's race and ethnicity, provider type, and continuity in and site of care: An analysis of data from the Connecticut Health Care Survey.

Science.gov (United States)

Aseltine, Robert H; Sabina, Alyse; Barclay, Gillian; Graham, Garth

2016-01-01

The purpose of this study is to examine the quality of patient-reported communication with their health care providers using data from a large, statewide survey of patients. We examine the relationship between patient's race and ethnicity, type of health care provider, site of and continuity in care, and the quality of patient-provider communication. We analyze data from the Connecticut Health Care Survey, a representative telephone survey of 4608 Connecticut residents conducted between June 2012 and February 2013. Eight measures of patient-provider communication were analyzed using weighted general linear and logistic regression models. Patients' assessments of the quality of communication with their health care providers were generally positive. Hispanic patients, those who received care in a clinic or hospital setting, and those who did not consistently see the same provider reported significantly poorer communication with their providers. Our data suggest that improving patient-provider communication for Hispanic patients may be a critical step in achieving health equity. However, increased access to health care delivered outside of physician offices where there may not be consistency in providers across encounters may pose challenges to effective health communication.

47 CFR 4.3 - Communications providers covered by the requirements of this part.

Science.gov (United States)

2010-10-01

..., paging service, and/or SS7 communications. (c) IXC or LEC tandem facilities refer to tandem switches (or... provide communications services directly to end users. (e) Signaling System 7 (SS7) is a signaling system... most paging services. For purposes of this rule part, SS7 refers to both the SS7 protocol and the...

Barriers to effective communication between veterans with chronic kidney disease and their healthcare providers.

Science.gov (United States)

Lederer, Swati; Fischer, Michael J; Gordon, Howard S; Wadhwa, Anuradha; Popli, Subhash; Gordon, Elisa J

2015-12-01

Many patients with chronic kidney disease (CKD) have insufficient knowledge about CKD, which is associated with poorer health outcomes. Effective patient-provider communication can improve CKD patients' knowledge, thereby augmenting their participation in self-care practices. However, barriers to addressing CKD patients' information needs have not been previously characterized. Adults with an estimated glomerular filtration rate (eGFR) of communication dynamics. Thirty-two patients participated. The mean age of participants was 63 years; most were male (94%) and non-Hispanic white (53%). CKD severity groups represented included CKD-3 (eGFR 30-59 mL/min/1.73 m(2); 34%), CKD-4 (eGFR 15-29 mL/min/1.73 m(2); 25%), CKD-5 (eGFR barriers to patient-provider communication based on patients' reported care at both VA and non-VA facilities, including patients perceived their role as a 'listener', reported limited CKD knowledge, did not understand physicians' explanations and were dissatisfied with the patient-provider relationship. Several barriers to patient-provider communication prevent patients from meeting their information needs and perpetuate patient passivity. Future research should evaluate whether interventions that empower CKD patients to actively participate in their care increase knowledge and improve health outcomes.

A mobile communication device adapted to provide a dynamic display arrangement

DEFF Research Database (Denmark)

2011-01-01

The invention relates to a mobile communication device comprising a light projector adapted to project a multi-coloured image onto a surface; a hinged mirror comprising a first mirror part adapted to be tilted around the hinge into the light path of the light projector; wherein the first mirror...... part comprises means for correcting a skew angle in the multi-coloured image projected onto a surface. Thereby is achieved that the mobile communication device is able to provide RGB full colour dynamic image projection which is preferred over monochromatic laser projection because it is a speckle free...... and eye-friendly projection....

Variation in patient–provider communication by patient’s race and ethnicity, provider type, and continuity in and site of care: An analysis of data from the Connecticut Health Care Survey

Directory of Open Access Journals (Sweden)

Robert H Aseltine

2016-01-01

Full Text Available Objectives: The purpose of this study is to examine the quality of patient-reported communication with their health care providers using data from a large, statewide survey of patients. We examine the relationship between patient’s race and ethnicity, type of health care provider, site of and continuity in care, and the quality of patient–provider communication. Methods: We analyze data from the Connecticut Health Care Survey, a representative telephone survey of 4608 Connecticut residents conducted between June 2012 and February 2013. Eight measures of patient–provider communication were analyzed using weighted general linear and logistic regression models. Results: Patients’ assessments of the quality of communication with their health care providers were generally positive. Hispanic patients, those who received care in a clinic or hospital setting, and those who did not consistently see the same provider reported significantly poorer communication with their providers. Conclusion: Our data suggest that improving patient–provider communication for Hispanic patients may be a critical step in achieving health equity. However, increased access to health care delivered outside of physician offices where there may not be consistency in providers across encounters may pose challenges to effective health communication.

Fluid-cooled heat sink with improved fin areas and efficiencies for use in cooling various devices

Science.gov (United States)

Bharathan, Desikan; Bennion, Kevin; Kelly, Kenneth; Narumanchi, Sreekant

2015-04-21

The disclosure provides a fluid-cooled heat sink having a heat transfer base and a plurality of heat transfer fins in thermal communication with the heat transfer base, where the heat transfer base and the heat transfer fins form a central fluid channel through which a forced or free cooling fluid may flow. The heat transfer pins are arranged around the central fluid channel with a flow space provided between adjacent pins, allowing for some portion of the central fluid channel flow to divert through the flow space. The arrangement reduces the pressure drop of the flow through the fins, optimizes average heat transfer coefficients, reduces contact and fin-pin resistances, and reduces the physical footprint of the heat sink in an operating environment.

A Review of Verbal and Non-Verbal Human-Robot Interactive Communication

OpenAIRE

Mavridis, Nikolaos

2014-01-01

In this paper, an overview of human-robot interactive communication is presented, covering verbal as well as non-verbal aspects of human-robot interaction. Following a historical introduction, and motivation towards fluid human-robot communication, ten desiderata are proposed, which provide an organizational axis both of recent as well as of future research on human-robot communication. Then, the ten desiderata are examined in detail, culminating to a unifying discussion, and a forward-lookin...

Valving for controlling a fluid-driven reciprocating apparatus

Science.gov (United States)

Whitehead, John C.

1995-01-01

A pair of control valve assemblies for alternately actuating a pair of fluid-driven free-piston devices by using fluid pressure communication therebetween. Each control valve assembly is switched by a pressure signal depending on the state of its counterpart's piston. The communication logic is arranged to provide overlap of the forward strokes of the pistons, so that at least one of the pair will always be pressurized. Thus, uninterrupted pumping of liquid is made possible from a pair of free-piston pumps. In addition, the speed and frequency of piston stroking is entirely dependent on the mechanical power load applied. In the case of a pair of pumps, this enables liquid delivery at a substantially constant pressure over the full range of flow rates, from zero to maximum flow. Each of the valve assemblies uses an intake-exhaust valve and a signal valve with the signal valve of one pump being connected to be pressure responsive to the piston of the opposite cylinder or pump.

Gender differences in health care provider-patient communication: are they due to style, stereotypes, or accommodation?

Science.gov (United States)

Street, Richard L

2002-12-01

This article examines gender differences in health care provider-patient communication within the framework of an ecological model of communication in the medical encounter. The ecological perspective posits that, although health care provider-patient interactions are situated within a number of contexts (e.g. organizational, political, cultural), the interpersonal domain is the primary context within which these interactions unfold. Hence, gender may influence provider-patient interaction to the extent that it can be linked to the interactants' goals, skills, perceptions, emotions, and the way the participants adapt to their partner's communication. The evidence reviewed in this essay indicates that gender differences in medical encounters may come from several sources including differences in men's and women's communicative styles, perceptions of their partners, and in the way they accommodate their partner's behavior during the interaction. However, because gender is but one of many personal and partner variables (e.g. age, ethnicity, personal experiences) that can influence these processes, gender differences are often quite modest (if apparent at all) when examined across a population of health care providers and patients. Implications for future research and communicative skill training are discussed.

Acoustic concentration of particles in fluid flow

Science.gov (United States)

Ward, Michael D.; Kaduchak, Gregory

2010-11-23

An apparatus for acoustic concentration of particles in a fluid flow includes a substantially acoustically transparent membrane and a vibration generator that define a fluid flow path therebetween. The fluid flow path is in fluid communication with a fluid source and a fluid outlet and the vibration generator is disposed adjacent the fluid flow path and is capable of producing an acoustic field in the fluid flow path. The acoustic field produces at least one pressure minima in the fluid flow path at a predetermined location within the fluid flow path and forces predetermined particles in the fluid flow path to the at least one pressure minima.

Acoustic concentration of particles in fluid flow

Science.gov (United States)

Ward, Michael W.; Kaduchak, Gregory

2017-08-15

Disclosed herein is a acoustic concentration of particles in a fluid flow that includes a substantially acoustically transparent membrane and a vibration generator that define a fluid flow path therebetween. The fluid flow path is in fluid communication with a fluid source and a fluid outlet and the vibration generator is disposed adjacent the fluid flow path and is capable of producing an acoustic field in the fluid flow path. The acoustic field produces at least one pressure minima in the fluid flow path at a predetermined location within the fluid flow path and forces predetermined particles in the fluid flow path to the at least one pressure minima.

The "Hand-in" Project: Jump-starting Communication Between Inpatient and Outpatient Providers.

Science.gov (United States)

Holleck, Jürgen L; Gunderson, Craig G; Antony, Sheila M; Gupta, Shaili; Chang, John J; Merchant, Naseema; Lin, Shin; Federman, Daniel G

2017-11-01

Communication between hospitalists and primary care providers (PCPs) upon discharge has been much discussed, but the transition from outpatient to inpatient has received less attention. We questioned whether a brief, standardized e-mail from the hospitalist to the PCP upon admission could facilitate information exchange, increase communication, elucidate PCP preferences, and improve outcomes. This prospective single-center study with a preintervention-to-postintervention design involved 300 inpatient admissions from June 2015 through October 2015 in the Veterans Affairs Connecticut Healthcare System. Hospitalists e-mailed an encrypted notification of admission along with standardized questions to PCPs within 1 day of admission. Measurements included the number of communications between PCPs and hospitalists, length of stay (LOS), 30-day readmissions, 30-day emergency department (ED) utilization rates, PCP preferences with regard to communication, and follow-up. Preintervention data for 94 patients during a 6-week period revealed 0.11 communications per patient, an LOS of 4.18 days, 30-day readmissions of 28.7%, and 30-day ED visits of 32%. Postintervention data on 206 patients during the next 12 weeks showed statistically significant increased communications per patient (0.5), and a nonsignificant decrease in LOS (3.96 days), 30-day readmissions (22.3%), and 30-day ED visits (31%). P values were communication upon discharge (40%) to telephone (25%) or instant messaging (13%), and 39% wanted a follow-up appointment within 2 weeks, regardless of what transpired. A hospitalist-led transition-of-care intervention designed to improve communication and information exchange between PCPs and hospitalists at the time of admission demonstrated that encrypted e-mail could be used as a tool to obtain useful additional medical and psychosocial information and to better understand PCP attitudes and preferences. The increased level of communication did not yield statistically

Communication practices about HPV testing among providers in Federally Qualified Health Centers

Directory of Open Access Journals (Sweden)

Lavinia Lin

2015-01-01

Conclusion: As HPV testing plays a more prominent role in cervical cancer screening, more attention should be given to communications between providers and patients about the benefits and harms of different screening options.

Patient-Provider Communication: Experiences of Low-Wage-Earning Breast Cancer Survivors in Managing Cancer and Work.

Science.gov (United States)

Nichols, Helen M; Swanberg, Jennifer E; Vanderpool, Robin C

2018-02-26

In 2017, there will be more than 250,000 new diagnoses of invasive breast cancer; most cases will occur in working-age women. The goal of this qualitative study was to explore low-wage-earning breast cancer survivors' experiences communicating with their oncology team about cancer and employment issues. Twenty-four low-wage-earning breast cancer survivors in the USA were interviewed in 2012 using a structured interview protocol. Sociodemographic data, cancer history, and patient-provider communication experiences regarding the management of cancer and work were collected. Interviews were analyzed using grounded theory strategy of constant comparative analysis. Low-wage-earning breast cancer survivors' experiences communicating with their oncology team about employment and cancer focused on three dimensions of patient-provider communication: extent, quality, and content. Over 70% of respondents reported no communication or only routine communication with their providers regarding work; three quarters of women reported poor or standard communication quality, and content of work-related communication covered scheduling issues, work absences, continuing to work during treatment, and financial concerns. Communication between oncology care teams and low-wage-earning cancer patients is critical to the successful management of treatment and work responsibilities given the vulnerable employment situation of these women. There is a need for education of oncology team members about how cancer and its treatment can impact employment for all workers, but especially for low-wage workers, thereby allowing the care team to address these issues proactively and help patients successfully manage both cancer treatment and work responsibilities.

A Novel Dual Separate Paths (DSP) Algorithm Providing Fault-Tolerant Communication for Wireless Sensor Networks.

Science.gov (United States)

Tien, Nguyen Xuan; Kim, Semog; Rhee, Jong Myung; Park, Sang Yoon

2017-07-25

Fault tolerance has long been a major concern for sensor communications in fault-tolerant cyber physical systems (CPSs). Network failure problems often occur in wireless sensor networks (WSNs) due to various factors such as the insufficient power of sensor nodes, the dislocation of sensor nodes, the unstable state of wireless links, and unpredictable environmental interference. Fault tolerance is thus one of the key requirements for data communications in WSN applications. This paper proposes a novel path redundancy-based algorithm, called dual separate paths (DSP), that provides fault-tolerant communication with the improvement of the network traffic performance for WSN applications, such as fault-tolerant CPSs. The proposed DSP algorithm establishes two separate paths between a source and a destination in a network based on the network topology information. These paths are node-disjoint paths and have optimal path distances. Unicast frames are delivered from the source to the destination in the network through the dual paths, providing fault-tolerant communication and reducing redundant unicast traffic for the network. The DSP algorithm can be applied to wired and wireless networks, such as WSNs, to provide seamless fault-tolerant communication for mission-critical and life-critical applications such as fault-tolerant CPSs. The analyzed and simulated results show that the DSP-based approach not only provides fault-tolerant communication, but also improves network traffic performance. For the case study in this paper, when the DSP algorithm was applied to high-availability seamless redundancy (HSR) networks, the proposed DSP-based approach reduced the network traffic by 80% to 88% compared with the standard HSR protocol, thus improving network traffic performance.

The Effect of Health Information Technology on Health Care Provider Communication: A Mixed-Method Protocol.

Science.gov (United States)

Manojlovich, Milisa; Adler-Milstein, Julia; Harrod, Molly; Sales, Anne; Hofer, Timothy P; Saint, Sanjay; Krein, Sarah L

2015-06-11

Communication failures between physicians and nurses are one of the most common causes of adverse events for hospitalized patients, as well as a major root cause of all sentinel events. Communication technology (ie, the electronic medical record, computerized provider order entry, email, and pagers), which is a component of health information technology (HIT), may help reduce some communication failures but increase others because of an inadequate understanding of how communication technology is used. Increasing use of health information and communication technologies is likely to affect communication between nurses and physicians. The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians with the ultimate goal of identifying how we can optimize the use of these technologies to support effective communication. Effective communication is the process of developing shared understanding between communicators by establishing, testing, and maintaining relationships. Our theoretical model, based in communication and sociology theories, describes how health information and communication technologies affect communication through communication practices (ie, use of rich media; the location and availability of computers) and work relationships (ie, hierarchies and team stability). Therefore we seek to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings, and (3) explore how differences in health information and communication technologies, communication practices, and work relationships between physicians and nurses influence communication. This 4-year study uses a sequential mixed-methods design, beginning with a

Perceptions of Provider Communication Among Vulnerable Patients With Diabetes: Influences of Medical Mistrust and Health Literacy.

Science.gov (United States)

White, Richard O; Chakkalakal, Rosette J; Presley, Caroline A; Bian, Aihua; Schildcrout, Jonathan S; Wallston, Kenneth A; Barto, Shari; Kripalani, Sunil; Rothman, Russell

2016-01-01

Patient-provider communication is modifiable and is linked to diabetes outcomes. The association of communication quality with medical mistrust is unknown. We examined these factors within the context of a low-literacy/numeracy-focused intervention to improve diabetes care, using baseline data from diverse patients enrolled in a randomized trial of a health communication intervention. Demographics, measures of health communication (Communication Assessment Tool [CAT], Interpersonal Processes of Care survey [IPC-18]), health literacy (Short Test of Functional Health Literacy in Adults), depression, medical mistrust, and glycemic control were ascertained. Adjusted proportional odds models were used to test the association of mistrust with patient-reported communication quality. The interaction effect of health literacy on mistrust and communication quality was also assessed. A total of 410 patients were analyzed. High levels of mistrust were observed. In multivariable modeling, patients with higher mistrust had lower adjusted odds of reporting a higher CAT score (adjusted odds ratio [AOR] = 0.67, 95% confidence interval [CI] [0.52, 0.86], p = .003) and higher scores on the Communication (AOR = 0.69, 95% CI [0.55, 0.88], p = .008), Decided Together (AOR = 0.74, 95% CI [0.59, 0.93], p = .02), and Interpersonal Style (AOR = 0.69, 95% CI [0.53, 0.90], p = .015) subscales of the IPC-18. We observed evidence of an interaction effect of health literacy for the association between mistrust and the Decided Together subscale of the IPC-18 such that patients with higher mistrust and lower literacy perceived worse communication relative to mistrustful patients with higher literacy. In conclusion, medical mistrust was associated with poorer communication with providers in this public health setting. Patients' health literacy level may vary the effect of mistrust on interactional aspects of communication. Providers should consider the impact of mistrust on communication

Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing

DEFF Research Database (Denmark)

Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

2016-01-01

Objectives: In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. Methods: In-depth int......Objectives: In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. Methods: In....... Results: Four themes emerged describing barriers to communication, from the HIV-positive women’s point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider’s emphasis on ‘scientific’ facts, (iv...

Improving Interdisciplinary Provider Communication Through a Unified Paging System.

Science.gov (United States)

Heidemann, Lauren; Petrilli, Christopher; Gupta, Ashwin; Campbell, Ian; Thompson, Maureen; Cinti, Sandro; Stewart, David A

2016-06-01

Interdisciplinary communication at a Veterans Affairs (VA) academic teaching hospital is largely dependent on alphanumeric paging, which has limitations as a result of one-way communication and lack of reliable physician identification. Adverse patient outcomes related to difficulty contacting the correct consulting provider in a timely manner have been reported. House officers were surveyed on the level of satisfaction with the current VA communication system and the rate of perceived adverse patient outcomes caused by potential delays within this system. Respondents were then asked to identify the ideal paging system. These results were used to develop and deploy a new Web site. A postimplementation survey was repeated 1 year later. This study was conducted as a quality improvement project. House officer satisfaction with the preintervention system was 3%. The majority used more than four modalities to identify consultants, with 59% stating that word of mouth was a typical source. The preferred mode of paging was the university hospital paging system, a Web-based program that is used at the partnering academic institution. Following integration of VA consulting services within the university hospital paging system, the level of satisfaction improved to 87%. Significant decreases were seen in perceived adverse patient outcomes (from 16% to 2%), delays in patient care (from 90% to 16%), and extended hospitalizations (from 46% to 4%). Our study demonstrates significant improvement in physician satisfaction with a newly implemented paging system that was associated with a decreased perceived number of adverse patient events and delays in care.

Communication Between Middle SES Black Women and Healthcare Providers About HIV Testing.

Science.gov (United States)

Fray, Niasha A; Caldwell, Kia Lilly

2017-01-01

This article explores the impact of patient and healthcare provider communication (PPC) on the HIV testing behaviors of middle socioeconomic status (SES) Black women in North Carolina. We explore how PPC about STIs and HIV (or the lack thereof) affects the provision of STI/HIV testing by either confirming the need for middle SES Black women to test routinely or potentially deterring women from feeling they need to be tested. After conducting 15 qualitative interviews with middle SES Black women between 25 and 45 years of age, we uncovered the role of patient self-advocacy in promoting HIV testing among middle SES Black women when they communicate with their healthcare providers. We discuss the importance of healthcare providers engaging their middle SES Black female patients in routine discussions about sexual health and sexual risk reduction, regardless of providers' perceptions of their potential STI/HIV risk. We recommend including SES as a variable in data collection and research in order to better understand how social class, race, and gender affect sexual health behavior and the provision of STI and HIV/AIDS prevention to diverse populations. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.

Patients’ Perception of Patient–Provider Communication in Fertility Preservation Decision Making Among Young Women With Cancer

Directory of Open Access Journals (Sweden)

Aakrati Mathur

2013-09-01

Full Text Available Fertility preservation (FP for patients with cancer is an emerging field. With the advancement of technology, patients may face a complex decision-making process about whether to preserve fertility. The purpose of this article is to explore how young women with cancer perceive patient–provider communication in FP decision making. In this study, 25 women between the ages of 18 and 39 were interviewed retrospectively. They were interviewed one time to learn about their decision-making process related to FP. Results of this analysis indicate that patients seek support and involvement from providers throughout the process of decision making. They prefer providers to be directive when referring to the fertility clinic. Later in the process, they expect a supportive style of communication from providers. Patient-accessible language, supportive and reassuring styles of communication, and an existing relationship with providers may enhance well-being of the patients.

Nuclear reactor core support incorporating also a cooling fluid flow system

International Nuclear Information System (INIS)

Pennell, W.E.

1975-01-01

A description is given of a core bearing plate with several modular intake units having cooling fluid intake openings on their lower extensions, and on their upper ends located above the bearing plate, at least one fuel assembly which is thus in communication with the area under the bearing plate through the modular intake unit. The means for introducing the cooling fluid into the reactor vessel area are located under the bearing plate. The lower ends of the modular intake have ribs arranged essentially on a plane and join together with openings provided between the seals, in such a manner that the ribs form a barrier. The cooling fluid intake openings are located above this barrier, so that the cooling fluid is compelled to cross it before penetrating into the modular intake units [fr

The role of provider-patient communication and trust in online sources in Internet use for health-related activities.

Science.gov (United States)

Hou, Jiran; Shim, Minsun

2010-01-01

Provider-patient communication is an important factor influencing patients' satisfaction and health outcomes. This study draws upon the uses and gratification theory to examine how individuals' perception of communication with healthcare providers is associated with their Internet use for health-related activities. Using the data from the 2007 Health Information National Trends Survey (HINTS), we found that as individuals perceived their communication with providers to be less patient-centered, they were more likely to engage in various types of online health activities, such as using websites for healthy lifestyles, searching for healthcare providers, and seeking health information. Trust in online health information was also found to be a significant predictor of online health activities. The results of this study emphasized the important role of provider-patient communication in motivating individuals to turn to the Internet for health purposes.

Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?

Science.gov (United States)

Rochon, Elizabeth; Sidani, Souraya; Shaw, Alexander; Ben-David, Boaz M.; Saragosa, Marianne; Boscart, Veronique M.; Wilson, Rozanne; Galimidi-Epstein, Karmit K.

2016-01-01

Background: Effective communication between residents with dementia and care providers in long-term care homes (LTCHs) is essential to resident-centered care. Purpose: To determine the effects of a communication intervention on residents’ quality of life (QOL) and care, as well as care providers’ perceived knowledge, mood, and burden. Method: The intervention included (1) individualized communication plans, (2) a dementia care workshop, and (3) a care provider support system. Pre- and postintervention scores were compared to evaluate the effects of the intervention. A total of 12 residents and 20 care providers in an LTCH participated in the feasibility study. Results: The rate of care providers’ adherence to the communication plans was 91%. Postintervention, residents experienced a significant increase in overall QOL. Care providers had significant improvement in mood and perceived reduced burden. Conclusion: The results suggest that the communication intervention demonstrates preliminary evidence of positive effects on residents’ QOL and care providers’ mood and burden. PMID:27899433

An Intervention to Enhance Goals-of-Care Communication Between Heart Failure Patients and Heart Failure Providers.

Science.gov (United States)

Doorenbos, Ardith Z; Levy, Wayne C; Curtis, J Randall; Dougherty, Cynthia M

2016-09-01

Heart failure patients contend with a markedly impaired quality of life, experiencing emotional distress and severe physical discomfort that increases in frequency in the last months of life. Improving communication between patients and providers about goals of care has the potential to improve patient-provider communication and patient outcomes. To determine the effects of a goals-of-care (GoC) intervention compared to usual care on the number of GoC conversations, quality of communication between patients and providers, referrals to palliative care services and completion of advance care directives. A two-group randomized study (n = 40/group) compared a GoC intervention to usual care, conducted in an academic heart failure (HF) clinic. The GoC intervention was a previsit patient activation-education, telephone-based intervention delivered by a nurse. The primary outcome of the study was number of GoC conversations between HF patients and HF providers. Secondary outcomes were quality of communication, number of referrals to palliative care, and completion of advance directives. Patients averaged 58.15 ± 11.26 years of age, with mean left ventricular ejection fraction = 30.31 ± 9.72% and Seattle Heart Failure Model scores = 95.1 ± 1.60. There was a significant increase in goals-of-care conversations (58% vs. 2.6%, P communication (P = 0.03) in the GoC group compared to usual care after the intervention. There were no differences between groups on the other outcomes. The GoC intervention resulted in more GoC conversations and higher quality communication between HF patients and providers without increased anxiety or depression. Further studies are needed to assess impact on longer term quality of care and patient outcomes. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Influence of English proficiency on patient-provider communication and shared decision-making.

Science.gov (United States)

Paredes, Anghela Z; Idrees, Jay J; Beal, Eliza W; Chen, Qinyu; Cerier, Emily; Okunrintemi, Victor; Olsen, Griffin; Sun, Steven; Cloyd, Jordan M; Pawlik, Timothy M

2018-06-01

The number of patients in the United States (US) who speak a language other than English is increasing. We evaluated the impact of English proficiency on self-reported patient-provider communication and shared decision-making. The 2013-2014 Medical Expenditure Panel Survey database was utilized to identify respondents who spoke a language other than English. Patient-provider communication (PPC) and shared decision-making (SDM) scores from 4-12 were categorized as "poor" (4-7), "average" (8-11), and "optimal." The relationship between PPC, SDM, and English proficiency was analyzed. Among 13,880 respondents, most were white (n = 10,281, 75%), age 18-39 (n = 6,677, 48%), male (n = 7,275, 52%), middle income (n = 4,125, 30%), and born outside of the US (n = 9,125, 65%). English proficiency was rated as "very well" (n = 7,221, 52%), "well" (n = 2,378, 17%), "not well" (n = 2,820, 20%), or "not at all" (n = 1,463, 10%). On multivariable analysis, patients who rated their English as "well" (OR 1.73, 95% CI 1.37-2.18) or "not well" (OR 1.53, 95% CI 1.10-2.14) were more likely to report "poor" PPC (both P English proficiency as "not well" (OR 1.31, 95% CI 1.04-1.65, P = .02). Decreased English proficiency was associated with worse self-reported patient-provider communication and shared decision-making. Attention to patients' language needs is critical to patient satisfaction and improved perception of care. Copyright © 2018 Elsevier Inc. All rights reserved.

Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE.

Science.gov (United States)

Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L

2016-02-01

To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote

Communication at an online infertility expert forum: provider responses to patients' emotional and informational cues.

Science.gov (United States)

Aarts, J W M; van Oers, A M; Faber, M J; Cohlen, B J; Nelen, W L D M; Kremer, J A M; van Dulmen, A M

2015-01-01

Online patient-provider communication has become increasingly popular in fertility care. However, it is not known to what extent patients express cues or concerns and how providers respond. In this study, we investigated cues and responses that occur in online patient-provider communication at an infertility-specific expert forum. We extracted 106 threads from the multidisciplinary expert forum of two Dutch IVF clinics. We performed the following analyses: (1) thematic analysis of patients' questions; and (2) rating patients' emotional and informational cues and subsequent professionals' responses using an adaptation of the validated Medical Interview Aural Rating Scale. Frequencies of themes, frequencies of cues and responses, and sequences (what cue is followed by what response) were extracted. Sixty-five infertile patients and 19 providers participated. The most common themes included medication and lifestyle. Patients gave more informational than emotional cues (106 versus 64). Responses to informational cues were mostly adequate (61%). The most common response to emotional cues was empathic acknowledgment (72%). Results indicate that an online expert forum could have a positive effect on patient outcomes, which should guide future research. Offering infertile patients an expert forum to communicate with providers can be a promising supplement to usual care in both providing information and addressing patients' concerns.

Communication and cultural issues in providing reproductive health care to immigrant women: health care providers' experiences in meeting the needs of [corrected] Somali women living in Finland.

Science.gov (United States)

Degni, Filio; Suominen, Sakari; Essén, Birgitta; El Ansari, Walid; Vehviläinen-Julkunen, Katri

2012-04-01

Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives' communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics.

Patient-provider communication and hormonal therapy side effects in breast cancer survivors.

Science.gov (United States)

Lin, Jenny J; Chao, Jennifer; Bickell, Nina A; Wisnivesky, Juan P

2017-09-01

Side effects from hormonal therapy (HT) for breast cancer treatment occur frequently and are associated with worse quality of life and HT non-adherence. Whether improved patient-physician communication is associated with patients' reporting of side effects is unknown. We undertook this study to assess factors associated with women's reports of HT side effects. Between December 2012 and April 2013, we conducted a cross-sectional survey of breast cancer patients undergoing HT in an urban medical center. Descriptive statistics, univariate analyses, and multivariate analyses were used to evaluate associations. Of the 100 participants, 67% reported having HT side effects. However, when prompted, an additional 9% reported experiencing specific HT-related symptoms. Despite very high communication scores, one-third of participants reported they had not discussed side effects with providers. Multivariate analysis showed that after controlling for age, education, race, and medication beliefs, women who had difficulty asking providers for more information were more likely to report side effects (odds ratio 8.27, 95% confidence interval 1.01-69.88). Although HT side effects often occur and are bothersome, patient-provider discussions about side effects remain suboptimal. Providers should actively ask patients about medication side effects so that they can be addressed to improve quality of life and potentially, medication adherence.

Implementation of physiological fluids to provide insight into the characterization, fate, and biological interactions of silver nanoparticles

Science.gov (United States)

Breitner, Emily K.; Burns, Katherine E.; Hussain, Saber M.; Comfort, Kristen K.

2018-06-01

Silver nanoparticles (AgNPs) are being increasingly utilized in consumer and medical applications. However, there remains conflicting reports on their safety, which are evaluated through a combination of in vitro and in vivo exposure models. These discrepancies may arise, in part, due to the inherent differences between cell-based and animal systems. It is well established that nanotoxicological effects are highly dependent on the unique physicochemical properties and behavior of the particle set, including size, surface chemistry, agglomeration, and ionic dissolution. However, recent studies have identified that these properties vary as a function of exposure environment; providing a rationale for the contradictory results between in vitro and in vivo assessments. Artificial physiological fluids are emerging as a powerful tool as they allow for the characterization of NPs in an environment which they would likely encounter in vivo, in addition to having the experimental advantages of flexibility and consistency. Here, we demonstrated that the utilization of artificial fluids provided a mechanism to assess AgNP behavior and induced bioresponses in environments that they would likely encounter in vivo. AgNPs were introduced within an alveolar-based exposure model, which included alveolar epithelial (A549) cells incubated within artificial alveolar fluid (AF). Additionally, the particles underwent extensive characterization within both AF and lysosomal fluid, which the AgNPs would encounter following cellular internalization. Following incubation in physiological environments AgNP properties were significantly modified versus a traditional media environment, including alterations to both extent of agglomeration and rate of ionic dissolution. Moreover, when A549s were exposed to AgNPs in AF, the cells displayed lower cytotoxicity and stress rates, corresponding to a fluid-dependent drop in silver ion production. This work highlights the need for enhanced in vitro

Provider Communication, Prompts, and Feedback to Improve HPV Vaccination Rates in Resident Clinics.

Science.gov (United States)

Rand, Cynthia M; Schaffer, Stanley J; Dhepyasuwan, Nui; Blumkin, Aaron; Albertin, Christina; Serwint, Janet R; Darden, Paul M; Humiston, Sharon G; Mann, Keith J; Stratbucker, William; Szilagyi, Peter G

2018-04-01

Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. Staff and providers in 8 resident clinics participated in a 12-month QI study. The intervention included training to strengthen provider communication about the HPV vaccine. Clinics also implemented provider prompts, received monthly performance feedback, and participated in learning collaborative calls. The primary outcome measure was eligible visits with vaccination divided by vaccine-eligible visits (captured HPV vaccination opportunities). Practices performed chart audits that were fed into monthly performance feedback on captured HPV vaccination opportunities. We used conditional logistic regression (conditioning on practice) to assess captured vaccination opportunities, with the time period of the study (before and after the QI intervention) as the independent variable. Overall, captured opportunities for HPV vaccination increased by 16.4 percentage points, from 46.9% to 63.3%. Special cause was demonstrated by centerline shift, with 8 consecutive points above the preintervention mean. On adjusted analyses, patients were more likely to receive a vaccine during, versus before, the intervention (odds ratio: 1.87; 95% confidence interval: 1.54-2.28). Captured HPV vaccination rates improved at both well-child and other visits (by 11.7 and 13.0 percentage points, respectively). A bundled intervention of provider prompts and training in communication skills plus performance feedback increased captured opportunities for HPV vaccination. Copyright © 2018 by the American Academy of Pediatrics.

Acculturation differences in communicating information about child mental health between Latino parents and primary care providers.

Science.gov (United States)

Lê Cook, Benjamin; Brown, Jonathan D; Loder, Stephen; Wissow, Larry

2014-12-01

Significant Latino-white disparities in youth mental health care access and quality exist yet little is known about Latino parents' communication with providers about youth mental health and the role of acculturation in influencing this communication. We estimated regression models to assess the association between time in the US and the number of psychosocial issues discussed with the medical assistant (MA) and doctor, adjusting for child and parent mental health and sociodemographics. Other proxies of acculturation were also investigated including measures of Spanish and English language proficiency and nativity. Parent's length of time in the US was positively associated with their communication of: their child's psychosocial problems with their child's MA, stress in their own life with their child's MA, and their child's school problems with their child's doctor. These differences were especially apparent for parents living in the US for >10 years. Parent-child language discordance, parent and child nativity were also significantly associated with communication of psychosocial problems. Greater provider and MA awareness of variation in resistance to communicating psychosocial issues could improve communication, and improve the prevention, diagnosis and treatment of youth mental illness.

Group consultations in antenatal care: Patients’ perspectives on what patient-patient communication provides

DEFF Research Database (Denmark)

Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

Background and objectives: The group consultation, where a medical professional engages simultaneously with a group of patients, is increasingly being used in healthcare encounters. Its introduction has been associated with two perceived advantages: 1) that it can provide a more economically...... in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife...... in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis...

Health literacy in the "oral exchange": an important element of patient-provider communication.

Science.gov (United States)

Nouri, Sarah S; Rudd, Rima E

2015-05-01

Oral communication between health care providers and patients--the "oral exchange"--greatly impacts patient health outcomes; however, only recently have health literacy inquiries been incorporated into this field. This review examines the intersection between oral and aural literacy and the oral exchange. A systematic literature search was carried out. Papers published in English since 2003 that specifically examine oral/aural literacy and oral patient-provider communication were included. The search yielded 999 articles, 12 of which were included in this review. Three tools have been developed to measure either patient or provider oral/aural literacy. There is a discrepancy between patient and provider oral/aural literacy levels, and high literacy demand is associated with reduced patient learning. Low patient oral/aural literacy is associated with poor health outcomes. Two interventions have been developed to reduce literacy demand. This review demonstrates the critical role of oral and aural literacy in the oral exchange, the importance of reducing literacy demand, and the need for future research in this field. Recommendations include the use of plain language and teach-back by providers, as well as incorporation of awareness of oral and aural literacy into community programs and health care provider education and training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Conductor for a fluid-cooled winding

Science.gov (United States)

Kenney, Walter J.

1983-01-01

A conductor and method of making the conductor are provided for use in winding electrical coils which are cooled by a fluid communicating with the conductor. The conductor is cold worked through twisting and reshaping steps to form a generally rectangular cross section conductor having a plurality of helical cooling grooves extending axially of the conductor. The conductor configuration makes it suitable for a wide variety of winding applications and permits the use of simple strip insulation between turns and perforated sheet insulation between layers of the winding.

Electronic cigarette use among patients with cancer: Reasons for use, beliefs, and patient-provider communication.

Science.gov (United States)

Correa, John B; Brandon, Karen O; Meltzer, Lauren R; Hoehn, Hannah J; Piñeiro, Bárbara; Brandon, Thomas H; Simmons, Vani N

2018-04-19

Smoking tobacco cigarettes after a cancer diagnosis increases risk for several serious adverse outcomes. Thus, patients can significantly benefit from quitting smoking. Electronic cigarettes are an increasingly popular cessation method. Providers routinely ask about combustible cigarette use, yet little is known about use and communication surrounding e-cigarettes among patients with cancer. This study aims to describe patterns, beliefs, and communication with oncology providers about e-cigarette use of patients with cancer. Patients with cancer (N = 121) who currently used e-cigarettes were surveyed in a cross-sectional study about their patterns and reasons for use, beliefs, and perceptions of risk for e-cigarettes, combustible cigarettes, and nicotine replacement therapies. Patient perspectives on provider communication regarding e-cigarettes were also assessed. Most participants identified smoking cessation as the reason for initiating (81%) and continuing (60%) e-cigarette use. However, 51% of patients reported current dual use of combustible cigarettes and e-cigarettes, and most patients reported never having discussed their use of e-cigarettes with their oncology provider (72%). Patients characterized e-cigarettes as less addictive, less expensive, less stigmatizing, and less likely to impact cancer treatment than combustible cigarettes (Ps < .05), and more satisfying, more useful for quitting smoking, and more effective at reducing cancer-related stress than nicotine replacement therapies (Ps < .05). Patients with cancer who use e-cigarettes have positive attitudes toward these devices and use them to aid in smoking cessation. This study also highlights the need for improved patient-provider communication on the safety and efficacy of e-cigarettes for smoking cessation. Copyright © 2018 John Wiley & Sons, Ltd.

Gynecologic cancer screening and communication with health care providers in women with Lynch syndrome

Science.gov (United States)

Burton-Chase, AM; Hovick, SR; Sun, CC; Boyd-Rogers, S; Lynch, PM; Lu, KH; Peterson, SK

2014-01-01

We evaluated knowledge of gynecologic cancer screening recommendations, screening behaviors, and communication with providers among women with Lynch syndrome (LS). Women aged ≥25 years who were at risk for LS-associated cancers completed a semi-structured interview and a questionnaire. Of 74 participants (mean age 40 years), 61% knew the appropriate age to begin screening, 75–80% correctly identified the recommended screening frequency, and 84% reported no previous screening endometrial biopsy. Women initiated discussions with their providers about their LS cancer risks, but many used nonspecific terms or relied on family history. Most were not offered high-risk screening options. While many women were aware of risk-appropriate LS screening guidelines, adherence was suboptimal. Improving communication between women and their providers regarding LS-related gynecologic cancer risk and screening options may help improve adherence. PMID:23906188

Fluid mechanics in dentinal microtubules provides mechanistic insights into the difference between hot and cold dental pain.

Science.gov (United States)

Lin, Min; Luo, Zheng Yuan; Bai, Bo Feng; Xu, Feng; Lu, Tian Jian

2011-03-23

Dental thermal pain is a significant health problem in daily life and dentistry. There is a long-standing question regarding the phenomenon that cold stimulation evokes sharper and more shooting pain sensations than hot stimulation. This phenomenon, however, outlives the well-known hydrodynamic theory used to explain dental thermal pain mechanism. Here, we present a mathematical model based on the hypothesis that hot or cold stimulation-induced different directions of dentinal fluid flow and the corresponding odontoblast movements in dentinal microtubules contribute to different dental pain responses. We coupled a computational fluid dynamics model, describing the fluid mechanics in dentinal microtubules, with a modified Hodgkin-Huxley model, describing the discharge behavior of intradental neuron. The simulated results agreed well with existing experimental measurements. We thence demonstrated theoretically that intradental mechano-sensitive nociceptors are not "equally sensitive" to inward (into the pulp) and outward (away from the pulp) fluid flows, providing mechanistic insights into the difference between hot and cold dental pain. The model developed here could enable better diagnosis in endodontics which requires an understanding of pulpal histology, neurology and physiology, as well as their dynamic response to the thermal stimulation used in dental practices.

