WorldWideScience

Sample records for providing hourly values

  1. 8 Hour Ozone Design Value for 1998-2000

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Ozone design value is based on the average of the annual 4th highest daily 8-hour maximum over a 3-year period (1998-2000) in this case. This is a human health...

  2. Forecasting Kp from solar wind data: input parameter study using 3-hour averages and 3-hour range values

    Science.gov (United States)

    Wintoft, Peter; Wik, Magnus; Matzka, Jürgen; Shprits, Yuri

    2017-11-01

    We have developed neural network models that predict Kp from upstream solar wind data. We study the importance of various input parameters, starting with the magnetic component Bz, particle density n, and velocity V and then adding total field B and the By component. As we also notice a seasonal and UT variation in average Kp we include functions of day-of-year and UT. Finally, as Kp is a global representation of the maximum range of geomagnetic variation over 3-hour UT intervals we conclude that sudden changes in the solar wind can have a big effect on Kp, even though it is a 3-hour value. Therefore, 3-hour solar wind averages will not always appropriately represent the solar wind condition, and we introduce 3-hour maxima and minima values to some degree address this problem. We find that introducing total field B and 3-hour maxima and minima, derived from 1-minute solar wind data, have a great influence on the performance. Due to the low number of samples for high Kp values there can be considerable variation in predicted Kp for different networks with similar validation errors. We address this issue by using an ensemble of networks from which we use the median predicted Kp. The models (ensemble of networks) provide prediction lead times in the range 20-90 min given by the time it takes a solar wind structure to travel from L1 to Earth. Two models are implemented that can be run with real time data: (1) IRF-Kp-2017-h3 uses the 3-hour averages of the solar wind data and (2) IRF-Kp-2017 uses in addition to the averages, also the minima and maxima values. The IRF-Kp-2017 model has RMS error of 0.55 and linear correlation of 0.92 based on an independent test set with final Kp covering 2 years using ACE Level 2 data. The IRF-Kp-2017-h3 model has RMSE = 0.63 and correlation = 0.89. We also explore the errors when tested on another two-year period with real-time ACE data which gives RMSE = 0.59 for IRF-Kp-2017 and RMSE = 0.73 for IRF-Kp-2017-h3. The errors as function

  3. A representative value for 24-hour monitored ambulatory blood pressure.

    OpenAIRE

    Yoo, W. S.; Park, H.J.; Lee, E Y; Choi, S. K.

    1986-01-01

    Several shorter-term alternatives for whole-day ambulatory monitoring of blood pressure using Pressurometer III or conventional sphygmomanometer were evaluated in 12 male patients with mild hypertension. Averages of BP reading at 8 AM once, 3 consecutive-readings either with Pressurometer or manually, serial readings for 2-hour intervals from 8-10 AM and 2-4 PM were compared with that of 24-hour ambulatory, non-invasive BP readings by Pressurometer. Both systolic and diastolic 2-hour BP avera...

  4. Work Hours, Social Value of Leisure and Globalisation

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Nielsen, Jørgen Ulff-Møller; Montagna, Catia

    We examine how openness interacts with the coordination of consumption-leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker's marginal utility of leisure t...

  5. Work Hours, Social Value of Leisure and Globalisation

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Molana, Hassan; Montagna, Catia

    2010-01-01

    We examine how openness interacts with the coordination of consumption-leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker's marginal utility of leisure t...

  6. Work hours, social value of leisure and globalisation

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Molana, Hassan; Montagna, Catia

    2012-01-01

    We examine how openness interacts with the coordination of consumption-leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker’s marginal utility of leisure t...

  7. One-hour glucose value as a long-term predictor of cardiovascular morbidity and mortality

    DEFF Research Database (Denmark)

    Nielsen, Mette Lundgren; Pareek, Manan; Leósdóttir, Margrét

    2018-01-01

    -cause mortality (HR 1.10, 95% CI:1.05-1.16, ptest, p=0.02) and all-cause mortality (likelihood......-ratio test, p=0.0001; significant IDI, p=0.0003). CONCLUSION: Among men without known diabetes, addition of 1-hour BG, but not FBG or 2-hour BG, to clinical risk factors provided incremental prognostic yield for prediction of cardiovascular death and all-cause mortality.......OBJECTIVE: To examine the predictive capability of a 1-hour versus 2-hour postload glucose value for cardiovascular morbidity and mortality. DESIGN: Prospective, population-based cohort study (Malmö Preventive Project) with subject inclusion 1974-1992. METHODS: 4934 men without known diabetes...

  8. Geomagnetic Absolute Mean Values at Hourly Intervals from 220 Observatories Worldwide

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This file is comprised of absolute mean hourly values of the geomagnetic components D, H and Z or X, Y and Z. These values, on magnetic tape, are available from...

  9. Comparison of monthly mean hourly sunshine fraction estimation techniques from calculated diffuse radiation values

    Energy Technology Data Exchange (ETDEWEB)

    Soler, A. [Escuela Tecnica Superior de Arquitextura, Madrid (Spain). Departamento de Fisica; Gopinathan, K.K. [The National University of Lesotho, Roma (Lesotho). Dept. of Physics; Robledo, L. [Escuela Universitaria de Informatica, Madrid (Spain). Departamento de Sistemas Inteligentes Aplicados

    1999-06-01

    Mean monthly hourly values of global I and diffuse radiation I{sub d}, along with mean monthly daily values of the sunshine fraction {sigma}{sub d} available for four locations in the United Kingdom, are used to develop six models relating U{sub d}/I with the monthly mean hourly clearness index K{sub t}, the estimated monthly mean hourly sunshine fraction {sigma}{sub h} and the monthly mean solar elevation at mid hour {alpha}. Two available methods are used to predict the values of {sigma}{sub h} from {sigma}{sub d} and the calculated I{sub d} data are compared. Statistical tests performed for a total of six locations, including those used to develop the models, show that the best results are obtained when {sigma}{sub h} predicted with the method developed by Page is employed in the estimation correlation. (author)

  10. 76 FR 16199 - Hours of Service of Railroad Employees; Substantive Regulations for Train Employees Providing...

    Science.gov (United States)

    2011-03-22

    ... model has been used by other entities, including the military and the airline industry. FAST was used to... consistently working on a less- than-24-hour cycle. Fatigue risk in an industry that operates 24 hours a day... initiate an on-duty period. However, the HSL for the railroad industry have never, up to the present day...

  11. [Predictive value of hour-specific transcutaneous bilirubin nomogram for neonatal hyperbilirubinemia: a national multicenter study].

    Science.gov (United States)

    2015-11-01

    To assess the predictive value of hour-specific transcutaneous bilirubin (TcB) nomogram for subsequent neonatal hyperbilirubinemia. Thirteen tertiary class-A hospitals (including two hospitals respectively in the northeastern, northern, eastern, south, northwest, southwestern regions of China, and one in central region) participated in this multicenter study between January 1 and December 31, 2013. All TcB measurements were obtained from healthy term and near-term newborns (gestational age ≥ 35 weeks, birth weight ≥ 2 000 g) by the JM-103 bilirubinometer between 0 and 168 postnatal hours.Developed an hour-specific TcB bilirubin nomogram with these data.Newborns were divided into 4 groups based on the predischarge bilirubin "risk zone" (≤ P40, >P40-P75, >P75-P95, and > P95 as low, low-intermediate, high-intermediate and high risk zones on the hour-specific bilirubin nomogram) to predict subsequent hyperbilirubinemia.Selected bilirubin measurements of three time quantums (25-48 h, 49-72 h, 73-96 h) as a predictor for the respective danger zone, and adopted ROC curve to assess the predictive ability of the TcB nomogram. Data from 19 601 healthy term and near-term newborns, and 2 673 cases with neonatal hyperbilirubinemia were collected. The prevalence was 13.6%. The P40, P75, and P95 peak percentile value of the hour-specific TcB nomogram was 167, 206, 253 µmol/L, respectively. The rate of rise in TcB was highest during the first 24 h of age, and the 95(th) percentile curve was faster than the P40 and P75 percentile curves. The areas under the ROC curves of 25-48 h, 49-72 h and 73-96 h were respectively 0.752 0, 0.834 4, 0.856 1. During 25-48 h, 49-72 h and 73-96 h after birth, the TcB before discharge were in the high-risk zone, its prevalence was 49.4%, 67.3%, 80.4%, its likelihood ratio was 6.20, 13.0, and 27.8, respectively. The constructed TcB nomogram shows a good predictivity for hyperbilirubinemia.

  12. Estimation of Sub Hourly Glacier Albedo Values Using Artificial Intelligence Techniques

    Science.gov (United States)

    Moya Quiroga, Vladimir; Mano, Akira; Asaoka, Yoshihiro; Udo, Keiko; Kure, Shuichi; Mendoza, Javier

    2013-04-01

    Glaciers are the most important fresh water reservoirs storing about 67% of total fresh water. Unfortunately, they are retreating and some small glaciers have already disappeared. Thus, snow glacier melt (SGM) estimation plays an important role in water resources management. Whether SGM is estimated by complete energy balance or a simplified method, albedo is an important data present in most of the methods. However, this is a variable value depending on the ground surface and local conditions. The present research presents a new approach for estimating sub hourly albedo values using different artificial intelligence techniques such as artificial neural networks and decision trees along with measured and easy to obtain data. . The models were developed using measured data from the Zongo-Ore station located in the Bolivian tropical glacier Zongo (68°10' W, 16°15' S). This station automatically records every 30 minutes several meteorological parameters such as incoming short wave radiation, outgoing short wave radiation, temperature or relative humidity. The ANN model used was the Multi Layer Perceptron, while the decision tree used was the M5 model. Both models were trained using the WEKA software and validated using the cross validation method. After analysing the model performances, it was concluded that the decision tree models have a better performance. The model with the best performance was then validated with measured data from the Equatorian tropical glacier Antizana (78°09'W, 0°28'S). The model predicts the sub hourly albedo with an overall mean absolute error of 0.103. The highest errors occur for albedo measured values higher than 0.9. Considering that this is an extreme value coincident with low measured values of incoming short wave radiation, it is reasonable to assume that such values include errors due to censored data. Assuming a maximum albedo of 0.9 improved the accuracy of the model reducing the MAE to less than 0.1. Considering that the

  13. How Academic Libraries Provide Value through Course Readings

    Science.gov (United States)

    Tabacaru, Simona; Hartnett, Eric

    2017-01-01

    Academic libraries are continually being asked to demonstrate their value. Showing benefits that provide financial value to the user community is one approach to meeting this challenge. With a focus on journal articles and monographs, the authors have analyzed course syllabi to determine the cost savings graduate students in psychology receive…

  14. What value do computers provide to NHS hospitals?

    OpenAIRE

    Lock, C.

    1996-01-01

    As the NHS spends around pond 220 million a year on information technology for use by acute hospitals that are hard pressed for resources, it is reasonable to ask what value is provided. A review of rigorous scientific evidence for the value of information technology to NHS hospitals found that published evidence is scarce and far from conclusive. Information technology in NHS hospitals needs further assessment so that future decisions on such necessary and important investments are based on ...

  15. Auroral Electrojet Index Designed to Provide a Global Measure, Hourly Intervals, of Auroral Zone Magnetic Activity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Auroral Electrojet (AE) index is designed to provide a global quantitative measure of auroral zone magnetic activity produced by enhanced ionospheric currents...

  16. Valuing environmental services provided by local stormwater management

    Science.gov (United States)

    Brent, Daniel A.; Gangadharan, Lata; Lassiter, Allison; Leroux, Anke; Raschky, Paul A.

    2017-06-01

    The management of stormwater runoff via distributed green infrastructures delivers a number of environmental services that go beyond the reduction of flood risk, which has been the focus of conventional stormwater systems. Not all of these services may be equally valued by the public, however. This paper estimates households' willingness to pay (WTP) for improvements in water security, stream health, recreational and amenity values, as well as reduction in flood risk and urban heat island effect. We use data from nearly 1000 personal interviews with residential homeowners in Melbourne and Sydney, Australia. Our results suggest that the WTP for the highest levels of all environmental services is A799 per household per year. WTP is mainly driven by residents valuing improvements in local stream health, exemptions in water restrictions, the prevention of flash flooding, and decreased peak urban temperatures respectively at A297, A244, A104 and A$65 per year. We further conduct a benefit transfer analysis and find that the WTP and compensating surplus are not significantly different between the study areas. Our findings provide additional support that stormwater management via green infrastructures have large nonmarket benefits and that, under certain conditions, benefit values can be transferred to different locations.

  17. Evaluating Frameworks That Provide Value Measures for Health Care Interventions.

    Science.gov (United States)

    Mandelblatt, Jeanne S; Ramsey, Scott D; Lieu, Tracy A; Phelps, Charles E

    2017-02-01

    The recent acceleration of scientific discovery has led to greater choices in health care. New technologies, diagnostic tests, and pharmaceuticals have widely varying impact on patients and populations in terms of benefits, toxicities, and costs, stimulating a resurgence of interest in the creation of frameworks intended to measure value in health. Many of these are offered by providers and/or advocacy organizations with expertise and interest in specific diseases (e.g., cancer and heart disease). To help assess the utility of and the potential biases embedded in these frameworks, we created an evaluation taxonomy with seven basic components: 1) define the purpose; 2) detail the conceptual approach, including perspectives, methods for obtaining preferences of decision makers (e.g., patients), and ability to incorporate multiple dimensions of value; 3) discuss inclusions and exclusions of elements included in the framework, and whether the framework assumes clinical intervention or offers alternatives such as palliative care or watchful waiting; 4) evaluate data sources and their scientific validity; 5) assess the intervention's effect on total costs of treating a defined population; 6) analyze how uncertainty is incorporated; and 7) illuminate possible conflicts of interest among those creating the framework. We apply the taxonomy to four representative value frameworks recently published by professional organizations focused on treatment of cancer and heart disease and on vaccine use. We conclude that each of these efforts has strengths and weaknesses when evaluated using our taxonomy, and suggest pathways to enhance the utility of value-assessing frameworks for policy and clinical decision making. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. The optimal threshold values for the severity of urinary incontinence based on the 1-hour pad test.

    Science.gov (United States)

    Li, Bin; Zhu, Lan; Xu, Tao; Lang, Jinghe

    2012-08-01

    To explore the correlation between the 1-hour pad test and Stamey incontinence grading and to obtain the optimal threshold values for the severity of urinary incontinence. In a cross-sectional retrospective study at Peking Union Medical College Hospital, 1-hour pad test results and Stamey grades of female patients who had undergone therapy for urinary incontinence between June 2005 and December 2010 were reviewed. The correlation between the objective and subjective measurements was assessed via a Spearman rank correlation test. The optimal diagnostic threshold was evaluated by ROC curve, and areas under the ROC curve reflected the accuracy of the 1-hour pad test. A strong positive correlation was found between the 1-hour pad test results and the subjective grades of 320 patients (correlation coefficient 0.757, Ptest, the optimal diagnostic cutoff points for the severity of urinary incontinence were 3.4 g and 10.2g. The 1-hour pad test could assess the severity of urinary incontinence accurately. The threshold values should be, approximately, less than 3g for mild, 3-10 g for moderate, and more than 10 g for severe urinary incontinence. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Primary Care Provider Perspectives on Reducing Low-Value Care

    National Research Council Canada - National Science Library

    Reid, Robert J; Cheadle, Allen; Chang, Eva; Buist, Diana S; Gundersen, Gabrielle; Handley, Matthew R; Pardee, Roy

    2015-01-01

    .... This study explores clinicians’ perceived use of and professional responsibility for reducing low-value care, barriers to decreasing its use, and knowledge and perceived legitimacy of the Choosing Wisely campaign. Methods...

  20. Providing sporting experiences for children in Out of School Hours Care (OSHC) environments: sport and physical activity participation and intentions.

    Science.gov (United States)

    Spittle, Michael; O'Meara, James; Garnham, Jennie; Kerr, Megan

    2008-06-01

    The Out of School Hours Sports Program (OSHSP) aimed to provide structured sporting experiences and community links to local clubs for children in Out of School Hours Care (OSHC). The OSHSP involved 17 State Sporting Associations (SSAs), 71 OSHC Services and local club representatives. This study explored children's participation in sport in and outside the OSHSP and parental intention for participation in sport in and outside the OSHSP. Surveys were received from 211 children (76 girls and 125 boys; mean age=7.9 years, S.D.=1.7) and their parents/guardians (37.9% response rate). OSHC is characterised by freedom of choice of participation in activities by children. The OSHSP was used to provide an opportunity to choose to participate in a sport while attending OSHC. At the OSHC Services surveyed, between 7.1 and 100% of the children attending OSHC chose to participate in the OSHSP. Of those children who chose to participate, 85% were participating in a sport, usually a different sport to the one offered in the OSHSP. This participation was largely club-based (49.8%), most often once a week for training and competition (55.2%). Parental intentions for children's participation in the OSHSP sports varied with respect to the number of years attending the OSHSP, where children played and trained in their main sport, and how many times a week a child played and trained in their main sport. Older children tended to play and train for sport more times per week and had been attending the OSHC for more years than younger children.

  1. General practice out-of-hours service in Ireland provides a new source of syndromic surveillance data on influenza.

    LENUS (Irish Health Repository)

    Brabazon, E D

    2010-01-01

    The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.

  2. Resident duty hour modification affects perceptions in medical education, general wellness, and ability to provide patient care.

    Science.gov (United States)

    Moeller, Andrew; Webber, Jordan; Epstein, Ian

    2016-07-13

    Resident duty hours have recently been under criticism, with concerns for resident and patient well-being. Historically, call shifts have been long, and some residency training programs have now restricted shift lengths. Data and opinions about the effects of such restrictions are conflicting. The Internal Medicine Residency Program at Dalhousie University recently moved from a traditional call structure to a day float/night float system. This study evaluated how this change in duty hours affected resident perceptions in several key domains. Senior residents from an internal medicine training program in Canada responded to an anonymous online survey immediately before and 6 months after the implementation of duty hour reform. The survey contained questions relating to three major domains: resident wellness, ability to deliver quality health care, and medical education experience. Mean pre- and post-intervention scores were compared using the t-test for paired samples. Twenty-three of 27 (85 %) senior residents completed both pre- and post-reform surveys. Residents perceived significant changes in many domains with duty hour reform. These included improved general wellness, less exposure to personal harm, fewer feelings of isolation, less potential for error, improvement in clinical skills expertise, increased work efficiency, more successful teaching, increased proficiency in medical skills, more successful learning, and fewer rotation disruptions. Senior residents in a Canadian internal medicine training program perceived significant benefits in medical education experience, ability to deliver healthcare, and resident wellness after implementation of duty hour reform.

  3. Supply and demand determine the market value of food providers in wild vervet monkeys.

    Science.gov (United States)

    Fruteau, Cécile; Voelkl, Bernhard; van Damme, Eric; Noë, Ronald

    2009-07-21

    Animals neither negotiate verbally nor conclude binding contracts, but nevertheless regularly exchange goods and services without overt coercion and manage to arrive at agreements over exchange rates. Biological market theory predicts that such exchange rates fluctuate according to the law of supply and demand. Previous studies showed that primates pay more when commodities become scarcer: subordinates groomed dominants longer before being tolerated at food sites in periods of shortage; females groomed mothers longer before obtaining permission to handle their infants when there were fewer newborns and males groomed fertile females longer before obtaining their compliance when fewer such females were present. We further substantiated these results by conducting a 2-step experiment in 2 groups of free-ranging vervet monkeys in the Loskop Dam Nature Reserve, South Africa. We first allowed a single low-ranking female to repeatedly provide food to her entire group by triggering the opening of a container and measured grooming bouts involving this female in the hour after she made the reward available. We then measured the shifts in grooming patterns after we added a second food container that could be opened by another low-ranking female, the second provider. All 4 providers received more grooming, relative to the amount of grooming they provided themselves. As biological market theory predicts, the initial gain of first providers was partially lost again after the introduction of a second provider in both groups. We conclude that grooming was fine-tuned to changes in the value of these females as social partners.

  4. Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure

    DEFF Research Database (Denmark)

    Olesen, Thomas B; Stidsen, Jacob V; Blicher, Marie K

    2017-01-01

    Markers of target-organ damage and 24-hour ambulatory blood pressure (BP) measurement improve cardiovascular risk stratification. The prevalence of target-organ damage and raised BP increases with aging. The study aim was to evaluate the impact of age and target-organ damage on the prognostic value...... ratio, 0.89 (95% confidence interval, 0.69-1.14; P=0.36); P for interaction, 0.01. Target-organ damage may be a marker of individual susceptibility to the harmful effects of pulse pressure and BP variability on the cardiovascular system in middle-aged individuals....... of ambulatory BP. Markers of target-organ damage and ambulatory BP were measured in 1408 healthy people aged 41 or 51 (middle-aged group), and 61 or 71 (older group) years. The primary outcome was cardiovascular events after 16 years of follow-up, with data obtained from national registries. The prognostic...

  5. Trends and patterns in antibiotic prescribing among out-of-hours primary care providers in England, 2010-14.

    Science.gov (United States)

    Edelstein, Michael; Agbebiyi, Adeola; Ashiru-Oredope, Diane; Hopkins, Susan

    2017-12-01

    Antimicrobial resistance is a global threat, increasing morbidity and mortality. In England, publicly funded clinical commissioning groups (CCGs) commission out-of-hours (OOH) primary care services outside daytime hours. OOH consultations represent 1% of in-hours general practice (GP) consultations. Antibiotic prescriptions increased 32% in non-GP community services between 2010 and 2013. We describe OOH antibiotic prescribing patterns and trends between 2010 and 2014. We: estimated the proportion of CCGs with OOH data available; described and compared antibiotic prescribing by volume of prescribed items, seasonality and trends in GP and OOH, using linear regression; and compared the proportion of broad-spectrum to total antibiotic prescriptions in OOHs with their respective CCGs in terms of seasonality and trends, using binomial regression. Data were available for 143 of 211 (68%) CCGs. OOH antibiotic prescription volume represented 4.5%-5.4% of GP prescription volume and was stable over time (P = 0.37). The proportion of broad-spectrum antibiotic prescriptions increased in OOH when it increased in the CCG they operated in (regression coefficient 0.98; 95% CI 0.96-0.99). Compared with GP, the proportion of broad-spectrum antibiotic prescriptions in OOH was higher but decreased both in GP and OOH (-0.57%, 95% CI - 0.54% to - 0.6% and -0.76%, 95% CI - 0.59% to - 0.93% per year, respectively). OOH proportionally prescribed more antibiotics than GPs although we could not comment on prescribing appropriateness. OOH prescribing volume was stable over time, and followed GP seasonal patterns. OOH antibiotic prescribing reflected the CCGs they operated in but with relatively more broad-spectrum antibiotics than in-hours GP. Understanding factors influencing prescribing in OOH will enable the development of tailored interventions promoting optimal prescribing in this setting.

  6. 24-HOUR ARTERIAL STIFFNESS VALUES IN MEN WITH DIFFERENT PHENOTYPES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE CONCURRENT WITH HYPERTENSION

    Directory of Open Access Journals (Sweden)

    N. A. Karoli

    2015-01-01

    Full Text Available Objective: to study the specific features of the daily arterial stiffness (AS profile in men with different phenotypes of chronic obstructive pulmonary disease (COPD concurrent with hypertension. Subjects and methods. The investigation enrolled 78 male patients with COPD and hypertension. The patients were divided according to COPD phenotypes into 2 groups: 1 COPD patients with emphysema; 2 those with bronchitis. The exclusion criteria were less than 40 years and more than 80 years of age; diabetes mellitus; coronary heart disease; vascular diseases; an exacerbation of chronic diseases; bronchial and pulmonary diseases of another etiology. The patients underwent 24-hour blood pressure and AS monitoring, external respiratory function testing: spirography with a short-acting β2-agonist test, a six-minute walk test at baseline and after a hemoglobin oxygen saturation test, and a CAT test. Results. The patients of both groups were observed to have a statistically significant increase in (dP/dtmax as compared to those of the control group (p < 0.05; p < 0.01 in both the daytime and nighttime. In these periods, the COPD patients with emphysema had a higher AIx than those with bronchitis (p < 0.001. There was a statistically significantly (p < 0.001 higher AIx in the nighttime than in the daytime in Groups 1 and 2 patients. Conclusion. The patients with different COPD phenotypes were noted to have impaired arterial elastic properties, circadian AS changes with predominantly nocturnal impaired vascular stiffness. Relationships were found between 24-hour AS values and clinicoanamnestic findings. 

  7. Relative value of clinical variables, bicycle ergometry, rest radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring at discharge to predict 1 year survival after myocardial infarction

    NARCIS (Netherlands)

    P.M. Fioretti (Paolo); R.W. Brower (Ronald); M.L. Simoons (Maarten); H.J. ten Katen (Harald); A. Beelen (Anita); T. Baardman (Taco); J. Lubsen (Jacob); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractThe relative value of predischarge clinical variables, bicycle ergometry, radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring for predicting survival during the first year in 351 hospital survivors of acute myocardial infarction was assessed. Discriminant

  8. Experiential value co-creation: what’s the significance of the co-created value to providers?

    Directory of Open Access Journals (Sweden)

    Frankline Otiende Awuor

    2015-10-01

    Full Text Available This study aimed at exploring the value providers derive from experiential value co-creation according to the sixth fundamental principle of the Service Dominant Logic. We use kayaking tour guides as cases and use data collected by means of questionnaires and in-depth interviews via content analysis approach. The result indicate that that tour guides co-consume the fun co-created with tourists and derive job satisfaction from experiential value co-creation.

  9. Just Add Hours? An Assessment of Pre-Service Teachers' Perception of the Value of Professional Experience in Attaining Teacher Competencies

    Science.gov (United States)

    Reynolds, Ruth; Howley, Peter; Southgate, Erica; Brown, Joanna

    2016-01-01

    This study compared pre-service teachers' perceptions of their professional competencies at two campuses of a large regional teacher education university, where one campus provided students 22% more hours of professional placement in schools and related educational settings. Students who had experienced more hours in schools and such settings were…

  10. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey

    Science.gov (United States)

    Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-01-01

    Objective To investigate the experience of users of out of hours general practitioner services in England, UK. Design Population based cross sectional postal questionnaire survey. Setting General Practice Patient Survey 2012-13. Main outcome measures Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users’ experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users’ experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. Results The overall response rate was 35%; 971 232/2 750 000 patients returned surveys. Data from 902 170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of −3.13 (95% confidence interval −4.96 to −1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care −3.62, −4.36 to −2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care −4.73, −5.29 to −4.17). Conclusions Commercial providers of out of hours GP care were associated with poorer experience of care

  11. An antiretroviral/zinc combination gel provides 24 hours of complete protection against vaginal SHIV infection in macaques.

    Directory of Open Access Journals (Sweden)

    Jessica Kenney

    2011-01-01

    Full Text Available Repeated use, coitus-independent microbicide gels that do not contain antiretroviral agents also used as first line HIV therapy are urgently needed to curb HIV spread. Current formulations require high doses (millimolar range of antiretroviral drugs and typically only provide short-term protection in macaques. We used the macaque model to test the efficacy of a novel combination microbicide gel containing zinc acetate and micromolar doses of the novel non-nucleoside reverse transcriptase inhibitor MIV-150 for up to 24 h after repeated gel application.Rhesus macaques were vaginally challenged with SHIV-RT up to 24 h after repeated administration of microbicide versus placebo gels. Infection status was determined by measuring virologic and immunologic parameters. Combination microbicide gels containing 14 mM zinc acetate dihydrate and 50 µM MIV-150 afforded full protection (21 of 21 animals for up to 24 h after 2 weeks of daily application. Partial protection was achieved with the MIV-150 gel (56% of control at 8 h after last application, 11% at 24 h, while the zinc acetate gel afforded more pronounced protection (67% at 8-24 h. Marked protection persisted when the zinc acetate or MIV-150/zinc acetate gels were applied every other day for 4 weeks prior to challenge 24 h after the last gel was administered (11 of 14 protected. More MIV-150 was associated with cervical tissue 8 h after daily dosing of MIV-150/zinc acetate versus MIV-150, while comparable MIV-150 levels were associated with vaginal tissues and at 24 h.A combination MIV-150/zinc acetate gel and a zinc acetate gel provide significant protection against SHIV-RT infection for up to 24 h. This represents a novel advancement, identifying microbicides that do not contain anti-viral agents used to treat HIV infection and which can be used repeatedly and independently of coitus, and underscores the need for future clinical testing of their safety and ability to prevent HIV transmission in

  12. Clinical value of 4-hour delayed gadolinium-Enhanced 3D FLAIR MR Images in Acute Vestibular Neuritis.

    Science.gov (United States)

    Byun, Hayoung; Chung, Jae Ho; Lee, Seung Hwan; Park, Chul Won; Park, Dong Woo; Kim, Tae Yoon

    2018-01-13

    To investigate the clinical significance of 4-hour delayed-enhanced 3.0 Tesla three-dimensional (3D) fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) imaging in acute vestibular neuritis. A prospective observational study. Twenty-nine vestibular neuritis patients were enrolled between January 2017 and June 2017. Vestibular function tests, comprising the caloric and video head impulse tests and vestibular-evoked myogenic potential measurements, were performed. Precontrast, 10-minute, and 4-hour delayed-enhanced 3D-FLAIR MR images using double-dose IV gadolinium were obtained. After laterality and extent of inner ear enhancement were defined, the patients were divided into groups based on the patterns of enhancement, and clinical parameters were analyzed according to the groups. Twenty patients (20 of 29, 69.0%) had obviously asymmetric enhancement of the affected inner ear structures on 4-hour delayed images, whereas only three patients (10.3%) had marked enhancement on 10-minute delayed images. The duration of spontaneous nystagmus (DurSN) was significantly longer in the patients with enhancement, especially with enhancement of the whole inner ear, including the vestibule and semicircular canals (P < 0.033). Spontaneous nystagmus resolved within 12 days in patients without laterality of enhancement, and within 16 days in ipsilesional enhancement confined to the inner auditory canal and fundus. Other results of vestibular function tests did not reveal any significant associations with MR enhancement. Contrast enhancement of the vestibular nerve and inner ear structures can be identified on 4-hour delayed-enhanced 3T 3D-FLAIR MR images in acute vestibular neuritis. The extent of inner ear enhancement may be associated with the DurSN. IV. Laryngoscope, 2017. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Single abnormal value on 3-hour oral glucose tolerance test during pregnancy is associated with adverse maternal and neonatal outcomes: a systematic review and metaanalysis.

    Science.gov (United States)

    Roeckner, Jared T; Sanchez-Ramos, Luis; Jijon-Knupp, Rubymel; Kaunitz, Andrew M

    2016-09-01

    The purpose of this study was to determine whether women with 1 abnormal value on 3-hour 100-g oral glucose tolerance test are at an increased risk for adverse pregnancy outcomes. Gestational diabetes mellitus is diagnosed by a 2-step method, with a 3-hour, 100-g oral glucose tolerance test that is reserved for women with an abnormal 1-hour, 50-g glucose challenge test. Although the increased maternal-fetal morbidity with gestational diabetes mellitus is well established, controversy remains about the risk that is associated with an isolated abnormal value during a 3-hour, 100-g oral glucose tolerance test. Prospective and retrospective studies that evaluated the maternal and perinatal impact of 1 abnormal glucose value during a 3-hour, 100-g oral glucose tolerance test were identified with the use of computerized databases. Data were extracted and quantitative analyses were performed. Twenty-five studies (7 prospective and 18 retrospective) that met criteria for metaanalysis included 4466 women with 1 abnormal glucose value on oral glucose tolerance test. Patients with 1 abnormal glucose value had significantly worse pregnancy outcomes compared with women with zero abnormal values with the following pooled odds ratios: macrosomia, 1.59 (95% confidence interval, 1.16-2.19); large for gestational age, 1.38 (95% confidence interval, 1.09-1.76); increased mean birthweight, 44.5 g (95% confidence interval, 8.10-80.80 g); neonatal hypoglycemia, 1.88 (95% confidence interval, 1.05-3.38); total cesarean delivery, 1.69 (95% confidence interval, 1.40-2.05); pregnancy-induced hypertension, 1.55 (95% confidence interval, 1.31-1.83), and Apgar score of test (normal glucose screen). With the exception of birthweight, outcomes of patients with 1 abnormal glucose value were similar to outcomes of patients with gestational diabetes mellitus. Women with 1 abnormal value on 3-hour, 100-g oral glucose tolerance test have a significantly increased risk for poor outcomes comparable

  14. Parents spend an average of nine hours a day providing palliative care for children at home and need to maintain an average of five life-saving devices.

    Science.gov (United States)

    Lazzarin, P; Schiavon, B; Brugnaro, L; Benini, F

    2018-02-01

    This Italian study investigated home-based palliative care for young children and how long it took parents to meet their needs. The study population consisted of 33 families with a child under the responsibility of the Veneto Regional Center for Pediatric Palliative Care, northern Italy, who needed medical support in at least two of the following areas: respiratory, feeding, pain and seizures. The children had a mean age of 6.8 ± 4.7 years. We found that 72% of the patients needed medical devices for feeding, 36% had a tracheostomy and 55% were on mechanical ventilatory support. The children needed an average of five different life-supporting medical appliances, and the time taken to provide for their care increased significantly with each additional appliance (p = 0.016). Their most time-consuming daily needs were feeding (174 minutes) and support when they woke up at night (67 minutes). The average daily time that parents spent taking care of their child amounted to eight hours and 54 minutes per day. Parents providing palliative care for children with life-limiting diseases spent an average of nine hours a day caring for them each day and had to maintain an average of five medical appliances. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies

    Science.gov (United States)

    Lehoux, Pascale; Miller, Fiona A.; Daudelin, Geneviève; Denis, Jean-Louis

    2017-01-01

    Background: New technologies constitute an important cost-driver in healthcare, but the dynamics that lead to their emergence remains poorly understood from a health policy standpoint. The goal of this paper is to clarify how entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies. Methods: Our 5-year qualitative research program examined the processes through which new health technologies were envisioned, financed, developed and commercialized by entrepreneurial clinical teams operating in Quebec’s (Canada) publicly funded healthcare system. Results: Entrepreneurs have a direct influence over a new technology’s value proposition, but investors actively transform this value. Investors support a technology that can find a market, no matter its intrinsic value for clinical practice or healthcare systems. Regulatory agencies reinforce the "double" value of a new technology—as a health intervention and as an economic commodity—and provide economic worth to the venture that is bringing the technology to market. Conclusion: Policy-oriented initiatives such as early health technology assessment (HTA) and coverage with evidence may provide technology developers with useful input regarding the decisions they make at an early stage. But to foster technologies that bring more value to healthcare systems, policy-makers must actively support the consideration of health policy issues in innovation policy. PMID:28949463

  16. Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies.

    Science.gov (United States)

    Lehoux, Pascale; Miller, Fiona A; Daudelin, Geneviève; Denis, Jean-Louis

    2017-01-25

    New technologies constitute an important cost-driver in healthcare, but the dynamics that lead to their emergence remains poorly understood from a health policy standpoint. The goal of this paper is to clarify how entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies. Our 5-year qualitative research program examined the processes through which new health technologies were envisioned, financed, developed and commercialized by entrepreneurial clinical teams operating in Quebec's (Canada) publicly funded healthcare system. Entrepreneurs have a direct influence over a new technology's value proposition, but investors actively transform this value. Investors support a technology that can find a market, no matter its intrinsic value for clinical practice or healthcare systems. Regulatory agencies reinforce the "double" value of a new technology-as a health intervention and as an economic commodity-and provide economic worth to the venture that is bringing the technology to market. Policy-oriented initiatives such as early health technology assessment (HTA) and coverage with evidence may provide technology developers with useful input regarding the decisions they make at an early stage. But to foster technologies that bring more value to healthcare systems, policy-makers must actively support the consideration of health policy issues in innovation policy.

  17. Predictive Value of a 4-Hour Accelerated Diagnostic Protocol in Patients with Suspected Ischemic Chest Pain Presenting to an Emergency Department

    Directory of Open Access Journals (Sweden)

    Mamatha P.R. Rao

    2012-05-01

    Full Text Available Objectives: Currently recommended risk stratification protocols for suspected ischemic chest pain in the emergency department (ED includes point-of-care availability of exercise treadmill/nuclear tests or CT coronary angiograms. These tests are not widely available for most of the ED’s. This study aims to prospectively validate the safety of a predefined 4-hour accelerated diagnostic protocol (ADP using chest pain, ECG, and troponin T among suspected ischemic chest pain patients presenting to an ED of a tertiary care hospital in Oman.Methods: One hundred and thirty-two patients aged over 18 years with suspected ischemic chest pain presenting within 12 hours of onset along with normal or non-diagnostic first ECG and negative first troponin T (<0.010 μg/l were recruited from September 2008 to February 2009. Low-probability acute coronary syndrome (ACS patients at 4-hours defined as absent chest pain and negative ECG or troponin tests were discharged home and observed for 30-days for major adverse cardiac events (MACE (Group I: negative ADP. High-probability ACS patients at 4-hours were defined by recurrent or persistent chest pain, positive ECG or troponin tests and were admitted and observed for in-hospital MACE (Group II: positive ADP.Results: One hundred and thirty-two patients were recruited and 110 patients completed the study. The overall 30-day MACE in this cohort was 15% with a mortality of less than 1%. 30-days MACE occurred in 8/95 of group I patients (8.4% and 9/15 of the in-hospital MACE patients in group II. The ADP had a sensitivity of 52% (95% CI: 0.28-0.76, specificity of 93% (0.85-0.97, a negative predictive value of 91% (0.83-0.96, a positive predictive value of 60% (0.32-0.82, negative likelihood ratio of 0.5 (0.30-0.83 and a positive likelihood ratio of 8.2 (3.3-20 in predicting MACE.Conclusion: A 4-hour ADP using chest pain, ECG, and troponin T had high specificity and negative predictive value in predicting 30-day MACE

  18. Valuing blue carbon: carbon sequestration benefits provided by the marine protected areas in Colombia.

    Science.gov (United States)

    Zarate-Barrera, Tatiana G; Maldonado, Jorge H

    2015-01-01

    Marine protected areas are aimed to protect and conserve key ecosystems for the provision of a number of ecosystem services that are the basis for numerous economic activities. Among the several services that these areas provide, the capacity of sequestering (capturing and storing) organic carbon is a regulating service, provided mainly by mangroves and seagrasses, that gains importance as alternatives for mitigating global warming become a priority in the international agenda. The objective of this study is to value the services associated with the capture and storage of oceanic carbon, known as Blue Carbon, provided by a new network of marine protected areas in Colombia. We approach the monetary value associated to these services through the simulation of a hypothetical market for oceanic carbon. To do that, we construct a benefit function that considers the capacity of mangroves and seagrasses for capturing and storing blue carbon, and simulate scenarios for the variation of key variables such as the market carbon price, the discount rate, the natural rate of loss of the ecosystems, and the expectations about the post-Kyoto negotiations. The results indicate that the expected benefits associated to carbon capture and storage provided by these ecosystems are substantial but highly dependent on the expectations in terms of the negotiations surrounding the extension of the Kyoto Protocol and the dynamics of the carbon credit's demand and supply. We also find that the natural loss rate of these ecosystems does not seem to have a significant effect on the annual value of the benefits. This approach constitutes one of the first attempts to value blue carbon as one of the services provided by conservation.

  19. Valuing blue carbon: carbon sequestration benefits provided by the marine protected areas in Colombia.

    Directory of Open Access Journals (Sweden)

    Tatiana G Zarate-Barrera

    Full Text Available Marine protected areas are aimed to protect and conserve key ecosystems for the provision of a number of ecosystem services that are the basis for numerous economic activities. Among the several services that these areas provide, the capacity of sequestering (capturing and storing organic carbon is a regulating service, provided mainly by mangroves and seagrasses, that gains importance as alternatives for mitigating global warming become a priority in the international agenda. The objective of this study is to value the services associated with the capture and storage of oceanic carbon, known as Blue Carbon, provided by a new network of marine protected areas in Colombia. We approach the monetary value associated to these services through the simulation of a hypothetical market for oceanic carbon. To do that, we construct a benefit function that considers the capacity of mangroves and seagrasses for capturing and storing blue carbon, and simulate scenarios for the variation of key variables such as the market carbon price, the discount rate, the natural rate of loss of the ecosystems, and the expectations about the post-Kyoto negotiations. The results indicate that the expected benefits associated to carbon capture and storage provided by these ecosystems are substantial but highly dependent on the expectations in terms of the negotiations surrounding the extension of the Kyoto Protocol and the dynamics of the carbon credit's demand and supply. We also find that the natural loss rate of these ecosystems does not seem to have a significant effect on the annual value of the benefits. This approach constitutes one of the first attempts to value blue carbon as one of the services provided by conservation.

  20. Impact of Provider Incentives on Quality and Value of Health Care.

    Science.gov (United States)

    Doran, Tim; Maurer, Kristin A; Ryan, Andrew M

    2017-03-20

    The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value-Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.

  1. Validation of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Beraldo O, B.; Paixao, L.; Donato da S, S. [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Post-graduation in Sciences and Technology of Radiations Minerals and Materials, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil); Araujo T, M. H. [Dr Maria Helena Araujo Teixeira Clinic, Guajajaras 40, 30180-100 Belo Horizonte (Brazil); Nogueira, M. S., E-mail: bbo@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil)

    2014-08-15

    Digital breast tomosynthesis (DBT) is an emerging imaging modality that provides quasi-three-dimensional structural information of the breast and has strong promise to improve the differentiation of normal tissue and suspicious masses reducing the tissue overlaps. DBT images are reconstructed from a sequence of low-dose X-ray projections of the breast acquired at a small number of angles over a limited angular range. The Ho logic Selen ia Dimensions system is equipped with an amorphous Selenium (a-Se) detector layer of 250 μm thickness and a 70 μm pixel pitch. Studies are needed to determine the radiation dose of patients that are undergoing this emerging procedure to compare with the results obtained in DBT images. The mean glandular dose (D{sub G}) is the dosimetric quantity used in quality control of the mammographic systems. The aim of this work is to validate D{sub G} values for different breast thicknesses provided by a Ho logic Selen ia Dimensions system using a DBT mode in comparison with the same results obtained by a calibrated 90 X 5-6M-model Radcal ionization chamber. D{sub G} values were derived from the incident air kerma (K{sub i}) measurements and tabulated conversion coefficients that are dependent on the half value layer (HVL) of the X-ray spectrum. Voltage and tube loading values were recorded in irradiations using W/Al anode/filter combination, automatic exposure control mode and polymethyl methacrylate (PMMA) slabs which simulate different breast thicknesses. For K{sub i} measurements, the ionization chamber was positioned at 655 mm from the focus and the same radiographic technique values were selected with the manual mode. D{sub G} values for a complete procedure ranged from 0.9 ± 0.1 to 3.7 ± 0.4 mGy. The results for different breast thicknesses are in accordance with values obtained by DBT images and with acceptable levels established by the Commission of the European Communities (Cec) and the International Atomic Energy Agency (IAEA

  2. Measuring value at the provider level in the management of cleft lip and palate patients.

    Science.gov (United States)

    Abbott, Megan M; Rosen, Heather; Kupfer, Philipp; Meara, John G

    2014-03-01

    "Value" has become a buzzword in current health-care discussions. This study demonstrates a provider-led strategy to measuring costs, an understudied component of the value equation, for a complex diagnosis for the purposes of improvement. A retrospective, microcosting methodology was used to measure costs for all hospital and physician services and costs to the patient over 18 months of multidisciplinary care for patients with cleft lip and palate. Short-term outcomes were also recorded. Overall costs to all parts of the system ranged from $35,826 to $56,611 for different subtypes, and insight was gained into major cost drivers and variations in care that will drive internal improvement efforts. It is critical that providers learn to work together and become familiar with their own costs in conjunction with outcomes as insurers increase pressure to reduce payments or accept alternative payments so that well-informed decisions can be made.

  3. Value-Added Electricity Services: New Roles for Utilities and Third-Party Providers

    Energy Technology Data Exchange (ETDEWEB)

    Blansfield, J. [Inst. for Electric Innovations, Washington, DC (United States); Wood, L. [Inst. for Electric Innovations, Washington, DC (United States); Katofsky, R. [Advanced Energy Economy, Washington, DC (United States); Stafford, B. [Advanced Energy Economy, Washington, DC (United States); Waggoner, D. [Advanced Energy Economy, Washington, DC (United States); Schwartz, L. C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-10-30

    New energy generation, storage, delivery, and end-use technologies support a broad range of value-added electricity services for retail electricity customers. Sophisticated energy management services, distributed generation coupled with storage, and electric vehicle charging are just a few examples of emerging offerings. Who should provide value-added services — utilities or third parties, or both, and under what conditions? What policy and regulatory changes may be needed to promote competition and innovation, to account for utility costs to enable these services, and to protect consumers? The report approaches the issues from three perspectives: utilities, third-party service providers, and consumers: -Jonathan Blansfield and Lisa Wood, Institute for Electric Innovation -Ryan Katofsky, Benjamin Stafford and Danny Waggoner, Advanced Energy Economy -National Association of State Utility Consumer Advocates

  4. Correlation of 2 hour, 4 hour, 8 hour and 12 hour urine protein with 24 hour urinary protein in preeclampsia.

    Directory of Open Access Journals (Sweden)

    Savita Rani Singhal

    2014-09-01

    Full Text Available To find shortest and reliable time period of urine collection for determination of proteinuria.It is a prospective study carried out on 125 pregnant women with preeclampsia after 20 weeks of gestation having urine albumin >1 using dipstick test. Urine was collected in five different time intervals in colors labeled containers with the assistance of nursing staff; the total collection time was 24 hours. Total urine protein of two-hour, four-hour, eight-hour, 12-hour and 24-hour urine was measured and compared with 24-hour collection. Data was analyzed using the Pearson correlation coefficient.There was significant correlation (p value < 0.01 in two, four, eight and 12-hour urine protein with 24-urine protein, with correlation coefficient of 0.97, 0.97, 0.96 and 0.97, respectively. When a cut off value of 25 mg, 50 mg. 100 mg, and 150 mg for urine protein were used for 2-hour, 4-hours, 8-hour and 12-hour urine collection, a sensitivity of 92.45%, 95.28%, 91.51%, and 96.23% and a specificity of 68.42%, 94.74%, 84.21% and 84.21% were obtained, respectively.Two-hour urine proteins can be used for assessment of proteinuria in preeclampsia instead of gold standard 24-hour urine collection for early diagnosis and better patient compliance.

  5. Value-added strategy models to provide quality services in senior health business.

    Science.gov (United States)

    Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin

    2017-06-20

    The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service.

  6. The Value of a Checklist for Child Abuse in Out-of-Hours Primary Care: To Screen or Not to Screen.

    Science.gov (United States)

    Schouten, Maartje Cm; van Stel, Henk F; Verheij, Theo Jm; Houben, Michiel L; Russel, Ingrid Mb; Nieuwenhuis, Edward Es; van de Putte, Elise M

    2017-01-01

    To assess the diagnostic value of the screening instrument SPUTOVAMO-R2 (checklist, 5 questions) for child abuse at Out-of-hours Primary Care locations (OPC), by comparing the test outcome with information from Child Protection Services (CPS). Secondary, to determine whether reducing the length of the checklist compromises diagnostic value. All children (abuse (32.8%). The positive predictive value (PPV) of the checklist for child abuse was 8.3 (95% CI 3.9-15.2). The negative predictive value (NPV) was 99.1 (98.8-99.3), with 52 false negatives. When the length of the checklist was reduced to two questions closely related to the medical process (SPUTOVAMO-R3), the PPV was 9.1 (3.7-17.8) and the NPV 99.1 (98.7-99.3). These two questions are on the injury in relation to the history, and the interaction between child and parents. The checklist SPUTOVAMO-R2 has a low detection rate of child abuse within the OPC setting, and a high false positive rate. Therefore, we recommend to use the shortened checklist only as a tool to increase the awareness of child abuse and not as a diagnostic instrument.

  7. Generalised extreme value distributions provide a natural hypothesis for the shape of seed mass distributions.

    Directory of Open Access Journals (Sweden)

    Will Edwards

    Full Text Available Among co-occurring species, values for functionally important plant traits span orders of magnitude, are uni-modal, and generally positively skewed. Such data are usually log-transformed "for normality" but no convincing mechanistic explanation for a log-normal expectation exists. Here we propose a hypothesis for the distribution of seed masses based on generalised extreme value distributions (GEVs, a class of probability distributions used in climatology to characterise the impact of event magnitudes and frequencies; events that impose strong directional selection on biological traits. In tests involving datasets from 34 locations across the globe, GEVs described log10 seed mass distributions as well or better than conventional normalising statistics in 79% of cases, and revealed a systematic tendency for an overabundance of small seed sizes associated with low latitudes. GEVs characterise disturbance events experienced in a location to which individual species' life histories could respond, providing a natural, biological explanation for trait expression that is lacking from all previous hypotheses attempting to describe trait distributions in multispecies assemblages. We suggest that GEVs could provide a mechanistic explanation for plant trait distributions and potentially link biology and climatology under a single paradigm.

  8. The economic value of the climate regulation ecosystem service provided by the Amazon rainforest

    Science.gov (United States)

    Heil Costa, Marcos; Pires, Gabrielle; Fontes, Vitor; Brumatti, Livia

    2017-04-01

    The rainy Amazon climate allowed important activities to develop in the region as large rainfed agricultural lands and hydropower plants. The Amazon rainforest is an important source of moisture to the regional atmosphere and helps regulate the local climate. The replacement of forest by agricultural lands decreases the flux of water vapor into the atmosphere and changes the precipitation patterns, which may severely affect such economic activities. Assign an economic value to this ecosystem service may emphasize the significance to preserve the Amazon rainforest. In this work, we provide a first approximation of the quantification of the climate regulation ecosystem service provided by the Amazon rainforest using the marginal production method. We use climate scenarios derived from Amazon deforestation scenarios as input to crop and runoff models to assess how land use change would affect agriculture and hydropower generation. The effects of forest removal on soybean production and on cattle beef production can both be as high as US 16 per year per ha deforested, and the effects on hydropower generation can be as high as US 8 per year per ha deforested. We consider this as a conservative estimate of a permanent service provided by the rainforest. Policy makers and other Amazon agriculture and energy businesses must be aware of these numbers, and consider them while planning their activities.

  9. Perceived value of providing peer reviewers with abstracts and preprints of related published and unpublished papers.

    Science.gov (United States)

    Hatch, C L; Goodman, S N

    1998-07-15

    Many journals provide peer reviewers with written instructions regarding review criteria, such as the originality of results, but little research has been done to investigate ways to improve or facilitate the peer review task. To assess the value that peer reviewers place on receipt of supplemental materials (eg, abstracts of related papers and preprints of related unpublished manuscripts). Questionnaire survey sent to all 733 peer reviewers recruited by the Journal of the National Cancer Institute to review 356 manuscripts consecutively sent out for review from February 24, 1997, through January 16, 1998. The inclusion of supplemental materials with manuscript review packages was optional. The peer reviewers' assessment of the actual or potential usefulness of supplemental materials on the performance of peer review. A total of 481 (66%) of 733 questionnaires were returned. Of the 471 respondents' questionnaires that could be used, 217 (46%) indicated that they received abstracts, and 44 (10%) of 458 respondents indicated that they received preprints. Higher proportions of peer reviewers who received supplemental materials than those who had not received them felt that they were (or would be) useful to them when reviewing the manuscript (63% [95% confidence interval (CI), 57%-69%] vs 45% [95% CI, 38%-52%]; P<.001) and to the peer review process in general (80% [95% CI, 75%-85%] vs 64% [95% CI, 58%-70%]; P<.001). The majority of respondents indicated that supplemental materials helped (or would have helped) them evaluate manuscripts and valued them more highly when they actually received them.

  10. Consumer fears and familiarity of processed food. The value of information provided by the FTNS.

    Science.gov (United States)

    Verneau, Fabio; Caracciolo, Francesco; Coppola, Adele; Lombardi, Pasquale

    2014-02-01

    Food choice and consumption behaviour are influenced by many interacting factors. In this paper we present an empirical effort to enhance understanding of the neophobia-neophilia forces affecting food choice. Starting from the analysis of consumer preferences for some of the most familiar highly processed foods, namely fat-reduced, functional (enriched drinks and yogurt) and ready-to-eat frozen food, our study investigates the role of traditional demographic variables vs attitudes to new food technologies in predicting the consumption behaviour of a sample of Italians buying such products. Consumer attitudes toward food technologies were collected by means of the Food Technology Neophobia Scale (FTNS). Moreover, this paper explicitly analyses the value of the information provided by the FTNS. Underlying the research is the hypothesis that the FTNS may contribute to provide a comprehensive picture of the driving forces behind consumers' behavioural responses towards processed foods which are the end-result of mature technologies. The four FTNS components, once measured and used independently, help clarify the influence on food choices of each neophobia-neophilia force (risk perception and novelty seeking, media influence, own health and environmental concerns) into a single, comprehensive framework. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Value Frameworks for the Patient-Provider Interaction: A Comparison of the ASCO Value Framework Versus NCCN Evidence Blocks in Determining Value in Oncology.