Gynecologic cancer screening and communication with health care providers in women with Lynch syndrome.

Science.gov (United States)

Burton-Chase, A M; Hovick, S R; Sun, C C; Boyd-Rogers, S; Lynch, P M; Lu, K H; Peterson, S K

2014-08-01

We evaluated knowledge of gynecologic cancer screening recommendations, screening behaviors, and communication with providers among women with Lynch syndrome (LS). Women aged ≥25 years who were at risk for LS-associated cancers completed a semi-structured interview and a questionnaire. Of 74 participants (mean age 40 years), 61% knew the appropriate age to begin screening, 75-80% correctly identified the recommended screening frequency, and 84% reported no previous screening endometrial biopsy. Women initiated discussions with their providers about their LS cancer risks, but many used nonspecific terms or relied on family history. Most were not offered high-risk screening options. While many women were aware of risk-appropriate LS screening guidelines, adherence was suboptimal. Improving communication between women and their providers regarding LS-related gynecologic cancer risk and screening options may help improve adherence. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

"Open your heart first of all": perspectives of holistic providers in Costa Rica about communication in the provision of health care.

Science.gov (United States)

Geist-Martin, Patricia; Bell, Keely K

2009-10-01

Research documents how the care the holistic providers offer represents the quality communication that patients often do not receive from their biomedical providers. However, research investigating the perspectives of holistic providers concerning the role they see themselves playing in the provision of health is limited. This research explores the perceptions of holistic providers in Costa Rica about their communication with their patients. The results reveal two practices of communication-authenticating and integrating as central to providers' communication with patients in the provision of holistic health care. Providers describe their communication as an exploration of an anatomy of pain/suffering, including investigating the location, timing, length, intensity, and overall rhythm of the patient's condition and sense making that leads them to seek the care of a holistic provider. Most holistic providers see their role as being careful or full of care and suggest that they have an obligation to open their heart first of all.

Fluid mechanics fundamentals and applications

CERN Document Server

Cengel, Yunus

2013-01-01

Cengel and Cimbala's Fluid Mechanics Fundamentals and Applications, communicates directly with tomorrow's engineers in a simple yet precise manner. The text covers the basic principles and equations of fluid mechanics in the context of numerous and diverse real-world engineering examples. The text helps students develop an intuitive understanding of fluid mechanics by emphasizing the physics, using figures, numerous photographs and visual aids to reinforce the physics. The highly visual approach enhances the learning of Fluid mechanics by students. This text distinguishes itself from others by the way the material is presented - in a progressive order from simple to more difficult, building each chapter upon foundations laid down in previous chapters. In this way, even the traditionally challenging aspects of fluid mechanics can be learned effectively. McGraw-Hill is also proud to offer ConnectPlus powered by Maple with the third edition of Cengel/Cimbabla, Fluid Mechanics. This innovative and powerful new sy...

49 CFR 1102.2 - Ex parte communications prohibited; penalties provided.

Science.gov (United States)

2010-10-01

... communication by means of the news media that in the ordinary course of business of the publisher is intended to... of the Board of such ex parte communications sent to the Section Chief. The Designated Agency Ethics... Ethics Official. The Chairman may require that any communication be placed in the correspondence section...

Reliance communications' flag telecom to provide ethernet link between CERN and TIFR

CERN Multimedia

2007-01-01

"Flag Telecom Group Limited (Flag), the undersea cable network arm of Anil Ambani-le Reliance Communications, has announced a landmark deal with CERn (Conseil Européen pour la Recheche Nucléaire), the European organisation for nuclear research based in Geneva, Switzerland and the Tata institute of Fundamental Research (TIFR) in Mumbai to provide gigabit Ethernet connectivity between the two." (1 page)

Improving sexual health communication between older women and their providers: how the integrative model of behavioral prediction can help.

Science.gov (United States)

Hughes, Anne K; Rostant, Ola S; Curran, Paul G

2014-07-01

Talking about sexual health can be a challenge for some older women. This project was initiated to identify key factors that improve communication between aging women and their primary care providers. A sample of women (aged 60+) completed an online survey regarding their intent to communicate with a provider about sexual health. Using the integrative model of behavioral prediction as a guide, the survey instrument captured data on attitudes, perceived norms, self-efficacy, and intent to communicate with a provider about sexual health. Data were analyzed using structural equation modeling. Self-efficacy and perceived norms were the most important factors predicting intent to communicate for this sample of women. Intent did not vary with race, but mean scores of the predictors of intent varied for African American and White women. Results can guide practice and intervention with ethnically diverse older women who may be struggling to communicate about their sexual health concerns. © The Author(s) 2013.

Multidimensional proteomics analysis of amniotic fluid to provide insight into the mechanisms of idiopathic preterm birth.

Directory of Open Access Journals (Sweden)

Irina A Buhimschi

2008-04-01

Full Text Available Though recent advancement in proteomics has provided a novel perspective on several distinct pathogenetic mechanisms leading to preterm birth (inflammation, bleeding, the etiology of most preterm births still remains elusive. We conducted a multidimensional proteomic analysis of the amniotic fluid to identify pathways related to preterm birth in the absence of inflammation or bleeding.A proteomic fingerprint was generated from fresh amniotic fluid using surface-enhanced laser desorbtion ionization time of flight (SELDI-TOF mass spectrometry in a total of 286 consecutive samples retrieved from women who presented with signs or symptoms of preterm labor or preterm premature rupture of the membranes. Inflammation and/or bleeding proteomic patterns were detected in 32% (92/286 of the SELDI tracings. In the remaining tracings, a hierarchical algorithm was applied based on descriptors quantifying similarity/dissimilarity among proteomic fingerprints. This allowed identification of a novel profile (Q-profile based on the presence of 5 SELDI peaks in the 10-12.5 kDa mass area. Women displaying the Q-profile (mean+/-SD, gestational age: 25+/-4 weeks, n = 40 were more likely to deliver preterm despite expectant management in the context of intact membranes and normal amniotic fluid clinical results. Utilizing identification-centered proteomics techniques (fluorescence two-dimensional differential gel electrophoresis, robotic tryptic digestion and mass spectrometry coupled with Protein ANalysis THrough Evolutionary Relationships (PANTHER ontological classifications, we determined that in amniotic fluids with Q-profile the differentially expressed proteins are primarily involved in non-inflammatory biological processes such as protein metabolism, signal transduction and transport.Proteomic profiling of amniotic fluid coupled with non-hierarchical bioinformatics algorithms identified a subgroup of patients at risk for preterm birth in the absence of intra

Stigma gets in my way: Factors affecting client-provider communication regarding childbearing among people living with HIV in Uganda.

Directory of Open Access Journals (Sweden)

Jolly Beyeza-Kashesya

Full Text Available Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda.400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis.75% of the sample was female; 61% were on antiretroviral therapy; and 61% had HIV-negative or unknown status partners. Nearly all (98% reported the desire to discuss childbearing intentions with their HIV provider; however, only 44% reported such discussions, the minority (28% of which was initiated by the provider. Issues discussed with HIV providers included: HIV transmission risk to partner (30%, HIV transmission risk to child (30%, and how to prevent transmission to the child (27%; only 8% discussed safer conception methods. Regression analysis showed that those who had communicated with providers about childbearing were more likely to have been diagnosed with HIV for a longer period [OR (95% CI = 1.09 (1.03, 1.15], while greater internalized childbearing stigma was associated with lower odds of this communication [OR (95% CI = 0.70 (0.49, 0.99], after controlling for all bivariate correlates and basic demographics.Communication between HIV clients and providers about childbearing needs is poor and associated with stigma. Innovations to mitigate stigma among clients as well as training to improve health worker communication and skills related to safer conception counseling is needed.

Multicomponent reactions provide key molecules for secret communication.

Science.gov (United States)

Boukis, Andreas C; Reiter, Kevin; Frölich, Maximiliane; Hofheinz, Dennis; Meier, Michael A R

2018-04-12

A convenient and inherently more secure communication channel for encoding messages via specifically designed molecular keys is introduced by combining advanced encryption standard cryptography with molecular steganography. The necessary molecular keys require large structural diversity, thus suggesting the application of multicomponent reactions. Herein, the Ugi four-component reaction of perfluorinated acids is utilized to establish an exemplary database consisting of 130 commercially available components. Considering all permutations, this combinatorial approach can unambiguously provide 500,000 molecular keys in only one synthetic procedure per key. The molecular keys are transferred nondigitally and concealed by either adsorption onto paper, coffee, tea or sugar as well as by dissolution in a perfume or in blood. Re-isolation and purification from these disguises is simplified by the perfluorinated sidechains of the molecular keys. High resolution tandem mass spectrometry can unequivocally determine the molecular structure and thus the identity of the key for a subsequent decryption of an encoded message.

We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record.

Science.gov (United States)

Sheu, Leslie; Fung, Kelly; Mourad, Michelle; Ranji, Sumant; Wu, Ethel

2015-05-01

Poor communication between hospitalists and outpatient physicians can contribute to adverse events after discharge. Electronic medical records (EMRs) shared by inpatient and outpatient clinicians offer primary care providers (PCPs) better access to information surrounding a patient's hospitalization. However, the PCP experience and subsequent expectations for discharge communication within a shared EMR are unknown. We surveyed PCPs 1 year after a shared EMR was implemented at our institution to assess PCP satisfaction with current discharge communication practices and identify areas for improvement. Seventy-five of 124 (60%) clinicians completed the survey. Although most PCPs reported receiving automated discharge notifications (71%), only 39% felt that notifications plus discharge summaries were adequate for safe transitions of care. PCPs expressed that complex hospitalizations necessitated additional communication via e-mail or telephone; only 31% reported receiving such communication. The content most important in additional communication included medication changes, follow-up actions, and active medical issues. Despite optimized access to information provided by a shared EMR, only 52% of PCPs were satisfied with current discharge communication. PCPs express a continued need for high-touch communication for safe transitions of care. Further standardization of discharge communication practices is necessary. © 2015 Society of Hospital Medicine.

Artificial intelligence and immediacy: designing health communication to personally engage consumers and providers.

Science.gov (United States)

Kreps, Gary L; Neuhauser, Linda

2013-08-01

We describe how ehealth communication programs can be improved by using artificial intelligence (AI) to increase immediacy. We analyzed major deficiencies in ehealth communication programs, illustrating how programs often fail to fully engage audiences and can even have negative consequences by undermining the effective delivery of information intended to guide health decision-making and influence adoption of health-promoting behaviors. We examined the use of AI in ehealth practices to promote immediacy and provided examples from the ChronologyMD project. Strategic use of AI is shown to help enhance immediacy in ehealth programs by making health communication more engaging, relevant, exciting, and actionable. AI can enhance the "immediacy" of ehealth by humanizing health promotion efforts, promoting physical and emotional closeness, increasing authenticity and enthusiasm in health promotion efforts, supporting personal involvement in communication interactions, increasing exposure to relevant messages, reducing demands on healthcare staff, improving program efficiency, and minimizing costs. User-centered AI approaches, such as the use of personally involving verbal and nonverbal cues, natural language translation, virtual coaches, and comfortable human-computer interfaces can promote active information processing and adoption of new ideas. Immediacy can improve information access, trust, sharing, motivation, and behavior changes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Methodical Approaches to Communicative Providing of Retailer Branding

Directory of Open Access Journals (Sweden)

Andrey Kataev

2017-07-01

Full Text Available The thesis is devoted to the rationalization of methodical approaches for provision of branding of retail trade enterprises. The article considers the features of brand perception by retail consumers and clarifies the specifics of customer reviews of stores for the procedures accompanying brand management. It is proved that besides traditional communication mix, the most important tool of communicative influence on buyers is the store itself as a place for comfortable shopping. The shop should have a stimulating effect on all five human senses, including sight, smell, hearing, touch, and taste, which shall help maximize consumer integration into the buying process.

Microfluidic device and method for focusing, segmenting, and dispensing of a fluid stream

Science.gov (United States)

Jacobson, Stephen C [Knoxville, TN; Ramsey, J Michael [Knoxville, TN

2008-09-09

A microfluidic device and method for forming and dispensing minute volume segments of a material are described. In accordance with the present invention, a microfluidic device and method are provided for spatially confining the material in a focusing element. The device is also adapted for segmenting the confined material into minute volume segments, and dispensing a volume segment to a waste or collection channel. The device further includes means for driving the respective streams of sample and focusing fluids through respective channels into a chamber, such that the focusing fluid streams spatially confine the sample material. The device may also include additional means for driving a minute volume segment of the spatially confined sample material into a collection channel in fluid communication with the waste reservoir.

Science Communications: Providing a Return on Investment to the Taxpayer

Science.gov (United States)

Horack, John M.; Borchelt, Rick E.

1999-01-01

Nowhere is the disconnect between needing to better communicate science and technology and the skills and techniques used for that communication more evident than in the Federal research enterprise. As Federal research budgets stagnate or decline, and despite public clamor for more and better scientific information, communication of basic research results continues to rank among the lowest agency priorities, mortgaged against traditional public-relations activities to polish an agency's image or control negative information flow to the press and public. Alone among the Federal agencies, NASA articulates in its strategic plan the need "...to advance and communicate scientific knowledge and understanding..." These words emphasize the reality that if new knowledge is generated but not communicated, only half the job has been done. This is a reflection of the transition of NASA from primarily an engineering organization used to help win the Cold War to a producer of new knowledge and technology in the National interest for the 21st century.

Supporting Early Childhood Educators' Use of Embedded Communication Strategies by Providing Feedback via Bug-in-Ear Technology

Science.gov (United States)

Riggie, Jennifer

2013-01-01

The purpose of this study was to examine the relationship between coaching provided with bug-in-ear technology, the frequency of the early childhood educators' use of targeted communication strategies and children's expressive communication. Four multiple-baseline single-case design experiments were completed to evaluate these relationships.…

Power Relations and Health Care Communication in Older Adulthood: Educating Recipients and Providers.

Science.gov (United States)

Eliassen, A Henry

2016-12-01

Unequal power relations lie just below the surface in much of today's discourse on health care communication with older adults. Focusing on pathologies or deficits tends to reinforce stereotypes of frailty and dependency, thus framing elders as a vulnerable group requiring special assistance. Implicit stereotyping frequently colors interactions of health care personnel with older clients and their families-interactions likely to affect elders' perceptions and health outcomes. Health care providers need to be attuned to the vast and growing diversity in today's older population, wherein many older adults are exemplars of what it takes to marshal resources and cope with multifaceted challenges. Thus, elders have the potential to teach medical personnel through narratives of resilience as well as tribulation. This potential can be fully realized, however, only in contexts where communication patterns characterized by paternalism, consumerism, and collaboration are mutually recognized and selectively challenged or implemented. Promising interventions to facilitate health care communication in older adulthood might well be directed toward (a) educating both recipients and providers to become more mindful of cues that evoke stereotypical thinking, (b) promoting an institutional culture that normalizes situationally appropriate assertive responses to stereotyping, and (c) formally ratifying older adults' life experience in the training of health care personnel. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Endoscopic Management of Peri-Pancreatic Fluid Collections.

Science.gov (United States)

Yip, Hon Chi; Teoh, Anthony Yuen Bun

2017-09-15

In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery. However, an endoscopic "step up" approach in the management of pancreatic walled-off necrosis has also been advocated. Both endoscopic and percutaneous drainage routes may be used depending on the anatomical location of the collections. New-generation large diameter EUS-specific stent systems have also recently been described. The device allows precise and effective drainage of the collections and permits endoscopic necrosectomy through the stents.

A mixed-methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities.

Science.gov (United States)

Shen, Megan Johnson; Binz-Scharf, Maria; D'Agostino, Tom; Blakeney, Natasha; Weiss, Elisa; Michaels, Margo; Patel, Shilpa; McKee, M Diane; Bylund, Carma L

2015-03-15

Research has demonstrated that communication and care coordination improve cancer patient outcomes. To improve communication and care coordination, it is important to understand primary care providers' (PCPs') perceptions of communication with oncologists as well as PCPs' communication needs. A mixed-methods approach was used in the present study. In the qualitative phase of the study, 18 PCPs practicing in underserved, minority communities were interviewed about their experiences communicating with oncologists. In the quantitative phase of the study, 128 PCPs completed an online survey about their preferences, experiences, and satisfaction with communication with oncologists. Results indicated a PCP-oncologist gap in communication occurred between diagnosis and treatment. PCPs wanted more communication with oncologists, updates on their patients' prognosis throughout treatment, and to be contacted via telephone or email and saw their role as crucial in providing supportive care for their patients. Although PCPs recognize that they play a critical, proactive role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding postreferral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of postreferral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients' quality of care, particularly in minority communities. © 2014 American Cancer Society.

Rheo-NMR - how nuclear magnetic resonance is providing new insight regarding complex fluid rheology

International Nuclear Information System (INIS)

Callaghan, P.T.

2000-01-01

Over the past five decades, NMR has revolutionised chemistry, and has found widespread application in condensed matter physics, in molecular biology, in medicine and in food technology. Most recently NMR has made a significant impact in chemical engineering, where it is being extensively used for the non-invasive study of dispersion and flow in porous media. One of the most recent applications of NMR in materials science concerns its use in the study of the mechanical properties of complex fluids. This particular aspect of NMR has been extensively developed in research carried out at Massey University in New Zealand. In this short article, some of the ideas behind this work and the applications which have resulted, will be described. These examples provide a glimpse of possible applications of Nuclear Magnetic Resonance to the study of complex fluid rheology. While this is a very new field of research in which only a handful of groups presently participate, the potential exists for a substantial increase in Rheo-NMR research activity. Systems studied to date include polymer melts and semi-dilute solutions, thermotropic and lyotropic liquid crystals and liquid crystalline polymers, micellar solutions, food materials and colloidal suspensions. Rheo-NMR suffers in a number of respects by comparison with optical methods. It is expensive, it is difficult to use, it suffers from poor signal-to-noise ratios and the effective interpretation of spectra often depends on familiarity with the nuclear spin Hamiltonian and the associated effects of spin dynamics. Nonetheless NMR offers some unique advantages, including the ability to work with opaque materials, the ability to combine velocimetry with localised spectroscopy, and the ability to access a wide range of molecular properties relating to organisation, orientation and dynamics. Rheo-NMR has been able to provide a direct window on a variety of behaviours, including slip, shear-thinning, shear banding, yield stress

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.

Interprovider Communication Using a Scheduled Provider Alert-Response Communication System in 3 Inpatient Neurology Units.

Science.gov (United States)

Siegler, James E; Finegan, Dan; Kasner, Scott E; Price, Raymond S

2017-10-01

Nonemergent communications between nursing staff and residents often occur randomly throughout the workday at teaching institutions, resulting in inefficiency and interruptions of scheduled resident educational conferences or periods of overnight rest. The aim of this study was to determine whether a quality improvement communication strategy can reduce interruptive notifications during scheduled resident didactic sessions. We conducted a prospective, mixed-methods trial of a communication strategy between nurses and residents in 3 neurology units of an academic institution. We measured content and volume of notifications from nurses to residents during scheduled conferences and overnight and categorized these notifications according to levels of urgency. We implemented an intervention requiring multidisciplinary evening work rounds between the on-call resident and charge nurse and batching of nonemergent communications. Survey data were collected. The total census during the 6-month study period was 728 patients. Of the 704 resident-reported nursing notifications, 50% could be safely deferred until change of shift. After the intervention, there was a 52% decrement of notifications (0.52 vs 0.25 notifications per patient, P communication system reduced interruptive calls during educational conferences and overnight by half. This intervention was perceived as safe and effective and resulted in higher satisfaction among participants.

Standardization of Thermo-Fluid Modeling in Modelica.Fluid

Energy Technology Data Exchange (ETDEWEB)

Franke, Rudiger; Casella, Francesco; Sielemann, Michael; Proelss, Katrin; Otter, Martin; Wetter, Michael

2009-09-01

This article discusses the Modelica.Fluid library that has been included in the Modelica Standard Library 3.1. Modelica.Fluid provides interfaces and basic components for the device-oriented modeling of onedimensional thermo-fluid flow in networks containing vessels, pipes, fluid machines, valves and fittings. A unique feature of Modelica.Fluid is that the component equations and the media models as well as pressure loss and heat transfer correlations are decoupled from each other. All components are implemented such that they can be used for media from the Modelica.Media library. This means that an incompressible or compressible medium, a single or a multiple substance medium with one or more phases might be used with one and the same model as long as the modeling assumptions made hold. Furthermore, trace substances are supported. Modeling assumptions can be configured globally in an outer System object. This covers in particular the initialization, uni- or bi-directional flow, and dynamic or steady-state formulation of mass, energy, and momentum balance. All assumptions can be locally refined for every component. While Modelica.Fluid contains a reasonable set of component models, the goal of the library is not to provide a comprehensive set of models, but rather to provide interfaces and best practices for the treatment of issues such as connector design and implementation of energy, mass and momentum balances. Applications from various domains are presented.

Fluid inclusion geothermometry

Science.gov (United States)

Cunningham, C.G.

1977-01-01

Fluid inclusions trapped within crystals either during growth or at a later time provide many clues to the histories of rocks and ores. Estimates of fluid-inclusion homogenization temperature and density can be obtained using a petrographic microscope with thin sections, and they can be refined using heating and freezing stages. Fluid inclusion studies, used in conjunction with paragenetic studies, can provide direct data on the time and space variations of parameters such as temperature, pressure, density, and composition of fluids in geologic environments. Changes in these parameters directly affect the fugacity, composition, and pH of fluids, thus directly influencing localization of ore metals. ?? 1977 Ferdinand Enke Verlag Stuttgart.

Fluids engineering

International Nuclear Information System (INIS)

Anon.

1991-01-01

Fluids engineering has played an important role in many applications, from ancient flood control to the design of high-speed compact turbomachinery. New applications of fluids engineering, such as in high-technology materials processing, biotechnology, and advanced combustion systems, have kept up unwaining interest in the subject. More accurate and sophisticated computational and measurement techniques are also constantly being developed and refined. On a more fundamental level, nonlinear dynamics and chaotic behavior of fluid flow are no longer an intellectual curiosity and fluid engineers are increasingly interested in finding practical applications for these emerging sciences. Applications of fluid technology to new areas, as well as the need to improve the design and to enhance the flexibility and reliability of flow-related machines and devices will continue to spur interest in fluids engineering. The objectives of the present seminar were: to exchange current information on arts, science, and technology of fluids engineering; to promote scientific cooperation between the fluids engineering communities of both nations, and to provide an opportunity for the participants and their colleagues to explore possible joint research programs in topics of high priority and mutual interest to both countries. The Seminar provided an excellent forum for reviewing the current state and future needs of fluids engineering for the two nations. With the Seminar ear-marking the first formal scientific exchange between Korea and the United States in the area of fluids engineering, the scope was deliberately left broad and general

Installations having pressurised fluid circuits

International Nuclear Information System (INIS)

Rigg, S.; Grant, J.

1977-01-01

Reference is made to nuclear installations having pressurised coolant flow circuits. Breaches in such circuits may quickly result in much damage to the plant. Devices such as non-return valves, orifice plates, and automatically operated shut-off valves have been provided to prevent or reduce fluid flow through a breached pipe line, but such devices have several disadvantages; they may present large restrictions to normal flow of coolant, and may depend on the operation of ancillary equipment, with consequent delay in bringing them into operation in an emergency. Other expedients that have been adopted to prevent or reduce reverse flow through an upstream breach comprise various forms of hydraulic counter flow brakes. The arrangement described has at least one variable fluid brake comprising a fluidic device connected into a duct in the pressurised circuit, the device having an inlet, an outlet, a vortex chamber between the inlet and outlet, a control jet for introducing fluid into the vortex chamber, connections communicating the inlet and the outlet into one part of the circuit and the control jet into another region at a complementary pressure so that, in the event of a breach in the circuit in one region, fluid passes from the other region to enter the vortex chamber to stimulate pressure to create a flow restricting vortex in the chamber that reduces flow through the breach. The system finds particular application to stream generating pressure tube reactors, such as the steam generating heavy water reactor at UKAEA, Winfrith. (U.K.)

The association between parent-reported provider communication quality and child obesity status: Variation by parent obesity and child race/ethnicity.

Science.gov (United States)

Wong, Michelle S; Showell, Nakiya N; Bleich, Sara N; Gudzune, Kimberly A; Chan, Kitty S

2017-08-01

To examine the association between healthcare provider communication quality and child obesity status, and the role of parent obesity and child race/ethnicity regarding this association. We conducted a cross-sectional secondary data analysis with the 2011-2013 Medical Expenditures Panel Survey of parents with children ages 6-12 (n=5390). We used multivariable logistic regression to examine the association of parent-reported healthcare provider communication quality (explaining well, listening carefully, showing respect, and spending enough time) with child obesity status, and effect modification by parent obesity and child race/ethnicity. Parents of obese children were more likely to report that their child's healthcare provider listened carefully (OR=1.41, p=0.002) and spent enough time (OR=1.33, p=0.022) than parents of non-obese children. Non-obese parents of obese children experienced better communication in the domains of listening carefully (pobese non-Hispanic Asian children and non-Hispanic Black children were more likely to report that providers explained things well (p=0.043) and listened carefully (p=0.012), respectively. Parents of obese children experienced better communication if parents were non-obese or children were non-Hispanic Black or Asian. Healthcare providers should ensure effective communication with obese parents of obese children. Copyright © 2017 Elsevier B.V. All rights reserved.

Communicating the benefits of combination vaccines to parents and health care providers.

Science.gov (United States)

Koslap-Petraco, Mary Beth; Parsons, Tamra

2003-01-01

Infants may receive as many as 5 separate injections at an office visit in order to comply with the 2002 childhood immunization schedule. Many parents and healthcare providers disagree with administering 4 or 5 injections at one visit, and therefore may delay some injections until another visit. This practice may lead to decreased compliance and can increase costs for the parent. New combination vaccines will help to simplify the immunization schedule, and health care providers will need to be able to address parental concerns regarding these vaccines. Nurses are often responsible for administering vaccines in the office setting, and therefore are also influential in deciding which vaccines should be ordered. The purpose of this article is to educate nurses on communicating the benefits of combination vaccines to parents and other healthcare providers.

A mixed methods study of patient-provider communication about opioid analgesics.

Science.gov (United States)

Hughes, Helen Kinsman; Korthuis, Philip Todd; Saha, Somnath; Eggly, Susan; Sharp, Victoria; Cohn, Jonathan; Moore, Richard; Beach, Mary Catherine

2015-04-01

To describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. We audio-recorded 45 HIV providers and 423 patients in routine outpatient encounters at four sites across the country. Providers completed post-visit questionnaires assessing their attitudes toward patients. We identified discussions about opioid pain management and analyzed them qualitatively. We used logistic regression to assess the association between opioid discussion and providers' attitudes toward patients. 48 encounters (11% of the total sample) contained substantive discussion of opioid-related pain management. Most conversations were initiated by patients (n=28, 58%) and ended by the providers (n=36, 75%). Twelve encounters (25%) contained dialog suggesting a difference of opinion or conflict. Providers more often agreed than disagreed to give the prescription (50% vs. 23%), sometimes reluctantly; in 27% (n=13) of encounters, no decision was made. Fewer than half of providers (n=20, 42%) acknowledged the patient's experience of pain. Providers had a lower odds of positive regard for the patient (adjusted OR=0.51, 95% CI: 0.27-0.95) when opioids were discussed. Pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients. Empathy and pain acknowledgment are tools that clinicians can use to facilitate productive discussions of pain management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Modern fluid dynamics

CERN Document Server

Kleinstreuer, Clement

2018-01-01

Modern Fluid Dynamics, Second Edition provides up-to-date coverage of intermediate and advanced fluids topics. The text emphasizes fundamentals and applications, supported by worked examples and case studies. Scale analysis, non-Newtonian fluid flow, surface coating, convection heat transfer, lubrication, fluid-particle dynamics, microfluidics, entropy generation, and fluid-structure interactions are among the topics covered. Part A presents fluids principles, and prepares readers for the applications of fluid dynamics covered in Part B, which includes computer simulations and project writing. A review of the engineering math needed for fluid dynamics is included in an appendix.

Impacts of mobile tablet computing on provider productivity, communications, and the process of care.

Science.gov (United States)

Schooley, Benjamin; Walczak, Steven; Hikmet, Neset; Patel, Nitin

2016-04-01

Health information technology investments continue to increase while the value derived from their implementation and use is mixed. Mobile device adoption into practice is a recent trend that has increased dramatically and formal studies are needed to investigate consequent benefits and challenges. The objective of this study is to evaluate practitioner perceptions of improvements in productivity, provider-patient communications, care provision, technology usability and other outcomes following the adoption and use of a tablet computer connected to electronic health information resources. A pilot program was initiated in June 2013 to evaluate the effect of mobile tablet computers at one health provider organization in the southeast United States. Providers were asked to volunteer for the evaluation and were each given a mobile tablet computer. A total of 42 inpatient and outpatient providers were interviewed in 2015 using a survey style questionnaire that utilized yes/no, Likert-style, and open ended questions. Each had previously used an electronic health record (EHR) system a minimum of one year outside of residency, and were regular users of personal mobile devices. Each used a mobile tablet computer in the context of their practice connected to the health system EHR. The survey results indicate that more than half of providers perceive the use of the tablet device as having a positive effect on patient communications, patient education, patient's perception of the provider, time spent interacting with patients, provider productivity, process of care, satisfaction with EHR when used together with the device, and care provision. Providers also reported feeling comfortable using the device (82.9%), would recommend the device to colleagues (69.2%), did not experience increased information security and privacy concerns (95%), and noted significant reductions in EHR login times (64.1%). Less than 25% of participants reported negative impacts on any of these areas as

Impact of Family History Assessment on Communication with Family Members and Health Care Providers: A report from the Family Healthware™ Impact Trial (FHITr)

Science.gov (United States)

Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T.; O'Neill, Suzanne M.; Rubinstein, Wendy S.; Acheson, Louise S.

2015-01-01

Objective This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. Methods A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6 month follow-up, adjusting for age, site and practice clustering. Results A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (psfamily members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Conclusion Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. PMID:25901453

Patient-provider communication and reproductive health among HIV-positive women in Rio de Janeiro, Brazil.

Science.gov (United States)

Malta, Monica; Todd, Catherine S; Stibich, Mark A; Garcia, Thais; Pacheco, Diego; Bastos, Francisco I

2010-12-01

To qualitatively assess the influence of patient-provider communication on contraceptive choice among HIV-positive women in the context of universal antiretroviral therapy (ART) access. Focus group discussions (FGD; n=3), in-depth (IDI; n=15) and freelist interviews (FLI; n=36) were conducted with HIV-positive women aged 18-40 years recruited from public health units in Rio de Janeiro/Brazil. Of 70 participants, 49 used ART and the median time since HIV diagnosis was 6 years (range: 1-18). The majority of participants (71.4%) reported some degree of dissatisfaction with their health providers (usually lack of open dialogue) and a few reported experiences of stigma/prejudice during appointments. Intra, interpersonal and social factors modulated behaviors and reproductive health decisions, and those issues were rarely addressed by providers during HIV clinical care. Despite dramatic increases in survival and life quality after universal ART implementation in Brazil, reproductive health issues are neglected by multiple cadres of HIV health providers. Communication on reproductive health issues remains fragmented and potentially contradictory, compromising care in these settings. Adequate provider training to address reproductive health-related issues in a comprehensive, culturally sensitive manner and improved integration of HIV and reproductive health care are urgently needed in this setting. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Barriers to Office-Based Mental Health Care and Interest in E-Communication With Providers: A Survey Study.

Science.gov (United States)

Rai, Minnie; Vigod, Simone N; Hensel, Jennifer M

2016-08-01

With rising availability and use of Internet and mobile technology in society, the demand and need for its integration into health care is growing. Despite great potential within mental health care and growing uptake, there is still little evidence to guide how these tools should be integrated into traditional care, and for whom. To examine factors that might inform how e-communication should be implemented in our local outpatient mental health program, including barriers to traditional office-based care, patient preferences, and patient concerns. We conducted a survey in the waiting room of our outpatient mental health program located in an urban, academic ambulatory hospital. The survey assessed (1) age, mobile phone ownership, and general e-communication usage, (2) barriers to attending office-based appointments, (3) preferences for, and interest in, e-communication for mental health care, and (4) concerns about e-communication use for mental health care. We analyzed the data descriptively and examined associations between the presence of barriers, identifying as a social media user, and interest level in e-communication. Respondents (N=68) were predominantly in the age range of 25-54 years. The rate of mobile phone ownership was 91% (62/68), and 59% (40/68) of respondents identified as social media users. There was very low existing use of e-communication between providers and patients, with high levels of interest endorsed by survey respondents. Respondents expressed an interest in using e-communication with their provider to share updates and get feedback, coordinate care, and get general information. In regression analysis, both a barrier to care and identifying as a social media user were significantly associated with e-communication interest (P=.03 and P=.003, respectively). E-communication interest was highest among people who both had a barrier to office-based care and were a social media user. Despite high interest, there were also many concerns

Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork.

Science.gov (United States)

Clark, Phillip G

2014-01-01

Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

Examination of Routine Use of Prenatal Weight Gain Charts as a Communication Tool for Providers.

Science.gov (United States)

Aguilera, Marijo; Sidebottom, Abbey C; McCool, Brigitte R

2017-10-01

Objectives In 2009 the IOM revised prenatal weight gain guidelines. The primary purpose of this pilot study was to assess if provider education and use of prenatal weight gain charts to track weight gain and counsel patients was associated with better patient and provider knowledge and communication about the guidelines. Methods A prospective non-randomized study conducted in four OB practices (two control, two intervention). Data sources included provider surveys (n = 16 intervention, 21 control), patient surveys (n = 332), and medical records. Intervention clinics received provider education on the IOM guidelines and used patient education materials and prenatal weight gain charts to track weight gain and as a counseling tool. Comparison clinics received no education and did not use the charts or patient education information. Results More patients at intervention clinics (92.3%) reported that a provider gave them advice about weight gain, compared to patients from comparison clinics (66.4%) (p gain (83.1 vs. 64.3%, p = 0.007). Intervention clinic patients were more likely to have knowledge of the guidelines indicated by 72.3% reporting a target weight gain amount within the guidelines versus 50.4% of comparison patients (p gain charts resulted in higher patient reported communication about weight gain from their provider, higher patient satisfaction with those discussions, and better knowledge of the appropriate target weight gain goals.

Provider communication behaviors that predict motivation to change in black adolescents with obesity.

Science.gov (United States)

Carcone, April Idalski; Naar-King, Sylvie; Brogan, Kathryn E; Albrecht, Terrance; Barton, Ellen; Foster, Tanina; Martin, Tim; Marshall, Sharon

2013-10-01

The goal of this research was to identify communication behaviors used by weight loss counselors that mostly strongly predicted black adolescents' motivational statements. Three types of motivational statements were of interest: change talk (CT; statements describing their own desires, abilities, reasons, and need for adhering to weight loss recommendations), commitment language (CML; statements about their intentions or plans for adhering), and counterchange talk (CCT; amotivational statements against change and commitment). Thirty-seven black adolescents with obesity received a single motivational interviewing session targeting weight-related behaviors. The video-recorded transcribed sessions were coded using the Minority Youth Sequential Coding for Observing Process Exchanges generating a sequential chain of communication. Data were then subjected to sequential analysis to determine causal relationships between counselor and adolescent communication. Asking open-ended questions to elicit adolescent CT and emphasizing adolescents' autonomy most often led to CT. Open-ended questions to elicit CML, reflecting adolescent CML, and emphasizing autonomy most often led to CML. In contrast, open-ended questions to elicit CCT, reflecting CCT, reflecting ambivalence, and neutral open-ended questions about the target behavior led to CCT. This study provides clinicians with insight into the most effective way to communicate with black adolescents with obesity about weight loss. Specifically, reflective statements and open questions focusing on their own desires, abilities, reasons, need, and commitment to weight loss recommendations are more likely to increase motivational statements, whereas other types of reflections and questions may be counterproductive. Finally, because adolescents have a strong need for autonomous decision making, emphasizing their autonomy may be particularly effective in evoking motivational statements.

Fluid resuscitation practices in cardiac surgery patients in the USA: a survey of health care providers

Directory of Open Access Journals (Sweden)

Solomon Aronson

2017-10-01

Full Text Available Abstract Background Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. Methods We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1 patients undergoing cardiopulmonary bypass (CPB without bleeding, (2 patients undergoing CPB with bleeding, (3 patients undergoing acute normovolemic hemodilution (ANH, (4 patients requiring extracorporeal membrane oxygenation (ECMO or use of a ventricular assist device (VAD, and (5 patients undergoing either off-pump coronary artery bypass graft (OPCABG surgery or transcatheter aortic valve replacement (TAVR. First-choice fluid used in fluid boluses for these five patient types was requested. Descriptive statistics were performed using Kruskal-Wallis test and follow-up tests, including t tests, to evaluate differences among respondent groups. Results The most commonly preferred indicators of volume status were blood pressure, urine output, cardiac output, central venous pressure, and heart rate. The first choice of fluid for patients needing volume expansion during CPB without bleeding was crystalloids, whereas 5% albumin was the most preferred first choice of fluid for bleeding patients. For volume expansion during ECMO or VAD, the respondents were equally likely to prefer 5% albumin or crystalloids as a first choice of IV fluid, with 5% albumin being the most frequently used adjunct fluid to crystalloids. Surgeons, as a group, more often chose starches as an adjunct fluid to crystalloids for patients needing volume expansion during CPB without bleeding. Surgeons

10th International Symposium on Applications of Laser Techniques to Fluid Mechanics

CERN Document Server

Adrian, R J; Heitor, M V; Maeda, M; Tropea, C; Whitelaw, J H

2002-01-01

This volume includes revised and extended versions of selected papers presented at the Tenth International Symposium on Applications of Laser Techniques to Fluid Mechanics held at the Calouste Gulbenkian Foundation in Lisbon, during the period of July 10 to 13, 2000. The papers describe instrumentation developments for Velocity, Scalar and Multi-Phase Flows and results of measurements of Turbulent Flows, and Combustion and Engines. The papers demonstrate the continuing and healthy interest in the development of understanding of new methodologies and implementation in terms of new instrumentation. The prime objective of the Tenth Symposium was to provide a forum for the presentation of the most advanced research on laser techniques for flow measurements, and communicate significant results to fluid mechanics. The application of laser techniques to scientific and engineering fluid flow research was emphasized, but contributions to the theory and practice of laser methods were also considered where they facilita...

Impact of family history assessment on communication with family members and health care providers: A report from the Family Healthware™ Impact Trial (FHITr).

Science.gov (United States)

Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T; O'Neill, Suzanne M; Rubinstein, Wendy S; Acheson, Louise S

2015-08-01

This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6month follow-up, adjusting for age, site and practice clustering. A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (p'scommunicating at baseline and those who were not. Among participants who were not communicating at baseline, intervention participants had higher odds of communicating with family members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns

International Nuclear Information System (INIS)

Eguchi, Takahiko; Nikaido, Yuji; Shiomi, Kazuaki; Fujimoto, Takatoshi; Otsuka, Hiroyuki; Takeuchi, Hiroshi; Taoka, Toshiaki.

1996-01-01

Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre-and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space. (author)

The human factor: the critical importance of effective teamwork and communication in providing safe care.