    Science.gov (United States)

    Shah-Manek, Bijal; Galanto, Joseph S; Nguyen, Huong; Ignoffo, Robert

    2017-06-01

    To address the rising concern about oncology drug costs, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recently developed unique tools to help providers and patients make informed decisions about the value of an anticancer regimen. The ASCO Value Framework (AVF) allows users to generate a net health benefit (NHB) score along with drug acquisition costs for oncology regimens that have been compared in a prospective randomized clinical trial. In contrast, the NCCN Evidence Blocks (NEB) derives ratings from an expert panel assessment in the categories of efficacy, safety, quality and consistency of evidence, and affordability. To compare the results of the AVF and NEB by applying each tool to the same clinical scenarios. We evaluated 2 regimens using the AVF and NEB scores: (1) enzalutamide for treatment of metastatic castration-resistant prostate cancer and (2) nivolumab versus docetaxel in treatment of advanced squamous and nonsquamous non-small cell lung cancer (NSCLC). Enzalutamide generated a total NHB score of 44.8 (range 0-180) for use before chemotherapy and 70.8 for use after chemotherapy with a monthly cost of $8,495 in the AVF. The NEB scored enzalutamide 4 (very effective) for efficacy, 4 (occasionally toxic) for safety, and 2 (expensive) for affordability in the no visceral metastases block. It scored 3 (moderately effective) for efficacy, 4 for safety, and 2 for affordability in the visceral metastases block. Nivolumab in advanced nonsquamous NSCLC scored 36.0 and 73.2 in advanced squamous NSCLC, with a monthly cost of $7,010 in the AVF. The NEB gave nivolumab a score of 4 for efficacy and safety and 1 (very expensive) for affordability in the NEB in advanced nonsquamous and advanced squamous NSCLC. The AVF and NEB are novel tools that take different approaches in assessing the value of an oncology treatment regimen. From this study, it is clear that the findings generated by these tools are

  12. Value Co-creation in the Interface Between City Logistics Provider and In-store Processes

    DEFF Research Database (Denmark)

    Gammelgaard, Britta; Bech Godskesen Andersen, Christina; Aastrup, Jesper

    2016-01-01

    This paper develops a framework for understanding how city logistics service co-creates value with users. The users’ perspective in city logistics research is limited, and value added services are rarely emphasized. The framework developed is based on literature on value in business markets, and in......-store processes. Two case stores and their use of city logistics demonstrate how value is co-created when changes in delivery patterns and value added services affect especially the use of store employees. Further, we show that there is a barrier to the co-creation of value when services get close to core...

  13. 5C.07: A METHOD TO ESTIMATE 24-HOUR SODIUM EXCRETION THROUGH SPOT URINE SAMPLES AND ITS APPLICATION VALUE FOR TARGET-ORGAN DAMAGE ASSESSMENT.

    Science.gov (United States)

    Wang, H; Zhao, L; Xi, Y; Sun, N

    2015-06-01

    24-h urine sodium excretion is considered the most reliable method to evaluate the salt intakes. However, this method is cumbersome. So we want to develop formulas to estimate 24-h urinary sodium excretion using spot urinary samples in Chinese hypertensive population and explore the application value of this method in salt intake assessment and target organ damage. 1. We enrolled 510 cases of hospitalized patients with hypertension, 2/3 of them were arranged randomly to formula group to develop a new formula and the remainings were used to test the performance of the formula. All participants were instructed to collect a 24-h urine sample, a second morning voiding urine sample (SMU), and a post-meridiem urine sample in the late afternoon or early evening, prior to the evening meal (PMU). All samples were sent to measure sodium and creatinine concentration.2. We compared the differences of office blood pressure, 24-hour ambulatory blood pressure and left ventricular hypertrophy, vascular stiffness and urine protein among groups of different sodium intake. 24hour sodium excretion formulas was obtained using SMU and PMU respectively, which have good cosistency. The difference between the estimated and measured values in sodium excretion is 12.66mmol/day (SMU) and 9.41mmol/day (PM), to be equal to 0.7 g (SMU) and 0.6 g (PM) salt intake. Comparing with Kawasaki and Tanaka method, the new formula shows the lower degree of deviation, and higher accuracy and precision. Blood pressure of high urinary sodium group is higher than that in low urinary sodium group (P < 0.05). Left ventricular hypertrophy and urinary albumin/creatinine aggravated with the salt intake increase, this has eliminated the influence of other factors. All of morphologies of the relationship between ambulatory arterial stiffness index, pulse wave velocity and carotid intima-media thickness with quartiles of sodium intake resembled a J-shaped curve. In Chinese hypertensive population, the

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

    Science.gov (United States)

    Makurat, Jan; Pillai, Aarati; Wieringa, Frank T; Chamnan, Chhoun; Krawinkel, Michael B

    2017-07-21

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

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

    Directory of Open Access Journals (Sweden)

    Jan Makurat

    2017-07-01

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

  16. Training Physicians to Provide High-Value, Cost-Conscious Care A Systematic Review

    NARCIS (Netherlands)

    Stammen, L.A.; Stalmeijer, R.E.; Paternotte, E.; Pool, A.O.; Driessen, E.W.; Scheele, F.; Stassen, L.P.S.

    2015-01-01

    Importance Increasing health care expenditures are taxing the sustainability of the health care system. Physicians should be prepared to deliver high-value, cost-conscious care. Objective To understand the circumstances in which the delivery of high-value, cost-conscious care is learned, with a goal

  17. Exploring the value of peer feedback in online learning for the provider

    NARCIS (Netherlands)

    Marijke Kral; Gino Camp; Esther van Popta; Robert Jan Simons; Rob L. Martens

    2017-01-01

    This paper reviews studies of peer feedback from the novel perspective of the providers of that feedback. The possible learning benefits of providing peer feedback in online learning have not been extensively studied. The goal of this study was therefore to explore the process of providing online

  18. Valuing the Resilience Provided by Solar and Battery Energy Storage Systems

    Energy Technology Data Exchange (ETDEWEB)

    McLaren, Joyce A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mullendore, Seth [Clean Energy Group

    2018-02-05

    This paper explores the impact of valuing resilience on the economics of photovoltaics (PV) and storage systems for commercial buildings. The analysis presented here illustrates that accounting for the cost of grid power outages can change the breakeven point for PV and storage system investment, and increase the size of systems designed to deliver the greatest economic benefit over time. In other words, valuing resilience can make PV and storage systems economical in cases where they would not be otherwise. As storage costs decrease, and outages occur more frequently, PV and storage are likely to play a larger role in building design and management considerations.

  19. Economic Diplomacy in the Innovation Global Value Chains as the National Security Providing Strategy Component

    Directory of Open Access Journals (Sweden)

    Vitaliy Omelyanenko

    2017-03-01

    Full Text Available The article deals with the analyzes of economic diplomacy application in the area of innovations. The strategy of economic diplomacy by improving the efficiency in global value chain participation was considered. The main effects of commercial diplomacy using in the innovation area were identified. The world experience using economic diplomacy in the innovation sphere was considered.

  20. Do Xpert MTB/RIF Cycle Threshold Values Provide Information about Patient Delays for Tuberculosis Diagnosis?

    Directory of Open Access Journals (Sweden)

    Willy Ssengooba

    Full Text Available Early diagnosis and initiation to appropriate treatment is vital for tuberculosis (TB control. The XpertMTB/RIF (Xpert assay offers rapid TB diagnosis and quantitative estimation of bacterial burden through Cycle threshold (Ct values. We assessed whether the Xpert Ct value is associated with delayed TB diagnosis as a potential monitoring tool for TB control programme performance.This analysis was nested in a prospective study under the routine TB surveillance procedures of the National TB Control Program in Manhiça district, Maputo province, Mozambique. Presumptive TB patients were tested using smear microscopy and Xpert. We explored the association between Xpert Ct values and self-reported delay of Xpert-positive TB patients as recorded at the time of diagnosis enrolment. Patients with >60 days of TB symptoms were considered to have long delays.Of 1,483 presumptive TB cases, 580 were diagnosed as TB of whom 505 (87.0% were due to pulmonary TB and 302 (94.1% were Xpert positive. Ct values (range, 9.7-46.4 showed a multimodal distribution. The median (IQR delay was 30 (30-45 days. Ct values showed no correlation with delay (R2 = 0.001, p = 0.621, nor any association with long delays: adjusted odds ratios (AOR (95% confidence interval [CI] comparing to >28 cycles 0.99 (0.50-1.96; p = 0.987 for 23-28 cycles, 0.93 (0.50-1.74; p = 0.828 for 16-22 cycles; and 1.05 (0.47-2.36; p = 0.897 for <16 cycles. Being HIV-negative (AOR [95% CI], 2.05 (1.19-3.51, p = 0.009 and rural residence 1.74 (1.08-2.81, p = 0.023, were independent predictors of long delays.Xpert Ct values were not associated with patient delay for TB diagnosis and cannot be used as an indicator of TB control program performance.

  1. ‘God is my forest’ – Xhosa cultural values provide untapped opportunities for conservation

    Directory of Open Access Journals (Sweden)

    Susi Vetter

    2012-05-01

    Full Text Available In South Africa conservation is still largely framed in terms of Western scientific values, with a focus on material benefits to local communities, whilst little is known about the intangible values local people attach to nature and biodiversity. We explored the cultural, spiritual and emotional relationships with nature expressed by Xhosa people, within the Maputaland-Pondoland-Albany Hotspot, as well as the activities that mediate this relationship. A descriptive research approach was applied to document the emotions, meanings and values associated with landscape elements. This approach included group and individual interviews and ‘walk-in-the-woods’ interviews and participatory mapping exercises. Respondents portrayed a strong, although not always easily articulated, appreciation for nature, especially ihlathi lesiXhosa (‘Xhosa forest’, vegetation types within the Thicket Biome. Activities such as collecting fuelwood and other resources, hunting and time spent at initiation schools were described as key opportunities for spending time in nature. The benefits of being in nature were ascribed not only to the physical experience of the forest environment and its biota, but also to the presence of ancestral spirits. Being in nature thus contributes significantly to the physical, mental and spiritual well-being of local people, and is also integral to their sense of cultural identity. This study has made it clear that maintenance of biodiversity and natural vegetation is as much in the interest of the local community’s well-being as it is in the interest of conservation planners. We recommend that cultural values be incorporated into local conservation plans.

  2. Turning the Lens Inward: Cultural Competence and Providers' Values in Health Care Decision Making

    Science.gov (United States)

    Chettih, Mindy

    2012-01-01

    The population of older adults in the United States is growing in size and diversity, presenting challenges to health care providers and patients in the context of health care decision making (DM), including obtaining informed consent for treatment, advance care planning, and deliberations about end-of-life care options. Although existing…

  3. How do migratory species add ecosystem service value to wilderness? Calculating the spatial subsidies provided by protected areas

    Science.gov (United States)

    Lopez-Hoffman, Laura; Semmens, Darius J.; Diffendorfer, Jay

    2013-01-01

    Species that migrate through protected and wilderness areas and utilize their resources, deliver ecosystem services to people in faraway locations. The mismatch between the areas that most support a species and those areas where the species provides most benefits to society can lead to underestimation of the true value of protected areas such as wilderness. We present a method to communicate the “off-site” value of wilderness and protected areas in providing habitat to migratory species that, in turn, provide benefits to people in distant locations. Using northern pintail ducks (Anas acuta) as an example, the article provides a method to estimate the amount of subsidy – the value of the ecosystem services provided by a migratory species in one area versus the cost to support the species and its habitat elsewhere.

  4. Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic?

    Science.gov (United States)

    Natarajan, Vivek; Bosch, Patrick; Dede, Ozgur; Deeney, Vincent; Mendelson, Stephen; Ward, Timothy; Brooks, Maria; Kenkre, Tanya; Roach, James

    2017-06-01

    The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic. A retrospective review was performed of all patients who had plain radiographs obtained in the pediatric orthopaedic clinic at an academic children's hospital over a 4-month period. For each radiographic series, the orthopaedist's note and the radiology interpretation were reviewed and a determination was made of whether the radiology read provided new clinically useful information and/or a new diagnosis, whether it recommended further imaging, or if it missed a diagnosis that was reflected in the orthopaedist's note. The hospital charges associated with the radiology read for each study were also quantified. The charts of 1570 consecutive clinic patients who were seen in the pediatric orthopaedic clinic from January to April, 2012 were reviewed. There were 2509 radiographic studies performed, of which 2264 had both a documented orthopaedist's note and radiologist's read. The radiologist's interpretation added new, clinically important information in 1.0% (23/2264) of these studies. In 1.7% (38/2264) of the studies, it was determined that the radiologist missed the diagnosis or clinically important information that could affect treatment. The total amount of the professional fees charged for the radiologists' interpretations was $87,362. On average, the hospital charges for each occurrence in which the radiologist's read provided an additional diagnosis or clinically important information beyond the orthopaedist's note were $3798. The results of this study suggest that eliminating the

  5. Vitamin Variation in Capsicum Spp. Provides Opportunities to Improve Nutritional Value of Human Diets.

    Science.gov (United States)

    Kantar, Michael B; Anderson, Justin E; Lucht, Sarah A; Mercer, Kristin; Bernau, Vivian; Case, Kyle A; Le, Nina C; Frederiksen, Matthew K; DeKeyser, Haley C; Wong, Zen-Zi; Hastings, Jennifer C; Baumler, David J

    2016-01-01

    Chile peppers, native to the Americas, have spread around the world and have been integrated into the diets of many cultures. Much like their heat content, nutritional content can vary dramatically between different pepper types. In this study, a diverse set of chile pepper types were examined for nutrient content. Some pepper types were found to have high levels of vitamin A, vitamin C, or folate. Correlations between nutrient content, species, cultivation status, or geographic region were limited. Varietal selection or plant breeding offer tools to augment nutrient content in peppers. Integration of nutrient rich pepper types into diets that already include peppers could help combat nutrient deficiencies by providing a significant portion of recommended daily nutrients.

  6. Vitamin Variation in Capsicum Spp. Provides Opportunities to Improve Nutritional Value of Human Diets.

    Directory of Open Access Journals (Sweden)

    Michael B Kantar

    Full Text Available Chile peppers, native to the Americas, have spread around the world and have been integrated into the diets of many cultures. Much like their heat content, nutritional content can vary dramatically between different pepper types. In this study, a diverse set of chile pepper types were examined for nutrient content. Some pepper types were found to have high levels of vitamin A, vitamin C, or folate. Correlations between nutrient content, species, cultivation status, or geographic region were limited. Varietal selection or plant breeding offer tools to augment nutrient content in peppers. Integration of nutrient rich pepper types into diets that already include peppers could help combat nutrient deficiencies by providing a significant portion of recommended daily nutrients.

  7. Liquid-containing Refluxes and Acid Refluxes May Be Less Frequent in the Japanese Population Than in Other Populations: Normal Values of 24- hour Esophageal Impedance and pH Monitoring.

    Science.gov (United States)

    Kawamura, Osamu; Kohata, Yukie; Kawami, Noriyuki; Iida, Hiroshi; Kawada, Akiyo; Hosaka, Hiroko; Shimoyama, Yasuyuki; Kuribayashi, Shiko; Fujiwara, Yasuhiro; Iwakiri, Katsuhiko; Inamori, Masahiko; Kusano, Motoyasu; Hongo, Micho

    2016-10-30

    Twenty-four-hour esophageal impedance and pH monitoring allows detection of all types of reflux episodes and is considered the best technique for identifying gastroesophageal refluxes. However, normative data for the Japanese population are lacking. This multicenter study aimed to establish the normal range of 24-hour esophageal impedance and pH data both in the distal and the proximal esophagus in Japanese subjects. Forty-two healthy volunteers (25 men and 17 women) with a mean ± standard deviation age of 33.3 ± 12.4 years (range: 22-72 years) underwent a combined 24-hour esophageal impedance and pH monitoring. According to the physical and pH properties, distal or proximal esophageal reflux events were categorized. Median 45 reflux events occurred in 24 hours, and the 95th percentile was 85 events. Unlike previous reports, liquid-containing reflux events are median 25/24 hours with the 95th percentile of 62/24 hours. Acidic reflux events were median 11/24 hours with the 95th percentile of 39/24 hours. Non-acidic gas reflux events were median 15/24 hours with the 95th percentile of 39/24 hours. Proximal reflux events accounted for 80% of the total reflux events and were mainly non-acidic gas refluxes. About 19% of liquid and mixed refluxes reached the proximal esophagus. Unlike previous studies, liquid-containing and acidic reflux events may be less frequent in the Japanese population. Non-acidic gas reflux events may be frequent and a cause of frequent proximal reflux events. This study provides important normative data for 24-hour impedance and pH monitoring in both the distal and the proximal esophagus in the Japanese population.

  8. Living hours under pressure

    DEFF Research Database (Denmark)

    Ilsøe, Anna; Larsen, Trine Pernille; Felbo-Kolding, Jonas

    2017-01-01

    Purpose The purpose of this paper is to investigate the effect of part-time work on absolute wages. The empirical focus is wages and working hours in three selected sectors within private services in the Danish labour market – industrial cleaning, retail, hotels and restaurants – and their agreem......Purpose The purpose of this paper is to investigate the effect of part-time work on absolute wages. The empirical focus is wages and working hours in three selected sectors within private services in the Danish labour market – industrial cleaning, retail, hotels and restaurants...... in industrial cleaning includes a minimum floor of 15 weekly working hours – this is not the case in retail, hotels and restaurants. This creates a loophole in the latter two sectors that can be exploited by employers to gain wage flexibility through part-time work. Originality/value The living wage literature...

  9. Estimation of the economic value of the ecosystem services provided by the Blue Nile Basin in Ethiopia

    NARCIS (Netherlands)

    Tesfaye, A.; Wolanios, N.; Brouwer, R.

    2016-01-01

    This paper aims to quantify and economically value the main ecosystem services provided by the Blue Nile basin in Ethiopia. It is the first study in its kind to do so in a consistent and comprehensive manner using the same valuation approach. Water flows are linked to corresponding economic market

  10. Putting the "th" in Tenths: Providing Place-Value Labels Helps Reveal the Structure of Our Base-10 Numeral System

    Science.gov (United States)

    Loehr, Abbey M.; Rittle-Johnson, Bethany

    2017-01-01

    Research has demonstrated that providing labels helps children notice key features of examples. Much less is known about how different labels impact children's ability to make inferences about the structure underlying mathematical notation. We tested the impact of labeling decimals such as 0.34 using formal place-value labels ("3 tenths and 4…

  11. Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

    Science.gov (United States)

    Steele, Joseph R; Schomer, Don F

    2009-07-01

    Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

  12. A COMPARATIVE STUDY OF PREEMPTIVE USE OF 0.2% ROPIVACAINE AND 0.125% BUPIVACAINE ALONG WITH FENTANYL AND FENTANYL INCREMENTS TO PROVIDE POSTOPERATIVE EPIDURAL ANALGESIA UP TO 24 HOURS

    Directory of Open Access Journals (Sweden)

    Chiranji Lal Khedia

    2016-06-01

    Full Text Available BACKGROUND AND OBJECTIVES The present study was carried out to compare duration of analgesia, haemodynamic changes (Systolic and Diastolic Blood Pressure, Pulse Rate, Respiratory Rate, total incremental doses of epidural fentanyl required to maintain VAS 3 up to 24 hours in each group and total required incremental fentanyl doses were compared between both the groups. Once the data were collected from all the patients, they were compared using, chi-square test, two sample t-test. The p-value was calculated and P <0.05 was considered statistically significant. RESULTS The duration of analgesia was more with Group BF (245+17.58 min. than Group RF (217.6+22.41 min., thus it is concluded that difference in duration of analgesia was statistically significant between the groups (P<0.05. In this study, it was noticed that patients of Group RF required much more incremental doses of epidural fentanyl (218+31.88 μg to maintain VAS<3 up to 24 hours than group BF (170+32.27 μg, and difference was statistically significant (P<0.05. Haemodynamic parameters like SBP, DBP, HR and RR were comparable in both the groups. Hypotension and bradycardia were noted in two patients of group BF. CONCLUSION Duration of analgesia was longer and comparatively better in group BF and less incremental doses were required to maintain VAS <3 up to 24 hours as compared to group RF, but haemodynamic stability was more in group RF as compared to group BF.

  13. Role and value of nitrogen regulation provided by oysters (Crassostrea virginica in the Mission-Aransas Estuary, Texas, USA.

    Directory of Open Access Journals (Sweden)

    Jennifer Beseres Pollack

    Full Text Available Suspension-feeding activities of oysters impart a potentially significant benefit to estuarine ecosystems via reduction of water column nutrients, plankton and seston biomass, and primary productivity which can have a significant impact on human well-being. This study considered nitrogen regulation by eastern oysters Crassostrea virginica in the Mission-Aransas Estuary, Texas, USA, as a function of denitrification, burial, and physical transport from the system via harvest. Oyster reefs were estimated to remove 502.5 kg N km(-2 through denitrification of biodeposits and 251.3 kg N km(-2 in burial of biodeposits to sediments. Nitrogen is also physically transported out of the estuary via harvest of oysters. Commercial harvest of oysters in the Mission-Aransas Estuary can remove approximately 21,665 kg N per year via physical transport from the system. We developed a transferable method to value the service of nitrogen regulation by oysters, where the potential cost equivalent value of nitrogen regulation is quantified via cost estimates for a constructed biological nutrient removal (BNR supplement to a wastewater treatment plant. The potential annual engineered cost equivalent of the service of nitrogen regulation and removal provided by reefs in the Mission-Aransas Estuary is $293,993 yr(-1. Monetizing ecosystem services can help increase awareness at the stakeholder level of the importance of oysters beyond commercial fishery values alone.

  14. Wild-Type MIC Distributions and Epidemiological Cutoff Values for Posaconazole and Voriconazole and Candida spp. as Determined by 24-Hour CLSI Broth Microdilution▿

    Science.gov (United States)

    Pfaller, M. A.; Boyken, L.; Hollis, R. J.; Kroeger, J.; Messer, S. A.; Tendolkar, S.; Diekema, D. J.

    2011-01-01

    We tested 16,191 strains of Candida against posaconazole and voriconazole, using the CLSI M27-A3 broth microdilution (BMD) method (24-h incubation), in order to define wild-type (WT) populations and epidemiological cutoff values (ECVs). From 2001 to 2009, 8,619 isolates of Candida albicans, 2,415 isolates of C. glabrata, 2,278 isolates of C. parapsilosis, 1,895 isolates of C. tropicalis, 508 isolates of C. krusei, 205 isolates of C. lusitaniae, 177 isolates of C. guilliermondii, and 93 isolates of C. kefyr were obtained from over 100 centers worldwide. The modal MICs (μg/ml) for posaconazole and voriconazole, respectively, were as follows: for C. albicans, 0.016 and 0.007; for C. glabrata, 0.5 and 0.06; for C. parapsilosis, 0.06 and 0.007; for C. tropicalis, 0.03 and 0.015; for C. krusei, 0.25 and 0.12; for C. lusitaniae, 0.03 and 0.007; for C. guilliermondii, 0.12 and 0.03; and for C. kefyr, 0.06 and 0.007. The ECVs (μg/ml [% of isolates that had MICs equal to or less than the ECV]) for posaconazole and voriconazole, respectively, were as follows: 0.06 (98.5) and 0.03 (98.9) for C. albicans, 2 (96.2) and 0.5 (90.4%) for C. glabrata, 0.25 (99.3) and 0.12 (97.9) for C. parapsilosis, 0.12 (97.6) and 0.06 (97.2) for C. tropicalis, 0.5 (99.8) and 0.5 (99.4) for C. krusei, 0.12 (95.6) and 0.03 (96.6) for C. lusitaniae, 0.5 (98.9) and 0.25 (98.3) for C. guilliermondii, and 0.25 (100.0) and 0.015 (100.0) for C. kefyr. In the absence of clinical breakpoints (CBPs) for posaconazole, these WT distributions and ECVs will be useful in surveillance for emergence of reduced susceptibility to posaconazole among Candida spp. Whereas a CBP for susceptibility of ≤1 μg/ml has been established for voriconazole and all species of Candida, it is notable that ECVs for this agent range from 10- to >100-fold lower than the CBP, depending on the species of Candida. The CBP is inadequate in detecting the emergence of voriconazole resistance among most Candida species encountered

  15. The difference in C-reactive protein value between initial and 24 hours follow-up (D-CRP) data as a predictor of mortality in organophosphate poisoned patients.

    Science.gov (United States)

    Lee, Jun Ho; Lee, Young Hwan; Park, Yong Hwan; Kim, Yong Hwan; Hong, Chong Kun; Cho, Kwang Won; Hwang, Seong Youn

    2013-01-01

    Organophosphate poisoning is a worldwide concern and there have been many reports about factors involved in the severity and prognosis of toxicity. The aim of this study was to evaluate the relationship between the serum C-reactive protein activity and clinical outcome in acute organophosphate-poisoned patients. This was a retrospective cohort study conducted from January 2007 to February 2012. Using a multivariate logistic analysis, data on the total population was retrospectively analyzed for association with mortality. The difference in C-reactive protein value between initial and follow-up after 24 hours (D-CRP) was compared in survivors and non-survivors. The D-CRP, APACHE (Acute Physiology and Chronic Health Evaluation) II scoring system and SOFA (Sequential Organ Failure Assessment) score were compared by analyzing receiver operating characteristic (ROC) curves. Among the 96 subjects, 74 survived and 22 died. In the total population, age, BUN, creatinine, APACHE II and SOFA score, MAP, GCS, hematocrit, respiratory rate, albumin, cholinesterase, and the difference in C-reactive protein value between initial and follow-up after 24 hours (D-CRP) were found to be associated with mortality. The fatality rate of organophosphate poisoning was 22.9% and the D-CRP was found to be associated with a significantly higher risk of death in a multiple logistic regression (Odds ratio = 1.178, 95% CI = 1.049-1.322, p = 0.006). The initial serum C-reactive protein and acetylcholinesterase were not found to be associated with the severity of acute organophosphate poisoning. However, the difference in C-reactive protein value between initial and follow-up after 24 hours (D-CRP) was associated with mortality in the total population of patients with acute organophosphate poisoning.

  16. A likelihood-based approach to P-value interpretation provided a novel, plausible, and clinically useful research study metric.

    Science.gov (United States)

    Adams, Nicholas G; O'Reilly, Gerard

    2017-12-01

    Interpretation of clinical research findings using the paradigm of null hypothesis significance testing has a number of limitations. These include arbitrary dichotomization of results, lack of incorporation of study power and prior probability, and the confusing use of conditional probability. This study aimed to describe a novel method of P-value interpretation that would address these limitations. Published clinical research was reinterpreted using the delta likelihood ratio. The delta likelihood ratio is an application of Bayes' rule incorporating the P-value and study power. Calculation of the delta likelihood ratio allows the determination of the most likely effect size using the maximum likelihood principle. We showed that the delta likelihood is easily calculated and produces plausible results using the example of several previously published research studies. Empirical evidence of validity was demonstrated by simulation. The delta likelihood ratio and most likely effect size are simple and intuitive metrics to summarize research findings. The delta likelihood ratio incorporates study power and provides a continuous measure of the probability that the research result is a true effect. The most likely effect size is an easily understood metric that should aid the interpretation of research. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2013-05-01

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

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

    Directory of Open Access Journals (Sweden)

    A. I. Khader

    2013-05-01

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

  19. Experiencing the Other. How Expressivity and Value-based Perception Provide a Non-solipsistic Account of Empathy

    Directory of Open Access Journals (Sweden)

    Maria Chiara Bruttomesso

    2016-12-01

    Full Text Available The problem of intersubjectivity has undergone multifold discussions in the philosophical, neuroscientific and psychological fields. Currently, the predominant theories in this ongoing debate contend that simulation or explicit reasoning must ground other-understanding. Yet this contention confines the subject to solipsistic self-projection without actual communication. I will provide an analysis suggesting that the roots of the concept of “empathy” reveal not only a dualistic inner-outer distinction but also an emerging reference to the bodily dimension. I claim that, by examining the verifiable-in-experience ideas of expressivity and dynamical value-based perception, the limits of the Theory Theory (TT and of the Simulation Theory (ST are resolved by means of a direct perceptual encounter that implies a unitary and never-isolated subject. I aim at showing that perception-based empathy provides an adequate basis for considering social dimensions from intersubjectivity to shared agency, since it allows for both direct embodied communication in cooperation and for the autonomy of agents involved in a collective domain.

  20. Stress myocardial perfusion imaging by CMR provides strong prognostic value to cardiac events regardless of patient's sex.

    Science.gov (United States)

    Coelho-Filho, Otavio R; Seabra, Luciana F; Mongeon, François-Pierre; Abdullah, Shuaib M; Francis, Sanjeev A; Blankstein, Ron; Di Carli, Marcelo F; Jerosch-Herold, Michael; Kwong, Raymond Y

    2011-08-01

    The major aim of this study is to test the hypothesis that stress cardiac magnetic resonance (CMR) imaging can provide robust prognostic value in women presenting with suspected ischemia, to the same extent as in men. Compelling evidence indicates that women with coronary artery disease (CAD) experience worse outcomes than men owing to a lack of early diagnosis and management. Numerous clinical studies have shown that stress CMR detects evidence of myocardial ischemia and infarction at high accuracy. Compared to nuclear scintigraphy, CMR is free of ionizing radiation, has high spatial resolution for imaging small hearts, and overcomes breast attenuation artifacts, which are substantial advantages when imaging women for CAD. We performed stress CMR in 405 patients (168 women, mean age 58 ± 14 years) referred for ischemia assessment. CMR techniques included cine cardiac function, perfusion imaging during vasodilating stress, and late gadolinium enhancement imaging. All patients were followed for major adverse cardiac events (MACE). At a median follow-up of 30 months, MACE occurred in 36 patients (9%) including 21 cardiac deaths and 15 acute myocardial infarctions. In women, CMR evidence of ischemia (ISCHEMIA) demonstrated strong association with MACE (unadjusted hazard ratio: 49.9, p women with ISCHEMIA(+) had an annual MACE rate of 15%, women with ISCHEMIA(-) had very low annual MACE rate (0.3%), which was not statistically different from the low annual MACE rate in men with ISCHEMIA(-) (1.1%). CMR myocardial ischemia score was the strongest multivariable predictor of MACE in this cohort, for both women and men, indicating robust cardiac prognostication regardless of sex. In addition to avoiding exposure to ionizing radiation, stress CMR myocardial perfusion imaging is an effective and robust risk-stratifying tool for patients of either sex presenting with possible ischemia. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All

  1. δ(15)N Values in Crassostrea virginica Shells Provides Early Direct Evidence for Nitrogen Loading to Chesapeake Bay.

    Science.gov (United States)

    Black, H D; Andrus, C F T; Lambert, W J; Rick, T C; Gillikin, D P

    2017-03-10

    Crassostrea virginica is one of the most common estuarine bivalves in the United States' east coast and is frequently found in archaeological sites and sub-fossil deposits. Although there have been several sclerochronological studies on stable carbon and oxygen isotopes in the shells of this species, less is known about δ(15)N values within their shells, which could be a useful paleoenvironmental proxy to assess estuarine nitrogen dynamics. Modern C. virginica samples were collected in Chesapeake Bay for comparison with archaeological shells from nearby sites ranging in age from ~100 to 3,200 years old. Left valves were sampled by milling the hinge area and the resulting powder was analyzed for %N and δ(15)N values. Comparison of δ(15)N values between C. virginica shells shows relatively constant values from ~1250 BC to ~1800 AD. After ~1800 AD, there are rapid increases in (15)N enrichment in the shells, which continue to increase in value up to the modern shell values. The increase in δ(15)N values is evidence of early anthropogenic impact in Chesapeake Bay. These results corroborate the observation that coastal nitrogen pollution occurred earlier than the 19th century and support the use of oyster shell δ(15)N values as a useful environmental proxy.

  2. δ15N Values in Crassostrea virginica Shells Provides Early Direct Evidence for Nitrogen Loading to Chesapeake Bay

    Science.gov (United States)

    Black, H. D.; Andrus, C. F. T.; Lambert, W. J.; Rick, T. C.; Gillikin, D. P.

    2017-01-01

    Crassostrea virginica is one of the most common estuarine bivalves in the United States’ east coast and is frequently found in archaeological sites and sub-fossil deposits. Although there have been several sclerochronological studies on stable carbon and oxygen isotopes in the shells of this species, less is known about δ15N values within their shells, which could be a useful paleoenvironmental proxy to assess estuarine nitrogen dynamics. Modern C. virginica samples were collected in Chesapeake Bay for comparison with archaeological shells from nearby sites ranging in age from ~100 to 3,200 years old. Left valves were sampled by milling the hinge area and the resulting powder was analyzed for %N and δ15N values. Comparison of δ15N values between C. virginica shells shows relatively constant values from ~1250 BC to ~1800 AD. After ~1800 AD, there are rapid increases in 15N enrichment in the shells, which continue to increase in value up to the modern shell values. The increase in δ15N values is evidence of early anthropogenic impact in Chesapeake Bay. These results corroborate the observation that coastal nitrogen pollution occurred earlier than the 19th century and support the use of oyster shell δ15N values as a useful environmental proxy. PMID:28281649

  3. δ15N Values in Crassostrea virginica Shells Provides Early Direct Evidence for Nitrogen Loading to Chesapeake Bay

    Science.gov (United States)

    Black, H. D.; Andrus, C. F. T.; Lambert, W. J.; Rick, T. C.; Gillikin, D. P.

    2017-03-01

    Crassostrea virginica is one of the most common estuarine bivalves in the United States’ east coast and is frequently found in archaeological sites and sub-fossil deposits. Although there have been several sclerochronological studies on stable carbon and oxygen isotopes in the shells of this species, less is known about δ15N values within their shells, which could be a useful paleoenvironmental proxy to assess estuarine nitrogen dynamics. Modern C. virginica samples were collected in Chesapeake Bay for comparison with archaeological shells from nearby sites ranging in age from ~100 to 3,200 years old. Left valves were sampled by milling the hinge area and the resulting powder was analyzed for %N and δ15N values. Comparison of δ15N values between C. virginica shells shows relatively constant values from ~1250 BC to ~1800 AD. After ~1800 AD, there are rapid increases in 15N enrichment in the shells, which continue to increase in value up to the modern shell values. The increase in δ15N values is evidence of early anthropogenic impact in Chesapeake Bay. These results corroborate the observation that coastal nitrogen pollution occurred earlier than the 19th century and support the use of oyster shell δ15N values as a useful environmental proxy.

  4. Surface Weather Observations Hourly

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Standard hourly observations taken at Weather Bureau/National Weather Service offices and airports throughout the United States. Hourly observations began during the...

  5. Working hours and productivity

    NARCIS (Netherlands)

    Collewet, Marion; Sauermann, Jan

    2017-01-01

    This paper studies the link between working hours and productivity using daily information on working hours and performance of a sample of call centre agents. We exploit variation in the number of hours worked by the same employee across days and weeks due to central scheduling, enabling us to

  6. The Market Value of Information System (IS) Security: An Event Study of E-Banking Service Providers

    Science.gov (United States)

    Brock, Linda

    2012-01-01

    Understanding the financial value resulting from IS security investments is critically important to organizations focused on protecting service confidentiality, integrity, and availability in order to preserve firm revenues and reputations. Quantifying the financial effect from IS security investments is difficult to derive. This study…

  7. Cancer Drugs Provide Positive Value In Nine Countries, But The United States Lags In Health Gains Per Dollar Spent.

    Science.gov (United States)

    Salas-Vega, Sebastian; Mossialos, Elias

    2016-05-01

    Cancer drugs account for a growing share of health care expenditure, raising questions about how much value is gained from their use. We used a proprietary international data set to examine real-world cancer drug consumption and expenditure in the period 2004-14 in Australia, Canada, France, Germany, Italy, Japan, Sweden, the United Kingdom, and the United States and to explore the value obtained. Even after adjusting for population and epidemiological factors, we found that the United States spent more than the other countries on cancer drugs, yet it often had lower utilization. All nine countries-most notably France and Japan-witnessed an improvement in neoplasm-related years of potential life lost, which suggests that although the costs of drugs have risen, their therapeutic benefits have increased as well. Net economic value derived from cancer drug expenditures appears to have remained positive, with base-case analyses indicating that the United States obtained an estimated $32.6 billion in net positive return from cancer drug care in 2014. However, the United States lags behind other countries in health gains obtained per dollar spent on cancer drugs, which suggests an opportunity to improve value in the oncology drug market. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Providing Semantic Metadata to Online Learning Resources on Sustainable Agriculture and Farming: Combining Values and Technical Knowledge

    Science.gov (United States)

    Garcia-Barriocanal, Elena; Sicilia, Miguel-Angel; Sanchez-Alonso, Salvador

    2013-01-01

    Sustainable or organic agriculture aims at harmonizing the efficient production of food with the preservation of the environmental conditions for continuing production in a sustained way. As such, it embodies a set of environmental values that are currently taught and learnt worldwide in specific courses or as part of broader programs or…

  9. Seasonal patterns in δ(2) H values of multiple tissues from Andean birds provide insights into elevational migration.

    Science.gov (United States)

    Villegas, Mariana; Newsome, Seth D; Blake, John G

    2016-12-01

    Elevational migration is a widespread phenomenon in tropical avifauna but it is difficult to identify using traditional approaches. Hydrogen isotope (δ(2) H) values of precipitation decrease with elevation so δ(2) H analysis of multiple bird tissues with different isotopic incorporation rates may be a reliable method for characterizing seasonal elevational migration. Here we compare δ(2) H values in metabolically inert (feathers and claws) and metabolically active (whole blood) tissues to examine whether an upslope migration occurs prior to the breeding season in the Yungas Manakin (Chiroxiphia boliviana). We compare results from C. boliviana with data from a known elevational migrant, the Streak-necked Flycatcher (Mionectes striaticollis). Opposite to our expectations, tissue δ(2) H values increased over time, largely reflecting seasonal patterns in precipitation δ(2) H rather than elevational effects; linear mixed-effects models with strongest support included ordinal date, tissue type, and elevation. This seasonal increase in precipitation δ(2) H is a general phenomenon in both tropical and temperate mountain ranges. We use these data to propose a hypothetical framework that predicts different patterns in tissue δ(2) H values collected in different seasons from residents and elevational migrants. This framework can serve as a reference for future studies that assess elevational migration in birds and other animals. © 2016 by the Ecological Society of America.

  10. Knowledge about food classification systems and value attributes provides insight for understanding complementary food choices in Mexican working mothers.

    Science.gov (United States)

    Rodriguez-Oliveros, Maria Guadalupe; Bisogni, Carole A; Frongillo, Edward A

    2014-12-01

    Knowledge about mothers' perceptions of food classification and values about complementary feeding is necessary for designing educational and food supply interventions targeted to young children. To determine classification, attributes, and consumption/preparation routines of key complementary foods, 44 mothers of children attributes exercises. Hierarchical clustering showed that mothers identified nine classes of key foods, including milk derivatives, complements, junk food, infant products, chicken parts, and other meats. From multidimensional scaling, mothers used three primary classification systems: food groups, food introduction stages, and food processing. Secondary classification systems were healthy-junk, heavy-light, hot-cold, good-bad fat, and main dish-complement. Child health and nutrition, particularly vitamin content, were salient attributes. Fruits and vegetables were preferred for initiating complementary feeding on the second month of age. Consumption of guava, mango, and legumes, however, was associated with digestive problems (empacho). Red meats were viewed as cold-type, heavy, and hard, not suitable for young children, but right for toddlers. Chicken liver was considered nutritious but dirty and bitter. Egg and fish were viewed as a vitamin source but potentially allergenic. Mothers valued vitamin content, flavor, and convenience of processed foods, but some were suspicious about expiration date, chemical and excessive sugar content and overall safety of these foods. Mothers' perceptions and values may differ from those of nutritionists and program designers, and should be addressed when promoting opportune introduction of complementary foods in social programs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Cracking the Credit Hour

    Science.gov (United States)

    Laitinen, Amy

    2012-01-01

    The basic currency of higher education--the credit hour--represents the root of many problems plaguing America's higher education system: the practice of measuring time rather than learning. "Cracking the Credit Hour" traces the history of this time-based unit, from the days of Andrew Carnegie to recent federal efforts to define a credit…

  12. Uncovering configurations of HRM service provider intellectual capital and worker human capital for creating high HRM service value using fsQCA

    NARCIS (Netherlands)

    Meijerink, Jeroen Gerard; Bondarouk, Tatiana

    Although traditionally applied independently, this study combines two theoretical perspectives – the intellectual capital theory and the consumer perspective – to uncover value-creating configurations of human resource management (HRM) service providers' and workers' knowledge resources. We examined

  13. Providing an imputation algorithm for missing values of longitudinal data using Cuckoo search algorithm: A case study on cervical dystonia.

    Science.gov (United States)

    Golabpour, Amin; Etminani, Kobra; Doosti, Hassan; Miri, Hamid Heidarian; Ghanbari, Reza

    2017-06-01

    Missing values in data are found in a large number of studies in the field of medical sciences, especially longitudinal ones, in which repeated measurements are taken from each person during the study. In this regard, several statistical endeavors have been performed on the concepts, issues, and theoretical methods during the past few decades. Herein, we focused on the missing data related to patients excluded from longitudinal studies. To this end, two statistical parameters of similarity and correlation coefficient were employed. In addition, metaheuristic algorithms were applied to achieve an optimal solution. The selected metaheuristic algorithm, which has a great search functionality, was the Cuckoo search algorithm. Profiles of subjects with cervical dystonia (CD) were used to evaluate the proposed model after applying missingness. It was concluded that the algorithm used in this study had a higher accuracy (98.48%), compared with similar approaches. Concomitant use of similar parameters and correlation coefficients led to a significant increase in accuracy of missing data imputation.

  14. 24-hour urine protein

    Science.gov (United States)

    Urine protein - 24 hour; Chronic kidney disease - urine protein; Kidney failure - urine protein ... Bladder tumor Heart failure High blood pressure during pregnancy ( preeclampsia ) Kidney disease caused by diabetes, high blood pressure, autoimmune disorders, ...

  15. Excel VBA 24-hour trainer

    CERN Document Server

    Urtis, Tom

    2015-01-01

    Master VBA automation quickly and easily to get more out of Excel Excel VBA 24-Hour Trainer, 2nd Edition is the quick-start guide to getting more out of Excel, using Visual Basic for Applications. This unique book/video package has been updated with fifteen new advanced video lessons, providing a total of eleven hours of video training and 45 total lessons to teach you the basics and beyond. This self-paced tutorial explains Excel VBA from the ground up, demonstrating with each advancing lesson how you can increase your productivity. Clear, concise, step-by-step instructions are combined wit

  16. Does Intelligence Provide Survival Value?

    OpenAIRE

    Cairns, John

    2009-01-01

    Intelligence is defined as a general mental capacity to reason, plan, solve problems, think abstractly, comprehend ideas, and learn. Intelligence can also be defined as the ability to acquire and apply information gathered from the environment to modify its behavior. It is this intelligence that has allowed the genus Homo to survive for 2 million years. However, recently the global financial meltdown and the deleterious effects of climate change raise the question of whether intelligence has ...

  17. HTML5 24-Hour Trainer

    CERN Document Server

    Lowery, Joseph W

    2011-01-01

    Comprehensive written and interactive instruction for learning HTML5 HTML is the core technology for building websites. Today, with HTML5 opening the Internet to new levels of rich content and dynamic interactivity, developers are looking for information to learn and utilize HTML5. HTML5 24-Hour Trainer provides that information, giving new and aspiring web developers the knowledge they need to achieve early success when building websites. Covers the most basic aspects of a web page, including a brief introduction to Cascading Style Sheets (CSS) Provides lessons that are backed up by prof

  18. Eleventh Hour Security+

    CERN Document Server

    Dubrawsky, Ido

    2009-01-01

    This book will focus on just the essentials needed to pass the Security+ certification exam. It will be filled with critical information in a way that will be easy to remember and use for your quickly approaching exam. It will focus on the main objectives of the exam and include the following pedagogy for ease of use in those final hours. The book will include:. •Exam Objectives – Fast Track Review. •Key words/definitions. •Five Toughest questions and their answers. •Exam Warnings – What to pay attention to

  19. Eleventh Hour Linux+

    CERN Document Server

    Speake, Graham; Happel, Chris; Lillard, Terrence V

    2009-01-01

    The 11th Hour Linux+ Study Guide is keyed to the XK0-003 revision of the CompTIA Linux+exam. This book is streamlined to include only core certification information and is presented for ease of last-minute studying. Main objectives of the exam are covered with key concepts highlighted. ..: ..; Fast Facts quickly review fundamentals ..; Exam Warnings highlight particularly tough sections of the exam ..; Crunch Time sidebars point out key concepts to remember ..; Did You Know? sidebars cover sometimes forgotten details ..; Top Five Toughest Questions and answers help you to prepare .. The 11th H

  20. Protocol of the sepsivit study : a prospective observational study to determine whether continuous heart rate variability measurement during the first 48 hours of hospitalisation provides an early warning for deterioration in patients presenting with infection or sepsis to the emergency department of a Dutch academic teaching hospital

    NARCIS (Netherlands)

    Quinten, Vincent M; van Meurs, Matijs; Renes, Maurits H; Ligtenberg, Jack J M; Ter Maaten, Jan C

    2017-01-01

    INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an

  1. Protocol of the sepsivit study : A prospective observational study to determine whether continuous heart rate variability measurement during the first 48 hours of hospitalisation provides an early warning for deterioration in patients presenting with infection or sepsis to the emergency department of a Dutch academic teaching hospital

    NARCIS (Netherlands)

    Quinten, Vincent M; van Meurs, Matijs; Renes, Maurits H; Ligtenberg, Jack J M; Ter Maaten, Jan C

    2017-01-01

    INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an

  2. Hourly temporal distribution of wind

    Science.gov (United States)

    Deligiannis, Ilias; Dimitriadis, Panayiotis; Koutsoyiannis, Demetris

    2016-04-01

    The wind process is essential for hydrometeorology and additionally, is one of the basic renewable energy resources. Most stochastic forecast models are limited up to daily scales disregarding the hourly scale which is significant for renewable energy management. Here, we analyze hourly wind timeseries giving emphasis on the temporal distribution of wind within the day. We finally present a periodic model based on statistical as well as hydrometeorological reasoning that shows good agreement with data. Acknowledgement: This research is conducted within the frame of the undergraduate course "Stochastic Methods in Water Resources" of the National Technical University of Athens (NTUA). The School of Civil Engineering of NTUA provided moral support for the participation of the students in the Assembly.

  3. Averaging and sampling for magnetic-observatory hourly data

    Science.gov (United States)

    Love, J. J.; Tsai, V. C.; Gannon, J. L.

    2010-11-01

    A time and frequency-domain analysis is made of the effects of averaging and sampling methods used for constructing magnetic-observatory hourly data values. Using 1-min data as a proxy for continuous, geomagnetic variation, we construct synthetic hourly values of two standard types: instantaneous "spot" measurements and simple 1-h "boxcar" averages. We compare these average-sample types with others: 2-h average, Gaussian, and "brick-wall" low-frequency-pass. Hourly spot measurements provide a statistically unbiased representation of the amplitude range of geomagnetic-field variation, but as a representation of continuous field variation over time, they are significantly affected by aliasing, especially at high latitudes. The 1-h, 2-h, and Gaussian average-samples are affected by a combination of amplitude distortion and aliasing. Brick-wall values are not affected by either amplitude distortion or aliasing, but constructing them is, in an operational setting, relatively more difficult than it is for other average-sample types. It is noteworthy that 1-h average-samples, the present standard for observatory hourly data, have properties similar to Gaussian average-samples that have been optimized for a minimum residual sum of amplitude distortion and aliasing. For 1-h average-samples from medium and low-latitude observatories, the average of the combination of amplitude distortion and aliasing is less than the 5.0 nT accuracy standard established by Intermagnet for modern 1-min data. For medium and low-latitude observatories, average differences between monthly means constructed from 1-min data and monthly means constructed from any of the hourly average-sample types considered here are less than the 1.0 nT resolution of standard databases. We recommend that observatories and World Data Centers continue the standard practice of reporting simple 1-h-average hourly values.

  4. Averaging and sampling for magnetic-observatory hourly data

    Directory of Open Access Journals (Sweden)

    J. J. Love

    2010-11-01

    Full Text Available A time and frequency-domain analysis is made of the effects of averaging and sampling methods used for constructing magnetic-observatory hourly data values. Using 1-min data as a proxy for continuous, geomagnetic variation, we construct synthetic hourly values of two standard types: instantaneous "spot" measurements and simple 1-h "boxcar" averages. We compare these average-sample types with others: 2-h average, Gaussian, and "brick-wall" low-frequency-pass. Hourly spot measurements provide a statistically unbiased representation of the amplitude range of geomagnetic-field variation, but as a representation of continuous field variation over time, they are significantly affected by aliasing, especially at high latitudes. The 1-h, 2-h, and Gaussian average-samples are affected by a combination of amplitude distortion and aliasing. Brick-wall values are not affected by either amplitude distortion or aliasing, but constructing them is, in an operational setting, relatively more difficult than it is for other average-sample types. It is noteworthy that 1-h average-samples, the present standard for observatory hourly data, have properties similar to Gaussian average-samples that have been optimized for a minimum residual sum of amplitude distortion and aliasing. For 1-h average-samples from medium and low-latitude observatories, the average of the combination of amplitude distortion and aliasing is less than the 5.0 nT accuracy standard established by Intermagnet for modern 1-min data. For medium and low-latitude observatories, average differences between monthly means constructed from 1-min data and monthly means constructed from any of the hourly average-sample types considered here are less than the 1.0 nT resolution of standard databases. We recommend that observatories and World Data Centers continue the standard practice of reporting simple 1-h-average hourly values.

  5. A Customer’s Possibilities to Increase the Performance of a Service Provider by Adding Value and Deepening the Partnership in Facility Management Service

    Directory of Open Access Journals (Sweden)

    Sillanpää Elina

    2016-06-01

    Full Text Available Reliable and good suppliers are an important competitive advantage for a customer and that is why the development of suppliers, improvement of performance and enhancement of customership are also in the interest of the customer. The purpose of this study is to clarify a customer’s possibilities to increase the performance of a service provider and to develop the service process in FM services and thus help to improve partnership development. This research is a qualitative research. The research complements the existing generic model of supplier development towards partnership development by customer and clarifies the special features that facility management services bring to this model. The data has been gathered from interviews of customers and service providers in the facility management service sector. The result is a model of customers’ possibilities to develop the performance of service providers from the viewpoint of value addition and relationship development and in that way ensure added value to the customer and the development of a long-term relationship. The results can be beneficial to customers when they develop the cooperation between the customer and the service provider toward being more strategic and more partnership focused.

  6. Geneva 24 Hours Swim

    CERN Multimedia

    2003-01-01

    The 18th edition of the Geneva 24 hours swim competition will take place at the Vernets Swimming Pool on the 4th and 5th of October. More information and the results of previous years are given at: http://www.carouge-natation.com/24_heures/home_24_heures.htm Last year, CERN obtained first position in the inter-company category with a total of 152.3 kms swam by 45 participants. We are counting on your support to repeat this excellent performance this year. For those who would like to train, the Livron swimming pool in Meyrin is open as from Monday the 8th September. For further information please do not hesitate to contact us. Gino de Bilio and Catherine Delamare

  7. Geneva 24 hours swim

    CERN Multimedia

    2003-01-01

    The 18th edition of the Geneva 24 hours swim competition will take place at the Vernets Swimming Pool on the 4th and 5th of October. More information and the results of previous years are given at: http://www.carouge-natation.com/24_heures/home_24_heures.htm Last year, CERN obtained first position in the inter-company category with a total of 152.3 kms swam by 45 participants. We are counting on your support to repeat this excellent performance this year. For those who would like to train, the Livron swimming pool in Meyrin is open as from Monday the 8th September. For further information please do not hesitate to contact us. Gino de Bilio and Catherine Delamare

  8. Estimating systemic fibrosis by combining galectin-3 and ST2 provides powerful risk stratification value for patients after acute decompensated heart failure.

    Science.gov (United States)

    Wang, Chao-Hung; Yang, Ning-I; Liu, Min-Hui; Hsu, Kuang-Hung; Kuo, Li-Tang

    2016-01-01

    Two fibrosis biomarkers, galectin-3 (Gal-3) and suppression of tumorigenicity 2 (ST2), provide prognostic value additive to natriuretic peptides and traditional risk factors in patients with heart failure (HF). However, it is to be investigated whether their combined measurement before discharge provides incremental risk stratification for patients after acute HF. A total of 344 patients with acute HF were analyzed with Gal-3, and ST2 measured. Patients were prospectively followed for 3.7 ± 1.3 years for deaths, and composite events (death/HF-related re-hospitalizations). The levels of Gal-3 and ST2 were only slightly related (r = 0.20, p risk factors. According to the cutoff at median values, patients were separated into four subgroups based on high and low Gal-3 (HG and LG, respectively) and ST2 levels (HS and LS, respectively). Kaplan-Meier survival curves showed that HGHS powerfully identified patients at risk of mortality (Log rank = 21.27, p risk stratification value.

  9. 75 FR 285 - Hours of Service

    Science.gov (United States)

    2010-01-05

    ... rule will remain in effect during the rulemaking proceedings. As described above, FMCSA is holding... flexibility would not increase safety risks or adversely impact driver health? 3. How many hours per day and... period long enough to provide restorative sleep regardless of the number of hours worked prior to the...

  10. Registrar working hours in Cape Town

    African Journals Online (AJOL)

    Nicky

    In the past surgical registrars were expected to work unusual- ly long hours. This was thought to provide better patient care, and to result in better registrar training. Junior doctors in the USA worked between 95 and 136 hours per week.1. The paradigm changed in 1984 after the death of Libby Zion in a New York hospital ...

  11. Comparison of the broth microdilution (BMD) method of the European Committee on Antimicrobial Susceptibility Testing with the 24-hour CLSI BMD method for testing susceptibility of Candida species to fluconazole, posaconazole, and voriconazole by use of epidemiological cutoff values.

    Science.gov (United States)

    Pfaller, M A; Espinel-Ingroff, A; Boyken, L; Hollis, R J; Kroeger, J; Messer, S A; Tendolkar, S; Diekema, D J

    2011-03-01

    The antifungal broth microdilution (BMD) method of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) was compared with CLSI BMD method M27-A3 for fluconazole, posaconazole, and voriconazole susceptibility testing of 1,056 isolates of Candida. The isolates were obtained in 2009 from more than 60 centers worldwide and included 560 isolates of C. albicans, 175 of C. glabrata, 162 of C. parapsilosis, 124 of C. tropicalis, and 35 of C. krusei. The overall essential agreement (EA) between EUCAST and CLSI results ranged from 96.9% (voriconazole) to 98.6% (fluconazole). The categorical agreement (CA) between methods and species of Candida was assessed using previously determined epidemiological cutoff values (ECVs). The ECVs (expressed as μg/ml) for fluconazole, posaconazole, and voriconazole, respectively, were as follows: 0.12, 0.06, and 0.03 for C. albicans; 32, 2, and 0.5 for C. glabrata; 2, 0.25, and 0.12 for C. parapsilosis; 2, 0.12, and 0.06 for C. tropicalis; 64, 0.5, and 0.5 for C. krusei. Excellent CA was observed for all comparisons between the EUCAST and CLSI results for fluconazole, posaconazole, and voriconazole, respectively, for each species: 98.9%, 93.6%, and 98.6% for C. albicans; 96.0%, 98.9%, and 93.7% for C. glabrata; 90.8%, 98.1%, and 98.1% for C. parapsilosis; 99.2%, 99.2%, and 96.8% for C. tropicalis; 97.1%, 97.1%, and 97.1% for C. krusei. We demonstrate high levels of EA and CA between the CLSI and EUCAST BMD methods for testing of triazoles against Candida when the MICs were determined after 24 h and ECVs were used to differentiate wild-type (WT) from non-WT strains. These results provide additional data in favor of the harmonization of these two methods.