Science.gov (United States)

Leonard, M; Graham, S; Bonacum, D

2004-10-01

Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members to unsafe situations. All too frequently, effective communication is situation or personality dependent. Other high reliability domains, such as commercial aviation, have shown that the adoption of standardised tools and behaviours is a very effective strategy in enhancing teamwork and reducing risk. We describe our ongoing patient safety implementation using this approach within Kaiser Permanente, a non-profit American healthcare system providing care for 8.3 million patients. We describe specific clinical experience in the application of surgical briefings, properties of high reliability perinatal care, the value of critical event training and simulation, and benefits of a standardised communication process in the care of patients transferred from hospitals to skilled nursing facilities. Additionally, lessons learned as to effective techniques in achieving cultural change, evidence of improving the quality of the work environment, practice transfer strategies, critical success factors, and the evolving methods of demonstrating the benefit of such work are described.

Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study.

Science.gov (United States)

Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

2016-05-01

In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. In-depth interviews (IDIs) were conducted with 48 HIV infected women receiving ART at 7 different HIV clinics providing comprehensive HIV care services in four districts in Uganda, between July and August 2012. All women were aware of their HIV diagnosis prior to pregnancy or had given birth while living with HIV. Four themes emerged describing barriers to communication, from the HIV-positive women's point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider's emphasis on 'scientific' facts, (iv) 'accidental pregnancy'. Existing evidence regarding effective provider-patient communication should be considered for its application for reproductive counseling among HIV infected women. These data demonstrate the need for current counseling guidelines to explore approaches that encourage open, non-judgmental, non-directive discussions with HIV positive individuals around their reproductive desires and intentions in a health care setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Colorectal cancer screening at US community health centers: Examination of sociodemographic disparities and association with patient-provider communication.

Science.gov (United States)

Lin, Sue C; McKinley, Duane; Sripipatana, Alek; Makaroff, Laura

2017-11-01

Colorectal cancer (CRC) screening rates are low among underserved populations. High-quality patient-physician communication potentially influences patients' willingness to undergo CRC screening. Community health centers (HCs) provide comprehensive primary health care to underserved populations. This study's objectives were to ascertain national CRC screening rates and to explore the relations between sociodemographic characteristics and patient-provider communication on the receipt of CRC screening among HC patients. Using 2014 Health Center Patient Survey data, bivariate and multivariate analyses examined the association of sociodemographic variables (sex, race/ethnicity, age, geography, preferred language, household income, insurance, and employment status) and patient-provider communication with the receipt of CRC screening. Patients between the ages of 65 and 75 years (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.33-4.64) and patients not in the labor force (aOR, 2.32; 95% CI, 1.37-3.94) had higher odds of receiving CRC screening, whereas patients who were uninsured (aOR, 0.33; 95% CI, 0.18-0.61) and patients who were non-English-speaking (aOR, 0.42; 95% CI, 0.18-0.99) had lower odds. Patient-provider communication was not associated with the receipt of CRC screening. The CRC screening rate for HC patients was 57.9%, whereas the rate was 65.1% according to the 2012 Behavioral Risk Factor Surveillance System and 58.2% according to the 2013 National Health Interview Survey. The high ratings of patient-provider communication, regardless of the screening status, suggest strides toward a patient-centered medical home practice transformation that will assist in a positive patient experience. Addressing the lack of insurance, making culturally and linguistically appropriate patient education materials available, and training clinicians and care teams in cultural competency are critical for increasing future CRC screening rates. Cancer 2017

Communications device identification methods, communications methods, wireless communications readers, wireless communications systems, and articles of manufacture

Science.gov (United States)

Steele, Kerry D [Kennewick, WA; Anderson, Gordon A [Benton City, WA; Gilbert, Ronald W [Morgan Hill, CA

2011-02-01

Communications device identification methods, communications methods, wireless communications readers, wireless communications systems, and articles of manufacture are described. In one aspect, a communications device identification method includes providing identification information regarding a group of wireless identification devices within a wireless communications range of a reader, using the provided identification information, selecting one of a plurality of different search procedures for identifying unidentified ones of the wireless identification devices within the wireless communications range, and identifying at least some of the unidentified ones of the wireless identification devices using the selected one of the search procedures.

Enhancing client welfare through better communication of private mental health data between rural service providers

Directory of Open Access Journals (Sweden)

Oliver Kisalay Burmeister

2015-11-01

Full Text Available Client welfare is detrimentally affected by poor communication of data between rural service providers, which in part is complicated by privacy legislation. A study of service provision involving interviews with mental health professionals, found challenges in communicative processes between agencies were exacerbated by the heavy workloads. Dependence on individual interpretations of legislation, and on manual handling, led to delays that detrimentally affected client welfare. The main recommendation arising from this article is the creation of an ehealth system that is able to negotiate differing levels of access to client data through centralised controls, where the administration of that system ensures that it stays current with changing legislative requirements. The main contribution of the proposed model is to combine two well-known concepts: data integration and generalisation. People with mental illness are amongst the most vulnerable members of society, and current ehealth systems that provide access to medical records inadequately cater to their needs.

Insertable fluid flow passage bridgepiece and method

Science.gov (United States)

Jones, Daniel O.

2000-01-01

A fluid flow passage bridgepiece for insertion into an open-face fluid flow channel of a fluid flow plate is provided. The bridgepiece provides a sealed passage from a columnar fluid flow manifold to the flow channel, thereby preventing undesirable leakage into and out of the columnar fluid flow manifold. When deployed in the various fluid flow plates that are used in a Proton Exchange Membrane (PEM) fuel cell, bridgepieces of this invention prevent mixing of reactant gases, leakage of coolant or humidification water, and occlusion of the fluid flow channel by gasket material. The invention also provides a fluid flow plate assembly including an insertable bridgepiece, a fluid flow plate adapted for use with an insertable bridgepiece, and a method of manufacturing a fluid flow plate with an insertable fluid flow passage bridgepiece.

Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?

Science.gov (United States)

Dexter, Eve N; Fields, Scott; Rdesinski, Rebecca E; Sachdeva, Bhavaya; Yamashita, Daisuke; Marino, Miguel

2016-01-01

Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital. All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload. © Copyright 2016 by the American Board of Family Medicine.

Methods of conveying fluids and methods of sublimating solid particles

Science.gov (United States)

Turner, Terry D; Wilding, Bruce M

2013-10-01

A heat exchanger and associated methods for sublimating solid particles therein, for conveying fluids therethrough, or both. The heat exchanger includes a chamber and a porous member having a porous wall having pores in communication with the chamber and with an interior of the porous member. A first fluid is conveyed into the porous member while a second fluid is conveyed into the porous member through the porous wall. The second fluid may form a positive flow boundary layer along the porous wall to reduce or eliminate substantial contact between the first fluid and the interior of the porous wall. The combined first and second fluids are conveyed out of the porous member. Additionally, the first fluid and the second fluid may each be conveyed into the porous member at different temperatures and may exit the porous member at substantially the same temperature.

Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools.

Science.gov (United States)

Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita

2015-01-01

The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.

Sensor and transmitter system for communication in pipelines

Science.gov (United States)

Cooper, John F.; Burnham, Alan K.

2013-01-29

A system for sensing and communicating in a pipeline that contains a fluid. An acoustic signal containing information about a property of the fluid is produced in the pipeline. The signal is transmitted through the pipeline. The signal is received with the information and used by a control.

Acoustic system for communication in pipelines

Science.gov (United States)

Martin, II, Louis Peter; Cooper, John F [Oakland, CA

2008-09-09

A system for communication in a pipe, or pipeline, or network of pipes containing a fluid. The system includes an encoding and transmitting sub-system connected to the pipe, or pipeline, or network of pipes that transmits a signal in the frequency range of 3-100 kHz into the pipe, or pipeline, or network of pipes containing a fluid, and a receiver and processor sub-system connected to the pipe, or pipeline, or network of pipes containing a fluid that receives said signal and uses said signal for a desired application.

Lagrangian finite element formulation for fluid-structure interaction and application

International Nuclear Information System (INIS)

Hautfenne, M.H.

1983-01-01

The aim of this communication is to present a new finite element software (FLUSTRU) for fluid-structure interaction in a lagrangian formulation. The stiffness and damping matrices of the fluid are computed from the governing laws of the medium: the fluid is supposed to be viscous and compressible (Stokes' equations). The main problem stated by the lagrangian formulation of the fluid is the presence of spurious free-vibration modes (zero energy modes) in the fluid. Those modes are generated by the particular form of the matrix. These spurious modes have been examined and two particular methods to eliminate them have been developed: industrial applications prove the efficiency of the proposed methods. (orig./GL)

Communication between cochlear perilymph and cerebrospinal fluid through the cochlear modiolus visualized after intratympanic administration of Gd-DTPA

International Nuclear Information System (INIS)

Naganawa, Shinji; Satake, Hiroko; Iwano, Shingo; Sone, Michihiko; Nakashima, Tsutomu

2008-01-01

Intratympanic injection of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) has been reported as a procedure to visualize endolymphatic hydrops of Meniere's disease. We frequently noted that cerebrospinal fluid (CSF) in the internal auditory canal (IAC) was also enhanced after this procedure. The purpose of this study was to evaluate how frequently this occurs and to investigate the specific features of patients who lack this communication. A total of 25 patients with clinically suspected endolymphatic hydrops underwent the procedure. After 24 h, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and 3D constructive interference in steady state (3D-CISS) were performed. The presence of contrast enhancement in the CSF space of the fundus of the IAC was evaluated. The contrast ratio between CSF of the IAC fundus and cerebellar white matter on the injected side was 1.49±0.65, and that of the noninjected side was 0.32±0.16 (P<0.01). Enhancement of the CSF space in the IAC fundus was seen in all but two subjects: one had enlarged endolymphatic duct and sac syndrome (EEDS), and the other had cochlear nerve agenesis. In these two patients, the cochlear modiolus seemed to be normal. Intratympanic Gd-DTPA administration can reveal permeability of the modiolus and might facilitate evaluation of functional abnormalities of the modiolus not detected by conventional imaging tests. (author)

New mission requirements methodologies for services provided by the Office of Space Communications

Science.gov (United States)

Holmes, Dwight P.; Hall, J. R.; Macoughtry, William; Spearing, Robert

1993-01-01

The Office of Space Communications, NASA Headquarters, has recently revised its methodology for receiving, accepting and responding to customer requests for use of that office's tracking and communications capabilities. This revision is the result of a process which has become over-burdened by the size of the currently active and proposed missions set, requirements reviews that focus on single missions rather than on mission sets, and negotiations most often not completed early enough to effect needed additions to capacity or capability prior to launch. The requirements-coverage methodology described is more responsive to project/program needs and provides integrated input into the NASA budget process early enough to effect change, and describes the mechanisms and tools in place to insure a value-added process which will benefit both NASA and its customers. Key features of the requirements methodology include the establishment of a mechanism for early identification of and systems trades with new customers, and delegates the review and approval of requirements documents to NASA centers in lieu of Headquarters, thus empowering the system design teams to establish and negotiate the detailed requirements with the user. A Mission Requirements Request (MRR) is introduced to facilitate early customer interaction. The expected result is that the time to achieve an approved set of implementation requirements which meet the customer's needs can be greatly reduced. Finally, by increasing the discipline in requirements management, through the use of base lining procedures, a tighter coupling between customer requirements and the budget is provided. A twice-yearly projection of customer requirements accommodation, designated as the Capacity Projection Plan (CPP), provides customer feedback allowing the entire mission set to be serviced.

Numerical simulation of cerebrospinal fluid hydrodynamics in the healing process of hydrocephalus patients

Science.gov (United States)

Gholampour, S.; Fatouraee, N.; Seddighi, A. S.; Seddighi, A.

2017-05-01

Three-dimensional computational models of the cerebrospinal fluid (CSF) flow and brain tissue are presented for evaluation of their hydrodynamic conditions before and after shunting for seven patients with non-communicating hydrocephalus. One healthy subject is also modeled to compare deviated patients data to normal conditions. The fluid-solid interaction simulation shows the CSF mean pressure and pressure amplitude (the superior index for evaluation of non-communicating hydrocephalus) in patients at a greater point than those in the healthy subject by 5.3 and 2 times, respectively.

Communication between Asian American Adolescents and Health Care Providers about Sexual Activity, Sexually Transmitted Infections, and Pregnancy Prevention

Science.gov (United States)

Zhao, Jessie; Lau, May; Vermette, David; Liang, David; Flores, Glenn

2017-01-01

Asian American adolescents have been reported to have the lowest amount of communication with health care providers regarding sexual health topics (sexual activity, contraception, sexually transmitted infections, and pregnancy prevention). This study identified Asian American adolescents' attitudes/beliefs regarding how health care providers can…

Fluid Mechanics An Introduction to the Theory of Fluid Flows

CERN Document Server

Durst, Franz

2008-01-01

Advancements of fluid flow measuring techniques and of computational methods have led to new ways to treat laminar and turbulent flows. These methods are extensively used these days in research and engineering practise. This also requires new ways to teach the subject to students at higher educational institutions in an introductory manner. The book provides the knowledge to students in engineering and natural science needed to enter fluid mechanics applications in various fields. Analytical treatments are provided, based on the Navier-Stokes equations. Introductions are also given into numerical and experimental methods applied to flows. The main benefit the reader will derive from the book is a sound introduction into all aspects of fluid mechanics covering all relevant subfields.

Development and implementation of an objective structured clinical examination to provide formative feedback on communication and interpersonal skills in geriatric training.

Science.gov (United States)

O'Sullivan, Patricia; Chao, Serena; Russell, Matthew; Levine, Sharon; Fabiny, Anne

2008-09-01

Teaching and assessment of communication and interpersonal skills, one of the American Council for Graduate Medical Education-designated core competencies, is an important but difficult task in the training of physicians. Assessment of trainees offers an opportunity to provide explicit feedback on their skills and encourages learning. This article describes a pilot study in which clinician-educators affiliated with the geriatrics training programs at Beth Israel Deaconess Medical Center and Boston University Medical Center designed and piloted a novel Objective Structured Clinical Examination (OSCE) to assess the communication and interpersonal skills of medical, dental, and geriatric psychiatry fellows. The OSCE consisted of three stations where geriatricians and standardized patients evaluated candidates using specifically designed checklists and an abbreviated version of the Master Interview Rating Scale. Communication skills were assessed through performance of specific "real life" clinical tasks, such as obtaining a medical history, explaining a diagnosis and prognosis, giving therapeutic instructions, and counseling. Interpersonal skills were assessed through the effect of the communication between doctor and standardized patient on fostering trust, relieving anxiety, and establishing a therapeutic relationship. This pilot study demonstrated that the OSCE format of assessment provides a valid means of evaluating the communication and interpersonal skills of interdisciplinary geriatric trainees and provides a valuable forum for formative assessment and feedback. Given that geriatricians and non geriatricians involved in elder care both need communication and interpersonal skills, this novel OSCE can be used for assessment of these skills in trainees in diverse healthcare subspecialties.

Hollow fiber apparatus and use thereof for fluids separations and heat and mass transfers

Energy Technology Data Exchange (ETDEWEB)

Bikson, Benjamin; Etter, Stephen; Ching, Nathaniel

2017-04-18

A hollow fiber fluid separation device includes a hollow fiber cartridge, comprising a plurality of hollow fiber membranes arranged around a central tubular core, a first tubesheet and a second tubesheet encapsulating respective distal ends of the hollow fiber bundle. The tubesheets have boreholes in fluid communication with bores of the hollow fiber membrane. In at least one of the tubesheets, the boreholes are formed radially and are in communication with the central tubular core. The hollow fiber fluid separation device can be utilized in liquid separation applications such as ultrafiltration and in gas separation processes such as air separation. The design disclosed herein is light weight and compact and is particularly advantageous at high operating temperatures when the pressure of the feed fluid introduced into the bores of hollow fibers is higher than the pressure on the shell side of the device.

How the Ethnography of Communication Provides Resources for Design

Science.gov (United States)

Leighter, James L.; Rudnick, Lisa; Edmonds, Theresa J.

2013-01-01

Designing solutions to social problems requires some degree of interpretive accountability to the sociocultural systems in which design solutions must live. Our case studies show how ethnography of communication research generates distinctive resources for design. (Contains 5 notes.)

Amniotic fluid RNA gene expression profiling provides insights into the phenotype of Turner syndrome.

Science.gov (United States)

Massingham, Lauren J; Johnson, Kirby L; Scholl, Thomas M; Slonim, Donna K; Wick, Heather C; Bianchi, Diana W

2014-09-01

Turner syndrome is a sex chromosome aneuploidy with characteristic malformations. Amniotic fluid, a complex biological material, could contribute to the understanding of Turner syndrome pathogenesis. In this pilot study, global gene expression analysis of cell-free RNA in amniotic fluid supernatant was utilized to identify specific genes/organ systems that may play a role in Turner syndrome pathophysiology. Cell-free RNA from amniotic fluid of five mid-trimester Turner syndrome fetuses and five euploid female fetuses matched for gestational age was extracted, amplified, and hybridized onto Affymetrix(®) U133 Plus 2.0 arrays. Significantly differentially regulated genes were identified using paired t tests. Biological interpretation was performed using Ingenuity Pathway Analysis and BioGPS gene expression atlas. There were 470 statistically significantly differentially expressed genes identified. They were widely distributed across the genome. XIST was significantly down-regulated (p Turner syndrome transcriptome from other aneuploidies we previously studied. Manual curation of the differentially expressed gene list identified genes of possible pathologic significance, including NFATC3, IGFBP5, and LDLR. Transcriptomic differences in the amniotic fluid of Turner syndrome fetuses are due to genome-wide dysregulation. The hematologic/immune system differences may play a role in early-onset autoimmune dysfunction. Other genes identified with possible pathologic significance are associated with cardiac and skeletal systems, which are known to be affected in females with Turner syndrome. The discovery-driven approach described here may be useful in elucidating novel mechanisms of disease in Turner syndrome.

The Agr communication system provides a benefit to the populations of Listeria monocytogenes in soil.

Science.gov (United States)

Vivant, Anne-Laure; Garmyn, Dominique; Gal, Laurent; Piveteau, Pascal

2014-01-01

In this study, we investigated whether the Agr communication system of the pathogenic bacterium Listeria monocytogenes was involved in adaptation and competitiveness in soil. Alteration of the ability to communicate, either by deletion of the gene coding the response regulator AgrA (response-negative mutant) or the signal pro-peptide AgrD (signal-negative mutant), did not affect population dynamics in soil that had been sterilized but survival was altered in biotic soil suggesting that the Agr system of L. monocytogenes was involved to face the complex soil biotic environment. This was confirmed by a set of co-incubation experiments. The fitness of the response-negative mutant was lower either in the presence or absence of the parental strain but the fitness of the signal-negative mutant depended on the strain with which it was co-incubated. The survival of the signal-negative mutant was higher when co-cultured with the parental strain than when co-cultured with the response-negative mutant. These results showed that the ability to respond to Agr communication provided a benefit to listerial cells to compete. These results might also indicate that in soil, the Agr system controls private goods rather than public goods.

Fluid and particle mechanics

CERN Document Server

Michell, S J

2013-01-01

Fluid and Particle Mechanics provides information pertinent to hydraulics or fluid mechanics. This book discusses the properties and behavior of liquids and gases in motion and at rest. Organized into nine chapters, this book begins with an overview of the science of fluid mechanics that is subdivided accordingly into two main branches, namely, fluid statics and fluid dynamics. This text then examines the flowmeter devices used for the measurement of flow of liquids and gases. Other chapters consider the principle of resistance in open channel flow, which is based on improper application of th

Improving support for parents of children with hearing loss: provider training on use of targeted communication strategies.

Science.gov (United States)

Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael

2015-02-01

When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management

Editorial Special Issue on Fluid Mechanics and Fluid Power (FMFP ...

Indian Academy of Sciences (India)

a shark is more efficient than a propeller; the notoriously complicated and nonlinear Navier–. Stokes equations governing fluid motion provide fertile ground for research to both applied and pure mathematicians. There is the phenomenon of turbulence in fluid flows. A statement in 1932, attributed to Horace Lamb, author of ...

Barriers to Real-Time Medical Direction via Cellular Communication for Prehospital Emergency Care Providers in Gujarat, India.

Science.gov (United States)

Lindquist, Benjamin; Strehlow, Matthew C; Rao, G V Ramana; Newberry, Jennifer A

2016-07-08

Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care. We sought to identify obstacles in the cellular communication process among GVK Emergency Management and Research Institute (GVK EMRI) EMTs in Gujarat, India. A convenience sample of practicing EMTs in Gujarat, India were surveyed regarding the barriers to call initiation and completion. 108 EMTs completed the survey. Overall, ninety-seven (89.8%) EMTs responded that the most common reason they did not initiate a call with the call center physician was insufficient time. Forty-six (42%) EMTs reported that they were unable to call the physician one or more times during a typical workweek (approximately 5-6 twelve-hour shifts/week) due to their hands being occupied performing direct patient care. Fifty-eight (54%) EMTs reported that they were unable to reach the call center physician, despite attempts, at least once a week. This study identified multiple barriers to communication, including insufficient time to call for advice and inability to reach call center physicians. Identification of simple interventions and best practices may improve communication and ensure timely and appropriate prehospital care.

Impact of audit and feedback and pay-for-performance interventions on pediatric hospitalist discharge communication with primary care providers.

Science.gov (United States)

Tejedor-Sojo, Javier; Creek, Tracy; Leong, Traci

2015-01-01

The study team sought to improve hospitalist communication with primary care providers (PCPs) at discharge through interventions consisting of (a) audit and feedback and (b) inclusion of a discharge communication measure in the incentive compensation for pediatric hospitalists. The setting was a 16-physician pediatric hospitalist group within a tertiary pediatric hospital. Discharge summaries were selected randomly for documentation of communication with PCPs. At baseline, 57% of charts had documented communication with PCPs, increasing to 84% during the audit and feedback period. Following the addition of a financial incentive, documentation of communication with PCPs increased to 93% and was sustained during the combined intervention period. The number of physicians meeting the study's performance goal increased from 1 to 14 by the end of the study period. A financial incentive coupled with an audit and feedback tool was effective at modifying physician behavior, achieving focused, measurable quality improvement gains. © 2014 by the American College of Medical Quality.

FAST - A multiprocessed environment for visualization of computational fluid dynamics

International Nuclear Information System (INIS)

Bancroft, G.V.; Merritt, F.J.; Plessel, T.C.; Kelaita, P.G.; Mccabe, R.K.

1991-01-01

The paper presents the Flow Analysis Software Toolset (FAST) to be used for fluid-mechanics analysis. The design criteria for FAST including the minimization of the data path in the computational fluid-dynamics (CFD) process, consistent user interface, extensible software architecture, modularization, and the isolation of three-dimensional tasks from the application programmer are outlined. Each separate process communicates through the FAST Hub, while other modules such as FAST Central, NAS file input, CFD calculator, surface extractor and renderer, titler, tracer, and isolev might work together to generate the scene. An interprocess communication package making it possible for FAST to operate as a modular environment where resources could be shared among different machines as well as a single host is discussed. 20 refs

THE INFORMATION TECHNOLOGY AND COMMUNICATION USED BY LOGISTICS SERVICE PROVIDERS: LITERATURE REVIEW

Directory of Open Access Journals (Sweden)

Carolina Luisa dos Santos Vieira

2012-10-01

Full Text Available With the growth in the supply of logistics services, and the increase of competition, the use of information and communication technologies (ICT is now considered by logistics service providers (LSP, a source of competitive advantage. Through a literature review, this paper seeks to identify which technologies have been used by the PSL. Analyzing 47 articles on the subject, published in international journal that has the largest number of works on PSL, applications of technologies by PSL were analyzed according to a taxonomy suggested based on literature - software, hardware and networks. Among the results highlight the technologies cited by categories and greater scientific interest, such as EDI, RFID, TTS, WMS and Internet.

[Communication strategies used by health care professionals in providing palliative care to patients].

Science.gov (United States)

Trovo de Araújo, Monica Martins; da Silva, Maria Júlia Paes

2012-06-01

The objective of this study is to verify the relevance and utilization of communication strategies in palliative care. This is a multicenter qualitative study using a questionnaire, performed from August of 2008 to July of 2009 with 303 health care professionals who worked with patients receiving palliative care. Data were subjected to descriptive statistical analysis. Most participants (57.7%) were unable to state at least one verbal communication strategy, and only 15.2% were able to describe five signs or non-verbal communication strategies. The verbal strategies most commonly mentioned were those related to answering questions about the disease/treatment. Among the non-verbal strategies used, the most common were affective touch, looking, smiling, physical proximity, and careful listening. Though professionals have assigned a high degree of importance to communication in palliative care, they showed poor knowledge regarding communication strategies. Final considerations include the necessity of training professionals to communicate effectively in palliative care.

Health information technology to facilitate communication involving health care providers, caregivers, and pediatric patients: a scoping review.

Science.gov (United States)

Gentles, Stephen James; Lokker, Cynthia; McKibbon, K Ann

2010-06-18

Pediatric patients with health conditions requiring follow-up typically depend on a caregiver to mediate at least part of the necessary two-way communication with health care providers on their behalf. Health information technology (HIT) and its subset, information communication technology (ICT), are increasingly being applied to facilitate communication between health care provider and caregiver in these situations. Awareness of the extent and nature of published research involving HIT interventions used in this way is currently lacking. This scoping review was designed to map the health literature about HIT used to facilitate communication involving health care providers and caregivers (who are usually family members) of pediatric patients with health conditions requiring follow-up. Terms relating to care delivery, information technology, and pediatrics were combined to search MEDLINE, EMBASE, and CINAHL for the years 1996 to 2008. Eligible studies were selected after three rounds of duplicate screening in which all authors participated. Data regarding patient, caregiver, health care provider, HIT intervention, outcomes studied, and study design were extracted and maintained in a Microsoft Access database. Stage of research was categorized using the UK's Medical Research Council (MRC) framework for developing and evaluating complex interventions. Quantitative and qualitative descriptive summaries are presented. We included 104 eligible studies (112 articles) conducted in 17 different countries and representing 30 different health conditions. The most common conditions were asthma, type 1 diabetes, special needs, and psychiatric disorder. Most studies (88, 85%) included children 2 to 12 years of age, and 73 (71%) involved home care settings. Health care providers operated in hospital settings in 96 (92%) of the studies. Interventions featured 12 modes of communication (eg, Internet, intranets, telephone, video conferencing, email, short message service [SMS], and

Multisoliton solutions in terms of double Wronskian determinant for a generalized variable-coefficient nonlinear Schroedinger equation from plasma physics, arterial mechanics, fluid dynamics and optical communications

International Nuclear Information System (INIS)

Lue Xing; Zhu Hongwu; Yao Zhenzhi; Meng Xianghua; Zhang Cheng; Zhang Chunyi; Tian Bo

2008-01-01

In this paper, the multisoliton solutions in terms of double Wronskian determinant are presented for a generalized variable-coefficient nonlinear Schroedinger equation, which appears in space and laboratory plasmas, arterial mechanics, fluid dynamics, optical communications and so on. By means of the particularly nice properties of Wronskian determinant, the solutions are testified through direct substitution into the bilinear equations. Furthermore, it can be proved that the bilinear Baecklund transformation transforms between (N - 1)- and N-soliton solutions

Cryogenic Fluid Management Facility

Science.gov (United States)

Eberhardt, R. N.; Bailey, W. J.

1985-01-01

The Cryogenic Fluid Management Facility is a reusable test bed which is designed to be carried within the Shuttle cargo bay to investigate the systems and technologies associated with the efficient management of cryogens in space. Cryogenic fluid management consists of the systems and technologies for: (1) liquid storage and supply, including capillary acquisition/expulsion systems which provide single-phase liquid to the user system, (2) both passive and active thermal control systems, and (3) fluid transfer/resupply systems, including transfer lines and receiver tanks. The facility contains a storage and supply tank, a transfer line and a receiver tank, configured to provide low-g verification of fluid and thermal models of cryogenic storage and transfer processes. The facility will provide design data and criteria for future subcritical cryogenic storage and transfer system applications, such as Space Station life support, attitude control, power and fuel depot supply, resupply tankers, external tank (ET) propellant scavenging, and ground-based and space-based orbit transfer vehicles (OTV).

Personalised fluid resuscitation in the ICU: still a fluid concept?

Science.gov (United States)

van Haren, Frank

2017-12-28

The administration of intravenous fluid to critically ill patients is one of the most common, but also one of the most fiercely debated, interventions in intensive care medicine. Even though many thousands of patients have been enrolled in large trials of alternative fluid strategies, consensus remains elusive and practice is widely variable. Critically ill patients are significantly heterogeneous, making a one size fits all approach unlikely to be successful.New data from basic, animal, and clinical research suggest that fluid resuscitation could be associated with significant harm. There are several important limitations and concerns regarding fluid bolus therapy as it is currently being used in clinical practice. These include, but are not limited to: the lack of an agreed definition; limited and short-lived physiological effects; no evidence of an effect on relevant patient outcomes; and the potential to contribute to fluid overload, specifically when fluid responsiveness is not assessed and when targets and safety limits are not used.Fluid administration in critically ill patients requires clinicians to integrate abnormal physiological parameters into a clinical decision-making model that also incorporates the likely diagnosis and the likely risk or benefit in the specific patient's context. Personalised fluid resuscitation requires careful attention to the mnemonic CIT TAIT: context, indication, targets, timing, amount of fluid, infusion strategy, and type of fluid.The research agenda should focus on experimental and clinical studies to: improve our understanding of the physiological effects of fluid infusion, e.g. on the glycocalyx; evaluate new types of fluids; evaluate novel fluid minimisation protocols; study the effects of a no-fluid strategy for selected patients and scenarios; and compare fluid therapy with other interventions. The adaptive platform trial design may provide us with the tools to evaluate these types of interventions in the intrinsically

Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training.

Science.gov (United States)

Long, Ann C; Engelberg, Ruth A; Downey, Lois; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W; Back, Anthony L; Curtis, J Randall

2014-04-01

Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.

The development and preliminary testing of a multimedia patient–provider survivorship communication module for breast cancer survivors

Science.gov (United States)

Wen, Kuang-Yi; Miller, Suzanne M.; Stanton, Annette L.; Fleisher, Linda; Morra, Marion E.; Jorge, Alexandra; Diefenbach, Michael A.; Ropka, Mary E.; Marcus, Alfred C.

2012-01-01

Objective This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors’ preparedness for effective communication with their health care providers after active treatment. Methods The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Results Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. Conclusion The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Practice implications Our study demonstrates survivors’ openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. PMID:22770812

The development and preliminary testing of a multimedia patient-provider survivorship communication module for breast cancer survivors.

Science.gov (United States)

Wen, Kuang-Yi; Miller, Suzanne M; Stanton, Annette L; Fleisher, Linda; Morra, Marion E; Jorge, Alexandra; Diefenbach, Michael A; Ropka, Mary E; Marcus, Alfred C

2012-08-01

This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors' preparedness for effective communication with their health care providers after active treatment. The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Our study demonstrates survivors' openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. Copyright © 2012. Published by Elsevier Ireland Ltd.

Devices with extended area structures for mass transfer processing of fluids

Science.gov (United States)

TeGrotenhuis, Ward E.; Wegeng, Robert S.; Whyatt, Greg A.; King, David L.; Brooks, Kriston P.; Stenkamp, Victoria S.

2009-04-21

A microchannel device includes several mass transfer microchannels to receive a fluid media for processing at least one heat transfer microchannel in fluid communication with a heat transfer fluid defined by a thermally conductive wall, and at several thermally conductive fins each connected to the wall and extending therefrom to separate the mass transfer microchannels from one another. In one form, the device may optionally include another heat transfer microchannel and corresponding wall that is positioned opposite the first wall and has the fins and the mass transfer microchannels extending therebetween.

The Impact of Solid Surface Features on Fluid-Fluid Interface Configuration

Science.gov (United States)

Araujo, J. B.; Brusseau, M. L. L.

2017-12-01

Pore-scale fluid processes in geological media are critical for a broad range of applications such as radioactive waste disposal, carbon sequestration, soil moisture distribution, subsurface pollution, land stability, and oil and gas recovery. The continued improvement of high-resolution image acquisition and processing have provided a means to test the usefulness of theoretical models developed to simulate pore-scale fluid processes, through the direct quantification of interfaces. High-resolution synchrotron X-ray microtomography is used in combination with advanced visualization tools to characterize fluid distributions in natural geologic media. The studies revealed the presence of fluid-fluid interface associated with macroscopic features on the surfaces of the solids such as pits and crevices. These features and respective fluid interfaces, which are not included in current theoretical or computational models, may have a significant impact on accurate simulation and understanding of multi-phase flow, energy, heat and mass transfer processes.

Extraperitoneal Fluid Collection due to Chronic Pancreatitis

Directory of Open Access Journals (Sweden)

Takeo Yasuda

2013-08-01

Full Text Available A 39-year-old man was referred to our hospital for the investigation of abdominal fluid collection. He was pointed out to have alcoholic chronic pancreatitis. Laboratory data showed inflammation and slightly elevated serum direct bilirubin and amylase. An abdominal computed tomography demonstrated huge fluid collection, multiple pancreatic pseudocysts and pancreatic calcification. The fluid showed a high level of amylase at 4,490 IU/l. Under the diagnosis of pancreatic ascites, endoscopic pancreatic stent insertion was attempted but was unsuccessful, so surgical treatment (Frey procedure and cystojejunostomy was performed. During the operation, a huge amount of fluid containing bile acid (amylase at 1,474 IU/l and bilirubin at 13.5 mg/dl was found to exist in the extraperitoneal space (over the peritoneum, but no ascites was found. His postoperative course was uneventful and he shows no recurrence of the fluid. Pancreatic ascites is thought to result from the disruption of the main pancreatic duct, the rupture of a pancreatic pseudocyst, or possibly leakage from an unknown site. In our extremely rare case, the pancreatic pseudocyst penetrated into the hepatoduodenal ligament with communication to the common bile duct, and the fluid flowed into the round ligament of the liver and next into the extraperitoneal space.

Race, Income, and Education: Associations with Patient and Family Ratings of End-of-Life Care and Communication Provided by Physicians-in-Training

Science.gov (United States)

Engelberg, Ruth A.; Downey, Lois; Kross, Erin K.; Reinke, Lynn F.; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W.; Back, Anthony L.; Curtis, J. Randall

2014-01-01

Abstract Background: Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. Objective: To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. Methods: As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Results: Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Conclusions: Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families. PMID:24592958

Assistive Technologies for Improving Communication of Hearing Impairment in the Higher Education in Panama

Directory of Open Access Journals (Sweden)

Lineth Alain

2016-12-01

Full Text Available The ability to communicate, specifically the gift of hearing, is a necessity often taken for granted. A lack of sense of hearing affects the intellectual and emotional development of the human being who suffers from it. It prevents the fluid exchange of knowledge, thoughts and ideas that allow personal growth and development. This article emerges due to an interest in providing assistive technologies that can be considered to improve communication among hearing impaired and normal hearing listeners in the class-room of a higher education level in the Republic of Panama. Information has been compiled from various primary and secondary sources highlighting the communication problem facing this group of disabled people. Information about the situation of hearing impairment, laws, organizations, the reality with the higher education system, and finally, we will talk about Information and Communication Technologies (TICs that will work as technology support in order to improve communication in the classroom in higher education among normal-hearing and deaf people.

Extension of Generalized Fluid System Simulation Program's Fluid Property Database

Science.gov (United States)

Patel, Kishan

2011-01-01

This internship focused on the development of additional capabilities for the General Fluid Systems Simulation Program (GFSSP). GFSSP is a thermo-fluid code used to evaluate system performance by a finite volume-based network analysis method. The program was developed primarily to analyze the complex internal flow of propulsion systems and is capable of solving many problems related to thermodynamics and fluid mechanics. GFSSP is integrated with thermodynamic programs that provide fluid properties for sub-cooled, superheated, and saturation states. For fluids that are not included in the thermodynamic property program, look-up property tables can be provided. The look-up property tables of the current release version can only handle sub-cooled and superheated states. The primary purpose of the internship was to extend the look-up tables to handle saturated states. This involves a) generation of a property table using REFPROP, a thermodynamic property program that is widely used, and b) modifications of the Fortran source code to read in an additional property table containing saturation data for both saturated liquid and saturated vapor states. Also, a method was implemented to calculate the thermodynamic properties of user-fluids within the saturation region, given values of pressure and enthalpy. These additions required new code to be written, and older code had to be adjusted to accommodate the new capabilities. Ultimately, the changes will lead to the incorporation of this new capability in future versions of GFSSP. This paper describes the development and validation of the new capability.

FRACTURING FLUID CHARACTERIZATION FACILITY

Energy Technology Data Exchange (ETDEWEB)

Subhash Shah

2000-08-01

Hydraulic fracturing technology has been successfully applied for well stimulation of low and high permeability reservoirs for numerous years. Treatment optimization and improved economics have always been the key to the success and it is more so when the reservoirs under consideration are marginal. Fluids are widely used for the stimulation of wells. The Fracturing Fluid Characterization Facility (FFCF) has been established to provide the accurate prediction of the behavior of complex fracturing fluids under downhole conditions. The primary focus of the facility is to provide valuable insight into the various mechanisms that govern the flow of fracturing fluids and slurries through hydraulically created fractures. During the time between September 30, 1992, and March 31, 2000, the research efforts were devoted to the areas of fluid rheology, proppant transport, proppant flowback, dynamic fluid loss, perforation pressure losses, and frictional pressure losses. In this regard, a unique above-the-ground fracture simulator was designed and constructed at the FFCF, labeled ''The High Pressure Simulator'' (HPS). The FFCF is now available to industry for characterizing and understanding the behavior of complex fluid systems. To better reflect and encompass the broad spectrum of the petroleum industry, the FFCF now operates under a new name of ''The Well Construction Technology Center'' (WCTC). This report documents the summary of the activities performed during 1992-2000 at the FFCF.

Fluid dynamics

CERN Document Server

Bernard, Peter S

2015-01-01

This book presents a focused, readable account of the principal physical and mathematical ideas at the heart of fluid dynamics. Graduate students in engineering, applied math, and physics who are taking their first graduate course in fluids will find this book invaluable in providing the background in physics and mathematics necessary to pursue advanced study. The book includes a detailed derivation of the Navier-Stokes and energy equations, followed by many examples of their use in studying the dynamics of fluid flows. Modern tensor analysis is used to simplify the mathematical derivations, thus allowing a clearer view of the physics. Peter Bernard also covers the motivation behind many fundamental concepts such as Bernoulli's equation and the stream function. Many exercises are designed with a view toward using MATLAB or its equivalent to simplify and extend the analysis of fluid motion including developing flow simulations based on techniques described in the book.

Provider interaction with the electronic health record: the effects on patient-centered communication in medical encounters.

Science.gov (United States)

Street, Richard L; Liu, Lin; Farber, Neil J; Chen, Yunan; Calvitti, Alan; Zuest, Danielle; Gabuzda, Mark T; Bell, Kristin; Gray, Barbara; Rick, Steven; Ashfaq, Shazia; Agha, Zia

2014-09-01

The computer with the electronic health record (EHR) is an additional 'interactant' in the medical consultation, as clinicians must simultaneously or in alternation engage patient and computer to provide medical care. Few studies have examined how clinicians' EHR workflow (e.g., gaze, keyboard activity, and silence) influences the quality of their communication, the patient's involvement in the encounter, and conversational control of the visit. Twenty-three primary care providers (PCPs) from USA Veterans Administration (VA) primary care clinics participated in the study. Up to 6 patients per PCP were recruited. The proportion of time PCPs spent gazing at the computer was captured in real time via video-recording. Mouse click/scrolling activity was captured through Morae, a usability software that logs mouse clicks and scrolling activity. Conversational silence was coded as the proportion of time in the visit when PCP and patient were not talking. After the visit, patients completed patient satisfaction measures. Trained coders independently viewed videos of the interactions and rated the degree to which PCPs were patient-centered (informative, supportive, partnering) and patients were involved in the consultation. Conversational control was measured as the proportion of time the PCP held the floor compared to the patient. The final sample included 125 consultations. PCPs who spent more time in the consultation gazing at the computer and whose visits had more conversational silence were rated lower in patient-centeredness. PCPs controlled more of the talk time in the visits that also had longer periods of mutual silence. PCPs were rated as having less effective communication when they spent more time looking at the computer and when there was more periods of silence in the consultation. Because PCPs increasingly are using the EHR in their consultations, more research is needed to determine effective ways that they can verbally engage patients while simultaneously

Shaded computer graphic techniques for visualizing and interpreting analytic fluid flow models

Science.gov (United States)

Parke, F. I.