  12. Fixed Costs and Hours Constraints

    Science.gov (United States)

    Johnson, William R.

    2011-01-01

    Hours constraints are typically identified by worker responses to questions asking whether they would prefer a job with more hours and more pay or fewer hours and less pay. Because jobs with different hours but the same rate of pay may be infeasible when there are fixed costs of employment or mandatory overtime premia, the constraint in those…

  13. A high-quality genome assembly of quinoa provides insights into the molecular basis of salt bladder-based salinity tolerance and the exceptional nutritional value

    Science.gov (United States)

    Zou, Changsong; Chen, Aojun; Xiao, Lihong; Muller, Heike M; Ache, Peter; Haberer, Georg; Zhang, Meiling; Jia, Wei; Deng, Ping; Huang, Ru; Lang, Daniel; Li, Feng; Zhan, Dongliang; Wu, Xiangyun; Zhang, Hui; Bohm, Jennifer; Liu, Renyi; Shabala, Sergey; Hedrich, Rainer; Zhu, Jian-Kang; Zhang, Heng

    2017-01-01

    Chenopodium quinoa is a halophytic pseudocereal crop that is being cultivated in an ever-growing number of countries. Because quinoa is highly resistant to multiple abiotic stresses and its seed has a better nutritional value than any other major cereals, it is regarded as a future crop to ensure global food security. We generated a high-quality genome draft using an inbred line of the quinoa cultivar Real. The quinoa genome experienced one recent genome duplication about 4.3 million years ago, likely reflecting the genome fusion of two Chenopodium parents, in addition to the γ paleohexaploidization reported for most eudicots. The genome is highly repetitive (64.5% repeat content) and contains 54 438 protein-coding genes and 192 microRNA genes, with more than 99.3% having orthologous genes from glycophylic species. Stress tolerance in quinoa is associated with the expansion of genes involved in ion and nutrient transport, ABA homeostasis and signaling, and enhanced basal-level ABA responses. Epidermal salt bladder cells exhibit similar characteristics as trichomes, with a significantly higher expression of genes related to energy import and ABA biosynthesis compared with the leaf lamina. The quinoa genome sequence provides insights into its exceptional nutritional value and the evolution of halophytes, enabling the identification of genes involved in salinity tolerance, and providing the basis for molecular breeding in quinoa. PMID:28994416

  14. A high-quality genome assembly of quinoa provides insights into the molecular basis of salt bladder-based salinity tolerance and the exceptional nutritional value.

    Science.gov (United States)

    Zou, Changsong; Chen, Aojun; Xiao, Lihong; Muller, Heike M; Ache, Peter; Haberer, Georg; Zhang, Meiling; Jia, Wei; Deng, Ping; Huang, Ru; Lang, Daniel; Li, Feng; Zhan, Dongliang; Wu, Xiangyun; Zhang, Hui; Bohm, Jennifer; Liu, Renyi; Shabala, Sergey; Hedrich, Rainer; Zhu, Jian-Kang; Zhang, Heng

    2017-11-01

    Chenopodium quinoa is a halophytic pseudocereal crop that is being cultivated in an ever-growing number of countries. Because quinoa is highly resistant to multiple abiotic stresses and its seed has a better nutritional value than any other major cereals, it is regarded as a future crop to ensure global food security. We generated a high-quality genome draft using an inbred line of the quinoa cultivar Real. The quinoa genome experienced one recent genome duplication about 4.3 million years ago, likely reflecting the genome fusion of two Chenopodium parents, in addition to the γ paleohexaploidization reported for most eudicots. The genome is highly repetitive (64.5% repeat content) and contains 54 438 protein-coding genes and 192 microRNA genes, with more than 99.3% having orthologous genes from glycophylic species. Stress tolerance in quinoa is associated with the expansion of genes involved in ion and nutrient transport, ABA homeostasis and signaling, and enhanced basal-level ABA responses. Epidermal salt bladder cells exhibit similar characteristics as trichomes, with a significantly higher expression of genes related to energy import and ABA biosynthesis compared with the leaf lamina. The quinoa genome sequence provides insights into its exceptional nutritional value and the evolution of halophytes, enabling the identification of genes involved in salinity tolerance, and providing the basis for molecular breeding in quinoa.

  15. A Hybrid Artificial Reputation Model Involving Interaction Trust, Witness Information and the Trust Model to Calculate the Trust Value of Service Providers

    Directory of Open Access Journals (Sweden)

    Gurdeep Singh Ransi

    2014-02-01

    Full Text Available Agent interaction in a community, such as the online buyer-seller scenario, is often uncertain, as when an agent comes in contact with other agents they initially know nothing about each other. Currently, many reputation models are developed that help service consumers select better service providers. Reputation models also help agents to make a decision on who they should trust and transact with in the future. These reputation models are either built on interaction trust that involves direct experience as a source of information or they are built upon witness information also known as word-of-mouth that involves the reports provided by others. Neither the interaction trust nor the witness information models alone succeed in such uncertain interactions. In this paper we propose a hybrid reputation model involving both interaction trust and witness information to address the shortcomings of existing reputation models when taken separately. A sample simulation is built to setup buyer-seller services and uncertain interactions. Experiments reveal that the hybrid approach leads to better selection of trustworthy agents where consumers select more reputable service providers, eventually helping consumers obtain more gains. Furthermore, the trust model developed is used in calculating trust values of service providers.

  16. Hourly Precipitation Data (HPD) Publication

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hourly Precipitation Data (HPD) Publication is archived and available from the National Climatic Data Center (NCDC). This publication contains hourly precipitation...

  17. US Naval Observatory Hourly Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hourly observations journal from the National Observatory in Washington DC. The observatory is the first station in the United States to produce hourly observations...

  18. Ethylene Oxide: Acute Four-Hour and One-Hour Inhalation Toxicity Testing in Rats

    Directory of Open Access Journals (Sweden)

    William M. Snellings

    2011-01-01

    Full Text Available Ethylene oxide was tested on groups of rats for either 4-hour or 1-hour inhalation exposure, followed by 14 days of observation. Groups of five Sprague-Dawley rats/sex were exposed, and clinical signs and mortality were recorded. Clinical signs noted included irregular breathing, absence of certain reflexes, and tremors. Rats that died had moderate to severe pulmonary congestion. The calculated LC50 values, reported as ppm by volume (with 95% confidence limits, were as follows. 4-hour LC50 values were 1972 (1887 to 2061 ppm for males; 1537 (1391 to 1698 ppm for females; 1741 (1655 to 1831 ppm for the combined sexes. The 1-hour LC50 values were 5748 (5276 to 6262 ppm for males; 4439 (4034 to 4884 ppm for females; 5029 (4634 to 5459 ppm for the combined sexes.

  19. The Potential Influence of Value Added Tax Law Amendments on the Existence of E-Service Providing SMMEs in South Africa

    Directory of Open Access Journals (Sweden)

    Mogamat Riyaadh BARNES

    2016-02-01

    Full Text Available In South Africa, almost all existing businesses are regarded as Small Medium and Micro Enterprises (SMMEs. Through legislation, the South African government has identified SMMEs as the best enablers to help with the achievement of certain core socio-economic objectives; particularly the creation of jobs and reduction of poverty levels. According to previous research studies these business entities are not achieving the latter socio-economic objectives; mainly as a result of their weak existence rate – up to 80% of these business entities fail within their first three years of existence. The latter is believed to stem from the realisation of economic factors – a major economic factor which adversely influences South African SMMEs is that of taxation. Over the years, more South African SMMEs have started to make use of the internet to conduct their respective business, which spurred the national government to make amendments to existing Value Added Tax (VAT Laws by levying taxation on electronic services (e-services provided by e-service suppliers. Hence, for this research study, the perception was formulated that the amendments made to VAT Laws will have an adverse influence on the existence of e-service providing South African SMMEs in the foreseeable future. Empirical research was conducted through means of obtaining quantitative data from registered South African Tax Practitioners based in the Cape Metropolis; all of whom had to adhere to strict delineation criterion. It was found that the amendments made to VAT Laws, by national government, will have an adverse influence on the existence of e-service providing South African SMMEs in the foreseeable future.

  20. Combination of serum phosphorylated neurofilament heavy subunit and hyperintensity of intramedullary T2W on magnetic resonance imaging provides better prognostic value of canine thoracolumbar intervertebral disc herniation.

    Science.gov (United States)

    Mashita, Tadahisa; Kamishina, Hiroaki; Nakamoto, Yuya; Akagi, Yosuke; Nakanishi, Ataru; Harasaki, Yusuke; Ozawa, Tsuyoshi; Uemura, Takashi; Kobatake, Yui; Shimamura, Shunsuke; Kitamura, Naoki; Maeda, Sadatoshi; Uzuka, Yuji; Shaw, Gerry; Yasuda, Jun

    2015-04-01

    The aim of this study was to evaluate the prognostic value of concurrent measurement of serum phosphorylated neurofilament heavy subunit (pNF-H) concentration and intramedullary T2W hyperintensity in paraplegic to paraplegic dogs. Our hypothesis was that concurrent measurement of these would provide a more accurate prediction of functional outcome in dogs with thoracolumbar intervertebral disc herniation (IVDH). A prospective case-control clinical study was designed using 94 dogs with acute onset of thoracolumbar IVDH. The association of serum pNF-H concentration, T2W hyperintensity on sagittal MRI (T2H/L2), deep pain perception and surgical outcome were evaluated with logistic regression analysis after three months for all 94 surgically treated dogs. Sensitivity to predict non-ambulatory outcome was compared among pNF-H and T2H/L2 and combination of both. Logistic regression analysis indicated that serum pNF-H concentration and T2H/L2 were significantly correlated with surgical outcome (PpNF-H concentration, 1.9 for T2H/L2 and 2.3 for deep pain sensation. The sensitivity and specificity to predict non-ambulatory outcome for using serum parameter pNF-H>2.6 ng/ml, using T2H/L2 value of>0.84 and using both serum pNF-H and T2H/L2, were 95% and 75.7%, 65% and 86.5%, and 90.0% and 97.5%, respectively. Therefore, combined measurements of serum pNF-H and T2H/L2 might be useful for predicting long-term outcome in dogs with thoracolumbar IVDH.

  1. The composition and extent of coronary artery plaque detected by multislice computed tomographic angiography provides incremental prognostic value in patients with suspected coronary artery disease.

    Science.gov (United States)

    Miszalski-Jamka, Tomasz; Klimeczek, Piotr; Banyś, Robert; Krupiński, Maciej; Nycz, Krzysztof; Bury, Krzysztof; Lada, Michał; Pelberg, Robert; Kereiakes, Dean; Mazur, Wojciech

    2012-03-01

    Multislice computed tomographic coronary angiography (CTCA) provides accurate noninvasive assessment of coronary artery disease (CAD). However, data on the prognostic value of CTCA in patients with suspected CAD are only beginning to emerge. The aim of the study was to assess the prognostic value of CTCA in patients with suspected CAD. Patients (males = 259, females = 235; mean age 58.2 ± 9.8 years) with suspected CAD who underwent 16- or 64-slice CTCA were followed for 1,308 ± 318 days for cardiac death, nonfatal myocaridal infarction (MI) and late (>90 days after CTCA) revascularization. Patient outcomes were related to clinical and CTCA data. Cox proportional-hazards model was applied in stepwise forward fashion to identify outcome predictors. Coronary artery plaque was found in 340 patients. Cardiac events occurred in 40 patients including cardiac death (n = 9), nonfatal MI (n = 8) and late revascularization (n = 23). A multivariable analysis identified the following independent predictors for adverse cardiac events: obstructive plaque in a proximal coronary artery segment (hazard ratio (HR) 2.73; 95% confidence interval (CI): 1.35-5.54; P = 0.005), the number of segments with noncalcified plaque(s) (HR 1.53 per segment; 95%CI: 1.21-1.92; P < 0.001), the number of segments with mixed plaque(s) (HR 1.56 per segment; 95%CI: 1.27-1.92; P < 0.001) and the number of segments with calcified plaque(s) (HR 1.21 per segment; 95%CI: 1.07-1.37; P = 0.002). In patients with suspected CAD, both the extent and composition of atherosclerotic plaque as determined by CTCA are prognostic of subsequent cardiac events.

  2. Staggered Bargaining and Hours Worked

    OpenAIRE

    Samuel Danthine; Stephane Auray

    2004-01-01

    A matching model with labor/leisure choice and staggered bargaining is used to explain (i)differences in GDP per hour and GDP per capita, (ii) differences in employment, (iii) differences in the proportion of part-time work across countries. The model predicts that the higher the level of rigidity in wages and hours the lower are GDP per capita, employment, part-time work and hours worked, but the higher is GDP per hours worked. In addition, it predicts that a country with a high level of rig...

  3. Bargaining frictions and hours worked

    OpenAIRE

    Stéphane AURAY; Danthine, Samuel

    2005-01-01

    A matching model with labor/leisure choice and bargaining frictions is used to explain (i) differences in GDP per hour and GDP per capita, (ii) differences in employment, (iii) differences in the proportion of part-time work across countries. The model predicts that the higher the level of rigidity in wages and hours the lower are GDP per capita, employment, part-time work and hours worked, but the higher is GDP per hours worked. In addition, it predicts that a country with a high level of ri...

  4. Hourly wind speed analysis in Sicily

    Energy Technology Data Exchange (ETDEWEB)

    Bivona, S.; Leone, C. [Palermo Univ., Dip di Fisica e Technologie Relative, Palermo (Italy); Burlon, R. [Palermo Univ., Dip. di Ingegnaria Nucleare, Palermo (Italy)

    2003-07-01

    The hourly average wind speed data recorded by CNMCA (Centro Nazionale di Meteorologia e Climatologia Aeronautica) have been used to study the statistical properties of the wind speed at nine locations on Sicily. By grouping the observations month by month, we show that the hourly average wind speed, with calms omitted, is represented by a Weibull function. The suitability of the distribution is judged by the discrepancies between the observed and calculated values of the monthly average wind speed and of the standard deviation. (Author)

  5. Averaging and sampling for magnetic-observatory hourly data

    OpenAIRE

    J. J. Love; Tsai, V. C.; J. L. Gannon

    2010-01-01

    A time and frequency-domain analysis is made of the effects of averaging and sampling methods used for constructing magnetic-observatory hourly data values. Using 1-min data as a proxy for continuous, geomagnetic variation, we construct synthetic hourly values of two standard types: instantaneous "spot" measurements and simple 1-h "boxcar" averages. We compare these average-sample types with others: 2-h average, Gaussian, and "brick-wall" low-frequency-pass. Hour...

  6. Neighborhood walkability, income, and hour-by-hour physical activity patterns.

    Science.gov (United States)

    Arvidsson, Daniel; Eriksson, Ulf; Lönn, Sara Larsson; Sundquist, Kristina

    2013-04-01

    This study aimed to investigate both the mean daily physical activity and the hour-by-hour physical activity patterns across the day using accelerometry and how they are associated with neighborhood walkability and individual income. Moderate physical activity (MPA) was assessed by accelerometry in 2252 adults in the city of Stockholm, Sweden. Neighborhood walkability (residential density, street connectivity, and land use mix) was objectively assessed within 1000m network buffers around the participants' residence and individual income was self-reported. Living in a high walkability neighborhood was associated with more mean daily MPA compared with living in a low walkability neighborhood on weekdays and weekend days. Hour-by-hour analyses showed that this association appeared mainly in the afternoon/early evening during weekdays, whereas it appeared across the middle of the day during weekend days. Individual income was associated with mean daily MPA on weekend days. On weekdays, the hour-by-hour analyses showed that high income was associated with more MPA around noon and in late afternoon/early evening, whereas low income was associated with more MPA at the hours before noon and in the early afternoon. During the weekend, high income was more consistently associated with higher MPA. Hour-by-hour accelerometry physical activity patterns provides a more comprehensive picture of the associations between neighborhood walkability and individual income and physical activity and the variability of these associations across the day.

  7. Ozone Nonattainment Areas - 1 Hour

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Ozone - 1hour (Legacy...

  8. The 24-Hour Mathematical Modeling Challenge

    Science.gov (United States)

    Galluzzo, Benjamin J.; Wendt, Theodore J.

    2015-01-01

    Across the mathematics curriculum there is a renewed emphasis on applications of mathematics and on mathematical modeling. Providing students with modeling experiences beyond the ordinary classroom setting remains a challenge, however. In this article, we describe the 24-hour Mathematical Modeling Challenge, an extracurricular event that exposes…

  9. The reinforcing value of vegetables does not increase with repeated exposure during a randomized controlled provided vegetable intervention among overweight and obese adults

    Science.gov (United States)

    Objective: The primary aim of this randomized controlled trial is to determine whether the relative reinforcing value (RRV) of vegetables compared to a snack food can be increased through repeated exposure (incentive sensitization) to amounts of vegetables recommended by the Dietary Guidelines for A...

  10. Effect of nursing care hours on the outcomes of Intensive Care assistance.

    Directory of Open Access Journals (Sweden)

    Tatiana do Altíssimo Nogueira

    Full Text Available To correlate the average number of nursing care hours dedicated to Intensive Care Unit (ICU patients with nursing care indicators.Transverse, descriptive study conducted between 2011 and 2013. Data were obtained from the electronic records system and from the nursing staff daily schedule. Generalized Linear Models were used for analysis.A total of 1,717 patients were included in the study. The average NAS (Nursing Activities Score value was 54.87. The average ratio between the number of nursing care hours provided to the patient and the number of nursing care hours required by the patient (hours ratio was 0.87. Analysis of the correlation between nursing care indicators and the hours ratio showed that the indicators phlebitis and ventilator-associated pneumonia significantly correlated with hours ratio; that is, the higher the hours ratio, the lower the incidence of phlebitis and ventilator-associated pneumonia.The number of nursing care hours directly impacts patient outcomes, which makes adjustment of nurse staffing levels essential.

  11. Effect of nursing care hours on the outcomes of Intensive Care assistance.

    Science.gov (United States)

    Nogueira, Tatiana do Altíssimo; Menegueti, Mayra Gonçalves; Perdoná, Gleice da Silva Castro; Auxiliadora-Martins, Maria; Fugulin, Fernanda Maria Togeiro; Laus, Ana Maria

    2017-01-01

    To correlate the average number of nursing care hours dedicated to Intensive Care Unit (ICU) patients with nursing care indicators. Transverse, descriptive study conducted between 2011 and 2013. Data were obtained from the electronic records system and from the nursing staff daily schedule. Generalized Linear Models were used for analysis. A total of 1,717 patients were included in the study. The average NAS (Nursing Activities Score) value was 54.87. The average ratio between the number of nursing care hours provided to the patient and the number of nursing care hours required by the patient (hours ratio) was 0.87. Analysis of the correlation between nursing care indicators and the hours ratio showed that the indicators phlebitis and ventilator-associated pneumonia significantly correlated with hours ratio; that is, the higher the hours ratio, the lower the incidence of phlebitis and ventilator-associated pneumonia. The number of nursing care hours directly impacts patient outcomes, which makes adjustment of nurse staffing levels essential.

  12. Longer Opening Hours for the Library

    CERN Multimedia

    2001-01-01

    The scientific information service. The CERN library is open 24 hours a day, 365 days a year. So how, you might be wondering, can they improve on that? The answer is in the detail. Although you can already use the library whenever you want, items can only be checked out when the front desk is staffed. A decision taken last week by the Scientific Information Policy Board now means that there will someone at the desk through out CERN's official working hours, with an extra 90 minutes at the end of the day so that people can check out material on their way home. In other words, the library will be open from 8:30 to 19:00, Monday to Friday. The library continues, of course, to be open 24 hours a day, all year round, and services provided via the digital library remain at your disposal day and night: http://library.cern.ch

  13. Concept and development of a discharge alert filter for abnormal laboratory values coupled with computerized provider order entry: a tool for quality improvement and hospital risk management.

    Science.gov (United States)

    Mathew, George; Kho, Abel; Dexter, Paul; Bloodworth, Nathaniel; Fantz, Corinne; Spell, Nathan; LaBorde, David V

    2012-06-01

    To develop a clinical decision support system activated at the time of discharge to reduce potentially inappropriate discharges from unidentified or unaddressed abnormal laboratory values. We identified 106 laboratory tests for possible inclusion in the discharge alert filter. We selected 7 labs as widely available, commonly obtained, and associated with high risk for potential morbidity or mortality within abnormal ranges. We identified trigger thresholds at levels that would capture significant laboratory abnormalities while avoiding excessive flag generation because of laboratory results that minimally deviate outside the normal reference range. We selected sodium (>155 or 6 mEq/dL) phosphorous (11,000 cells/mm with a rise of 20% or more between the 2 most recent results), and international normalized ratio greater than 4. A discharge alert filter that reliably and effectively identifies patients that may be discharged in unsafe situations because of unaddressed critical laboratory values can improve patient safety at discharge and potentially reduce the incidence of costly litigation. Further research is needed to validate whether the proposed discharge alert filter is effective at improving patient safety at discharge.

  14. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers

    Directory of Open Access Journals (Sweden)

    Radwan M

    2017-08-01

    Full Text Available Mahmoud Radwan,1 Ali Akbari Sari,1 Arash Rashidian,1 Amirhossein Takian,1 Sanaa Abou-Dagga,2 Aymen Elsous1 1Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine Background: Diabetes mellitus (DM is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA by using the competing values framework (CVF and examining its influence on the adherence to the Clinical Practice Guideline (CPG for DM.Methods: A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323 who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. Results: The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p<0.001; 47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA. In the PHC-MoH, the clan/group culture was the most predominant (mean =41.13; standard deviation [SD] =8.92, followed by hierarchical (mean =33.14; SD=5.96, while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51, followed by clan/group (mean =29.73; SD =8.37. Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Conclusion: Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research

  15. Public Values

    DEFF Research Database (Denmark)

    Beck Jørgensen, Torben; Rutgers, Mark R.

    2015-01-01

    administration is approached in terms of processes guided or restricted by public values and as public value creating: public management and public policy-making are both concerned with establishing, following and realizing public values. To study public values a broad perspective is needed. The article suggest......This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public...... a research agenda for this encompasing kind of public values research. Finally the contributions to the symposium are introduced....

  16. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers.

    Science.gov (United States)

    Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

    2017-01-01

    Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH) and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) by using the competing values framework (CVF) and examining its influence on the adherence to the Clinical Practice Guideline (CPG) for DM. A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323) who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p<0.001; 47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA). In the PHC-MoH, the clan/group culture was the most predominant (mean =41.13; standard deviation [SD] =8.92), followed by hierarchical (mean =33.14; SD=5.96), while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51), followed by clan/group (mean =29.73; SD =8.37). Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research should preferably mix quantitative and qualitative approaches and explore the use of more sensitive instruments to measure such a complex construct and its effects on guideline adherence in small-sized clinics.

  17. OPENING HOURS FOR CARDS OFFICE

    CERN Multimedia

    Human Resources Division

    2001-01-01

    Due to the extra workload generated by the global renewal of French cards and in order to preserve the level of service offered by the cards office, please note that this office will in future be open every morning from 8.30 a.m. to 12.30 p.m. until further notice. The service can be contacted by telephone during the same hours. Thank you for your understanding.

  18. Using multimedia information and communication technology (ICT) to provide added value to reminiscence therapy for people with dementia : Lessons learned from three field studies.

    Science.gov (United States)

    Bejan, Alexander; Gündogdu, Ramazan; Butz, Katherina; Müller, Nadine; Kunze, Christophe; König, Peter

    2018-01-01

    In the care of people with dementia (PwD), occupational therapies and activities aiming at maintaining the quality of life of PwD, such as reminiscence therapy (RT), are taking on a more and more important role. Information and communication technology (ICT) has the potential to improve and to facilitate RT by facilitating access to and selection of biographical information and related contents or by providing novel multimodal interaction forms to trigger memories; however, interactive multimedia technology is barely used in practice. This article presents three exploratory field studies that evaluated different aspects of RT technology use for PwD in care homes, including the utilization of online movie databases, interactive surface touch computers as well as natural user interfaces allowing gestures and haptic interaction. In these studies, the usage of prototype systems was observed in occupational sessions by 5, 12 and 16 PwD. The results indicate positive effects of technology use, e. g. in the form of verbally elicited reminiscence statements, expressed joy and playful interaction. Lessons learned for the design of technology-based RT interventions are presented and discussed.

  19. Transcutaneous bilirubin levels for the first 120 postnatal hours in healthy neonates.

    Science.gov (United States)

    Fouzas, Sotirios; Mantagou, Lito; Skylogianni, Eleni; Mantagos, Stefanos; Varvarigou, Anastasia

    2010-01-01

    The objective of this study was to provide data on transcutaneous bilirubin (TcB) levels for the first 120 postnatal hours and to develop an hour-specific TcB nomogram for healthy term and near-term neonates. From September 2005 to August 2008, we obtained 14864 TcB measurements from 2818 healthy neonates (gestational age >or= 35 weeks and birth weight >or= 2000 g). All measurements were performed with the BiliCheck bilirubinometer, at designated times from 12 to 120 postnatal hours. TcB percentiles for each designated time were calculated and used for the development of an hour-specific nomogram. TcB percentiles for neonates who required phototherapy are also presented. The developed TcB nomogram reflects the natural history of TcB levels in healthy neonates up to the fifth postnatal day. A different pattern of TcB increasing rate was noted in neonates who did and did not require phototherapy but with substantial overlap of TcB values between the 2 groups. We provide data on TcB levels for the first 120 postnatal hours from a large population of white, healthy, term and near-term neonates. We also present a percentile-based TcB nomogram designated for noninvasive and hour-specific evaluation of neonatal hyperbilirubinemia.

  20. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests.

    Science.gov (United States)

    Hegedus, Eric J; Goode, Adam P; Cook, Chad E; Michener, Lori; Myer, Cortney A; Myer, Daniel M; Wright, Alexis A

    2012-11-01

    rule in a SLAP lesion when positive. A sensitive test (sensitivity >80%, LR- ≤ 0.20) of note is the shoulder shrug sign, for stiffness-related disorders (osteoarthritis and adhesive capsulitis) as well as rotator cuff tendinopathy. There are six additional tests with higher sensitivities, specificities, or both but caution is urged since all of these tests have been studied only once and more than one ShPE test (ie, active compression, biceps load II) has been introduced with great diagnostic statistics only to have further research fail to replicate the results of the original authors. The belly-off and modified belly press tests for subscapularis tendinopathy, bony apprehension test for bony instability, olecranon-manubrium percussion test for bony abnormality, passive compression for a SLAP lesion, and the lateral Jobe test for rotator cuff tear give reason for optimism since they demonstrated both high sensitivities and specificities reported in low bias studies. Finally, one additional test was studied in two separate papers. The dynamic labral shear may be sensitive for SLAP lesions but, when modified, be diagnostic of labral tears generally. Based on data from the original 2008 review and this update, the use of any single ShPE test to make a pathognomonic diagnosis cannot be unequivocally recommended. There exist some promising tests but their properties must be confirmed in more than one study. Combinations of ShPE tests provide better accuracy, but marginally so. These findings seem to provide support for stressing a comprehensive clinical examination including history and physical examination. However, there is a great need for large, prospective, well-designed studies that examine the diagnostic accuracy of the many aspects of the clinical examination and what combinations of these aspects are useful in differentially diagnosing pathologies of the shoulder.

  1. Traffic Analysis Zones, Traffic Counts; s44ttc02; This data set contains the annual 24 Hour Average Daily Traffic Count Locations on State maintained roads in Rhode Island for 2001., Published in 2003, 1:4800 (1in=400ft) scale, Rhode Island and Providence Plantations.

    Data.gov (United States)

    NSGIC State | GIS Inventory — Traffic Analysis Zones dataset current as of 2003. Traffic Counts; s44ttc02; This data set contains the annual 24 Hour Average Daily Traffic Count Locations on State...

  2. Patient satisfaction with out of hours primary medical care

    OpenAIRE

    Mckinley, R; Roberts, C

    2001-01-01

    Objectives—To describe the relationship between patient satisfaction with out of hours care provided by deputising and practice doctors in four urban areas in England and characteristics of the service provided and patients, the care given, and health outcomes.

  3. Java programming 24-hour trainer

    CERN Document Server

    Fain, Yakov

    2015-01-01

    Quick and painless Java programming with expert multimedia instruction Java Programming 24-Hour Trainer, 2nd Edition is your complete beginner's guide to the Java programming language, with easy-to-follow lessons and supplemental exercises that help you get up and running quickly. Step-by-step instruction walks you through the basics of object-oriented programming, syntax, interfaces, and more, before building upon your skills to develop games, web apps, networks, and automations. This second edition has been updated to align with Java SE 8 and Java EE 7, and includes new information on GUI b

  4. 7 positions in 2 hours

    Directory of Open Access Journals (Sweden)

    Jessica Ackerman

    2013-07-01

    Full Text Available 7 positions in 2 hours (2013 is a drawing that documents the process of making the short film Role Reversal Rehearsal. It became quickly apparent that the process of making the work was more dynamic and interesting than the finished piece itself. Relationships between the childcare arrangements of the participants and the collective working process brought about the necessity of collaboration for parent artists. Each participant gave their time, energy and creative insight towards filming a series of birthing positions with roles reversed. The male performer became the central figure in an attempt to prompt empathy, humour, and to embody the importance of the male role in childbirth. There were two hours to choreograph, rehearse, and film the sequence. The drawing by Ackerman encapsulates the 'rhizomatic' approach to producing creative work under the constraints of parenthood. The 'arborescent' structure of hierarchy encouraged in industrial filmmaking is subsumed in favour of a horizontal structure. This new structure allows for the creative input, and flow of collaboration between all people involved - including the 3 and 5 year olds, who contributed ideas for camera and soundtrack in situ.

  5. Electoral (Amendment) (Hours of Polling) Bill 2013

    DEFF Research Database (Denmark)

    Butler, Graham; Hunt, Brian; Doyle, Andrew

    2013-01-01

    Private Members' Bill (legislation) introduced in Dáil Éireann (House of Deputies), Houses of the Oireachtas (Parliament of Ireland). An Act to set voting hours for Dáil Elections, Dáil Bye-Elections, Presidential Elections, European Parliament Elections, Local Government Elections and Referenda...... as being 7.00 a.m. to 10.00 p.m. and for that purpose to amend the Electoral Act 1992, Presidential Elections Act 1993, Referendum Act 1994, European Parliament Elections Act 1997, the Local Government Act 2001 and to provide for related matters....

  6. CORRELATION OF SPOT URINE ALBUMIN AND 12-HOUR URINE PROTEIN WITH 24-HOUR URINE PROTEIN IN PRE-ECLAMPSIA

    Directory of Open Access Journals (Sweden)

    S. Vinayachandran

    2017-11-01

    Full Text Available BACKGROUND Pre-eclampsia is defined as the development of new-onset hypertension in the second half of pregnancy often accompanied by new-onset proteinuria with other signs and symptoms. Proteinuria is defined by the excretion of 300 mg or more of protein in a 24-hour urine collection. To avoid time consumed in collection of 24-hour urine specimens, efforts have been made to develop faster methods to determine concentration of urine protein. Preliminary studies have suggested that 12-hour urine protein collection maybe adequate for evaluation of pre-eclampsia with advantage of early diagnosis and treatment of pre-eclampsia as well as potential for early hospital discharge and increased compliance with specimen collection. The aim of the study is to evaluate and correlate spot urine albumin and 12-hour urine protein with 24-hour urine protein in pre-eclampsia. MATERIALS AND METHODS A diagnostic evaluation study- a 24-hour urine protein, 12-hour urine protein and spot urine albumin results are analysed. Correlation of 12-hour urine protein and spot urine albumin with 24-hour urine protein is analysed using SPSS software. The strength of correlation was measured by Pearson’s correlation coefficient (r. Student’s t-test and Chi-square tests were used to compare patients with and without 24-hour urine protein ≥300 mg. Probability value of 165 mg with 24-hour urine protein ≥300 mg suggest that this test has role in the evaluation of women with suspected pre-eclampsia and could be substituted for 24-hour urine protein as a simple, faster and cheaper method.

  7. Hourly weather forecasts for gas turbine power generation

    Directory of Open Access Journals (Sweden)

    G. Giunta

    2017-06-01

    Full Text Available An hourly short-term weather forecast can optimize processes in Combined Cycle Gas Turbine (CCGT plants by helping to reduce imbalance charges on the national power grid. Consequently, a reliable meteorological prediction for a given power plant is crucial for obtaining competitive prices for the electric market, better planning and stock management, sales and supplies of energy sources. The paper discusses the short-term hourly temperature forecasts, at lead time day+1 and day+2, over a period of thirteen months in 2012 and 2013 for six Italian CCGT power plants of 390 MW each (260 MW from the gas turbine and 130 MW from the steam turbine. These CCGT plants are placed in three different Italian climate areas: the Po Valley, the Adriatic coast, and the North Tyrrhenian coast. The meteorological model applied in this study is the eni-Kassandra Meteo Forecast (e‑kmf™, a multi-model approach system to provide probabilistic forecasts with a Kalman filter used to improve accuracy of local temperature predictions. Performance skill scores, computed by the output data of the meteorological model, are compared with local observations, and used to evaluate forecast reliability. In the study, the approach has shown good overall scores encompassing more than 50,000 hourly temperature values. Some differences from one site to another, due to local meteorological phenomena, can affect the short-term forecast performance, with consequent impacts on gas-to-power production and related negative imbalances. For operational application of the methodology in CCGT power plant, the benefits and limits have been successfully identified.

  8. Working hours and health behaviour among nurses at public hospitals

    Directory of Open Access Journals (Sweden)

    Juliana da Costa Fernandes

    2013-09-01

    Full Text Available OBJECTIVE: to analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. METHODS: this is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279. RESULTS: men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. CONCLUSION: both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.

  9. Verification of hourly forecasts of wind turbine power output

    Energy Technology Data Exchange (ETDEWEB)

    Wegley, H.L.

    1984-08-01

    A verification of hourly average wind speed forecasts in terms of hourly average power output of a MOD-2 was performed for four sites. Site-specific probabilistic transformation models were developed to transform the forecast and observed hourly average speeds to the percent probability of exceedance of an hourly average power output. (This transformation model also appears to have value in predicting annual energy production for use in wind energy feasibility studies.) The transformed forecasts were verified in a deterministic sense (i.e., as continuous values) and in a probabilistic sense (based upon the probability of power output falling in a specified category). Since the smoothing effects of time averaging are very pronounced, the 90% probability of exceedance was built into the transformation models. Semiobjective and objective (model output statistics) forecasts were made compared for the four sites. The verification results indicate that the correct category can be forecast an average of 75% of the time over a 24-hour period. Accuracy generally decreases with projection time out to approx. 18 hours and then may increase due to the fairly regular diurnal wind patterns that occur at many sites. The ability to forecast the correct power output category increases with increasing power output because occurrences of high hourly average power output (near rated) are relatively rare and are generally not forecast. The semiobjective forecasts proved superior to model output statistics in forecasting high values of power output and in the shorter time frames (1 to 6 hours). However, model output statistics were slightly more accurate at other power output levels and times. Noticeable differences were observed between deterministic and probabilistic (categorical) forecast verification results.

  10. Spatial characteristics of extreme rainfall over China with hourly through 24-hour accumulation periods based on national-level hourly rain gauge data

    Science.gov (United States)

    Zheng, Yongguang; Xue, Ming; Li, Bo; Chen, Jiong; Tao, Zuyu

    2016-11-01

    Hourly rainfall measurements of 1919 national-level meteorological stations from 1981 through 2012 are used to document, for the first time, the climatology of extreme rainfall in hourly through 24-h accumulation periods in China. Rainfall amounts for 3-, 6-, 12- and 24-h periods at each station are constructed through running accumulation from hourly rainfall data that have been screened by proper quality control procedures. For each station and for each accumulation period, the historical maximum is found, and the corresponding 50-year return values are estimated using generalized extreme value theory. Based on the percentiles of the two types of extreme rainfall values among all the stations, standard thresholds separating Grade I, Grade II and Grade III extreme rainfall are established, which roughly correspond to the 70th and 90th percentiles for each of the accumulation periods. The spatial characteristics of the two types of extreme rainfall are then examined for different accumulation periods. The spatial distributions of extreme rainfall in hourly through 6-h periods are more similar than those of 12- and 24-h periods. Grade III rainfall is mostly found over South China, the western Sichuan Basin, along the southern and eastern coastlines, and in the large river basins and plains. There are similar numbers of stations with Grade III extreme hourly rainfall north and south of 30°N, but the percentage increases to about 70% south of 30°N as the accumulation period increases to 24 hours, reflecting richer moisture and more prolonged rain events in southern China. Potential applications of the extreme rainfall climatology and classification standards are suggested at the end.

  11. CERN restaurants: opening hours during summer

    CERN Multimedia

    2016-01-01

    In the summer, the three CERN restaurants remain open during their usual hours. On Monday 1st August and Thursday 8 September, the Restaurant 1 will be open from 7:00 a.m. to 10:00 p.m.   The satellites will be open as follows: Building 6: normal hours Building 13: normal hours Building 30: normal hours Building 40: closing at 4:30 p.m. instead of 5:00 pm Building 54: normal hours in July, closed in August Building 864: normal hours Building 865: normal hours Building 774: normal hours

  12. Does multi-slice CT provide reliable attenuation values if measured with low slice thickness and low tube current? Results of a phantom study; Sind mit der Mehrschicht-Computertomografie Dichtemessungen auch bei geringer Schichtdicke und niedrigem Roehrenstrom verlaesslich?

    Energy Technology Data Exchange (ETDEWEB)

    Kirchhof, K.; Bohndorf, K. [Klinik fuer Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg (Germany); Welzel, T. [Abt. klinische Radiologie, Radiologische Universitaetsklinik Heidelberg (Germany); Wagner, T. [Pathologisches Inst., Klinikum Augsburg (Germany); Behr, W. [Inst. fuer Laboratoriumsmedizin, Mikrobiologie und Umwelthygiene, Klinikum Augsburg (Germany)

    2008-01-15

    Purpose: to test whether CT with low slice thickness and low tube current provides reliable attenuation measurements. Materials and methods: using multi-slice CT and a phantom, we measured the attenuation values of thrombi with different proportions of erythrocytes, using a slice thickness of 1.25 mm, 2.5 mm, and 5 mm with tube currents of 200 mA, 300 mA, and 400 mA and a slice thickness of 0.625 mm with tube currents of 150 mA, 175 mA, and 200 mA. Differences in attenuation values and pixel noise between the three thrombi for tube current and slice thickness were statistically analyzed. Results: the attenuation values of all thrombi increased (p < 0.05) when the slice thickness decreased using a tube current of 200 mA or when the tube current decreased using a slice thickness of 1.25 mm. With higher tube currents and thicker slices, the CT values depended on the type of thrombus and the slice thickness. In slices with a thickness of 0.625 mm, the CT values decreased with the tube current in the mixed thrombus with a low proportion of erythrocytes and in the red thrombus (p < 0.05). The maximal difference in mean attenuation values was 4.3 HU with a slice thickness of 0.625 mm and 2.2 HU with a slice thickness of 1.25 mm. The pixel noise increased as the slice thickness decreased (p < 0.05) with the exception of the red thrombus, if reduced to 0.625 mm. The pixel noise also increased as the tube current decreased (p < 0.05) except in mixed thrombi measured with 0.625 mm. The maximal difference in mean standard deviation was 1.8 HU with a slice thickness of 1.25 mm. (orig.)

  13. Extended working hours: Impacts on workers

    Science.gov (United States)

    D. Mitchell; T. Gallagher

    2010-01-01

    Some logging business owners are trying to manage their equipment assets by increasing the scheduled machine hours. The intent is to maximize the total tons produced by a set of equipment. This practice is referred to as multi-shifting, double-shifting, or extended working hours. One area often overlooked is the impact that working non-traditional hours can have on...

  14. 50 CFR 20.23 - Shooting hours.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Shooting hours. 20.23 Section 20.23... PLANTS (CONTINUED) MIGRATORY BIRD HUNTING Taking § 20.23 Shooting hours. No person shall take migratory game birds except during the hours open to shooting as prescribed in subpart K of this part and subpart...

  15. 75 FR 9376 - Hours of Service

    Science.gov (United States)

    2010-03-02

    ... Federal Motor Carrier Safety Administration 49 CFR Part 395 RIN 2126-AB26 Hours of Service AGENCY: Federal... held in January 2010) to solicit comments and information on potential hours-of-service (HOS... the hours- of-service rules, contact Mr. Tom Yager, Chief, Driver and Carrier Operations ] Division...

  16. Online retailing: open all hours?

    OpenAIRE

    Ellis-Chadwick, Fiona

    2008-01-01

    Globally, online retailing has become increasingly important to retailers and consumers. In the UK, the online shopping spend has increased from 0.07% to 7% of the annual retail sales and the consumers' appetite for buying online continues to grow as the internet becomes increasingly accessible, convenient and secure. However, does the internet provide a truly comprehensive shopping experience or are there limitations? A visit to eBay can enable bargain hunters to find almost any product, but...

  17. Pregnancy outcomes using stallion epididymal sperm stored at 5 °C for 24 or 48 hours before harvest.

    Science.gov (United States)

    Stawicki, R J; McDonnell, S M; Giguère, S; Turner, R M

    2016-03-01

    The cryopreservation of epididymal sperm can be useful in a variety of circumstances for ensuring genetic preservation of a valued stallion. Although early studies have reported pregnancy rates significantly lower than those achieved with cryopreserved ejaculated sperm, two recent studies report over 60% one-cycle pregnancy rates with epididymal sperm stored for 24 hours at 5 °C before harvest and cryopreservation. The aims of this study were to: (1) attempt to replicate the one-cycle pregnancy rate of over 60% using epididymal sperm cooled and stored within the epididymis for 24 hours before harvest and cryopreservation and (2) evaluate pregnancy outcome with sperm cooled and stored within the epididymis for 48 hours before sperm harvest and cryopreservation. Testicles were obtained from 13 stallions undergoing routine castration. The epididymides were stored at 5 °C for either 24 or 48 hours before sperm harvest and cryopreservation in an egg yolk and dimethylformamide-based freezing extender. Thirteen mares were bred on one cycle with cryopreserved epididymal sperm stored for 24 hours before harvest, and 10 of those 13 mares were also bred on a previous or subsequent cycle with samples from the same stallion that had been stored for 48 hours before harvest. Pregnancy occurred in 7 of the 13 inseminations of sperm stored for 24 hours before harvest, and in 4 of the 10 inseminations of sperm stored for 48 hours before harvest. The pregnancy rate using epididymal sperm stored for 24 hours before harvest is consistent with that of previous reports. In addition, these results provide evidence that pregnancies can be achieved when the epididymides are cooled and stored for 48 hours before sperm harvest and cryopreservation. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Effects of the accreditation council for graduate medical education duty hour limits on sleep, work hours, and safety.

    Science.gov (United States)

    Landrigan, Christopher P; Fahrenkopf, Amy M; Lewin, Daniel; Sharek, Paul J; Barger, Laura K; Eisner, Melanie; Edwards, Sarah; Chiang, Vincent W; Wiedermann, Bernhard L; Sectish, Theodore C

    2008-08-01

    To mitigate the risks of fatigue-related medical errors, the Accreditation Council for Graduate Medical Education introduced work hour limits for resident physicians in 2003. Our goal was to determine whether work hours, sleep, and safety changed after implementation of the Accreditation Council for Graduate Medical Education standards. We conducted a prospective cohort study in which residents from 3 large pediatric training programs provided daily reports of work hours and sleep. In addition, they completed reports of near-miss and actual motor vehicle crashes, occupational exposures, self-reported medical errors, and ratings of educational experience. They were screened for depression and burnout. Concurrently, at 2 of the centers, data on medication errors were collected prospectively by using an established active surveillance method. A total of 220 residents provided 6007 daily reports of their work hours and sleep, and 16 158 medication orders were reviewed. Although scheduling changes were made in each program to accommodate the standards, 24- to 30-hour shifts remained common, and the frequency of residents' call remained largely unchanged. There was no change in residents' measured total work hours or sleep hours. There was no change in the overall rate of medication errors, and there was a borderline increase in the rate of resident physician ordering errors, from 1.06 to 1.38 errors per 100 patient-days. Rates of motor vehicle crashes, occupational exposures, depression, and self-reported medical errors and overall ratings of work and educational experiences did not change. The mean length of extended-duration (on-call) shifts decreased 2.7% to 28.5 hours, and rates of resident burnout decreased significantly (from 75.4% to 57.0%). Total hours of work and sleep did not change after implementation of the duty hour standards. Although fewer residents were burned out, rates of medication errors, resident depression, and resident injuries and educational

  19. Diagnosis of Myocardial Infarction Using a High-Sensitivity Troponin I 1-Hour Algorithm.

    Science.gov (United States)

    Neumann, Johannes Tobias; Sörensen, Nils Arne; Schwemer, Tjark; Ojeda, Francisco; Bourry, Rafael; Sciacca, Vanessa; Schaefer, Sarina; Waldeyer, Christoph; Sinning, Christoph; Renné, Thomas; Than, Martin; Parsonage, William; Wildi, Karin; Makarova, Nataliya; Schnabel, Renate B; Landmesser, Ulf; Mueller, Christian; Cullen, Louise; Greenslade, Jaimi; Zeller, Tanja; Blankenberg, Stefan; Karakas, Mahir; Westermann, Dirk

    2016-07-01

    Rapid and accurate diagnosis of acute myocardial infarction (AMI) currently constitutes an unmet need. To test a 1-hour diagnostic algorithm to diagnose AMI using a high-sensitivity troponin I assay with a new cutoff level of 6 ng/L. The Biomarkers in Acute Cardiac Care study is a prospective study that investigated the application of the troponin I assay for the diagnosis of AMI in 1040 patients presenting to the emergency department with acute chest pain from July 19, 2013, to December 31, 2014. Results were validated in 2 independent cohorts of 4009 patients. Final follow-up was completed on July 1, 2015, and data were assessed from July 2 to December 15, 2015. Acute chest pain suggestive of AMI. Accurate diagnosis or exclusion of AMI and 12-month mortality in patients with acute chest pain. Of the 1040 patients included from the study cohort, 673 (64.7%) were male and had a median age of 65 (interquartile range, 52-75) years. With application of a low troponin I cutoff value of 6 ng/L, the rule-out algorithm showed a high negative predictive value of 99.8% (95% CI, 98.6%-100.0%) after 1 hour for non-ST-segment elevation MI type 1. The 1-hour approach was comparable to a 3-hour approach. Similarly, a rule-in algorithm based on troponin I levels provided a high positive predictive value with 82.8% (95% CI, 73.2%-90.0%). Moreover, application of the cutoff of 6 ng/L resulted in lower follow-up mortality (1.0%) compared with the routinely used 99th percentile (3.7%) for this assay. Two independent cohorts further validated the performance of this algorithm with high negative and positive predictive values. Patients with possible AMI can be triaged within 1 hour after admission with no loss of safety compared with a 3-hour approach, when a low and sensitive cutoff is applied. This concept enables safe discharge or rapid treatment initiation after 1 hour.

  20. A Trial of Extending Hemodialysis Hours and Quality of Life.

    Science.gov (United States)

    Jardine, Meg J; Zuo, Li; Gray, Nicholas A; de Zoysa, Janak R; Chan, Christopher T; Gallagher, Martin P; Monaghan, Helen; Grieve, Stuart M; Puranik, Rajesh; Lin, Hongli; Eris, Josette M; Zhang, Ling; Xu, Jinsheng; Howard, Kirsten; Lo, Serigne; Cass, Alan; Perkovic, Vlado

    2017-06-01

    The relationship between increased hemodialysis hours and patient outcomes remains unclear. We randomized (1:1) 200 adult recipients of standard maintenance hemodialysis from in-center and home-based hemodialysis programs to extended weekly (≥24 hours) or standard (target 12-15 hours, maximum 18 hours) hemodialysis hours for 12 months. The primary outcome was change in quality of life from baseline assessed by the EuroQol 5 dimension instrument (3 level) (EQ-5D). Secondary outcomes included medication usage, clinical laboratory values, vascular access events, and change in left ventricular mass index. At 12 months, median weekly hemodialysis hours were 24.0 (interquartile range, 23.6-24.0) and 12.0 (interquartile range, 12.0-16.0) in the extended and standard groups, respectively. Change in EQ-5D score at study end did not differ between groups (mean difference, 0.04 [95% confidence interval, -0.03 to 0.11]; P=0.29). Extended hours were associated with lower phosphate and potassium levels and higher hemoglobin levels. Blood pressure (BP) did not differ between groups at study end. Extended hours were associated with fewer BP-lowering agents and phosphate-binding medications, but were not associated with erythropoietin dosing. In a substudy with 95 patients, we detected no difference between groups in left ventricular mass index (mean difference, -6.0 [95% confidence interval, -14.8 to 2.7] g/m2; P=0.18). Five deaths occurred in the extended group and two in the standard group (P=0.44); two participants in each group withdrew consent. Similar numbers of patients experienced vascular access events in the two groups. Thus, extending weekly hemodialysis hours did not alter overall EQ-5D quality of life score, but was associated with improvement in some laboratory parameters and reductions in medication burden. (Clinicaltrials.gov identifier: NCT00649298). Copyright © 2017 by the American Society of Nephrology.

  1. Distribution of hourly variability index of sky clearness | Madhlopa ...

    African Journals Online (AJOL)

    Clouds affect the values of insolation for solar technology and other applications. To detect the presence of variability in the sky clearness, an hourly variability index ( 3) is calculated. The present study examined the frequency distribution of this variable as a tool for assessing the utilizability of solar radiation at a site.

  2. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

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

  3. [Fluctuation of intraocular pressure in 24-hour telemonitoring compared to tonometry during normal office hours].

    Science.gov (United States)

    Jürgens, C; Antal, S; Henrici, K; Grossjohann, R; Tost, F H

    2009-01-01

    Elevated intraocular pressure (IOP) is a clinically relevant factor in glaucoma progression. As a dynamic parameter the IOP depends on various internal and exogenic influencing factors. Therefore, we analysed intraindividual IOD variations between ambulant care and 24-h home-monitoring using self-tonometry. This study is based on paper-based glaucoma cards of 25 patients with primary open angle glaucoma. Additionally, all patients participated in a telemedical home-monitoring study with self-measurements of IOP and blood pressure stored in an electronic patient record. The glaucoma cards contained a total number of 409 IOP values with documentation periods from 0.5 to 10 years. In the teletonometry project all 25 patients were observed for 6 months with 1490 recorded IOP values. Statistical analysis was performed with SPSS software. Average IOP values for all 25 glaucoma patients were 16.3 +/- 2.9 mmHg for both eyes in glaucoma card documentation, whereas the electronic patient records showed IOP averages of 18.9 +/- 4.7 mmHg for right eyes and 18.2 +/- 4.4 mmHg for left eyes. Corresponding to the practice opening hours the glaucoma cards contained no IOP records from 12:00 pm to 01:30 pm as well as between 06:00 pm and 07:15 am. In these time periods 17 % of all IOP values recorded in 24-hour teletonometry were higher than 20 mmHg. However, statistical analysis and clinical evaluation of device parameters and measurement characteristics revealed sporadic measuring errors. The additional involvement of self-tonometry in telemedical 24-h home-monitoring is a feasible method to record and detect intraday IOP fluctuations. Compared to single IOP measurements documented in common paper-based glaucoma cards, the 24-h electronic patient record showed more frequent circadian IOP variations. As a result, self-tonometry and home-monitoring can be a useful link to fill the gap between singular ambulant IOP measurement and hospitalisation with 24-hour IOP profiles.

  4. Statistical analysis and verification of 3-hourly geomagnetic activity probability predictions

    Science.gov (United States)

    Wang, Jingjing; Zhong, Qiuzhen; Liu, Siqing; Miao, Juan; Liu, Fanghua; Li, Zhitao; Tang, Weiwei

    2015-12-01

    The Space Environment Prediction Center (SEPC) has classified geomagnetic activity into four levels: quiet to unsettled (Kp 6). The 3-hourly Kp index prediction product provided by the SEPC is updated half hourly. In this study, the statistical conditional forecast models for the 3-hourly geomagnetic activity level were developed based on 10 years of data and applied to more than 3 years of data, using the previous Kp index, interplanetary magnetic field, and solar wind parameters measured by the Advanced Composition Explorer as conditional parameters. The quality of the forecast models was measured and compared against verifications of accuracy, reliability, discrimination capability, and skill of predicting all geomagnetic activity levels, especially the probability of reaching the storm level given a previous "calm" (nonstorm level) or "storm" (storm level) condition. It was found that the conditional models that used the previous Kp index, the peak value of BtV (the product of the total interplanetary magnetic field and speed), the average value of Bz (the southerly component of the interplanetary magnetic field), and BzV (the product of the southerly component of the interplanetary magnetic field and speed) over the last 6 h as conditional parameters provide a relative operating characteristic area of 0.64 and can be an appropriate predictor for the probability forecast of geomagnetic activity level.

  5. Elderly toileting: is two hourly too often?

    Science.gov (United States)

    Jilek, R

    The purpose of this study was to investigate the effectiveness of two hourly toileting regimes for the management of urinary incontinence in elderly nursing home residents. A comparison of two hourly regimes with four hourly toileting was undertaken over two eight-week periods to establish the most effective form of continence promotion. No significant difference in the levels of incontinence was noted and the severity of incontinence did not significantly differ between regimes. The author concludes that two hourly regimes are a waste of nurses' time and cause unnecessary discomfort to patients.

  6. Estimation of Rainfall Erosivity via 1-Minute to Hourly Rainfall Data from Taipei, Taiwan

    Science.gov (United States)

    Huang, Ting-Yin; Yang, Ssu-Yao; Jan, Chyan-Deng

    2017-04-01

    Soil erosion is a natural process on hillslopes that threats people's life and properties, having a considerable environmental and economic implications for soil degradation, agricultural activity and water quality. The rainfall erosivity factor (R-factor) in the Universal Soil Loss Equation (USLE), composed of total kinetic energy (E) and the maximum 30-min rainfall intensity (I30), is widely used as an indicator to measure the potential risks of soil loss caused by rainfall at a regional scale. This R factor can represent the detachment and entrainment involved in climate conditions on hillslopes, but lack of 30-min rainfall intensity data usually lead to apply this factor more difficult in many regions. In recent years, fixed-interval, hourly rainfall data is readily available and widely used due to the development of automatic weather stations. Here we assess the estimations of R, E, and I30 based on 1-, 5-, 10-, 15-, 30-, 60-minute rainfall data, and hourly rainfall data obtained from Taipei weather station during 2004 to 2010. Results show that there is a strong correlation among R-factors estimated from different interval rainfall data. Moreover, the shorter time-interval rainfall data (e.g., 1-min) yields larger value of R-factor. The conversion factors of rainfall erosivity (ratio of values estimated from the resolution lower than 30-min rainfall data to those estimated from 60-min and hourly rainfall data, respectively) range from 1.85 to 1.40 (resp. from 1.89 to 1.02) for 60-min (resp. hourly) rainfall data as the time resolution increasing from 30-min to 1-min. This paper provides useful information on estimating R-factor when hourly rainfall data is only available.

  7. Quality-control of an hourly rainfall dataset and climatology of extremes for the UK.

    Science.gov (United States)

    Blenkinsop, Stephen; Lewis, Elizabeth; Chan, Steven C; Fowler, Hayley J

    2017-02-01

    Sub-daily rainfall extremes may be associated with flash flooding, particularly in urban areas but, compared with extremes on daily timescales, have been relatively little studied in many regions. This paper describes a new, hourly rainfall dataset for the UK based on ∼1600 rain gauges from three different data sources. This includes tipping bucket rain gauge data from the UK Environment Agency (EA), which has been collected for operational purposes, principally flood forecasting. Significant problems in the use of such data for the analysis of extreme events include the recording of accumulated totals, high frequency bucket tips, rain gauge recording errors and the non-operation of gauges. Given the prospect of an intensification of short-duration rainfall in a warming climate, the identification of such errors is essential if sub-daily datasets are to be used to better understand extreme events. We therefore first describe a series of procedures developed to quality control this new dataset. We then analyse ∼380 gauges with near-complete hourly records for 1992-2011 and map the seasonal climatology of intense rainfall based on UK hourly extremes using annual maxima, n-largest events and fixed threshold approaches. We find that the highest frequencies and intensities of hourly extreme rainfall occur during summer when the usual orographically defined pattern of extreme rainfall is replaced by a weaker, north-south pattern. A strong diurnal cycle in hourly extremes, peaking in late afternoon to early evening, is also identified in summer and, for some areas, in spring. This likely reflects the different mechanisms that generate sub-daily rainfall, with convection dominating during summer. The resulting quality-controlled hourly rainfall dataset will provide considerable value in several contexts, including the development of standard, globally applicable quality-control procedures for sub-daily data, the validation of the new generation of very high

  8. A survey of radiology practices' use of after-hours radiology services.

    Science.gov (United States)

    Kaye, Adam H; Forman, Howard P; Kapoor, Roger; Sunshine, Jonathan H

    2008-06-01

    The study's purpose was to identify the characteristics of and the motives behind radiologists' use of after-hours services. From August of 2005 to June of 2006, 300 nonspecialty hospitals randomly selected from the 2005 American Hospital Association Directory of Hospitals were contacted by phone, e-mail, and mail, with an attempt made to speak to the chiefs of radiology. We obtained 115 responses, a 38.3% response rate, including 64 from practices that used an external after-hours service. These 64 are the subject of this study. Responses were analyzed using descriptive statistical analyses. Practices gave convenience as the most important reason they use after-hours services, with value for recruiting ranked second and shortage of radiologists for off-hours coverage ranked third. Three-fourths of practices said they receive 5% or less of their reads from these services. Two-thirds of practices paid the service approximately as much as they collected or more. Approximately 40% of respondents used an after-hours service located internationally. Of these, 56% said that the radiologists reading internationally were either all Americans or mostly Americans and 40% did not know the proportion of foreigners. Regardless, in-state licensure of all interpreting teleradiologists is essentially universal. Most radiology groups using after-hours services do so for convenience rather than shortage of staff to provide coverage. Most practices send a small percentage of their studies to the services. Although overseas-located services are commonly used, there is little evidence of other than American radiologists or American-trained radiologists at these services.

  9. Cost-efficient staffing under annualized hours

    NARCIS (Netherlands)

    van der Veen, Egbert; Hans, Elias W.; Veltman, Bart; Berrevoets, Leo M.; Berden, Hubert J.J.M.

    2012-01-01

    We study how flexibility in workforce capacity can be used to efficiently match capacity and demand. Flexibility in workforce capacity is introduced by the annualized hours regime. Annualized hours allow organizations to measure working time per year, instead of per month or per week. An additional

  10. Hours Constraints Within and Between Jobs

    NARCIS (Netherlands)

    Euwals, R.W.

    1997-01-01

    In the empirical literature on labour supply, several models are developed to incorporate constraints on working hours. These models do not address the question to which extent working hours are constrained within and between jobs. In this paper I investigate the effect of individual changes in

  11. 17 CFR 201.104 - Business hours.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Business hours. 201.104 Section 201.104 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Rules of Practice General Rules § 201.104 Business hours. The Headquarters office of the Commission, at...

  12. 20 CFR 801.304 - Business hours.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Business hours. 801.304 Section 801.304 Employees' Benefits BENEFITS REVIEW BOARD, DEPARTMENT OF LABOR ESTABLISHMENT AND OPERATION OF THE BOARD Action by the Board § 801.304 Business hours. The office of the Clerk of the Board at Washington, DC...

  13. MODELS OF HOURLY DRY BULB TEMPERATURE AND ...

    African Journals Online (AJOL)

    Hourly meteorological data of both dry bulb temperature and relative humidity for 18 locations in Nigeria for the period 1995 to 2009 were analysed to obtain the mean monthly average and monthly hourly average of each of the two meteorological variables for each month for each location. The difference between the ...

  14. Long working hours and cancer risk

    DEFF Research Database (Denmark)

    Heikkila, Katriina; Nyberg, Solja T.; Madsen, Ida E. H.

    2016-01-01

    ; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working greater than or equal to55 h...... per week was associated with 1.60-fold (95% confidence interval 1.12–2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift- and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity......Background: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. Methods: This multi-cohort study examined the association between working hours and cancer risk...

  15. The Value of Value

    DEFF Research Database (Denmark)

    Sørensen, Asger

    As a social scientist of ethics and morality, Luhmann has noticed the ethical wave that has recently swept across the western world, and states that this particular kind of wave seems to have a wavelength of about one hundred years (cf. Luhmann 1989: 9 ff.). Even though the frequency and the regu...... attempted to answer this question by investigating what the use of the term `value' leads to in ethical discourses, i.e., what moral implications it has for ethics to focus on the concept of value....... parts of business ethics given prominence to especially one term, namely `value'. The question that interests me is the following: What does the articulation of ethics and morality in terms of values mean for ethics and morality as such. Or, to put the question in a more fashionably way: What...... is the value of value for morality and ethics?To make things a bit more precise, we can make use of the common distinction between ethics and morality, i.e. that morality is the immediate, collective and unconscious employment of morals, whereas ethics is the systematic, individual and conscious reflections...

  16. Toward the 24-Hour Knowledge Factory

    OpenAIRE

    Gupta, Amar; Seshasai, Satwik

    2004-01-01

    The term 24-Hour Knowledge Factory connotes a globally distributed work environment in which members of the global team work on a project around the clock; each member of the team works the normal workday hours that pertain to his or her time zone. At the end of such a workday, a fellow team member located in a different time zone continues the same task. This creates the shift-style workforce that was originally conceived in the manufacturing sector. A globally distributed 24-hour call cente...

  17. What Value "Value Added"?

    Science.gov (United States)

    Richards, Andrew

    2015-01-01

    Two quantitative measures of school performance are currently used, the average points score (APS) at Key Stage 2 and value-added (VA), which measures the rate of academic improvement between Key Stage 1 and 2. These figures are used by parents and the Office for Standards in Education to make judgements and comparisons. However, simple…

  18. U.S. Hourly Precipitation Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hourly Precipitation Data (HPD) is digital data set DSI-3240, archived at the National Climatic Data Center (NCDC). The primary source of data for this file is...

  19. Ozone Nonattainment Areas - 8 Hour (1997 Standard)

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for ozone over 8 hours and...

  20. U.S. Hourly Precipitation Data Publication

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This publication contains hourly precipitation amounts obtained from recording rain gages located at National Weather Service, Federal Aviation Administration, and...

  1. CHALLENGES OF HUMANIZATION IN UPA 24HOURS

    National Research Council Canada - National Science Library

    S. D. Leite; S. F. S. Moraes; C. B. Venazzi; N. T. Costa

    2017-01-01

    Humanization referenced by the national policy of humanization (HNP) it is what is expected in customer service together with the risk classification front to emergency services and emergency UPA 24 hours...

  2. SO2 8 Hour Nonattainment Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Sulfur dioxide 8 hour...

  3. 50 CFR 20.102 - Seasons, limits, and shooting hours for Alaska.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Seasons, limits, and shooting hours for Alaska. 20.102 Section 20.102 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT... Shooting Hours Schedules § 20.102 Seasons, limits, and shooting hours for Alaska. This section provides for...

  4. The Value of Reciprocity

    Science.gov (United States)

    Molm, Linda D.; Schaefer, David R.; Collett, Jessica L.

    2007-01-01

    The value of reciprocity in social exchange potentially comprises both instrumental value (the value of the actual benefits received from exchange) and communicative or symbolic value (the expressive and uncertainty reduction value conveyed by features of the act of reciprocity itself). While all forms of exchange provide instrumental value, we…

  5. The value of demand response in Florida

    Energy Technology Data Exchange (ETDEWEB)

    Stoll, Brady; Buechler, Elizabeth; Hale, Elaine

    2017-11-01

    Many electrical loads may be operated flexibly to provide grid services, including peaking capacity, reserves, and load shifting. The authors model 14 demand end uses in Florida and analyze their operational impacts and overall value for a wide range of solar penetrations and grid flexibility options. They find demand response is able to reduce production costs, reduce the number of low-load hours for traditional generators, reduce starting of gas generators, and reduce curtailment.

  6. Medicare and Medicaid programs: hospital outpatient prospective payment; ambulatory surgical center payment; hospital value-based purchasing program; physician self-referral; and patient notification requirements in provider agreements. Final rule with comment period.

    Science.gov (United States)

    2011-11-30

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) for CY 2012 to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we set forth the relative payment weights and payment amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other ratesetting information for the CY 2012 ASC payment system. We are revising the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, adding new requirements for ASC Quality Reporting System, and making additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. We also are allowing eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. Finally, we are making changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements.

  7. Strategies to accommodate resident work-hour restrictions: impact on surgical education.

    Science.gov (United States)

    Freiburg, Carter; James, Ted; Ashikaga, Takamura; Moalem, Jacob; Cherr, Greg

    2011-01-01

    The introduction of duty-hour restrictions has impacted surgical training. Several strategies were introduced by training programs in response to these restrictions. The purpose of this study was to assess the various strategies employed by residency programs to comply with work-hour restrictions with respect to the impact on the quality of surgical education. A national survey was developed and distributed to resident members of the Resident and Associate Society of the American College of Surgeons in all accredited residency programs across North America. Questions in the survey addressed 10 separate accommodation strategies used by training programs to adhere to resident work-hour restrictions. Resident respondents completed a 5-point Likert scale rating each strategy according to its impact on surgical education (detrimental, not very helpful, neutral, somewhat helpful, and very helpful). A total of 599 (9.7%) responses were received from 6186 members of the Resident Associate Society. The use of health information technology (IT), nurse practitioners, and physician assistants were most highly rated. Hiring clinical fellows, establishing nonteaching services, and shift-work scheduling were the three most poorly rated accommodations to work-hour restrictions with respect to resident education. Hospital IT and nonphysician care providers were rated by residents to optimize surgical education in the current work-hour limitation environment. We infer that strategies which lead to increased efficiency and redistribution of resident workload allow surgical trainees to spend more time on activities perceived to have higher educational value. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. Long working hours and alcohol use

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies......, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were...... countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1...

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

    Science.gov (United States)

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

    2017-04-01

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

  10. Constructing gridded hourly temperature data sets

    Science.gov (United States)

    Dumitrescu, Alexandru

    2013-04-01

    Air temperature is the main climatological element, with major impact on the earth-atmosphere energy balance. The characteristics of the surface air temperature in locations without meteorological measurements are obtained using spatio-temporal interpolation techniques. Gridded surface meteorological data are essential for evaluating the performance of regional climate models (RCMs), for applying Statistical Downscaling (SD) methods and as input data for hydrological models. In this study we proposed a methodolgy for interpolating hourly surface temperatures. Three gridding methods are compared. A two-step multivariate gridding approach was used. First we interpolated the hourly normal maps, considered as multiannual average (1961-2010), of air temperature for each hour (4 meteorological terms) of a standard year (366 days). In this step, the Residual Kriging method was used with potential predictors derived from DEM and Landcover Corinne. For interpolating the residuals of the regression model we tested 3 gridding methods: Multiquadratic (MQ), Ordinary Kriging (OK) and 3D Kriging (using time as a third dimension). In the second step, we calculated the anomalies of each hour, day, year for the period 1961-2010. The anomalies were interpolated using the same methods applied for gridding regression residuals. The final hourly surface air temperature maps were obtained by summing the maps from first step with the anomlies map. The main data used in this work were the hourly air temperatures of the 4 observation terms (01, 07, 13, 19), measured between 1961-2010 at the weather stations of the Romanian Meteorological Administration. The predictors were derived from SRTM (Shuttle Radar Topography Mission) DEM and from CORINE Land Cover 2000 product. The gridding was performed in a Romanian National Grid (Stereo 70), at 1 km2 spatial resolution, using R language. The study has been financed by the research project Changes in climate extremes and associated impact in

  11. The diffuse fraction of hourly solar radiation for Amman-Jordan

    Energy Technology Data Exchange (ETDEWEB)

    Hijazin, M.I. [American University of Beirut (Lebanon). Faculty of Engineering and Architecture

    1998-02-01

    This paper presents various correlations of the hourly clearness index Ksub(t) with the hourly diffuse fraction Ksub(d) on a horizontal surface for Amman/Jordan. The first correlation is based on Orgill and Hollands method, but using weighted averages. The second correlation is based on hourly integrated values of Ksub(t)`s and Ksub(d)`s without any grouping. A refinement of the latter correlation is attempted by including a random shock. (author)

  12. Automatization of physicians' phone-in hours.

    Science.gov (United States)

    Turunen, J; Loula, P; Soininen, H

    1999-01-01

    In this paper we present a computer-based system that is designed to reduce the number of patient calls in physicians' phone-in hours. Simultaneously it will offer a parallel alternative channel for the patients to listen to their laboratory results. The system requirements were reliability, security and the low costs. The results showed after a two-month test period that the tailored system proved extremely successful. The average time that the physician saved by using this system was over 4 minutes and doctors can leave the messages to the server also outside the phone-in hours.

  13. Analysis of Office/Laboratory Staying Hour and Home Working Hour of Japanese Scientists and Engineers

    Science.gov (United States)

    Ejiri, A.

    The second questionnaire for scientists and engineers was carried out in 2007, and status of Japanese scientists and engineers were analyzed and reported. A part of the data was reanalyzed from the viewpoint of work life balance. In particular, office/laboratory staying hour and home working hour were analyzed and dependences on various factors were investigated. It was found that these hours depend on gender, marital status, number of child, employment status and age. In addition, the total hours tend to be kept constant regardless of various factors.

  14. Hourly associations between heat and ambulance calls.

    Science.gov (United States)

    Guo, Yuming

    2017-01-01

    The response speed of ambulance calls is very crucial to rescue patients suffering immediately life threatening conditions. The serious health outcomes might be caused by exposing to extreme heat only several hours before. However, limited evidence is available on this topic. This study aims to examine the hourly association between heat and ambulance calls, to improve the ambulance services and to better protect health. Hourly data on ambulance calls for non-accidental causes, temperature and air pollutants (PM10, NO2, and O3) were collected from Brisbane, Australia, during 2001 and 2007. A time-stratified case-crossover design was used to examine the associations between hourly ambulance calls and temperature during warm season (Nov, Dec, Jan, Feb, and Mar), while adjusting for potential confounders. Stratified analyses were performed for sex and age groups. Ambulance calls peaked at 10am for all groups, except those aged 27 °C) increase the demands of ambulance. This information is helpful to increase the efficiency of ambulance service then save lives, for example, preparing more ambulance before appearance of extremely hot temperature in combination with weather forecast. Also, people should better arrange their time for outdoor activities to avoid exposing to extreme hot temperatures. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Installation Service - Changes in opening hours

    CERN Multimedia

    GS Department

    2010-01-01

    For organizational matters, please note that, as from 15 March 2010, the Installation Service will have wen opening hours. The new schedule will be from 14:00 to 17:00 (Monday to Friday). Contact persons are: Martine Briant, Karine Robert and Claudia Bruggmann. The office address remains 73-3-014. Installation Service

  16. 75 FR 2467 - Hours of Service

    Science.gov (United States)

    2010-01-15

    ... Federal Motor Carrier Safety Administration 49 CFR Part 395 RIN 2126-AB26 Hours of Service AGENCY: Federal...-service (HOS) regulations. Specifically, the Agency wants to know what factors, issues, and data it should... allow us to arrange for such services. There is no guarantee that interpreter services requested on...

  17. Long working hours and alcohol use

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies, su...

  18. Estimator's electrical man-hour manual

    CERN Document Server

    Page, John S

    1999-01-01

    This manual's latest edition continues to be the best source available for making accurate, reliable man-hour estimates for electrical installation. This new edition is revised and expanded to include installation of electrical instrumentation, which is used in monitoring various process systems.

  19. Estimation of clear sky hourly global solar radiation in Iraq

    Energy Technology Data Exchange (ETDEWEB)

    Al-Jumaily, Kais J.; Al-Zuhairi, Munya F.; Mahdi, Zahraa S. [Department of Atmospheric Sciences, College of Science, Al-Mustansiriyah University, Baghdad (Iraq)

    2012-07-01

    The availability of hourly solar radiation data is very important for applications utilizing solar energy and for climate and environmental aspects. The aim of this work is to use a simple model for estimating hourly global solar radiation under clear sky condition in Iraq. Calculations were compared with measurements obtained from local station in Baghdad city and from Meteosat satellite data for different locations in Iraq. The statistical test methods of the mean bias error (MBE), root mean square error (RMSE) and t-test were used to evaluate the performance of the model. Results indicated that a fairly good agreement exists between calculated and measured values for all locations in Iraq. Since the model is independent of any meteorological variable, it would be of a practical use for rural areas where no meteorological data are available.

  20. 76 FR 50359 - Hours of Service of Railroad Employees; Substantive Regulations for Train Employees Providing...

    Science.gov (United States)

    2011-08-12

    ..., Section-by-Section Analysis, below. III. Scientific Background Most mammals, including human beings, have... between human physiology and work times, something that would be very difficult to specify through other... 20590 (telephone: 202-493-6350); Dr. Thomas G. Raslear, Staff Director, Human Factors Research Program...

  1. CMAQv5.1 Base NEIv2 AQS Hourly site compare output

    Data.gov (United States)

    U.S. Environmental Protection Agency — CMAQv5.1 Base NEIv2 AQS Hourly site compare output containing paired model/ob values that were used for some of the plots in the manuscript. This dataset is...

  2. Cardiovascular emergency hospital visits and hourly changes in air pollution.

    Science.gov (United States)

    Yorifuji, Takashi; Suzuki, Etsuji; Kashima, Saori

    2014-05-01

    Few studies have examined the effect of hourly changes in air pollution on cardiovascular disease morbidity. We evaluated the associations between hourly changes in air pollution and the risks of several types of cardiovascular disease. We used a time-stratified case-crossover design. Study participants were 10,949 residents of the city of Okayama, Japan, aged≥65 years who were taken to hospital emergency rooms between January 2006 and December 2010 for onset of cardiovascular disease. We calculated city representative hourly average concentrations of air pollutants from several monitoring stations and examined the associations between air pollution exposure before the case event, focusing mainly on suspended particulate matter, and disease onset. Suspended particulate matter exposure 0 to <6 hours before the case events was associated with risks of onset of cardiovascular and cerebrovascular disease; odds ratios after 1 interquartile range increase in suspended particulate matter exposure were 1.04 (95% confidence interval, 1.01-1.06) for cardiovascular disease and 1.04 (95% confidence interval, 1.00-1.08) for cerebrovascular disease. We observed an elevated risk of hemorrhagic as well as ischemic stroke, but the risk was slightly higher for hemorrhagic stroke, and this elevation was persistent. Women tended to have higher effect estimates. This study provides further evidence that particulate matter exposure increases the risks of onset of cardiovascular and cerebrovascular disease (including hemorrhagic stroke) shortly after exposure.

  3. Implementation and Evaluation of a Values Clarification Activity for a Large Undergraduate Human Sexuality Course

    Science.gov (United States)

    Lederer, Alyssa M.

    2016-01-01

    Values clarification is an important tool that helps individuals to clarify their beliefs about sexuality-related issues. This lesson plan provides instructions for a 1-hour values clarification activity for a large undergraduate human sexuality course that serves as an introduction to course content and tone, stimulates students' initial thinking…

  4. Appy Hour: Health Sciences Professionals Learn About Apps.

    Science.gov (United States)

    Casucci, Tallie; Gregory, Joan M; Shipman, Jean P

    2016-01-01

    Appy Hour is a recurring event hosted by an academic health sciences library featuring apps that are informally presented and demonstrated by invited speakers. The audience is encouraged to ask questions during the presentation of the featured app(s). This event provides learning and networking opportunities for health sciences faculty, staff, students, and health care professionals. This article illustrates the process for hosting the event, shares lessons learned, and discusses possible future directions to gain a wider audience.

  5. Long working hours and alcohol use

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies......, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were...... obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. RESULTS: Cross sectional analysis was based on 61 studies representing 333,693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100,602 participants from nine...

  6. CERN takes part in Earth Hour

    CERN Multimedia

    Anaïs Vernède

    2011-01-01

    From 8.30 to 9.30 p.m. on Saturday, 26 March 2011, the Globe of Science and Innovation will be plunged into darkness to mark CERN's participation in Earth Hour. A growing number of countries and cities across the planet are involved in this global initiative against climate change, which was launched by the WWF in 2007.   The lights on the Globe were switched off for the 2009 Earth Hour event. Along with individuals, companies and tourist attractions in thousands of towns and cities all over the world participating in the fourth annual Earth Hour event, CERN will turn off the lights of the Globe for 60 minutes at 8.30 p.m. on Saturday 26 March. CERN's participation in the initiative is one of several examples of its commitment to respect the environment and keep its ecological footprint to the minimum. A recent example under the green transport heading was the replacement of part of CERN's petrol vehicle fleet with cars running on natural gas with a view to reducing air pollution. Other examples...

  7. 24-hour rehabilitation nursing: the proof is in the documentation.

    Science.gov (United States)

    Hentschke, Pam

    2009-01-01

    For a facility to be classified as an inpatient rehabilitation facility (IRF), Medicare requires that the facility provide 24-hour rehabilitation nursing. Documentation is important because it helps determine the most appropriate site for the provision of care. Functional assessments are ongoing and should provide information about patients and which interventions are most appropriate; this allows for successful achievement of rehabilitation goals. Nurses must define the elements of a quality assessment based on the individual patient and then monitor findings and respond appropriately. Reimbursement is supported by measuring functional outcomes based on the initial assessment of patients. The final reimbursement, based on possible denial of a claim, is supported by documentation of the functional outcome in the medical record. Medicare contractors cannot observe the everyday interventions nurses use with patients, so they require documentation as proof. This article features examples of documentation that nurses can use to help meet the expectation of 24-hour nursing. Following through with these suggestions will not only help provide proof of 24-hour nursing, more accurate reimbursement, and the security of a full reimbursement, but ultimately will ensure quality rehabilitation services and care for patients.

  8. Fair Value or Market Value?

    Directory of Open Access Journals (Sweden)

    Bogdan Cosmin Gomoi

    2014-12-01

    Full Text Available When taking into consideration the issue of defining the “fair value” concept, those less experimented in the area often fall in the “price trap”, which is considered as an equivalent of the fair value of financial structures. This valuation basis appears as a consequence of the trial to provide an “accurate image” by the financial statements and, also, as an opportunity for the premises offered by the activity continuing principle. The specialized literature generates ample controversies regarding the “fair value” concept and the “market value” concept. The paper aims to debate this issue, taking into account various opinions.

  9. Practice and Reflection on Library Open 24 Hours a Day

    OpenAIRE

    Wang, Qiyun

    2009-01-01

    Effective management is to minimize the cost or waste in a limited period of time, and obtain the best result which we expected. The waste of time is the losses of value. To pay attention, analysis and research the readers time cost, so that readers with minimal time to get the most satisfaction. It is one of the most basic and ultimate services goals of library. The article systematically inspected the forms of library open 24 hours a day, focuses on the practice of Huaihai Institute of Tech...

  10. Is 24-hour Intraocular Pressure Monitoring Necessary in Glaucoma?

    Science.gov (United States)

    Mansouri, Kaweh; Weinreb, Robert N.; Medeiros, Felipe A.

    2013-01-01

    Although intraocular pressure (IOP) is the only treatable risk factor for glaucoma, its 24-hour behavior is poorly understood. Conflicting information is available in the literature with regard to the importance and predictive value of IOP peaks and fluctuations on the risk of glaucoma development and progression. This may be secondary to lack of prospective studies designed to address this issue. This article critically reviews the current evidence for the importance of 24-h IOP measurements in glaucoma and discusses shortcomings of current methods to assess 24-h IOP data, drawing attention to new developments in this field. PMID:23697618

  11. Research on measuring pipe tray processing man-hour quota based on genetic neural network

    Directory of Open Access Journals (Sweden)

    Yanhua Pan

    2017-11-01

    Full Text Available Tray is the unit of infield fabrication of the ship pipes. The number of pipes in each tray is different, and the structure of pipe itself is complex, resulting in more difficulty in determination of the entire pipe tray processing man-hour. In order to exactly measure the pipe tray man-hour quota, this paper analyzes main characteristic quantity of the pipe tray and selects the relevant information of 60characteristic quantities of the pipe tray for analysis based on the genetic neural algorithm, and uses MATLAB software simulated data curve to construct a model for measurement of tray pipe processing man-hour, and substitute into new tray pipe man-hour data for verification. The research results show that it is feasible to use this method to predict the pipe tray processing man-hour. The conclusion has some reference values for the prediction of the pipe tray processing man-hour.

  12. The Provident Principal.

    Science.gov (United States)

    McCall, John R.

    This monograph offers leadership approaches for school principals. Discussion applies the business leadership theory of Warren Bennis and Burt Nanus to the role of the principal. Each of the booklet's three parts concludes with discussion questions. Part 1, "Visions and Values for the Provident Principal," demonstrates the importance of…

  13. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

    Science.gov (United States)

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    Institute of Medicine report has been largely confined to the medical education community, led by the Accreditation Council for Graduate Medical Education (ACGME). To begin gathering these perspectives and developing a plan to implement safer work hours for resident physicians, a conference entitled "Enhancing sleep, supervision and safety: What will it take to implement the Institute of Medicine recommendations?" was held at Harvard Medical School on June 17-18, 2010. This White Paper is a product of a diverse group of 26 representative stakeholders bringing relevant new information and innovative practices to bear on a critical patient safety problem. Given that our conference included experts from across disciplines with diverse perspectives and interests, not every recommendation was endorsed by each invited conference participant. However, every recommendation made here was endorsed by the majority of the group, and many were endorsed unanimously. Conference members participated in the process, reviewed the final product, and provided input before publication. Participants provided their individual perspectives, which do not necessarily represent the formal views of any organization. In September 2010 the ACGME issued new rules to go into effect on July 1, 2011. Unfortunately, they stop considerably short of the Institute of Medicine's recommendations and those endorsed by this conference. In particular, the ACGME only applied the limitation of 16 hours to first-year resident physicans. Thus, it is clear that policymakers, hospital administrators, and residency program directors who wish to implement safer health care systems must go far beyond what the ACGME will require. We hope this White Paper will serve as a guide and provide encouragement for that effort. RESIDENT PHYSICIAN WORKLOAD AND SUPERVISION: By the end of training, a resident physician should be able to practice independently. Yet much of resident physicians' time is dominated by tasks with little

  14. WordPress 24-hour trainer

    CERN Document Server

    Plumley, George

    2015-01-01

    Create and expand feature-rich sites with no programming experience Ready to build, maintain, and expand your web site with WordPress but have no prior programming experience? WordPress 24-Hour Trainer, 3rd Edition is your book-and-video learning solution that walks you step-by-step through all the important features you will need to know. Lessons range from focused, practical everyday tasks to more advanced, creative features. Learn from an industry professional how to enter content, create pages, manage menus, utilize plug-ins, connect to social media, create membership and e-commerce site

  15. Gate A: changes to opening hours

    CERN Multimedia

    2015-01-01

    Due to maintenance work, the opening hours of Gate A (near Reception) will be modified between Monday, 13 and Friday, 17 April 2015.   During this period, the gate will be open to vehicles between 7 a.m. and 9.30 a.m., then between 4.30 p.m. and 7 p.m. It will be completely closed to traffic between 9.30 a.m. and 4.30 p.m. Pedestrians and cyclists may continue to use the gate. We apologise for any inconvenience and thank you for your understanding.

  16. Temporary new opening hours for Gate C

    CERN Multimedia

    GS Department

    2010-01-01

    Please note the new temporary opening hours for the gate C as from 22 September 2010 until 29 October 2010 (working days): Morning: between 7:00 a.m. and 9:00 a.m. Lunch: between 12:00 and 2:00 p.m. Evening: between 5:00 pm and 7:00 p.m. Traffic flow will be permitted in both directions during this period. Please minimize your speed accordingly and respect all road signs. GS-SEM Group General Infrastructure Services Department

  17. Strategies for 96-hour critical infrastructure compliance.

    Science.gov (United States)

    Storbakken, Steven H; Kendall, Shannon; Lackey, Connie

    2009-01-01

    Organizations that stand the best chance at survival following a disaster do so because they can depend on the sharing of resources and mutual ideologies, the authors claim, pointing out that when it comes to strategizing for 96-hour critical infrastructure compliance, it is important to keep at the forefront not only the idea of collaborative planning from within the organization--involving security and safety, clinical, facilities and administrative staffs--but also includes collaborative planning with the local and regional businesses surrounding the organization.

  18. Production Facility Prototype Blower 1000 Hour Test Results II

    Energy Technology Data Exchange (ETDEWEB)

    Wass, Alexander Joseph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Woloshun, Keith Albert [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dale, Gregory E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dalmas, Dale Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Romero, Frank Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-01-08

    Long duration tests of the Aerzen GM 12.4 roots style blower in a closed loop configuration provides valuable data and lessons learned for long-term operation at the Mo-99 production facility. The blower was operated in a closed loop configuration with the flow conditions anticipated in plant operation with a Mo-100 target inline. The additional thermal energy generated from beam heating of the Mo-100 disks were not included in these tests. Five 1000 hour tests have been completed since the first test was performed in January of 2016. All five 1000 hour tests have proven successful in exposing preventable issues related to oil and helium leaks. All blower tests to this date have resulted in stable blower performance and consistency. A summary of the results for each test, including a review of the first and second tests, are included in this report.

  19. 3B.02: 24-HOUR AMBULATORY CENTRAL BLOOD PRESSURE VARIABILITY AND TARGET-ORGAN DAMAGE IN ADOLESCENTS AND YOUNG ADULTS.

    Science.gov (United States)

    Ntineri, A; Kollias, A; Zeniodi, M; Moyssakis, I; Georgakopoulos, D; Servos, G; Vazeou, A; Stergiou, G S

    2015-06-01

    Some studies suggested that ambulatory blood pressure (ABP) variability may provide useful information beyond that of average ABP levels. This study investigated the relationship between central ABP variability and target-organ damage in young individuals in whom the central-peripheral blood pressure discrepancy might be considerable. Apparently healthy adolescents and young adults referred for elevated blood pressure and healthy volunteers (age 12-26 years) were subjected to: (i) 24-hour monitoring of central ABP using a noninvasive brachial cuff-based oscillometric device (Mobil-O-Graph 24 h PWA); (ii) 24-hour pulse wave velocity (PWV) monitoring (Mobil-O-Graph 24 h PWA); (iii) echocardiographic determination of left ventricular mass index (LVMI); (iv) measurement (ultrasonography) of the common carotid intima-media thickness (IMT). The standard deviation (SD) of ABP (24-hour weighted/awake/asleep), as well as the respective coefficients of variation (CV) were used for assessing variability. The study included 68 individuals (mean age 18.7 ± 4.7 years, 52 males, body mass index [BMI] 24.5 ± 4.7 kg/m, 24 volunteers, 15 with hypertension [24-hour peripheral ABP >=95th percentile for adolescents or >=130/80 mmHg for adults]). LVMI was correlated with 24-hour/awake/asleep central systolic ABP (r=0.50/0.49/0.40, all p ABP (r = 0.40/0.37/0.30, all p ABP (r = 0.94/0.88/0.84, all p ABP and SD/CV of ABP values), LVMI and 24-hour PWV were determined by BMI, age, and 24-hour central systolic ABP, and IMT by male gender and 24-hour weighted SD of central PP. In young individuals, 24-hour central ABP variability appears to be associated only with early carotid damage when accounting for ABP levels, whereas LVMI and PWV are mainly determined by average ABP levels.

  20. Insights from Smart Meters: The Potential for Peak-Hour Savings from Behavior-Based Programs

    Energy Technology Data Exchange (ETDEWEB)

    Todd, Annika; Perry, Michael; Smith, Brian; Sullivan, Michael; Cappers, Peter; Goldman, Charles

    2014-03-25

    The rollout of smart meters in the last several years has opened up new forms of previously unavailable energy data. Many utilities are now able in real-time to capture granular, household level interval usage data at very high-frequency levels for a large proportion of their residential and small commercial customer population. This can be linked to other time and locationspecific information, providing vast, constantly growing streams of rich data (sometimes referred to by the recently popular buzz word, “big data”). Within the energy industry there is increasing interest in tapping into the opportunities that these data can provide. What can we do with all of these data? The richness and granularity of these data enable many types of creative and cutting-edge analytics. Technically sophisticated and rigorous statistical techniques can be used to pull interesting insights out of this highfrequency, human-focused data. We at LBNL are calling this “behavior analytics”. This kind of analytics has the potential to provide tremendous value to a wide range of energy programs. For example, highly disaggregated and heterogeneous information about actual energy use would allow energy efficiency (EE) and/or demand response (DR) program implementers to target specific programs to specific households; would enable evaluation, measurement and verification (EM&V) of energy efficiency programs to be performed on a much shorter time horizon than was previously possible; and would provide better insights in to the energy and peak hour savings associated with specifics types of EE and DR programs (e.g., behavior-based (BB) programs). In this series, “Insights from Smart Meters”, we will present concrete, illustrative examples of the type of value that insights from behavior analytics of these data can provide (as well as pointing out its limitations). We will supply several types of key findings, including: • Novel results, which answer questions the industry

  1. Make a movie in 48 hours

    CERN Multimedia

    Brokk Toggerson

    2011-01-01

    This year, the 48-hour film project (48hfp) returns to Geneva after a one-year hiatus. Organized by Neal Hartman and the CERN film-making club, Open Your Eyes Films, the 48hfp challenges teams of film-makers to write, shoot, soundtrack and edit a 4 to 7 minute film in 48 hours from 4 to 6 November.   At the start of the festival, contestants picked their film genre from a hat. The films will be screened on 8 and 9 November, with the awards presentation on the 9th. The winner will receive a trip to the US to compete in the international version of the competition. “There are so many short films being made now," says Hartman, “I think, however, that the 48hfp allows a critical creative mass to form. The result is that these 20 teams make 20 better films than if each participant were making their own." Each team draws a genre from a hat and is given a character, a prop and a line of dialogue that must appear in their film. The genres run the gamut from &am...

  2. The importance and challenges of measuring work hours

    OpenAIRE

    Stewart, Jay

    2014-01-01

    Work hours are key components in estimating productivity growth and hourly wages as well as being a useful cyclical indicator in their own right, so measuring them correctly is important. The US Bureau of Labor Statistics (BLS) collects data on work hours in several surveys and publishes three widely-used series that measure average weekly hours. The series tell different stories about average weekly hours and trends in those hours but qualitatively similar stories about the cyclical behavior...

  3. Value Set Authority Center

    Data.gov (United States)

    U.S. Department of Health & Human Services — The VSAC provides downloadable access to all official versions of vocabulary value sets contained in the 2014 Clinical Quality Measures (CQMs). Each value set...

  4. PLSS Townships and Sections, The PLSS vector data provides value added, vector representations of the United States Public Land Survey System for Louisiana as depicted on the USGS 1:24,000 DRGs., Published in 2004, 1:24000 (1in=2000ft) scale, Louisiana State University (LSU).

    Data.gov (United States)

    NSGIC Education | GIS Inventory — PLSS Townships and Sections dataset current as of 2004. The PLSS vector data provides value added, vector representations of the United States Public Land Survey...

  5. Does a home-based strength and balance programme in people aged > or =80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions.

    Science.gov (United States)

    Davis, J C; Robertson, M C; Ashe, M C; Liu-Ambrose, T; Khan, K M; Marra, C A

    2010-02-01

    To investigate the value for money of strategies to prevent falls in older adults living in the community. Systematic review of peer reviewed journal articles reporting an economic evaluation of a falls prevention intervention as part of a randomised controlled trial or a controlled trial, or using an analytical model. MEDLINE, PUBMED, EMBASE and NHS EED databases were searched to identify cost-effectiveness, cost-utility and cost-benefit studies from 1945 through July 2008. The primary outcome measure was incremental cost-effectiveness, cost-utility and cost-benefit ratios in the reported currency and in pounds sterling at 2008 prices. The quality of the studies was assessed using two instruments: (1) an economic evaluation checklist developed by Drummond and colleagues and (2) the Quality of Health Economic Studies instrument. Nine studies meeting our inclusion criteria included eight cost-effectiveness analyses, one cost-utility and one cost-benefit analysis. Three effective falls prevention strategies were cost saving in a subgroup of (1) an individually customised multifactorial programme in those with four or more of the eight targeted fall risk factors, (2) the home-based Otago Exercise Programme in people > or =80 years and (3) a home safety programme in the subgroup with a previous fall. These three findings were from six studies that scored > or =75% on the Quality of Health Economic Studies instrument. Best value for money came from effective single factor interventions such as the Otago Exercise Programme which was cost saving in adults 80 years and older. This programme has broad applicability thus warranting warrants health policy decision-makers' close scrutiny.

  6. Official CERN holidays | Restaurant opening hours

    CERN Multimedia

    2013-01-01

    Please note that the CERN Restaurants will have the following opening hours during the upcoming holidays: Restaurant #1 will be open from 7 a.m. to 11 p.m. on Wednesday 1 May, Thursday 9 May (Ascension Thursday) and Monday 20 May (Pentecost) - on Friday 10 May the restaurant will be open at the usual times. Restaurant #2 will be closed over the 3 official CERN holidays, but will be open on Friday 10 May at the usual times (brasserie will be closed). Restaurant #3 will be closed over the 3 official CERN holidays, as well as Friday 10 May.

  7. PLANNING OF TRAINING AIRCRAFT FLIGHT HOURS

    Directory of Open Access Journals (Sweden)

    Visnja Vojvodić Rosenzweig

    2010-12-01

    Full Text Available Maintenance of the training aircraft causes downtime of operations and thereby reduces the operational availability, which is crucial for flight planning in a training organisation. Manual daily planning within the fleet delivers suboptimal results and often causes discontinued flight of several aircraft that have to be maintained at the same time. Optimal maintenance schedule of training aircraft can be obtained by a sliding scale method. This paper presents a mathematical model of the sliding scale formulated by a mixed integer linear problem. Allocation of flight hours is optimised by using AMPL programming language, assuring that a sufficient number of aircraft are always available for training. The model can be used by a flight dispatch department in a training organisation as a basis for optimised planning and reduction of maintenance downtime.

  8. 50 CFR 20.107 - Seasons, limits, and shooting hours for tundra swans.

    Science.gov (United States)

    2010-10-01

    ... tundra swans. 20.107 Section 20.107 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.107 Seasons, limits, and shooting hours for tundra swans. This section provides for the annual hunting of tundra swans in designated portions of the 48 contiguous United...

  9. 50 CFR 20.103 - Seasons, limits, and shooting hours for mourning and white-winged doves and wild pigeons.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Seasons, limits, and shooting hours for... BIRD HUNTING Annual Seasons, Limits, and Shooting Hours Schedules § 20.103 Seasons, limits, and shooting hours for mourning and white-winged doves and wild pigeons. This section provides for the annual...

  10. Just Checking In: The Effect of an Office Hour Meeting and Learning Reflection in an Introductory Statistics Course

    Science.gov (United States)

    McGrath, April L.

    2014-01-01

    Office hours provide time outside of class for students to consult with instructors about course material, progress, and evaluation. Yet office hours, at times, remain an untapped source of academic support. The current study examined whether office hour attendance in combination with a learning reflection would help students learn material in an…

  11. The spatial return level of aggregated hourly extreme rainfall in Peninsular Malaysia

    Science.gov (United States)

    Shaffie, Mardhiyyah; Eli, Annazirin; Wan Zin, Wan Zawiah; Jemain, Abdul Aziz

    2015-07-01

    This paper is intended to ascertain the spatial pattern of extreme rainfall distribution in Peninsular Malaysia at several short time intervals, i.e., on hourly basis. Motivation of this research is due to historical records of extreme rainfall in Peninsular Malaysia, whereby many hydrological disasters at this region occur within a short time period. The hourly periods considered are 1, 2, 3, 6, 12, and 24 h. Many previous hydrological studies dealt with daily rainfall data; thus, this study enables comparison to be made on the estimated performances between daily and hourly rainfall data analyses so as to identify the impact of extreme rainfall at a shorter time scale. Return levels based on the time aggregate considered are also computed. Parameter estimation using L-moment method for four probability distributions, namely, the generalized extreme value (GEV), generalized logistic (GLO), generalized Pareto (GPA), and Pearson type III (PE3) distributions were conducted. Aided with the L-moment diagram test and mean square error (MSE) test, GLO was found to be the most appropriate distribution to represent the extreme rainfall data. At most time intervals (10, 50, and 100 years), the spatial patterns revealed that the rainfall distribution across the peninsula differ for 1- and 24-h extreme rainfalls. The outcomes of this study would provide additional information regarding patterns of extreme rainfall in Malaysia which may not be detected when considering only a higher time scale such as daily; thus, appropriate measures for shorter time scales of extreme rainfall can be planned. The implementation of such measures would be beneficial to the authorities to reduce the impact of any disastrous natural event.

  12. Analysis of 24-hour versus 48-hour traffic counts for HPMS sampling.

    Science.gov (United States)

    2014-04-01

    The Illinois Department of Transportation (IDOT) has requested a waiver from the Federal Highway Administration (FHWA) to : allow IDOT to implement a 24-hour traffic-count program on the non-state HPMS routes, as opposed to the current Highway : Perf...

  13. Generation of hourly solar radiation for inclined surfaces using monthly mean sunshine duration in Algeria

    Energy Technology Data Exchange (ETDEWEB)

    Mefti, A.; Bouroubi, M.Y. [Centre of Development of Renewable Energy, Lab. of Energy Resources, Algiers (Algeria); Adane, A. [Univ. of Science and Technology of Algiers (U.S.T.H.B.), Lab. of Image Processing and Radiation, Algiers (Algeria)

    2003-11-01

    Hourly global solar radiation flux incident on an inclined surface is evaluated in any site of Algeria using monthly mean daily sunshine duration measurements. The methodology used consists of successive transformations of solar data, respectively, based on the exponential probability distribution of daily sunshine duration, Angstrom equation, beta probability distribution of hourly global solar radiation flux, polynomial correlations of hourly direct and diffuse radiation with global solar radiation and the Klucher model. Monthly mean values of daily sunshine duration data recorded in 54 meteorological stations of Algeria and hourly solar radiation data collected in Algiers, Bechar and Tamanrasset are available for this study. Knowing the monthly mean daily sunshine duration measurements, the hourly global solar radiation data are then obtained on a tilted surface for the locations of Algiers, Tamanrasset and Bechar. The monthly mean hourly global solar radiation data estimated for Algiers are in reasonably good agreement with the experimental ones. Associated with the principal component analysis, the above method has been extended to all the other meteorological stations, and monthly mean values of hourly global solar radiation flux incident on an inclined surface have been simulated for every site of Algeria. This yields an important database useful for solar energy applications. (Author)

  14. Hour-by-hour physical activity patterns of adults aged 45–65 years : A cross-sectional study

    NARCIS (Netherlands)

    Jansen, F M; van Kollenburg, G.H.; Kamphuis, C B M; Pierik, F H; Ettema, D F

    2018-01-01

    Background Limited information exists on hour-by-hour physical activity (PA) patterns among adults aged 45–65 years. Therefore, this study aimed to distinguish typical hour-by-hour PA patterns, and examined which individuals typically adopt certain PA patterns. Methods Accelerometers measured light

  15. Job-related stress in academia : the role of relative deprivation, hours worked for different tasks, and childre

    OpenAIRE

    Takahashi, Ana Maria

    2014-01-01

    We examine the role of income relative deprivation, hours worked for different tasks, and children in the job-related stress experienced by academics. Males' job-related stress increases when their incomes are lower than that of their peers', but females are not susceptible to such income comparisons. Job-related stress decreases with hours spent on research provided the hours are not excessive, but hours spent in teaching and on administrative tasks always increase job-related stress. The pr...

  16. The value compass

    NARCIS (Netherlands)

    Erik Jan Kostelijk

    2015-01-01

    In the psychological field, a lot of progress has been made in values theory. In marketing theory, however, the use of values has been undervalued. Despite the widespread managerial use of brand values, attention has remained focused on the brand personality concept. This book intends to provide a

  17. Value Investing

    OpenAIRE

    Kubínyi, Tomáš

    2014-01-01

    This bachelor's thesis deals with value investing in the form defined by Benjamin Graham. In clarifying the theoretical aspects, particular attention is given to an intrinsic value of stocks and to its calculation methods. A way to overcome the deficiencies in the two most widely used models of calculation is introduced. It is value screening, which by defining of certain criteria makes an assumption of undervalued stocks. Then the investment approach of the most successful investor, Warren B...

  18. Reduced antiplatelet effect of aspirin during 24 hours in patients with coronary artery disease and type 2 diabetes.

    Science.gov (United States)

    Christensen, Kristian H; Grove, Erik L; Würtz, Morten; Kristensen, Steen D; Hvas, Anne-Mette

    2015-01-01

    Reduced antiplatelet effect of aspirin has been reported in patients with type 2 diabetes, and recent studies suggest that once-daily aspirin provides insufficient platelet inhibition. We investigated if the effect of aspirin declined during the 24-hour dosing interval in patients with coronary artery disease and type 2 diabetes, and whether this correlated with increased platelet turnover. Furthermore, the intra-individual variation in platelet aggregation was determined during a 28-day period. We included 47 patients with coronary artery disease and type 2 diabetes treated with aspirin 75 mg daily. Blood samples were obtained 1 and 24 hours after aspirin intake, and this was repeated three times with a 2-week interval between each visit. Platelet aggregation was evaluated by impedance aggregometry (Multiplate® Analyzer) using arachidonic acid (1.0 mM) and collagen (3.2 µg/ml) as agonists. Markers of platelet turnover were measured by flow cytometry. Compliance was confirmed by serum thromboxane B2. Platelet aggregation levels measured 1 and 24 hours after aspirin intake were compared using the mean of 1- and 24-hour measurements at the three study visits. The difference in platelet aggregation was 70 ± 97 AU × min (p aspirin intake (p values 0.06 and 0.07). Median intra-individual variation of platelet aggregation was 9-16%. Patients with coronary artery disease and type 2 diabetes had increased platelet aggregation at the end of the 24-hour aspirin dosing interval. Platelet turnover did not correlate significantly with residual platelet aggregation, although a trend was observed. The intra-individual variation of platelet aggregation after aspirin intake was low.

  19. Households' hourly electricity consumption and peak demand in Denmark

    DEFF Research Database (Denmark)

    Møller Andersen, Frits; Baldini, Mattia; Hansen, Lars Gårn

    2017-01-01

    The electrification of residential energy demand for heating and transportation is expected to increase peak load and require additional generation and transmission capacities. Electrification also provides an opportunity to increase demand response. With a focus on household electricity consumpt......The electrification of residential energy demand for heating and transportation is expected to increase peak load and require additional generation and transmission capacities. Electrification also provides an opportunity to increase demand response. With a focus on household electricity...... consumption, we analyse the contribution of appliances and new services, such as individual heat pumps and electric vehicles, to peak consumption and the need for demand response incentives to reduce the peak.Initially, the paper presents a new model that represents the hourly electricity consumption profile...... to a considerable introduction of electric vehicles and individual heat pumps, household consumption is expected to increase considerably, especially peak hour consumption is expected to increase.Next the paper presents results from a new experiment where household customers are given economic and/or environmental...

  20. Ergonomic Microscope: Need of the Hour

    Science.gov (United States)

    Mhaske, Shubhangi Ashok; Ahmad, Malik Ajaz; Yuwanati, Monal B.; Prabhu, Shweta; Pardhe, Nilesh

    2015-01-01

    Background Prolonged use of conventional microscope develops musculo-skeletal injuries like chronic pain syndrome, including shoulder, neck, back aches & fatigue. Since the problems go unnoticed, the injuries can lead to some serious permanent damages. This further leads to a compromise in the health and welfare of the person and the institute. Hence, an understanding about the ergonomics is the need of the hour in this postmodern era. Inspite of few studies and surveys about ergonomics, there is still a steep rise in the musculoskeletal disorders. Aim of the Study The aim of our study was to gauge the general awareness of pathologists, microbiologists and oral pathologists towards ergonomics in their profession. Materials and Methods A cross-sectional survey based study was de­signed, which included a questionnaire. The questionnaire included multiple choice questions with four alternatives. Professionals (pathologists, microbiologists and oral pathologists) were included in the survey. Teaching faculty (Professors, Associate Professors and Lecturers) and Post graduate students formed the study group. Results and Observations The response to the questionnaire was 100%. Less than 50% of oral pathologists were aware of the importance of ergonomics in their profession. The most common site affected was neck and back. One of the drastic observations was that, Oral Pathologists suffered from a combination of problems affecting neck, back, eyes, headache, shoulders, arms and wrists. Conclusion Increase in our understanding regarding ergonomic­ally designed microscopes can increase our efficiency and in turn improve our general well-being. With improvements in ergonomics, professionals would be able to modify and optimize their working conditions. Certain guidelines need to be followed by the profes­sionals to reduce chances of musculoskeletal disorders. PMID:26155565

  1. Impact of 24-hour helpline service for people with diabetes.

    Science.gov (United States)

    Ahmed, Farrukh; Asim-Bin-Zafar; Riaz, Musarrat; Ghafoor, Erum; Rehman, Rabia Abdul; Uddin, Qutub

    2017-01-01

    To evaluate the impact and effectiveness of 24-hour helpline service in providing information and educating patients about self-management of diabetes. The study was conducted at Baqai Institute of Diabetology & Endocrinology (BIDE), a tertiary diabetes care center, Karachi, Pakistan. People with diabetes attending the outpatient department from November 2012 to October 2014 were included in this study. After providing diabetes education, a helpline number was provided for emergency situations. Calls of registered patients were received by diabetes educators stationed at the BIDE around the clock. Data was collected through specially designed interface of HMS (health management system) in which the current complaint of caller and the advice of educator was recorded. A total of 4842 calls were received. Out of those, 4268 (88%) were made by Type-2 diabetics and 526 calls (10%) were made by Type-1 diabetics. The average age of patients was 47.6 years. Three seventy-four calls (7.7%) were received with complaint of Hypoglycemia (72-80mg/dl). Six hundred and ninety-eight calls (14.4%) were received with complaint of hyperglycemia (>200mg/dl). Insulin dose was adjusted on 935 calls (19.3%). Calls regarding other special situations such as (insulin handling, technique, medicine information) 2014 (41.6%) were received. Station based 24-hour telephonic helpline service is an effective tool for providing continuous support to people with diabetes and their families, for the self-management of diabetes. It can help in the management of various acute complication of diabetes, thereby preventing unnecessary hospital visits and admission.

  2. The value of value congruence.

    Science.gov (United States)

    Edwards, Jeffrey R; Cable, Daniel M

    2009-05-01

    Research on value congruence has attempted to explain why value congruence leads to positive outcomes, but few of these explanations have been tested empirically. In this article, the authors develop and test a theoretical model that integrates 4 key explanations of value congruence effects, which are framed in terms of communication, predictability, interpersonal attraction, and trust. These constructs are used to explain the process by which value congruence relates to job satisfaction, organizational identification, and intent to stay in the organization, after taking psychological need fulfillment into account. Data from a heterogeneous sample of employees from 4 organizations indicate that the relationships that link individual and organizational values to outcomes are explained primarily by the trust that employees place in the organization and its members, followed by communication, and, to a lesser extent, interpersonal attraction. Polynomial regression analyses reveal that the relationships emanating from individual and organizational values often deviated from the idealized value congruence relationship that underlies previous theory and research. The authors' results also show that individual and organizational values exhibited small but significant relationships with job satisfaction and organizational identification that bypassed the mediators in their model, indicating that additional explanations of value congruence effects should be pursued in future research. (c) 2009 APA, all rights reserved.