1981-01-01

Mathematical models which predict the behavior of fluid flow in different experiments are simulated using digital computers. The simulations predict values of parameters of the fluid flow (pressure, temperature and velocity vector) at many points in the fluid. Visualization of the spatial variation in the value of these parameters is important to comprehend and check the data generated, to identify the regions of interest in the flow, and for effectively communicating information about the flow to others. The state of the art imaging techniques developed in the field of three dimensional shaded computer graphics is applied to visualization of fluid flow. Use of an imaging technique known as 'SCAN' for visualizing fluid flow, is studied and the results are presented.

Sedimentary basin geochemistry and fluid/rock interactions workshop

Energy Technology Data Exchange (ETDEWEB)

NONE

1991-12-31

Fundamental research related to organic geochemistry, fluid-rock interactions, and the processes by which fluids migrate through basins has long been a part of the U.S. Department of Energy Geosciences program. Objectives of this program were to emphasize those principles and processes which would be applicable to a wide range of problems associated with petroleum discovery, occurrence and extraction, waste disposal of all kinds, and environmental management. To gain a better understanding of the progress being made in understanding basinal fluids, their geochemistry and movement, and related research, and to enhance communication and interaction between principal investigators and DOE and other Federal program managers interested in this topic, this workshop was organized by the School of Geology and Geophysics and held in Norman, Oklahoma in November, 1991.

The effects on health behavior and health outcomes of Internet-based asynchronous communication between health providers and patients with a chronic condition: a systematic review.

Science.gov (United States)

de Jong, Catharina Carolina; Ros, Wynand Jg; Schrijvers, Guus

2014-01-16

In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. The effect of

Short or Long End of the Lever? Associations between Provider Communication of the "Asthma-Action Plan" and Outpatient Revisits for Pediatric Asthma.

Science.gov (United States)

Rangachari, Pavani; Mehta, Renuka; Rethemeyer, R Karl; Ferrang, Carole; Dennis, Clifton; Redd, Vickie

2015-10-01

At the Children's Hospital of Georgia (CHOG), we found that outpatient revisits for pediatric asthma were significantly above national norms. According to the NIH, costly hospital revisits for asthma can be prevented through guidelines-based self-management of asthma, central to which, is the use of a written Asthma-Action Plan (AAP). The asthma services literature has emphasized the role of the healthcare provider in promoting asthma self-management using the AAP, to prevent hospital revisits. On the other hand, the asthma policy literature has emphasized the need for community-based interventions to promote asthma self-management. A gap remains in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma, through effective communication of AAP in the outpatient setting. Our study sought to address this gap. We conducted a 6-month intervention to implement "patient-and-family-centered communication of the AAP" in CHOG outpatient clinics, based on the "change-management" theoretical framework. Provider communication of AAP was assessed through a survey of "Parent Understanding of the Child's AAP." A quasi-experimental approach was used to measure outpatient revisits for pediatric asthma, pre- and post-intervention. Survey results showed that provider communication of the AAP was unanimously perceived highly positively by parents of pediatric asthma patients, across various metrics of patient-centered care. However, there were no statistically significant differences in outpatient "revisit behavior" for pediatric asthma between pre- and post-intervention periods after controlling for several demographic variables. Additionally, revisits remained significantly above national norms. Results suggest limited potential of "effective provider communication of AAP," in reducing outpatient revisits for pediatric asthma; and indicate need for broader community-based interventions to address patient life variables

Short communication: Pseudomonas azotoformans causes gray discoloration in HTST fluid milk.

Science.gov (United States)

Evanowski, Rachel L; Reichler, Samuel J; Kent, David J; Martin, Nicole H; Boor, Kathryn J; Wiedmann, Martin

2017-10-01

Pseudomonas species are well recognized as dairy product spoilage organisms, particularly due to their ability to grow at refrigeration temperatures. Although Pseudomonas-related spoilage usually manifests itself in flavor, odor, and texture defects, which are typically due to production of bacterial enzymes, Pseudomonas is also reported to cause color defects. Because of consumer complaints, a commercial dairy company shipped 4 samples of high temperature, short time (HTST)-pasteurized milk with distinctly gray colors to our laboratory. Bacterial isolates from all 4 samples were identified as Pseudomonas azotoformans. All isolates shared the same partial 16S rDNA sequence and showed black pigmentation on Dichloran Rose Bengal Chloramphenicol agar. Inoculation of one pigment-producing P. azotoformans isolate into HTST-pasteurized fluid milk led to development of gray milk after 14 d of storage at 6°C, but only in containers that had half of the total volume filled with milk (∼500 mL of milk in ∼1,000-mL bottles). We conclusively demonstrate that Pseudomonas can cause a color defect in fluid milk that manifests in gray discoloration, adding to the palette of color defects known to be caused by Pseudomonas. This information is of considerable interest to the dairy industry, because dairy processors and others may not typically associate black or gray colors in fluid milk with the presence of microbial contaminants but rather with product tampering (e.g., addition of ink) or other inadvertent chemical contamination. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Patient-provider communication and trust in relation to use of an online patient portal among diabetes patients: The Diabetes and Aging Study.

Science.gov (United States)

Lyles, Courtney R; Sarkar, Urmimala; Ralston, James D; Adler, Nancy; Schillinger, Dean; Moffet, Howard H; Huang, Elbert S; Karter, Andrew J

2013-01-01

Patient-provider relationships influence diabetes care; less is known about their impact on online patient portal use. Diabetes patients rated provider communication and trust. In this study, we linked responses to electronic medical record data on being a registered portal user and using secure messaging (SM). We specified regression models to evaluate main effects on portal use, and subgroup analyses by race/ethnicity and age. 52% of subjects were registered users; among those, 36% used SM. Those reporting greater trust were more likely to be registered users (relative  risk (RR)=1.14) or SM users (RR=1.29). In subgroup analyses, increased trust was associated with being a registered user among white, Latino, and older patients, as well as SM use among white patients. Better communication ratings were also related to being a registered user among older patients. Since increased trust and communication were associated with portal use within subgroups, this suggests that patient-provider relationships encourage portal engagement.

Induced fluid rotation and bistable fluidic turn-down valves (a survey

Directory of Open Access Journals (Sweden)

Tesař Václav

2015-01-01

Full Text Available Paper surveys engineering applications of an unusual fluidic principle — momentum transfer through a relatively small communicating window into a vortex chamber, where the initially stationary fluid is put into rotation. The transfer is often by shear stress acting in the window plane, but may be enhanced and perhaps even dominated by fluid flow crossing the boundary. The case of zero-time-mean fluid transport through the window has found use in experimental fluid mechanics: non-invasive measurement of wall shear stress on objects by evaluating the induced rotation in the vortex chamber. The case with the non-zero flow through the interface became the starting point in development of fluidic valves combining two otherwise mutually incompatible properties: bistability and flow turning down.

The Cocos Ridge hydrothermal system revealed by microthermometry of fluid and melt inclusions

Science.gov (United States)

Brandstätter, J.; Kurz, W.; Krenn, K.

2017-12-01

). The microthermometric data indicate a seawater/pore water like fluid source in communication with a deeper sourced, up to 400 °C hot fluid. This implies that seawater within the Cocos Ridge aquifer communicated with high-temperature fluids and/or were modified by heat advection.

Optimal composition of fluid-replacement beverages.

Science.gov (United States)

Baker, Lindsay B; Jeukendrup, Asker E

2014-04-01

The objective of this article is to provide a review of the fundamental aspects of body fluid balance and the physiological consequences of water imbalances, as well as discuss considerations for the optimal composition of a fluid replacement beverage across a broad range of applications. Early pioneering research involving fluid replacement in persons suffering from diarrheal disease and in military, occupational, and athlete populations incurring exercise- and/or heat-induced sweat losses has provided much of the insight regarding basic principles on beverage palatability, voluntary fluid intake, fluid absorption, and fluid retention. We review this work and also discuss more recent advances in the understanding of fluid replacement as it applies to various populations (military, athletes, occupational, men, women, children, and older adults) and situations (pathophysiological factors, spaceflight, bed rest, long plane flights, heat stress, altitude/cold exposure, and recreational exercise). We discuss how beverage carbohydrate and electrolytes impact fluid replacement. We also discuss nutrients and compounds that are often included in fluid-replacement beverages to augment physiological functions unrelated to hydration, such as the provision of energy. The optimal composition of a fluid-replacement beverage depends upon the source of the fluid loss, whether from sweat, urine, respiration, or diarrhea/vomiting. It is also apparent that the optimal fluid-replacement beverage is one that is customized according to specific physiological needs, environmental conditions, desired benefits, and individual characteristics and taste preferences.

FameLab provides competition and coaching on science communication

Science.gov (United States)

Scalice, Daniella; Weiss, Peter

2012-10-01

In today's media-intensive environment, the ability to convey science can reshape the face of scientific exploration and discovery. Many early-career scientists could benefit from training on how to communicate their work effectively to all stakeholders along their career paths, from deans and political representatives to neighbors and students, and perhaps even to public audiences through the lens of a camera or the voice of a blog.

Working fluid selection for organic Rankine cycles - Impact of uncertainty of fluid properties

DEFF Research Database (Denmark)

Frutiger, Jerome; Andreasen, Jesper Graa; Liu, Wei

2016-01-01

This study presents a generic methodology to select working fluids for ORC (Organic Rankine Cycles)taking into account property uncertainties of the working fluids. A Monte Carlo procedure is described as a tool to propagate the influence of the input uncertainty of the fluid parameters on the ORC...... modeloutput, and provides the 95%-confidence interval of the net power output with respect to the fluid property uncertainties. The methodology has been applied to a molecular design problem for an ORCusing a low-temperature heat source and consisted of the following four parts: 1) formulation...... of processmodels and constraints 2) selection of property models, i.e. Penge Robinson equation of state 3)screening of 1965 possible working fluid candidates including identification of optimal process parametersbased on Monte Carlo sampling 4) propagating uncertainty of fluid parameters to the ORC netpower output...

Exploring the Cervical Cancer Screening Experiences of Black Lesbian, Bisexual, and Queer Women: The Role of Patient-Provider Communication.

Science.gov (United States)

Agénor, Madina; Bailey, Zinzi; Krieger, Nancy; Austin, S Bryn; Gottlieb, Barbara R

2015-01-01

Few studies have focused on the health and health care of U.S. black lesbian, bisexual, and queer (LBQ) women. To understand the facilitators of and barriers to cervical cancer screening in this population, focus group discussions were conducted in Boston and Cambridge, Massachusetts between November and December 2012. Using purposive sampling methods, the authors enrolled 18 black LBQ women who participated in one of four focus groups. Using thematic analysis, patient-provider communication was identified, which consisted of four sub-themes--health care provider communication style and demeanor; heteronormative provider assumptions; heterosexism, racism, and classism; and provider professional and sociodemographic background--as the most salient theme. Participants reported fears and experiences of multiple forms of discrimination and preferred receiving care from providers who were knowledgeable about same-sex sexual health and shared their life experiences at the intersection of gender, race/ethnicity, and sexual orientation. The cervical cancer screening experiences of black LBQ women would be improved by training all health care providers in same-sex sexual health, offering opportunities for clinicians to learn about the effects of various forms of discrimination on women's health care, and increasing the presence of LBQ women of color in health care settings.

MR phase imaging and cerebrospinal fluid flow in the head and spine

International Nuclear Information System (INIS)

Levy, L.M.; Di Chiro, G.

1990-01-01

Motion of the cerebrospinal fluid (CSF) in and around the brain spinal cord was examined in healthy subjects and in a number of patients with abnormalities of the CSF circulation. The pulsatile motion of the CSF was determined by spin echo phase (velocity) imaging, sometimes in combination with gradient echo phase contrast cine. Differences in flow patterns across CSF spaces were observed: Flow reversal in the cerebellomedullary cistern and lumbar area relative to cervical CSF, and in the posterior versus the anterior subarachnoid space in the spinal canal. Flow communication was demonstrated in known communicating cysts or cavities. Differences in flow were also noted across spinal narrowing or block, and across the walls of a variety of cystic lesions in the brain and spinal cord. MR phase imaging of CSF flow provides pathophysiological information of potential clinical importance for the assessment of diseases affecting the CSF circulation. (orig.)

Validation of King's transaction process for healthcare provider-patient communication in pharmaceutical context: One cross-sectional study.

Science.gov (United States)

Wang, Dan; Liu, Chenxi; Zhang, Zinan; Ye, Liping; Zhang, Xinping

2018-03-27

With the impressive advantages of patient-pharmacist communication being advocated and poor pharmacist-patient communication in different settings, it is of great significance and urgency to explore the mechanism of the pharmacist-patient communicative relationship. The King's theory of goal attainment is proposed as one of the most promising models to be applied, because it takes into consideration both improving the patient-pharmacist relationship and attaining patients' health outcomes. This study aimed to validate the King's transaction process and build the linkage between the transaction process and patient satisfaction in a pharmaceutical context. A cross-sectional study was conducted in four tertiary hospitals in two provincial cities (Wuhan and Shanghai) in central and east China in July 2017. Patients over 18 were investigated in the pharmacies of the hospitals. The instrument for the transaction process was revised and tested. Path analysis was conducted for the King's transaction process and its relationship with patient satisfaction. Five hundred eighty-nine participants were investigated for main study. Prior to the addition of covariates, the hypothesised model of the King's transaction process was validated, in which all paths of the transaction process were statistically significant (p process had direct effects on patient satisfaction (p process was established as one valid theoretical framework of healthcare provider-patient communication in a pharmaceutical context. Copyright © 2018 Elsevier Inc. All rights reserved.

Self-lubricating fluid bearing assembly

International Nuclear Information System (INIS)

Kapich, D.D.

1981-01-01

A sealed self-lubricating fluid bearing assembly is described for circulating fluid in the form of a gas coolant in a nuclear reactor, the power for the circulator being provided by a shaft located within the primary containment vessel. In such a system the reactor coolant is isolated from the fluid region at the far end of the drive shaft. (U.K.)

Personal Communication Device Use by Nurses Providing In-Patient Care: Survey of Prevalence, Patterns, and Distraction Potential.

Science.gov (United States)

McBride, Deborah L; LeVasseur, Sandra A

2017-04-13

Coincident with the proliferation of employer-provided mobile communication devices, personal communication devices, including basic and enhanced mobile phones (smartphones) and tablet computers that are owned by the user, have become ubiquitous among registered nurses working in hospitals. While there are numerous benefits of personal communication device use by nurses at work, little is known about the impact of these devices on in-patient care. Our aim was to examine how hospital-registered nurses use their personal communication devices while doing both work-related and non‒work-related activities and to assess the impact of these devices on in-patient care. A previously validated survey was emailed to 14,797 members of two national nursing organizations. Participants were asked about personal communication device use and their opinions about the impact of these devices on their own and their colleagues' work. Of the 1268 respondents (8.57% response rate), only 5.65% (70/1237) never used their personal communication device at work (excluding lunch and breaks). Respondents self-reported using their personal communication devices at work for work-related activities including checking or sending text messages or emails to health care team members (29.02%, 363/1251), as a calculator (25.34%, 316/1247), and to access work-related medical information (20.13%, 251/1247). Fewer nurses reported using their devices for non‒work-related activities including checking or sending text messages or emails to friends and family (18.75%, 235/1253), shopping (5.14%, 64/1244), or playing games (2.73%, 34/1249). A minority of respondents believe that their personal device use at work had a positive effect on their work including reducing stress (29.88%, 369/1235), benefiting patient care (28.74%, 357/1242), improving coordination of patient care among the health care team (25.34%, 315/1243), or increasing unit teamwork (17.70%, 220/1243). A majority (69.06%, 848/1228) of

A systematic mapping review of effective interventions for communicating with, supporting and providing information to parents of preterm infants.

Science.gov (United States)

Brett, Jo; Staniszewska, Sophie; Newburn, Mary; Jones, Nicola; Taylor, Lesley

2011-06-02

Background and objective The birth of a preterm infant can be an overwhelming experience of guilt, fear and helplessness for parents. Provision of interventions to support and engage parents in the care of their infant may improve outcomes for both the parents and the infant. The objective of this systematic review is to identify and map out effective interventions for communication with, supporting and providing information for parents of preterm infants. Design Systematic searches were conducted in the electronic databases Medline, Embase, PsychINFO, the Cochrane library, the Cumulative Index to Nursing and Allied Health Literature, Midwives Information and Resource Service, Health Management Information Consortium, and Health Management and Information Service. Hand-searching of reference lists and journals was conducted. Studies were included if they provided parent-reported outcomes of interventions relating to information, communication and/or support for parents of preterm infants prior to the birth, during care at the neonatal intensive care unit and after going home with their preterm infant. Titles and abstracts were read for relevance, and papers judged to meet inclusion criteria were included. Papers were data-extracted, their quality was assessed, and a narrative summary was conducted in line with the York Centre for Reviews and Dissemination guidelines. Studies reviewed Of the 72 papers identified, 19 papers were randomised controlled trials, 16 were cohort or quasi-experimental studies, and 37 were non-intervention studies. Results Interventions for supporting, communicating with, and providing information to parents that have had a premature infant are reported. Parents report feeling supported through individualised developmental and behavioural care programmes, through being taught behavioural assessment scales, and through breastfeeding, kangaroo-care and baby-massage programmes. Parents also felt supported through organised support groups and

Apparatus and method for rapid separation and detection of hydrocarbon fractions in a fluid stream

Science.gov (United States)

Sluder, Charles S.; Storey, John M.; Lewis, Sr., Samuel A.

2013-01-22

An apparatus and method for rapid fractionation of hydrocarbon phases in a sample fluid stream are disclosed. Examples of the disclosed apparatus and method include an assembly of elements in fluid communication with one another including one or more valves and at least one sorbent chamber for removing certain classifications of hydrocarbons and detecting the remaining fractions using a detector. The respective ratios of hydrocarbons are determined by comparison with a non separated fluid stream.

Fluid sampling tool

Science.gov (United States)

Garcia, Anthony R.; Johnston, Roger G.; Martinez, Ronald K.

1999-05-25

A fluid sampling tool for sampling fluid from a container. The tool has a fluid collecting portion which is drilled into the container wall, thereby affixing it to the wall. The tool may have a fluid extracting section which withdraws fluid collected by the fluid collecting section. The fluid collecting section has a fluted shank with an end configured to drill a hole into a container wall. The shank has a threaded portion for tapping the borehole. The shank is threadably engaged to a cylindrical housing having an inner axial passageway sealed at one end by a septum. A flexible member having a cylindrical portion and a bulbous portion is provided. The housing can be slid into an inner axial passageway in the cylindrical portion and sealed to the flexible member. The bulbous portion has an outer lip defining an opening. The housing is clamped into the chuck of a drill, the lip of the bulbous section is pressed against a container wall until the shank touches the wall, and the user operates the drill. Wall shavings (kerf) are confined in a chamber formed in the bulbous section as it folds when the shank advances inside the container. After sufficient advancement of the shank, an o-ring makes a seal with the container wall.

Fluid and Electrolyte Disturbances in Critically Ill Patients

OpenAIRE

Lee, Jay Wook

2010-01-01

Disturbances in fluid and electrolytes are among the most common clinical problems encountered in the intensive care unit (ICU). Recent studies have reported that fluid and electrolyte imbalances are associated with increased morbidity and mortality among critically ill patients. To provide optimal care, health care providers should be familiar with the principles and practice of fluid and electrolyte physiology and pathophysiology. Fluid resuscitation should be aimed at restoration of normal...

Application of ICT supported learning in fluid mechanics

DEFF Research Database (Denmark)

Brohus, Henrik; Svidt, Kjeld

2004-01-01

of tools for knowledge transfer facilitates deep understanding and increases learning efficiency. Air flow is by nature invisible and represents a further challenge in the effort of providing sufficient understanding of typical flow patterns and behaviour of room air flow. An example of visualisation......This paper focuses on the application of ICT, Information & Communication Technology, supported learning in the area of fluid mechanics education. Taking a starting point in a course in Ventilation Technology, including room air flow and contaminant distribution, it explains how ICT may be used...... actively in the learning environment to increase efficiency in the learning process. The paper comprises past experiences and lessons learnt as well as prospect for future development in the area. A model is presented that describes a high efficiency learning environment where ICT plays an important role...

A New Concept for an Effective Leak Detection and Loclisation in Multiphase Fluid Pipelines

Directory of Open Access Journals (Sweden)

Mahmoud Meribout

2011-02-01

Full Text Available The aim of this paper is to present a secure wireless sensor network-based infrastructure for fast and accurate detection of eventual leaks that might occur in multiphase pipelines (i.e., pipelines which carry simultaneously more than one fluid. The system is scalable to monitor long distances of pipelines. It consists of a newly designed low cost pipeline set which is composed of an inner pipe that carries the multiphase fluid, surrounded by a second outer pipe that holds the leak detection unit. This latest comprises an air-ultrasonic sensor which continuously senses the presence of the leak. The location of the leak is determined by a bidirectional microphone. Both these sensors are interfaced to a wireless sensor module which performs control, signal processing, and transmission tasks. Hence, the second contribution of the paper is to provide a new secure and reliable communication protocol that takes into consideration the nature of the network in terms of packets patterns and hardware constraints of the communicating nodes. Online tests in a laboratory scale flow loop indicate that the system is capable to accurately determine the location of the leak and its rate (in l/min in fast response time for different scenarios of leaks.

Microgravity Fluids for Biology, Workshop

Science.gov (United States)

Griffin, DeVon; Kohl, Fred; Massa, Gioia D.; Motil, Brian; Parsons-Wingerter, Patricia; Quincy, Charles; Sato, Kevin; Singh, Bhim; Smith, Jeffrey D.; Wheeler, Raymond M.

2013-01-01

Microgravity Fluids for Biology represents an intersection of biology and fluid physics that present exciting research challenges to the Space Life and Physical Sciences Division. Solving and managing the transport processes and fluid mechanics in physiological and biological systems and processes are essential for future space exploration and colonization of space by humans. Adequate understanding of the underlying fluid physics and transport mechanisms will provide new, necessary insights and technologies for analyzing and designing biological systems critical to NASAs mission. To enable this mission, the fluid physics discipline needs to work to enhance the understanding of the influence of gravity on the scales and types of fluids (i.e., non-Newtonian) important to biology and life sciences. In turn, biomimetic, bio-inspired and synthetic biology applications based on physiology and biology can enrich the fluid mechanics and transport phenomena capabilities of the microgravity fluid physics community.

Mobile-based patient-provider communication in cancer survivors: The roles of health literacy and patient activation.

Science.gov (United States)

Jiang, Shaohai; Hong, Y Alicia

2018-03-01

Thanks to rapid penetration of mobile tools, more and more cancer survivors have adopted mobile-based patient-provider communication (MBPPC). The relationship between MBPPC and patients' health outcomes, however, remains unclear; how health literacy and patient activation interact with such relationship is unexplored. Data were drawn from National Cancer Institute's Health Information National Trends Survey 4 Cycle 3. A sample of 459 cancer survivors were included in the analysis. Based on the 3-stage model of health promotion using interactive media, this study empirically tested a moderated mediation model. MBPPC (eg, patient use of email, text message, mobile app, and social media to communicate with providers) had no direct effect on cancer survivors' emotional health. Instead, health literacy completely mediated this path. Patient activation positively moderated the effect of health literacy on emotional health and further increased the indirect effect of MBPPC on emotional health. MBPPC alone does not directly result in better emotional health outcomes; health literacy is the key to realize its health benefits; patient activation significantly strengthens the effects of MBPPC. As we embrace the mHealth movement, innovative programs are needed to promote MBPPC, and improve health literacy and activation of cancer survivors, particularly in underserved communities, to reduce health disparities. Copyright © 2017 John Wiley & Sons, Ltd.

Legitimacy and Strategic Communication in Globalization

DEFF Research Database (Denmark)

Holmstrøm, Susanne Maria; Falkheimer, Jesper; Gade Nielsen, Astrid

2010-01-01

for strategic communication. As globalizing organizations increasingly face conflicting perceptions of legitimacy, new challenges to strategic communication arise. Different types of societal constitution breed different legitimating corporate settings. Taking as the empirical example the transnational...... Scandinavian dairy group Arla Foods, three fundamentally different legitimacy conflicts and their interplay with strategic communication are analyzed: between Western and Middle-East values; between former and present ideals as society changes from solid to fluid modernity; and between the neighboring...... Scandinavian welfare states of Sweden and Denmark. By relating legitimating notions to society's constitution and forms of social coordination generic patterns are identified in the multitudinous diversity of legitimacy conflicts within which global organizations are embedded....

Disappearing fluid?

International Nuclear Information System (INIS)

Graney, K.; Chu, J.; Lin, P.C.

2002-01-01

Full text: A 78-year old male in end stage renal failure (ESRF) with a background of NIDDM retinopathy, nephropathy, and undergoing continuous ambulatory peritoneal dialysis (CAPD) presented with anorexia, clinically unwell, decreased mobility and right scrotal swelling. There was no difficulty during CAPD exchange except there was a positive fluid balance Peritoneal dialysates remained clear A CAPD peritoneal study was requested. 100Mbq 99mTc Sulphur Colloid was injected into a standard dialysate bag containing dialysate. Anterior dynamic images were acquired over the abdomen pelvis while the dialysate was infused Static images with anatomical markers were performed 20 mins post infusion, before and after patient ambulation and then after drainage. The study demonstrated communication between the peritoneal cavity and the right scrotal sac. Patient underwent right inguinal herniaplasty with a marlex mesh. A repeat CAPD flow study was performed as follow up and no abnormal connection between the peritoneal cavity and the right scrotal sac was demonstrated post operatively. This case study shows that CAPD flow studies can be undertaken as a simple, minimally invasive method to evaluate abnormal peritoneal fluid flow dynamics in patients undergoing CAPD, and have an impact on dialysis management. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Karl Marx & Communication @ 200: Towards a Marxian Theory of Communication

Directory of Open Access Journals (Sweden)

Christian Fuchs

2018-05-01

Full Text Available This contribution takes Marx’s bicentenary as occasion for reflecting on foundations of a Marxian theory of communication. It aims to show that Marx provides a consistent account as foundation for a critical, dialectical theory of communication. The article first discusses the relationship of communication and materialism in order to ground a communicative materialism that avoids the dualist assumption that communication is a superstructure erected on a material base. Second, the paper provides an overview of how Marx’s approach helps us to understand the role of the means of communication and communicative labour in capitalism. Third, it conceives of ideology as a form of fetishised communication and fetishism as ideological communication. Given that communicative capitalism is a significant dimension of contemporary society, it is about time to develop a Marxian theory of communication.

Spreading dynamics of power-law fluid droplets

International Nuclear Information System (INIS)

Liang Zhanpeng; Peng Xiaofeng; Wang Xiaodong; Lee, D-J; Su Ay

2009-01-01

This paper aims at providing a summary of the theoretical models available for non-Newtonian fluid spreading dynamics. Experimental findings and model predictions for a Newtonian fluid spreading test are briefly reviewed. Then how the complete wetting and partial wetting power-law fluids spread over a solid substrate is examined. The possible extension of Newtonian fluid models to power-law fluids is also discussed.

Diffusion-Weighted Magnetic Resonance Imaging of Cerebrospinal Fluid in Patients with and without Communicating Hydrocephalus

International Nuclear Information System (INIS)

Nasel, C.; Gentzsch, S.; Heimberger, K.

2007-01-01

Background: Recent concepts about cerebrospinal fluid (CSF) circulation in communicating hydrocephalus (CoHy), which is also termed 'restricted arterial pulsation hydrocephalus,' suggest reduced arterial pulsations of subarachnoid vessels with a smaller amount of CSF shifted in subarachnoid spaces during the early systole. The postulated restriction of subarachnoid arterial pulsations in CoHy should induce a smaller motion artifact and reduced local stream effects in CSF in magnetic resonance (MR) diffusion-weighted imaging (DWI). Purpose: To investigate the maximum diffusivity in CSF in patients with and without CoHy using DWI. Material and Methods: 12 patients without CSF circulation disturbances and six cases with proven CoHy were assessed. Diffusion was measured in six non collinear directions without triggering the arterial pulse wave (scan time 6:45 min, voxel size 2x2x2 mm). Due to expected artifacts, the calculated maximum diffusivity was called apparent diffusivity. Regional high and low apparent diffusivity was assessed in CSF spaces on newly created 3D CSF motion maps. Results: Patients with regular CSF circulation exhibited high apparent diffusivity in CSF in basal subarachnoid spaces, whereas apparent diffusivity was low there in patients with CoHy. Conclusion: DWI opens a feasible approach to study CSF motion in the neurocranium. Restricted arterial pulsations seem to be involved in CoHy

Diffusion-Weighted Magnetic Resonance Imaging of Cerebrospinal Fluid in Patients with and without Communicating Hydrocephalus

Energy Technology Data Exchange (ETDEWEB)

Nasel, C.; Gentzsch, S.; Heimberger, K. [Cerebrovascular Imaging Workgroup of the Div. of Neuroradiology, Dept. of Radiology, Medical Univ. Vienna, Vienna (Austria)

2007-09-15

Background: Recent concepts about cerebrospinal fluid (CSF) circulation in communicating hydrocephalus (CoHy), which is also termed 'restricted arterial pulsation hydrocephalus,' suggest reduced arterial pulsations of subarachnoid vessels with a smaller amount of CSF shifted in subarachnoid spaces during the early systole. The postulated restriction of subarachnoid arterial pulsations in CoHy should induce a smaller motion artifact and reduced local stream effects in CSF in magnetic resonance (MR) diffusion-weighted imaging (DWI). Purpose: To investigate the maximum diffusivity in CSF in patients with and without CoHy using DWI. Material and Methods: 12 patients without CSF circulation disturbances and six cases with proven CoHy were assessed. Diffusion was measured in six non collinear directions without triggering the arterial pulse wave (scan time 6:45 min, voxel size 2x2x2 mm). Due to expected artifacts, the calculated maximum diffusivity was called apparent diffusivity. Regional high and low apparent diffusivity was assessed in CSF spaces on newly created 3D CSF motion maps. Results: Patients with regular CSF circulation exhibited high apparent diffusivity in CSF in basal subarachnoid spaces, whereas apparent diffusivity was low there in patients with CoHy. Conclusion: DWI opens a feasible approach to study CSF motion in the neurocranium. Restricted arterial pulsations seem to be involved in CoHy.

Fluid Annotations in a Open World

DEFF Research Database (Denmark)

Zellweger, Polle Trescott; Bouvin, Niels Olof; Jehøj, Henning

2001-01-01

Fluid Documents use animated typographical changes to provide a novel and appealing user experience for hypertext browsing and for viewing document annotations in context. This paper describes an effort to broaden the utility of Fluid Documents by using the open hypermedia Arakne Environment to l...... to layer fluid annotations and links on top of abitrary HTML pages on the World Wide Web. Changes to both Fluid Documents and Arakne are required....

DC microgrids providing frequency regulation in electrical power system - imperfect communication issues

DEFF Research Database (Denmark)

Bašić, Hrvoje; Dragicevic, Tomislav; Pandžić, Hrvoje

2017-01-01

This paper presents a model of multiple DC microgrids with battery energy storage systems and demand response capability, taking part in primary frequency regulation of electrical power system. Although DC microgrids can contribute to stability and efficiency of frequency regulation, these complex...... systems may cause serious stability issues due to the imperfect communication. This work presents possible scenarios of unstable primary frequency regulation in a simplified model of electrical power system with DC microgrids, which are controlled through communication network....

Short or Long End of the Lever? Associations between Provider Communication of the “Asthma-Action Plan” and Outpatient Revisits for Pediatric Asthma

Science.gov (United States)

Rangachari, Pavani; Mehta, Renuka; Rethemeyer, R. Karl; Ferrang, Carole; Dennis, Clifton; Redd, Vickie

2017-01-01

Background At the Children’s Hospital of Georgia (CHOG), we found that outpatient revisits for pediatric asthma were significantly above national norms. According to the NIH, costly hospital revisits for asthma can be prevented through guidelines-based self-management of asthma, central to which, is the use of a written Asthma-Action Plan (AAP). Purpose The asthma services literature has emphasized the role of the healthcare provider in promoting asthma self-management using the AAP, to prevent hospital revisits. On the other hand, the asthma policy literature has emphasized the need for community-based interventions to promote asthma self-management. A gap remains in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma, through effective communication of AAP in the outpatient setting. Our study sought to address this gap. Methods We conducted a 6-month intervention to implement “patient-and-family-centered communication of the AAP” in CHOG outpatient clinics, based on the “change-management” theoretical framework. Provider communication of AAP was assessed through a survey of “Parent Understanding of the Child’s AAP.” A quasi-experimental approach was used to measure outpatient revisits for pediatric asthma, pre- and post-intervention. Results Survey results showed that provider communication of the AAP was unanimously perceived highly positively by parents of pediatric asthma patients, across various metrics of patient-centered care. However, there were no statistically significant differences in outpatient “revisit behavior” for pediatric asthma between pre- and post-intervention periods after controlling for several demographic variables. Additionally, revisits remained significantly above national norms. Conclusions Results suggest limited potential of “effective provider communication of AAP,” in reducing outpatient revisits for pediatric asthma; and indicate need for

Interdisciplinary Analysis of Drought Communication Through Social Media Platforms and Risk Communication

Science.gov (United States)

Wygant, M.

2015-12-01

As droughts continue to impact businesses and communities throughout the United States, there needs to be a greater emphasis on drought communication through interdisciplinary approaches, risk communication, and digital platforms. The purpose of this research is to provide an overview of the current literature on communicating drought and suggests areas for further improvement. Specifically, this research focuses on communicating drought through social media platforms such as Facebook, Twitter, and Instagram. It also focuses on the conglomeration of theoretical frameworks within the realm of risk communication, to provide a strong foundation towards future drought communication. This research proposal provides a critical step to advocate for paradigmatic shifts within natural hazard communication.

Critical care providers refer to information tools less during communication tasks after a critical care clinical information system introduction.

Science.gov (United States)

Ballermann, Mark; Shaw, Nicola T; Mayes, Damon C; Gibney, R T Noel

2011-01-01

Electronic documentation methods may assist critical care providers with information management tasks in Intensive Care Units (ICUs). We conducted a quasi-experimental observational study to investigate patterns of information tool use by ICU physicians, nurses, and respiratory therapists during verbal communication tasks. Critical care providers used tools less at 3 months after the CCIS introduction. At 12 months, care providers referred to paper and permanent records, especially during shift changes. The results suggest potential areas of improvement for clinical information systems in assisting critical care providers in ensuring informational continuity around their patients.

Effects of fluid properties on the cross-flow between subchannels

International Nuclear Information System (INIS)

Azuma, Mie; Hotta, Akitoshi; Shirai, Hiroshi; Ninokata, Hisashi

2004-01-01

This study is one part of the fundamental research on the development of generalized boiling transition analysis methodology applicable to a wide variety of BWR-type fuel bundle geometries. In this study, quantitative identification of the void drift component in cross-flow is conducted by the combination of the Computational Fluid Dynamics (CFD) interface tracking technique and the Multiple Auto Regressive (MAR) method. The numerical model consists of two subchannels with a communication slit. The cross section is modeled in a reference of the Tapucu model, which is extracted from a symmetrical cell pair of actual square lattice fuel rod bundles. An air-water mixture in the slug and churn regimes at atmospheric pressure and room temperature is used as the working fluid. As a result, a concept on extraction of void drift and turbulent mixing components from cross-flow according to experimental data is confirmed by a numerical approach in which pressure is adjusted at each channel outlet using a model of two parallel channels with a communication slit. Criteria to extract components of the turbulent mixing and the void drift components from cross-flow assuming a multi-component mixture are proposed. Effects of surface tension and density ratio of water and air on the cross-flow between subchannels are investigated under conditions to maintain the gas-liquid evolution process based on the proposed criteria. The qualitative evaluation technique with dependency on surface tension and density ratio was proposed. It is expected to provide supplemental information which is difficult to obtain from experiments. (author)

Fluid sampling tool

Science.gov (United States)

Garcia, A.R.; Johnston, R.G.; Martinez, R.K.

1999-05-25

A fluid sampling tool is described for sampling fluid from a container. The tool has a fluid collecting portion which is drilled into the container wall, thereby affixing it to the wall. The tool may have a fluid extracting section which withdraws fluid collected by the fluid collecting section. The fluid collecting section has a fluted shank with an end configured to drill a hole into a container wall. The shank has a threaded portion for tapping the borehole. The shank is threadably engaged to a cylindrical housing having an inner axial passageway sealed at one end by a septum. A flexible member having a cylindrical portion and a bulbous portion is provided. The housing can be slid into an inner axial passageway in the cylindrical portion and sealed to the flexible member. The bulbous portion has an outer lip defining an opening. The housing is clamped into the chuck of a drill, the lip of the bulbous section is pressed against a container wall until the shank touches the wall, and the user operates the drill. Wall shavings (kerf) are confined in a chamber formed in the bulbous section as it folds when the shank advances inside the container. After sufficient advancement of the shank, an o-ring makes a seal with the container wall. 6 figs.

ListeningTime; participatory development of a web-based preparatory communication tool for elderly cancer patients and their healthcare providers.

NARCIS (Netherlands)

Noordman, J.; Driesenaar, J.A.; Bruinessen, I.R. van; Dulmen, S. van

2017-01-01

Objective: This paper outlines the participatory development process of a web-based preparatory communication tool for elderly cancer patients and their oncological healthcare providers (HCPs). This tool aims to support them to (better) prepare their encounters. An overarching aim of the project is

Fluid Dynamics for Physicists

Science.gov (United States)

Faber, T. E.

1995-08-01

This textbook provides an accessible and comprehensive account of fluid dynamics that emphasizes fundamental physical principles and stresses connections with other branches of physics. Beginning with a basic introduction, the book goes on to cover many topics not typically treated in texts, such as compressible flow and shock waves, sound attenuation and bulk viscosity, solitary waves and ship waves, thermal convection, instabilities, turbulence, and the behavior of anisotropic, non-Newtonian and quantum fluids. Undergraduate or graduate students in physics or engineering who are taking courses in fluid dynamics will find this book invaluable.

Local linear viscoelasticity of confined fluids.

Science.gov (United States)

Hansen, J S; Daivis, P J; Todd, B D

2007-04-14

In this paper the authors propose a novel method to study the local linear viscoelasticity of fluids confined between two walls. The method is based on the linear constitutive equation and provides details about the real and imaginary parts of the local complex viscosity. They apply the method to a simple atomic fluid undergoing zero mean oscillatory flow using nonequilibrium molecular dynamics simulations. The method shows that the viscoelastic properties of the fluid exhibit dramatic spatial changes near the wall-fluid boundary due to the high density in this region. It is also shown that the real part of the viscosity converges to the frequency dependent local shear viscosity sufficiently far away from the wall. This also provides valuable information about the transport properties in the fluid, in general. The viscosity is compared with predictions from the local average density model. The two methods disagree in that the local average density model predicts larger viscosity variations near the wall-fluid boundary than what is observed through the method presented here.

Molecular mechanics and structure of the fluid-solid interface in simple fluids

Science.gov (United States)

Wang, Gerald J.; Hadjiconstantinou, Nicolas G.

2017-09-01

Near a fluid-solid interface, the fluid spatial density profile is highly nonuniform at the molecular scale. This nonuniformity can have profound effects on the dynamical behavior of the fluid and has been shown to play an especially important role when modeling a wide variety of nanoscale heat and momentum transfer phenomena. We use molecular-mechanics arguments and molecular-dynamics (MD) simulations to develop a better understanding of the structure of the first fluid layer directly adjacent to the solid in the layering regime, as delineated by a nondimensional number that compares the effects of wall-fluid interaction to thermal energy. Using asymptotic analysis of the Nernst-Planck equation, we show that features of the fluid density profile close to the wall, such as the areal density of the first layer ΣFL (defined as the number of atoms in this layer per unit of fluid-solid interfacial area), can be expressed as polynomial functions of the fluid average density ρave. This is found to be in agreement with MD simulations, which also show that the width of the first layer hFL is a linear function of the average density and only a weak function of the temperature T . These results can be combined to show that, for system average densities corresponding to a dense fluid (ρave≥0.7 ), the ratio C ≡ΣFLρavehFL, representing a density enhancement with respect to the bulk fluid, depends only weakly on temperature and is essentially independent of density. Further MD simulations suggest that the above results, nominally valid for large systems (solid in contact with semi-infinite fluid), also describe fluid-solid interfaces under considerable nanoconfinement, provided ρave is appropriately defined.

Nonlinear transport processes and fluid dynamics: Cylindrical Couette flow of Lennard-Jones fluids

International Nuclear Information System (INIS)

Khayat, R.E.; Eu, B.C.

1988-01-01

In this paper we report on calculations of flow profiles for cylindrical Couette flow of a Lennard-Jones fluid. The flow is subjected to a temperature gradient and thermoviscous effects are taken into consideration. We apply the generalized fluid dynamic equations which are provided by the modified moment method for the Boltzmann equation reported previously. The results of calculations are in good agreement with the Monte Carlo direct simulation method by K. Nanbu [Phys. Fluids 27, 2632 (1984)] for most of Knudsen numbers for which the simulation data are available

A review of cost communication in oncology: Patient attitude, provider acceptance, and outcome assessment.

Science.gov (United States)

Shih, Ya-Chen Tina; Chien, Chun-Ru

2017-05-15

The American Society of Clinical Oncology released its first guidance statement on the cost of cancer care in August 2009, affirming that patient-physician cost communication is a critical component of high-quality care. This forward-thinking recommendation has grown increasingly important in oncology practice today as the high costs of cancer care impose tremendous financial burden to patients, their families, and the health care system. For the current review, a literature search was conducted using the PubMed and Web of Science databases to identify articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes; and 15 articles from 12 distinct studies were identified. Although most articles that addressed patient attitude suggested that cost communication is desired by >50% of patients in the respective study cohorts, only communication. When asked about whether cost communication actually took place in their practice, percentages reported by physicians varied widely from 60%. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality. Both patients and physicians expressed a strong need for accurate, accessible, and transparent information about the cost of cancer care. Cancer 2017;123:928-39. © 2016 American Cancer Society. © 2016 American Cancer Society.

The fluid dynamics of climate

CERN Document Server

Palazzi, Elisa; Fraedrich, Klaus

2016-01-01

This volume provides an overview of the fluid aspects of the climate system, focusing on basic aspects as well as recent research developments. It will bring together contributions from diverse fields of the physical, mathematical and engineering sciences. The volume will be useful to doctorate students, postdocs and researchers working on different aspects of atmospheric, oceanic and environmental fluid dynamics. It will also be of interest to researchers interested in quantitatively understanding how fluid dynamics can be applied to the climate system, and to climate scientists willing to gain a deeper insight into the fluid mechanics underlying climate processes.

Magnetic power piston fluid compressor

Science.gov (United States)

Gasser, Max G. (Inventor)

1994-01-01

A compressor with no moving parts in the traditional sense having a housing having an inlet end allowing a low pressure fluid to enter and an outlet end allowing a high pressure fluid to exit is described. Within the compressor housing is at least one compression stage to increase the pressure of the fluid within the housing. The compression stage has a quantity of magnetic powder within the housing, is supported by a screen that allows passage of the fluid, and a coil for selectively providing a magnetic field across the magnetic powder such that when the magnetic field is not present the individual particles of the powder are separated allowing the fluid to flow through the powder and when the magnetic field is present the individual particles of the powder pack together causing the powder mass to expand preventing the fluid from flowing through the powder and causing a pressure pulse to compress the fluid.

Application of a distributed network in computational fluid dynamic simulations

Science.gov (United States)

Deshpande, Manish; Feng, Jinzhang; Merkle, Charles L.; Deshpande, Ashish

1994-01-01

A general-purpose 3-D, incompressible Navier-Stokes algorithm is implemented on a network of concurrently operating workstations using parallel virtual machine (PVM) and compared with its performance on a CRAY Y-MP and on an Intel iPSC/860. The problem is relatively computationally intensive, and has a communication structure based primarily on nearest-neighbor communication, making it ideally suited to message passing. Such problems are frequently encountered in computational fluid dynamics (CDF), and their solution is increasingly in demand. The communication structure is explicitly coded in the implementation to fully exploit the regularity in message passing in order to produce a near-optimal solution. Results are presented for various grid sizes using up to eight processors.

Fluid jet electric discharge source

Science.gov (United States)

Bender, Howard A [Ripon, CA

2006-04-25

A fluid jet or filament source and a pair of coaxial high voltage electrodes, in combination, comprise an electrical discharge system to produce radiation and, in particular, EUV radiation. The fluid jet source is composed of at least two serially connected reservoirs, a first reservoir into which a fluid, that can be either a liquid or a gas, can be fed at some pressure higher than atmospheric and a second reservoir maintained at a lower pressure than the first. The fluid is allowed to expand through an aperture into a high vacuum region between a pair of coaxial electrodes. This second expansion produces a narrow well-directed fluid jet whose size is dependent on the size and configuration of the apertures and the pressure used in the reservoir. At some time during the flow of the fluid filament, a high voltage pulse is applied to the electrodes to excite the fluid to form a plasma which provides the desired radiation; the wavelength of the radiation being determined by the composition of the fluid.

Fluid-solid contact vessel having fluid distributors therein

Science.gov (United States)

Jones, Jr., John B.

1980-09-09

Rectangularly-shaped fluid distributors for large diameter, vertical vessels include reinforcers for high heat operation, vertical sides with gas distributing orifices and overhanging, sloped roofs. Devices are provided for cleaning the orifices from a buildup of solid deposits resulting from the reactions in the vessel.

An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal.

Science.gov (United States)

Clarke, Malcolm; Mars, Maurice

2015-02-01

We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access to manage chronic disease, local support and management of patients (to reduce unnecessary travel to the hospital), emergency care (up to 8 h for an ambulance to arrive), e-mail, access to up-to-date information (Web), and teleclinics. We made site measurements at a representative set of health clinics to determine the type of coverage (general packet radio service [GPRS]/3G), its capabilities to support videoconferencing (H323 and Skype™ [Microsoft, Redmond, WA]) and audio (Skype), and throughput for transmission control protocol (TCP) to gain a measure of application performance. We found that none of the remote health clinics had 3G service. The GPRS service provided typical upload speed of 44 kilobits per second (Kbps) and download speed of 64 Kbps. This was not sufficient to support any form of videoconferencing. We also observed that GPRS had significant round trip time (RTT), in some cases in excess of 750 ms, and this led to slow start-up for TCP applications. We found audio was always so broken as to be unusable and further observed that many applications such as Web access would fail under conditions of very high RTT. We found some health clinics were so remote that they had no mobile service. 3G, where available, had measured upload speed of 331 Kbps and download speed of 446 Kbps and supported videoconferencing and audio at all sites, but we frequently experienced 3G changing to GPRS. We conclude that mobile communications currently provide insufficient coverage and capability to provide reliable clinical services and would advocate dedicated wireless services where reliable

Supercritical fluid reverse micelle separation

Science.gov (United States)

Fulton, J.L.; Smith, R.D.

1993-11-30

A method of separating solute material from a polar fluid in a first polar fluid phase is provided. The method comprises combining a polar fluid, a second fluid that is a gas at standard temperature and pressure and has a critical density, and a surfactant. The solute material is dissolved in the polar fluid to define the first polar fluid phase. The combined polar and second fluids, surfactant, and solute material dissolved in the polar fluid is maintained under near critical or supercritical temperature and pressure conditions such that the density of the second fluid exceeds the critical density thereof. In this way, a reverse micelle system defining a reverse micelle solvent is formed which comprises a continuous phase in the second fluid and a plurality of reverse micelles dispersed in the continuous phase. The solute material is dissolved in the polar fluid and is in chemical equilibrium with the reverse micelles. The first polar fluid phase and the continuous phase are immiscible. The reverse micelles each comprise a dynamic aggregate of surfactant molecules surrounding a core of the polar fluid. The reverse micelle solvent has a polar fluid-to-surfactant molar ratio W, which can vary over a range having a maximum ratio W[sub o] that determines the maximum size of the reverse micelles. The maximum ratio W[sub o] of the reverse micelle solvent is then varied, and the solute material from the first polar fluid phase is transported into the reverse micelles in the continuous phase at an extraction efficiency determined by the critical or supercritical conditions. 27 figures.

Microscope-Based Fluid Physics Experiments in the Fluids and Combustion Facility on ISS

Science.gov (United States)

Doherty, Michael P.; Motil, Susan M.; Snead, John H.; Malarik, Diane C.

2000-01-01

At the NASA Glenn Research Center, the Microgravity Science Program is planning to conduct a large number of experiments on the International Space Station in both the Fluid Physics and Combustion Science disciplines, and is developing flight experiment hardware for use within the International Space Station's Fluids and Combustion Facility. Four fluids physics experiments that require an optical microscope will be sequentially conducted within a subrack payload to the Fluids Integrated Rack of the Fluids and Combustion Facility called the Light Microscopy Module, which will provide the containment, changeout, and diagnostic capabilities to perform the experiments. The Light Microscopy Module is planned as a fully remotely controllable on-orbit microscope facility, allowing flexible scheduling and control of experiments within International Space Station resources. This paper will focus on the four microscope-based experiments, specifically, their objectives and the sample cell and instrument hardware to accommodate their requirements.

Improving health outcomes for young people with long term conditions: The role of digital communication in current and future patient-clinician communication for NHS providers of specialist clinical services for young people - LYNC study protocol.

Science.gov (United States)

Griffiths, Frances E; Atherton, Helen; Barker, Jack R; Cave, Jonathan Ak; Dennick, Kathryn; Dowdall, Peter; Fraser, Joe; Huxley, Caroline; Kim, Sung-Wook; Madan, Jason J; Matharu, Harjit; Musumadi, Luhanga; Palmer, Tom M; Paul, Moli; Sankaranarayanan, Sailesh; Slowther, Anne-Marie; Sujan, Mark A; Sutcliffe, Paul A; Sturt, Jackie

2015-01-01

Young people living with long term conditions are vulnerable to health service disengagement. This endangers their long term health. Studies report requests for digital forms of communication - email, text, social media - with their health care team. Digital clinical communication is troublesome for the UK NHS. In this article we aim to present the research protocol for evaluating the impacts and outcomes of digital clinical communications for young people living with long term conditions and provide critical analysis of their use, monitoring and evaluation by NHS providers (LYNC study: Long term conditions, Young people, Networked Communications). The research involves: (a) patient and public involvement activities with 16-24 year olds with and without long term health conditions; (b) six literature reviews; (c) case studies - the main empirical part of the study - and (d) synthesis and a consensus meeting. Case studies use a mixed methods design. Interviews and non-participant observation of practitioners and patients communicating in up to 20 specialist clinical settings will be combined with data, aggregated at the case level (non-identifiable patient data) on a range of clinical outcomes meaningful within the case and across cases. We will describe the use of digital clinical communication from the perspective of patients, clinical staff, support staff and managers, interviewing up to 15 young people and 15 staff per case study. Outcome data includes emergency admissions, A&E attendance and DNA (did not attend) rates. Case studies will be analysed to understand impacts of digital clinical communication on patient health outcomes, health care costs and consumption, ethics and patient safety.

Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers.

Science.gov (United States)

Porter, Laura S; Pollak, Kathryn I; Farrell, David; Cooper, Meredith; Arnold, Robert M; Jeffreys, Amy S; Tulsky, James A

2015-10-01

Patients often struggle to express their emotional concerns to their oncology providers and may therefore experience unmet needs. This paper describes the development and implementation of an online program that teaches patients how to communicate their emotions to their oncology providers. The intervention was developed by a multidisciplinary team consisting of palliative care physicians, psychologists, and an intervention software developer and included input from patients. It incorporated elements of Social Cognitive Theory and validated cognitive behavioral strategies for communication skills training. Strategies to increase intervention adherence were implemented midway through the study. The intervention consists of four interactive, online modules to teach patients strategies for expressing emotional concerns to their providers and asking for support. In addition to skill-building, the intervention was designed to raise patients' expectations that expressing emotional concerns to providers would be helpful, to enhance their self-efficacy for doing so, and to help them overcome barriers to having these conversations. After implementing strategies to improve adherence, usage rates increased from 47 to 64 %. This intervention addresses an unmet educational need for patients with advanced cancer. Strategies to increase adherence led to improvements in usage rates in this population of older patients. We are currently evaluating the intervention in a randomized clinical trial to determine its efficacy in increasing patient expression of emotional concerns and requests for support. If successful, this intervention could serve as a model for future online patient education programs.

Human papillomavirus vaccine awareness, uptake, and parental and health care provider communication among 11- to 18-year-old adolescents in a rural Appalachian Ohio county in the United States.

Science.gov (United States)

Bhatta, Madhav P; Phillips, Lynette

2015-01-01

This study examined human papillomavirus (HPV) vaccine awareness and uptake, and communication with a parent and/or a health care provider among 11- to 18-year-old male and female adolescents in an Appalachian Ohio county. Five questions regarding the HPV vaccine were added to the 2012 Youth Risk Behavior Surveillance System (YRBSS) surveys administered to middle and high school students in the county. The YRBSS surveys are school-based, anonymous, and voluntary. The questions added were about vaccine awareness and uptake, and communication with a parent or health care provider about the vaccine. Of the 1,299 participants, 51.9% were male and 90.3% were white. Overall, 49.2%, 23.5%, 19.2%, and 24.6%, respectively, reported vaccine awareness, uptake of at least 1 dose of the HPV vaccine, communication with a parent, and communication with a health care provider. Females and adolescents ≥ 15 years were significantly more likely to report awareness, uptake, and parental and provider communication than males and adolescents ≤ 14 years. Adolescents receiving any dose of the vaccine were significantly more likely to have had a parent (OR: 3.74; 95% CI: 2.30-6.06) or a health care provider (OR: 10.91; 95% CI: 6.42-18.6) discuss the vaccine than those who had not received any dose. Despite the strong link between parental and health care provider communication and HPV vaccine uptake, the levels of communication remain low in this Appalachian population. These findings suggest the need for public health education programs targeting the health care providers, the parents, and the adolescents to improve awareness, knowledge, and HPV vaccine uptake. © 2014 National Rural Health Association.

Non-electronic communication aids for people with complex communication needs.

Science.gov (United States)

Iacono, Teresa; Lyon, Katie; West, Denise

2011-10-01

Non-electronic communication aids provide one form of augmentative and alternative communication (AAC) for people with complex communication needs. The aim here was to explore non-electronic communication aids as one AAC option and research challenges. This aim was addressed by reviewing funding for the provision of AAC systems, data from an Australian pilot project providing non-electronic communication aids, an audit of aided AAC published studies (2000-2009), and discussion of the review literature. Combined, these sources indicate that although there is great demand for non-electronic communication aids, funding schemes, both in Australia and internationally, have focused on electronic communication aids. Such funding has usually failed to meet the total device costs and has not provided for adequate speech-language pathology support. Data from the pilot indicated the demand for non-electronic communication aids, and patterns suggest potential factors that govern the types selected. Despite the high demand for non-electronic aids, the research literature has tended to focus on electronic communication aids, including within intervention studies and addressing design features and long-term outcomes. Concerns about ensuring that AAC systems are chosen according to the assessed needs of individuals are discussed within the context of limitations in outcomes research and appropriate outcome measures.

Introduction to mathematical fluid dynamics

CERN Document Server

Meyer, Richard E

2010-01-01

An introduction to the behavior of liquids and gases, this volume provides excellent coverage of kinematics, momentum principle, Newtonian fluid, rotating fluids, compressibility, and more. It is geared toward advanced undergraduate and graduate students of mathematics and general science, and it requires a background in calculus and vector analysis. 1971 edition.

An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal

OpenAIRE

Clarke, M; Mars, M

2014-01-01

This article has been made available through the Brunel Open Access Publishing Fund. Abstract Background: We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. Materials and Methods: We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access...

Fluid control structures in microfluidic devices

Science.gov (United States)

Mathies, Richard A.; Grover, William H.; Skelley, Alison; Lagally, Eric; Liu, Chung N.

2017-05-09

Methods and apparatus for implementing microfluidic analysis devices are provided. A monolithic elastomer membrane associated with an integrated pneumatic manifold allows the placement and actuation of a variety of fluid control structures, such as structures for pumping, isolating, mixing, routing, merging, splitting, preparing, and storing volumes of fluid. The fluid control structures can be used to implement a variety of sample introduction, preparation, processing, and storage techniques.

Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments

Directory of Open Access Journals (Sweden)

Noortgate Nele

2009-12-01

Full Text Available Abstract Background The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. Methods A cross-sectional mail survey was sent to all acute hospitals (67 main campuses in Flanders (Belgium. The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. Results The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%. While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%. More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Conclusions Most Flemish acute hospitals have developed a policy on end-of-life practices

Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments.

Science.gov (United States)

D'Haene, Ina; Vander Stichele, Robert H; Pasman, H Roeline W; Noortgate, Nele Van den; Bilsen, Johan; Mortier, Freddy; Deliens, Luc

2009-12-30

The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. A cross-sectional mail survey was sent to all acute hospitals (67 main campuses) in Flanders (Belgium). The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%). While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%). More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Most Flemish acute hospitals have developed a policy on end-of-life practices. However, communication, training and the education of health care

A Systematic Review of End-of-Life Care Communication Skills Training for Generalist Palliative Care Providers: Research Quality and Reporting Guidance.

Science.gov (United States)

Brighton, Lisa Jane; Koffman, Jonathan; Hawkins, Amy; McDonald, Christine; O'Brien, Suzanne; Robinson, Vicky; Khan, Shaheen A; George, Rob; Higginson, Irene J; Selman, Lucy Ellen

2017-09-01

End-of-life care (EoLC) communication skills training for generalist palliative care providers is recommended in policy guidance globally. Although many training programs now exist, there has been no comprehensive evidence synthesis to inform future training delivery and evaluation. To identify and appraise how EoLC communication skills training interventions for generalist palliative care providers are developed, delivered, evaluated, and reported. Systematic review. Ten electronic databases (inception to December 2015) and five relevant journals (January 2004 to December 2015) were searched. Studies testing the effectiveness of EoLC communication skills training for generalists were included. Two independent authors assessed study quality. Descriptive statistics and narrative synthesis are used to summarize the findings. From 11,441 unique records, 170 reports were identified (157 published, 13 unpublished), representing 160 evaluation studies of 153 training interventions. Of published papers, eight were of low quality, 108 medium, and 41 high. Few interventions were developed with service user involvement (n = 7), and most were taught using a mixture of didactics (n = 123), reflection and discussion (n = 105), and role play (n = 86). Evaluation designs were weak: communication skills training interventions in the literature, evidence is limited by poor reporting and weak methodology. Based on our findings, we present a CONSORT statement supplement to improve future reporting and encourage more rigorous testing. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Racial and ethnic disparities in patient-provider communication, quality-of-care ratings, and patient activation among long-term cancer survivors.

Science.gov (United States)

Palmer, Nynikka R A; Kent, Erin E; Forsythe, Laura P; Arora, Neeraj K; Rowland, Julia H; Aziz, Noreen M; Blanch-Hartigan, Danielle; Oakley-Girvan, Ingrid; Hamilton, Ann S; Weaver, Kathryn E

2014-12-20

We examined racial and ethnic disparities in patient-provider communication (PPC), perceived care quality, and patient activation among long-term cancer survivors. In 2005 to 2006, survivors of breast, prostate, colorectal, ovarian, and endometrial cancers completed a mailed survey on cancer follow-up care. African American, Asian/Pacific Islander (Asian), Hispanic, and non-Hispanic white (white) survivors who had seen a physician for follow-up care in the past 2 years (n = 1,196) composed the analytic sample. We conducted linear and logistic regression analyses to identify racial and ethnic differences in PPC (overall communication and medical test communication), perceived care quality, and patient activation in clinical care (self-efficacy in medical decisions and perceived control). We further examined the potential contribution of PPC to racial and ethnic differences in perceived care quality and patient activation. Compared with white survivors (mean score, 85.16), Hispanic (mean score, 79.95) and Asian (mean score, 76.55) survivors reported poorer overall communication (P = .04 and P Asian survivors (mean score, 79.97) reported poorer medical test communication (P = .001). Asian survivors were less likely to report high care quality (odds ratio, 0.47; 95% CI, 0.30 to 0.72) and reported lower self-efficacy in medical decisions (mean score, 74.71; P Asian disparities remained significant. Asian survivors report poorer follow-up care communication and care quality. More research is needed to identify contributing factors beyond PPC, such as cultural influences and medical system factors. © 2014 by American Society of Clinical Oncology.

Advances in Environmental Fluid Mechanics

CERN Document Server

Mihailovic, Dragutin T

2010-01-01

Environmental fluid mechanics (EFM) is the scientific study of transport, dispersion and transformation processes in natural fluid flows on our planet Earth, from the microscale to the planetary scale. This book brings together scientists and engineers working in research institutions, universities and academia, who engage in the study of theoretical, modeling, measuring and software aspects in environmental fluid mechanics. It provides a forum for the participants, and exchanges new ideas and expertise through the presentations of up-to-date and recent overall achievements in this field.

The human factor: the critical importance of effective teamwork and communication in providing safe care

OpenAIRE

Leonard, M; Graham, S; Bonacum, D

2004-01-01

Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members...

Fluid mechanics in fluids at rest.

Science.gov (United States)

Brenner, Howard

2012-07-01

Using readily available experimental thermophoretic particle-velocity data it is shown, contrary to current teachings, that for the case of compressible flows independent dye- and particle-tracer velocity measurements of the local fluid velocity at a point in a flowing fluid do not generally result in the same fluid velocity measure. Rather, tracer-velocity equality holds only for incompressible flows. For compressible fluids, each type of tracer is shown to monitor a fundamentally different fluid velocity, with (i) a dye (or any other such molecular-tagging scheme) measuring the fluid's mass velocity v appearing in the continuity equation and (ii) a small, physicochemically and thermally inert, macroscopic (i.e., non-Brownian), solid particle measuring the fluid's volume velocity v(v). The term "compressibility" as used here includes not only pressure effects on density, but also temperature effects thereon. (For example, owing to a liquid's generally nonzero isobaric coefficient of thermal expansion, nonisothermal liquid flows are to be regarded as compressible despite the general perception of liquids as being incompressible.) Recognition of the fact that two independent fluid velocities, mass- and volume-based, are formally required to model continuum fluid behavior impacts on the foundations of contemporary (monovelocity) fluid mechanics. Included therein are the Navier-Stokes-Fourier equations, which are now seen to apply only to incompressible fluids (a fact well-known, empirically, to experimental gas kineticists). The findings of a difference in tracer velocities heralds the introduction into fluid mechanics of a general bipartite theory of fluid mechanics, bivelocity hydrodynamics [Brenner, Int. J. Eng. Sci. 54, 67 (2012)], differing from conventional hydrodynamics in situations entailing compressible flows and reducing to conventional hydrodynamics when the flow is incompressible, while being applicable to both liquids and gases.

The efficacy of online communication platforms for plastic surgeons providing extended disaster relief.

Science.gov (United States)

Fan, Kenneth L; Avashia, Yash J; Dayicioglu, Deniz; DeGennaro, Vincent A; Thaller, Seth R

2014-04-01

Immediately after the January 2010 earthquake in Haiti, plastic surgeons provided disaster relief services through the University of Miami Miller School of Medicine for 5 months. To improve surgical care and promote awareness of plastic surgery's role in humanitarian assistance, an online communication platform (OCP) was initiated. An OCP is a Web-based application combining Web blogging, picture uploading, news posting, and private messaging systems into a single platform. The purpose of this study was to analyze the use of OCP during disaster relief. Surgeries performed during the period from January 13 to May 28, 2010, were documented. The OCP was established with 4 priorities: ease of use, multimedia integration, organization capabilities, and security. Web traffic was documented. A 17-question survey was administered to 18 plastic surgeons who used the OCP after 1 year to assess their attitudes and perceptions. From January 13 to May 28, 2010, 413 operations were performed at the field hospital. Of the overall number of procedures, 46.9% were performed by plastic surgery teams. In a year, beginning from January 12, 2011, the OCP had 1117 visits with 530 absolute unique visitors. Of 17 plastic surgeons, 71% responded that the OCP improved follow-up and continuity of care by debriefing rotating plastic surgery teams. One hundred percent claimed that the OCP conveyed the role of plastic surgeons with the public. Results demonstrate the necessity of OCP during disaster relief. Online communication platform permitted secure exchange of surgical management details, follow-up, photos, and miscellaneous necessary recommendations. Posted experiences and field hospital progress assisted in generating substantial awareness regarding the significant role and contribution played by plastic surgeons in disaster relief.

Sources of variability in human communicative skills

Directory of Open Access Journals (Sweden)

Inge eVolman

2012-11-01

Full Text Available When established communication systems cannot be used, people rapidly create novel systems to modify the mental state of another agent according to their intentions. However, there are dramatic inter-individual differences in the implementation of this human competence for communicative innovation. Here we characterize psychological sources of inter-individual variability in the ability to build a shared communication system from scratch. We consider two potential sources of variability in communicative skills. Cognitive traits of two individuals could independently influence their joint ability to establish a communication system. Another possibility is that the overlap between those individual traits influences the communicative performance of a dyad. We assess these possibilities by quantifying the relationship between cognitive traits and behavior of communicating dyads. Cognitive traits were assessed with psychometric scores quantifying cooperative attitudes and fluid intelligence. Competence for implementing successful communicative innovations was assessed by using a non-verbal communicative task. Individual capacities influence communicative success when communicative innovations are generated. Dyadic similarities and individual traits modulate the type of communicative strategy chosen. The ability to establish novel communicative actions was influenced by a combination of the communicator’s ability to understand intentions and the addressee’s ability to recognize patterns. Communicative pairs with comparable systemizing abilities or behavioral inhibition were more likely to explore the search space of possible communicative strategies by systematically adding new communicative behaviors to those already available. No individual psychometric measure seemed predominantly responsible for communicative success. These findings support the notion that the human ability for fast communicative innovations represents a special type of

Three-dimensional fluid-structure interaction case study on cubical fluid cavity with flexible bottom

Science.gov (United States)

Ghelardi, Stefano; Rizzo, Cesare; Villa, Diego

2017-12-01

In this paper, we report our study on a numerical fluid-structure interaction problem originally presented by Mok et al. (2001) in two dimensions and later studied in three dimensions by Valdés Vazquez (2007), Lombardi (2012), and Trimarchi (2012). We focus on a 3D test case in which we evaluated the sensitivity of several input parameters on the fluid and structural results. In particular, this analysis provides a starting point from which we can look deeper into specific aspects of these simulations and analyze more realistic cases, e.g., in sails design. In this study, using the commercial software ADINA™, we addressed a well-known unsteadiness problem comprising a square box representing the fluid domain with a flexible bottom modeled with structural shell elements. We compared data from previously published work whose authors used the same numerical approach, i.e., a partitioned approach coupling a finite volume solver (for the fluid domain) and a finite element solver (for the solid domain). Specifically, we established several benchmarks and made comparisons with respect to fluid and solid meshes, structural element types, and structural damping, as well as solution algorithms. Moreover, we compared our method with a monolithic finite element solution method. Our comparisons of new and old results provide an outline of best practices for such simulations.

Fluid intelligence: A brief history.

Science.gov (United States)

Kent, Phillip

2017-01-01

The concept of fluid and crystallized intelligence was introduced to the psychological community approximately 75 years ago by Raymond B. Cattell, and it continues to be an area of active research and controversy. The purpose of this paper is to provide a brief overview of the origin of the concept, early efforts to define intelligence and uses of intelligence tests to address pressing social issues, and the ongoing controversies associated with fluid intelligence and the structure of intelligence. The putative neuropsychological underpinnings and neurological substrates of fluid intelligence are discussed.

Boundary control of fluid flow through porous media

DEFF Research Database (Denmark)

Hasan, Agus; Foss, Bjarne; Sagatun, Svein Ivar

2010-01-01

The flow of fluids through porous media can be described by the Boussinesq’s equation with mixed boundary conditions; a Neumann’s boundary condition and a nonlinear boundary condition. The nonlinear boundary condition provides a means to control the fluid flow through porous media. In this paper,......, some stabilizing controllers are constructed for various cases using Lyapunov design.......The flow of fluids through porous media can be described by the Boussinesq’s equation with mixed boundary conditions; a Neumann’s boundary condition and a nonlinear boundary condition. The nonlinear boundary condition provides a means to control the fluid flow through porous media. In this paper...

Ripple Communication.

Science.gov (United States)

Wilcox, R. Stimson

1980-01-01

Discusses how surface-dwelling animals use the water surface as a mode of communication by making ripple signals while they swim about. Provides information about surfaces and surface waves, ripple communication in water striders, ripple signal characteristics, sensing and orienting, other modes of communication, and evolution of ripple…

Effectiveness of the Lunch is in the Bag program on communication between the parent, child and child-care provider around fruits, vegetables and whole grain foods: A group-randomized controlled trial.

Science.gov (United States)

Sharma, Shreela V; Rashid, Tasnuva; Ranjit, Nalini; Byrd-Williams, Courtney; Chuang, Ru-Jye; Roberts-Gray, Cynthia; Briley, Margaret; Sweitzer, Sara; Hoelscher, Deanna M

2015-12-01

To evaluate the effectiveness of the parent- and early care education (ECE) center-based Lunch is in the Bag program on communication between parent, child, and their ECE center providers around fruits, vegetables and whole grain foods (FVWG). A total of n=30 ECE center; 577 parent-child dyads participated in this group-randomized controlled trial conducted from 2011 to 2013 in Texas (n=15 ECE center, 327 dyads intervention group; n=15 ECE center, 250 dyads comparison group). Parent-child and parent-ECE center provider communication was measured using a parent-reported survey administered at baseline and end of the five-week intervention period. Multilevel linear regression analysis was used to compare the pre-to-post intervention changes in the parent-child and parent-ECE center provider communication scales. Significance was set at pparent-child and parent-ECE center provider communication scores were low. There was a significant increase post-intervention in the parent-ECE center provider communication around vegetables (Adjusted β=0.78, 95%CI: 0.13, 1.43, p=0.002), and around fruit (Adjusted β=0.62, 95%CI: 0.04, 0.20, p=0.04) among the parents in the intervention group as compared to those in the comparison group. There were no significant intervention effects on parent-child communication. Lunch is in the Bag had significant positive effects on improving communication between the parents and ECE center providers around FVWG. Copyright © 2015 Elsevier Inc. All rights reserved.

Communicating hydrocephalus. Cisternographic and neuropathologic studies

International Nuclear Information System (INIS)

Price, D.L.; James, E.; Sperber, E.; Strecker, E.P.

1976-01-01

Chronic communicating hydrocephalus was produced in adult dogs by injection of silastic into the subarachnoid space. Electron microscopy was used to verify the sequence of pathologic changes in the ventricular wall. The pathologic findings were correlated with cisternographic images and measurements of cerebrospinal fluid (CSF) pressure. Early in hydrocephalus, the CSF pressure was increased and cisternograms showed ventricular entry and clearing; the ependyma was stretched and fluid accumulated in subependymal regions. In animals with chronic hydrocephalus, the CSF pressure was normal and cisternograms disclosed radioactivity persisting in the ventricles. At this time the ependyma was severely damaged, the subependymal white matter showed enlargement of the extracellular space, and degenerative changes were present in axons and myelin sheaths

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

Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study.

Science.gov (United States)

Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B; Howard, Andrea A

2017-01-01

mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.

Communication Speaks

Science.gov (United States)

Kinman, Robin Lynn

2010-01-01

When the author recently turned her attention to the National Council of Teachers of Mathematics (NCTM) "Principles and Standards," she was startled to see communication as key. She adjusted her teaching to meet the NCTM Communication Standard and promote communication in her classroom by providing a safe environment, developing discourse and…

Magnelok technology: a complement to magnetorheological fluids

Science.gov (United States)

Carlson, J. David

2004-07-01

Magnetorheological or MR fluids have been successfully used to enable highly effective semi-active control systems in automobile primary suspensions to control unwanted motions in civil engineering structures and to provide force-feedback in steer-by-wire systems. A key to the successful use of MR fluids is an appreciation and understanding of the balance and trade-off between the magnetically controlled on-state force and the ever-present off-state viscous force. In all MR fluid applications, one must deal with the fact that MR fluids never fully decouple or go to zero force in their off-state. Magnelok devices are a magnetically controlled compliment to traditional MR fluid devices that have been developed to enable a true force decoupling in the off-state. Magnelok devices may be embodied as linear or rotary dampers, brakes, lockable struts or position holding devices. They are particularly suitable for lock/un-lock applications. Unlike MR fluid devices they contain no fluid yet they do provide a variable level of friction damping that is controlled by the magnitude of the applied magnetic field. Magnelok devices are low cost as they easily accommodate relatively loose mechanical tolerances and require no seals or accumulator. A variety of controllable Magnelok devices and applications are described.

Perception of risk and communication among conventional and complementary health care providers involving cancer patients' use of complementary therapies: a literature review.

Science.gov (United States)

Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E; Musial, Frauke; Salamonsen, Anita

2016-09-08

Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with

Provider-to-provider communication in dermatology and implications of missing clinical information in skin biopsy requisition forms: a systematic review.

Science.gov (United States)

Comfere, Nneka I; Sokumbi, Olayemi; Montori, Victor M; LeBlanc, Annie; Prokop, Larry J; Murad, M Hassan; Tilburt, Jon C

2014-05-01

Various components of the skin biopsy requisition form (SBRF) may contribute to accurate dermatopathologic interpretation. A search of electronic databases, including those of Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Scopus, was conducted from inception to October 2011. Two authors independently screened all articles for eligibility. Inclusion criteria required material to represent original studies on skin biopsy and pathology requisition forms. Data abstracted from each article that met the inclusion criteria included details of the study characteristics, including the study location, type of pathology practice, specimen type, type of dermatoses, medical specialty of the requesting provider, suggested clinical components, and format of the SBRF. Of 32 titles and abstracts reviewed, seven articles were included. From these, we determined that dermatologists, general practitioners and surgeons completed SBRFs. Commonly included components were patient demographics and requesting clinician characteristics. Clinical information and differential diagnosis were provided in 4% (two of 48 surgeons) to 36% (18 of 50 dermatologists) of requisitions. Most SBRFs did not include information on specimen type, clinical morphology, photographs or clinical history. The limited medical literature demonstrates variation in the content of SBRFs across clinicians and practices, and suggests an important target for improvement in the quality of communication and dermatologic care by requesting clinicians and pathologists. © 2013 The International Society of Dermatology.

The Impact of a Group Communication Course on Veterinary Medical Students' Perceptions of Communication Competence and Communication Apprehension.

Science.gov (United States)

Kedrowicz, April A

2016-01-01

This paper explores the impact of a group communication course on veterinary medical students' perceptions of communication competence and communication anxiety. Students enrolled in the Group Communication in Veterinary Medicine course completed the Personal Report of Communication Apprehension and the Communicative Competence Scale at the beginning (Time 1) and end (Time 2) of the semester. Results show that first-year veterinary students' self-perceptions of communication competence increased and their self-reported levels of communication apprehension decreased across multiple contexts from Time 1 to Time 2. This research provides support for experiential communication training fostering skill development and confidence.

Fluid simulation for computer graphics

CERN Document Server

Bridson, Robert

2008-01-01

Animating fluids like water, smoke, and fire using physics-based simulation is increasingly important in visual effects, in particular in movies, like The Day After Tomorrow, and in computer games. This book provides a practical introduction to fluid simulation for graphics. The focus is on animating fully three-dimensional incompressible flow, from understanding the math and the algorithms to the actual implementation.

Resolution of through tubing fluid flow and behind casing fluid flow in multiple completion wells

International Nuclear Information System (INIS)

Arnold, D.M.

1977-01-01

A method is provided for resolving undesired fluid flow in cement channels behind casing in one producing zone of a multi zone completion well operating on gas lift from the fluid flow from lower producing zones in the same well which is contained in production tubing passing through the producing zone being investigated. Gamma rays which are characteristic of the decay of the unstable isotope nitrogen 16 produced by activation of elemental oxygen nuclei comprising the molecular structure of both the tubing fluid flow and the undesired fluid flow are detected in at least two energy bonds at two longitudinally spaced detectors in a well borehole. By appropriately combining the four count rate signals so producing according to predetermined relationships the two fluid flow components in the same direction may be uniquely distinguished on the basis of their differing distances from the gamma ray detectors. 9 claims, 17 figures

Hydraulic fracturing chemicals and fluids technology

CERN Document Server

Fink, Johannes

2013-01-01

When classifying fracturing fluids and their additives, it is important that production, operation, and completion engineers understand which chemical should be utilized in different well environments. A user's guide to the many chemicals and chemical additives used in hydraulic fracturing operations, Hydraulic Fracturing Chemicals and Fluids Technology provides an easy-to-use manual to create fluid formulations that will meet project-specific needs while protecting the environment and the life of the well. Fink creates a concise and comprehensive reference that enables the engineer to logically select and use the appropriate chemicals on any hydraulic fracturing job. The first book devoted entirely to hydraulic fracturing chemicals, Fink eliminates the guesswork so the engineer can select the best chemicals needed on the job while providing the best protection for the well, workers and environment. Pinpoints the specific compounds used in any given fracturing operation Provides a systematic approach to class...

NASA Fluid Lensing & MiDAR: Next-Generation Remote Sensing Technologies for Aquatic Remote Sensing

Science.gov (United States)

Chirayath, Ved

2018-01-01

We present two recent instrument technology developments at NASA, Fluid Lensing and MiDAR, and their application to remote sensing of Earth's aquatic systems. Fluid Lensing is the first remote sensing technology capable of imaging through ocean waves in 3D at sub-cm resolutions. MiDAR is a next-generation active hyperspectral remote sensing and optical communications instrument capable of active fluid lensing. Fluid Lensing has been used to provide 3D multispectral imagery of shallow marine systems from unmanned aerial vehicles (UAVs, or drones), including coral reefs in American Samoa and stromatolite reefs in Hamelin Pool, Western Australia. MiDAR is being deployed on aircraft and underwater remotely operated vehicles (ROVs) to enable a new method for remote sensing of living and nonliving structures in extreme environments. MiDAR images targets with high-intensity narrowband structured optical radiation to measure an objectâ€"TM"s non-linear spectral reflectance, image through fluid interfaces such as ocean waves with active fluid lensing, and simultaneously transmit high-bandwidth data. As an active instrument, MiDAR is capable of remotely sensing reflectance at the centimeter (cm) spatial scale with a signal-to-noise ratio (SNR) multiple orders of magnitude higher than passive airborne and spaceborne remote sensing systems with significantly reduced integration time. This allows for rapid video-frame-rate hyperspectral sensing into the far ultraviolet and VNIR wavelengths. Previously, MiDAR was developed into a TRL 2 laboratory instrument capable of imaging in thirty-two narrowband channels across the VNIR spectrum (400-950nm). Recently, MiDAR UV was raised to TRL4 and expanded to include five ultraviolet bands from 280-400nm, permitting UV remote sensing capabilities in UV A, B, and C bands and enabling mineral identification and stimulated fluorescence measurements of organic proteins and compounds, such as green fluorescent proteins in terrestrial and

A method of providing a barrier in a fracture-containing system

DEFF Research Database (Denmark)

2014-01-01

The present invention relates to a method of providing a barrier in a fracture-containing system, comprising: i) Providing a treatment fluid comprising: a) a base fluid; b) an elastomeric material, wherein said elastomeric material comprises at least one polymer capable of crosslinking into an el......The present invention relates to a method of providing a barrier in a fracture-containing system, comprising: i) Providing a treatment fluid comprising: a) a base fluid; b) an elastomeric material, wherein said elastomeric material comprises at least one polymer capable of crosslinking...... into an elastomer, and c) at least one crosslinking agent; ii) Placing the treatment fluid in a fracture-containing system; iii) Allowing the elastomeric material to crosslink with itself to form a barrier in said fracture-containing system; wherein the elastomeric material and/or the crosslinking agent...... are of neutral buoyancy with regard to the base fluid. The invention is contemplated to having utility not only in the oil-drilling industry but also in the plugging of fractures in sewer drains, pipelines etc....