  3. After-hours care and its coordination with primary care in the U.S.

    Science.gov (United States)

    O'Malley, Ann S; Samuel, Divya; Bond, Amelia M; Carrier, Emily

    2012-11-01

    Despite expectations that medical homes provide "24 × 7 coverage" there is little to guide primary care practices in developing sustainable models for accessible and coordinated after-hours care. To identify and describe models of after-hours care in the U.S. that are delivered in primary care sites or coordinated with a patient's usual primary care provider. Qualitative analysis of data from in-depth telephone interviews. Primary care practices in 16 states and the organizations they partner with to provide after-hours coverage. Forty-four primary care physicians, practice managers, nurses and health plan representatives from 28 organizations. Analyses examined after-hours care models, facilitators, barriers and lessons learned. Based on 28 organizations interviewed, five broad models of after-hours care were identified, ranging in the extent to which they provide continuity and patient access. Key themes included: 1) The feasibility of a model varies for many reasons, including patient preferences and needs, the local health care market supply, and financial compensation; 2) A shared electronic health record and systematic notification procedures were extremely helpful in maintaining information continuity between providers; and 3) after-hours care is best implemented as part of a larger practice approach to access and continuity. After-hours care coordinated with a patient's usual primary care provider is facilitated by consideration of patient demand, provider capacity, a shared electronic health record, systematic notification procedures and a broader practice approach to improving primary care access and continuity. Payer support is important to increasing patients' access to after-hours care.

  4. Value Representations

    DEFF Research Database (Denmark)

    Rasmussen, Majken Kirkegaard; Petersen, Marianne Graves

    2011-01-01

    Stereotypic presumptions about gender affect the design process, both in relation to how users are understood and how products are designed. As a way to decrease the influence of stereotypic presumptions in design process, we propose not to disregard the aspect of gender in the design process......, as the perspective brings valuable insights on different approaches to technology, but instead to view gender through a value lens. Contributing to this perspective, we have developed Value Representations as a design-oriented instrument for staging a reflective dialogue with users. Value Representations...

  5. Providing Compassion through Flow

    Directory of Open Access Journals (Sweden)

    Lydia Royeen

    2015-07-01

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

  6. Do We Provide Opportunities or Only Value Productivity?

    Science.gov (United States)

    de la Iglesia Mayol, Begona

    2006-01-01

    With a view to improving the quality of life of persons living with disabilities without direct intervention but in the context of action at the level of their personal development, and with the institutional support of the University of the Balearic Islands and funding from "SA Nostra" Caixa de Balears, we decided to develop, implement…

  7. Defining, valuing and providing ecosystem goods and services

    Science.gov (United States)

    Thomas C. Brown; John C. Bergstrom; John B. Loomis

    2007-01-01

    Ecosystem services are the specific results of ecosystem processes that either directly sustain or enhance human life (as does natural protection from the sun's harmful ultraviolet rays) or maintain the qualify of ecosystem goods (as water purification maintains the quality of streamflow). "Ecosystem service" has come to represent several related topics...

  8. Rush Hour Pollution May Be Worse Than Thought

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_167478.html Rush Hour Pollution May Be Worse Than Thought Higher ... what you're inhaling as you idle in rush-hour traffic? New research finds air pollution levels ...

  9. CMAQv502 Base AQS Hourly site compare output

    Data.gov (United States)

    U.S. Environmental Protection Agency — Monthly AQS hourly site compare output files for the CMAQv502 Base simulation. Monthly files contain hourly paired model/ob data for the AQS network. These data were...

  10. Psychiatry out-of-hours: a focus group study of GPs' experiences in Norwegian casualty clinics

    Directory of Open Access Journals (Sweden)

    Carlsen Benedicte

    2011-05-01

    Full Text Available Abstract Background For Norwegian general practitioners (GPs, acute treatment of mental illness and substance abuse are among the most commonly experienced emergency situations in out-of-hours primary healthcare. The largest share of acute referrals to emergency psychiatric wards occurs out-of-hours, and out-of-hours services are responsible for a disproportionately high share of compulsory referrals. Concerns exist regarding the quality of mental healthcare provided in the out-of-hours setting. The aim of this study was to explore which challenges GPs experience when providing emergency care out-of-hours to patients presenting problems related to mental illness or substance abuse. Methods We conducted a qualitative study based on two individual interviews and six focus groups with purposively sampled GPs (totally 45 participants. The interviews were analysed successively in an editing style, using a thematic approach based on methodological descriptions by Charmaz and Malterud. Results Safety and uncertainty were the dominating themes in the discussions. The threat to personal safety due to unpredictable patient behaviour was a central concern, and present security precautions in the out-of-hours services were questioned. The GPs expressed high levels of uncertainty in their work with patients presenting problems related to mental illness or substance abuse. The complexity of the problems presented, shortage of time, limited access to reliable information and limited range of interventions available during out-of-hours contributed to this uncertainty. Perceived access to second opinion seemed to have a major impact on subjectively experienced work stress. Conclusions The GPs experienced out-of-hours psychiatry as a field with high levels of uncertainty and limited support to help them meet the experienced challenges. This might influence the quality of care provided. If the current organisation of emergency mental healthcare is to be kept, we

  11. Off-Hour Surgery Among Orthopedic Subspecialties at an Urban, Quaternary-Care, Level 1 Trauma Center.

    Science.gov (United States)

    Lans, Amanda; Janssen, Stein J; Ring, David

    2016-12-01

    night. These data can inform how we organize, value, and incentivize off-hour care. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  12. Impact of working hours on work-life balance

    OpenAIRE

    Holly, Sarah; Mohnen, Alwine

    2012-01-01

    To examine the influence of working hours on employees' satisfaction, this article uses a large, representative set of panel data from German households (GSOEP). The results show that high working hours and overtime in general do not lead to decreased satisfaction. Rather, increasing working hours and overtime have positive effects on life and job satisfaction, whereas the desire to reduce working hours has a negative impact on satisfaction. In 2009, nearly 60% of employees wanted to reduce t...

  13. Twenty-four hour intraocular pressure measurements and home tonometry.

    Science.gov (United States)

    Meier-Gibbons, Frances; Berlin, Michael S; Töteberg-Harms, Marc

    2018-03-01

    IOP is the only treatable risk factor contributing to glaucoma and most management and treatment of glaucoma is based on IOP. However, current IOP measurements are limited to office hours and control of glaucoma in many patients would benefit from the ability to monitor IOP diurnally so as not to miss abnormal pressures, which occur outside of office hours Consequently, to improve patient care, the ability to enable accurate and minimally disruptive diurnal IOP monitoring would improve caring for these patients. The studies we selected for this review can be divided into three categories: self-/home-tonometry, continuous invasive intraocular pressure measurements, and continuous noninvasive ocular measurements. The desire to obtain better insight in our patients' true diurnal IOP has led to the development of home-tonometers, in addition to extraocular and intraocular continuous pressure measurement devices. All of the devices have respective advantages and disadvantages, but none to date completely fulfills the goal of providing a true diurnal IOP profile.Video abstracthttp://links.lww.com/COOP/A27.

  14. Hourly Calculation Method of Air Source Heat Pump Behavior

    Directory of Open Access Journals (Sweden)

    Ludovico Danza

    2016-04-01

    Full Text Available The paper describes an hourly simplified model for the evaluation of the energy performance of heat pumps in cooling mode maintaining a high accuracy and low computational cost. This approach differs from the methods used for the assessment of the overall energy consumption of the building, normally placed in the so-called white or black box models, where the transient conduction equation is deterministically and stochastically solved, respectively. The present method wants to be the expression of the grey box model, taking place between the previous approaches. The building envelope is defined using a building thermal model realized with a 3 Resistance 1 Capacitance (3R1C thermal network based on the solution of the lumped capacitance method. The simplified model evaluates the energy efficiency ratio (EER of a heat pump through the determination of the hourly second law efficiency of a reversed Carnot cycle. The results of the simplified method were finally compared with those provided by EnergyPlus, a dynamic building energy simulation program, and those collected from an outdoor test cell in real working conditions. The results are presented in temperatures and energy consumptions profiles and are validated using the Bland-Altman test.

  15. 24-hour intraocular pressure and ocular perfusion pressure in glaucoma.

    Science.gov (United States)

    Quaranta, Luciano; Katsanos, Andreas; Russo, Andrea; Riva, Ivano

    2013-01-01

    This review analyzes the currently available literature on circadian rhythms of intraocular pressure (IOP), blood pressure, and calculated ocular perfusion pressure (OPP) in patients with open-angle glaucoma. Although adequately powered, prospective trials are not available. The existing evidence suggests that high 24-hour IOP and OPP fluctuations can have detrimental effects in eyes with glaucoma. The currently emerging continuous IOP monitoring technologies may soon offer important contributions to the study of IOP rhythms. Once telemetric technologies become validated and widely available for clinical use, they may provide an important tool towards a better understanding of long- and short-term IOP fluctuations during a patient's daily routine. Important issues that need to be investigated further include the identification of appropriate surrogate measures of IOP and OPP fluctuation for patients unable to undergo 24-hour measurements, the determination of formulae that best describe the relationship between systemic blood pressure and IOP with OPP, and the exact clinical relevance of IOP and OPP fluctuation in individual patients. Despite the unanswered questions, a significant body of literature suggests that OPP assessment may be clinically relevant in a significant number of glaucoma patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Hourly Electricity Prices in Day-Ahead Markets

    NARCIS (Netherlands)

    R. Huisman (Ronald); C. Huurman; R.J. Mahieu (Ronald)

    2007-01-01

    textabstractThis paper focuses on the characteristics of hourly electricity prices in day-ahead markets. In these markets, quotes for day-ahead delivery of electricity are submitted simultaneously for all hours in the next day. The same information set is used for quoting all hours of the day. The

  17. "Hour of Code": Can It Change Students' Attitudes toward Programming?

    Science.gov (United States)

    Du, Jie; Wimmer, Hayden; Rada, Roy

    2016-01-01

    The Hour of Code is a one-hour introduction to computer science organized by Code.org, a non-profit dedicated to expanding participation in computer science. This study investigated the impact of the Hour of Code on students' attitudes towards computer programming and their knowledge of programming. A sample of undergraduate students from two…

  18. 19 CFR 101.6 - Hours of business.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Hours of business. 101.6 Section 101.6 Customs... GENERAL PROVISIONS § 101.6 Hours of business. Except as specified in paragraphs (a) through (g) of this section, each CBP office shall be open for the transactions of general CBP business between the hours of 8...

  19. Evaluation of a nurse practitioner-led extended hours mental health liaison nurse service based in the emergency department.

    Science.gov (United States)

    Wand, Timothy; D'Abrew, Natalie; Barnett, Catherine; Acret, Louise; White, Kathryn

    2015-02-01

    To evaluate a nurse practitioner (NP)-led extended hours mental health liaison nurse (MHLN) service based in the emergency department (ED) of an inner city teaching hospital in Sydney and to explicate a model of care that is transferable across a broad range of ED settings, both in metropolitan and rural contexts. This mixed-methods evaluation encompassed descriptive data on ED mental health presentations, quantifying waiting times for MHLN involvement and interviews with MHLN team members at the commencement of the evaluation and 12 months later. Interviews were also conducted with a snapshot of ED patients, and a sample of ED and psychiatry staff. The expanded MHLN service was rapidly incorporated into the ED structure, enthusiastically endorsed by ED patients and highly valued by staff and the organisation. The MHLN team saw 55% of referred patients within the first hour of arrival (frequently before medical assessment), thereby initiating and expediting co-ordination of care at an early stage of the ED process. An NP-led extended hours MHLN team based in the ED provides prompt and effective access to specialised mental health care for people with 'undifferentiated health problems', and removes a significant workload from nursing and medical staff. Embedding the NP-led MHLN service within the ED structure was pivotal to the success and sustainability of this model of care.

  20. 77 FR 28423 - Final Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard...

    Science.gov (United States)

    2012-05-14

    ... the 1997 8-Hour Ozone National Ambient Air Quality Standard: Classification of Areas That Were... National Ambient Air Quality Standard: Classification of Areas That Were Initially Classified Under Subpart.... Initial classifications are based on the 8-hour ozone design values (derived from 2001-2003 air quality...

  1. Hourly Electricity Prices in Day-Ahead Markets

    OpenAIRE

    Huisman, Ronald; Huurman, C.; Mahieu, Ronald

    2007-01-01

    textabstractThis paper focuses on the characteristics of hourly electricity prices in day-ahead markets. In these markets, quotes for day-ahead delivery of electricity are submitted simultaneously for all hours in the next day. The same information set is used for quoting all hours of the day. The dynamics of hourly electricity prices does not behave as a time series process. Instead, these prices should be treated as a panel in which the prices of 24 cross-sectional hours vary from day to da...

  2. The Value of Value Sets

    DEFF Research Database (Denmark)

    Sløk-Madsen, Stefan Kirkegaard; Christensen, Jesper

    behavior. This paper attempt to test such a claim. This is done via unique and privileged access to top-level managers in a Fortune 250 company. This company is special in having very well-defined, long-running values that are in opposition to a narrowly defined homo-economics rationality. These values...... involving vignettes and games. Their results were compared to their actual knowledge of the content of the company corporate values. The results were tested against hypotheses on expected rational behavior and a control group consisting of similar level managers from other companies. This study makes...... and anecdotally true surprisingly little hard evidence has been produced either for or against. This study attempts to rectify this. The study claims that for corporate values to matter they must at least align, and potentially alter, employee decision-making hence their concept of optimality and rational...

  3. Mesoscale storm and dry period parameters from hourly precipitation data: program documentation

    Energy Technology Data Exchange (ETDEWEB)

    Thorp, J.M.

    1984-09-01

    Wet deposition of airborne chemical pollutants occurs primarily from precipitation. Precipitation rate, amount, duration, and location are important meteorological factors to be considered when attempting to understand the relationship of precipitation to pollutant deposition. The Pacific Northwest Laboratory (PNL) has conducted studies and experiments in numerous locations to collect data that can be incorporated into theories and models that attempt to describe the complex relationship between precipitation occurrence and chemical wet desposition. Model development often requires the use of average rather than random condition as input. To provide mean values of storm parameters, the task, Climatological Analysis of Mesoscale Storms, was created as a facet of the Environmental Protection Agency's related-service project, Precipitation Scavenging Module Development. Within this task computer programs have been developed at PNL which incorporate hourly precipitation data from National Weather Service stations to calculate mean values and frequency distributions of precipitation periods and of the interspersed dry periods. These programs have been written with a degree of flexibiity that will allow user modification for applications to different, but similar, analyses. This report describes in detail the rationale and operation of the two computer programs which produce the tables of average and frequency distributions of storm and dry period parameters from the precipitation data. A listing of the programs and examples of the generated output are included in the appendices. 3 references, 3 figures, 6 tables.

  4. 2,445 Hours of Code: What I Learned from Facilitating Hour of Code Events in High School Libraries

    Science.gov (United States)

    Colby, Jennifer

    2015-01-01

    This article describes a school librarian's experience with initiating an Hour of Code event for her school's student body. Hadi Partovi of Code.org conceived the Hour of Code "to get ten million students to try one hour of computer science" (Partovi, 2013a), which is implemented during Computer Science Education Week with a goal of…

  5. Systematic screening of child abuse in out-of-hours primary care

    NARCIS (Netherlands)

    Schouten, MCM

    2017-01-01

    Child abuse is a serious global health problem. This thesis focused on – improving – the detection of child abuse in the out-of-hours primary care (OOH-PC). The main aim was to assess the diagnostic value of the screening instrument SPUTOVAMO-R2 for child abuse. We found that the detection rate of

  6. Randomized clinical trial between hourly titrated and 2 hourly static oral misoprostol solution for induction of labor.

    Science.gov (United States)

    Rouzi, Abdulrahim A; Alsahly, Nora; Alamoudi, Rana; Almansouri, Nisma; Alsinani, Nawal; Alkafy, Souzan; Rozzah, Rayyan; Abduljabbar, Hassan

    2017-04-01

    Misoprostol is an effective agent for the induction of labor. Existing guidelines recommend oral misoprostol solution 25 μg every 2 hours. However, more research is required to optimize the use of oral misoprostol solution for the induction of labor. The purpose of this study was to compare efficacy and safety of hourly titrated-dose oral misoprostol solution with static-dose oral misoprostol solution every 2 hours for labor induction. In this randomized controlled study, oral misoprostol solution was administered as (1) 20 μg hourly (≤4 doses) that was increased in the absence of regular uterine contractions to 40 μg hourly (≤4 doses) and then to 60 μg hourly (≤16 doses) or (2) 25 μg every 2 hours until active labor began (≤12 doses). A sample size of 146 women was planned with the use of a projected 95% rate for the primary endpoint (vaginal delivery within 24 hours) for hourly titrated-dose misoprostol and 80% rate for static-dose misoprostol every 2 hours. Safety outcomes included maternal morbidity and adverse neonatal outcomes. From December 2013 to July 2015, 146 women were assigned randomly to treatment. Demographic and clinical factors were similar between groups, except for age. Vaginal delivery was achieved within 24 hours in 47 women (64.4%) who received hourly titrated-doses of misoprostol solution and 48 women (65.8%) who received 2-hourly static-dose misoprostol solution (P=1.00). Rates of vaginal delivery within 24 hours did not differ significantly between treatment groups for women who were nulliparous (P=1.00) or who had postterm pregnancies (P=.66), a Bishop score of ≤3 (P=.84), or oxytocin augmentation (P=.83). Cesarean deliveries were performed within 24 hours in 9 women who received hourly titrated-dose misoprostol solution and 2 women who received 2-hourly static-dose misoprostol solution (P=.056). Pyrexia and meconium-stained liquor occurred more frequently with the hourly titrated-dose regimen. The static-dose oral

  7. The value of space

    DEFF Research Database (Denmark)

    Panduro, Toke Emil

    are concerned with the value of different types of green space and how these values can be applied in urban planning policies related to climate adaption. The results presented in this thesis, ensure a “level playing field” in the assessment of the cost and benefits of different climate adaptation strategies...... and provide reliable estimates of the value of different types of green space....

  8. Value Chain Engineering

    DEFF Research Database (Denmark)

    Wæhrens, Brian Vejrum; Slepniov, Dmitrij

    2015-01-01

    This workbook is recommended for the attention of students of and managers in Danish small and medium sized enterprises (SMEs). Danish SMEs are currently facing a number of key challenges related to their position in global value chains. This book provides an insight into value chain management...

  9. Values and Governance Systems

    NARCIS (Netherlands)

    Ruys, P.H.M.; van den Brink, J.R.; Semenov, R.

    1999-01-01

    Cooperative behavior as well as other cultural rules and values are made explicit in organizational units that procure and provide a common service. The common service is procured by a club, which consists of a user-value function, a representation governance, and a budget-allocation function. The

  10. International 24-Hour LEO Space Debris Measurement Campaign 2015

    Science.gov (United States)

    Hamilton, Joseph; Letsch, Klemens; Blackwell, Christopher; McSheehy, Richard; Quanette, Juarez

    2017-01-01

    The Inter-Agency Space Debris Coordination Committee (IADC) provides the organizational framework for sponsoring periodic international measurement campaigns of the space debris environment. The IADC has conducted two types of campaigns: high altitude campaigns designed to measure the debris environment at near-geostationary altitudes using mostly optical telescopes, and low altitude campaigns using primarily radars. One of the goals of the low altitude campaigns is to collect data for 24 contiguous hours. This way, all orbit planes can be sampled. Multiple sensors are used, each with its own strengths and weaknesses, to provide a more complete understanding of the environment. Comparing results between sensors also provides a better understanding of the potential biases resulting from any one sensor. Conducting the campaigns at roughly regular intervals over a long period also allows researchers to examine trends and growth of the environment over time. For this reason, low altitude campaigns are anticipated at two-year intervals. This is the eighth IADC low altitude campaign conducted. The first campaign was conducted in 1996 and two campaigns were conducted in 1999. The 2002 campaign was delayed until January 2003 because of scheduling conflicts, and the fifth, sixth, and seventh campaigns were conducted in 2004, 2008, and 2013 respectively. The eighth campaign was conducted on 8 December 2015.

  11. Shared Value

    OpenAIRE

    Jensen, Mette; Kampmann, Hack; Nielsen, Michalis; Larsen, Rasmus

    2016-01-01

    This project investigates the kind of value being presented when two seemingly different organisations - Red Bull and The Royal Theatre (Det Kongelige Teater) comes together to collaborate and present the Red Bull Cliff Diving 2015 series in Copenhagen in June 2015. The project draws on theories on Axiology, Experience Economy, Branding and Content Marketing, Culture Theory and Public Private Partnerships, all in relation to Theodor Adorno and Max Horkheimers’ theory of “Cultural Industry: En...

  12. Work hours regulations for house staff in psychiatry: bad or good for residency training?

    Science.gov (United States)

    Rasminsky, Sonya; Lomonaco, Allison; Auchincloss, Elizabeth

    2008-01-01

    The movement to limit work hours for house staff has gained momentum in recent years. The authors set out to review the literature on work hours reform, particularly as it applies to psychiatric residency training, and to provide two different viewpoints on the controversy. The authors present the historical background of work hours reform in the United States and review recent literature about resident work hours limitations. Using a debate format, the authors discuss whether the new regulations are having a positive or negative impact on residency training in psychiatry. Drs. Lomonaco and Auchincloss argue that currently-existing work hours restrictions may have unintended consequences for the health of patients and an untoward impact on residents' professional development and academic medicine's overall structure. Dr. Rasminsky argues that work hours restrictions do not go far enough in protecting residents and patients from the harmful effects of fatigue, and that our definition of professionalism needs to be reexamined in light of emerging scientific literature. There should be some limitation on resident work hours, with exact numbers to be determined by growing scientific knowledge about the effects of prolonged wakefulness. More study is needed, particularly in the area of psychiatric residency training.

  13. Long Working Hours and Work-related Cerebro-cardiovascular Disease in Korea

    Science.gov (United States)

    CHUNG, Yun Kyung; KWON, Young-jun

    2013-01-01

    The aim of the present study was to determine a good discriminatory cutoff for long working hours as a surrogate of chronic overload at work, which is associated with the approval of workers’ compensation claims for work-related cerebro-cardiovascular disease (WR-CVD) in Korea. We evaluated weekly working hours for four weeks prior to the onset of disease for all manufacturing industry claimants (N=319) of WR-CVD in 2010. The discrimination of long working hours in predicting approval of worker’s compensation pertaining to WR-CVD was compared across cases. The cutoff was calculated with sensitivity, specificity, and the area under the curve with 95% CI using the receiver operating curve (ROC) method. The cutoff point was thus calculated to be 60.75 h (AUC=0.89, 95% CI [0.84–0.93]), showing a sensitivity value of 65% and specificity of 94%. This is the first study to report that long working hours could be a predictor with good discrimination and high specificity of approval of WR-CVD cases. In Korea, long working hours and widespread chronic overload at work are recognized as a social problem. Our study results suggest an appropriate cutoff for working hours as an indicator of chronic overload for the purpose of approving claims of WR-CVD. Furthermore, these results could contribute to improving the consistency of evaluation. PMID:23892901

  14. Online data on opening hours of general practices in England: a comparison with telephone survey data.

    Science.gov (United States)

    Richards, Emma C; Cowling, Thomas E; Gunning, Elinor J; Harris, Matthew J; Soljak, Michael A; Nowlan, Naomi; Dharmayat, Kanika; Johari, Nur; Majeed, Azeem

    2015-12-01

    The NHS Choices website (www.nhs.uk) provides data on the opening hours of general practices in England. If the data are accurate, they could be used to examine the benefits of extended hours. To determine whether online data on the opening times of general practices in England are accurate regarding the number of hours in which GPs provide face-to-face consultations. Cross-sectional comparison of data from NHS Choices and telephone survey data reported by general practice staff, for a nationally representative sample of 320 general practices (December 2013 to September 2014). GP face-to-face consultation times were collected by telephone for each sampled practice for each day of the week. NHS Choices data on surgery times were available online. Analysis was based on differences in the number of surgery hours (accounting for breaks) and the times of the first and last consultations of the day only between the two data sources. The NHS Choices data recorded 8.8 more hours per week than the survey data on average (40.1 versus 31.2; 95% confidence interval [CI] = 7.4 to 10.3). This was largely accounted for by differences in the recording of breaks between sessions. The data were more similar when only the first and last consultation times were considered (mean difference = 1.6 hours; 95% CI = 0.9 to 2.3). NHS Choices data do not accurately measure the number of hours in which GPs provide face-to-face consultations. They better record the hours between the first and last consultations of the day. © British Journal of General Practice 2015.

  15. Interns shall not sleep: the duty hours boomerang

    Directory of Open Access Journals (Sweden)

    Quan SF

    2017-04-01

    Full Text Available No abstract available. Article truncated after 150 words. On March 10, 2017, the Accreditation Council for Graduate Medical Education (ACGME announced revisions to its common program requirements related to duty hours (1. Effective on July 1, 2017, the most important change will be an increase in the maximum consecutive hours that an intern may work. Interns will now be able to continuously perform patient care work up to a maximum of 24 hours with an additional 4 hours for managing care transitions. This reverses the controversial reduction to 16 hours that occurred in 2011 (2. The regulation of house staff duty hours formally began in the late 1980s. It was precipitated largely because of the publicity resulting from the 1984 death of Libby Zion in a New York teaching hospital that was attributed partly to poor decisions made by fatigued and overworked house staff (3. Consequently, the state of New York in 1989 passed laws restricting the …

  16. Inflight Exercise Regimen for the 2-Hour Prebreathe Protocol

    Science.gov (United States)

    Foster, Philip P.; Gernhardt, Michael L.; Woodruff, Kristin K.; Schneider, Susan M.; Homick, Jerry L. (Technical Monitor)

    2000-01-01

    A 10 min aerobic prebreathe exercise up to 75% V-O2(sub max) on a dual-cycle ergometer, included in the 2-hour prebreathe protocol, has been shown to dramatically reduce the incidence of decompression sickness (DCS) at altitude. In-flight only leg ergometry will be available. A balanced exercise was developed using surgical tubing with the ergometer on-orbit. We hypothesize that a 75% V02max workload, individually prescribed, would be achieved using a target heart rate to regulate the intensity of the arm exercise. VO2, heart rate (HR) / ECG, V-CO2 /V-O2, V(sub E), and V(sub T), and rate of perceived exertion (Borg scale) were measured in eleven healthy subjects who passed a US Air Force Class III Physical examination. A V-O2 peak test was performed to assess the sub-maximal exercise prescription. Two series of sub-maximal tests were performed: (1) leg ergometer/hand ergometer and (2) leg ergometer/surgical tubes. We found no significant differences (P > 0.05) in comparing the means for V-O2 and HR between the predicted and measured values during the final 4 minute-stage at "75% V-O2 workload" or between the two types of sub-maximal tests. The prescribed prebreathe sub-maximal exercise performed with flight certified surgical tubes was achieved using the target HR.

  17. Managing sleep and wakefulness in a 24-hour world.

    Science.gov (United States)

    Coveney, Catherine M

    2014-01-01

    This article contributes to literature on the sociology of sleep by exploring the sleeping practices and subjective sleep experiences of two social groups: shift workers and students. It draws on data, collected in the UK from 25 semi-structured interviews, to discuss the complex ways in which working patterns and social activities impact upon experiences and expectations of sleep in our wired awake world. The data show that, typically, sleep is valued and considered to be important for health, general wellbeing, appearance and physical and cognitive functioning. However, sleep time is often cut back on in favour of work demands and social activities. While shift workers described their efforts to fit in an adequate amount of sleep per 24-hour period, for students, the adoption of a flexible sleep routine was thought to be favourable for maintaining a work-social life balance. Collectively, respondents reported using a wide range of strategies, techniques, technologies and practices to encourage, overcome or delay sleep(iness) and boost, promote or enhance wakefulness/alertness at socially desirable times. The analysis demonstrates how social context impacts not only on how we come to think about sleep and understand it, but also how we manage or self-regulate our sleeping patterns. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  18. The validity of a structured interactive 24-hour recall in estimating energy and nutrient intakes in 15-month-old rural Malawian children.

    Science.gov (United States)

    Thakwalakwa, Chrissie M; Kuusipalo, Heli M; Maleta, Kenneth M; Phuka, John C; Ashorn, Per; Cheung, Yin Bun

    2012-07-01

    This study aimed to compare the nutritional intake values among 15-month-old rural Malawian children obtained by weighed food record (WFR) with those obtained by modified 24-hour recall (mod 24-HR), and to develop algorithm for adjusting mod 24-HR values so as to predict mean intake based on WFRs. The study participants were 169 15-month-old children who participated in a clinical trial. Food consumption on one day was observed and weighed (established criterion) by a research assistant to provide the estimates of energy and nutrient intakes. On the following day, another research assistant, blinded to the direct observation, conducted the structured interactive 24-hour recall (24-HR) interview (test method). Paired t-tests and scatter-plots were used to compare intake values of the two methods. The structured interactive 24-HR method tended to overestimate energy and nutrient intakes (each P < 0.001). The regression-through-the-origin method was used to develop adjustment algorithms. Results showed that multiplying the mean energy, protein, fat, iron, zinc and vitamin A intake estimates based on the test method by 0.86, 0.80, 0.68, 0.69, 0.72 and 0.76, respectively, provides an approximation of the mean values based on WFRs. © 2011 Blackwell Publishing Ltd.

  19. Critical values in hematology.

    Science.gov (United States)

    McFarlane, A; Aslan, B; Raby, A; Bourner, G; Padmore, R

    2015-02-01

    Critical values are life-threatening results that require immediate notification to the patient's healthcare provider. Accreditation bodies require laboratories to establish critical values. A survey of Ontario laboratories was conducted to determine current practice for critical values in hematology. The survey was sent to 182 participants questioning sources for establishing critical values, levels, review frequency, delta checks, and reporting. The survey was completed by laboratory managers, supervisors, technical specialists, senior technologists, and bench technologists working in hematology. The majority of participating laboratories have established critical values limits for hemoglobin, leukocyte counts, and platelet counts. Most laboratories also include the presence of malaria parasites and blast cells. Some laboratories reported the presence of plasma cells, sickle cells, schistocytes, and spherocytes as critical values. Multiple sources are used for establishing a critical value policy. There was variability for the frequency of critical values review. Rules may differ for a first-time patient sample vs. a repeat patient sample. Delta checks are seldom used to determine whether a result should be called a critical value. Most participants require the individual taking the critical result(s) to read back and confirm that they are directly involved with the patient's care. There is a lack of consensus for critical values reporting in hematology. As critical value reporting is crucial for patient safety, standardization of this practice would be beneficial. © 2014 John Wiley & Sons Ltd.

  20. Some sensitivity analyses of an hourly soil-plant water relations model

    Energy Technology Data Exchange (ETDEWEB)

    Luxmoore, R.J.; Stolzy, J.L.; Holdeman, J.T.

    1976-05-01

    Nineteen parameters representing landscape, plant, and soil characteristics were examined for their influence on midday plant water relations, daily fluxes and monthly water balance components predicted by a soil-plant-water relations model having hourly resolution. A standard set of parameters was chosen to represent a hardwood forest on ridge top soil in the Oak Ridge, Tennessee, area during a representative summer month (July). Each parameter was varied through a range with all other parameters held at the standard value. The results of the study showed that the model was sensitive to nine plant parameters in noon, daily and monthly results. The ten other parameters had partial or no influence on the simulations. Two leaf characteristics and two landscape properties cause the model to be sensitive in midday values but less sensitive in monthly results due to the negative feedback aspects of the model. Five parameters had almost no influence on the model results in the case examined. The canopy interception parameter had almost no influence on the model results on sunny days, but was a significant component of the monthly water balance. The study highlighted the importance of the root and stem resistances to water flow in influencing plant water status and the monthly water balance. This study has provided an assessment of the model stability to wide ranges of parameter values and suggests the model's utility in a range of applications. These would include forest and agricultural crops on most soils and in diverse landscape situations. Further, the consequences of using parameters with high uncertainty in an application may be partially evaluated from these sensitivity tests.

  1. Deregulating Overtime Hours Restrictions on Women and its Effects on Female Employment

    DEFF Research Database (Denmark)

    Kato, Takao; Kodama, Naomi

    2017-01-01

    This paper provides novel evidence on the effect of deregulating overtime hours restrictions on women by using the 1985 Amendments to the Labour Standards Act (LSA) in Japan as a natural experiment. The original LSA of 1947 prohibited women from working overtime exceeding two hours a day; six hours...... a week; and 150 hours a year. The 1985 Amendments exempted a variety of occupations and industries from such an overtime restriction on women. Applying a difference-in-difference model to census data, we find causal evidence pointing to the positive effect of this particular piece of labour market......, we use quantile regressions and find that for jobs with more rapidly growing proportion of female employment, the effect of the exemption from the overtime work restriction on women is larger....

  2. The Road Ahead to Continuous 24-Hour Intraocular Pressure Monitoring in Glaucoma

    Directory of Open Access Journals (Sweden)

    Kaweh Mansouri

    2014-01-01

    Full Text Available Intraocular pressure (IOP is the only treatable risk factor for glaucoma. Yet, current glaucoma management usually relies on single IOP measurements during clinic hours despite the fact that IOP is a dynamic parameter with individual rhythms. Single IOP measurements underpin all major clinical guidelines on treatment of glaucoma. Other potentially informative parameters, such as IOP fluctuations and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. The search for continuous 24-hour IOP monitoring started over 50 years ago, but only recent technological advances have provided clinician-researchers with devices for continuous IOP monitoring. Herein, we discuss innovative approaches with permanent and temporary devices for 24-hour IOP monitoring, such as a contact lens sensor. Despite being in their infancy, these devices may soon enable clinicians to use 24-hour IOP data to improve glaucoma management and reduce the glaucoma-related burden of disease.

  3. The road ahead to continuous 24-hour intraocular pressure monitoring in glaucoma.

    Science.gov (United States)

    Mansouri, Kaweh

    2014-04-01

    Intraocular pressure (IOP) is the only treatable risk factor for glaucoma. Yet, current glaucoma management usually relies on single IOP measurements during clinic hours despite the fact that IOP is a dynamic parameter with individual rhythms. Single IOP measurements underpin all major clinical guidelines on treatment of glaucoma. Other potentially informative parameters, such as IOP fluctuations and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. The search for continuous 24-hour IOP monitoring started over 50 years ago, but only recent technological advances have provided clinician-researchers with devices for continuous IOP monitoring. Herein, we discuss innovative approaches with permanent and temporary devices for 24-hour IOP monitoring, such as a contact lens sensor. Despite being in their infancy, these devices may soon enable clinicians to use 24-hour IOP data to improve glaucoma management and reduce the glaucoma-related burden of disease.

  4. Modelling hourly rates of evaporation from small lakes

    Directory of Open Access Journals (Sweden)

    R. J. Granger

    2011-01-01

    Full Text Available The paper presents the results of a field study of open water evaporation carried out on three small lakes in Western and Northern Canada. In this case small lakes are defined as those for which the temperature above the water surface is governed by the upwind land surface conditions; that is, a continuous boundary layer exists over the lake, and large-scale atmospheric effects such as entrainment do not come into play. Lake evaporation was measured directly using eddy covariance equipment; profiles of wind speed, air temperature and humidity were also obtained over the water surfaces. Observations were made as well over the upwind land surface.

    The major factors controlling open water evaporation were examined. The study showed that for time periods shorter than daily, the open water evaporation bears no relationship to the net radiation; the wind speed is the most significant factor governing the evaporation rates, followed by the land-water temperature contrast and the land-water vapour pressure contrast. The effect of the stability on the wind field was demonstrated; relationships were developed relating the land-water wind speed contrast to the land-water temperature contrast. The open water period can be separated into two distinct evaporative regimes: the warming period in the Spring, when the land is warmer than the water, the turbulent fluxes over water are suppressed; and the cooling period, when the water is warmer than the land, the turbulent fluxes over water are enhanced.

    Relationships were developed between the hourly rates of lake evaporation and the following significant variables and parameters (wind speed, land-lake temperature and humidity contrasts, and the downwind distance from shore. The result is a relatively simple versatile model for estimating the hourly lake evaporation rates. The model was tested using two independent data sets. Results show that the modelled evaporation follows the observed values

  5. Cardiac arrhythmias 48 hours before, during, and 48 hours after discharge from hospital following acute myocardial infarction.

    OpenAIRE

    Morrison, G W; Kumar, E B; Portal, R. W.; Aber, C P

    1981-01-01

    The cardiac rate and rhythm were studied by 24-hour ambulatory electrocardiographic recording in 44 patients before, during, and after being discharged from hospital following an acute myocardial infarction. The first recordings were started 48 hours before discharge, the second on the morning of the day of discharge, and the third 48 hours after discharge (at home). While in hospital and after returning home the heart rate fell during sleep but there was no diurnal variation in the frequency...

  6. CDC Lab Values

    Centers for Disease Control (CDC) Podcasts

    2015-02-02

    More than fifteen hundred scientists fill the lab benches at CDC, logging more than four million hours each year. CDC’s laboratories play a critical role in the agency’s ability to find, stop, and prevent disease outbreaks. This podcast provides a brief overview of what goes on inside CDC’s labs, and why this work makes a difference in American’s health.  Created: 2/2/2015 by Office of the Associate Director for Communication (OADC).   Date Released: 2/2/2015.

  7. Relative values.

    Science.gov (United States)

    Bright, Les

    2010-03-25

    THE ANNUAL state of social care report was a publication I looked forward to reading each year because it provided comprehensive information on how services were doing, and allowed the reader to make comparisons year-on-year, standard-by-standard.

  8. Health system values and social values of dental practitioners.

    Science.gov (United States)

    Brennan, David S; Singh, Kiran A; Spencer, A John

    2008-05-01

    To describe the social and health system values of dentists, examine the associations of essential and instrumental health system values and social values with health system values. A random sample of Australian dentists was surveyed by mailed self-complete questionnaires in 2004 (response rate=72%, n=191). A minority agreed with egalitarian social values (19%), while the majority endorsed the essential health system values of fair access (84%), quality of care (93%), efficiency (82%), respect for patients (90%) and patient advocacy (81%). A minority agreed with the instrumental health system values of personal responsibility (48%) and social solidarity (45%), but a majority agreed with social advocacy (73%), provider autonomy (95%), consumer sovereignty (91%) and personal security (65%). The strongest associations between essential values and instrumental values (Pinstrumental values of social advocacy (rho=0.51) and social solidarity (rho=0.43). Egalitarian values were associated with [odds ratio; 95% CI] the essential value of fair access (2.35; 1.24-4.45) and the instrumental value of social solidarity (2.39; 1.31-4.34). Dentists endorsed essential health system values, but varied in their support for instrumental health system values. A minority endorsed egalitarian values, which were positively associated with the essential value of fair access and the instrumental value of social solidarity. It is important to consider the role of values of key stakeholders such as providers and patients in health policy development.

  9. 29 CFR 2530.200b-2 - Hour of service.

    Science.gov (United States)

    2010-07-01

    ... the injury under a disability insurance plan maintained by the employee's employer. At the time of the... payment of $1000 is made to the employee under a disability insurance plan maintained by the employer... period or more frequently. (1) An hour of service is each hour for which an employee is paid, or entitled...

  10. Assessment of discharge after 24 hours following elective ...

    African Journals Online (AJOL)

    Objective: to assess patient satisfaction and morbidity associated with 24 hours hospital stay after elective caesarean section. Methodology: A descriptive study done in Omdurman maternity hospital (OMH) in 2010. All women admitted for elective C/S were counselled for discharge after 24 hours from C/S. Those with ...

  11. correlation between sunshine hours and climatic parameters at four

    African Journals Online (AJOL)

    Mgina

    ABSTRACT. One of the most important factors in solar energy production is related to the predictability of sunshine hours. The objective of this study is to assess the correlation between sunshine hours and relative humidity, cloud cover, maximum and minimum temperature, for the purpose of identifying the most appropriate ...

  12. 19 CFR 360.107 - Hours of operation.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Hours of operation. 360.107 Section 360.107 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND... 24 hours a day, 7 days a week but may be unavailable at selected times for server maintenance. If the...

  13. Number of Instructional Days/Hours in the School Year

    Science.gov (United States)

    Rowland, Julie

    2014-01-01

    While state requirements vary on the number of instructional days and/or hours in the school year, the majority of states require 180 days of student instruction. Most also specify the minimum length of time that constitutes an instructional day. Some states set instructional time in terms of days, some specify hours, and some provide…

  14. Emotional exhaustion may trigger cut in working hours

    NARCIS (Netherlands)

    Koppes, L.

    2012-01-01

    Researchers in the Netherlands have been examining to what extent workers are modifying their hours to cope with high levels of work-related emotional exhaustion. Findings reveal that most full-time employees would prefer a cut in their hours, with those reporting emotional exhaustion wanting a

  15. 17 CFR 232.12 - Business hours of the Commission.

    Science.gov (United States)

    2010-04-01

    ... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS General § 232.12 Business hours of the... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Business hours of the..., whichever is currently in effect. (c) Submissions by direct transmission. Electronic filings and other...

  16. Reduced Contact Hour Accelerated Courses and Student Learning

    Science.gov (United States)

    Thornton, Barry; Demps, Julius; Jadav, Arpita

    2017-01-01

    Undergraduate instruction in the Davis College of Business at Jacksonville University utilizes two course delivery methods. Traditional daytime classes are 15 weeks long and have approximately 40 contact hours, while evening courses are offered in the Accelerated Degree program in a compressed 8-week format with 24 contact hours. The curriculum is…

  17. 17 CFR 171.3 - Business address; hours.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Business address; hours. 171.3 Section 171.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO... MEMBER RESPONSIBILITY ACTIONS General Provisions § 171.3 Business address; hours. The principal office of...

  18. 17 CFR 10.4 - Business address; hours.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Business address; hours. 10.4 Section 10.4 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES OF PRACTICE General Provisions § 10.4 Business address; hours. The Office of Proceedings is located at Three Lafayette...

  19. 17 CFR 12.3 - Business address; hours.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Business address; hours. 12.3 Section 12.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.3 Business address; hours. The...

  20. Stochastic Simulation of Hourly Average Wind Speed in Umudike ...

    African Journals Online (AJOL)

    Ten years of hourly average wind speed data were used to build a seasonal autoregressive integrated moving average (SARIMA) model. The model was used to simulate hourly average wind speed and recommend possible uses at Umudike, South eastern Nigeria. Results showed that the simulated wind behaviour was ...

  1. 39 CFR 959.3 - Office, business hours.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Office, business hours. 959.3 Section 959.3 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE PRIVATE EXPRESS STATUTES § 959.3 Office, business hours. The offices of the officials mentioned in these rules are...

  2. 39 CFR 954.4 - Office business hours.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Office business hours. 954.4 Section 954.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.4 Office business hours. The offices of the...

  3. 39 CFR 952.4 - Office business hours.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Office business hours. 952.4 Section 952.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.4 Office business hours. The offices of the officials mentioned in these...

  4. Electronic ampere-hour integrator is accurate to one percent

    Science.gov (United States)

    Paulkovich, J.

    1965-01-01

    Electronic ampere-hour integrator is based on current-to-frequency conversion. It operates on low power and is accurate to one percent. This device can measure the ampere-hour capacity of batteries and can be adapted for other functions.

  5. Correlation between sunshine hours and climatic parameters at four ...

    African Journals Online (AJOL)

    One of the most important factors in solar energy production is related to the predictability of sunshine hours. The objective of this study is to assess the correlation between sunshine hours and relative humidity, cloud cover, maximum and minimum temperature, for the purpose of identifying the most appropriate ...

  6. 19 CFR 132.3 - Observation of official hours.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Observation of official hours. 132.3 Section 132.3 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY QUOTAS General Provisions § 132.3 Observation of official hours. An entry summary for consumption...

  7. Appropriate working hours for surgical training according to Australasian trainees.

    Science.gov (United States)

    O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew

    2012-04-01

    The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  8. With long hours of work, might depression then lurk?

    DEFF Research Database (Denmark)

    Varma, Anshu; Marott, Jacob Louis; Stoltenberg, Christian Ditlev Gabriel

    2012-01-01

    The aim of this study was to examine depression as a potential negative health effect of long work hours, anticipating an exposure-response relationship.......The aim of this study was to examine depression as a potential negative health effect of long work hours, anticipating an exposure-response relationship....

  9. A direct sensitivity approach to predict hourly ozone resulting from compliance with the National Ambient Air Quality Standard.

    Science.gov (United States)

    Simon, Heather; Baker, Kirk R; Akhtar, Farhan; Napelenok, Sergey L; Possiel, Norm; Wells, Benjamin; Timin, Brian

    2013-03-05

    In setting primary ambient air quality standards, the EPA's responsibility under the law is to establish standards that protect public health. As part of the current review of the ozone National Ambient Air Quality Standard (NAAQS), the US EPA evaluated the health exposure and risks associated with ambient ozone pollution using a statistical approach to adjust recent air quality to simulate just meeting the current standard level, without specifying emission control strategies. One drawback of this purely statistical concentration rollback approach is that it does not take into account spatial and temporal heterogeneity of ozone response to emissions changes. The application of the higher-order decoupled direct method (HDDM) in the community multiscale air quality (CMAQ) model is discussed here to provide an example of a methodology that could incorporate this variability into the risk assessment analyses. Because this approach includes a full representation of the chemical production and physical transport of ozone in the atmosphere, it does not require assumed background concentrations, which have been applied to constrain estimates from past statistical techniques. The CMAQ-HDDM adjustment approach is extended to measured ozone concentrations by determining typical sensitivities at each monitor location and hour of the day based on a linear relationship between first-order sensitivities and hourly ozone values. This approach is demonstrated by modeling ozone responses for monitor locations in Detroit and Charlotte to domain-wide reductions in anthropogenic NOx and VOCs emissions. As seen in previous studies, ozone response calculated using HDDM compared well to brute-force emissions changes up to approximately a 50% reduction in emissions. A new stepwise approach is developed here to apply this method to emissions reductions beyond 50% allowing for the simulation of more stringent reductions in ozone concentrations. Compared to previous rollback methods, this

  10. Preventing Violent Extremism through Value Complexity: Being Muslim Being British

    Directory of Open Access Journals (Sweden)

    Jose Liht

    2013-12-01

    Full Text Available This article reports on an intervention designed to prevent violent extremism in young UK Muslims, and provides an empirical assessment of its effectiveness. The course was designed to expose participants to the multiplicity of value priorities that influential Muslims embody, and to structure group activities that allow participants to explore all value positions on issues central to radical Islamist discourse, free from criticism or social pressure. The intervention, a 16 contact hour course using films and group activities that enables participants to problem solve according to a broad array of their own values, was pre and post tested with 81 young Muslims (mean age 19.48; SD=2.14 across seven pilot groups around the UK. As hypothesised, value spread and integrative complexity increased significantly by the end of the course in group discussions, and in written responses to moral dilemmas, conflict resolution style shifted towards collaboration and compromise.

  11. After-hours respiratory physiotherapy for intubated and mechanically ventilated patients with community-acquired pneumonia: An Australian perspective.

    Science.gov (United States)

    van der Lee, Lisa; Hill, Anne-Marie; Patman, Shane

    2017-11-15

    Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals. A cross-sectional, mixed methods online survey was conducted. Participants were senior intensive care unit physiotherapists from 88 public and private hospitals. Main outcome measures included presence and nature of an after-hours physiotherapy service and factors perceived to influence the need for after-hours respiratory physiotherapy intervention, when the service was available, for intubated adult patients with CAP. Data were also collected regarding respiratory intervention provided after-hours by other ICU professionals. Response rate was 72% (n=75). An after-hours physiotherapy service was provided by n=31 (46%) hospitals and onsite after-hours physiotherapy presence was limited (22%), with a combination of onsite and on-call service reported by 19%. Treatment response (83%) was the most frequent factor for referring patients with CAP for after-hours physiotherapy intervention by the treating day-time physiotherapist. Nurses performing respiratory intervention (77%) was significantly associated with no available after-hours physiotherapy service (p=0.04). Physiotherapy after-hours service in Australia is limited, therefore it is common for intubated patients with CAP not to receive any respiratory physiotherapy intervention outside of normal business hours. In the absence of an after-hours physiotherapist, nurses were most likely to perform after-hours respiratory intervention to intubated patients with CAP. Further research is required to determine whether the frequency of respiratory physiotherapy intervention, including after-hours provision of treatment

  12. Maximizing utilization of sport halls during peak hours

    DEFF Research Database (Denmark)

    Iversen, Evald Bundgård; Forsberg, Peter

    BACKGROUNDDuring peak hours (4.30pm-8pm) demand for timeslots in sport halls in Denmark are high and there are few timeslots available. Further, focus on how public resources are spent most efficient is increasing (Iversen, 2013). This makes it interesting to analyse how utilization could...... be increased during peak hours. DATA AND METHODOLOGYData is collected by observation of activities during two weeks on for example whether halls are used or not; the amount of playing field used; and number of participants (Iversen, 2012). Data on 1.331 activities in 36 sport halls across 4 municipalities have...... been collected. RESULTS The number of participants per activity is higher during peak hours, which is expected when demand is high. However, the usage of sport floor only differs slightly between peak and low hours. Both during peak and low hours on average 80-100 per cent of floor space is used...

  13. Adaptation of Impact Questions from an Existing Toolkit Provided Clear Assessment of Valued Service Elements and Desirable Service Improvements in a Primary Health Care Library and Information Service. A Review of: Urquhart, C., Thomas, R., Ovens, J., Lucking, W., & Villa, J. (2010. Planning changes to health library services on the basis of impact assessment. Health Information and Libraries Journal, 27(4, 277-285. doi: 10.1111/j.1471-1842.2010.00900.x

    Directory of Open Access Journals (Sweden)

    Kate Kelly

    2011-01-01

    resources for loan (n=57, 37.5% were the top two service elements used, with literature searching third (n=46, 30.3%.The service completely met the needs of 93% (n=141 of respondents, with 97.4% (n=148 reporting being wholly satisfied that information was delivered in time.In terms of the immediate cognitive impact of the information obtained, 93% (n=141 reported obtaining relevant information, 76% (n=115 current information, and 72% (n=109 accurate information. Nearly 70% were distributing information or resources to other people, and 68% were sharing or discussing information provided with colleagues. Nobody claimed that they had found little or nothing of value.Advice to patients, clients or carers was the most frequently cited impact category (n=104, 68%, followed by advice to colleagues (n=84, 55.3%.The main strengths of the service were the perceived reliability of the service, the current awareness and alerting service run from one site, and literature searching support for commissioning and public health enquiries. Respondents reported saving time, and the main cognitive impact was the perceived relevance of the information obtained. Service weaknesses identified related to accessibility issues such as parking, opening hours, and staff coverage, and outreach was identified as the main service development opportunity.Conclusion – The adaptation of an existing questionnaire provided a clear assessment of the effectiveness of a primary health care information service to a broad spectrum of users. Respondents identified what they valued about the service and how it could be improved.

  14. Use of non-linear mixed-effects modelling and regression analysis to predict the number of somatic coliphages by plaque enumeration after 3 hours of incubation.

    Science.gov (United States)

    Mendez, Javier; Monleon-Getino, Antonio; Jofre, Juan; Lucena, Francisco

    2017-10-01

    The present study aimed to establish the kinetics of the appearance of coliphage plaques using the double agar layer titration technique to evaluate the feasibility of using traditional coliphage plaque forming unit (PFU) enumeration as a rapid quantification method. Repeated measurements of the appearance of plaques of coliphages titrated according to ISO 10705-2 at different times were analysed using non-linear mixed-effects regression to determine the most suitable model of their appearance kinetics. Although this model is adequate, to simplify its applicability two linear models were developed to predict the numbers of coliphages reliably, using the PFU counts as determined by the ISO after only 3 hours of incubation. One linear model, when the number of plaques detected was between 4 and 26 PFU after 3 hours, had a linear fit of: (1.48 × Counts3 h + 1.97); and the other, values >26 PFU, had a fit of (1.18 × Counts3 h + 2.95). If the number of plaques detected was hours, we recommend incubation for (18 ± 3) hours. The study indicates that the traditional coliphage plating technique has a reasonable potential to provide results in a single working day without the need to invest in additional laboratory equipment.

  15. Expected Value

    OpenAIRE

    Robert Lapson

    1992-01-01

    A procedure for decision-making under risk is developed and axiomatized. It provides another explanation for the Allais paradox as well as justification for some other preference patterns that can not be represented by the expected utility model, but it includes expected utility representation fo preferences as a particular case. The idea of the procedure is that evaluation of the lotteries takes two steps. First, a decision maker classifies a lottery as a "bad," "good" or "medium" one. Then ...

  16. Hour-glass ceilings: Work-hour thresholds, gendered health inequities.

    Science.gov (United States)

    Dinh, Huong; Strazdins, Lyndall; Welsh, Jennifer

    2017-03-01

    Long workhours erode health, which the setting of maximum weekly hours aims to avert. This 48-h limit, and the evidence base to support it, has evolved from a workforce that was largely male, whose time in the labour force was enabled by women's domestic work and care giving. The gender composition of the workforce has now changed, and many women (as well as some men) combine care-giving with paid work, a change viewed as fundamental for gender equality. However, it raises questions on the suitability of the work time limit and the extent it is protective of health. We estimate workhour-mental health thresholds, testing if they vary for men and women due to gendered workloads and constraints on and off the job. Using six waves of data from a nationally representative sample of Australian adults (24-65 years), surveyed in the Household Income Labour Dynamics of Australia Survey (N = 3828 men; 4062 women), our study uses a longitudinal, simultaneous equation approach to address endogeneity. Averaging over the sample, we find an overall threshold of 39 h per week beyond which mental health declines. Separate curves then estimate thresholds for men and women, by high or low care and domestic time constraints, using stratified and pooled samples. We find gendered workhour-health limits (43.5 for men, 38 for women) which widen further once differences in resources on and off the job are considered. Only when time is 'unencumbered' and similar time constraints and contexts are assumed, do gender gaps narrow and thresholds approximate the 48-h limit. Our study reveals limits to contemporary workhour regulation which may be systematically disadvantaging women's health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Valuing vaccination

    Science.gov (United States)

    Bärnighausen, Till; Bloom, David E.; Cafiero-Fonseca, Elizabeth T.; O’Brien, Jennifer Carroll

    2014-01-01

    Vaccination has led to remarkable health gains over the last century. However, large coverage gaps remain, which will require significant financial resources and political will to address. In recent years, a compelling line of inquiry has established the economic benefits of health, at both the individual and aggregate levels. Most existing economic evaluations of particular health interventions fail to account for this new research, leading to potentially sizable undervaluation of those interventions. In line with this new research, we set forth a framework for conceptualizing the full benefits of vaccination, including avoided medical care costs, outcome-related productivity gains, behavior-related productivity gains, community health externalities, community economic externalities, and the value of risk reduction and pure health gains. We also review literature highlighting the magnitude of these sources of benefit for different vaccinations. Finally, we outline the steps that need to be taken to implement a broad-approach economic evaluation and discuss the implications of this work for research, policy, and resource allocation for vaccine development and delivery. PMID:25136129

  18. Blood volume extracted from the critical patient in the first 24 hours after admission.

    Science.gov (United States)

    Maqueda-Palau, M; Pérez-Juan, E

    To calculate the number of analytical tests and blood volume drawn during the first 24hours of admission to the Intensive Care Unit (ICU). To analyse values of basal haemoglobin and at 24hours, relate them to blood loss, weight variation, and scoring system. An observational descriptive pilot study. Variables studied: age, sex, diagnosis on admission, analytical tests extracted, waste quantity before the extraction of samples, total volume blood extracted in 24hours, weight variation, APACHE, SAPS, basal haemoglobin and at 24hours. Statistical analysis with SPSS vs 20.0. Variables correlation sex, weight variation, the number of analytical tests and haemoglobin change. The study included 100 patients. The average number of extractions per patient/day was 7.2 (±2.6). The average waste quantity was 32.61ml (±15.8). The blood volume used for determinations was 48.18ml / 24h (±16.74). The haemoglobin value decreased in the first 24hours of admission, being higher in men (P<.05). The scoring systems were statistically significant for levels of haemoglobin (Hb1 -0.3; P=.001; Hb2 -0.4; P=.001). Of the total volume of blood extracted in ICU, 40% belongs to a volume of waste and 60% of blood is used for analytical tests. There is a decrease in haemoglobin exists 24hours after admission of the critical patient. Statistically, it has not been possible to demonstrate its relation with the number of analytical tests. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Tetrahydrobiopterin responsiveness in phenylketonuria: prediction with the 48-hour loading test and genotype.

    Science.gov (United States)

    Anjema, Karen; van Rijn, Margreet; Hofstede, Floris C; Bosch, Annet M; Hollak, Carla E M; Rubio-Gozalbo, Estela; de Vries, Maaike C; Janssen, Mirian C H; Boelen, Carolien C A; Burgerhof, Johannes G M; Blau, Nenad; Heiner-Fokkema, M Rebecca; van Spronsen, Francjan J

    2013-07-10

    How to efficiently diagnose tetrahydrobiopterin (BH4) responsiveness in patients with phenylketonuria remains unclear. This study investigated the positive predictive value (PPV) of the 48-hour BH4 loading test and the additional value of genotype. Data of the 48-hour BH4 loading test (20 mg BH4/kg/day) were collected at six Dutch university hospitals. Patients with ≥30% phenylalanine reduction at ≥1 time points during the 48 hours (potential responders) were invited for the BH4 extension phase, designed to establish true-positive BH4 responsiveness. This is defined as long-term ≥30% reduction in mean phenylalanine concentration and/or ≥4 g/day and/or ≥50% increase of natural protein intake. Genotype was collected if available. 177/183 patients successfully completed the 48-hour BH4 loading test. 80/177 were potential responders and 67/80 completed the BH4 extension phase. In 58/67 true-positive BH4 responsiveness was confirmed (PPV 87%). The genotype was available for 120/177 patients. 41/44 patients with ≥1 mutation associated with long-term BH4 responsiveness showed potential BH4 responsiveness in the 48-hour test and 34/41 completed the BH4 extension phase. In 33/34 true-positive BH4 responsiveness was confirmed. 4/40 patients with two known putative null mutations were potential responders; 2/4 performed the BH4 extension phase but showed no true-positive BH4 responsiveness. The 48-hour BH4 loading test in combination with a classified genotype is a good parameter in predicting true-positive BH4 responsiveness. We propose assessing genotype first, particularly in the neonatal period. Patients with two known putative null mutations can be excluded from BH4 testing.

  20. Hourly test reference weather data in the changing climate of Finland for building energy simulations

    Directory of Open Access Journals (Sweden)

    Kirsti Jylhä

    2015-09-01

    Full Text Available Dynamic building energy simulations need hourly weather data as input. The same high temporal resolution is required for assessments of future heating and cooling energy demand. The data presented in this article concern current typical values and estimated future changes in outdoor air temperature, wind speed, relative humidity and global, diffuse and normal solar radiation components. Simulated annual and seasonal delivered energy consumptions for heating of spaces, heating of ventilation supply air and cooling of spaces in the current and future climatic conditions are also presented for an example house, with district heating and a mechanical space cooling system. We provide details on how the synthetic future weather files were created and utilised as input data for dynamic building energy simulations by the IDA Indoor Climate and Energy program and also for calculations of heating and cooling degree-day sums. The information supplied here is related to the research article titled “Energy demand for the heating and cooling of residential houses in Finland in a changing climate” [1].

  1. Applications of 24-hour Noninvasive Ambulatory Blood Pressure Monitoring

    Directory of Open Access Journals (Sweden)

    Yung-Zu Tseng

    2006-01-01

    Full Text Available Casual blood pressure (CBP measurements using a standard sphygmomanometer have traditionally constituted the principal modality for the assessment and management of hypertension. However, CBP measurement has shortcomings. Ambulatory blood pressure monitoring (ABPM provides abundant information on blood pressure (BP, including heart rate, all BP readings for test periods, BP average, BP variability, BP load, load index, distribution pattern of BP, reduction percentage of BP, trough/peak ratio, and summary statistics for overall 24-hour, daytime and nighttime periods. Over the last three decades, ABPM has evolved from a research device to an established and valuable clinical tool for assessment and management of hypertension. This technology has been proven to be useful in terms of the distribution pattern of BP, characterization of BP profiles in normotensive and hypertensive patients, evaluation of patients with mild or labile hypertension, physiologic and psychologic factors for fluctuation of BP, load index study, study of white coat hypertension, etiology of hypertension, prognosis of hypertension, and assessment of antihypertensive management. Nevertheless, the technology remains underused due to lack of insurance reimbursement in most countries. Accordingly, insurance reimbursement is crucial to promote increased utility of ABPM. Clinicians should be familiar with the role of this technology in the care of patients with abnormal BP. This review is an attempt to increase clinicians' understanding of ABPM and the appropriate use of this technology.

  2. Infectious encephalitis: Management without etiological diagnosis 48hours after onset.

    Science.gov (United States)

    Fillatre, P; Crabol, Y; Morand, P; Piroth, L; Honnorat, J; Stahl, J P; Lecuit, M

    2017-05-01

    The etiological diagnosis of infectious encephalitis is often not established 48hours after onset. We aimed to review existing literature data before providing management guidelines. We performed a literature search on PubMed using filters such as "since 01/01/2000", "human", "adults", "English or French", and "clinical trial/review/guidelines". We also used the Mesh search terms "encephalitis/therapy" and "encephalitis/diagnosis". With Mesh search terms "encephalitis/therapy" and "encephalitis/diagnosis", we retrieved 223 and 258 articles, respectively. With search terms "encephalitis and corticosteroid", we identified 38 articles, and with "encephalitis and doxycycline" without the above-mentioned filters we identified 85 articles. A total of 210 articles were included in the analysis. Etiological investigations must focus on recent travels, animal exposures, age, immunodeficiency, neurological damage characteristics, and potential extra-neurological signs. The interest of a diagnosis of encephalitis for which there is no specific treatment is also to discontinue any empirical treatments initially prescribed. Physicians must consider and search for autoimmune encephalitis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Potential of energy-oriented network optimisation: Switching off over-capacity in off-peak hours

    NARCIS (Netherlands)

    Litjens, R.; Jorguseski, L.

    2010-01-01

    Mobile communication networks are usually planned to provide some minimum service quality level during peak traffic hours. Consequently, in off-peak hours, when traffic loads are lower, the network is characterised by over-capacity, in the sense that same service quality targets can typically be

  4. Impact of working hours on sleep and mental health.

    Science.gov (United States)

    Afonso, P; Fonseca, M; Pires, J F

    2017-07-01

    The number of hours people are required to work has a pervasive influence on both physical and mental health. Excessive working hours can also negatively affect sleep quality. The impact at work of mental health problems can have serious consequences for individuals' as well as for organizations' productivity. To evaluate differences in sleep quality and anxiety and depression symptoms between longer working hours group (LWHG) and regular working hours group (RWHG). To examine factors influencing weekly working hours, sleep quality and anxiety and depressive symptoms. Participants were divided into two groups, RWHG and LWHG, based on working hours, with a cut-off of 48 h per week. We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression symptoms and the Pittsburgh Sleep Quality Index (PSQI) to measure the quality and patterns of sleep. The response rate was 23%. Among the 429 study participants, those in the LWHG group (n = 256, 53%) had significantly more depressive and anxiety symptoms and worse sleep quality than those in RWHG (n = 223, 47%). Working time was significantly positively correlated with higher corporate position and HADS scores. Moreover, HADS scores were positively correlated with PSQI scores and negatively correlated with age. This study suggests that longer working hours are associated with poorer mental health status and increasing levels of anxiety and depression symptoms. There was a positive correlation between these symptoms and sleep disturbances.

  5. Transcutaneous Bilirubin Nomogram for Healthy Term and Late Preterm Neonates in First 96 Hours of Life.

    Science.gov (United States)

    Thakkar, Pareshkumar; Chavda, Hardas; Doshi, Vikas

    2017-05-15

    To develop nomogram of Transcutaneous Bilirubin among healthy term and late-preterm neonates during first 96 hours of age. Longitudinal observational study. Neonatal unit of a tertiary care Hospital of Central Gujarat, India. 1075 healthy term and late preterm neonates (≥35weeks). Six-hourly transcutaneous bilirubin was obtained from birth to 96 hour of life using Drager JM 103 Transcutaneous Bilirubinometer. Main outcome measures: Nomogram of Transcutaneous Bilirubin with percentile values was obtained, rate of rise of bilirubin was calculated and predictive ability of normative data was analyzed for subsequent need of phototherapy. The age-specific percentile curves and nomogram were developed from the transcutaneous bilirubin readings of 1,010 neonates. Rate of rise in first 12 hour was 0.2 mg/dL and was 0.17 mg/dL in 12 to 24 hour of life which decreased on second day of life. Neonates who required phototherapy had consistently higher readings of transcutaneous bilirubin and also higher rate of rise in first 48 hrs. Neonates whose transcutaneous bilirubin is above the 50th percentile should be monitored for the development of significant hyperbilirubinemia.

  6. Parathyroid hormone levels 1 hour after thyroidectomy: an early predictor of postoperative hypocalcemia.

    Science.gov (United States)

    AlQahtani, Awad; Parsyan, Armen; Payne, Richard; Tabah, Roger

    2014-08-01

    Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total or completion thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. A simple, reliable indicator to identify patients at risk would permit earlier pharmacologic prophylaxis to avoid these adverse outcomes. We examined the role of intact parathormone (PTH) levels 1 hour after surgery as a predictor of post-thyroidectomy hypocalcemia. We prospectively reviewed the cases of consecutive patients undergoing total or completion thyroidectomy. Ionized calcium (Ca(2+)) and intact PTH levels were measured preoperatively and at 1-, 6- and 24-hour intervals postoperatively. The specificity, sensitivity, negative and positive predictive values of the 1-hour PTH serum levels (PTH-1) in predicting 24-hour post-thyroidectomy hypocalcemia and eucalcemia were determined. We reviewed the cases of 149 patients. Biochemical hypocalcaemia (Ca(2+) levels were predictive of symptomatic hypocalcemia 24 hours after thyroidectomy. Routine use of this assay should be considered, as it could prompt the early administration of calcitriol in patients at risk of hypocalcemia and allow for the safe and timely discharge of patients expected to remain eucalcemic.

  7. Weekly hours of informal caregiving and paid work, and the risk of cardiovascular disease

    DEFF Research Database (Denmark)

    Mortensen, Jesper; Dich, Nadya; Lange, Theis

    2017-01-01

    Background: Little is known on the association between weekly hours of informal caregiving and risk of cardiovascular disease (CVD). The objective was to investigate the individual and joint effects of weekly hours of informal caregiving and paid work on the risk of CVD. Methods: Pooled analysis...... with 1396 informal caregivers in gainful employment, from the Swedish Longitudinal Occupational Survey of Health and the Whitehall II study. Informal caregiving was defined as care for an aged or disabled relative. The outcome was CVD during 10 years follow-up. Analyzes were adjusted for age, sex, children......, marital status and occupational grade. Results: There were 59 cases of CVD. Providing care >20 h weekly were associated with a higher risk of CVD compared to those providing care 1-8 h weekly (hazard ratio = 2.63, 95%CI: 1.20; 5.76), irrespectively of weekly work hours. In sensitivity analyzes, we found...

  8. An assessment of organisational values, culture and performance in ...

    African Journals Online (AJOL)

    The top 10 current organisational values were not sharing information, cost reduction, community involvement, confusion, control, manipulation, blame, power, results orientation, hierarchy, long hours and teamwork. Desired organisational values were open communication, shared decision-making, accountability, staff ...

  9. Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

    Science.gov (United States)

    Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

    2011-01-01

    , discussion of the Institute of Medicine report has been largely confined to the medical education community, led by the Accreditation Council for Graduate Medical Education (ACGME). To begin gathering these perspectives and developing a plan to implement safer work hours for resident physicians, a conference entitled “Enhancing sleep, supervision and safety: What will it take to implement the Institute of Medicine recommendations?” was held at Harvard Medical School on June 17–18, 2010. This White Paper is a product of a diverse group of 26 representative stakeholders bringing relevant new information and innovative practices to bear on a critical patient safety problem. Given that our conference included experts from across disciplines with diverse perspectives and interests, not every recommendation was endorsed by each invited conference participant. However, every recommendation made here was endorsed by the majority of the group, and many were endorsed unanimously. Conference members participated in the process, reviewed the final product, and provided input before publication. Participants provided their individual perspectives, which do not necessarily represent the formal views of any organization. In September 2010 the ACGME issued new rules to go into effect on July 1, 2011. Unfortunately, they stop considerably short of the Institute of Medicine’s recommendations and those endorsed by this conference. In particular, the ACGME only applied the limitation of 16 hours to first-year resident physicans. Thus, it is clear that policymakers, hospital administrators, and residency program directors who wish to implement safer health care systems must go far beyond what the ACGME will require. We hope this White Paper will serve as a guide and provide encouragement for that effort. Resident physician workload and supervision By the end of training, a resident physician should be able to practice independently. Yet much of resident physicians’ time is dominated by

  10. "Hidden treasures": librarian office hours for three health sciences schools.

    Science.gov (United States)

    Handler, Lara; Lackey, Mellanye; Vaughan, K T L

    2009-10-01

    The changing needs of students and faculty have prompted UNC Chapel Hill's Health Sciences Library to reconsider the delivery of library services. Several years of outreach and office hours have yielded an array of "hidden treasures," or secondary outcomes, of both online and in-person office hours. The online office hours are tailored for the Schools of Medicine, Pharmacy, and Public Health. This article examines the benefits that go beyond simple consultation statistics and encompass more qualitative aspects of success resulting from increased outreach, goodwill, and stronger library-departmental partnerships.

  11. Global Value Chain Configuration

    DEFF Research Database (Denmark)

    Hernandez, Virginia; Pedersen, Torben

    2017-01-01

    This paper reviews the literature on global value chain configuration, providing an overview of this topic. Specifically, we review the literature focusing on the concept of the global value chain and its activities, the decisions involved in its configuration, such as location, the governance...... modes chosen and the different ways of coordinating them. We also examine the outcomes of a global value chain configuration in terms of performance and upgrading. Our aim is to review the state of the art of these issues, identify research gaps and suggest new lines for future research that would...

  12. A Model for Hourly Solar Radiation Data Generation from Daily Solar Radiation Data Using a Generalized Regression Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Tamer Khatib

    2015-01-01

    Full Text Available This paper presents a model for predicting hourly solar radiation data using daily solar radiation averages. The proposed model is a generalized regression artificial neural network. This model has three inputs, namely, mean daily solar radiation, hour angle, and sunset hour angle. The output layer has one node which is mean hourly solar radiation. The training and development of the proposed model are done using MATLAB and 43800 records of hourly global solar radiation. The results show that the proposed model has better prediction accuracy compared to some empirical and statistical models. Two error statistics are used in this research to evaluate the proposed model, namely, mean absolute percentage error and root mean square error. These values for the proposed model are 11.8% and −3.1%, respectively. Finally, the proposed model shows better ability in overcoming the sophistic nature of the solar radiation data.

  13. Implementation and impact of an extended-hours service in mental health care: lessons learned.

    Science.gov (United States)

    Erskine, Deanna; Baumgartner, Barbara; Patterson, Sue

    2015-11-01

    To describe the activity and impact of an extended-hours mental health service established to meet perceived need and improve service efficiency. Lessons developed in evaluation could usefully inform development of services in similar settings. A specialist mental health service providing assessment and treatment to 330 000 catchment residents of an Australian capital city. Pragmatic mixed-methods evaluation, combining review of 12 months service data and interviews with 65 stakeholders; with integration of descriptive statistics and thematic analysis of qualitative data. Over 12 months, 2040 individuals were provided with a range of services during extended-hours, indicating that some sort of service was needed. However, evaluation demonstrated that flaws in assumptions underpinning the extended-hours service design, particularly regarding the population seeking after-hours care, necessitated adaptation of the proposed model. Ambiguity in purpose contributed to perceived lack of a cohesive identity, compounded by critical differences in the philosophies of care teams from which the extended-hours service clinicians were drawn. Nonetheless the service was considered effective by many stakeholders and co-location of different teams built collegiality within the service. A comprehensive needs analysis, enabling full description of target populations and their needs, should underpin establishment of any service. Such understanding is needed to ensure resources are appropriate. Importantly, because mental health clinicians are not interchangeable, matching philosophy of care and clinical skills to identified need is critical to quality and efficiency.

  14. Values in dialogic pedagogy

    Directory of Open Access Journals (Sweden)

    Eugene Matusov

    2015-02-01

    Full Text Available In November 2014 on the Dialogic Pedagogy Journal Facebook page, there was an interesting discussion of the issue of values in dialogic pedagogy[1]. The main issue can be characterized as the following. Should dialogic pedagogy teach values? Should it avoid teaching values? Is there some kind of a third approach? The participants of the Facebook discussions were focusing on teaching values in dialogic pedagogy and not about teaching aboutvalues. On the one hand, it seems to be impossible to avoid teaching values. However, on the other hand, shaping students in some preset molding is apparently non-dialogic and uncritical (Matusov, 2009. In the former case, successful teaching is defined by how well and deeply the students accept and commit to the taught values. In the latter case, successful dialogic teaching may be defined by students’ critical examination of their own values against alternative values in a critical dialogue. Below, Eugene Matusov and Jay Lemke, active participants of this Facebook dialogue, provide their reflection on this important issue and encourage readers to join their reflective dialogue.[1] See in a public Facebook domain: https://www.facebook.com/DialogicPedagogyJournal/posts/894734337204533, https://www.facebook.com/DialogicPedagogyJournal/posts/896916850319615

  15. No Correlation Between Work-Hours and Operative Volumes

    DEFF Research Database (Denmark)

    Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

    2016-01-01

    OBJECTIVE: Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week....... We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. DESIGN: Retrospective comparative study. PARTICIPANTS...... find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes...

  16. U.S. Hourly Climate Normals (1981-2010)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The U.S. Hourly Climate Normals for 1981 to 2010 are 30-year averages of meteorological parameters for thousands of U.S. stations located across the 50 states, as...

  17. Resident job satisfaction: will 80 hours make a difference?

    Science.gov (United States)

    Lund, Kirsten J; Alvero, Ruben; Teal, Stephanie B

    2004-11-01

    This study was undertaken to assess job satisfaction and quality of life among obstetrics and gynecology residents before the 80-hour work week. We administered a job satisfaction survey to residents before July 1, 2003, assessing satisfaction with residency training, indicators of current quality of life, and predictions for the effect of reduced work hours. Residents were satisfied with training, with important outliers, including leisure time, ability to pursue educational reading, and surgical experience. We created job satisfaction facets that were generally reliable constructs and valid predictors for overall residency satisfaction. Residents predict more free time and a healthier lifestyle under the new requirements, but do not anticipate using additional time to study or teach. Job satisfaction facets for residents are proposed here and may be refined through further study. Lower scores for surgical experience are of concern in light of decreasing work hours. Educators must monitor self-directed learning efforts under new work hours.

  18. 100 Hours of Astronomy Cornerstone Project of IYA2009

    Science.gov (United States)

    Simmons, M.

    2008-11-01

    The 100 Hours of Astronomy cornerstone project (100HA) is a round-the-clock, worldwide event with 100 continuous hours of a wide range of public outreach activities taking place from 2--5 April. A high-profile opening event will include presentation of Galileo's original telescope. Webcasts of international science center discussions and 24 hours of webcasts from professional research observatories will follow. A 24-hour global star party will occur on the last day. The Moon's phase will range from first quarter to gibbous, good phases for early evening observing, and Saturn will also be well placed for early evening observing events. Amateur astronomers will be encouraged to present educational events in schools as well as non-traditional venues. Online resources will include advertising, educational and how-to materials.

  19. Surface Airways Observations (SAO) Hourly Data 1928-1948 (CDMP)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The dataset consists of hourly U.S. surface airways observations (SAO). These observations extend as far back as 1928, from the time when commercial aviation began...

  20. NOS CO-OPS Water Level Data, Verified, Hourly

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset has verified (quality-controlled), hourly, water level (tide) data from NOAA NOS Center for Operational Oceanographic Products and Services (CO-OPS)....

  1. Enhanced Hourly Wind Station Data for the Contiguous United States

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — U.S. Enhanced Hourly Wind Station Data is digital data set DSI-6421, archived at the National Centers for Environmental Information (NCEI; formerly National Climatic...

  2. Shift work, long working hours, and later risk of dementia

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Garde, AH; Ishtiak-Ahmed, K

    2017-01-01

    –1971 and 1985–1986), long working hours defined as >45 hours per week (collected in 1970–1971), socioeconomic status, sleep, stress, and cardiovascular risk factors. Information about dementia diagnoses was obtained from registers. Participants were followed until 2014 (mean length of follow-up was 17.8 years......Objectives: The aim of this study was to investigate the effect of shift work and long working hours in midlife on the risk of dementia in old age. Methods: The present study comprised 4766 participants from the Copenhagen Male Study. We used information on shift work (collected in 1970......). We employed Poisson regression for the survival analyses and estimated incidence rate ratios (IRR) and their 95% confidence intervals (CI). Results: We found no statistically significant association between shift work (IRR 0.86, 95% CI 0.70–1.05) or long working hours (IRR 0.97, 95% CI 0...

  3. [Medical justification of the eight-hour shift work].

    Science.gov (United States)

    Haro-García, Luis; Sánchez-Román, Raúl; Juárez-Pérez, Cuauhtémoc Arturo; Larios-Díaz, Enrique

    2007-01-01

    The 8-hour shift work is one of the main achievements of the organized workers. International solidarity with United States miners, who were massacred in Chicago in 1886, and the aftermath of World War I promoted the establishment of 8-hour shift work in many countries. In Mexico, the 1917 Social Rights Declaration adhered to this position under the idea that the excessive workload above the 8-hour limit had negative effects on the health of workers; nevertheless, this statement seems to be sustained only by testimonies, anecdotal opinions and/or by the logic and common sense that then prevailed. For this reason, a literature review was carried out in search for the evidence supporting this apparently immovable length of the shift work. The globalization of the economy and the tendency towards flexibility and deregulation of current contractual relationships, are the new challenges that the 8-hour shift work is facing.

  4. Out-of-hours GPs and palliative care-a qualitative study exploring information exchange and communication issues

    Directory of Open Access Journals (Sweden)

    Taubert Mark

    2010-08-01

    Full Text Available Abstract Background Out-of-hours general practitioners (GPs cover the community over a significant proportion of a given week, and palliative care patients are seen as a priority. Little is known about how well these GPs feel supported in their line of work and whether communication exchanges work well for the proportion of their patients who have palliative care needs. For this study, GPs who provide out-of-hours care were interviewed in order to explore factors that they identified as detrimental or beneficial for good communication between themselves, patients, relatives and other professionals, specifically to palliative care encounters. Methods Nine GPs were interviewed using face-to-face semi-structured interviews. All nine GPs worked regular out-of-hours sessions. Data from transcripts was analysed using Interpretative Phenomenological Analysis. Results A predominant theme expressed by GPs related to constraints within the system provided by the local private company owned out-of-hours provider. A strong feeling of 'being alone out there' emerged, with some GPs more willing to call for help than others, and others expressing their concern at access to pharmacies and medication being very inconsistent. Out-of-hours GPs felt left alone on occasion, unable to access daytime services and not knowing who to call for advice. Information hand-over systems from in-hours to out-of-hours with regard to palliative care were felt to be inadequate. Out-of-hours doctors interviewed felt left out of the care loop; handover sheets from specialist palliative care providers were a rarity. Conclusions Out-of-hours services need to be mindful of the needs of the GPs they employ, in particular relating to the palliative care they provide in this setting. Other healthcare professionals should aim to keep their local out-of-hours service informed about palliative care patients they may be called to see.

  5. Half a million hours of rugby football. The injuries.

    Science.gov (United States)

    Sparks, J. P.

    1981-01-01

    In 30 seasons at Rugby School half a million hours of Rugby football have led to 9,885 injuries, an incidence of 197.7 injuries per 10.000 player hours. This incidence is compared with those from other school games, and with those of other series of Rugby football injuries. The injuries are compared regionally with those of other series, and the more important are listed. Images p30-a PMID:7248678

  6. Working hours and Work-Life Balance Satisfaction in Couples

    OpenAIRE

    Georges, Nathalie; Méda, Dominique; Trancart, Danièle

    2010-01-01

    Over the past several years, many studies have highlighted the strategic nature of working hours, the way they are determined, their regularity and their predictability to judge the qualities of a job and how family life and work life are reconciled. Our results confirm those obtained by previous studies and clarify them, while also showing that both the working hours of the persons questioned and those of their spouse constitute a central variable. We will first review the results from the a...

  7. Effectiveness and Safety of 2-Hourly 20 MCG Oral Misoprostol ...

    African Journals Online (AJOL)

    Results: The overall induction success rates in the misoprostol arm was 81% versus 83% in the oxytocin arm (P=0.447). The mean induction to vaginal delivery interval in the misoprostol arm was 8.4 hours as compared to 9.45 hours in the oxytocin arm (P=0.116). The induction to active labour interval was similar in the two ...

  8. Regional precipitation-frequency analysis and spatial mapping for 24-hour and 2-hour durations for Washington State

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available This study is an update of the information contained in the precipitation-frequency atlas published by the US National Weather Service in 1973. Data collection for the NWS study ended in 1966 while this study uses the current data base which more than doubles the record length used in the NWS study. Washington State has highly variable topography and climate; in particular Mean Annual Precipitation (MAP varies from over 260 inches a year to less than 7 inches. Steep high mountain ranges provide very wet slopes as well as pronounced rain shadows with large climate changes occurring in relatively short distances. In addition there are four distinct sources for the atmospheric moisture needed for precipitation which gives rise to complex seasonal and spatial interactions. The PRISM mapping system used in this study has greatly improved the spatial mapping of precipitation and increased the reliability of estimates of precipitation in the broad areas between precipitation measurement stations. Further, the development and use of regional L-Moments has greatly improved the reliability of precipitation magnitude-frequency estimates, particularly for the rarer and more extreme storms. Washington State could be specified adequately by 12 regions for the purposes of estimating the 2-hour and 24 hour precipitation frequencies. Within each region algorithms were developed for L-CV and L-Skewness expressed as functions of the MAP. The GEV distribution was acceptable statistically for all regions up to the 1 in 500 recurrence interval, beyond which the four-parameter Kappa distribution is recommended. The estimated changes in precipitation magnitudes for a given frequency as regional boundaries were crossed were found to be small, and well within the expected differences likely from sampling errors. An interesting transition zone was observed at the eastern edge of the Cascade foothills, associated with the maxima having a seasonal change from autumn

  9. Effect of a Protected Sleep Period on Hours Slept During Extended Overnight In-hospital Duty Hours Among Medical Interns

    Science.gov (United States)

    Volpp, Kevin G.; Shea, Judy A.; Small, Dylan S.; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian; Novak, Cristina; Bellini, Lisa M.; Dine, C. Jessica; Mollicone, Daniel J.; Dinges, David F.

    2013-01-01

    Context A 2009 Institute of Medicine report recommended protected sleep periods for medicine trainees on extended overnight shifts, a position reinforced by new Accreditation Council for Graduate Medical Education requirements. Objective To evaluate the feasibility and consequences of protected sleep periods during extended duty. Design, Setting, and Participants Randomized controlled trial conducted at the Philadelphia VA Medical Center medical service and Oncology Unit of the Hospital of the University of Pennsylvania (2009–2010). Of the 106 interns and senior medical students who consented, 3 were not scheduled on any study rotations. Among the others, 44 worked at the VA center, 16 at the university hospital, and 43 at both. Intervention Twelve 4-week blocks were randomly assigned to either a standard intern schedule (extended duty overnight shifts of up to 30 hours; equivalent to 1200 overnight intern shifts at each site), or a protected sleep period (protected time from 12:30 AM to 5:30 AM with handover of work cell phone; equivalent to 1200 overnight intern shifts at each site). Participants were asked to wear wrist actigraphs and complete sleep diaries. Main Outcome Measures Primary outcome was hours slept during the protected period on extended duty overnight shifts. Secondary outcome measures included hours slept during a 24-hour period (noon to noon) by day of call cycle and Karolinska sleepiness scale. Results For 98.3% of on-call nights, cell phones were signed out as designed. At the VA center, participants with protected sleep had a mean 2.86 hours (95% CI, 2.57–3.10 hours) of sleep vs 1.98 hours (95% CI, 1.68–2.28 hours) among those who did not have protected hours of sleep (P sleep had a mean 3.04 hours (95% CI, 2.77–3.45 hours) of sleep vs 2.04 hours (95% CI, 1.79–2.24) among those who did not have protected sleep (P sleep were significantly less likely to have call nights with no sleep: 5.8% (95% CI, 3.0%–8.5%) vs 18.6% (95% CI, 13

  10. “Friday off”: Reducing Working Hours in Europe

    Directory of Open Access Journals (Sweden)

    Jack Rossiter

    2013-04-01

    Full Text Available This article explores the pros and cons for reducing working hours in Europe. To arrive to an informed judgment we review critically the theoretical and empirical literature, mostly from economics, concerning the relation between working hours on the one hand, and productivity, employment, quality of life, and the environment, on the other. We adopt a binary economics distinction between capital and labor productiveness, and are concerned with how working hours may be reduced without harming the earning capacity of workers. There are reasons to believe that reducing working hours may absorb some unemployment, especially in the short-run, even if less than what is advocated by proponents of the proposal. Further, there may well be strong benefits for the quality of peoples’ lives. Environmental benefits are likely but depend crucially on complementary policies or social conditions that will ensure that the time liberated will not be directed to resource-intensive or environmentally harmful consumption. It is questionable whether reduced working hours are sustainable in the long-term given resource limits and climate change. We conclude that while the results of reducing working hours are uncertain, this may be a risk worth taking, especially as an interim measure that may relieve unemployment while other necessary structural changes are instituted.

  11. ACGME proposes dropping the 16 hour resident shift limit

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-11-01

    Full Text Available No abstract available. Article truncated after 150 words. The Accreditation Council for Graduate Medical Education (ACGME is proposing that first-year residents would no longer be limited to 16-hour shifts during the 2017-2018 academic year under a controversial proposal released today (1. Instead, individual residency programs could assign first-year trainees to shifts as long as 28 hours, the current limit for all other residents. The 28-hour maximum includes 4 transitional hours that's designed in part to help residents improve continuity of care. The plan to revise training requirements does not change other rules designed to protect all residents from overwork. including the maximum80 hours per week. The ACGME capped the shifts of first-year residents at 16 hours in 2011 as a part of an ongoing effort to make trainee schedules more humane and avoid clinical errors caused by sleep deprivation. ACGME CEO Thomas Nasca, MD, told Medscape Medical News that the problem arises largely from first-year residents not being ...

  12. Therapy Provider Phase Information

    Data.gov (United States)

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

  13. Changing commuters' behavior using rewards: a study of rush-hour avoidance

    NARCIS (Netherlands)

    Ben Elia, E.; Ettema, D.F.

    2011-01-01

    In a 13-week field study conducted in The Netherlands, participants were provided with daily rewards – monetary and in-kind, in order to encourage them to avoid driving during the morning rush-hour. Participants could earn a reward (money or credits to keep a Smartphone handset), by driving to work

  14. A COMPREHENSIVE STUDY OF HOURLY AND DAILY SEWAGE FLOW RATES IN FLORIDA PUBLIC SCHOOLS.

    Science.gov (United States)

    FOGARTY, WILLIAM J.; REEDER, MILTON E.

    A DETERMINATION OF THE HOURLY AND DAILY SEWAGE FLOW RATES IN FLORIDA PUBLIC SCHOOLS WAS MADE TO IDENTIFY THE FLOW CHARACTERISTICS AND TO PROVIDE A MORE PRECISE BASIS FOR THE ESTABLISHMENT OF DESIGN CRITERIA FOR SEWAGE DISPOSAL FACILITIES IN SCHOOLS. WATER FLOW DATA WAS COLLECTED FOR 158 SCHOOLS AND SEWAGE FLOW DATA FROM 42 SCHOOLS. THE FINDINGS…

  15. Documenting and Improving the Hourly Wage Measure in the Danish IDA Database

    DEFF Research Database (Denmark)

    Lund, Christian Giødesen; Vejlin, Rune Majlund

    This paper overhauls the hourly wage measure that is most often used in Danish research, the TIMELON variable in the IDA database. Based on a replication that we have constructed, we provide a documentation of the wage variable, the first of its kind, then continue with a performance analysis. We...

  16. 25 Hours in Family: How Family Internships Can Help School Leaders Transform from within

    Science.gov (United States)

    Alonzo, Julie; Bushey, Lisa; Gardner, Douglas; Hasazi, Susan; Johnstone, Christopher; Miller, Peter

    2006-01-01

    This article describes the ways in which a 25-hour internship with families who have children with disabilities impacted four doctoral students in educational leadership. We discuss the lessons we learned as a result of our experiences and provide insight into the structural components of the internship experience that were critical to enhancing…

  17. GPs' experiences with out-of-hours GP cooperatives: a survey study from the Netherlands.

    Science.gov (United States)

    Smits, Marleen; Keizer, Ellen; Huibers, Linda; Giesen, Paul

    2014-09-01

    Out-of-hours primary care has been provided by general practitioner (GP) cooperatives since the year 2000 in the Netherlands. Early studies in countries with similar organizational structures showed positive GP experiences. However, nowadays it is said that GPs experience a high workload at the cooperative and that they outsource a considerable part of their shifts. To examine positive and negative experiences of GPs providing out-of-hours primary care, and the frequency and reasons for outsourcing shifts. A cross-sectional observational survey among 688 GPs connected to six GP cooperatives in the Netherlands, using a web-based questionnaire. The response was 55% (n = 378). The main reasons for working in GP cooperatives were to retain registration as GP (79%) and remain experienced in acute care (74%). GPs considered the peak hours (81%) and the high number of patients (73%) as the most negative aspects. Most GPs chose to provide the out-of-hours shifts themselves: 85% outsourced maximally 25% of their shifts. The percentage of outsourced shifts increased with age. Main reasons for outsourcing were the desire to have more private time (76%); the high workload in daytime practice (71%); and less the workload during out-of-hours (46%). GPs are motivated to work in out-of-hours GP cooperatives, and they outsource few shifts. GPs consider the peak load and the large number of (non-urgent) help requests as the most negative aspects. To motivate and involve GPs for 7 × 24-h primary care, it is important to set limits on their workload.

  18. The clinical efficacy of Colgate Total Plus Whitening Toothpaste containing a special grade of silica and Colgate Total Toothpaste for controlling breath odor twelve hours after toothbrushing: a single-use clinical study.

    Science.gov (United States)

    Sharma, Naresh C; Galustians, H Jack; Qaqish, Jimmy; Galustians, Ana; Petrone, Margaret E; Rustogi, Kedar N; Zhang, Yun Po; DeVizio, William; Volpe, Anthony R

    2002-01-01

    The objective of this double-blind clinical study, conducted in harmony with American Dental Association guidelines, was to compare a new dentifrice formulation variant of Colgate Total Toothpaste containing a special grade of silica (Colgate Total Plus Whitening Toothpaste) to the commercially available, ADA-Accepted and clinically proven Colgate Total Toothpaste for controlling breath odor twelve hours after brushing the teeth. Breath odor was evaluated by a panel of three examiners using a nine-point hedonic scale. Following a baseline evaluation of breath odor, prospective study subjects who scored above the threshold value for unpleasant breath odor were stratified by score and randomized into two treatment groups. Subjects were provided with a soft-bristled toothbrush, and brushed their teeth thoroughly in their regular and customary manner with their assigned dentifrice. Subjects refrained from dental hygiene, breath mints or mounthrinses for the next twelve hours, after which they were again evaluated for breath odor. Eighty-three (83) adult male and female subjects from the Mississauga, Ontario, Canada area participated in the study. At twelve hours after brushing their teeth, subjects in both dentifrice treatment groups presented mean breath odor scores which were statistically significantly lower than the mean scores observed at baseline. Importantly, there was no statistical difference between the two dentifrices of the mean twelve-hour breath odor scores. The mean twelve-hour breath scores for the Colgate Total Plus Whitening Toothpaste group and the Colgate Total Toothpaste group were 4.89 and 4.67, respectively, which are within the range of values corresponding to pleasant breath odor. Thus, the results of this double-blind clinical study, conducted according to a protocol which had been approved by the Council on Scientific Affairs of the American Dental Association, support the conclusion that Colgate Total Plus Whitening Toothpaste and Colgate

  19. Predicting success of methotrexate treatment by pretreatment HCG level and 24-hour HCG increment.

    Science.gov (United States)

    Levin, Gabriel; Saleh, Narjes A; Haj-Yahya, Rani; Matan, Liat S; Avi, Benshushan

    2017-11-20

    To evaluate β-human chorionic gonadotropin (β-HCG) level and its 24-hour increment as predictors of successful methotrexate treatment for ectopic pregnancy. Data were retrospectively reviewed from women with ectopic pregnancy who were treated by single-dose methotrexate (50 mg/m 2 ) at a university hospital in Jerusalem, Israel, between January 1, 2000, and June 30, 2015. Serum β-HCG before treatment and its percentage increment in the 24 hours before treatment were compared between treatment success and failure groups. Sixty-nine women were included in the study. Single-dose methotrexate treatment was successful for 44 (63.8%) women. Both mean β-HCG level and its 24-hour increment were lower for women with successful treatment than for those with failed treatment (respectively, 1224 IU\\L vs 2362 IU\\L, P=0.018; and 13.5% vs 29.6%, P=0.009). Receiver operator characteristic curve analysis yielded cutoff values of 1600 IU\\L and 14% increment with a positive predictive value of 75% and 82%, respectively, for treatment success. β-HCG level and its 24-hour increment were independent predictors of treatment outcome by logistic regression (both PHCG increment of less than 14% in the 24 hours before single-dose methotrexate and serum β-HCG of less than 1600 IU\\L were found to be good predictors of treatment success. © 2017 International Federation of Gynecology and Obstetrics.

  20. Revisiting enduring values

    Directory of Open Access Journals (Sweden)

    Michael Gorman

    2015-05-01

    Full Text Available The paper discusses the nature of values in general and the nature and utility of the values of librarianship.  Delineates the changes that have occurred and are occurring in the wider world and the nature of change; also the importance of values in providing a framework for dealing with present and future change.  Stresses the centrality of the human record to societal progress, the place of the human record in cultural heritage, and the central purpose of libraries in facilitating interaction with the human record and furthering the transmission of cultural heritage.  Urges a turning away from the alien value systems of information technology, consumerism, materialism, and corporate management, and a consequent set of alliances between libraries and a wide range of cultural institutions and associations.

  1. Prevalence of 24-hour urine collection in high risk stone formers.

    Science.gov (United States)

    Milose, Jaclyn C; Kaufman, Samuel R; Hollenbeck, Brent K; Wolf, J Stuart; Hollingsworth, John M

    2014-02-01

    Secondary prevention has an important role in urinary stone disease. The core of secondary prevention is the identification of modifiable risk factors by a 24-hour urine collection, which then directs selective medical therapy. While this decreases the recurrence rate, little is known about the frequency with which 24-hour urine collections are obtained. Using medical claims from 2002 to 2006 we identified adults with incident urinary stone episodes. With appropriate diagnosis codes we determined those at high risk for recurrence. Of these patients we determined the proportion in whom a 24-hour urine collection was done within 6 months of diagnosis. Finally, we fitted regression models to measure associations between patient and provider level factors, and obtaining a 24-hour urine collection. We identified 28,836 patients at high risk for recurrence. The prevalence of 24-hour urine testing increased from 7.0% in 2003 to 7.9% in 2006 (p = 0.011), although the overall prevalence was exceedingly low at 7.4%. Multivariable regression revealed that region of residence and level of comorbid illness were independently associated with 24-hour urine collection, as was the type of physician who performed the followup. For instance, the odds of metabolic evaluation were 2.9 times higher when a patient was seen by a nephrologist (OR 2.92, 95% CI 2.32-3.67), and more than threefold higher when seen by a urologist (OR 3.87, 95% CI 3.48-4.30). Obtaining 24-hour urine collections in stone formers at high risk is uncommon, raising a quality of care concern. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  2. Modeling Hourly Resident Productivity in the Emergency Department.

    Science.gov (United States)

    Joseph, Joshua W; Henning, Daniel J; Strouse, Connie S; Chiu, David T; Nathanson, Larry A; Sanchez, Leon D

    2017-08-01

    Resident productivity, defined as new patients per hour, carries important implications for emergency department operations. In high-volume academic centers, essential staffing decisions can be made on the assumption that residents see patients at a static rate. However, it is unclear whether this model mirrors reality; previous studies have not rigorously examined whether productivity changes over time. We examine residents' productivity across shifts to determine whether it remained consistent. This was a retrospective cohort study conducted in an urban academic hospital with a 3-year emergency medicine training program in which residents acquire patients ad libitum throughout their shift. Time stamps of all patient encounters were automatically logged. A linear mixed model was constructed to predict productivity per shift hour. A total of 14,364 8- and 9-hour shifts were worked by 75 residents between July 1, 2010, and June 20, 2015. This comprised 6,127 (42.7%) postgraduate year (PGY) 1 shifts, 7,236 (50.4%) PGY-2 shifts, and 998 (6.9%) PGY-3 nonsupervisory shifts (Table 1). Overall, residents treated a mean of 10.1 patients per shift (SD 3.2), with most patients at Emergency Severity Index level 3 or more acute (93.8%). In the initial hour, residents treated a mean of 2.14 patients (SD 1.2), and every subsequent hour was associated with a significant decrease, with the largest in the second, third, and final hours. Emergency medicine resident productivity during a single shift follows a reliable pattern that decreases significantly hourly, a pattern preserved across PGY years and types of shifts. This suggests that resident productivity is a dynamic process, which should be considered in staffing decisions and studied further. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  3. Cardiac arrhythmias 48 hours before, during, and 48 hours after discharge from hospital following acute myocardial infarction.

    Science.gov (United States)

    Morrison, G W; Kumar, E B; Portal, R W; Aber, C P

    1981-05-01

    The cardiac rate and rhythm were studied by 24-hour ambulatory electrocardiographic recording in 44 patients before, during, and after being discharged from hospital following an acute myocardial infarction. The first recordings were started 48 hours before discharge, the second on the morning of the day of discharge, and the third 48 hours after discharge (at home). While in hospital and after returning home the heart rate fell during sleep but there was no diurnal variation in the frequency of ventricular extrasystoles. Daytime heart rate and both the frequency and grade (severity) of ventricular arrhythmias were significantly raised 48 hours after discharge. The frequency of ventricular extrasystoles during sleep was also increased in the 48 hours post-discharge recording. Rises in heart rate and frequency and severity of ventricular extrasystoles were observed on the morning of the day of discharge, increasing up to the time of leaving hospital, but during the journey home they all diminished. No relation was found between ventricular arrythmias during early convalescence and (i) ventricular arrhythmias during the acute phase of acute myocardial infarction (including ventricular fibrillation); (ii) peak aspartate aminotransferase; (iii) the level of anxiety; or (iv) the personality type. Six patients taking beta-blocking drugs behaved similarly. Five patients taking anxiolytic drugs has significantly raised frequency of ventricular extrasystoles during each 24-hour electrocardiogram. In spite of the above findings, at the time of leaving hospital after acute myocardial infarction there does not appear to be a serious risk from the development of major cardiac arrhythmias.

  4. Value of information

    DEFF Research Database (Denmark)

    Straub, D.; Chatzi, E.; Bismut, E.

    2017-01-01

    The concept of value of information (VoI) enables quantification of the benefits provided by structural health monitoring (SHM) systems –in principle. Its implementation is challenging, as it requires an explicit modelling of the structural system’s life cycle, in particular of the decisions...

  5. CHIS – Opening hours of UNIQA offices during end-of-year closure

    CERN Multimedia

    2013-01-01

    The office of UNIQA at CERN (Main Building) will be closed during the end-of-year closure.   During that period, the Geneva offices of UNIQA will be open on 23, 26, 27 and 30 December as well as on 2 and 3 January. Opening hours: 8 a.m. to 12.30 p.m. and 1.30 p.m. to 5 p.m. During these hours, you can also call 022 718 63 00. Mail sent to uniqa.assurances@cern.ch will be handled only during these opening hours. For urgent medical assistance, you may call +43 512 224 22, 24h/day.  Please note that this service only provides medical advice and is not in a position to inform you on your administrative situation nor on the coverage by CHIS of medical expenses. HR Department Tel.: 74125

  6. Characteristics of worst hour rainfall rate for radio wave propagation modelling in Nigeria

    Science.gov (United States)

    Osita, Ibe; Nymphas, E. F.

    2017-10-01

    Radio waves especially at the millimeter-wave band are known to be attenuated by rain. Radio engineers and designers need to be able to predict the time of the day when radio signal will be attenuated so as to provide measures to mitigate this effect. This is achieved by characterizing the rainfall intensity for a particular region of interest into worst month and worst hour of the day. This paper characterized rainfall in Nigeria into worst year, worst month, and worst hour. It is shown that for the period of study, 2008 and 2009 are the worst years, while September is the most frequent worst month in most of the stations. The evening time (LT) is the worst hours of the day in virtually all the stations.

  7. A step towards using urinary nitrogen as a tool for validating 24-hour dietary recall interviews.

    Science.gov (United States)

    Kahn, H A

    1987-09-01

    In an active population, can urinary nitrogen output provide a satisfactory basis for estimating protein intake without preliminary screening to rule out metabolic disease? A successful demonstration would justify comparing average protein intake for active groups derived from 24-hour recall interviews with that obtained from 24-hour urine specimens. This could then be a practical test of the hypothesis that 24-hour recall data provide valid estimates for groups. Volunteers (45) from a university population limited their diet for four days to a commercially prepared liquid diet and provided a 24-hour urine specimen beginning on the morning of the fourth day. For men, average daily intake of protein was 112.8 grams and the estimated intake based on urinary nitrogen was 114.5. Corresponding data for women were 84.6 and 83.9. Screening for metabolic disease seems unnecessary but persons restricting their intake to less than their caloric needs will have their protein intake overestimated on the basis of urinary nitrogen measurement.

  8. Nurses' extended work hours: Patient, nurse and organizational outcomes.

    Science.gov (United States)

    Kunaviktikul, W; Wichaikhum, O; Nantsupawat, A; Nantsupawat, R; Chontawan, R; Klunklin, A; Roongruangsri, S; Nantachaipan, P; Supamanee, T; Chitpakdee, B; Akkadechanunt, T; Sirakamon, S

    2015-09-01

    Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems

  9. Maintaining outcomes in a surgical residency while complying with resident working hour regulations.

    Science.gov (United States)

    Hassett, James M; Nawotniak, Ruth; Cummiskey, Donna; Berger, Roseanne; Posner, Alan; Seibel, Roger; Hoover, E

    2002-10-01

    Regulatory requirements for resident working hours were designed to improve patient care. Compliance challenges a training program to meet procedural and clinical requirements. This is a retrospective study of a 5-year experience in addressing the challenges and studying the impact of compliance on resident caseload and board performance. Our surgical program adopted strict start/stop working hours for clinical contact. Program leadership modified the program to establish procedural and performance criteria. Procedures were prioritized and assignments were changed to maximize clinical and procedural experience while reducing redundancy of experience. Procedural activity was monitored frequently. Compliance with working hour regulations was monitored and behavior modified where necessary. A web based computer program was developed to improve measurement of compliance and provide feedback. Outcome measures included both the number of procedures as reported by the ACGME and performance on the American Board of Surgery, Qualifying Examination. Working hour compliance is greater than 95%. First time pass rate on the Qualifying examination is 90% (45/50). There is no significant difference in the procedural activity. Complying with working hour regulations improves the quality of a resident's life and can be achieved while maintaining procedural experience and guaranteeing academic development.

  10. Modeling Aggregate Hourly Energy Consumption in a Regional Building Stock

    Directory of Open Access Journals (Sweden)

    Anna Kipping

    2017-12-01

    Full Text Available Sound estimates of future heat and electricity demand with high temporal and spatial resolution are needed for energy system planning, grid design, and evaluating demand-side management options and polices on regional and national levels. In this study, smart meter data on electricity consumption in buildings are combined with cross-sectional building information to model hourly electricity consumption within the household and service sectors on a regional basis in Norway. The same modeling approach is applied to model aggregate hourly district heat consumption in three different consumer groups located in Oslo. A comparison of modeled and metered hourly energy consumption shows that hourly variations and aggregate consumption per county and year are reproduced well by the models. However, for some smaller regions, modeled annual electricity consumption is over- or underestimated by more than 20%. Our results indicate that the presented method is useful for modeling the current and future hourly energy consumption of a regional building stock, but that larger and more detailed training datasets are required to improve the models, and more detailed building stock statistics on regional level are needed to generate useful estimates on aggregate regional energy consumption.

  11. Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level

    Directory of Open Access Journals (Sweden)

    Guilherme Brasil Grezzana

    Full Text Available Abstract Background: Hypertension is an important risk factor for cardiovascular outcomes. Primary health care (PHC physicians should be prepared to act appropriately in the prevention of cardiovascular risk factors. However, the rates of patients with control of blood pressure (BP remain low. The impact of the reclassification of high BP by 24-hour ambulatory BP monitoring (ABPM can lead to different medical decisions in PHC. Objective: To evaluate the agreement between the BP measured by a conventional method by PHC physicians and by 24-hour ABPM, considering different BP normal thresholds for the 24-hour ABPM according to the V Brazilian ABPM Guidelines and the European Society of Hypertension Guidelines. Methods: A cross-sectional study including 569 hypertensive patients. The BP was initially measured by the PHC physicians and, later, by 24-hour ABPM. The BP measurements were obtained independently between the two methods. The therapeutic targets for the conventional BP followed the guidelines by the Eighth Joint National Committee (JNC 8, the V ABPM Brazilian Guidelines, and the 2013 European Hypertension Guidelines. Results: There was an accuracy of 54.8% (95% confidence interval [95%CI] 0.51 - 0.58% for the BP measured with the conventional method when compared with the 24-hour ABPM, with a sensitivity of 85% (95%CI 80.8 - 88.6%, specificity of 31.9% (95%CI 28.7 - 34.7%, and kappa value of 0.155, when considering the European Hypertension Guidelines. When using more stringent thresholds to characterize the BP as "normal" by ABPM, the accuracy was 45% (95%CI 0.41 - 0.47% for conventional measurement when compared with 24-hour ABPM, with a sensitivity of 86.7% (95%CI 0.81 - 0.91%, specificity of 29% (95%CI 0.26 - 0.30%, and kappa value of 0.103. Conclusion: The BP measurements obtained by PHC physicians showed low accuracy when compared with those obtained by 24-hour ABPM, regardless of the threshold set by the different guidelines.

  12. Stochastic modeling of hourly rainfall times series in Campania (Italy)

    Science.gov (United States)

    Giorgio, M.; Greco, R.