Does routine psychosocial screening improve referral to psychosocial care providers and patient-radiotherapist communication? A cluster randomized controlled trial.

Science.gov (United States)

Braeken, Anna P B M; Lechner, Lilian; Eekers, Daniëlle B P; Houben, Ruud M A; van Gils, Francis C J M; Ambergen, Ton; Kempen, Gertrudis I J M

2013-11-01

This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication. A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention. Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (Pcommunication. Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients. Psychosocial screening can be enhanced by effective radiotherapist-patient communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Apparatus and method for continuous separation of magnetic particles from non-magnetic fluids

Science.gov (United States)

Oder, Robin R.; Jamison, Russell E.

2010-02-09

A magnetic separator vessel (1) for separating magnetic particles from non-magnetic fluid includes a separation chamber having an interior and exterior wall, a top and bottom portion; a magnet (3) having first and second poles (2) positioned adjacent to the exterior wall, wherein the first pole is substantially diametrically opposed to the second pole; a inlet port (5) is directed into the top portion of the separation chamber, wherein the inlet port (5) is positioned adjacent to one of the first and second poles (2), wherein the inlet port (5) is adapted to transfer a mixture into the separation chamber; an underflow port (6) in communication with the bottom portion, wherein the underflow port (6) is adapted to receive the magnetic particles; and an overflow port (9) in communication with the separation chamber, wherein the overflow port (9) is adapted to receive the non-magnetic fluid.

Communication access in the library for individuals who use augmentative and alternative communication.

Science.gov (United States)

Shepherd, Tracy A; McDougall, Stacy

2008-12-01

Libraries for All is a community-based program that aims to enhance communication access to the library for individuals who use augmentative and alternative communication (AAC), by providing resources and instruction. The goals are to (a) provide communication boards, (b) complete facilitator training, and (c) promote the program. To accomplish these goals, four communication boards were created and provided to all public libraries in London, Ontario. A train-the-trainer model was employed to ensure that all members of the library staff were familiar with the boards and aware of strategies to communicate more effectively with individuals who use AAC. Marketing materials were sent to potential stakeholders. The success of the program in meeting these three goals is highlighted.

4-H NFPA Fluid Power Challenge

OpenAIRE

Bonnett, Erika D

2016-01-01

The 4-H NFPA Fluid Power Challenge partnered Purdue Polytechnic Institute and Indiana 4-H with the National Fluid Power Association and Center for Compact and Efficient Fluid Power to provide teams of Indiana youth in 6-8th grades with opportunity to learn about hydraulics, engineering design, and other STEM skills. This created an opportunity to give youth a learning experience with STEM through hands-on, experiential learning activities. Youth experienced a one day workshop in which they wo...

Characteristics of laminar MHD fluid hammer in pipe

International Nuclear Information System (INIS)

Huang, Z.Y.; Liu, Y.J.

2016-01-01

As gradually wide applications of MHD fluid, transportation as well as control with pumps and valves is unavoidable, which induces MHD fluid hammer. The paper attempts to combine MHD effect and fluid hammer effect and to investigate the characteristics of laminar MHD fluid hammer. A non-dimensional fluid hammer model, based on Navier–Stocks equations, coupling with Lorentz force is numerically solved in a reservoir–pipe–valve system with uniform external magnetic field. The MHD effect is represented by the interaction number which associates with the conductivity of the MHD fluid as well as the external magnetic field and can be interpreted as the ratio of Lorentz force to Joukowsky force. The transient numerical results of pressure head, average velocity, wall shear stress, velocity profiles and shear stress profiles are provided. The additional MHD effect hinders fluid motion, weakens wave front and homogenizes velocity profiles, contributing to obvious attenuation of oscillation, strengthened line packing and weakened Richardson annular effect. Studying the characteristics of MHD laminar fluid hammer theoretically supplements the gap of knowledge of rapid-transient MHD flow and technically provides beneficial information for MHD pipeline system designers to better devise MHD systems. - Highlights: • Characteristics of laminar MHD fluid hammer are discussed by simulation. • MHD effect has significant influence on attenuation of wave. • MHD effect strengthens line packing. • MHD effect inhibits Richardson annular effect.

Patients' perspective of the design of provider-patients electronic communication services.

Science.gov (United States)

Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

2014-06-12

Information Delivery is one the most important tasks in healthcare practice. This article discusses patient's tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design.

Single-particle Schroedinger fluid. I. Formulation

International Nuclear Information System (INIS)

Kan, K.K.; Griffin, J.J.

1976-01-01

The problem of a single quantal particle moving in a time-dependent external potential well is formulated specifically to emphasize and develop the fluid dynamical aspects of the matter flow. This idealized problem, the single-particle Schroedinger fluid, is shown to exhibit already a remarkably rich variety of fluid dynamical features, including compressible flow and line vortices. It provides also a sufficient framework to encompass simultaneously various simplified fluidic models for nuclei which have earlier been postulated on an ad hoc basis, and to illuminate their underlying restrictions. Explicit solutions of the single-particle Schroedinger fluid problem are studied in the adiabatic limit for their mathematical and physical implications (especially regarding the collective kinetic energy). The basic generalizations for extension of the treatment to the many-body Schroedinger fluid are set forth

Teaching Paraeducators to Support the Communication of Young Children with Complex Communication Needs

Science.gov (United States)

Douglas, Sarah N.; Light, Janice C.; McNaughton, David B.

2013-01-01

Paraeducators are frequent communication partners for young children with complex communication needs (CCN) in early childhood settings. This study examined the impact of instruction to paraeducators in two communication interaction strategies (IPLAN [Identify activities for communication, Provide means for communication, Locate and provide…

Clusters in simple fluids

International Nuclear Information System (INIS)

Sator, N.

2003-01-01

This article concerns the correspondence between thermodynamics and the morphology of simple fluids in terms of clusters. Definitions of clusters providing a geometric interpretation of the liquid-gas phase transition are reviewed with an eye to establishing their physical relevance. The author emphasizes their main features and basic hypotheses, and shows how these definitions lead to a recent approach based on self-bound clusters. Although theoretical, this tutorial review is also addressed to readers interested in experimental aspects of clustering in simple fluids

Fluids in crustal deformation: Fluid flow, fluid-rock interactions, rheology, melting and resources

Science.gov (United States)

Lacombe, Olivier; Rolland, Yann

2016-11-01

Fluids exert a first-order control on the structural, petrological and rheological evolution of the continental crust. Fluids interact with rocks from the earliest stages of sedimentation and diagenesis in basins until these rocks are deformed and/or buried and metamorphosed in orogens, then possibly exhumed. Fluid-rock interactions lead to the evolution of rock physical properties and rock strength. Fractures and faults are preferred pathways for fluids, and in turn physical and chemical interactions between fluid flow and tectonic structures, such as fault zones, strongly influence the mechanical behaviour of the crust at different space and time scales. Fluid (over)pressure is associated with a variety of geological phenomena, such as seismic cycle in various P-T conditions, hydrofracturing (including formation of sub-horizontal, bedding-parallel veins), fault (re)activation or gravitational sliding of rocks, among others. Fluid (over)pressure is a governing factor for the evolution of permeability and porosity of rocks and controls the generation, maturation and migration of economic fluids like hydrocarbons or ore forming hydrothermal fluids, and is therefore a key parameter in reservoir studies and basin modeling. Fluids may also help the crust partially melt, and in turn the resulting melt may dramatically change the rheology of the crust.

Gas powered fluid gun with recoil mitigation

Science.gov (United States)

Grubelich, Mark C; Yonas, Gerold

2013-11-12

A gas powered fluid gun for propelling a stream or slug of a fluid at high velocity toward a target. Recoil mitigation is provided that reduces or eliminates the associated recoil forces, with minimal or no backwash. By launching a quantity of water in the opposite direction, net momentum forces are reduced or eliminated. Examples of recoil mitigation devices include a cone for making a conical fluid sheet, a device forming multiple impinging streams of fluid, a cavitating venturi, one or more spinning vanes, or an annular tangential entry/exit.

A Wireless Text Messaging System Improves Communication for Neonatal Resuscitation.

Science.gov (United States)

Hughes Driscoll, Colleen A; Schub, Jamie A; Pollard, Kristi; El-Metwally, Dina

Handoffs for neonatal resuscitation involve communicating critical delivery information (CDI). The authors sought to achieve ≥95% communication of CDI during resuscitation team requests. CDI included name of caller, urgency of request, location of delivery, gestation of fetus, status of amniotic fluid, and indication for presence of the resuscitation team. Three interventions were implemented: verbal scripted handoff, Spök text messaging, and Engage text messaging. Percentages of CDI communications were analyzed using statistical process control. Following implementation of Engage, the communication of all CDI, except for indication, was ≥95%; communication of indication occurred 93% of the time. Control limits for most CDI were narrower with Engage, indicating greater reliability of communication compared to the verbal handoff and Spök. Delayed resuscitation team arrival, a countermeasure, was not higher with text messaging compared to verbal handoff ( P = 1.00). Text messaging improved communication during high-risk deliveries, and it may represent an effective tool for other delivery centers.

Equilibrium and nonequilibrium dynamics of soft sphere fluids.

Science.gov (United States)

Ding, Yajun; Mittal, Jeetain

2015-07-14

We use computer simulations to test the freezing-point scaling relationship between equilibrium transport coefficients (self-diffusivity, viscosity) and thermodynamic parameters for soft sphere fluids. The fluid particles interact via the inverse-power potential (IPP), and the particle softness is changed by modifying the exponent of the distance-dependent potential term. In the case of IPP fluids, density and temperature are not independent variables and can be combined to obtain a coupling parameter to define the thermodynamic state of the system. We find that the rescaled coupling parameter, based on its value at the freezing point, can approximately collapse the diffusivity and viscosity data for IPP fluids over a wide range of particle softness. Even though the collapse is far from perfect, the freezing-point scaling relationship provides a convenient and effective way to compare the structure and dynamics of fluid systems with different particle softness. We further show that an alternate scaling relationship based on two-body excess entropy can provide an almost perfect collapse of the diffusivity and viscosity data below the freezing transition. Next, we perform nonequilibrium molecular dynamics simulations to calculate the shear-dependent viscosity and to identify the distinct role of particle softness in underlying structural changes associated with rheological properties. Qualitatively, we find a similar shear-thinning behavior for IPP fluids with different particle softness, though softer particles exhibit stronger shear-thinning tendency. By investigating the distance and angle-dependent pair correlation functions in these systems, we find different structural features in the case of IPP fluids with hard-sphere like and softer particle interactions. Interestingly, shear-thinning in hard-sphere like fluids is accompanied by enhanced translational order, whereas softer fluids exhibit loss of order with shear. Our results provide a systematic evaluation

Electronic Payments using Mobile Communication Devices

NARCIS (Netherlands)

Waaij, B.D. van der; Siljee, B.I.J.; Broekhuijsen, B.J.; Ponsioen, C.; Maas, A.; Aten, R.M.; Hoepman, J.H.; Loon, J.H. van; Smit, M.

2009-01-01

A method of making a payment uses a first mobile communication device (1) and a second mobile communication device (2), each mobile communication device being provided with a respective near field communication unit (11, 21) and at least one of the mobile communication devices being provided with an

DOE Fundamentals Handbook: Thermodynamics, Heat Transfer, and Fluid Flow, Volume 1

International Nuclear Information System (INIS)

1992-06-01

The Thermodynamics, Heat Transfer, and Fluid Flow Fundamentals Handbook was developed to assist nuclear facility operating contractors provide operators, maintenance personnel, and the technical staff with the necessary fundamentals training to ensure a basic understanding of the thermal sciences. The handbook includes information on thermodynamics and the properties of fluids; the three modes of heat transfer -- conduction, convection, and radiation; and fluid flow, and the energy relationships in fluid systems. This information will provide personnel with a foundation for understanding the basic operation of various types of DOE nuclear facility fluid systems

DOE Fundamentals Handbook: Thermodynamics, Heat Transfer, and Fluid Flow, Volume 3

International Nuclear Information System (INIS)

1992-06-01

The Thermodynamics, Heat Transfer, and Fluid Flow Fundamentals Handbook was developed to assist nuclear facility operating contractors provide operators, maintenance personnel, and the technical staff with the necessary fundamentals training to ensure a basic understanding of the thermal sciences. The handbook includes information on thermodynamics and the properties of fluids; the three modes of heat transfer -- conduction, convection, and radiation; and fluid flow, and the energy relationships in fluid systems. This information will provide personnel with a foundation for understanding the basic operation of various types of DOE nuclear facility fluid systems

DOE Fundamentals Handbook: Thermodynamics, Heat Transfer, and Fluid Flow, Volume 2

International Nuclear Information System (INIS)

1992-06-01

The Thermodynamics, Heat Transfer, and Fluid Flow Fundamentals Handbook was developed to assist nuclear facility operating contractors provide operators, maintenance personnel, and the technical staff with the necessary fundamentals training to ensure a basic understanding of the thermal sciences. The handbook includes information on thermodynamics and the properties of fluids; the three modes of heat transfer -- conduction, convection, and radiation; and fluid flow, and the energy relationships in fluid systems. This information will provide personnel with a foundation for understanding the basic operation of various types of DOE nuclear facility fluid systems

Integrating Technical Communication in the Mechanical Engineering Curriculum

Science.gov (United States)

Norberg, Seth; Ashcraft, Timothy; van Poppel, Bret

2017-11-01

Technical communication is essential to engineering practice, but these skills can be challenging to teach and assess in the classroom. Instructors in the Mechanical Engineering (ME) program at the United States Military Academy are developing new learning exercises to prepare students for success in their capstone design course and beyond. In this paper we highlight the recent successes and lessons learned from two courses: junior-level Thermal-Fluid Systems and the senior-level ME Seminar. Both courses support the newly implemented West Point Writing Program (WPWP), an institutional, writing-across-the-curriculum program. The junior course incorporates four hands-on experiments, which provide an abundance of data for students to analyze, assess, and present. In the senior course the majority of the content that students present is from their ongoing capstone design projects. Between the two courses, students craft essays, lab reports, short summaries, posters, quad charts, and technical presentations. Both courses include peer evaluation, revision exercises, and timed (on demand) writing assignments. The junior course includes assignments co-authored by a group as well as an individual report. An overview of both courses' assignments with course-end feedback from the students and the faculty is provided. Strengths and weaknesses are identified and recommendations for instructors seeking to implement similar technical communications assignments in their own courses are presented.

Wave Interactions and Fluid Flows

Science.gov (United States)

Craik, Alex D. D.

1988-07-01

This up-to-date and comprehensive account of theory and experiment on wave-interaction phenomena covers fluids both at rest and in their shear flows. It includes, on the one hand, water waves, internal waves, and their evolution, interaction, and associated wave-driven means flow and, on the other hand, phenomena on nonlinear hydrodynamic stability, especially those leading to the onset of turbulence. This study provide a particularly valuable bridge between these two similar, yet different, classes of phenomena. It will be of value to oceanographers, meteorologists, and those working in fluid mechanics, atmospheric and planetary physics, plasma physics, aeronautics, and geophysical and astrophysical fluid dynamics.

Fluid-structure interaction of submerged structures

International Nuclear Information System (INIS)

Tang, H.T.; Becker, E.B.; Taylor, L.M.

1979-01-01

The purpose of the paper is to investigate fluid-structure interaction (FSI) of submerged structures in a confined fluid-structure system. Our particular interest is the load experienced by a rigid submerged structure subject to a pressure excitation in a fluid domain bounded by a structure which is either flexible or rigid. The objective is to see whether the load experienced by the submerged structure will be influenced by its confinement conditions. This investigation is intended to provide insight into the characteristics of FSI and answer the question as to whether one can obtain FSI independent data by constructing a small scale rigid submerged structure inside a flexible fluid-structure system. (orig.)

The Device for Communication in the Tool for Measurement in Boreholes

Directory of Open Access Journals (Sweden)

Miloš Slankamenac

2005-10-01

Full Text Available In this paper an implementation and test of the device for communication between Telemetry system and Surface unit with the tool for measurement of pipe diameter, fluid velocity and direction of flow in the borehole (Calliper-Fullbore Flowmeter - CFF are presented. This communication is done according to SIPLOS (Simultaneous Production Logging String protocol and it is used by Hotwell company [1] as a part of a larger system for borehole investigations.

Optimizing drilling performance using a selected drilling fluid

Science.gov (United States)

Judzis, Arnis [Salt Lake City, UT; Black, Alan D [Coral Springs, FL; Green, Sidney J [Salt Lake City, UT; Robertson, Homer A [West Jordan, UT; Bland, Ronald G [Houston, TX; Curry, David Alexander [The Woodlands, TX; Ledgerwood, III, Leroy W.

2011-04-19

To improve drilling performance, a drilling fluid is selected based on one or more criteria and to have at least one target characteristic. Drilling equipment is used to drill a wellbore, and the selected drilling fluid is provided into the wellbore during drilling with the drilling equipment. The at least one target characteristic of the drilling fluid includes an ability of the drilling fluid to penetrate into formation cuttings during drilling to weaken the formation cuttings.

Geophysical fluid dynamics

CERN Document Server

Pedlosky, Joseph

1982-01-01

The content of this book is based, largely, on the core curriculum in geophys­ ical fluid dynamics which land my colleagues in the Department of Geophysical Sciences at The University of Chicago have taught for the past decade. Our purpose in developing a core curriculum was to provide to advanced undergraduates and entering graduate students a coherent and systematic introduction to the theory of geophysical fluid dynamics. The curriculum and the outline of this book were devised to form a sequence of courses of roughly one and a half academic years (five academic quarters) in length. The goal of the sequence is to help the student rapidly advance to the point where independent study and research are practical expectations. It quickly became apparent that several topics (e. g. , some aspects of potential theory) usually thought of as forming the foundations of a fluid-dynamics curriculum were merely classical rather than essential and could be, however sadly, dispensed with for our purposes. At the same tim...

Geophysical fluid dynamics

CERN Document Server

Pedlosky, Joseph

1979-01-01

The content of this book is based, largely, on the core curriculum in geophys­ ical fluid dynamics which I and my colleagues in the Department of Geophysical Sciences at The University of Chicago have taught for the past decade. Our purpose in developing a core curriculum was to provide to advanced undergraduates and entering graduate students a coherent and systematic introduction to the theory of geophysical fluid dynamics. The curriculum and the outline of this book were devised to form a sequence of courses of roughly one and a half academic years (five academic quarters) in length. The goal of the sequence is to help the student rapidly advance to the point where independent study and research are practical expectations. It quickly became apparent that several topics (e. g. , some aspects of potential theory) usually thought of as forming the foundations of a fluid-dynamics curriculum were merely classical rather than essential and could be, however sadly, dispensed with for our purposes. At the same ti...

Correlation analysis between team communication characteristics and frequency of inappropriate communications

International Nuclear Information System (INIS)

Kim, Ar Ryum; Lee, Seung Woo; Park, Jinkyun; Kang, Hyun Gook; Seong, Poong Hyun

2013-01-01

Highlights: • We proposed a method to evaluate team communication characteristics based on social network analysis. • We compare team communication characteristics with the frequency of inappropriate communications. • Frequency of inappropriate communications were decreased when more operators perform the same types of role as others. • Frequency of inappropriate communications were decreased for teams who provide more number of acknowledgment. - Abstract: The characteristics of team communications are important since large process systems such as nuclear power plants, airline, and railways are operated by operating teams. In such situation, inappropriate communications can cause a lack of situational information and lead to serious consequences for the systems. As a result, the communication characteristics of operating teams should be understood in order to extract meaningful insights to address the nature of inappropriate communications. The purpose of this study was to develop a method to evaluate the characteristics of team communications based on social network analysis and compare them with the frequency of inappropriate communications. In order to perform the analysis, verbal protocol data, which were audio-visual recorded under training sessions by operating teams, were used and interfacing system loss of coolant accident scenarios were selected. As a result of the study, it was found that the frequency of inappropriate communications decreased when more operators perform the same types of role as other operators, since they can easily and effectively back up each other. Also, the frequency of inappropriate communication is decreased for teams which provide a relatively large communication content that acknowledge or confirm another communication content

Internet health information in the patient-provider dialogue.

Science.gov (United States)

Hong, Traci

2008-10-01

A patient discussing Internet health information with a health care provider (referred to as "patient-provider communication about Internet health information") can contribute positively to health outcomes. Although research has found that once Internet access is achieved, there are no ethnic differences in Internet health information seeking, it is unclear if there are ethnic differences in patient-provider communication about Internet health information. To help fill this gap in the literature, the National Cancer Institute's Health Information National Trends Survey 2005 was analyzed with Stata 9. Two sets of logistic regression analyses were conducted, one for a subsample of Internet users (n = 3,244) and one for a subsample of Internet users who are first-generation immigrants (n = 563). The dependent variable was patient-provider communication about Internet health information, which assessed whether survey participants had discussed online health information with a health care provider. The predictor variables included trust of health care provider, trust of online health information, Internet use, health care coverage, frequency of visits to health care provider, health status, and demographics. Among all Internet users, Whites had higher levels of patient-provider communication about Internet health information than Blacks and Asians. Similarly, among Internet users who are immigrants, Whites had higher levels of patient-provider communication about Internet health information than Blacks and Asians. While the digital divide is narrowing in terms of Internet access, racial differences in patient-provider communication about Internet health information may undermine the potential benefits of the information age.

A Fluid Membrane-Based Soluble Ligand Display System for Live CellAssays

Energy Technology Data Exchange (ETDEWEB)

Nam, Jwa-Min; Nair, Pradeep N.; Neve, Richard M.; Gray, Joe W.; Groves, Jay T.

2005-10-14

Cell communication modulates numerous biological processes including proliferation, apoptosis, motility, invasion and differentiation. Correspondingly, there has been significant interest in the development of surface display strategies for the presentation of signaling molecules to living cells. This effort has primarily focused on naturally surface-bound ligands, such as extracellular matrix components and cell membranes. Soluble ligands (e.g. growth factors and cytokines) play an important role in intercellular communications, and their display in a surface-bound format would be of great utility in the design of array-based live cell assays. Recently, several cell microarray systems that display cDNA, RNAi, or small molecules in a surface array format were proven to be useful in accelerating high-throughput functional genetic studies and screening therapeutic agents. These surface display methods provide a flexible platform for the systematic, combinatorial investigation of genes and small molecules affecting cellular processes and phenotypes of interest. In an analogous sense, it would be an important advance if one could display soluble signaling ligands in a surface assay format that allows for systematic, patterned presentation of soluble ligands to live cells. Such a technique would make it possible to examine cellular phenotypes of interest in a parallel format with soluble signaling ligands as one of the display parameters. Herein we report a ligand-modified fluid supported lipid bilayer (SLB) assay system that can be used to functionally display soluble ligands to cells in situ (Figure 1A). By displaying soluble ligands on a SLB surface, both solution behavior (the ability to become locally enriched by reaction-diffusion processes) and solid behavior (the ability to control the spatial location of the ligands in an open system) could be combined. The method reported herein benefits from the naturally fluid state of the supported membrane, which allows

Guidelines for European workplace drug testing in oral fluid.

Science.gov (United States)

Cooper, Gail; Moore, Christine; George, Claire; Pichini, Simona

2011-05-01

Over the past decade, oral fluid has established itself as a robust testing matrix for monitoring drug use or misuse. Commercially available collection devices provide opportunities to collect and test oral fluid by the roadside and near-patient testing with both clinical and criminal justice applications. One of the main advantages of oral fluid relates to the collection of the matrix which is non-invasive, simple, and can be carried out under direct observation making it ideal for workplace drug testing. Laboratories offering legally defensible oral fluid workplace drug testing must adhere to national and international quality standards (ISO/IEC 17025); however, these standards do not address issues specific to oral fluid testing. The European Workplace Drug Testing Society (EWDTS) recognizes the importance of providing best practice guidelines to organizations offering testing and those choosing to use oral fluid drug testing to test their employees. The aim of this paper is to present the EWDTS guidelines for oral fluid workplace drug testing. Copyright © 2011 John Wiley & Sons, Ltd.

"Are You Done?" Child Care Providers' Verbal Communication at Mealtimes that Reinforce or Hinder Children's Internal Cues of Hunger and Satiation

Science.gov (United States)

Ramsay, Samantha A.; Branen, Laurel J.; Fletcher, Janice; Price, Elizabeth; Johnson, Susan L.; Sigman-Grant, Madeleine

2010-01-01

Objective: To explore the verbal communication of child care providers regarding preschool children's internal and non-internal hunger and satiation cues. Methods: Video observation transcripts of Head Start staff (n=29) at licensed child care centers in Colorado, Idaho, and Nevada were analyzed for common themes. Results: Adults' verbal…

Connection Between Thermodynamics and Dynamics of Simple Fluids in Pores: Impact of Fluid-Fluid Interaction Range and Fluid-Solid Interaction Strength.

Science.gov (United States)

Krekelberg, William P; Siderius, Daniel W; Shen, Vincent K; Truskett, Thomas M; Errington, Jeffrey R

2017-08-03

Using molecular simulations, we investigate how the range of fluid-fluid (adsorbate-adsorbate) interactions and the strength of fluid-solid (adsorbate-adsorbent) interactions impact the strong connection between distinct adsorptive regimes and distinct self-diffusivity regimes reported in [Krekelberg, W. P.; Siderius, D. W.; Shen, V. K.; Truskett, T. M.; Errington, J. R. Langmuir 2013 , 29 , 14527-14535]. Although increasing the fluid-fluid interaction range changes both the thermodynamics and the dynamic properties of adsorbed fluids, the previously reported connection between adsorptive filling regimes and self-diffusivity regimes remains. Increasing the fluid-fluid interaction range leads to enhanced layering and decreased self-diffusivity in the multilayer-formation regime but has little effect on the properties within film-formation and pore-filling regimes. We also find that weakly attractive adsorbents, which do not display distinct multilayer formation, are hard-sphere-like at super- and subcritical temperatures. In this case, the self-diffusivity of the confined and bulk fluid has a nearly identical scaling-relationship with effective density.

Climate change communication: what can we learn from communication theory?

DEFF Research Database (Denmark)

Ballantyne, Anne Gammelgaard

2016-01-01

the field of communication theory are highlighted and discussed in the context of communicating climate change. Rooted in the interaction paradigm, the article proposes a meta‐theoretical framework that conceptualizes communication as a constitutive process of producing and reproducing shared meanings...... as a theoretical construct. In some instances, communication theory appears reduced to an ‘ad hoc’ toolbox, from which theories are randomly picked to provide studies with a fitting framework. Inspired by the paradigm shift from transmission to interaction within communication theory, potential lessons from...

Diffraction of Elastic Waves in Fluid-Layered Solid Interfaces by an Integral Formulation

Directory of Open Access Journals (Sweden)

J. E. Basaldúa-Sánchez

2013-01-01

Full Text Available In the present communication, scattering of elastic waves in fluid-layered solid interfaces is studied. The indirect boundary element method is used to deal with this wave propagation phenomenon in 2D fluid-layered solid models. The source is represented by Hankel’s function of second kind and this is always applied in the fluid. Our method is an approximate boundary integral technique which is based upon an integral representation for scattered elastic waves using single-layer boundary sources. This approach is typically called indirect because the sources’ strengths are calculated as an intermediate step. In addition, this formulation is regarded as a realization of Huygens’ principle. The results are presented in frequency and time domains. Various aspects related to the different wave types that emerge from this kind of problems are emphasized. A near interface pulse generates changes in the pressure field and can be registered by receivers located in the fluid. In order to show the accuracy of our method, we validated the results with those obtained by the discrete wave number applied to a fluid-solid interface joining two half-spaces, one fluid and the other an elastic solid.

Method for measuring particulate and gaseous metals in a fluid stream, device for measuring particulate and gaseous metals in a fluid stream

Science.gov (United States)

Farber, Paul S.; Huang, Hann-Shen

2001-01-01

A method for analyzing metal in a fluid is provided comprising maintaining a first portion of a continuous filter media substrate at a temperature coinciding with the phase in which the metal is to be analyzed; contacting the fluid to a first portion of said substrate to retain the metal on the first portion of said substrate; preventing further contact of the fluid to the first portion of substrate; and contacting the fluid to a second portion of said substrate to retain metal on the second portion of the said substrate while simultaneously analyzing the first portion for metal. Also provided is a device for the simultaneous monitoring and analysis of metal in a fluid comprising a continuous filter media substrate; means for maintaining a first portion of said filter media substrate at a temperature coinciding with the phase in which the metal is to be analyzed; a means for contacting the fluid to the first portion of said substrate; a means for preventing further contact of the fluid to the first portion of substrate; a means for contacting the fluid to a second portion of said substrate to retain metal on the second portion of the said substrate; and means for analyzing the first portion for metal.

Knowledge, Beliefs, and Communication Behavior of Oncology Health-care Providers (HCPs) regarding Lesbian, Gay, Bisexual, and Transgender (LGBT) Patient Health care.

Science.gov (United States)

Banerjee, Smita C; Walters, Chasity B; Staley, Jessica M; Alexander, Koshy; Parker, Patricia A

2018-01-01

Delivery of culturally competent care toward lesbian, gay, bisexual, and transgender (LGBT) patients depends on how health-care providers (HCPs) communicate with them; however, research about knowledge, attitude, and behavior of HCPs toward LGBT patients is scant. The objectives of our study were to describe oncology HCPs' knowledge and examine if beliefs about LGB and transgender patients mediate the effects of LGBT health-care knowledge on open communication behaviors with LGB and transgender patients, respectively. A total of 1253 HCPs (187 physicians, 153 advance practice professionals (APPs), 828 nurses, and 41 others) at a Comprehensive Cancer Center completed an online survey that included the following measures: LGBT health-care knowledge, beliefs, communication behaviors, willingness to treat LGBT patients, encouraging LGBT disclosure, and perceived importance of LGBT sensitivity training. Only 50 participants (5%) correctly answered all 7 knowledge items, and about half the respondents answered 3 (out of 7) items correctly. Favorable beliefs about LGBT health care mediated the effect of higher LGBT health-care knowledge on open communication behaviors with transgender patients, controlling for effects of type of profession, religious orientation, gender identity, sexual orientation, and having LGBT friends/family. The results of this study demonstrated an overall lack of medical knowledge and the need for more education about LGBT health care among oncology HCPs.

Adrenal hormones in human follicular fluid.

Science.gov (United States)

Jimena, P; Castilla, J A; Peran, F; Ramirez, J P; Vergara, F; Molina, R; Vergara, F; Herruzo, A

1992-11-01

Considerable evidence indicates that adrenal hormones may affect gonadal function. To assess the role of some adrenal hormones in human follicular fluid and their relationship with the ability of the oocyte to be fertilized and then to cleave in vitro, cortisol and dehydroepiandrosterone sulfate were measured in follicular fluid obtained at the time of oocyte recovery for in vitro fertilization from cycles stimulated by clomiphene citrate, human menopausal gonadotropin and human chorionic gonadotropin. Thirty-six follicular fluid containing mature oocyte-corona-cumulus complexes and free of visible blood contamination were included in this study. There was no significant difference in follicular fluid dehydroepiandrosterone sulfate concentration between follicles with oocytes which did or did not fertilize (5.1 +/- 1.1 vs 5.8 +/- 2.0 mumol/l). However, follicular fluid from follicles whose oocytes were not fertilized had levels of cortisol significantly higher than those in follicular fluid from follicles containing successfully fertilized oocytes (406.0 +/- 75.9 vs 339.2 +/- 37.0 nmol/l; p < 0.005). No significant correlations were found between rates of embryo cleavage and cortisol and dehydroepiandrosterone levels in follicular fluid. We conclude that cortisol levels in follicular fluid may provide an index of fertilization outcome, at least in stimulated cycles by clomiphene citrate, human menopausal gonadotropin and human chorionic gonadotropin.

On the characteristics of a numerical fluid dynamics simulator

International Nuclear Information System (INIS)

Winkler, K.H.A.; Norman, M.L.; Norton, J.L.

1986-01-01

John von Neumann envisioned scientists and mathematicians analyzing and controlling their numerical experiments on nonlinear dynamic systems interactively. The authors describe their concept of a real-time Numerical Fluid Dynamics Simulator NFDS. The authors envision the NFDS to be composed of simulation processors, data storage devices, and image processing devices of extremely high power and capacity, interconnected by very high throughput communication channels. They present individual component performance requirements for both real-time and playback operating modes of the NFDS, using problems of current interest in fluid dynamics as examples. Scaling relations are derived showing the dependence of system requirements on the dimensionality and complexity of the numerical model. The authors conclude by extending their analysis to the system requirements posed in modeling the more involved physics of radiation hydrodynamics

On the fluid mechanics of fires

Energy Technology Data Exchange (ETDEWEB)

TIESZEN,SHELDON R.

2000-02-29

Fluid mechanics research related to fire is reviewed with focus on canonical flows, multiphysics coupling aspects, experimental and numerical techniques. Fire is a low-speed, chemically-reacting, flow in which buoyancy plans an important role. Fire research has focused on two canonical flows, the reacting boundary-layer and the reacting free plume. There is rich, multi-lateral, bi-directional, coupling among fluid mechanics and scalar transport, combustion, and radiation. There is only a limited experimental fluid-mechanics database for fire due to measurement difficulties in the harsh environment, and the focus within the fire community on thermal/chemical consequences. Increasingly, computational fluid dynamics techniques are being used to provide engineering guidance on thermal/chemical consequences and to study fire phenomenology.

Persistent Homology to describe Solid and Fluid Structures during Multiphase Flow

Science.gov (United States)

Herring, A. L.; Robins, V.; Liu, Z.; Armstrong, R. T.; Sheppard, A.

2017-12-01

The question of how to accurately and effectively characterize essential fluid and solid distributions and structures is a long-standing topic within the field of porous media and fluid transport. For multiphase flow applications, considerable research effort has been made to describe fluid distributions under a range of conditions; including quantification of saturation levels, fluid-fluid pressure differences and interfacial areas, and fluid connectivity. Recent research has effectively used topological metrics to describe pore space and fluid connectivity, with researchers demonstrating links between pore-scale nonwetting phase topology to fluid mobilization and displacement mechanisms, relative permeability, fluid flow regimes, and thermodynamic models of multiphase flow. While topology is clearly a powerful tool to describe fluid distribution, topological metrics by definition provide information only on the connectivity of a phase, not its geometry (shape or size). Physical flow characteristics, e.g. the permeability of a fluid phase within a porous medium, are dependent on the connectivity of the pore space or fluid phase as well as the size of connections. Persistent homology is a technique which provides a direct link between topology and geometry via measurement of topological features and their persistence from the signed Euclidean distance transform of a segmented digital image (Figure 1). We apply persistent homology analysis to measure the occurrence and size of pore-scale topological features in a variety of sandstones, for both the dry state and the nonwetting phase fluid during two-phase fluid flow (drainage and imbibition) experiments, visualized with 3D X-ray microtomography. The results provide key insights into the dominant topological features and length scales of a media which control relevant field-scale engineering properties such as fluid trapping, absolute permeability, and relative permeability.

Fluid moderator control system reactor internals distribution system

International Nuclear Information System (INIS)

Fensterer, H.F.; Klassen, W.E.; Veronesi, L.; Boyle, D.E.; Salton, R.B.

1987-01-01

This patent describes a spectral shift pressurized water nuclear reactor employing a low neutron moderating fluid for the spectral shift including a reactor pressure vessel, a core comprising a plurality of fuel assemblies, a core support plate, apparatus comprising means for penetrating the reactor vessel for introducing the moderating fluid into the reactor vessel. Means associated with the core support plate for directly distributing the moderating fluid to and from the fuel assemblies comprises at least one inlet flow channel in the core plate; branch inlet feed lines connect to the inlet flow channel in the core plate; vertical inlet flow lines flow connected to the branch inlet feed lines; each vertical flow line communicates with a fuel assembly; the distribution means further comprise lines serving as return flow lines, each of which is connected to one of the fuel assemblies; branch exit flow lines in the core plate flow connected to the return flow lines of the fuel assembly; and at least one outlet flow channel flow connected to the branch exit flow lines; and a flow port interposed between the penetration means and the distribution means for flow connecting the penetration means with the distribution means

Who's talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda.

Science.gov (United States)

Langlois-Klassen, Deanne; Kipp, Walter; Rubaale, Tom

2008-07-01

Communication between patients and physicians about herbal medicine is valuable, enabling physicians to address issues of potential herb-drug interactions and ensuring appropriate medical care. As seemingly harmless herbal remedies may have detrimental interactions with various HIV antiretroviral drugs, the importance of communication is intensified, but often stifled around the use of herbal medicine in the treatment of HIV/AIDS. In western Uganda, 137 HIV-infected adults attending conventional HIV/AIDS treatment programmes (67 of whom were receiving antiretroviral therapy) shared their experiences and perceptions about traditional herbal medicine and related patient-physician communication issues through interviews and focus group discussions. Although close to 64% of respondents reported using herbal medicine after being diagnosed with HIV, only 16% of these respondents had informed their conventional medical practitioners about using these herbs. Furthermore, only 13% of antiretroviral therapy recipients had inquired about concurrent herb-antiretroviral drug use with their HIV/AIDS treatment providers, largely because they perceived a low acceptance and support for herbal medicine by conventional medical practitioners. Importantly however, almost 68% of HIV-infected adults indicated they would be willing to discuss herbal medicine use if directly asked by a conventional medical practitioner, and the overwhelming majority (91%) said they were amenable to following physician advice about herbal medicine. As such, improved patient-physician communication about herbal medicine is needed, and we recommend that herbal medicine histories be completed when patient histories are taken. Also, HIV/AIDS treatment programmes should be encouraged to develop specific patient-physician communication standards and best practice guidelines to ensure that patients can make informed decisions about herb and pharmaceutical drug co-therapy based on known risks, particularly in the

Thermodynamic properties of cryogenic fluids

CERN Document Server

Leachman, Jacob; Lemmon, Eric; Penoncello, Steven

2017-01-01

This update to a classic reference text provides practising engineers and scientists with accurate thermophysical property data for cryogenic fluids. The equations for fifteen important cryogenic fluids are presented in a basic format, accompanied by pressure-enthalpy and temperature-entropy charts and tables of thermodynamic properties. It begins with a chapter introducing the thermodynamic relations and functional forms for equations of state, and goes on to describe the requirements for thermodynamic property formulations, needed for the complete definition of the thermodynamic properties of a fluid. The core of the book comprises extensive data tables and charts for the most commonly-encountered cryogenic fluids. This new edition sees significant updates to the data presented for air, argon, carbon monoxide, deuterium, ethane, helium, hydrogen, krypton, nitrogen and xenon. The book supports and complements NIST’s REFPROP - an interactive database and tool for the calculation of thermodynamic propertie...

Strategic Communication Institutionalized

DEFF Research Database (Denmark)

Kjeldsen, Anna Karina

2013-01-01

of institutionalization when strategic communication is not yet visible as organizational practice, and how can such detections provide explanation for the later outcome of the process? (2) How can studies of strategic communication benefit from an institutional perspective? How can the virus metaphor generate a deeper...... understanding of the mechanisms that interact from the time an organization is exposed to a new organizational idea such as strategic communication until it surfaces in the form of symptoms such as mission and vision statements, communication manuals and communication positions? The first part of the article...... focuses on a discussion of the virus metaphor as an alternative to the widespread fashion metaphor for processes of institutionalization. The second part of the article provides empirical examples of the virus metaphor employed, examples that are drawn from a study of the institutionalization of strategic...

Two-phase cooling fluids; Les fluides frigoporteurs diphasiques

Energy Technology Data Exchange (ETDEWEB)

Lallemand, A. [Institut National des Sciences Appliquees (INSA), 69 - Lyon (France)

1997-12-31

In the framework of the diminution of heat transfer fluid consumption, the concept of indirect refrigerating circuits, using cooling intermediate fluids, is reviewed and the fluids that are currently used in these systems are described. Two-phase cooling fluids advantages over single-phase fluids are presented with their thermophysical characteristics: solid fraction, two-phase mixture enthalpy, thermal and rheological properties, determination of heat and mass transfer characteristics, and cold storage through ice slurry

Non-invasive nuclear device for communicating pressure inside a body to the exterior thereof

International Nuclear Information System (INIS)

Fleischmann, L.W.; Meyer, G.A.; Hittman, F.; Lyon, W.C.; Hayes, W.H. Jr.

1979-01-01

The need for a non-invasive technique for measuring the pressure in body cavities of animals or humans is recognized as highly desirable for continuous or intermittent monitoring of body conditions. The non-invasive nuclear device of the present invention is fully implantable and is fully capable of communicating pressure inside a body to the exterior to allow readout non-invasively. In its preferred form, the invention includes a housing for subcutaneous implantation with the radioactive source. An urging means such as a bellows is provided in the housing interior. The fluid pressure from a fluid pressure sensing device within the body is transmitted to the housing interior by means of a pressure-limiting fluid through a conduit. This causes the radioactive source to move against the force out of the initial or repose shielded relationship causing a proportional increase in pressure in the body portion being monitored. The radioactive output from the radioactive source corresponds to the magnitude of the pressure within the body. The housing may be securely mounted on a supporting portion of the body and the mounting serves as a radiation shield for the body. (JTA)

Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

OpenAIRE

Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

2017-01-01

Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to su...

Two-fluid and parallel compressibility effects in tokamak plasmas

International Nuclear Information System (INIS)

Sugiyama, L.E.; Park, W.

1998-01-01

The MHD, or single fluid, model for a plasma has long been known to provide a surprisingly good description of much of the observed nonlinear dynamics of confined plasmas, considering its simple nature compared to the complexity of the real system. On the other hand, some of the supposed agreement arises from the lack of the detailed measurements that are needed to distinguish MHD from more sophisticated models that incorporate slower time scale processes. At present, a number of factors combine to make models beyond MHD of practical interest. Computational considerations still favor fluid rather than particle models for description of the full plasma, and suggest an approach that starts from a set of fluid-like equations that extends MHD to slower time scales and more accurate parallel dynamics. This paper summarizes a set of two-fluid equations for toroidal (tokamak) geometry that has been developed and tested as the MH3D-T code [1] and some results from the model. The electrons and ions are described as separate fluids. The code and its original MHD version, MH3D [2], are the first numerical, initial value models in toroidal geometry that include the full 3D (fluid) compressibility and electromagnetic effects. Previous nonlinear MHD codes for toroidal geometry have, in practice, neglected the plasma density evolution, on the grounds that MHD plasmas are only weakly compressible and that the background density variation is weaker than the temperature variation. Analytically, the common use of toroidal plasma models based on aspect ratio expansion, such as reduced MHD, has reinforced this impression, since this ordering reduces plasma compressibility effects. For two-fluid plasmas, the density evolution cannot be neglected in principle, since it provides the basic driving energy for the diamagnetic drifts of the electrons and ions perpendicular to the magnetic field. It also strongly influences the parallel dynamics, in combination with the parallel thermal

Fluid mechanics for engineers. A graduate textbook

Energy Technology Data Exchange (ETDEWEB)

Schobeiri, Meinhard T. [Texas A and M Univ., College Station, TX (United States). Dept. of Mechanical Engineering

2010-07-01

The contents of this book covers the material required in the Fluid Mechanics Graduate Core Course (MEEN-621) and in Advanced Fluid Mechanics, a Ph.D-level elective course (MEEN-622), both of which I have been teaching at Texas A and M University for the past two decades. While there are numerous undergraduate fluid mechanics texts on the market for engineering students and instructors to choose from, there are only limited texts that comprehensively address the particular needs of graduate engineering fluid mechanics courses. To complement the lecture materials, the instructors more often recommend several texts, each of which treats special topics of fluid mechanics. This circumstance and the need to have a textbook that covers the materials needed in the above courses gave the impetus to provide the graduate engineering community with a coherent textbook that comprehensively addresses their needs for an advanced fluid mechanics text. Although this text book is primarily aimed at mechanical engineering students, it is equally suitable for aerospace engineering, civil engineering, other engineering disciplines, and especially those practicing professionals who perform CFD-simulation on a routine basis and would like to know more about the underlying physics of the commercial codes they use. Furthermore, it is suitable for self study, provided that the reader has a sufficient knowledge of calculus and differential equations. (orig.)

Cardiac fluid dynamics meets deformation imaging.

Science.gov (United States)

Dal Ferro, Matteo; Stolfo, Davide; De Paris, Valerio; Lesizza, Pierluigi; Korcova, Renata; Collia, Dario; Tonti, Giovanni; Sinagra, Gianfranco; Pedrizzetti, Gianni

2018-02-20

Cardiac function is about creating and sustaining blood in motion. This is achieved through a proper sequence of myocardial deformation whose final goal is that of creating flow. Deformation imaging provided valuable contributions to understanding cardiac mechanics; more recently, several studies evidenced the existence of an intimate relationship between cardiac function and intra-ventricular fluid dynamics. This paper summarizes the recent advances in cardiac flow evaluations, highlighting its relationship with heart wall mechanics assessed through the newest techniques of deformation imaging and finally providing an opinion of the most promising clinical perspectives of this emerging field. It will be shown how fluid dynamics can integrate volumetric and deformation assessments to provide a further level of knowledge of cardiac mechanics.

Cerebrospinal fluid flow. Pt. 3

International Nuclear Information System (INIS)

Schroth, G.; Klose, U.

1992-01-01

Cardiac- and respiration-related movements of the cerebrospinal fluid (CSF) were investigated by MRI in 71 patients. In most patients with arteriosclerotic occlusive vascular disease CSF pulsations are normal. Decreased pulsatile flow is detectable in those with arteriovenous malformations, intracranial air and following lumbar puncture and withdrawal of CSF. Increased pulsatile flow in the cerebral aqueduct was found in 2 patients with large aneurysms, idiopathic communicating syringomyelia and in most cases of normal pressure hydrocephalus (NPH). CSF flow in the cervical spinal canal is, however, reduced or normal in NPH, indicating reduction of the unfolding ability of the surface of the brain and/or inhibition of rapid CSF movements in the subrachnoid space over its convexity. (orig.)

Viscous Flow with Large Fluid-Fluid Interface Displacement

DEFF Research Database (Denmark)

Rasmussen, Henrik Koblitz; Hassager, Ole; Saasen, Arild

1998-01-01

The arbitrary Lagrange-Euler (ALE) kinematic description has been implemented in a 3D transient finite element program to simulate multiple fluid flows with fluid-fluid interface or surface displacements. The description of fluid interfaces includes variable interfacial tension, and the formulation...... is useful in the simulation of low and intermediate Reynolds number viscous flow. The displacement of two immiscible Newtonian fluids in a vertical (concentric and eccentric) annulus and a (vertical and inclined)tube is simulated....

Hierarchical Bayesian Modeling of Fluid-Induced Seismicity

Science.gov (United States)

Broccardo, M.; Mignan, A.; Wiemer, S.; Stojadinovic, B.; Giardini, D.

2017-11-01

In this study, we present a Bayesian hierarchical framework to model fluid-induced seismicity. The framework is based on a nonhomogeneous Poisson process with a fluid-induced seismicity rate proportional to the rate of injected fluid. The fluid-induced seismicity rate model depends upon a set of physically meaningful parameters and has been validated for six fluid-induced case studies. In line with the vision of hierarchical Bayesian modeling, the rate parameters are considered as random variables. We develop both the Bayesian inference and updating rules, which are used to develop a probabilistic forecasting model. We tested the Basel 2006 fluid-induced seismic case study to prove that the hierarchical Bayesian model offers a suitable framework to coherently encode both epistemic uncertainty and aleatory variability. Moreover, it provides a robust and consistent short-term seismic forecasting model suitable for online risk quantification and mitigation.

Natural convection in superposed fluid-porous layers

CERN Document Server

Bagchi, Aniruddha

2013-01-01

Natural Convection in Composite Fluid-Porous Domains provides a timely overview of the current state of understanding on the phenomenon of convection in composite fluid-porous layers. Natural convection in horizontal fluid-porous layers has received renewed attention because of engineering problems such as post-accident cooling of nuclear reactors, contaminant transport in groundwater, and convection in fibrous insulation systems. Because applications of the problem span many scientific domains, the book serves as a valuable resource for a wide audience.

Method of calibrating a fluid-level measurement system

Science.gov (United States)

Woodard, Stanley E. (Inventor); Taylor, Bryant D. (Inventor)

2010-01-01

A method of calibrating a fluid-level measurement system is provided. A first response of the system is recorded when the system's sensor(s) is (are) not in contact with a fluid of interest. A second response of the system is recorded when the system's sensor(s) is (are) fully immersed in the fluid of interest. Using the first and second responses, a plurality of expected responses of the system's sensor(s) is (are) generated for a corresponding plurality of levels of immersion of the sensor(s) in the fluid of interest.

Fluid transport due to nonlinear fluid-structure interaction

DEFF Research Database (Denmark)

Jensen, Jakob Søndergaard

1997-01-01

This work considers nonlinear fluid-structure interaction for a vibrating pipe containing fluid. Transverse pipe vibrations will force the fluid to move relative to the pipe creating unidirectional fluid flow towards the pipe end. The fluid flow induced affects the damping and the stiffness...... of the pipe. The behavior of the system in response to lateral resonant base excitation is analysed numerically and by the use of a perturbation method (multiple scales). Exciting the pipe in the fundamental mode of vibration seems to be most effective for transferring energy from the shaker to the fluid......, whereas higher modes of vibration can be used to transport fluid with pipe vibrations of smaller amplitude. The effect of the nonlinear geometrical terms is analysed and these terms are shown to affect the response for higher modes of vibration. Experimental investigations show good agreement...

Quantum cryptography communication technology

Energy Technology Data Exchange (ETDEWEB)

Cho, Jai Wan; Choi, Young Soo; Lee, Jae Chul; Choi, Yu Rak; Jung, Gwang Il; Jung, Jong Eun; Hong, Seok Boong; Koo, In Soo

2007-09-15

Quantum cryptography communication based on quantum mechanics provides and unconditional security between two users. Even though huge advance has been done since the 1984, having a complete system is still far away. In the case of real quantum cryptography communication systems, an unconditional security level is lowered by the imperfection of the communication unit. It is important to investigate the unconditional security of quantum communication protocols based on these experimental results and implementation examples for the advanced spread all over the world. The Japanese report, titled, 'Investigation report on the worldwide trends of quantum cryptography communications systems' was translated and summarized in this report. An unconditional security theory of the quantum cryptography and real implementation examples in the domestic area are investigated also. The goal of the report is to make quantum cryptography communication more useful and reliable alternative telecommunication infrastructure as the one of the cyber security program of the class 1-E communication system of nuclear power plant. Also another goal of this report is to provide the quantitative decision basis on the quantum cryptography communication when this secure communication system will be used in class 1-E communication channel of the nuclear power plant.

Quantum cryptography communication technology

International Nuclear Information System (INIS)

Cho, Jai Wan; Choi, Young Soo; Lee, Jae Chul; Choi, Yu Rak; Jung, Gwang Il; Jung, Jong Eun; Hong, Seok Boong; Koo, In Soo

2007-09-01

Quantum cryptography communication based on quantum mechanics provides and unconditional security between two users. Even though huge advance has been done since the 1984, having a complete system is still far away. In the case of real quantum cryptography communication systems, an unconditional security level is lowered by the imperfection of the communication unit. It is important to investigate the unconditional security of quantum communication protocols based on these experimental results and implementation examples for the advanced spread all over the world. The Japanese report, titled, 'Investigation report on the worldwide trends of quantum cryptography communications systems' was translated and summarized in this report. An unconditional security theory of the quantum cryptography and real implementation examples in the domestic area are investigated also. The goal of the report is to make quantum cryptography communication more useful and reliable alternative telecommunication infrastructure as the one of the cyber security program of the class 1-E communication system of nuclear power plant. Also another goal of this report is to provide the quantitative decision basis on the quantum cryptography communication when this secure communication system will be used in class 1-E communication channel of the nuclear power plant

Communicating about eating behaviors. A qualitative study of Chilean women and their health-care providers.

Science.gov (United States)

Gálvez, Patricia; Valencia, Alejandra; Palomino, Ana M; Cataldo, Marjorie; Schwingel, Andiara

2015-01-01

Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence women's eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of women's personality traits and past eating behaviors, as well as work on improving women's self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.

Cerebrospinal fluid cisternography

International Nuclear Information System (INIS)

Sandler, M.P.; Price, A.C.; Partain, C.L.; James, A.E.; Runge, V.M.

1988-01-01

The evaluation of CSF dynamics has been discussed utilizing nuclear medicine, computed tomography, and magnetic resonance imaging. Cerebrospinal fluid leaks are readily diagnosed by both CT and nuclear scintigraphy. The major advantage of CT is the exact anatomic localization of the site of CSF leakage. Contrast toxicity, as well as complex and costly technology, often limit the wide applicability of CT in the diagnosis of CSF leaks. Nuclear scintigraphy, on the other hand, offers nonexact localization of CSF leaks, but is often more readily available than Ct. Magnetic resonance resolution is presently insufficient for diagnosis of CSF leaks. The anatomic diagnosis of hydrocephalus is more readily established with CT and MRI as compared to nuclear scintigraphy. However, none of the imaging modalities discussed are clearly superior in differentiating communicating from obstructive hydrocephalus. Nuclear scintigraphy remains the imaging modality of choice in the quantitative evaluation of CSF shunts and their patency

Mass Communication as a Perspective on Human Communication: The Quandary of a Discipline.

Science.gov (United States)

Trapp, Mary E.; McLuskie, Ed

The empirical and critical traditions in mass communication inquiry are examined in this paper to determine if mass communication inquiry can provide a useful perspective on human communication. The paper first describes the development of interest in mass communication in the nineteenth century, then explains the empirical research tradition in…

Modeling of Non-Isothermal Cryogenic Fluid Sloshing

Science.gov (United States)

Agui, Juan H.; Moder, Jeffrey P.

2015-01-01

A computational fluid dynamic model was used to simulate the thermal destratification in an upright self-pressurized cryostat approximately half-filled with liquid nitrogen and subjected to forced sinusoidal lateral shaking. A full three-dimensional computational grid was used to model the tank dynamics, fluid flow and thermodynamics using the ANSYS Fluent code. A non-inertial grid was used which required the addition of momentum and energy source terms to account for the inertial forces, energy transfer and wall reaction forces produced by the shaken tank. The kinetics-based Schrage mass transfer model provided the interfacial mass transfer due to evaporation and condensation at the sloshing interface. The dynamic behavior of the sloshing interface, its amplitude and transition to different wave modes, provided insight into the fluid process at the interface. The tank pressure evolution and temperature profiles compared relatively well with the shaken cryostat experimental test data provided by the Centre National D'Etudes Spatiales.

Quantum communications

CERN Document Server

Cariolaro, Gianfranco

2015-01-01

This book demonstrates that a quantum communication system using the coherent light of a laser can achieve performance orders of magnitude superior to classical optical communications Quantum Communications provides the Masters and PhD signals or communications student with a complete basics-to-applications course in using the principles of quantum mechanics to provide cutting-edge telecommunications. Assuming only knowledge of elementary probability, complex analysis and optics, the book guides its reader through the fundamentals of vector and Hilbert spaces and the necessary quantum-mechanical ideas, simply formulated in four postulates. A turn to practical matters begins with and is then developed by: ·         development of the concept of quantum decision, emphasizing the optimization of measurements to extract useful information from a quantum system; ·         general formulation of a transmitter–receiver system ·         particular treatment of the most popular quantum co...

Fluid-fluid level on MR image: significance in Musculoskeletal diseases

Energy Technology Data Exchange (ETDEWEB)

Chung, Hye Won; Lee, Kyung Won [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine; Song, Chi Sung [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Han, Sang Wook; Kang, Heung Sik [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine

1998-01-01

To evaluate the frequency, number and signal intensity of fluid-fluid levels of musculoskeletal diseases on MR images, and to determine the usefulness of this information for the differentiation of musculoskeletal diseases. MR images revealed fluid-fluid levels in the following diseases : giant cell tumor(6), telangiectatic osteosarcoma(4), aneurysmal bone cyst(3), synovial sarcoma(3), chondroblastoma(2), soft tissue tuberculous abscess(2), hematoma(2), hemangioma (1), neurilemmoma(1), metastasis(1), malignant fibrous histiocytoma(1), bursitis(1), pyogenic abscess(1), and epidermoid inclusion cyst(1). Fourteen benign tumors and ten malignant, three abscesses, and the epidermoid inclusion cyst showed only one fluid-fluid level in a unilocular cyst. On T1-weighted images, the signal intensities of fluid varied, but on T2-weighted images, superior layers were in most cases more hyperintense than inferior layers. Because fluid-fluid layers are a nonspecific finding, it is difficult to specifically diagnose each disease according to the number of fluid-fluid levels or signal intensity of fluid. In spite of the nonspecificity of fluid-fluid levels, they were frequently seen in cases of giant cell tumor, telangiectatic osteosarcoma, aneurysmal bone cycle, and synovial sarcoma. Nontumorous diseases such abscesses and hematomas also demonstrated this finding. (author). 11 refs., 1 tab., 4 figs.

Fluid-fluid level on MR image: significance in Musculoskeletal diseases

International Nuclear Information System (INIS)

Chung, Hye Won; Lee, Kyung Won; Han, Sang Wook; Kang, Heung Sik

1998-01-01

To evaluate the frequency, number and signal intensity of fluid-fluid levels of musculoskeletal diseases on MR images, and to determine the usefulness of this information for the differentiation of musculoskeletal diseases. MR images revealed fluid-fluid levels in the following diseases : giant cell tumor(6), telangiectatic osteosarcoma(4), aneurysmal bone cyst(3), synovial sarcoma(3), chondroblastoma(2), soft tissue tuberculous abscess(2), hematoma(2), hemangioma (1), neurilemmoma(1), metastasis(1), malignant fibrous histiocytoma(1), bursitis(1), pyogenic abscess(1), and epidermoid inclusion cyst(1). Fourteen benign tumors and ten malignant, three abscesses, and the epidermoid inclusion cyst showed only one fluid-fluid level in a unilocular cyst. On T1-weighted images, the signal intensities of fluid varied, but on T2-weighted images, superior layers were in most cases more hyperintense than inferior layers. Because fluid-fluid layers are a nonspecific finding, it is difficult to specifically diagnose each disease according to the number of fluid-fluid levels or signal intensity of fluid. In spite of the nonspecificity of fluid-fluid levels, they were frequently seen in cases of giant cell tumor, telangiectatic osteosarcoma, aneurysmal bone cycle, and synovial sarcoma. Nontumorous diseases such abscesses and hematomas also demonstrated this finding. (author). 11 refs., 1 tab., 4 figs

XXII Fluid Mechanics Conference (KKMP2016)

International Nuclear Information System (INIS)

2016-01-01

This Journal of Physics: Conference Series contains papers that have been presented at XXII Fluid Mechanics Conference (XXII FMC) held in Słok near Bełchatów in Poland during llth-14th September of 2016. The Conference is organized by Wrocław University of Science and Technology, Polish Academy of Sciences - Committee of Mechanics and Foun-dation for Development of Wroclaw University of Science and Technology. Let us recall some historical facts: Fluid Mechanics Conferences have been taking place every two years since 1974, which makes a total of forty-two years. The goal of this conference is to provide a forum for exposure and exchange of ideas, methods and results in fluid mechanics. We have already met in Bełchatów 10 years ago (XVII KKMP). It was a successful meeting. Since then the National Conference on Fluid Mechanics has changed title and has started to be named Fluid Mechanics Conference in the hopes that it will attract more participants from other countries. English became the Conference's first language and we started to invite world leading scientists - working in the field of fluid mechanics. At the 2006 conference we hosted for the first time prof. Keith Moffatt from the Cambridge University. In this year prof. Moffatt once again promised us to arrive to Bełchatów. The whole fluid mechanics community celebrates 9 2 anniversary of his birthday. So let us also wish happy anniversary to prof. Moffatt. In the mean time we had to pay last respects to our collages. Prof. Prosnak who is regarded as a founder of the Notational Conference on Fluid Mechanics and is well known through his books. Prof. Puzyrewski who was present at all conferences so far. He was providing via his discussions a special value to these conferences, and our colleague prof. Konrad Bajer who was intended to be the organizer and host of the present conference. Short memories to them will be given during the opening ceremony. Conference topics include, but are not limited

Hydromagnetic stability of rotating stratified compressible fluid flows

Energy Technology Data Exchange (ETDEWEB)

Srinivasan, V; Kandaswamy, P [Dept. of Mathematics, Bharathiar University, Coimbatore, Tamil Nadu, India; Debnath, L [Dept. of Mathematics, University of Central Florida, Orlando, USA

1984-09-01

The hydromagnetic stability of a radially stratified compressible fluid rotating between two coaxial cylinders is investigated. The stability with respect to axisymmetric disturbances is examined. The fluid system is found to be thoroughly stable to axisymmetric disturbances provided the fluid rotates very rapidly. The system is shown to be unstable to non-axisymmetric disturbances, and the slow amplifying hydromagnetic wave modes propagate against the basic rotation. The lower and upper bounds of the azimuthal phase speeds of the amplifying waves are determined. A quadrant theorem on the slow waves characteristic of a rapidly rotating fluid is derived. Special attention is given to the effects of compressibility of the fluid. Some results concerning the stability of an incompressible fluid system are obtained as special cases of the present analysis.

A fuzzy multi-objective model for capacity allocation and pricing policy of provider in data communication service with different QoS levels

Science.gov (United States)

Pan, Wei; Wang, Xianjia; Zhong, Yong-guang; Yu, Lean; Jie, Cao; Ran, Lun; Qiao, Han; Wang, Shouyang; Xu, Xianhao

2012-06-01

Data communication service has an important influence on e-commerce. The key challenge for the users is, ultimately, to select a suitable provider. However, in this article, we do not focus on this aspect but the viewpoint and decision-making of providers for order allocation and pricing policy when orders exceed service capacity. It is a multiple criteria decision-making problem such as profit and cancellation ratio. Meanwhile, we know realistic situations in which much of the input information is uncertain. Thus, it becomes very complex in a real-life environment. In this situation, fuzzy sets theory is the best tool for solving this problem. Our fuzzy model is formulated in such a way as to simultaneously consider the imprecision of information, price sensitive demand, stochastic variables, cancellation fee and the general membership function. For solving the problem, a new fuzzy programming is developed. Finally, a numerical example is presented to illustrate the proposed method. The results show that it is effective for determining the suitable order set and pricing policy of provider in data communication service with different quality of service (QoS) levels.

Magnetic fluid seals for DWDM filter manufacturing

International Nuclear Information System (INIS)

Li Zhixin

2002-01-01

Performance requirements of rotary magnetic fluid seals for thin film dense wavelength division multiplexing filter manufacturing are discussed. High speed, large diameter, tight tolerance for rotating accuracy and motion control are some of the technical challenges in this application. Analytical methods for studying these technical issues and experimental data are presented. Innovative design approaches are also discussed. It is shown that using the most advanced magnetic fluid technology and seal design technology, magnetic fluid seals can provide satisfactory performance in this challenging new application

Digital communication communication, multimedia, security

CERN Document Server

Meinel, Christoph

2014-01-01

The authors give a detailed summary about the fundamentals and the historical background of digital communication. This includes an overview of the encoding principles and algorithms of textual information, audio information, as well as images, graphics, and video in the Internet. Furthermore the fundamentals of computer networking, digital security and cryptography are covered. Thus, the book provides a well-founded access to communication technology of computer networks, the internet and the WWW. Numerous pictures and images, a subject-index and a detailed list of historical personalities in

Supercritical fluid technology: concepts and pharmaceutical applications.

Science.gov (United States)

Deshpande, Praful Balavant; Kumar, G Aravind; Kumar, Averineni Ranjith; Shavi, Gopal Venkatesh; Karthik, Arumugam; Reddy, Meka Sreenivasa; Udupa, Nayanabhirama

2011-01-01

In light of environmental apprehension, supercritical fluid technology (SFT) exhibits excellent opportunities to accomplish key objectives in the drug delivery sector. Supercritical fluid extraction using carbon dioxide (CO(2)) has been recognized as a green technology. It is a clean and versatile solvent with gas-like diffusivity and liquid-like density in the supercritical phase, which has provided an excellent alternative to the use of chemical solvents. The present commentary provides an overview of different techniques using supercritical fluids and their future opportunity for the drug delivery industry. Some of the emerging applications of SFT in pharmaceuticals, such as particle design, drug solubilization, inclusion complex, polymer impregnation, polymorphism, drug extraction process, and analysis, are also covered in this review. The data collection methods are based on the recent literature related to drug delivery systems using SFT platforms. SFT has become a much more versatile and environmentally attractive technology that can handle a variety of complicated problems in pharmaceuticals. This cutting-edge technology is growing predominantly to surrogate conventional unit operations in relevance to the pharmaceutical production process. Supercritical fluid technology has recently drawn attention in the field of pharmaceuticals. It is a distinct conception that utilizes the solvent properties of supercritical fluids above their critical temperature and pressure, where they exhibit both liquid-like and gas-like properties, which can enable many pharmaceutical applications. For example, the liquid-like properties provide benefits in extraction processes of organic solvents or impurities, drug solubilization, and polymer plasticization, and the gas-like features facilitate mass transfer processes. It has become a much more versatile and environmentally attractive technology that can handle a variety of complicated problems in pharmaceuticals. This review is

A state of emergency in crisis communication: An intercultural crisis communication research agenda

OpenAIRE

Diers-Lawson, AR

2016-01-01

This article seeks to provide an evidence-based set of recommendations for the development of an intercultural crisis communication research agenda with three goals. First, to provide an advancement in our understanding of the state of crisis communication research in general. Second, to offer a grounded introduction to crisis communication for intercultural scholars who may not be as familiar with the field. Finally to identify three broad evidence-based areas for developing intercultural cr...

Heat transfer and fluid flow in biological processes advances and applications

CERN Document Server

Becker, Sid

2015-01-01

Heat Transfer and Fluid Flow in Biological Processes covers emerging areas in fluid flow and heat transfer relevant to biosystems and medical technology. This book uses an interdisciplinary approach to provide a comprehensive prospective on biofluid mechanics and heat transfer advances and includes reviews of the most recent methods in modeling of flows in biological media, such as CFD. Written by internationally recognized researchers in the field, each chapter provides a strong introductory section that is useful to both readers currently in the field and readers interested in learning more about these areas. Heat Transfer and Fluid Flow in Biological Processes is an indispensable reference for professors, graduate students, professionals, and clinical researchers in the fields of biology, biomedical engineering, chemistry and medicine working on applications of fluid flow, heat transfer, and transport phenomena in biomedical technology. Provides a wide range of biological and clinical applications of fluid...

Bone Conduction: Anatomy, Physiology, and Communication

National Research Council Canada - National Science Library

Henry, Paula; Letowski, Tomasz R

2007-01-01

... conduction transmission, and the use of the bone conduction pathway for communication. Bone conduction for the transmission of communication is effective and feasible for Soldiers because it provides a means of providing radio communication in combination with hearing protection devices.

Generalized Fluid System Simulation Program (GFSSP) Version 6 - General Purpose Thermo-Fluid Network Analysis Software

Science.gov (United States)

Majumdar, Alok; Leclair, Andre; Moore, Ric; Schallhorn, Paul

2011-01-01

GFSSP stands for Generalized Fluid System Simulation Program. It is a general-purpose computer program to compute pressure, temperature and flow distribution in a flow network. GFSSP calculates pressure, temperature, and concentrations at nodes and calculates flow rates through branches. It was primarily developed to analyze Internal Flow Analysis of a Turbopump Transient Flow Analysis of a Propulsion System. GFSSP development started in 1994 with an objective to provide a generalized and easy to use flow analysis tool for thermo-fluid systems.

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

Hamiltonian description of the ideal fluid

International Nuclear Information System (INIS)

Morrison, P.J.

1994-01-01

Fluid mechanics is examined from a Hamiltonian perspective. The Hamiltonian point of view provides a unifying framework; by understanding the Hamiltonian perspective, one knows in advance (within bounds) what answers to expect and what kinds of procedures can be performed. The material is organized into five lectures, on the following topics: rudiments of few-degree-of-freedom Hamiltonian systems illustrated by passive advection in two-dimensional fluids; functional differentiation, two action principles of mechanics, and the action principle and canonical Hamiltonian description of the ideal fluid; noncanonical Hamiltonian dynamics with examples; tutorial on Lie groups and algebras, reduction-realization, and Clebsch variables; and stability and Hamiltonian systems

Engine with exhaust gas recirculation system and variable geometry turbocharger

Science.gov (United States)

Keating, Edward J.

2015-11-03

An engine assembly includes an intake assembly, an internal combustion engine defining a plurality of cylinders and configured to combust a fuel and produce exhaust gas, and an exhaust assembly in fluid communication with a first subset of the plurality of cylinders. Each of the plurality of cylinders are provided in fluid communication with the intake assembly. The exhaust assembly is provided in fluid communication with a first subset of the plurality of cylinders, and a dedicated exhaust gas recirculation system in fluid communication with both a second subset of the plurality of cylinders and with the intake assembly. The dedicated exhaust gas recirculation system is configured to route all of the exhaust gas from the second subset of the plurality of cylinders to the intake assembly. Finally, the engine assembly includes a turbocharger having a variable geometry turbine in fluid communication with the exhaust assembly.

Dimensional crossover in fluids under nanometer-scale confinement.

Science.gov (United States)

Das, Amit; Chakrabarti, J

2012-05-01

Several earlier studies have shown signatures of crossover in various static and dynamics properties of a confined fluid when the confining dimension decreases to about a nanometer. The density fluctuations govern the majority of such properties of a fluid. Here, we illustrate the crossover in density fluctuation in a confined fluid, to provide a generic understanding of confinement-induced crossover of fluid properties, using computer simulations. The crossover can be understood as a manifestation of changes in the long-wavelength behavior of fluctuation in density due to geometrical constraints. We further show that the confining potential significantly affects the crossover behavior.

A matrix free, partitioned solution of fluid-structure interaction problems using finite volume and finite element methods

CSIR Research Space (South Africa)

Suliman, Ridhwaan

2015-01-01

Full Text Available . The solver is parallelised for distributed-memory systems using METIS for domaindecomposition and MPI for inter-domain communication. The developed technology is evaluated by application to benchmark problems for strongly-coupled fluid-structure interaction...

Fluid-structure interactions models, analysis and finite elements

CERN Document Server

Richter, Thomas

2017-01-01

This book starts by introducing the fundamental concepts of mathematical continuum mechanics for fluids and solids and their coupling. Special attention is given to the derivation of variational formulations for the subproblems describing fluid- and solid-mechanics as well as the coupled fluid-structure interaction problem. Two monolithic formulations for fluid-structure interactions are described in detail: the well-established ALE formulation and the modern Fully Eulerian formulation, which can effectively deal with problems featuring large deformation and contact. Further, the book provides details on state-of-the-art discretization schemes for fluid- and solid-mechanics and considers the special needs of coupled problems with interface-tracking and interface-capturing techniques. Lastly, advanced topics like goal-oriented error estimation, multigrid solution and gradient-based optimization schemes are discussed in the context of fluid-structure interaction problems.

Object-oriented communications

International Nuclear Information System (INIS)

Chapman, L.J.

1989-01-01

OOC is a high-level communications protocol based on the object-oriented paradigm. OOC's syntax, semantics, and pragmatics balance simplicity and expressivity for controls environments. While natural languages are too complex, computer protocols are often insufficiently expressive. An object-oriented communications philosophy provides a base for building the necessary high-level communications primitives like I don't understand and the current value of X is K. OOC is sufficiently flexible to express data acquisition, control requests, alarm messages, and error messages in a straightforward generic way. It can be used in networks, for inter-task communication, and even for intra-task communication

Heidegger, communication, and healthcare.

Science.gov (United States)

Rentmeester, Casey

2018-01-12

Communication between medical professionals and patients is an important aspect of therapy and patient satisfaction. Common barriers that get in the way of effective communication in this sphere include: (1) gender, age, and cultural differences; (2) physical or psychological discomfort or pain; (3) medical literacy; and (4) distraction due to technological factors or simply being overworked. The author examines these communicative barriers from a philosophical lens and then utilizes Martin Heidegger's phenomenology and hermeneutics to provide guidance for medical professional-patient interactions. The phenomenological approach espoused emphasizes the particular, contextual nature of such interactions, and thus is opposed to abstract, theoretical principles. Heidegger's hermeneutics provides a philosophical approach to communication that may guide the back-and-forth interpretation that should happen between medical professionals and patients to achieve effective communication.

Organic compounds in hydraulic fracturing fluids and wastewaters: A review.

Science.gov (United States)

Luek, Jenna L; Gonsior, Michael

2017-10-15

High volume hydraulic fracturing (HVHF) of shale to stimulate the release of natural gas produces a large quantity of wastewater in the form of flowback fluids and produced water. These wastewaters are highly variable in their composition and contain a mixture of fracturing fluid additives, geogenic inorganic and organic substances, and transformation products. The qualitative and quantitative analyses of organic compounds identified in HVHF fluids, flowback fluids, and produced waters are reviewed here to communicate knowledge gaps that exist in the composition of HVHF wastewaters. In general, analyses of organic compounds have focused on those amenable to gas chromatography, focusing on volatile and semi-volatile oil and gas compounds. Studies of more polar and non-volatile organic compounds have been limited by a lack of knowledge of what compounds may be present as well as quantitative methods and standards available for analyzing these complex mixtures. Liquid chromatography paired with high-resolution mass spectrometry has been used to investigate a number of additives and will be a key tool to further research on transformation products that are increasingly solubilized through physical, chemical, and biological processes in situ and during environmental contamination events. Diverse treatments have been tested and applied to HVHF wastewaters but limited information has been published on the quantitative removal of individual organic compounds. This review focuses on recently published information on organic compounds identified in flowback fluids and produced waters from HVHF. Copyright © 2017 Elsevier Ltd. All rights reserved.

Edge Fracture in Complex Fluids.

Science.gov (United States)

Hemingway, Ewan J; Kusumaatmaja, Halim; Fielding, Suzanne M

2017-07-14

We study theoretically the edge fracture instability in sheared complex fluids, by means of linear stability analysis and direct nonlinear simulations. We derive an exact analytical expression for the onset of edge fracture in terms of the shear-rate derivative of the fluid's second normal stress difference, the shear-rate derivative of the shear stress, the jump in shear stress across the interface between the fluid and the outside medium (usually air), the surface tension of that interface, and the rheometer gap size. We provide a full mechanistic understanding of the edge fracture instability, carefully validated against our simulations. These findings, which are robust with respect to choice of rheological constitutive model, also suggest a possible route to mitigating edge fracture, potentially allowing experimentalists to achieve and accurately measure flows stronger than hitherto possible.

Can risk communication provide assistance in nuclear energy disputes?

International Nuclear Information System (INIS)

Meadd, Ellen

2001-01-01

The continued use of nuclear technology in Canada appears to he limited by a lack of public acceptance of fuel waste disposal strategies. The outcome of the recent environmental assessment process conducted on the deep geological disposal concept bears-out this point. A brief review of transcripts from the he public hearing portion of this process indicates that public sentiment on the issue includes anti-nuclear attitudes and concern over equity, safety, and trust. This paper discusses Canadian sentiment on the issue and suggests that it is in line with public views on similar issues in other nations. The field of risk communication has played a significant role in understanding the root causes of public opposition. This paper suggests that the field is well-placed to play an expanded role in resolving the issues underlying public concerns, (e.g., lack of trust, public disenfranchisement with the decision making process); however, this is a supportive role. It is suggested that broad-based involvement, commitment, and collaboration among all stake holders in this dispute are necessary if improvement is to be achieved. (author)

Auxillary Fluid Flowmeter

DEFF Research Database (Denmark)

RezaNejad Gatabi, Javad; Forouzbakhsh, Farshid; Ebrahimi Darkhaneh, Hadi

2010-01-01

The Auxiliary Fluid Flow meter is proposed to measure the fluid flow of any kind in both pipes and open channels. In this kind of flow measurement, the flow of an auxiliary fluid is measured Instead of direct measurement of the main fluid flow. The auxiliary fluid is injected into the main fluid ...

Digital communication system

Science.gov (United States)

Monford, L. G., Jr. (Inventor)

1974-01-01

A digital communication system is reported for parallel operation of 16 or more transceiver units with the use of only four interconnecting wires. A remote synchronization circuit produces unit address control words sequentially in data frames of 16 words. Means are provided in each transceiver unit to decode calling signals and to transmit calling and data signals. The transceivers communicate with each other over one data line. The synchronization unit communicates the address control information to the transceiver units over an address line and further provides the timing information over a clock line. A reference voltage level or ground line completes the interconnecting four wire hookup.

The mobility of U and Th in subduction zone fluids: an indicator of oxygen fugacity and fluid salinity

Science.gov (United States)

Bali, Enikő; Audétat, Andreas; Keppler, Hans

2011-04-01

The solubility of U and Th in aqueous solutions at P-T-conditions relevant for subduction zones was studied by trapping uraninite or thorite saturated fluids as synthetic fluid inclusions in quartz and analyzing their composition by Laser Ablation-ICPMS. Uranium is virtually insoluble in aqueous fluids at Fe-FeO buffer conditions, whereas its solubility increases both with oxygen fugacity and with salinity to 960 ppm at 26.1 kbar, Re-ReO2 buffer conditions and 14.1 wt% NaCl in the fluid. At 26.1 kbar and 800°C, uranium solubility can be reproduced by the equation: log {{U}} = 2.681 + 0.1433log f{{O}}2 + 0.594{{Cl,}} where fO2 is the oxygen fugacity, and Cl is the chlorine content of the fluid in molality. In contrast, Th solubility is generally low (uranium increases strongly both with oxygen fugacity and with salinity. We show that reducing or NaCl-free fluids cannot produce primitive arc magmas with U/Th ratio higher than MORB. However, the dissolution of several wt% of oxidized, saline fluids in arc melts can produce U/Th ratios several times higher than in MORB. We suggest that observed U/Th ratios in arc magmas provide tight constraints on both the salinity and the oxidation state of subduction zone fluids.

Fluid and electrolyte disturbances in critically ill patients.

Science.gov (United States)

Lee, Jay Wook

2010-12-01

Disturbances in fluid and electrolytes are among the most common clinical problems encountered in the intensive care unit (ICU). Recent studies have reported that fluid and electrolyte imbalances are associated with increased morbidity and mortality among critically ill patients. To provide optimal care, health care providers should be familiar with the principles and practice of fluid and electrolyte physiology and pathophysiology. Fluid resuscitation should be aimed at restoration of normal hemodynamics and tissue perfusion. Early goal-directed therapy has been shown to be effective in patients with severe sepsis or septic shock. On the other hand, liberal fluid administration is associated with adverse outcomes such as prolonged stay in the ICU, higher cost of care, and increased mortality. Development of hyponatremia in critically ill patients is associated with disturbances in the renal mechanism of urinary dilution. Removal of nonosmotic stimuli for vasopressin secretion, judicious use of hypertonic saline, and close monitoring of plasma and urine electrolytes are essential components of therapy. Hypernatremia is associated with cellular dehydration and central nervous system damage. Water deficit should be corrected with hypotonic fluid, and ongoing water loss should be taken into account. Cardiac manifestations should be identified and treated before initiating stepwise diagnostic evaluation of dyskalemias. Divalent ion deficiencies such as hypocalcemia, hypomagnesemia and hypophosphatemia should be identified and corrected, since they are associated with increased adverse events among critically ill patients.