    2009-04-01

    Occurrence of flowslides and floods in small catchments is uneasy to predict, since it is affected by a number of variables, such as mechanical and hydraulic soil properties, slope morphology, vegetation coverage, rainfall spatial and temporal variability. Consequently, landslide risk assessment procedures and early warning systems still rely on simple empirical models based on correlation between recorded rainfall data and observed landslides and/or river discharges. Effectiveness of such systems could be improved by reliable quantitative rainfall prediction, which can allow gaining larger lead-times. Analysis of on-site recorded rainfall height time series represents the most effective approach for a reliable prediction of local temporal evolution of rainfall. Hydrological time series analysis is a widely studied field in hydrology, often carried out by means of autoregressive models, such as AR, ARMA, ARX, ARMAX (e.g. Salas [1992]). Such models gave the best results when applied to the analysis of autocorrelated hydrological time series, like river flow or level time series. Conversely, they are not able to model the behaviour of intermittent time series, like point rainfall height series usually are, especially when recorded with short sampling time intervals. More useful for this issue are the so-called DRIP (Disaggregated Rectangular Intensity Pulse) and NSRP (Neymann-Scott Rectangular Pulse) model [Heneker et al., 2001; Cowpertwait et al., 2002], usually adopted to generate synthetic point rainfall series. In this paper, the DRIP model approach is adopted, in which the sequence of rain storms and dry intervals constituting the structure of rainfall time series is modeled as an alternating renewal process. Final aim of the study is to provide a useful tool to implement an early warning system for hydrogeological risk management. Model calibration has been carried out with hourly rainfall hieght data provided by the rain gauges of Campania Region civil

  13. Implementing after-hours pharmacy coverage for critical access hospitals in northeast Minnesota.

    Science.gov (United States)

    Stratton, Timothy P; Worley, Marcia M; Schmidt, Mark; Dudzik, Michael

    2008-09-15

    A project that used health information technology (IT) to provide after-hours pharmacy coverage to critical access hospitals in northeast Minnesota is described. SISU Medical Systems was established to address the health care IT needs of the Wilderness Health Care Coalition hospitals. Administrators and nursing and pharmacy leaders at several Wilderness Coalition hospitals were interested in obtaining after-hours pharmacy services to optimize patient safety. Eight of the Wilderness Coalition critical access hospitals obtained the technology necessary to allow pharmacy staff at St. Luke's Hospital (the hub hospital) in Duluth, Minnesota, to electronically enter orders into the rural hospitals' patient electronic medical records. The system placed the orders into the patients' medication profiles on automated dispensing machines located at seven of the eight rural hospitals. The pharmacy computer system allowed for medication order processing, drug interaction checking, medication dispensing via automated dispensing cabinets at the rural hospital sites, and formulary and inventory management. Medications that were not available in a rural hospital's automated dispensing cabinet were obtained from the locked pharmacy by the nurse supervisor. Round-the-clock pharmacy coverage was almost achieved. Participating rural hospitals received 24-hour coverage from the hub hospital during weekends and holidays, but no after-hours (4 a.m.-7 a.m.) coverage was provided on weekdays. The staff at the rural hospitals determined from their experiences that new orders were less likely to be written during these hours. Using Internet-based health IT, pharmacists from a metropolitan (hub) hospital with round-the-clock pharmacist coverage participated in the care of patients at a number of small, rural hospitals and helped ensure that those patients received safe and effective medication therapy. The coverage provided by pharmacists at the hub hospital improved nursing satisfaction with

  14. Employees' use of social media for private reasons during working hours

    Science.gov (United States)

    Gunnlaugsdottir, Johanna

    2015-02-01

    The objectives of the study were to find out: Whether Icelandic organizations allowed open access to social media (SM), whether the respondents used SM for private reasons during working hours, which SM they used, how much time they devoted to such use, and what was the attitude of managers and the employees themselves towards such use. The respondents were asked to disclose whether they worked in the private or the public sector and the type of organization that they worked for. This was a two-dimensional study: A questionnaire sent to an internet panel and a telephone survey both based on a random sample selected from the National Registry in February 2013. A similar study has not been performed in Iceland before. Foreign studies of the same nature are not known, only related research. The main findings were that about half of the organizations allowed open access to SM, just below 50% of respondents took advantage of SM for personal use during working hours and the great majority used Facebook. Employees used a considerable part of their working hours for personal use of SM. The majority of respondents were of the opinion that managers objected to the use of SM during working hours and a larger majority believed that such use of themselves was unacceptable. The survey adds valuable information for a better understanding of the status of SM at places of work. The results could be of value to organizations that want to evaluate the pros and cons of SM for the organization.

  15. Hourly energy management for grid-connected wind-hydrogen systems

    Energy Technology Data Exchange (ETDEWEB)

    Bernal-Agustin, Jose L.; Dufo-Lopez, Rodolfo [Department of Electrical Engineering, University of Zaragoza, Calle Maria de Luna 3, 50018 Zaragoza (Spain)

    2008-11-15

    This paper is a complete technical-economic analysis of the hourly energy management of the energy generated in wind-hydrogen systems. Wind power generation depends on the unpredictable nature of the wind. If the wind-power penetration becomes high in the Spanish electrical grid, energy management will be necessary for some wind farms. A method is proposed in this paper to adjust the generation curve to the demand curve, consisting of the generation of hydrogen and storing it in a hydrogen tank during off-peak (low demand) hours, while during the rest of the hours (peak hours, high demand) the stored hydrogen can be used to generate electricity. After revising the results obtained in this paper, for the current values of efficiency of the electricity-hydrogen-electricity conversion (approximately 30%) and due to the high cost of the hydrogen components, for a wind-hydrogen system to be economically viable the price of the sale of the energy generated by the fuel cell would be very high (approximately 171 cEUR/kWh). (author)

  16. Simplified hourly method to calculate summer temperatures in dwellings

    DEFF Research Database (Denmark)

    Mortensen, Lone Hedegaard; Aggerholm, Søren

    2012-01-01

    :2008 but with further simplifications. The method is used for calculating room temperatures for all hours of a reference year. It is essential that the simplified method is able to predict the temperature in the room with the highest heat load. The heat load is influenced by the solar load, internal load, ventilation...... with an ordinary distribution of windows and a “worst” case where the window area facing south and west was increased by more than 60%. The simplified method used Danish weather data and only needs information on transmission losses, thermal mass, surface contact, internal load, ventilation scheme and solar load......The objective of this study was to develop a method for hourly calculation of the operating temperature in order to evaluate summer comfort in dwellings to help improve building design. A simplified method was developed on the basis of the simple hourly method of the standard ISO 13790...

  17. Administrative Circular No. 23 (Rev. 4) - Special working hours

    CERN Multimedia

    Department Head Office - HR Department

    2016-01-01

    Administrative Circular No. 23 (Rev. 4) entitled "Special working hours", approved by the Director-General following discussion in the Standing Concertation Committee meeting on 22 March 2016, will be available on 1st September 2016 via the following link: https://cds.cern.ch/record/2208539.   This revised circular cancels and replaces Administrative Circular No. 23 (Rev. 3) also entitled "Special working hours" of January 2013. This document contains modifications to reflect the new career structure and ensuring the provision consistent with practice that compensation or remuneration of special working hours performed remotely is possible only in case of emergency.   This circular will enter into force on 1st September 2016.

  18. Early Postoperative 24-Hour Continuous Jejunostomy Feeding in Esophagectomy Patients

    Science.gov (United States)

    Lim, Jeong Hyun; Ju, Dal Lae; Hwang, Yoohwa

    2014-01-01

    Esophagectomy can result in various postoperative nutrition-related complications that may impair the nutritional status of the patient. In our institution, we usually initiate 16-hour continuous jejunostomy feeding using an enteral feeding pump on postoperative day 2 as a routine protocol after esophagectomy. The target calorie intake was achieved in 6-7 days with this protocol, which is longer than that required with other recently reported feeding protocols. Accordingly, early jejunostomy feeding protocol, which starts on postoperative day 1 and continues for 24 hours was attempted. In the present report, we described 3 cases of early 24-hour continuous jejunostomy feeding after esophagectomy. The use of this new protocol reduced the duration required to achieve the target calorie intake as less than 5 days without any enteral feeding-related complications. PMID:24527423

  19. Long working hours as a risk factor for atrial fibrillation

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Nyberg, Solja T.; Batty, G. David

    2017-01-01

    .003). There was no significant heterogeneity between the cohort-specific effect estimates (I2=0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N= 2006, hazard ratio= 1.36, 95% CI= 1.05-1.76, P = 0.0180). Adjustment for potential...... confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours....

  20. Information meeting on the new provisions for working hours

    CERN Document Server

    HR Department

    2008-01-01

    Monday 23 June 2008 at 14:00, Council Chamber (503/1-001) At the June 2008 Finance Committee and Council meetings, the Management will submit proposals to modify Chapter III, Section 1 of the Staff Rules and Regulations on Working Hours. These provisions will touch upon areas including compensation during the annual closure, periods of stand-by duty, plus compensation and eligibility for special working hours. A general information meeting, at which E. Chiaveri, Head of HR Department, will present the new policy, will be held on Monday 23 June at 14:00 in the Council Chamber. HR Department

  1. Palliative Care Office Hours for Patients with Hematologic Malignancies: An Innovative Model for Symptom Management and Education.

    Science.gov (United States)

    Foxwell, Anessa M; Moyer, Mary E; Casarett, David J; O'Connor, Nina R

    2017-10-01

    Palliative care programs are experiencing rapid growth, with demand for consults surpassing staffing. Innovative models are needed to equip nonpalliative care providers to manage basic palliative care issues. To develop a novel program of palliative care office hours for hematologic oncology advanced practice providers, and to evaluate its impact on palliative care consult volume and composition. A palliative care nurse practitioner or pharmacist was available for weekday office hours to all inpatient hematologic oncology advanced practice providers at an academic medical center to offer advice on pain, nonpain symptoms, and psychosocial distress. A retrospective study looking at outcome measures after six months of office hour utilization and palliative care consults from the hematologic oncology services. Palliative care office hours had a mean duration of 16 minutes per day (range 5 to 55). A mean of 11 patients were discussed per week (range 4 to 20). Pain, nausea, and anxiety were the issues most frequently raised. Of 299 patients discussed during office hours, 44 (14.7%) subsequently required a full palliative care consult. Overall, palliative care consults from the hematologic oncology services decreased from 19.6% to 10.2% of admissions (87/445 vs. 61/594, p care. Office hours are an efficient way to address palliative care needs when demand for palliative care consults exceeds capacity. Office hours may serve an educational function as well, enabling primary teams to manage basic palliative care issues with increasing independence over time.

  2. Company Value Anatomy

    Directory of Open Access Journals (Sweden)

    Luiz Nelson Guedes de Carvalho

    2008-10-01

    Full Text Available The seminal propositions by Modigliani and Miller started a new study area in modern finance theory. Over time, their basic assumptions were relaxed, to the extent that, nowadays, situations in which they can be fully applied, with consistent and satisfactory results, are rare. On the other hand, as this simple set of propositions became known worldwide and was easily applicable, it was adopted as a rule of thumb for general enterprise valuation. However, in situations without methodological bias, the resulting enterprise values obtained by traditional methodologies are abstruse and do not allow for the analysis and management of the individual values that make up the firm and own capital values. In order to avoid this kind of abstruseness in company valuation, this study theoretically deducts an alternative valuation methodology, which permits the identification of assets’ value independently of their financing; moreover, we identify the gain on debt value that the debt provides to the shareholders, the debt tax shield and the value loss of assets and tax shield due to the increase in shareholder risk because of the leverage capital structure.

  3. Vaccinations Administered During Off-Clinic Hours at a National Community Pharmacy: Implications for Increasing Patient Access and Convenience

    Science.gov (United States)

    Goad, Jeffery A.; Taitel, Michael S.; Fensterheim, Leonard E.; Cannon, Adam E.

    2013-01-01

    PURPOSE Approximately 50,000 adults die annually from vaccine-preventable diseases in the United States. Most traditional vaccine providers (eg, physician offices) administer vaccinations during standard clinic hours, but community pharmacies offer expanded hours that allow patients to be vaccinated at convenient times. We analyzed the types of vaccines administered and patient populations vaccinated during off-clinic hours in a national community pharmacy, and their implications for vaccination access and convenience. METHODS We retrospectively reviewed data for all vaccinations given at the Walgreens pharmacy chain between August 2011 and July 2012. The time of vaccination was categorized as occurring during traditional hours (9:00 am–6:00 pm weekdays) or off-clinic hours, consisting of weekday evenings, weekends, and federal holidays. We compared demographic characteristics and types of vaccine. We used a logistic regression model to identify predictors of being vaccinated during off-clinic hours. RESULTS During the study period, pharmacists administered 6,250,402 vaccinations, of which 30.5% were provided during off-clinic hours: 17.4% were provided on weekends, 10.2% on evenings, and 2.9% on holidays. Patients had significantly higher odds of off-clinic vaccination if they were younger than 65 years of age, were male, resided in an urban area, and did not have any chronic conditions. CONCLUSIONS A large proportion of adults being vaccinated receive their vaccines during evening, weekend, and holiday hours at the pharmacy, when traditional vaccine providers are likely unavailable. Younger, working-aged, healthy adults, in particular, a variety of immunizations during off-clinic hours. With the low rates of adult and adolescent vaccination in the United States, community pharmacies are creating new opportunities for vaccination that expand access and convenience. PMID:24019274

  4. The generation of hourly diffuse irradiation: A model from the analysis of the fluctuation of global irradiance series

    Energy Technology Data Exchange (ETDEWEB)

    Posadillo, R.; Lopez Luque, R. [Grupo de Investigacion de Fisica para las Energias y Recursos Renovables, Dpto. de Fisica Aplicada, UCO, Edificio C2 Campus de Rabanales, 14071 Cordoba (Spain)

    2010-04-15

    An analysis of models for the estimation of hourly diffuse irradiation based on the interrelations between the hourly diffuse fraction k{sub d} and the hourly clearness index k{sub t}, has concluded that k{sub t} is not a sufficient variable for parametrizing the effect of clouds on diffuse irradiation. A detailed study of the dispersion recorded by this diffuse component for a specific clearness index under partly cloudy sky conditions has led to analyzing how the variability in the instantaneous clearness index influences this dispersion. The data sets correspond to 10 years of hourly and instantaneous value records of global and diffuse radiation collected in Cordoba, Spain. In addition to the inclusion of the sine of solar elevation as a variable into the k{sub d}-k{sub t} correlations, this model propose the inclusion of others parameters related to the variability in the normalized clearness index within an hour and with the fluctuations presented by the time series of the instantaneous values of that index. Also presented is the implementation of an algorithm permitting both the determination of the hourly diffuse irradiation and the discrimination between the different sky conditions in those situations known by the designation partly cloudy sky. (author)

  5. The value compass : A study of consumer values and brand values

    NARCIS (Netherlands)

    Erik Jan Kostelijk

    2015-01-01

    In the psychological field, a lot of progress has been made in values theory. In marketing theory, however, the use of values has been undervalued. Despite the widespread managerial use of brand values, attention has remained focused on the brand personality concept. This book intends to provide a

  6. The Value Compass : A study of consumer values and brand values

    NARCIS (Netherlands)

    Kostelijk, Erik Jan

    2015-01-01

    In the psychological field, a lot of progress has been made in values theory. In marketing theory, however, the use of values has been undervalued. Despite the widespread managerial use of brand values, attention has remained focused on the brand personality concept. This book intends to provide a

  7. Organizational values in managerial communication

    OpenAIRE

    Malbašić, Ivan; Brčić, Ruža

    2012-01-01

    Organizational values have recently been regaining importance, which is reflected in the fact that they are commonly referred to as organizational foundations. Indeed, practice has proved that those values provide the basis for decision-making at all levels of the organization – from senior management to the non-managerial employees. This paper addresses the issue of communicating organizational values in managerial communication. In particular, communicating organizational values to employee...

  8. Working Hours, Promotion and the Gender Gap in the Workplace

    DEFF Research Database (Denmark)

    Kato, Takao; Owan, Hideo; Ogawa, Hiromasa

    This paper presents a novel model of promotion within the firm which sheds new light on the interplay between working hours and the odds of subsequent promotion. The model's key feature is the coexistence of two different sources of asymmetric information: (i) the worker's cost of long working ho...

  9. A Dutch Book of Hours from the 15th Century

    DEFF Research Database (Denmark)

    Vrieland, Seán D.; Hansen, Anne Mette

    2016-01-01

    Private books of hours were the European bestseller of the 14th-16th centuries, especially among the aristocracy and urban élite. They typically began with a calendar, which listed saints’ days and other religious holidays, the most important of which were written in red – the so-called “red...

  10. Forecasting Day-Ahead Electricity Prices : Utilizing Hourly Prices

    NARCIS (Netherlands)

    E. Raviv (Eran); K.E. Bouwman (Kees); D.J.C. van Dijk (Dick)

    2013-01-01

    textabstractThe daily average price of electricity represents the price of electricity to be delivered over the full next day and serves as a key reference price in the electricity market. It is an aggregate that equals the average of hourly prices for delivery during each of the 24 individual

  11. Globalization and working time: working hours and flexibility in Germany

    NARCIS (Netherlands)

    Burgoon, B.; Raess, D.

    2009-01-01

    This article challenges popular wisdom that economic globalization uniformly increases working time in industrialized countries. International investment and trade, they argue, have uneven effects for workplace bargaining over standard hours and over work-time flexibility, such as use of temporary

  12. The 150-Hour Requirement for CPA Licensure: One Institution's Response

    Science.gov (United States)

    Larkin, Joseph M.

    2014-01-01

    Virtually all states now require candidates for the Certified Public Accountant (CPA) examination and subsequent licensure to have completed 150 semester hours of college education. The rationale behind this requirement is to improve the preparation of students entering the profession and to increase their chances of successful completion of the…

  13. correlation between sunshine hours and climatic parameters at four

    African Journals Online (AJOL)

    Mgina

    Niels 1991, Karume et al. 2005, Otiti 1994,. Karekezi 1995). Naturally solar insolation increases with sunshine hours. Therefore, sunshine data can be used as input to predict the performance of concentrating solar energy systems (John and Tony 2000). However, it is not often possible to have solar radiation data at any.

  14. Estimation of global solar radiation from sunshine hours for Warri ...

    African Journals Online (AJOL)

    Multiple linear regression models were developed to estimate the monthly daily sunshine hours using four parameters during a period of eleven years (1997 to 2007) for Warri, Nigeria (Latitude of 5o 34' 21.0''); the parameters include, Relative Humidity, Maximum and Minimum Temperature, Rainfall and Wind Speed.

  15. Mortality Pattern within Twenty-Four Hours of Emergency Paediatric ...

    African Journals Online (AJOL)

    BACKGROUND: Mortality among emergency paediatric admissions within the first 24 hours is high in resource- poor nations. Measures to reduce the childhood mortality rate can only be effectively planned and implemented when the causes and magnitude of this problem are well defined. OBJECTIVE: To determine the ...

  16. Utilization of Leisure Hours among Students of Ambrose Alli ...

    African Journals Online (AJOL)

    The purpose of this study is to find out the utilization of leisure hours among students of Ambrose Alli University, Ekpoma, Nigeria. The researchers attempted to find out whether the students of Ambrose Alli University, Ekpoma creates time for their leisure activities, the factors that affect the participation in leisure activities, the ...

  17. The star-bright hour : [luuletused] / Betti Alver

    Index Scriptorium Estoniae

    Alver, Betti, 1906-1989

    2006-01-01

    Sisu: The star-bright hour ; Not a dream ; The Piper ; Corals in an ancent river. Luuletused pärinevad kogumikust "Tuulelaeval valgusest on aerud = Windship with Oars of Light. (Tallinn : Huma, 2001). Orig.: Tähetund ; Mitte viirastus, meelepett ; Vilepuhuja ; Korallid Emajões

  18. Storage beyond Three Hours at Ambient Temperature Alters the ...

    African Journals Online (AJOL)

    These results suggest that breast milk is stable for 3 hours, beyond which significant changes occur in its biochemical composition and nutritional quality. The implications of these findings are discussed with respect to their consequences on the child's survival. (Afr J Reprod Health 2001; 5[2]: 130-134) RÉSUMÉ

  19. Allergic colitis presenting within the first hours of premature life.

    NARCIS (Netherlands)

    Faber, M.R.; Rieu, P.N.M.A.; Semmekrot, B.A.; Krieken, J.H.J.M. van; Tolboom, J.J.M.; Draaisma, J.M.T.

    2005-01-01

    A prematurely born infant developed rectal blood loss several hours after birth, after his first formula feeding. Discontinuing the feeding resolved symptoms, but after resuming feeding rectal blood loss reappeared. There were no signs of necrotizing enterocolitis. Suspecting cow's milk allergy, the

  20. Accuracy of 24- and 48-Hour Forecasts of Haines' Index

    Science.gov (United States)

    Brian E. Potter; Jonathan E. Martin

    2001-01-01

    The University of Wisconsin-Madison produces Web-accessible, 24- and 48-hour forecasts of the Haines Index (a tool used to measure the atmospheric potential for large wildfire development) for most of North America using its nonhydrostatic modeling system. The authors examined the accuracy of these forecasts using data from 1999 and 2000. Measures used include root-...

  1. Ampere hour method of sizing a stand alone photovoltaic system ...

    African Journals Online (AJOL)

    Stand-alone photovoltaic power systems are natural options for application in electrification of remote areas which are not served by the grid electricity supply system. An ampere-hour method of sizing a stand-alone PV system for application in any remote location has been presented. The design which is for both ac and dc ...

  2. "Rosetta" Mission's "7 Hours of Terror" and "Philae's" Descent

    Science.gov (United States)

    Blanco, Philip

    2015-01-01

    In November 2014 the "Rosetta" mission to Comet 67P/Churyumov-Gerasimenko made the headlines when its "Philae" lander completed a successful unpowered descent onto the surface of the comet nucleus after "7 hours of terror" for the mission scientists. 67P's irregular shape and rotation made this task even more…

  3. Why do Pit-Hours outlive the Pit?

    NARCIS (Netherlands)

    S.R. Ozturk (Sait); M. van der Wel (Michel); D.J.C. van Dijk (Dick)

    2015-01-01

    markdownabstract__Abstract__ We study why a majority of trades still happen during the pit hours, i.e. when the trading pit is open, even after the pit ceased to be a liquid and informative venue. We investigate the case of 30-year U.S. Treasury futures using a ten-years-long intraday data set

  4. The star-bright hour : [poems] / Betti Alver

    Index Scriptorium Estoniae

    Alver, Betti, 1906-1989

    2003-01-01

    Autori lühitutvustus lk. 231. Sisu: The star-bright hour ; The debt ; Not a dream ; Fog-bound ; Corals in an Ancient river ; Frou-frou 1-3. Orig.: Tähetund ; Vilepuhuja ; Võlg ; "Mitte viirastus, meelepett..." ; Udus ; Korallid Emajões ; Froufrou 1-3

  5. EFFECT OF DAYLIGHT HOURS ON PERFORMANCE OF GROWING

    African Journals Online (AJOL)

    user

    birds and breeding cycles for most mammals (Gwinner,. 1986). G. S. I. Wogar, Department of Animal Science, University ... such as reproduction, behavior, coat growth and camouflage colouring in some animals (Arendt and. Skene ... reproductive performance of grasscutters. The grasscutter is active during night hours and.

  6. Telework: Timesaving or Timeconsuming? An Investigation into Actual Working Hours

    NARCIS (Netherlands)

    Peters, P.; Wetzels, C.; Tijdens, K.

    2008-01-01

    This paper aims to clarify the relationship between telework and the actual time employees put into their jobs. One of the reported threats to teleworkers' personal lives is that in order to finish their work, they not only use up saved commuting time, but also part of their non-working hours, even

  7. Transferring PSM craft skills in a 2 hour session

    NARCIS (Netherlands)

    Zijderveld, E.J.A. van; Morill, N.; Shaw, D.; Belton, V.; Harvey, P.; Rouwette, E.

    2007-01-01

    Many of those involved in the Problem Structuring Methods (PSM) community have commented on the struggle that novices face in building the craft skills associated with conducting a PSM intervention. As part of this year's Operational Research Society Conference, we have three 2-hour practical

  8. 75 FR 82170 - Hours of Service of Drivers

    Science.gov (United States)

    2010-12-29

    ... highway safety, FMCSA anticipates an additional benefit from reducing allowable daily and weekly work... hours spent sleeping, and truck drivers working high-intensity schedules get significantly less than the... some extent, mortality among these drivers. These benefits should be counted as outcomes of reductions...

  9. 75 FR 71545 - Changes to NARA Facilities' Hours of Operation

    Science.gov (United States)

    2010-11-24

    ....gov . The Presidential library museums are open every day except Thanksgiving, December 25, and...). For more specific information about museum hours, please contact the libraries directly or visit the... kennedy.library@nara.gov . (f) Lyndon Baines Johnson Library and Museum is located at 2313 Red River St...

  10. 75 FR 54543 - Changes to NARA Facilities' Hours of Operation

    Science.gov (United States)

    2010-09-08

    ...://www.archives.gov . The Presidential library museums are open every day except Thanksgiving, December... December 25). For more specific information about museum hours, please contact the libraries directly or... kennedy.library@nara.gov . (f) Lyndon Baines Johnson Library and Museum is located at 2313 Red River St...

  11. 24-Hour Holter Monitoring at the Lagos State University Teaching ...

    African Journals Online (AJOL)

    Background The 24-hour Holter ambulatory ECG monitor is a device introduced over 2 decades ago, to monitor the electrocardiogram of patients throughout the day. It is able to document paroxysmal tachyarrhythmias that might be missed on a normal routine ECG recording. It has only been available in few centers in ...

  12. Comparative chemical composition of 24-hour fermented sweet ...

    African Journals Online (AJOL)

    Comparative chemical composition of 24-hour fermented sweet orange fruit ( Citrus sinensis ) peel meal and maize and effect on performance response of starting pullet ... Substitution of maize with SOFPM significantly (p<0.05) reduced feed cost/25kg, feed cost/bird and cost of production while decreasing efficiency of feed ...

  13. International Offshore Students' Perceptions of Virtual Office Hours

    Science.gov (United States)

    Wdowik, Steven; Michael, Kathy

    2013-01-01

    Purpose: The main aim of this study is to gauge international offshore students' perceptions of virtual office hours (VOH) to consult with their offshore unit coordinators in Australia. Design/methodology/approach: This paper employs a quantitative and qualitative approach where data was sourced from three offshore campuses over a 12-month period…

  14. After-hour physiotherapy services in a tertiary general hospital.

    Science.gov (United States)

    Lim, Edwin C W; Liu, Jinyu; Yeung, Meredith T L; Wong, Wai Pong

    2008-01-01

    The aims of the present study were to describe the after-hour physiotherapy services in a tertiary general hospital, the patients and their demographics, and to determine which independent variables would predict physiotherapists' referrals to after-hour physiotherapy. A retrospective record review from April 1, 2004, to April 30, 2005, identified 992 patients (mean age 63.8 years; 95% confidence interval [CI] 62.6-65.0 years) who were either referred by daytime physiotherapists (68%) or referred by medical practitioners for urgent attendance after hours (32%). Pneumonia was formally diagnosed medically in 20% (n=197) of the patients. Of all the patients who had surgery, upper abdominal or thoracic incisions formed the majority (61%; n=236). Whether patients had upper abdominal/thoracic surgery (estimated odds ratio 3.4; 95% CI 2.3-4.9) and the presence of pneumonia (2.8; 95% CI 1.9-4.2) were two independent factors identified from a logistic regression model predicting daytime physiotherapists' referral of patients to after-hour service. This model correctly predicted 65.5% of the cases. Most patients were seen for mucociliary clearance. Referral behaviour by physiotherapists reflects the basis of their clinical decision making and has implications for practice, training, and further research.

  15. estimation of global solar radiation from sunshine hours for warri ...

    African Journals Online (AJOL)

    DJFLEX

    Key words: Sunshine hours, Relative humidity, rainfall, wind speed. ... meteorological parameters. This is because it plays a very major role in the determination of global solar radiation data. It is also the parameter with the best correlation with global solar ... enables spatial interpolation thus filling in gaps left by missing or ...

  16. The hour-to-hour influence of weather conditions on walking and cycling among Dutch older adults.

    Science.gov (United States)

    Prins, Richard G; van Lenthe, F J

    2015-09-01

    physical activity (PA) is an important factor to promote healthy ageing. However, older adults are not physically active enough. Socio-ecological models suggest that weather conditions are determinants of PA and may bias relations between other environmental factors and PA. This may especially be the case for the most vulnerable and inactive older persons. Understanding the role of weather conditions is based on daily or seasonal variation in weather, but it can be improved by using hour-to-hour measured weather conditions. to study the hour-to-hour relationships between weather factors and objectively measured walking and cycling in a sample of Dutch older adults. baseline data (2013) of a sub-sample of older adults (3,248 observations clustered in 43 adults) participating in The Neighborhood Walking in Rotterdam Older ADultS (NEW.ROADS) trial were used. Participants wore a GPS logger for 7 consecutive days. Hour-to-hour weather data (temperature, wind speed, rain and sun time) for the city of Rotterdam were retrieved from the Royal Netherlands Meteorological Institute. Multilevel linear regression models were fitted with minutes walked and minutes cycled as dependent variables and the weather variables as independent variables. the time older adults walked increased with higher temperature, higher wind speed and the absence of rain. The time cycled increased with higher temperature. this study improves the evidence of weather factors as a determinant for walking and cycling in older adults. Studies on the relation between environmental factors and PA should consider adjustment for weather factors. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Preferred provider organizations.

    Science.gov (United States)

    Davy, J D

    1984-05-01

    The 1980s has marked the beginning of a new alternative health care delivery system: the preferred provider organization ( PPO ). This system has developed from the health maintenance organization model and is predominant in California and Colorado. A PPO is a group of providers, usually hospitals and doctors, who agree to provide health care to subscribers for a negotiated fee that is usually discounted. Preferred provider organizations are subject to peer review and strict use controls in exchange for a consistent volume of patients and speedy turnaround on claims payments. This article describes the factors leading to the development of PPOs and the implications for occupational therapy.

  18. Direct observations in the dusk hours of the characteristics of the storm-time ring current particles during the beginning of magnetic storms

    Science.gov (United States)

    Smith, P. H.; Hoffman, R. A.

    1973-01-01

    The characteristic features of the initial enhancement of the storm-time ring current particles in the evening hours are consistent with flow patterns resulting from a combination of inward convection, gradient drift, and corotation which carries plasma sheet protons into low L-values near midnight and the higher energy proton component into the plasmasphere and through the evening hours. Data from four magnetic storms during the early life of Explorer 45, when the local time of apogee was in the afternoon and evening hours, show that protons with lower magnetic moments penetrate deeper into the magnetosphere until a low limit, determined by the corotation and gradient drift forces, is reached. Such particle motions produce the stable energy dependent inner boundary of the ring current protons inside the plasmapause in the dusk sector and also provide the mechanism for energy injection into the ring current region. From the analyses of the pitch angle distributions it is evident that charge exchange and wave particle interactions are not the dominant causes of this inner boundary.

  19. Difference in 24-Hour Urine Composition between Diabetic and Non-Diabetic Adults without Nephrolithiasis.

    Directory of Open Access Journals (Sweden)

    Wei Zhu

    Full Text Available Diabetic patients are more likely to develop kidney stones than the general population. The underlying mechanisms for this disparity remain to be elucidated. Little is known about the relationship between urine composition and diabetes mellitus in non-stone-forming individuals. We sought to examine the differences in the 24-hour (24-h urine composition between diabetic and non-diabetic adults who were not stone formers.A convenience sample of 538 individuals without a history of nephrolithiasis, gout, hyperparathyroidism, or gastroenteric diseases participated in this study. The 24-h urine profiles of 115 diabetic adults were compared with those of 423 non-diabetic adults. Diabetes was defined by self-reported physician diagnosis or medication use. All participants were non-stone formers confirmed by urinary tract ultrasonography. Participants provided a fasting blood sample and a single 24-h urine collection for stone risk analysis. Student's t-test was used to compare mean urinary values. Linear regression models were adjusted for age, gender, body mass index, hypertension, fasting serum glucose, serum total cholesterol, estimated creatinine clearance rate and urinary factors.Univariable analysis showed that the diabetic participants had significantly higher 24-h urine volumes and lower urine calcium and magnesium excretions than non-diabetic participants (all P 0.05. The main limitation of this study is that the convenience samples and self-reported data may have been sources of bias.Our data showed that there were no differences in 24-h urine composition between diabetic and non-diabetic adults who are not stone formers. The reason for it might be the improved glycemic control in diabetic individuals in our study. Therefore, a tighter glycemic control might reduce stone formation in diabetic adults.

  20. General Sentiment and Value

    DEFF Research Database (Denmark)

    Arvidsson, Adam; Etter, Michael; Colleoni, Elanor

    The aim of this paper is to deepen the understanding of the relationship between corporate reputation and financial value. Theories as the resource based view or the contractual view lie ground for the assumption of a linear positive correlation between reputation and financial performance. However......, existing empirical studies have provided conflicting results regarding the direction and strength of this relationship so far. In this paper we claim that the assumption of a direct linear correlation between corporate reputation and financial value misrepresents current financial practices...... and underestimates the complexity of the calculative situations in which values are set on financial markets. Based on in-depth interviews with traders, equity analysts and financial tool developers about the real use of reputation measurement tools, we argue that reputation data rather function as interpretative...

  1. Earned value project management

    CERN Document Server

    Fleming, Quentin W

    2010-01-01

    Organizations that follow the principles of good Earned Value Management (EVM) create an environment that allows teams to successfully operate and thrive ? even in the face of challenges that could negatively impact their projects. Earned Value Project Management (EVPM) is a methodology used to measure and communicate the real physical progress of a project taking into account the work completed, the time taken and the costs incurred to complete that work. As a result, EVPM allows more educated and effective management decision-making, which helps evaluate and control project risk by measuring project progress in monetary terms. In the first two editions of Earned Value Project Management, Quentin W. Fleming and Joel M. Koppelman provided guidance for project management practitioners already familiar with EVPM, was well as those who were new to the use of this technique. The third edition expanded the information available on of EVPM for medium and smaller projects while still being relevant for larger projec...

  2. IDENTIFICATIONS PEAK HOURS ON INTERSECTIONS SET IN BIELSKO-BIAŁA CITY

    Directory of Open Access Journals (Sweden)

    Marcin KŁOS

    2016-03-01

    Full Text Available Traffic flow in cities is usually examined locally. This method is not effective for through traffic analysis. The paper discusses the problem of determining peak traffic hours taking into account vehicle distributions. Peak hours represent time periods of traffic flow which demand special treatment by traffic control systems. This is particularly important in the case of ITS. High values of traffic flow require relieving actions not only at the junctions but preferably along the transit routes. The north-south transit route in Bielsko-Biała was chosen for analysis. Instead of the usual two distinct peaks it is determined that the traffic flow is characterised by five peaks. This pattern is the result of specific location of the route, which links residential areas, industrial zones and shopping centres besides carrying through traffic. This multi peak graph more accurately models the traffic flow.

  3. Emergency medicine resident clinical hours: a national survey.

    Science.gov (United States)

    Stowell, Jeffrey R; Vohra, Taher T; Luber, Samuel D

    2015-04-01

    Emergency medicine (EM) residency programs have significant scheduling flexibility. As a result, there is potentially significant variation in scheduling practices. Few studies have previously sought to describe this variation. It is unknown how this affects training time in the emergency department. The purpose of this study was to describe the current variation in clinical training practices through clinical hour, shift length, and rotation survey data. A 21-item questionnaire was distributed to all allopathic EM training programs utilizing an online survey during the 2011-2012 academic year. Questions included demographic data, number of EM rotations per year, shifts, average hours, shift length, and scheduling practices. A total of 122 responses were received and 82 programs were analyzed (51.6% of 159 allopathic programs). EM residents work, on average, 45.50 h per week. Postgraduate year 1-3 programs utilizing 28-day schedules averaged two additional EM rotations and 338.2 more clinical EM hours compared with calendar-month rotations. The residents of 4-year programs work approximately 1300 additional hours during residency, with an average of 1279.26 h and 7.9 clinical EM rotations in the fourth year. Clinical hour ranges of 2670-5112 and 4248-6113 were observed for 3-year and 4-year programs, respectively. There are different scheduling modalities used to create resident schedules. This flexibility results in a large amount of diversity in scheduling practices, with certain patterns allowing for significantly more clinical time. This may result in a vastly different training experience for EM residents. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

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

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...

  5. Providing free autopoweroff plugs

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  6. Relationship among morning blood pressure surge, 24-hour blood pressure variability, and cardiovascular outcomes in a white population.

    Science.gov (United States)

    Bombelli, Michele; Fodri, Danilo; Toso, Elena; Macchiarulo, Mario; Cairo, Matteo; Facchetti, Rita; Dell'Oro, Raffaella; Grassi, Guido; Mancia, Giuseppe

    2014-11-01

    Cardiovascular events have their greatest prevalence in the early morning period. Whether this is attributable to an arousal-dependent blood pressure (BP) increase is far from being clear. It is also not clear to what extent this phenomenon reflects overall 24-hour BP variability. In 2051 subjects (aged 25-74 years) representative of the population of Monza (Italy), we measured 24-hour ambulatory systolic BP (SBP) and calculated the difference between the 2-hour average values after morning arousal and the lowest 3 or average 2-hour values before arousal (morning BP surge 1 and 2, respectively). For either measure, we sought the relationship with a variety of indices of 24-hour SBP variability and collected information on (1) the occurrence of cardiovascular and all cause deaths during a follow-up of ≈16 years and (2) the appearance of echocardiographic left ventricular hypertrophy after 10 years from the baseline visit. Morning SBP surge 1 was directly related to indices of 24-hour SBP variability, including those made independent on the magnitude of the day-night SBP difference. There was a weak positive relationship between morning SBP surge 1 and the risk of cardiovascular and all-cause death, which disappeared after adjustment for confounders. This was the case also for development of left ventricular hypertrophy. Morning SBP surge 2 was smaller, inconsistently related to 24-hour SBP variability and not at all related to fatal events or new-onset left ventricular hypertrophy. In a white population, morning BP surge was not found to be an independent predictor of cardiovascular death, all-cause death, or development of high cardiovascular risk (as documented by new-onset cardiac damage) even when appropriately assessed by measures that reflect its association with 24-hour BP variability. © 2014 American Heart Association, Inc.

  7. Qualitative Value Profiling

    DEFF Research Database (Denmark)

    Duus, Henrik Johannsen; Bjerre, Mogens

    2015-01-01

    Qualitative value profiling (QVP) is a relatively unknown method of strategic analysis for companies in international business-to-business settings. The purpose of QVP is to reduce the information complexity that is faced by international companies in dealing with business partners. The QVP method...... and consequently, for the advancement of international development. Further use of QVP is recommended and suggestions for future research are provided....

  8. Intraocular pressure 3 to 4 hours and 20 hours after cataract surgery with and without ab interno trabeculectomy.

    Science.gov (United States)

    Weiner, Yotam; Severson, Melissa L; Weiner, Asher

    2015-10-01

    To evaluate intraocular pressure (IOP) immediately after cataract surgery with or without ab interno trabeculectomy (Trabectome) and whether trabeculectomy-related hyphema increases the risk for IOP spikes. Private glaucoma practice. Retrospective interventional nonrandomized comparative chart review. Intraocular pressure was measured 3 to 4 hours and 20 hours postoperatively. The combined group comprised 73 eyes of 73 patients and the cataract-only group, 75 eyes of 75 patients. The mean preoperative IOP was 15.8 mm Hg ± 3.6 (SD) and 14.9 ± 3.0 mm Hg, respectively (P = .09). In the combined group, the IOP decrease was significant at 3 to 4 hours (P = .0003) and 20 hours (P = .0007). In the cataract-only group, the IOP increased significantly (P interno trabeculectomy and cataract surgery reduced short-term postoperative IOP and the incidence of IOP spikes despite the common hyphema. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Value Appropriation in Business Exchange

    DEFF Research Database (Denmark)

    Ellegaard, Chris; Medlin, Christopher J.; Geersbro, Jens

    2014-01-01

    master the difficult balance between value creation and appropriation. This review has provided an overview of the many managerial options for value appropriation and created knowledge on the effects of the various appropriation mechanisms enabling managers to secure company rents while not jeopardizing......Purpose – Value appropriation is a central, yet neglected aspect in business exchange research. The purpose of the paper is to generate an overview of research on active value appropriation in business exchange and provide the foundation for further research into value appropriation, as well...... as some initial guidance for managers. Design/methodology/approach – Literatures investigating value appropriation were identified by the means of a systematic review of the overall management literature. Findings – The authors provide an overview and comparison of the literatures and find that they apply...

  10. Out-of-hours palliative care: what are the educational needs and preferences of general practitioners?

    Science.gov (United States)

    Magee, Claire; Koffman, Jonathan

    2016-09-01

    Offering genuine choice to patients over place of care and death requires the provision of high-quality palliative care 24/7. This study examines the confidence of out-of-hours general practitioners (GPs) in symptom control and end of life prescribing, and identifies their educational needs and preferences in order to inform recommendations for future education. A self-completion postal survey was designed and sent to 1005 GPs working for an independent provider of out-of-hours services across England. Quantitative data were analysed using descriptive statistics and non-parametric tests. 203 (20.3%) GPs completed the survey questionnaire; 13.3% (n=27) worked exclusively out-of-hours. Confidence in assessing palliative care emergencies (42.8%, n=87: 'not so confident' or 'not at all confident'), managing symptoms in non-cancer patients (39.4%, n=80) and prescribing a new syringe driver (39.0%, n=79) was lowest. Lower confidence was associated with infrequent exposure to palliative patients (ppalliative care (ppalliative care competences is severely lacking. Educational strategies to address this concern must be targeted at GPs preferences for content and mode of delivery. Regular e-learning is favoured, but should be blended with other approaches that promote engagement including out-of-hours themed workshops and case discussion. Specialist palliative care services should engage with out-of-hours providers to support education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Continuous 24-hour intraocular pressure monitoring for glaucoma--time for a paradigm change.

    Science.gov (United States)

    Mansouri, K; Weinreb, R

    2012-03-28

    Glaucoma is the main cause of irreversible blindness and intraocular pressure (IOP) is its only modifiable risk factor. The importance of robust lowering of IOP for prevention of glaucoma onset and progression is well established. Although IOP is a dynamic parameter with individual circadian rhythms, current management usually relies on single IOP measurements during regular clinic hours performed a few times a year. Recent technological advances have provided clinicians with tools for continuous IOP monitoring during a 24 hour period in an ambulatory setting. There are two approaches being investigated. The first is permanent IOP monitoring through an implantable sensor and the other is temporary monitoring through a contact lens sensor. In this article, we discuss the shortcomings of the current gold standard for tonometry (Goldmann Applanation Tonometry) and the current experience with the first commercially available continuous 24 hour IOP monitoring technology (SENSIMED Triggerfish®); a telemetric contact lens sensor produced by a Swiss start-up company (Sensimed AG, Lausanne, Switzerland). Recent studies suggest that 24 hour continuous monitoring of IOP can be integrated into clinical practice and have the potential to contribute to the reduction of glaucoma-related vision loss.

  12. Work hours and sleep/wake behavior of Australian hospital doctors.

    Science.gov (United States)

    Ferguson, Sally A; Thomas, Matthew J W; Dorrian, Jillian; Jay, Sarah M; Weissenfeld, Adrian; Dawson, Drew

    2010-07-01

    The objective of the study was to describe the work and sleep patterns of doctors working in Australian hospitals. Specifically, the aim was to examine the influence of work-related factors, such as hospital type, seniority, and specialty on work hours and their impact on sleep. A total of 635 work periods from 78 doctors were analyzed together with associated sleep history. Work and sleep diary information was validated against an objective measure of sleep/wake activity to provide the first comprehensive database linking work and sleep for individual hospital doctors in Australia. Doctors in large and small facilities had fewer days without work than those doctors working in medium-sized facilities. There were no significant differences in the total hours worked across these three categories of seniority; however, mid-career and senior doctors worked more overnight and weekend on-call periods than junior doctors. With respect to sleep, although higher work hours were related to less sleep, short sleeps (hospital doctors, total hours worked do impact sleep, but the pattern of work, together with other nonwork factors are also important mediators.

  13. Neurobiology of value integration: when value impacts valuation.

    Science.gov (United States)

    Park, Soyoung Q; Kahnt, Thorsten; Rieskamp, Jörg; Heekeren, Hauke R

    2011-06-22

    Everyday choice options have advantages (positive values) and disadvantages (negative values) that need to be integrated into an overall subjective value. For decades, economic models have assumed that when a person evaluates a choice option, different values contribute independently to the overall subjective value of the option. However, human choice behavior often violates this assumption, suggesting interactions between values. To investigate how qualitatively different advantages and disadvantages are integrated into an overall subjective value, we measured the brain activity of human subjects using fMRI while they were accepting or rejecting choice options that were combinations of monetary reward and physical pain. We compared different subjective value models on behavioral and neural data. These models all made similar predictions of choice behavior, suggesting that behavioral data alone are not sufficient to uncover the underlying integration mechanism. Strikingly, a direct model comparison on brain data decisively demonstrated that interactive value integration (where values interact and affect overall valuation) predicts neural activity in value-sensitive brain regions significantly better than the independent mechanism. Furthermore, effective connectivity analyses revealed that value-dependent changes in valuation are associated with modulations in subgenual anterior cingulate cortex-amygdala coupling. These results provide novel insights into the neurobiological underpinnings of human decision making involving the integration of different values.

  14. Enteral Nutrition Delivery Is Overestimated in Provider Documentation.

    Science.gov (United States)

    Kesey, Jenna; Puckett, Yana; Dissanaike, Sharmila

    2017-06-21

    Burn-injured patients have the highest metabolic demand of all critically ill patients and are vulnerable to complications of malnutrition. Many burn centers have challenges in achieving prescribed rates of nutrition, despite aggressive algorithms. One possible reason for the discrepancy is inaccurate documentation of volumes. This is a retrospective review of patients requiring tube feeding admitted to a regional burn center between June and August 2015. Demographics were abstracted including gender, type of injury, TBSA, and age. The total feeding volume was recorded from the feeding pump every 24 hours. The values were compared with the enteral nutrition volume charted by the nursing staff and rate prescribed by the physician team. Repeated measures analysis of variance was used to compare continuous variables. Twenty-five patients were observed during the study period providing a total of 105 patient days. The average age was 44 years with 42% TBSA mean burn size. The average volume prescribed by providers was 1,598 ml/d. According to documentation, the average volume given was 1,448 ml/d, a significant difference (P = enteral nutrition was not provided. There was a significant discrepancy between ordered, recorded, and delivered volume of enteral nutrition. Potential reasons for the discrepancy may be frequent interruption for repositioning, wound care, linen changes, or other nursing workflow. Burn providers should be aware of the potential for underfeeding patients.

  15. Ambulatory blood pressure values in healthy children

    Directory of Open Access Journals (Sweden)

    Paripović Dušan

    2006-01-01

    Full Text Available Ambulatory blood pressure monitoring (ABPM is an important tool in the diagnosis and management of childhood hypertension. Normal ambulatory blood pressure (ABP values in children with body heights between 100 and 120 cm have not been reported. The aim of the study was to establish the normal range of values for ABPM in these children. 24-hour ABPM was performed in 40 normotensive (auscultatory casual blood pressure was obtained before ABPM subjects, aged from 4 to 6 years (26 males, 14 females with body heights between 95 and 125 cm. ABPM was carried out on non-dominant arm using the oscillometric device (SpaceLab 90207 with appropriate cuff size. The monitor was programmed to measure BP every 15 min. during the day (6 a.m. to 10 p.m. and every 30 min. during the night (10 p.m. to 6 a.m.. The mean daytime SBP/DBP in boys and girls was 108+/-6/67+/-5 and 105+/-5/66+/-1, respectively. The mean nighttime SBP/DBP in boys and girls was 98+/-6/56+/-5 and 97+/-7/56+/-4, respectively. There was a significant difference between day and night readings of SBP, DBP and heart rate (nocturnal fall was observed. The distribution of ABP noted in this study could serve as preliminary reference. A multicenter study should be performed to provide normal ranges of ABP.

  16. Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK

    OpenAIRE

    Carroll, C.; Zajicek, J.

    2004-01-01

    OBJECTIVES: The ABN has published standards of care for patients with acute neurological disease. Derriford Hospital provides a 24 hour neurology intake service to a population of 500,000 with the equivalent of four consultants, three specialist registrars (SpRs), and four senior house officers (SHOs) with a 37 bed ward. The authors undertook a prospective study of all neurology admissions to enable calculation of manpower necessary to meet the ABN guidelines. METHODS: All admissions to the n...

  17. Patients in 24-hour home care striving for control and safety

    OpenAIRE

    Swedberg, Lena; Hammar Chiriac, Eva; Törnkvist, Lena; Hylander, Ingrid

    2012-01-01

    Abstract Background This article concerns Swedish patients receiving 24-hour home care from health care assistants (HC assistants) employed by the municipality. Home care is a complex interactive process involving the patient, family, HC assistants as well as professional care providers. Previous studies exploring patient perspectives on home care have been based mainly on patient interviews. In contrast, the present study took a broad perspective on patients’ experiences and thoughts by comb...

  18. Exploring the relationship between compressed work hours satisfaction and absenteeism in front-line service work

    OpenAIRE

    Deery, Stephen; Walsh, Janet; Zatzick, Christopher D.; Hayes, Andrew J

    2017-01-01

    There has been an upsurge of interest in compressed workweek schedules because of the opportunities they provide for enhanced organizational efficiency and more balanced work and life roles for employees. This study tested a moderated mediation model of the effects of compressed work hours satisfaction on absenteeism with the purpose of exploring both the mediation effects of emotional exhaustion and physical health and the moderating effects of sex on this relationship. It utilized data draw...

  19. A 13000-hour test of a mercury hollow cathode

    Science.gov (United States)

    Rawlin, V. K.

    1973-01-01

    A mercury-fed hollow cathode was tested for 12,979 hours in a bell jar at SERT 2 neutralizer operating conditions. The net electron current drawn to a collector was 0.25 ampere at average collector voltages between 21.8 and 36.7 volts. The mercury flow rate was varied from 5.6 to 30.8 equivalent milliamperes to give stable operation at the desired electrode voltages and currents. Variations with time in the neutralizer discharge characteristics were observed and hypothesized to be related to changes in the cathode orifice dimensions and the availability of electron emissive material. A facility failure caused abnormal test conditions for the last 876 hours and led to the cathode heater failure which concluded the test.

  20. The Effects of the 80-hour Workweek on Occupational Hazards.

    Science.gov (United States)

    Drazin, Doniel; Al-Khouja, Lutfi; Colen, Chaim

    2016-04-03

    BACKGROUND : The most recent work-hour restrictions were implemented in July 2011 for training physicians. The impact of these regulations on workplace injuries is not yet fully understood. Our goal is to determine the effect of the work-hour limitation on the rates of needlestick and eyesplash injuries. METHODS : Approximately 1200 neurosurgery residents and fellows in the United States were emailed a survey, several times, Sept 2013-February 2014. There were 212 responses across postgraduate years 1-7 and fellowship regarding the rate of needlestick and eyesplash injuries experienced or witnessed before and after July 2011. RESULTS : Regarding witnessing a needlestick/eyesplash accident: 89.33% of respondents claimed witnessing an injury. Specifically regarding percutaneous injuries (PCIs): before July 2011, 21.77% claimed never witnessing; after July 2011, only 8.9% indicated never witnessing. Specifically regarding eyesplash injuries: comparing the injuries (40.94%) before July 2011 to those (51.94%) after July 2011, the survey indicated an increase in eyesplash injuries. CONCLUSION : The results of this survey document that neurosurgery residents/fellows observed (or personally sustained) an increased number of needlestick and eyesplash injuries after implementation of the July 2011 work-hour limitations. Although the last set of reduced-hour regulations have been in place for more than three years, there does not therefore seem to be a safety advantage associated with them regarding a reduction in PCI or eyesplash accidents. This may be due to other confounding factors, not yet affirmatively identified, which warrant additional investigation and identification, directed at preventing future injuries.

  1. Student midwives' duty hours: risks, standards, and recommendations.

    Science.gov (United States)

    Lawrence, Rachel; Kantrowitz-Gordon, Ira; Landis, Andrea

    2014-01-01

    A growing body of literature has emerged describing the risks of extended-duty shifts and sleep deprivation. Worldwide, midwifery organizations have not adopted standards for practitioner or student duty shifts. This project reviews the literature related to extended-duty shifts in an effort to develop evidence-based recommendations for student nurse-midwives/student midwives (SNMs/SMs). A comprehensive literature search was conducted through electronic databases, major journals, and reference lists published in English since January 2001. Primary research studies evaluating sleep deprivation and shift duration were included. Studies that did not include the target population (shift workers) and those that formed conclusions related to extended-duty shifts greater than 30 hours were excluded. In addition, an extensive worldwide review of duty-hour recommendations from more than 300 health care organizations was conducted. A total of 40 studies met the inclusion criteria. Extended-duty shifts (those greater than 12 hours) increased the risk for cognitive and physical functional errors, safety concerns, and decreased quality of life from sleep deprivation. Cognitive function errors included attention lapses, visual tracking errors, decreased mentation and immediate recall, and decreased learning capacity. Physical errors included decreased motor skills and slowed reaction times in clinical simulations. These deficits led to an increased risk of motor vehicle accidents, needle sticks, and performance equivalent to unsafe blood alcohol concentrations. An overall decrease in quality of life and job satisfaction was linked to extended-duty shifts. Seven organizations for medical residents or advanced practice nurses have developed policy statements on duty shifts, with extended-duty shift limitations between 12 and 24 hours. The risks associated with extended-duty shifts may inhibit the development of SNMs/SMs into competent practitioners and place patients at risk. It

  2. Aggressive behavior during the first 24 hours of psychiatric admission

    Directory of Open Access Journals (Sweden)

    Vitor Crestani Calegaro

    2014-09-01

    Full Text Available OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients.METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS. The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive.RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002 and individual component scores, and their results showed more activation (p < 0.001 and thinking disorders (p = 0.009, but less anxious-depression (p = 0.008. Violent patients had more severe psychomotor agitation (p = 0.027, hallucinations (p = 0.017 and unusual thought content (p = 0.020. Additionally, self-aggressive patients had more disorientation (p = 0.011 and conceptual disorganization (p = 0.007.CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation.

  3. Work patterns, sleeping hours and excess weight in commercial drivers.

    Science.gov (United States)

    Lemke, M K; Hege, A; Perko, M; Sönmez, S; Apostolopoulos, Y

    2015-12-01

    Work and sleep patterns for commercial motor vehicle (CMV) drivers often include long working hours, shift work and diminished sleep duration and quality, which have been linked to overweight, obesity and other problems. To explore possible connections between work, sleep and obesity among CMV drivers. Survey and anthropometric data were collected from male long-haul CMV drivers in central North Carolina, USA, over a period of 6 months. Drivers' body mass index (BMI) was used as a measure of total body obesity and sagittal abdominal diameter (SAD) as a measure of central adiposity. Among the 260 study subjects, mean BMI was 33.1 (64% were obese or morbidly obese) and mean SAD was 32.3cm, classifying 89% of drivers as being at high or very high cardiometabolic risk. About 83% of drivers worked an irregular daily schedule, 64% worked irregular total daily hours, 32% worked irregular days of the week and 46% reported getting sleep during work nights. Significant predictors of BMI included the number of hours worked daily (P sleep quality included the extent of shift work (P sleep duration (P sleep configurations appear to affect the weight status of CMV drivers. Shift work and sleep duration are both associated with the weight status of CMV drivers, and both appear to function as indicators of their sleep quality. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Trends analyses of 30 years of ambient 8 hour ozone and precursor monitoring data in the South Central U.S.: progress and challenges.

    Science.gov (United States)

    Sather, Mark E; Cavender, Kevin

    2016-07-13

    In the last 30 years ambient ozone concentrations have notably decreased in the South Central U.S. Yet, current ambient ozone concentrations measured over the past three years 2013-2015 in this area of the U.S. are not meeting the U.S. 2015 8 hour ozone standard of 70 parts per billion (ppb). This paper provides an update on long-term trends analyses of ambient 8 hour ozone and ozone precursor monitoring data collected over the past 30 years (1986-2015) in four South Central U.S. cities, following up on two previously published reviews of 20 and 25 year trends for these cities. All four cities have benefitted from national ozone precursor controls put in place during the 1990s and 2000s involving cleaner vehicles (vehicle fleet turnover/replacement over time), cleaner fuels, cleaner gasoline and diesel engines, and improved inspection/maintenance programs for existing vehicles. Additional ozone precursor emission controls specific to each city are detailed in this paper. The controls have resulted in impressive ambient ozone and ambient ozone precursor concentration reductions in the four South Central U.S. cities over the past 30 years, including 31-70% ambient nitrogen oxides (NOx) concentration declines from historical peaks to the present, 43-72% volatile organic compound (VOC) concentration declines from historical peaks to the present, a related 45-76% VOC reactivity decline for a subset of VOC species from historical peaks to the present, and an 18-38 ppb reduction in city 8 hour ozone design value concentrations. A new challenge for each of the four South Central U.S. cities will be meeting the U.S. 2015 8 hour ozone standard of 70 ppb.

  5. Stability of Thawed Apheresis Fresh-Frozen Plasma Stored for up to 120 Hours at 1°C to 6°C

    Directory of Open Access Journals (Sweden)

    William P. Sheffield

    2016-01-01

    Full Text Available Regulations concerning the storage of transfusable plasma differ internationally. In Canada, plasma obtained from whole blood donations and frozen within 24 hours of phlebotomy (frozen plasma, FP may be thawed and transfused within 120 hours of refrigerated storage. However, plasma frozen within 8 hours of phlebotomy following apheresis donation (FFPA must be transfused within 24 hours of thawing and refrigeration. Our objectives were to measure coagulation factors (F V, VII, and VIII, fibrinogen activities, and the prothrombin time (PT in thawed refrigerated FFPA at 0, 24, and 120 hours of storage and to compare these values to those in thawed refrigerated FP. Fibrinogen activity remained unchanged over time, while mean factor levels in 28 FFPA units declined by 17% (FV, 19.7% (FVII, and 54.6% (FVIII over 120 hours, while PT values rose to 7.6%. Factor activities were significantly higher in FFPA than FP after 120 hours of refrigerated storage. Residual FVIII activities in thawed FFPA met predefined noninferiority criteria compared to thawed FP after 120 hours. These results support a change in Canadian regulations to permit transfusion of thawed FFPA made in a closed system and refrigerated for up to 120 hours, one that could reduce wastage of transfusable plasma.

  6. Provider of Services File

    Data.gov (United States)

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

  7. What HERA may provide?

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-09-15

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

  8. care Providers in Ibadan

    African Journals Online (AJOL)

    Three hundred and eighty six respondents (77.7%) were aware of intermittent preventive treatment (IPT). Awareness ... Key Words: malaria in pregnancy, intermittent preventive treatment, malaria control, health care providers. Department of Obstetrics .... Auxiliary nurses do not have formal training prior to employment.

  9. Medicare and Medicaid programs: hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs; Hospital Value-Based Purchasing Program; organ procurement organizations; quality improvement organizations; Electronic Health Records (EHR) Incentive Program; provider reimbursement determinations and appeals. Final rule with comment period and final rules.

    Science.gov (United States)

    2013-12-10

    : This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2014 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Hospital Value-Based Purchasing (VBP) Program. In the final rules in this document, we are finalizing changes to the conditions for coverage (CfCs) for organ procurement organizations (OPOs); revisions to the Quality Improvement Organization (QIO) regulations; changes to the Medicare fee-for-service Electronic Health Record (EHR) Incentive Program; and changes relating to provider reimbursement determinations and appeals.

  10. The Value Landscape in Ecosystem Services: Value, Value Wherefore Art Thou Value?

    Directory of Open Access Journals (Sweden)

    Adam P. Hejnowicz

    2017-05-01

    Full Text Available Ecosystem services has risen to become one of the preeminent global policy discourses framing the way we conceive and articulate environment–society relations, integral to the form and function of a number of far-reaching international policies such as the Aichi 2020 Biodiversity Targets and the recently adopted Sustainable Development Goals. Value; its pursuit, definition, quantification, monetization, multiplicity and uncertainty, both in terms of meaning and attribution, is fundamental to the economic foundations of ecosystem services and a core feature driving its inclusion across multiple policy domains such as environmental management and conservation. Distilling current knowledge and developments in this arena are thus highly prescient. In this article, we cast a critical eye over the evidence base and aim to provide a comprehensive synthesis of what values are, why they are important and the methodological approaches employed to elicit them (including their pros and cons and the arguments for and against. We also illustrate the current ecosystem service value landscape, highlight some of the fundamental challenges in discerning and applying values, and outline future research activities. In so doing, we further advance ecosystem valuation discourse, contribute to wider debates linking ecosystem services and sustainability and strengthen connections between ecosystem services and environmental policy.

  11. Assessing variability of the 24-hour pad weight test in men with post-prostatectomy incontinence.

    Science.gov (United States)

    Malik, Rena D; Cohn, Joshua A; Fedunok, Pauline A; Chung, Doreen E; Bales, Gregory T

    2016-01-01

    Decision-making regarding surgery for post-prostatectomy incontinence (PPI) is challenging. The 24-hour pad weight test is commonly used to objectively quantify PPI. However, pad weight may vary based upon activity level. We aimed to quantify variability in pad weights based upon patient-reported activity. 25 patients who underwent radical prostatectomy were prospectively enrolled. All patients demonstrated clinical stress urinary incontinence without clinical urgency urinary incontinence. On three consecutive alternating days, patients submitted 24-hour pad weights along with a short survey documenting activity level and number of pads used. Pad weights collected across the three days were well correlated to the individual (ICC 0.85 (95% CI 0.74-0.93), ppad weight leakage and maximum leakage per patient was 133.4g (95% CI 80.4-186.5). The mean increase in 24-hour leakage for a one-point increase in self-reported activity level was 118.0g (95% CI 74.3-161.7, pPad weights also varied significantly when self-reported activity levels did not differ (mean difference 51.2g (95% CI 30.3-72.1), ppad weight leakage may vary significantly on different days of collection. This variation is more pronounced with changes in activity level. Taking into account patient activity level may enhance the predictive value of pad weight testing.

  12. Relationship of serum bilirubin concentration to kidney function and 24-hour urine protein in Korean adults.

    Science.gov (United States)

    Shin, Ho Sik; Jung, Yeon Soon; Rim, Hark

    2011-06-28

    The relationships among serum bilirubin concentration, kidney function and proteinuria have yet to be fully elucidated, nor have these relationships been investigated in Korean adults. We retrospectively reviewed the medical records of Korean adults who were evaluated at Kosin University Gospel Hospital (Busan, Republic of Korea) during a five-year period from January 2005 to December 2009. We evaluated the relationships among serum bilirubin concentration, estimated glomerular filtration rate (eGFR) and 24-hour urinary protein excretion in a sample of 1363 Korean adults aged 18 years or older. The values of eGFR urine albumin ≥150 mg/day were observed in 26.1% (n = 356) and 40.5% (n = 553) of subjects, respectively. Fasting glucose levels ≥126 mg/dL were observed in 44.9% (n = 612) of the total sample. After adjustment for potential confounding factors including demographic characteristics, comorbidities and other laboratory measures, total serum bilirubin was positively associated with eGFR and negatively associated with proteinuria both in the whole cohort and in a subgroup of diabetic individuals. To our knowledge, this is the first hospital-based study specifically aimed at examining the relationships among serum total bilirubin concentration, 24-hour urine protein and kidney function in Korean adults. We demonstrated that serum total bilirubin concentration was negatively correlated with 24-hour urine protein and positively correlated with eGFR in Korean non-diabetic and diabetic adults.

  13. Comparison of Hourly PM2.5 Observations Between Urban and Suburban Areas in Beijing, China

    Science.gov (United States)

    Yao, Ling; Lu, Ning; Yue, Xiafang; Du, Jia; Yang, Cundong

    2015-01-01

    Hourly PM2.5 observations collected at 12 stations over a 1-year period are used to identify variations between urban and suburban areas in Beijing. The data demonstrates a unique monthly variation form, as compared with other major cities. Urban areas suffer higher PM2.5 concentration (about 92 μg/m3) than suburban areas (about 77 μg/m3), and the average PM2.5 concentration in cold season (about 105 μg/m3) is higher than warm season (about 78 μg/m3). Hourly PM2.5 observations exhibit distinct seasonal, diurnal and day-of-week variations. The diurnal variation of PM2.5 is observed with higher concentration at night and lower value at daytime, and the cumulative growth of nighttime (22:00 p.m. in winter) PM2.5 concentration maybe due to the atmospheric stability. Moreover, annual average PM2.5 concentrations are about 18 μg/m3 higher on weekends than weekdays, consistent with driving restrictions on weekdays. Additionally, the nighttime peak in weekdays (21:00 p.m.) is one hour later than weekends (20:00 p.m.) which also shows the evidence of human activity. These observed facts indicate that the variations of PM2.5 concentration between urban and suburban areas in Beijing are influenced by complex meteorological factors and human activities. PMID:26426035

  14. Comparison of Hourly PM2.5 Observations Between Urban and Suburban Areas in Beijing, China

    Directory of Open Access Journals (Sweden)

    Ling Yao

    2015-09-01

    Full Text Available Hourly PM2.5 observations collected at 12 stations over a 1-year period are used to identify variations between urban and suburban areas in Beijing. The data demonstrates a unique monthly variation form, as compared with other major cities. Urban areas suffer higher PM2.5 concentration (about 92 μg/m3 than suburban areas (about 77 μg/m3, and the average PM2.5 concentration in cold season (about 105 μg/m3 is higher than warm season (about 78 μg/m3. Hourly PM2.5 observations exhibit distinct seasonal, diurnal and day-of-week variations. The diurnal variation of PM2.5 is observed with higher concentration at night and lower value at daytime, and the cumulative growth of nighttime (22:00 p.m. in winter PM2.5 concentration maybe due to the atmospheric stability. Moreover, annual average PM2.5 concentrations are about 18 μg/m3 higher on weekends than weekdays, consistent with driving restrictions on weekdays. Additionally, the nighttime peak in weekdays (21:00 p.m. is one hour later than weekends (20:00 p.m. which also shows the evidence of human activity. These observed facts indicate that the variations of PM2.5 concentration between urban and suburban areas in Beijing are influenced by complex meteorological factors and human activities.

  15. Assessment of heart rate variability in breath holding children by 24 hour Holter monitoring.

    Science.gov (United States)

    Yilmaz, Osman; Ciftel, Murat; Ozturk, Kezban; Kilic, Omer; Kahveci, Hasan; Laloğlu, Fuat; Ceylan, Ozben

    2015-02-01

    Previous studies have shown that the underlying pathophysiologic mechanism in children with breath holding may be generalised autonomic dysregulation. Thus, we performed cardiac rhythm and heart rate variability analyses using 24-hour Holter monitoring to evaluate the cardiac effects of autonomic dysregulation in children with breath-holding spells. We performed cardiac rhythm and heart rate analyses using 24-hour Holter monitors to evaluate the cardiac effects of autonomic dysregulation in children during a breath-holding spell. Our study group consisted of 68 children with breath-holding spells - 56 cyanotic type and 12 pallid type - and 39 healthy controls. Clinical and heart rate variability results were compared between each spell type - cyanotic or pallid - and the control group; significant differences (p50 ms, and square root of the mean of the sum of squares of the differences between adjacent NN intervals values were found between the pallid and cyanotic groups. Holter monitoring for 24 hours and heart rate variability parameters, particularly in children with pallid spells, are crucial for evaluation of cardiac rhythm changes.

  16. Illustrating the benefit of using hourly monitoring data on secondary inorganic aerosol and its precursors for model evaluation

    Directory of Open Access Journals (Sweden)

    M. Schaap

    2011-11-01

    Full Text Available Secondary inorganic aerosol, most notably ammonium nitrate and ammonium sulphate, is an important contributor to ambient particulate mass and provides a means for long range transport of acidifying components. The modelling of the formation and fate of these components is challenging. Especially, the formation of the semi-volatile ammonium nitrate is strongly dependent on ambient conditions and the precursor concentrations. For the first time an hourly artefact free data set from the MARGA instrument is available for the period of a full year (1 August 2007 to 1 August 2008 at Cabauw, the Netherlands. This data set is used to verify the results of the LOTOS-EUROS model. The comparison showed that the model underestimates the SIA levels. Closer inspection revealed that base line values appear well estimated for ammonium and sulphate and that the underestimation predominantly takes place at the peak concentrations. For nitrate the variability towards high concentrations is much better captured, however, a systematic relative underestimation was found. The model is able to reproduce many features of the intra-day variability observed for SIA. Although the model captures the seasonal and average diurnal variation of the SIA components, the modelled variability for the nitrate precursor gas nitric acid is much too large. It was found that the thermodynamic equilibrium module produces a too stable ammonium nitrate in winter and during night time in summer, whereas during the daytime in summer it is too unstable. We recommend to improve the model by verification of the equilibrium module, inclusion of coarse mode nitrate and to address the processes concerning SIA formation combined with a detailed analysis of the data set at hand. The benefit of the hourly data with both particulate and gas phase concentrations is illustrated and a continuation of these measurements may prove to be very useful in future model evaluation and improvement studies. Based

  17. Illustrating the benefit of using hourly monitoring data on secondary inorganic aerosol and its precursors for model evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Schaap, M. [TNO, Business unit Environment, Health and Safety, P.O. Box 80015, 3508 TA Utrecht (Netherlands); Otjes, R.P.; Weijers, E.P. [Energy research Centre of the Netherlands (ECN), P.O. Box 1, 1755 LE Petten (Netherlands)

    2011-11-08

    Secondary inorganic aerosol, most notably ammonium nitrate and ammonium sulphate, is an important contributor to ambient particulate mass and provides a means for long range transport of acidifying components. The modelling of the formation and fate of these components is challenging. Especially, the formation of the semi-volatile ammonium nitrate is strongly dependent on ambient conditions and the precursor concentrations. For the first time an hourly artefact free data set from the MARGA instrument is available for the period of a full year (1 August 2007 to 1 August 2008) at Cabauw, the Netherlands. This data set is used to verify the results of the LOTOS-EUROS model. The comparison showed that the model underestimates the SIA levels. Closer inspection revealed that base line values appear well estimated for ammonium and sulphate and that the underestimation predominantly takes place at the peak concentrations. For nitrate the variability towards high concentrations is much better captured, however, a systematic relative underestimation was found. The model is able to reproduce many features of the intra-day variability observed for SIA. Although the model captures the seasonal and average diurnal variation of the SIA components, the modelled variability for the nitrate precursor gas nitric acid is much too large. It was found that the thermodynamic equilibrium module produces a too stable ammonium nitrate in winter and during night time in summer, whereas during the daytime in summer it is too unstable. We recommend to improve the model by verification of the equilibrium module, inclusion of coarse mode nitrate and to address the processes concerning SIA formation combined with a detailed analysis of the data set at hand. The benefit of the hourly data with both particulate and gas phase concentrations is illustrated and a continuation of these measurements may prove to be very useful in future model evaluation and improvement studies. Based on our findings we

  18. Beyond Values Clarification: Addressing Client Values in Clinical Behavior Analysis

    Science.gov (United States)

    Bonow, Jordan T.; Follette, William C.

    2009-01-01

    Ethical principles of psychology, as exemplified in the American Psychological Association (APA) Code of Ethics (2002), provide impractical advice for addressing client values during psychotherapy. These principles seem to argue that each client's values should be respected and protected at all times, except in cases in which this would result in…

  19. Internet Medline providers.

    Science.gov (United States)

    Vine, D L; Coady, T R

    1998-01-01

    Each database in this review has features that will appeal to some users. Each provides a credible interface to information available within the Medline database. The major differences are pricing and interface design. In this context, features that cost more and might seem trivial to the occasional searcher may actually save time and money when used by the professional. Internet Grateful Med is free, but Ms. Coady and I agree the availability of only three ANDable search fields is a major functional limitation. PubMed is also free but much more powerful. The command line interface that permits very sophisticated searches requires a commitment that casual users will find intimidating. Ms. Coady did not believe the feedback currently provided during a search was sufficient for sustained professional use. Paper Chase and Knowledge Finder are mature, modestly priced Medline search services. Paper Chase provides a menu-driven interface that is very easy to use, yet permits the user to search virtually all of Medline's data fields. Knowledge Finder emphasizes the use of natural language queries but fully supports more traditional search strategies. The impact of the tradeoff between fuzzy and Boolean strategies offered by Knowledge Finder is unclear and beyond the scope of this review. Additional software must be downloaded to use all of Knowledge Finders' features. Other providers required no software beyond the basic Internet browser, and this requirement prevented Ms. Coady from evaluating Knowledge Finder. Ovid and Silver Platter offer well-designed interfaces that simplify the construction of complex queries. These are clearly services designed for professional users. While pricing eliminates these for casual use, it should be emphasized that Medline citation access is only a portion of the service provided by these high-end vendors. Finally, we should comment that each of the vendors and government-sponsored services provided prompt and useful feedback to e

  20. Record Values of a Pareto Distribution.

    Science.gov (United States)

    Ahsanullah, M.

    The record values of the Pareto distribution, labelled Pareto (II) (alpha, beta, nu), are reviewed. The best linear unbiased estimates of the parameters in terms of the record values are provided. The prediction of the sth record value based on the first m (s>m) record values are obtained. A classical Pareto distribution provides reasonably…

  1. Changing the hours of shiftwork: a comparison of 8- and 12-hour shift rosters in a group of computer operators.

    Science.gov (United States)

    Williamson, A M; Gower, C G; Clarke, B C

    1994-02-01

    Twelve-hour shifts are currently regarded by many workers as one solution to the disruptive effects of shiftwork on health, well-being and lifestyle. Twelve-hour shifts offer larger and more frequent blocks of leisure time than do 8-h shifts. Nevertheless, concern must be addressed about the possible effects of working these additional hours on work quality and productivity and whether they are worked at significant extra cost to the worker. In a study of 75 computer operators, the effect of changing from a predominantly 8 h per shift irregular roster to a 12 h per shift regular roster was investigated. Operators completed a questionnaire covering demographic and health details including the General Health Questionnaire (GHQ), and details about general job satisfaction including the Work Environment Scale (WES). They also completed a 14-day diary of sleeping and eating patterns and mood state at the beginning and end of each shift for the same period. The questionnaires and diaries were completed first under the 8-h shift roster, then again 12 months later after the 12-h shift roster had been worked for 7 months. Work quality, productivity, staff turnover and sickness and other absence data were also collected under the two shift systems. The results showed that changing to the 12-h shift roster produced improvements in health, particularly in psychological health and in reduced feelings of tiredness throughout the work period. The change in working hours was at no cost to feelings of job satisfaction or the worker's perceptions of any particular aspects of the work environment, or to measures of productivity.

  2. Ecosystem services provided by waterbirds.

    Science.gov (United States)

    Green, Andy J; Elmberg, Johan

    2014-02-01

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

  3. Providing plastic zone extrusion

    Science.gov (United States)

    Manchiraju, Venkata Kiran; Feng, Zhili; David, Stan A.; Yu, Zhenzhen

    2017-04-11

    Plastic zone extrusion may be provided. First, a compressor may generate frictional heat in stock to place the stock in a plastic zone of the stock. Then, a conveyer may receive the stock in its plastic zone from the compressor and transport the stock in its plastic zone from the compressor. Next, a die may receive the stock in its plastic zone from the conveyer and extrude the stock to form a wire.

  4. Thailand: refining cultural values.

    Science.gov (United States)

    Ratanakul, P

    1990-01-01

    In the second of a set of three articles concerned with "bioethics on the Pacific Rim," Ratanakul, director of a research center for Southeast Asian cultures in Thailand, provides an overview of bioethical issues in his country. He focuses on four issues: health care allocation, AIDS, determination of death, and euthanasia. The introduction of Western medicine into Thailand has brought with it a multitude of ethical problems created in part by tension between Western and Buddhist values. For this reason, Ratanakul concludes that "bioethical enquiry in Thailand must not only examine ethical dilemmas that arise in the actual practice of medicine and research in the life sciences, but must also deal with the refinement and clarification of applicable Thai cultural and moral values."

  5. Relationship of serum bilirubin concentration to kidney function and 24-hour urine protein in Korean adults

    Directory of Open Access Journals (Sweden)

    Jung Yeon Soon

    2011-06-01

    Full Text Available Abstract Background The relationships among serum bilirubin concentration, kidney function and proteinuria have yet to be fully elucidated, nor have these relationships been investigated in Korean adults. Method We retrospectively reviewed the medical records of Korean adults who were evaluated at Kosin University Gospel Hospital (Busan, Republic of Korea during a five-year period from January 2005 to December 2009. We evaluated the relationships among serum bilirubin concentration, estimated glomerular filtration rate (eGFR and 24-hour urinary protein excretion in a sample of 1363 Korean adults aged 18 years or older. Results The values of eGFR 2 and 24-hour urine albumin ≥150 mg/day were observed in 26.1% (n = 356 and 40.5% (n = 553 of subjects, respectively. Fasting glucose levels ≥126 mg/dL were observed in 44.9% (n = 612 of the total sample. After adjustment for potential confounding factors including demographic characteristics, comorbidities and other laboratory measures, total serum bilirubin was positively associated with eGFR and negatively associated with proteinuria both in the whole cohort and in a subgroup of diabetic individuals. Conclusions To our knowledge, this is the first hospital-based study specifically aimed at examining the relationships among serum total bilirubin concentration, 24-hour urine protein and kidney function in Korean adults. We demonstrated that serum total bilirubin concentration was negatively correlated with 24-hour urine protein and positively correlated with eGFR in Korean non-diabetic and diabetic adults.

  6. An approach for generating synthetic fine temporal resolution solar radiation time series from hourly gridded datasets

    Directory of Open Access Journals (Sweden)

    Matthew Perry

    2017-06-01

    Full Text Available A tool has been developed to statistically increase the temporal resolution of solar irradiance time series. Fine temporal resolution time series are an important input into the planning process for solar power plants, and lead to increased understanding of the likely short-term variability of solar energy. The approach makes use of the spatial variability of hourly gridded datasets around a location of interest to make inferences about the temporal variability within the hour. The unique characteristics of solar irradiance data are modelled by classifying each hour into a typical weather situation. Low variability situations are modelled using an autoregressive process which is applied to ramps of clear-sky index. High variability situations are modelled as a transition between states of clear sky conditions and different levels of cloud opacity. The methods have been calibrated to Australian conditions using 1 min data from four ground stations for a 10 year period. These stations, together with an independent dataset, have also been used to verify the quality of the results using a number of relevant metrics. The results show that the method generates realistic fine resolution synthetic time series. The synthetic time series correlate well with observed data on monthly and annual timescales as they are constrained to the nearest grid-point value on each hour. The probability distributions of the synthetic and observed global irradiance data are similar, with Kolmogorov-Smirnov test statistic less than 0.04 at each station. The tool could be useful for the estimation of solar power output for integration studies.

  7. 24-HOUR ARTERIAL STIFFNESS PROFILE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. V. Borodkin

    2015-01-01

    Full Text Available Objective: to study the specific features of arterial stiffness (AS in patients with chronic obstructive pulmonary disease (COPD and chronic heart failure (CHF as evidenced by 24­hour monitoring. Subjects and methods. A total of 111 patients with COPD, including 76 with signs of CHF, were examined. The patients with COPD and CHF were divided into 2 groups according to the presence or absence of prior myocardial infarction (MI. A BPLab МнСДП­2 apparatus was used to study 24­hour AS monitoring readings. Results. The patients with COPD and CHF were noted to have higher values of AS index (ASI (during a day, daytime and pulse wave propa­ gation velocity (during a day, daytime, nighttime than those with COPD without CHF. There was an association between ASI and major car­ diovascular risk factors (hypertension, age, body mass index. The patients with COPD, CHF, and prior MI, unlike those without the latter, were found to have an increased augmentation index throughout the follow­up (during both daytime and nighttime. In the patients with CHF without prior MI, the diurnal ASI was considerably greater than that in both the COPD patients without CHF and those with CHF and prior MI. Conclusion. Increased vascular wall stiffness was detected in the patients with COPD and CHF. By taking into account pronounced AS changes not only during daytime and nighttime hours, it is reasonable to perform 24­hour AS monitoring in patients with comorbidities in order to obtain more objective results. 

  8. Assessing variability of the 24-hour pad weight test in men with post-prostatectomy incontinence

    Directory of Open Access Journals (Sweden)

    Rena D. Malik

    2016-04-01

    Full Text Available ABSTRACT Purpose: Decision-making regarding surgery for post-prostatectomy incontinence (PPI is challenging. The 24-hour pad weight test is commonly used to objectively quantify PPI. However, pad weight may vary based upon activity level. We aimed to quantify variability in pad weights based upon patient-reported activity. Materials and Methods: 25 patients who underwent radical prostatectomy were prospectively enrolled. All patients demonstrated clinical stress urinary incontinence without clinical urgency urinary incontinence. On three consecutive alternating days, patients submitted 24-hour pad weights along with a short survey documenting activity level and number of pads used. Results: Pad weights collected across the three days were well correlated to the individual (ICC 0.85 (95% CI 0.74–0.93, p<0.001. The mean difference between the minimum pad weight leakage and maximum leakage per patient was 133.4g (95% CI 80.4–186.5. The mean increase in 24-hour leakage for a one-point increase in self-reported activity level was 118.0g (95% CI 74.3–161.7, p<0.001. Pad weights also varied significantly when self-reported activity levels did not differ (mean difference 51.2g (95% CI 30.3–72.1, p<0.001. Conclusions: 24-hour pad weight leakage may vary significantly on different days of collection. This variation is more pronounced with changes in activity level. Taking into account patient activity level may enhance the predictive value of pad weight testing.

  9. Health and psychosocial effects of flexible working hours

    Directory of Open Access Journals (Sweden)

    Daniela Janssen

    2004-12-01

    Full Text Available OBJECTIVE: To examine whether any impairments in health and social lives can be found under different kinds of flexible working hours, and whether such effects are related to specific characteristics of these working hours. METHODS: Two studies - a company based survey (N=660 and an internet survey (N=528 - have been conducted. The first one was a questionnaire study (paper and pencil on employees working under some 'typical' kinds of different flexible working time arrangements in different companies and different occupational fields (health care, manufacturing, retail, administration, call centres. The second study was an internet-based survey, using an adaptation of the questionnaire from the first study. RESULTS: The results of both studies consistently show that high variability of working hours is associated with increased impairments in health and well-being and this is especially true if this variability is company controlled. These effects are less pronounced if variability is self-controlled; however, autonomy does not compensate the effects of variability. CONCLUSIONS: Recommendations for an appropriate design of flexible working hours should be developed in order to minimize any impairing effects on health and psychosocial well-being; these recommendations should include - besides allowing for discretion in controlling one's (flexible working hours - that variability in flexible working hours should be kept low (or at least moderate, even if this variability is self-controlled.OBJETIVO: Investigar se ocorre prejuízo à saúde e à vida social com diferentes tipos de horas de trabalho flexíveis e se há relação entre estes efeitos e características específicas das horas de trabalho. MÉTODOS: Foram realizados dois estudos, uma pesquisa em uma empresa (N=660 e outra pela Internet (N=528. O primeiro estudo consistiu de um questionário (papel e lápis aplicado a funcionários sujeitos a diferentes ajustes "típicos" de horas de

  10. Illegitimate Tasks Reach Into Afterwork Hours: A Multilevel Study.

    Science.gov (United States)

    Sonnentag, Sabine; Lischetzke, Tanja

    2017-02-16

    This study examines illegitimate tasks as a specific type of job stressors. Illegitimate tasks comprise unreasonable and unnecessary tasks and refer to inappropriate task assignments that go beyond an employee's role requirements. Building on the stressor-detachment model, we hypothesized that illegitimate tasks experienced during the day predict high negative affect and low self-esteem at the end of the workday, which in turn should predict poor psychological detachment from work during evening hours, resulting in sustained high levels of negative affect and low self-esteem at bedtime. Over the course of 1 workweek, 137 employees completed daily surveys at the end of the workday and at bedtime (total of 567 days). Multilevel path modeling revealed a distinct pattern of findings at the day and the person level. At the day level, unnecessary tasks predicted high negative affect and low self-esteem at the end of the workday, with low self-esteem predicting poor psychological detachment from work during afterwork hours. Poor psychological detachment predicted a further increase in negative affect and a decrease in self-esteem over evening hours. At the between-person level, unreasonable tasks were related to high negative affect and low self-esteem at the end of the workday, with negative affect being related to poor psychological detachment from work. Overall, the findings demonstrate that illegitimate tasks are associated with unfavorable states at the end of the workday and are indirectly related to poor psychological detachment from work, undermining recovery from the stressful events experienced at work. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Providing Contraception to Adolescents.

    Science.gov (United States)

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Ysla S. Catalina & Providence

    OpenAIRE

    Diazgranados, Carlos Nicolás; Torres Carreño, Guillermo Andrés; Castell, Edmon; Moreno, Santiago; Ramirez, Natalia

    2010-01-01

    Esta Hoja de Mano pertenece a la exposición temporal "Ysla S. Catalina & Providence". Contiene un resumen histórico de las Islas de Santa Catalina y Providencia en los idiomas inglés y español y un mapa del siglo VI que lo hace más didáctico apoyado por figuras recortables. Esta muestra hace parte del proyecto IDA y VUELTA del Sistema de Patrimonio Cultural y Museos SPM que gestiona la descentralización del patrimonio cultural de la Universidad Nacional de Colombia a otras ciudades del pa...

  13. The Identification of a Threshold of Long Work Hours for Predicting Elevated Risks of Adverse Health Outcomes.

    Science.gov (United States)

    Conway, Sadie H; Pompeii, Lisa A; Gimeno Ruiz de Porras, David; Follis, Jack L; Roberts, Robert E

    2017-07-15

    Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Off-hours admission and quality of hip fracture care

    DEFF Research Database (Denmark)

    Kristiansen, Nina Sahlertz; Kristensen, Pia Kjær; Nørgård, Bente Mertz

    2016-01-01

    OBJECTIVE: Higher risks of adverse outcomes have been reported for patients admitted acutely during off-hours. However, in relation to hip fracture, the evidence is inconsistent. We examined whether time of admission influenced compliance with performance measures, surgical delay and 30-day...... mortality in patients with hip fracture. DESIGN: Cohort study. SETTING: Data from The Danish Multidisciplinary Hip Fracture Registry linked with data from Danish National Registries. PARTICIPANTS: Danish patients undergoing hip fracture surgery, aged >65 years, admitted 1 March 2010 to 30 November 2013 (N...

  15. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

    1995-01-01

    device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P ..., but surprisingly normal arterial blood pressure during the nighttime, and the circadian variation in blood pressure and HR is diminished, probably because of an almost unaltered cardiac output during the 24 hours. These results may reflect a major defect in the ability of optimal regulation of blood pressure...

  16. Penile Replantation After Five Hours of Warm Ischemia

    Directory of Open Access Journals (Sweden)

    Fernando N. Facio Jr.

    2015-05-01

    Full Text Available Although a rare occurrence, this event may occur as a result of self-mutilation among individuals with psychiatric disturbances or due to work-related accidents, iatrogenic injuries or the actions of individuals motivated by jealously, rage and feelings of betrayal. In western societies, most penile amputations are the result of self-aggression during a psychotic episode, the treatment of victims involves resuscitation, stabilization and immediate psychiatric support. The amputated tissue must be preserved under hypothermic conditions. Micro-surgery is currently the most widely employed method for penile replantation. This paper describes a successful case of penile replantation following 5 hours of warm ischemia.

  17. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

    1995-01-01

    Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant......, but surprisingly normal arterial blood pressure during the nighttime, and the circadian variation in blood pressure and HR is diminished, probably because of an almost unaltered cardiac output during the 24 hours. These results may reflect a major defect in the ability of optimal regulation of blood pressure...

  18. Rosetta Mission's "7 Hours of Terror" and Philae's Descent

    Science.gov (United States)

    Blanco, Philip

    2015-09-01

    In November 2014 the Rosetta mission to Comet 67P/Churyumov-Gerasimenko made the headlines when its Philae lander completed a successful unpowered descent onto the surface of the comet nucleus after "7 hours of terror" for the mission scientists. 67P's irregular shape and rotation made this task even more challenging. Philae fell almost radially towards 67P, as shown in an animation produced by the European Space Agency (ESA) prior to the event. Below, we investigate whether it is possible to model the spacecraft's descent time and impact speed using concepts taught in an introductory physics course.

  19. LinkedIn Marketing An Hour a Day

    CERN Document Server

    von Rosen, Viveka

    2012-01-01

    A step-by-step guide for succeeding on the for ''business'' social media network LinkedIn Marketing: An Hour a Day helps you create, customize, and optimize a presence on LinkedIn, the world's largest social network for professionals. In this detailed, step-by-step book, LinkedIn expert Viveka von Rosen reveals how to use this powerful platform to ensure that you or your company get noticed by the right audience. Discover previously undocumented tips and tricks for community growth and management, including how to best use Groups, events, and other LinkedIn features and applications. Offers a

  20. Historical trend of hourly extreme rainfall in Peninsular Malaysia

    Science.gov (United States)

    Syafrina, A. H.; Zalina, M. D.; Juneng, L.

    2015-04-01

    Hourly rainfall data between the years 1975 and 2010 across the Peninsular Malaysia were analyzed for trends in hourly extreme rainfall events. The analyses were conducted on rainfall occurrences during the northeast monsoon (November-February) known as NEM, the southwest monsoon (May-August) known as SWM, and the two inter-monsoon seasons, i.e., March-April (MA) and September-October (SO). Several extreme rainfall indices were calculated at the station level. The extreme rainfall events in Peninsular Malaysia showed an increasing trend between the years 1975 and 2010. The trend analysis was conducted using linear regression; no serial correlation was detected from the Durbin-Watson test. Ordinary kriging was used to determine the spatial patterns of trends in seasonal extremes. The total amount of rainfall received during NEM is higher compared to rainfall received during inter-monsoon seasons. However, intense rainfall is observed during the inter-monsoon season with higher hourly total amount of rainfall. The eastern part of peninsular was most affected by stratiform rains, while convective rain contributes more precipitation to areas in the western part of the peninsular. From the distribution of spatial pattern of trend, the extreme frequency index (Freq >20) gives significant contribution to the positive extreme rainfall trend during the monsoon seasons. Meanwhile, both extreme frequency and extreme intensity (24-Hr Max, Freq >95th, Tot >95th, Tot >99th, and Hr Max) indices give significant contribution to the positive extreme rainfall trend during the inter-monsoon seasons. Most of the significant extreme indices showed the positive sign of trends. However, a negative trend of extreme rainfall was found in the northwest coast due to the existence of Titiwangsa Range. The extreme intensity, extreme frequency, and extreme cumulative indices showed increasing trends during the NEM and MA while extreme intensity and extreme frequency had similar trends during

  1. Prognostic value of reading-to-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations

    DEFF Research Database (Denmark)

    Hansen, Tine W; Thijs, Lutgarde; Li, Yan

    2010-01-01

    In previous studies, of which several were underpowered, the relation between cardiovascular outcome and blood pressure (BP) variability was inconsistent. We followed health outcomes in 8938 subjects (mean age: 53.0 years; 46.8% women) randomly recruited from 11 populations. At baseline, we asses...

  2. Measuring emergency physicians' work: factoring in clinical hours, patients seen, and relative value units into 1 metric.

    Science.gov (United States)

    Silich, Bert A; Yang, James J

    2012-05-01

    Measuring workplace performance is important to emergency department management. If an unreliable model is used, the results will be inaccurate. Use of inaccurate results to make decisions, such as how to distribute the incentive pay, will lead to rewarding the wrong people and will potentially demoralize top performers. This article demonstrates a statistical model to reliably measure the work accomplished, which can then be used as a performance measurement.

  3. Measuring Emergency Physicians’ Work: Factoring in Clinical Hours, Patients Seen, and Relative Value Units into 1 Metric

    Directory of Open Access Journals (Sweden)

    Bert A. Silich, MD, MS

    2012-05-01

    Full Text Available Measuring workplace performance is important to emergency department management. If anunreliable model is used, the results will be inaccurate. Use of inaccurate results to make decisions,such as how to distribute the incentive pay, will lead to rewarding the wrong people and will potentiallydemoralize top performers. This article demonstrates a statistical model to reliably measure the workaccomplished, which can then be used as a performance measurement.

  4. Projects as value constellations

    DEFF Research Database (Denmark)

    Laursen, Markus

    Creating value has been outlined as very central to projects applying the organizational perspective to projects. It has been suggested that value is created in value constellations or project networks, where actors work together to create value. However, research on the value creation process...... in value constellations is scarce, and through an exploratory study of two project networks in a cultural setting we investigate how value is created in value constellations. We outline how each project may be a distinct type of value constellation, one project creates value for the partners of the network...... as a consortium, and the project creates value primarily for others as a facilitator....

  5. Reference Values of Skin Autofluorescence

    NARCIS (Netherlands)

    Koetsier, M.; Lutgers, H. L.; de Jonge, C.; Links, T. P.; Smit, A. J.; Graaff, R.

    Background: Skin autofluorescence (AF) as measured with the AGE Reader (DiagnOptics Technologies, Groningen, The Netherlands) is a noninvasive prognostic marker in diabetes mellitus and other diseases with increased cardiovascular risk. This study provides reference values of healthy Caucasian

  6. The value of neonatal autopsy.

    LENUS (Irish Health Repository)

    Hickey, Leah

    2012-01-01

    Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

  7. A feasible method to study the Danish out-of-hours primary care service

    DEFF Research Database (Denmark)

    Flarup, Lone; Moth, Grete; Christensen, Morten Bondo

    2014-01-01

    little is known about the reasons for encounter, the performed clinical work and the patient perspectives. MATERIAL AND METHODS: During a one-year period (2010- 2011), data on patient contacts were collected using pop-up questionnaires integrated into the existing IT system. The questions explored......INTRODUCTION: The primary care out-of-hours (OOH) service is of considerable importance; it is the main provider of freely accessible medical advice outside daytime hours, and it covers 75% of the active time in the healthcare system. Although the OOH handles three million contacts annually, only...... registered; and the distribution of patient, contact and GP characteristics in OOH contacts was similar to the background contacts. Telephone consultations were most often offered to children and home visits primarily to elderly patients. The patient response rate was 51.2%. Females comprised the majority...

  8. Detection of vancomycin resistances in enterococci within 3 1/2 hours

    Science.gov (United States)

    Schröder, U. -Ch.; Beleites, C.; Assmann, C.; Glaser, U.; Hübner, U.; Pfister, W.; Fritzsche, W.; Popp, J.; Neugebauer, U.

    2015-02-01

    Vancomycin resistant enterococci (VRE) constitute a challenging problem in health care institutions worldwide. Novel methods to rapidly identify resistances are highly required to ensure an early start of tailored therapy and to prevent further spread of the bacteria. Here, a spectroscopy-based rapid test is presented that reveals resistances of enterococci towards vancomycin within 3.5 hours. Without any specific knowledge on the strain, VRE can be recognized with high accuracy in two different enterococci species. By means of dielectrophoresis, bacteria are directly captured from dilute suspensions, making sample preparation very easy. Raman spectroscopic analysis of the trapped bacteria over a time span of two hours in absence and presence of antibiotics reveals characteristic differences in the molecular response of sensitive as well as resistant Enterococcus faecalis and Enterococcus faecium. Furthermore, the spectroscopic fingerprints provide an indication on the mechanisms of induced resistance in VRE.

  9. Development of a method for mapping monthly average hourly diffuse erythemal ultraviolet radiation

    Science.gov (United States)

    Choosri, P.; Janjai, S.; Nunez, M.; Buntoung, S.; Chanalert, W.

    2017-08-01

    In this study, a model for calculating monthly average hourly diffuse erythemal solar ultraviolet (EUV) radiation under all sky conditions in Thailand was developed. The model is a function of air mass, aerosol optical depth and satellite-derived cloud index, as these parameters are sensitive to diffuse EUV radiation. Diffuse EUV irradiance were measured using UV-biometers equipped with shade ball during April 2011-March 2014 at four stations in Thailand. Data from these stations were used to formulate the model. The model was validated using an independent dataset (April 2014-March 2016) at the same sites. The modeled diffuse EUV irradiance showed good agreement with that from the ground-based measurements, with root mean square difference (RMSD) of 12.7% and mean bias difference (MBD) of -2.8%. The use of satellite data provided a simple and practical method to calculate monthly average hourly diffuse EUV irradiance over Thailand. Spatial monthly distributions are shown as maps.

  10. Impact of gender and personality traits on preferred pricing of public transport in rush hours

    DEFF Research Database (Denmark)

    Pavlicek, Antonin; Sudzina, Frantisek

    2017-01-01

    the time because the distance of travel stays the same. The paper analyzes if gender and personality traits influence for which pricing a person would decide. The logic for the three ways of pricing were not provided in the questionnaire. Big Five Inventory-10 was used to measure personality traits......Price is an inherent part of marketing mix. It is used for multiple reasons, from skimming consumer's surplus to antimarketing. In public transport, higher prices are often used in rush hours. The logic is to give an incentive to customers to travel outside rush hours, thus more evenly distribute....... Moreover, narcissism, and trust were included. The research was conducted in the Czech Republic using an on-line questionnaire....

  11. Heterogeneity of prognostic studies of 24-hour blood pressure variability: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Kathryn S Taylor

    Full Text Available In addition to mean blood pressure, blood pressure variability is hypothesized to have important prognostic value in evaluating cardiovascular risk. We aimed to assess the prognostic value of blood pressure variability within 24 hours. Using MEDLINE, EMBASE and Cochrane Library to April 2013, we conducted a systematic review of prospective studies of adults, with at least one year follow-up and any day, night or 24-hour blood pressure variability measure as a predictor of one or more of the following outcomes: all-cause mortality, cardiovascular mortality, all cardiovascular events, stroke and coronary heart disease. We examined how blood pressure variability is defined and how its prognostic use is reported. We analysed relative risks adjusted for covariates including the appropriate mean blood pressure and considered the potential for meta-analysis. Our analysis of methods included 24 studies and analysis of predictions included 16 studies. There were 36 different measures of blood pressure variability and 13 definitions of night- and day-time periods. Median follow-up was 5.5 years (interquartile range 4.2-7.0. Comparing measures of dispersion, coefficient of variation was less well researched than standard deviation. Night dipping based on percentage change was the most researched measure and the only measure for which data could be meaningfully pooled. Night dipping or lower night-time blood pressure was associated with lower risk of cardiovascular events. The interpretation and use in clinical practice of 24-hour blood pressure variability, as an important prognostic indicator of cardiovascular events, is hampered by insufficient evidence and divergent methodologies. We recommend greater standardisation of methods.

  12. Heterogeneity of Prognostic Studies of 24-Hour Blood Pressure Variability: Systematic Review and Meta-Analysis

    Science.gov (United States)

    Taylor, Kathryn S.; Heneghan, Carl J.; Stevens, Richard J.; Adams, Emily C.; Nunan, David; Ward, Alison

    2015-01-01

    In addition to mean blood pressure, blood pressure variability is hypothesized to have important prognostic value in evaluating cardiovascular risk. We aimed to assess the prognostic value of blood pressure variability within 24 hours. Using MEDLINE, EMBASE and Cochrane Library to April 2013, we conducted a systematic review of prospective studies of adults, with at least one year follow-up and any day, night or 24-hour blood pressure variability measure as a predictor of one or more of the following outcomes: all-cause mortality, cardiovascular mortality, all cardiovascular events, stroke and coronary heart disease. We examined how blood pressure variability is defined and how its prognostic use is reported. We analysed relative risks adjusted for covariates including the appropriate mean blood pressure and considered the potential for meta-analysis. Our analysis of methods included 24 studies and analysis of predictions included 16 studies. There were 36 different measures of blood pressure variability and 13 definitions of night- and day-time periods. Median follow-up was 5.5 years (interquartile range 4.2–7.0). Comparing measures of dispersion, coefficient of variation was less well researched than standard deviation. Night dipping based on percentage change was the most researched measure and the only measure for which data could be meaningfully pooled. Night dipping or lower night-time blood pressure was associated with lower risk of cardiovascular events. The interpretation and use in clinical practice of 24-hour blood pressure variability, as an important prognostic indicator of cardiovascular events, is hampered by insufficient evidence and divergent methodologies. We recommend greater standardisation of methods. PMID:25984791

  13. Implementation of new parameters in 24-hour pH monitoring andimpedance

    Directory of Open Access Journals (Sweden)

    Karolina Korszun

    2016-09-01

    Full Text Available 24-hour oesophageal multichannel impedance and  pH monitoring is  the  gold standard in the  diagnostic process of gastroesophageal reflux disease. Together with oesophagogastroduodenoscopy, it enables to distinguish different kinds of this disease and implement appropriate treatment. Recently, thanks to impedance, it was attempted to evaluate new parameters that could be helpful in diagnosis of gastroesophageal reflux disease and its differentiation from functional heartburn. One of these parameters is baseline impedance. It is measured when no swallows and refluxes occur in the oesophagus, i.e. when the oesophageal wall stays still. Postreflux swallow-induced peristaltic wave (PSPW index is another parameter measured in 24-hour oesophageal multichannel intraluminal impedance and pH-monitoring. It is a quotient of the number of reflux episodes with postreflux swallow-induced peristaltic wave and the total number of reflux episodes. It was proven that baseline impedance and postreflux swallow-induced peristaltic wave index are correlated with oesophageal mucosa integrity. Values of these parameters differ in healthy volunteers, patients with functional heartburn as well as with erosive and nonerosive gastroesophageal reflux disease. They may be useful in the  diagnosis, but also in making decisions about pharmacological or surgical treatment. These parameters are not evaluated during 24-hour oesophageal multichannel impedance and pH-monitoring on a routine basis. Since the available studies have been carried out on small groups of patients, there is a need for further investigation to assess the diagnostic value of baseline impedance and PSPW.

  14. A procedure for assessing future trends of subdaily precipitation values on point scale

    Science.gov (United States)

    Rianna, Guido; Villani, Veronica; Mercogliano, Paola; Vezzoli, Renata

    2015-04-01

    In many areas of Italy, urban flooding or floods in small mountain basins, induced by heavy precipitations on subdaily scale, represent remarkable hazards able to cause huge damages and casualties often increased by very high population density. A proper assessment about how frequency and magnitude of such events could change under the effect of Climate Changes (CC) is crucial for the development of future territorial planning (such as early warning systems). The current constraints of climate modeling, also using high resolution RCM, prevent an adequate representation of subdaily precipitation patterns (mainly concerning extreme values) while available observed datasets are often unsuitable for the application of the bias-correction (BC) techniques requiring long time series. In this work, a new procedure is proposed: at point scale, precipitation outputs on 24 and 48 hours are provided by high resolution (about 8km) climate simulation performed through the RCM COSMO_CLM driven by GCM CMCC_CM and bias-corrected by quantile mapping approach. These ones are adopted for a monthly stochastic disaggregation approach combining Random Parameter Bartlett-Lewis (RPBL) gamma model with appropriate rainfall disaggregation technique. The last one implements empirical correction procedures, called adjusting procedures, to modify the model rainfall output, so that it is consistent with the observed rainfall values on daily time scale. In order to take into account the great difficulties related to minimization of objective function required by retrieving the 7 RPBL parameters, for each dataset the computations are repeated twenty times. Moreover, adopting statistical properties on 24 and 48 hours to retrieve RPBL parameters allows, according Bo et al. (1994), to infer statistical properties until hourly scale maintaining the information content about the possible changes in precipitation patterns due to CC. The entire simulation chain is tested on Baiso weather station, in

  15. Circulation types classification for hourly precipitation events in Lublin (East Poland)

    Science.gov (United States)

    Bartoszek, Krzysztof; Skiba, Dominika

    2016-04-01

    The paper presents an objective classification of circulation types for East-Central Europe with application to hourly precipitation events in Lublin (East Poland) from May to September. The development of the classification utilized sub-daily sea-level pressure values (at the main standard synoptic hours, i.e. 00, 06, 12 and 18 UTC). Sea-level pressure values and physical quantities (resultant flow direction and total shear vorticity) defined 27 circulation types: a) eight each of the directional cyclonic, transitional, and anticyclonic circulation types, and b) one each of the non-directional cyclonic, anticyclonic, and undefined types. In the years 1961-2010, the highest mean precipitation amount in the study area was recorded for cyclonic non-directional type C, followed by cyclonic types with air flow from the western and northern sectors. Type C was also distinguished by the highest number of precipitation events with high intensity irrespective of their duration, i.e. short-term, medium-term, and long-term precipitation events. Moreover, in the class of cyclonic types, precipitation events were considerably longer than in anticyclonic and transitional types. On the other hand, for anticyclonic types, precipitation with high intensity was recorded much more rarely, particularly in the case of advection from the southern sector.

  16. Assessment of Protein:Creatinine Ratio versus 24-Hour Urine Protein in the Diagnosis of Preeclampsia.

    Science.gov (United States)

    Valdés, Enrique; Sepúlveda-Martínez, Álvaro; Tong, Ana; Castro, Magdalena; Castro, Daniela

    2016-01-01

    Current evidence has tried to extrapolate the use of the protein:creatinine ratio (PCR) in a single urine sample as a rapid diagnostic tool for preeclampsia (PE). The present study addresses the effectiveness of the PCR in the differential diagnosis of the pregnancy hypertensive disorder (PHD). This is a prospective study conducted on patients admitted during 1 year with a diagnosis of PHD. These pregnant women were assessed for the correlation between the 24-hour test and the PCR to detect significant proteinuria. A ROC curve was made to determine the PCR cutoff value that would offer the best positive predictive value (PPV) as an early predictor of global and severe PE. A total of 72 patients with 24-hour proteinuria and PCR were studied (49 with PE). A significant correlation between the quick and the deferred sampling was observed (r = 0.60; p proteinuria. PCR proved to be an effective test for the differential diagnosis of PHS. © 2015 S. Karger AG, Basel.

  17. Analysis on the Hour-lines of Yangcheon-cheok

    Directory of Open Access Journals (Sweden)

    Sang Hyuk Kim

    2017-03-01

    Full Text Available We studied the hour-lines of six extant Yangcheon-cheoks in Korea. To find whether Yangcheon-cheok was used in the whole area of Korea, we calculated the length of shadows of Yangcheon-cheok on the Korean Peninsula, Nanjing and Beijing as well as Hanyang (Seoul, according to 24 solar terms. Comparing the length of shadows with hour-lines of those relics, we could find that Yangcheon-cheok was suitable for use at limited times (from 9:00 to 15:00 during the year. Also, this sundial is more appropriate for use at low latitudes than high ones. Among existing relics, that of Seoul Museum of History made with porcelain was much more suitable to use at Hanyang and its higher latitude. Lee’s collection was also suitable to use at Nanjing. It is certain that Yangcheon-cheok was a portable sundial which could be used from nine to fifteen of clock all the year around except for the winter season.

  18. Folding Proteins at 500 ns/hour with Work Queue.

    Science.gov (United States)

    Abdul-Wahid, Badi'; Yu, Li; Rajan, Dinesh; Feng, Haoyun; Darve, Eric; Thain, Douglas; Izaguirre, Jesús A

    2012-10-01

    Molecular modeling is a field that traditionally has large computational costs. Until recently, most simulation techniques relied on long trajectories, which inherently have poor scalability. A new class of methods is proposed that requires only a large number of short calculations, and for which minimal communication between computer nodes is required. We considered one of the more accurate variants called Accelerated Weighted Ensemble Dynamics (AWE) and for which distributed computing can be made efficient. We implemented AWE using the Work Queue framework for task management and applied it to an all atom protein model (Fip35 WW domain). We can run with excellent scalability by simultaneously utilizing heterogeneous resources from multiple computing platforms such as clouds (Amazon EC2, Microsoft Azure), dedicated clusters, grids, on multiple architectures (CPU/GPU, 32/64bit), and in a dynamic environment in which processes are regularly added or removed from the pool. This has allowed us to achieve an aggregate sampling rate of over 500 ns/hour. As a comparison, a single process typically achieves 0.1 ns/hour.

  19. Partial differential equations & boundary value problems with Maple

    CERN Document Server

    Articolo, George A

    2009-01-01

    Partial Differential Equations and Boundary Value Problems with Maple presents all of the material normally covered in a standard course on partial differential equations, while focusing on the natural union between this material and the powerful computational software, Maple. The Maple commands are so intuitive and easy to learn, students can learn what they need to know about the software in a matter of hours- an investment that provides substantial returns. Maple''s animation capabilities allow students and practitioners to see real-time displays of the solutions of partial differential equations.  Maple files can be found on the books website. Ancillary list: Maple files- http://www.elsevierdirect.com/companion.jsp?ISBN=9780123747327  Provides a quick overview of the software w/simple commands needed to get startedIncludes review material on linear algebra and Ordinary Differential equations, and their contribution in solving partial differential equationsIncorporates an early introduction to Sturm-L...

  20. The value of biodiversity

    Directory of Open Access Journals (Sweden)

    CJR. Alho

    Full Text Available In addition to its intrinsic value (nature working as it is; species are the product of a long history of continuing evolution by means of ecological processes, and so they have the right to continued existence, biodiversity also plays a fundamental role as ecosystem services in the maintenance of natural ecological processes. The economic or utilitarian values of biodiversity rely upon the dependence of man on biodiversity; products that nature can provide: wood, food, fibers to make paper, resins, chemical organic products, genes as well as knowledge for biotechnology, including medicine and cosmetic sub-products. It also encompasses ecosystem services, such as climate regulation, reproductive and feeding habitats for commercial fish, some organisms that can create soil fertility through complex cycles and interactions, such as earthworms, termites and bacteria, in addition to fungi responsible for cycling nutrients like nitrogen, phosphorus and sulfur and making them available to plant absorption. These services are the benefits that people indirectly receive from natural ecosystem functions (air quality maintenance, regional climate, water quality, nutrient cycling, reproductive habitats of commercial fish, etc. with their related economic values.