Delivering effective science communication: advice from a professional science communicator.

Science.gov (United States)

Illingworth, Sam

2017-10-01

Science communication is becoming ever more prevalent, with more and more scientists expected to not only communicate their research to a wider public, but to do so in an innovative and engaging manner. Given the other commitments that researchers and academics are required to fulfil as part of their workload models, it is unfair to be expect them to also instantly produce effective science communication events and activities. However, by thinking carefully about what it is that needs to be communicated, and why this is being done, it is possible to develop high-quality activities that are of benefit to both the audience and the communicator(s). In this paper, I present some practical advice for developing, delivering and evaluating effective science communication initiatives, based on over a decade of experience as being a professional science communicator. I provide advice regarding event logistics, suggestions on how to successfully market and advertise your science communication initiatives, and recommendations for establishing effective branding and legacy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Heat transfers and related effects in supercritical fluids

CERN Document Server

Zappoli, Bernard; Garrabos, Yves

2015-01-01

This book investigates the unique hydrodynamics and heat transfer problems that are encountered in the vicinity of the critical point of fluids. Emphasis is given on weightlessness conditions, gravity effects and thermovibrational phenomena. Near their critical point, fluids indeed obey universal behavior and become very compressible and expandable. Their comportment, when gravity effects are suppressed, becomes quite unusual. The problems that are treated in this book are of interest to students and researchers interested in the original behavior of near-critical fluids as well as to engineers that have to manage supercritical fluids. A special chapter is dedicated to the present knowledge of critical point phenomena. Specific data for many fluids are provided, ranging from cryogenics (hydrogen) to high temperature (water). Basic information in statistical mechanics, mathematics and measurement techniques is also included. The basic concepts of fluid mechanics are given for the non-specialists to be able to ...

WAVES IN THE COMMUNICATION FLOW

Directory of Open Access Journals (Sweden)

Fee-Alexandra Haase

2007-11-01

Full Text Available This article compares in case studies in the constitution, written laws, and other national institutions the influence of the state regarding the production and function of mass communication and related values in different countries. Our interest is to demonstrate the differences between countries under the aspects of national constitution and governmental institutions that provide or not provide guidelines in terms of the use and protection of communication national organizations that provide additional guidelines international organizations for the use of mass communication media in a country. The interplay of national constitution, legislative, and governmental institutions is the framework for the existence of national mass communication. Under the title “Waves in The Communication Flow“we will face the framework of exterior institutions of different national states regarding their influence on mass communication. As mass communication we can define all institutions producing information for a wide audience delivered in mass media. As a process we can define mass communication as a ‘flow of any information’ delivered by mass media. This flow can be promoted or prohibited by the framework of institutions named above. This article examines the extent and nature of the use of laws and constitutional systems with an interest in the methodology of comparative studies in constitutional law.

Improving nurse-patient communication with patients with communication impairments: hospital nurses' views on the feasibility of using mobile communication technologies.

Science.gov (United States)

Sharpe, Bridget; Hemsley, Bronwyn

2016-05-01

Nurses communicating with patients who are unable to speak often lack access to tools and technologies to support communication. Although mobile communication technologies are ubiquitous, it is not known whether their use to support communication is feasible on a busy hospital ward. The aim of this study was to determine the views of hospital nurses on the feasibility of using mobile communication technologies to support nurse-patient communication with individuals who have communication impairments. This study involved an online survey followed by a focus group, with findings analyzed across the two data sources. Nurses expected that mobile communication devices could benefit patient care but lacked access to these devices, encountered policies against use, and held concerns over privacy and confidentiality. The use of mobile communication technologies with patients who have communication difficulties is feasible and may lead to improvements in communication and care, provided environmental barriers are removed and facilitators enhanced. Copyright © 2015 Elsevier Inc. All rights reserved.

Applied Computational Fluid Dynamics at NASA Ames Research Center

Science.gov (United States)

Holst, Terry L.; Kwak, Dochan (Technical Monitor)

1994-01-01

The field of Computational Fluid Dynamics (CFD) has advanced to the point where it can now be used for many applications in fluid mechanics research and aerospace vehicle design. A few applications being explored at NASA Ames Research Center will be presented and discussed. The examples presented will range in speed from hypersonic to low speed incompressible flow applications. Most of the results will be from numerical solutions of the Navier-Stokes or Euler equations in three space dimensions for general geometry applications. Computational results will be used to highlight the presentation as appropriate. Advances in computational facilities including those associated with NASA's CAS (Computational Aerosciences) Project of the Federal HPCC (High Performance Computing and Communications) Program will be discussed. Finally, opportunities for future research will be presented and discussed. All material will be taken from non-sensitive, previously-published and widely-disseminated work.

ANALYSIS OF EXPECTED PRICE DYNAMICS BETWEEN FLUID MILK FUTURES CONTRACTS AND CASH PRICES FOR FLUID MILK

OpenAIRE

T. Randall FORTENBERY; Robert A. CROPP; Hector O. ZAPATA

1997-01-01

The objective of this study is to provide an empirical evaluation of the expected relationship between cash and futures prices for fluid milk. This is done using historic cash prices from 1988 to 1995, and making inferences about how futures prices would have behaved if they had traded during this sample period. Futures prices are simulated over the sample period based on two assumptions about futures market behavior for fluid milk. The first is that the futures market will essentially price ...

Communicating geological hazards: assisting geoscientists in communication skills

Science.gov (United States)

Liverman, D. G. E.

2009-04-01

Communication is important in all aspects of the geosciences but is more prominent in the area of geological hazards, as the main audience for scientific information often lacks a geoscience background; and because the implications of not communicating results effectively can be very serious. Geoscientists working in the hazards area face particular challenges in communicating the concepts of risk, probability and uncertainty. Barriers to effective communication of geoscience include the complex language used by geoscientists, restriction of dissemination of results to traditional scientific media, identification of the target audience, inability to tailor products to a variety of audiences, and lack of institutional support for communication efforts. Geoscientists who work in the area of natural hazards need training in risk communication, media relations, and communicating to non-technical audiences. Institutions need to support the efforts of geoscientists in communicating their results through providing communications training; ensuring access to communications professionals; rewarding efforts to engage the public; and devoting sufficient staff and budget to the effort of disseminating results. Geoscientists themselves have to make efforts to change attitudes towards social science, and to become involved in decision making at a community level. The International Union of Geological Sciences Commission for "Geoscience for Environmental Management" established a working group to deal with these issues. This group is holding workshops, publishing collections of papers, and is looking at other means to aid geoscientists in addressing these problems.

Newnes communications technology handbook

CERN Document Server

Lewis, Geoff

1994-01-01

Newnes Communications Technology Handbook provides a discussion on different topics relevant to communications technology. The book is comprised of 39 chapters that tackle a wide variety of concern in communications technology. The coverage of the text includes technologies, such as analog digital communications systems, radio frequency receiver, and satellite systems. The book also discusses some methods and techniques used in communications technology, including mixer signal processing, modulation and demodulation, and spread spectrum techniques. The text will be of great use to engineers, t

Creating fluid injectivity in tar sands formations

Science.gov (United States)

Stegemeier, George Leo; Beer, Gary Lee; Zhang, Etuan

2010-06-08

Methods for treating a tar sands formation are described herein. Methods for treating a tar sands may include heating a portion of a hydrocarbon layer in the formation from one or more heaters located in the portion. The heat may be controlled to increase the permeability of at least part of the portion to create an injection zone in the portion with an average permeability sufficient to allow injection of a fluid through the injection zone. A drive fluid and/or an oxidizing fluid may be provided into the injection zone. At least some hydrocarbons are produced from the portion.

Analysis of anisotropic shells containing flowing fluid

International Nuclear Information System (INIS)

Lakis, A.A.

1983-01-01

A general theory for the dynamic analysis of anisotropic thin cylindrical shells containing flowing fluid is presented. The shell may be uniform or non-uniform, provided it is geometrically axially symmetric. This is a finite- element theory, using cylindrical finite elements, but the displacement functions are determined by using classical shell theory. A new solution of the wave equation of the liquid finite element leads to an expression of the fluid pressure, p, as a function of the nodal displacements of the element and three operative forces (inertia, centrifugal and Coriolis) of the moving fluid. (Author) [pt

Communication skills: an essential component of medical curricula. Part I: Assessment of clinical communication: AMEE Guide No. 51.

Science.gov (United States)

Laidlaw, Anita; Hart, Jo

2011-01-01

This AMEE Guide in Medical Education is Part 1 of a two part Guide covering the issues of Communication. This Guide has been written to provide guidance for those involved in planning the assessment of clinical communication and provides guidance and information relating to the assessment of various aspects of clinical communication; its underlying theory; its practical ability to show that an individual is competent and its relationship to students' daily performance. The advantages and disadvantages of assessing specific aspects of communication are also discussed. The Guide draws attention to the complexity of assessing the ability to communicate with patients and healthcare professionals, with issues of reliability and validity being highlighted for each aspect. Current debates within the area of clinical communication teaching are raised: when should the assessment of clinical communication occur in undergraduate medical education?; should clinical communication assessment be integrated with clinical skills assessment, or should the two be separate?; how important should the assessment of clinical communication be, and the question of possible failure of students if they are judged not competent in communication skills? It is the aim of the authors not only to provide a useful reference for those starting to develop their assessment processes, but also provide an opportunity for review and debate amongst those who already assess clinical communication within their curricula, and a resource for those who have a general interest in medical education who wish to learn more about communication skills assessment.

Brain washing : Transport of cerebral extracellular fluids and solutes

NARCIS (Netherlands)

Bedussi, B.

2017-01-01

Regulation of extracellular volume and fluid composition provides a robust microenvironment for brain cells. In peripheral tissue, fluid surplus and solutes are removed from the interstitium via drainage into lymphatic channels. Since the central nervous system lacks a proper lymphatic vasculature,

Microscale fluid transport using optically controlled marangoni effect

Science.gov (United States)

Thundat, Thomas G [Knoxville, TN; Passian, Ali [Knoxville, TN; Farahi, Rubye H [Oak Ridge, TN

2011-05-10

Low energy light illumination and either a doped semiconductor surface or a surface-plasmon supporting surface are used in combination for manipulating a fluid on the surface in the absence of any applied electric fields or flow channels. Precise control of fluid flow is achieved by applying focused or tightly collimated low energy light to the surface-fluid interface. In the first embodiment, with an appropriate dopant level in the semiconductor substrate, optically excited charge carriers are made to move to the surface when illuminated. In a second embodiment, with a thin-film noble metal surface on a dispersive substrate, optically excited surface plasmons are created for fluid manipulation. This electrode-less optical control of the Marangoni effect provides re-configurable manipulations of fluid flow, thereby paving the way for reprogrammable microfluidic devices.

Communication with patients and colleagues

DEFF Research Database (Denmark)

Nørgaard, Birgitte

2012-01-01

Although patient-centred communication has provided a focus point in health care for many years, patient surveys continuously reveal serious communication problems as experienced by patients, due to poor communication. Likewise, poor inter-collegial communication can cause problems for both health...... care staff and patients. So, knowing that patient-centred communication and good inter-collegial communication is for the benefit of both health professionals and patients, the relevance of improving health care professionals' communication skills and investigating the effect on both professionals...

Patient Communication in Health Care Settings: new Opportunities for Augmentative and Alternative Communication.

Science.gov (United States)

Blackstone, Sarah W; Pressman, Harvey

2016-01-01

Delivering quality health care requires effective communication between health care providers and their patients. In this article, we call on augmentative and alternative communication (AAC) practitioners to offer their knowledge and skills in support of a broader range of patients who confront communication challenges in health care settings. We also provide ideas and examples about ways to prepare people with complex communication needs for the inevitable medical encounters that they will face. We argue that AAC practitioners, educators, and researchers have a unique role to play, important expertise to share, and an extraordinary opportunity to advance the profession, while positively affecting patient outcomes across the health care continuum for a large number of people.

Dynamic characteristics of Non Newtonian fluid Squeeze film damper

Science.gov (United States)

Palaksha, C. P.; Shivaprakash, S.; Jagadish, H. P.

2016-09-01

The fluids which do not follow linear relationship between rate of strain and shear stress are termed as non-Newtonian fluid. The non-Newtonian fluids are usually categorized as those in which shear stress depends on the rates of shear only, fluids for which relation between shear stress and rate of shear depends on time and the visco inelastic fluids which possess both elastic and viscous properties. It is quite difficult to provide a single constitutive relation that can be used to define a non-Newtonian fluid due to a great diversity found in its physical structure. Non-Newtonian fluids can present a complex rheological behaviour involving shear-thinning, viscoelastic or thixotropic effects. The rheological characterization of complex fluids is an important issue in many areas. The paper analyses the damping and stiffness characteristics of non-Newtonian fluids (waxy crude oil) used in squeeze film dampers using the available literature for viscosity characterization. Damping and stiffness characteristic will be evaluated as a function of shear strain rate, temperature and percentage wax concentration etc.

Ultrasonic techniques for fluids characterization

CERN Document Server

Povey, Malcolm J W

1997-01-01

This book is a comprehensive and practical guide to the use of ultrasonic techniques for the characterization of fluids. Focusing on ultrasonic velocimetry, the author covers the basic topics and techniques necessaryfor successful ultrasound measurements on emulsions, dispersions, multiphase media, and viscoelastic/viscoplastic materials. Advanced techniques such as scattering, particle sizing, and automation are also presented. As a handbook for industrial and scientific use, Ultrasonic Techniques for Fluids Characterization is an indispensable guide to chemists and chemical engineers using ultrasound for research or process monitoring in the chemical, food processing, pharmaceutical, cosmetic, biotechnology,and fuels industries. Key Features * Appeals to anyone using ultrasound to study fluids * Provides the first detailed description of the ultrasound profiling technique for dispersions * Describes new techniques for measuring phase transitions and nucleation, such as water/ice and oil/fat * Presents the l...

Fluid dynamics theory, computation, and numerical simulation

CERN Document Server

Pozrikidis, C

2017-01-01

This book provides an accessible introduction to the basic theory of fluid mechanics and computational fluid dynamics (CFD) from a modern perspective that unifies theory and numerical computation. Methods of scientific computing are introduced alongside with theoretical analysis and MATLAB® codes are presented and discussed for a broad range of topics: from interfacial shapes in hydrostatics, to vortex dynamics, to viscous flow, to turbulent flow, to panel methods for flow past airfoils. The third edition includes new topics, additional examples, solved and unsolved problems, and revised images. It adds more computational algorithms and MATLAB programs. It also incorporates discussion of the latest version of the fluid dynamics software library FDLIB, which is freely available online. FDLIB offers an extensive range of computer codes that demonstrate the implementation of elementary and advanced algorithms and provide an invaluable resource for research, teaching, classroom instruction, and self-study. This ...

Fluid mechanics a geometrical point of view

CERN Document Server

Rajeev, S G

2018-01-01

Fluid Mechanics: A Geometrical Point of View emphasizes general principles of physics illustrated by simple examples in fluid mechanics. Advanced mathematics (e.g., Riemannian geometry and Lie groups) commonly used in other parts of theoretical physics (e.g. General Relativity or High Energy Physics) are explained and applied to fluid mechanics. This follows on from the author's book Advanced Mechanics (Oxford University Press, 2013). After introducing the fundamental equations (Euler and Navier-Stokes), the book provides particular cases: ideal and viscous flows, shocks, boundary layers, instabilities, and transients. A restrained look at integrable systems (KdV) leads into a formulation of an ideal fluid as a hamiltonian system. Arnold's deep idea, that the instability of a fluid can be understood using the curvature of the diffeomorphism group, will be explained. Leray's work on regularity of Navier-Stokes solutions, and the modern developments arising from it, will be explained in language for physicists...

Behavior of fluids in a weightless environment

Science.gov (United States)

Fester, D. A.; Eberhardt, R. N.; Tegart, J. R.

1977-01-01

Fluid behavior in a low-g environment is controlled primarily by surface tension forces. Certain fluid and system characteristics determine the magnitude of these forces for both a free liquid surface and liquid in contact with a solid. These characteristics, including surface tension, wettability or contact angle, system geometry, and the relationships governing their interaction, are discussed. Various aspects of fluid behavior in a low-g environment are then presented. This includes the formation of static interface shapes, oscillation and rotation of drops, coalescence, the formation of foams, tendency for cavitation, and diffusion in liquids which were observed during the Skylab fluid mechanics science demonstrations. Liquid reorientation and capillary pumping to establish equilibrium configurations for various system geometries, observed during various free-fall (drop-tower) low-g tests, are also presented. Several passive low-g fluid storage and transfer systems are discussed. These systems use surface tension forces to control the liquid/vapor interface and provide gas-free liquid transfer and liquid-free vapor venting.

BioNet Digital Communications Framework

Science.gov (United States)

Gifford, Kevin; Kuzminsky, Sebastian; Williams, Shea

2010-01-01

BioNet v2 is a peer-to-peer middleware that enables digital communication devices to talk to each other. It provides a software development framework, standardized application, network-transparent device integration services, a flexible messaging model, and network communications for distributed applications. BioNet is an implementation of the Constellation Program Command, Control, Communications and Information (C3I) Interoperability specification, given in CxP 70022-01. The system architecture provides the necessary infrastructure for the integration of heterogeneous wired and wireless sensing and control devices into a unified data system with a standardized application interface, providing plug-and-play operation for hardware and software systems. BioNet v2 features a naming schema for mobility and coarse-grained localization information, data normalization within a network-transparent device driver framework, enabling of network communications to non-IP devices, and fine-grained application control of data subscription band width usage. BioNet directly integrates Disruption Tolerant Networking (DTN) as a communications technology, enabling networked communications with assets that are only intermittently connected including orbiting relay satellites and planetary rover vehicles.

Reinventing Corporate Communications.

Science.gov (United States)

Toth, Elizabeth L.; Trujillo, Nick

1987-01-01

Urges a "re-inventing" of corporate communications in today's organizations, and provides information about how corporations can change in new and positive ways during the current "information age." Discusses specific public relations and organizational communication concepts essential for a comprehensive understanding of…

Contribution to the current value of cerebrospinal fluid scintiscanning in neurological diagnostics

International Nuclear Information System (INIS)

Kukowski, B.

1983-01-01

The importance of scintiscanning of the subarachnoid space of the diagnosis and treatment of certain diseases, and the value of this method within the diagnostical instrumentarium were investigated on the basis of different indications. As a result it was found that scintiscanning of the subarachnoid space can to a large extent be dispensed with. In the remaining indications, by contrast, subarachnoid space scintiscanning is an important test disclosing the causes and extent of liquor circulation disturbances. It is particularly useful if completed by computerized tomography which provides morphologically precise statistical data. In routine investigations it is not as a roule necessary. Subarachnoid space scintiscanning should be carried through as an additional test only in cases of internal hydrocephalus or where symptoms suggest a communicating hydrocephalus. After osteoclastic craniotomy, the formation of an internal hydrocephalus is more frequent. In such cases cerebrospinal fluid scintiscanning should be more frequently considered. Shunt operations should not be carried through unless both investigations have ended up with definite results. If differential diagnosis, after a corresponding result of computerized tomography, suggests cerebral atrophy, subarachnoid space scintiscanning is the appropriate method to check the communication of this defect with the liquor-filled spaces and, were necessary, confirm the diagnosis. (orig./MG) [de

Fluid/structure interaction in BERDYNE (Level 4)

International Nuclear Information System (INIS)

Fox, M.J.H.

1988-02-01

A fluid-structure interaction capability has been developed for Level 4 of the finite element dynamics code BERDYNE, as part of the BERSAFE structural analysis system. This permits analysis of small amplitude free or forced vibration of systems comprising elastic structural components and inviscid volumes of possibly compressible fluid. Free fluid surfaces under the influence of gravity may be present. The formulation chosen uses the rigid walled fluid modes, calculated in a preliminary stage, as a basis for description of the coupled system, providing symmetric system matrices for which efficient solution procedures are available. The inclusion of the fluid modal variables within the system matrices is carried out through the use of the BERDYNE 'substructuring' feature, which allows the inclusion of very general 'super-elements' among the normal structural elements. The program also has a seismic analysis capability, used for the analysis of fluid-structure systems subjected to a specified support acceleration time history. In this case analysis is carried out in terms of relative structural motions, but absolute fluid pressures. Application of the BERDYNE fluid/structure interaction capability to some simple test cases produced results in good agreement with results obtained by analytic or independent numerical techniques. Full instructions on the use of the facility will be included in the BERDYNE Level 4 documentation. Interim documentation for the pre-release version is available from the author. (author)

Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy.

Science.gov (United States)

Malbrain, Manu L N G; Van Regenmortel, Niels; Saugel, Bernd; De Tavernier, Brecht; Van Gaal, Pieter-Jan; Joannes-Boyau, Olivier; Teboul, Jean-Louis; Rice, Todd W; Mythen, Monty; Monnet, Xavier

2018-05-22

In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition. In this paradigm-shifting review, we discuss different fluid management strategies including early adequate goal-directed fluid management, late conservative fluid management and late goal-directed fluid removal. In addition, we expand on the concept of the "four D's" of fluid therapy, namely drug, dosing, duration and de-escalation. During the treatment of patients with septic shock, four phases of fluid therapy should be considered in order to provide answers to four basic questions. These four phases are the resuscitation phase, the optimization phase, the stabilization phase and the evacuation phase. The four questions are "When to start intravenous fluids?", "When to stop intravenous fluids?", "When to start de-resuscitation or active fluid removal?" and finally "When to stop de-resuscitation?" In analogy to the way we handle antibiotics in critically ill patients, it is time for fluid stewardship.

The human communication space towards I-centric communications

CERN Document Server

Arbanowski, S; Steglich, S; Popescu-Zeletin, R

2001-01-01

A variety of concepts for service integration and corresponding systems have been developed. On one hand, they aim for the interworking and integration of classical telecommunications and data communications services. On the other, they are focusing on universal service access from a variety of end-user systems. Many of the technical problems, resulting from service integration and service personalisation, have been solved. However, all these systems are driven by the concept of providing several technologies to users by keeping the peculiarity of each service. Looking at human communication behaviour and communication space, it is obvious that human beings interact habitually in a set of contexts with their environment. The individual information preferences and needs, persons to interact with, and the set of devices controlled by each individual define their personal communication space. Following this view, a new approach is to build communication systems not on the basis of specific technologies, but on t...

Supercritical fluid analytical methods

International Nuclear Information System (INIS)

Smith, R.D.; Kalinoski, H.T.; Wright, B.W.; Udseth, H.R.

1988-01-01

Supercritical fluids are providing the basis for new and improved methods across a range of analytical technologies. New methods are being developed to allow the detection and measurement of compounds that are incompatible with conventional analytical methodologies. Characterization of process and effluent streams for synfuel plants requires instruments capable of detecting and measuring high-molecular-weight compounds, polar compounds, or other materials that are generally difficult to analyze. The purpose of this program is to develop and apply new supercritical fluid techniques for extraction, separation, and analysis. These new technologies will be applied to previously intractable synfuel process materials and to complex mixtures resulting from their interaction with environmental and biological systems

The visual communication of risk.

Science.gov (United States)

Lipkus, I M; Hollands, J G

1999-01-01

This paper 1) provides reasons why graphics should be effective aids to communicate risk; 2) reviews the use of visuals, especially graphical displays, to communicate risk; 3) discusses issues to consider when designing graphs to communicate risk; and 4) provides suggestions for future research. Key articles and materials were obtained from MEDLINE(R) and PsychInfo(R) databases, from reference article citations, and from discussion with experts in risk communication. Research has been devoted primarily to communicating risk magnitudes. Among the various graphical displays, the risk ladder appears to be a promising tool for communicating absolute and relative risks. Preliminary evidence suggests that people understand risk information presented in histograms and pie charts. Areas that need further attention include 1) applying theoretical models to the visual communication of risk, 2) testing which graphical displays can be applied best to different risk communication tasks (e.g., which graphs best convey absolute or relative risks), 3) communicating risk uncertainty, and 4) testing whether the lay public's perceptions and understanding of risk varies by graphical format and whether the addition of graphical displays improves comprehension substantially beyond numerical or narrative translations of risk and, if so, by how much. There is a need to ascertain the extent to which graphics and other visuals enhance the public's understanding of disease risk to facilitate decision-making and behavioral change processes. Nine suggestions are provided to help achieve these ends.

Communicating Your Science

Science.gov (United States)

Young, C. A.

2016-12-01

Effective science communication can open doors, accelerate your career and even make you a better scientist. Part of being an effective and productive scientist means being an effective science communicator. The scientist must communicate their work in talks, posters, peer-reviewed papers, internal reports, proposals as well as to the broader public (including law makers). Despite the importance of communication, it has traditionally not been part of our core training as scientists. Today's science students are beginning to have more opportunities to formally develop their science communication skills. Fortunately, new and even more established scientists have a range of tools and resources at their disposal. In this presentation, we will share some of these resources, share our own experiences utilizing them, and provide some practical tools to improve your own science communication skills.

Communication skills in psychiatry training.

Science.gov (United States)

Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel

2015-08-01

Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

An investigation of dentinal fluid flow in dental pulp during food mastication: simulation of fluid-structure interaction.

Science.gov (United States)

Su, Kuo-Chih; Chuang, Shu-Fen; Ng, Eddie Yin-Kwee; Chang, Chih-Han

2014-06-01

This study uses fluid-structure interaction (FSI) simulation to investigate the relationship between the dentinal fluid flow in the dental pulp of a tooth and the elastic modulus of masticated food particles and to investigate the effects of chewing rate on fluid flow in the dental pulp. Three-dimensional simulation models of a premolar tooth (enamel, dentine, pulp, periodontal ligament, cortical bone, and cancellous bone) and food particle were created. Food particles with elastic modulus of 2,000 and 10,000 MPa were used, respectively. The external displacement loading (5 μm) was gradually directed to the food particle surface for 1 and 0.1 s, respectively, to simulate the chewing of food particles. The displacement and stress on tooth structure and fluid flow in the dental pulp were selected as evaluation indices. The results show that masticating food with a high elastic modulus results in high stress and deformation in the tooth structure, causing faster dentinal fluid flow in the pulp in comparison with that obtained with soft food. In addition, fast chewing of hard food particles can induce faster fluid flow in the pulp, which may result in dental pain. FSI analysis is shown to be a useful tool for investigating dental biomechanics during food mastication. FSI simulation can be used to predict intrapulpal fluid flow in dental pulp; this information may provide the clinician with important concept in dental biomechanics during food mastication.

Digital communication system

International Nuclear Information System (INIS)

Union, D.C.

1980-01-01

A digital communication system for communicating among two central consoles and a plurality of local controllers, e.g. in a radiation and monitoring system, provides communication between each of the consoles and all of the local controllers via dual paths. Each path is independent of the other and each extends from one of the consoles to all of the local controllers from opposite directions, thereby forming a unique non-continuous loop. (author)

Numerical study of fluid motion in bioreactor with two mixers

Energy Technology Data Exchange (ETDEWEB)

Zheleva, I., E-mail: izheleva@uni-ruse.bg [Department of Heat Technology, Hydraulics and Ecology, Angel Kanchev University of Rousse, 8 Studentska str., 7017 Rousse (Bulgaria); Lecheva, A., E-mail: alecheva@uni-ruse.bg [Department of Mathematics, Angel Kanchev University of Rousse, 8 Studentska str., 7017 Rousse (Bulgaria)

2015-10-28

Numerical study of hydrodynamic laminar behavior of a viscous fluid in bioreactor with multiple mixers is provided in the present paper. The reactor is equipped with two disk impellers. The fluid motion is studied in stream function-vorticity formulation. The calculations are made by a computer program, written in MATLAB. The fluid structure is described and numerical results are graphically presented and commented.

Flowing cerebrospinal fluid in normal and hydrocephalic states: Appearance on MR images

International Nuclear Information System (INIS)

Bradley, W.G.; Kortman, K.E.; Burgoyne, B.; Eng, D.

1986-01-01

The signal intensity of the cerebrospinal fluid (CSF) in the cerebral aqueduct and lateral ventricles on magnetic resonance (MR) images was evaluated in 16 healthy individuals and in 32 patients with various forms of hydrocephalus (20 with chronic normal pressure hydrocephalus [NPH], seven with acute communicating hydrocephalus, and five with hydrocephalus ex vacuo [atrophy]). The low signal intensity frequently observed in the cerebral aqueduct is believed to reflect the pulsatile motion of CSF, which is related to the cardiac cycle. While this aqueductal flow void phenomenon can be observed in healthy individuals, it is most pronounced in patients with chronic, communicating NPH; is less evident in patients with acute, communicating hydrocephalus and is least evident in patients with atrophy. Ventricular compliance is known to be essentially normal in atrophy, mildly decreased in acute, communicating hydrocephalus; and severely decreased in NPH. The degree of aqueductal signal loss is believed to reflect the velocity of the pulsatile CSF motion, which in turn depends on the relative ventricular compliance and surface area

MFC Communications Infrastructure Study

Energy Technology Data Exchange (ETDEWEB)

Michael Cannon; Terry Barney; Gary Cook; George Danklefsen, Jr.; Paul Fairbourn; Susan Gihring; Lisa Stearns

2012-01-01

Unprecedented growth of required telecommunications services and telecommunications applications change the way the INL does business today. High speed connectivity compiled with a high demand for telephony and network services requires a robust communications infrastructure.   The current state of the MFC communication infrastructure limits growth opportunities of current and future communication infrastructure services. This limitation is largely due to equipment capacity issues, aging cabling infrastructure (external/internal fiber and copper cable) and inadequate space for telecommunication equipment. While some communication infrastructure improvements have been implemented over time projects, it has been completed without a clear overall plan and technology standard.   This document identifies critical deficiencies with the current state of the communication infrastructure in operation at the MFC facilities and provides an analysis to identify needs and deficiencies to be addressed in order to achieve target architectural standards as defined in STD-170. The intent of STD-170 is to provide a robust, flexible, long-term solution to make communications capabilities align with the INL mission and fit the various programmatic growth and expansion needs.

Fluid reasoning and the developing brain

Directory of Open Access Journals (Sweden)

Emilio Ferrer

2009-05-01

Full Text Available Fluid reasoning is a cornerstone of human cognition, both during development and in adulthood. In spite of this, the neural mechanisms underlying the development of fluid reasoning are largely unknown. Here we provide an overview of this important cognitive ability, how it is measured, how it changes over childhood and adolescence, and what is known about its neurobiological underpinnings. We review important findings from the psychometric, cognitive, and neuroscientific literatures, and outline important future directions for this interdisciplinary research.

Numerical Study of Thermo-Fluid Features of Electrically Conducting Fluids in Tube Bank Heat Exchangers Exposed to Uniform Magnetic Fields

Energy Technology Data Exchange (ETDEWEB)

Oh, Jin Ho; Kang, Namcheol [Kyungpook Nat’l Univ., Daegu (Korea, Republic of)

2017-10-15

When an electrically conducting fluid flows through a staggered tube bank, the heat transfer and fluid flow features are changed by the externally introduced magnetic field. This study provides a numerical investigation of this phenomenon. Heat and fluid flows are investigated for unsteady laminar flows at Reynolds numbers of 50 and 100 with the Hartmann number gradually increasing from zero to 100. As the Hartmann number increases, and owing to the effects of the introduced magnetic field, the velocity boundary layer near the tube wall is thinned, the flow separation is delayed downstream, and the shrinkage of a recirculation zone formed near the rear side is observed. Based on these thermo-fluid deformations, the resulting changes in the local and average Nusselt number are investigated.

Communication about sexuality and intimacy in couples affected by lung cancer and their clinical-care providers.

Science.gov (United States)

Lindau, Stacy Tessler; Surawska, Hanna; Paice, Judith; Baron, Shirley R

2011-02-01

Little is known about the effects of lung cancer on intimate and sexual relationships. This study explores health-care provider, patient, and partner perspectives on: (1) the effects of lung cancer on physical and emotional intimacy, (2) the ways in which intimacy affects the experience of living with lung cancer, and (3) communication about intimacy and sexuality in the context of lung cancer. Qualitative, in-depth interviews with eight cancer-care providers and 13 married couples (ages 43-79) affected by lung cancer were conducted and audiotaped in the clinical setting. Interviews were transcribed, iteratively analyzed, and coded according to the above domains. Coding was performed independently by members of an interdisciplinary team; inter-rater reliability was assessed using the kappa statistic; and analyses were summarized by domain. Most cancer-care providers and couples affected by lung cancer believed intimacy and sexuality issues were salient, yet few reported discussing these. Couples described negative and positive effects of cancer on intimacy. Negative effects were driven by cancer or its treatment, including physical and psychological effects. Positive effects included an increase in non-coital physical closeness and appreciation of the spouse. Age was perceived as an important factor influencing the relationship between lung cancer and intimacy. Emotional intimacy and sexuality are important concerns for couples affected by lung cancer. The findings suggest previously unrecognized positive effects of lung cancer on emotional and physical intimacy. Couples affected by lung cancer and providers believe these issues are relevant for lung cancer care. Copyright © 2010 John Wiley & Sons, Ltd.

Communication about Sexuality and Intimacy in Couples Affected by Lung Cancer and their Clinical Care Providers

Science.gov (United States)

Lindau, Stacy Tessler; Surawska, Hanna; Paice, Judith; Baron, Shirley R.

2012-01-01

OBJECTIVE Little is known about the effects of lung cancer on intimate and sexual relationships. This study explores health care provider, patient, and partner perspectives on: 1) the effects of lung cancer on physical and emotional intimacy, 2) the ways in which intimacy affects the experience of living with lung cancer, and 3) communication about intimacy and sexuality in the context of lung cancer. METHODS Qualitative, in-depth interviews with 8 cancer care providers and 13 married couples (ages 43–79) affected by lung cancer were conducted and audiotaped in the clinical setting. Interviews were transcribed, iteratively analyzed, and coded according to the above domains. Coding was performed independently by members of an interdisciplinary team; inter-rater reliability was assessed using the kappa statistic; and analyses were summarized by domain. RESULTS Most cancer care providers and couples affected by lung cancer believed intimacy and sexuality issues were salient, yet few reported discussing these. Couples described negative and positive effects of cancer on intimacy. Negative effects were driven by cancer or its treatment, including physical and psychological effects. Positive effects included an increase in non-coital physical closeness and appreciation of the spouse. Age was perceived as an important factor influencing the relationship between lung cancer and intimacy. CONCLUSIONS Emotional intimacy and sexuality are important concerns for couples affected by lung cancer. The findings suggest previously unrecognized positive effects of lung cancer on emotional and physical intimacy. Couples affected by lung cancer and providers believe these issues are relevant for lung cancer care. PMID:20540168

2013 AAHA/AAFP fluid therapy guidelines for dogs and cats.

Science.gov (United States)

Davis, Harold; Jensen, Tracey; Johnson, Anthony; Knowles, Pamela; Meyer, Robert; Rucinsky, Renee; Shafford, Heidi

2013-01-01

Fluid therapy is important for many medical conditions in veterinary patients. The assessment of patient history, chief complaint, physical exam findings, and indicated additional testing will determine the need for fluid therapy. Fluid selection is dictated by the patient's needs, including volume, rate, fluid composition required, and location the fluid is needed (e.g., interstitial versus intravascular). Therapy must be individualized, tailored to each patient, and constantly re-evaluated and reformulated according to changes in status. Needs may vary according to the existence of either acute or chronic conditions, patient pathology (e.g., acid-base, oncotic, electrolyte abnormalities), and comorbid conditions. All patients should be assessed for three types of fluid disturbances: changes in volume, changes in content, and/or changes in distribution. The goals of these guidelines are to assist the clinician in prioritizing goals, selecting appropriate fluids and rates of administration, and assessing patient response to therapy. These guidelines provide recommendations for fluid administration for anesthetized patients and patients with fluid disturbances.

EXPERIMENTAL BUBBLE FORMATION IN A LARGE SCALE SYSTEM FOR NEWTONIAN AND NONNEWTONIAN FLUIDS

Energy Technology Data Exchange (ETDEWEB)

Leishear, R; Michael Restivo, M

2008-06-26

The complexities of bubble formation in liquids increase as the system size increases, and a photographic study is presented here to provide some insight into the dynamics of bubble formation for large systems. Air was injected at the bottom of a 28 feet tall by 30 inch diameter column. Different fluids were subjected to different air flow rates at different fluid depths. The fluids were water and non-Newtonian, Bingham plastic fluids, which have yield stresses requiring an applied force to initiate movement, or shearing, of the fluid. Tests showed that bubble formation was significantly different in the two types of fluids. In water, a field of bubbles was formed, which consisted of numerous, distributed, 1/4 to 3/8 inch diameter bubbles. In the Bingham fluid, large bubbles of 6 to 12 inches in diameter were formed, which depended on the air flow rate. This paper provides comprehensive photographic results related to bubble formation in these fluids.

Fluid moments of the nonlinear Landau collision operator

Energy Technology Data Exchange (ETDEWEB)

Hirvijoki, E.; Pfefferlé, D. [Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States); Lingam, M.; Bhattacharjee, A. [Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States); Department of Astrophysical Sciences, Princeton University, Princeton, New Jersey 08544 (United States); Comisso, L. [Department of Astrophysical Sciences, Princeton University, Princeton, New Jersey 08544 (United States); Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States); Candy, J. [General Atomics, San Diego, California 92186 (United States)

2016-08-15

An important problem in plasma physics is the lack of an accurate and complete description of Coulomb collisions in associated fluid models. To shed light on the problem, this Letter introduces an integral identity involving the multivariate Hermite tensor polynomials and presents a method for computing exact expressions for the fluid moments of the nonlinear Landau collision operator. The proposed methodology provides a systematic and rigorous means of extending the validity of fluid models that have an underlying inverse-square force particle dynamics to arbitrary collisionality and flow.

Superconducting Coset Topological Fluids in Josephson Junction Arrays

CERN Document Server

Diamantini, M C; Trugenberger, C A; Sodano, Pasquale; Trugenberger, Carlo A.

2006-01-01

We show that the superconducting ground state of planar Josephson junction arrays is a P- and T-invariant coset topological quantum fluid whose topological order is characterized by the degeneracy 2 on the torus. This new mechanism for planar superconductivity is the P- and T-invariant analogue of Laughlin's quantum Hall fluids. The T=0 insulator-superconductor quantum transition is a quantum critical point characterized by gauge fields and deconfined degrees of freedom. Experiments on toroidal Josephson junction arrays could provide the first direct evidence for topological order and superconducting quantum fluids.

Study of magnetorheological fluids at high shear rates

Energy Technology Data Exchange (ETDEWEB)

Wang, Xiaojie; Gordaninejad, Faramarz [University of Nevada, Department of Mechanical Engineering, Reno, NV (United States)

2006-08-15

The tunable rheological properties of magnetorheological (MR) materials at high shear rates are studied using a piston-driven flow-mode-type rheometer. The proposed method provides measurement of the apparent viscosity and yield stress of MR fluids for a shear rate range of 50 to 40,000 s{sup -1}. The rheological properties of a commercial MR fluid, as well as a newly developed MR polymeric gel, and a ferrofluid-based MR fluid are investigated. The results for apparent viscosity and dynamic and static shear stresses under different applied magnetic fields are reported. (orig.)

Microfluidics with fluid walls.

Science.gov (United States)

Walsh, Edmond J; Feuerborn, Alexander; Wheeler, James H R; Tan, Ann Na; Durham, William M; Foster, Kevin R; Cook, Peter R