WorldWideScience

Sample records for providing statewide systems

  1. Intelligent Transportation Systems statewide architecture : final report.

    Science.gov (United States)

    2003-06-01

    This report describes the development of Kentuckys Statewide Intelligent Transportation Systems (ITS) Architecture. The process began with the development of an ITS Strategic Plan in 1997-2000. A Business Plan, developed in 2000-2001, translated t...

  2. The Effect of a Statewide Mandatory Prescription Drug Monitoring Program on Opioid Prescribing by Emergency Medicine Providers Across 15 Hospitals in a Single Health System.

    Science.gov (United States)

    Suffoletto, Brian; Lynch, Michael; Pacella, Charissa B; Yealy, Donald M; Callaway, Clifton W

    2018-04-01

    Prescription drug monitoring programs (PDMPs) enable registered prescribers to obtain real-time information on patients' prescription history of controlled medications. We sought to describe the effect of a state-mandated PDMP on opioid prescribing by emergency medicine providers. We retrospectively analyzed electronic medical records of 122,732 adult patients discharged with an opioid prescription from 15 emergency departments in a single health system in Pennsylvania from July 2015 to March, 2017. We used an interrupted time series design to evaluate the percentage of patients discharged each month with an opioid prescription before and after state law-mandated PDMP use on August 25, 2016. From August (pre-PDMP) to September, 2016 (post-PDMP), the opioid prescribing rate decreased from 12.4% (95% confidence interval [CI], 10.8%-14.1%) to 10.2% (95% CI, 8.8%-11.8%). For each month between September 2016 to March 2017, there was a mean decline of .46% (95% CI, -.38% to -.53%) in the percentage of patients discharged with an opioid prescription. There was heterogeneity in opioid prescribing across hospitals as well as according to patient diagnosis. This study examined the effect of a state-mandated PDMP on opioid prescribing among emergency medicine providers from 15 different hospitals in a single health system. Findings support current PDMP mandates in reducing opioid prescriptions, which could curb the prescription opioid epidemic and may ultimately reduce abuse, misuse, and overdose death. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  3. HPV vaccine hesitancy: findings from a statewide survey of health care providers.

    Science.gov (United States)

    McRee, Annie-Laurie; Gilkey, Melissa B; Dempsey, Amanda F

    2014-01-01

    Health care provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy. A statewide sample (n = 575) of Minnesota health care providers (20% pediatricians, 47% family medicine physicians, and 33% nurse practitioners) completed our online survey in April 2013. Only 76% of health care providers reported routinely recommending HPV vaccine for girls ages 11 to 12 years, and far fewer (46%) did so for boys (p parents' concerns (74%), but many lacked time to probe reasons (47%) or believed that they could not change parents' minds (55%). Higher levels of self-efficacy and outcome expectations were associated with routine recommendations (p HPV vaccine. Improving providers' self-efficacy to address hesitancy may be important for improving vaccination rates. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  4. Are Statewide Data Systems Meeting the Local Institution's Needs? AIR Forum Paper 1978.

    Science.gov (United States)

    Bryson, Charles H.

    Statewide data collection systems emerged in the late sixties as the vehicle to achieving greater efficiency and accountability in higher education. The expectations of statewide systems were that they would meet the needs of various levels of management. The example presented in this paper is the Georgia management information system and its…

  5. The Soft Underbelly of System Change: The Role of Leadership and Organizational Climate in Turnover during Statewide Behavioral Health Reform

    OpenAIRE

    Aarons, Gregory A.; Sommerfeld, David H.; Willging, Cathleen E.

    2011-01-01

    This study examined leadership, organizational climate, staff turnover intentions, and voluntary turnover during a large-scale statewide behavioral health system reform. The initial data collection occurred nine months after initiation of the reform with a follow-up round of data collected 18 months later. A self-administered structured assessment was completed by 190 participants (administrators, support staff, providers) employed by 14 agencies. Key variables included leadership, organizati...

  6. Final Report on the Study of the Impact of the Statewide Systemic Initiatives. Lessons Learned about Designing, Implementing, and Evaluating Statewide Systemic Reform. WCER Working Paper No. 2003-12

    Science.gov (United States)

    Heck, Daniel J.; Weiss, Iris R.; Boyd, Sally E.; Howard, Michael N.; Supovitz, Jonathan A.

    2003-01-01

    This document represents the first of two volumes presented in "Study of the Impact of the Statewide Systemic Initiatives Program" (Norman L. Webb and Iris R. Weiss). In an effort to evaluate the impact of the Statewide Systemic Initiatives (SSIs) on student achievement and the lessons that could be learned from the National Science…

  7. From Theory to Practice: Considerations for Implementing a Statewide Voucher System.

    Science.gov (United States)

    Doyle, Denis P.

    This monograph analyzes trends in American educational philosophy and history in its proposal to implement an all-public statewide school voucher system. Following an introduction, section 1, "Alternative Voucher Systems," discusses three concepts: universal unregulated vouchers, favored by Milton Friedman; regulated compensatory vouchers,…

  8. Use Contexts and Usage Patterns of Interactive Case Simulation Tools by HIV Healthcare Providers in a Statewide Online Clinical Education Program.

    Science.gov (United States)

    Wang, Dongwen

    2017-01-01

    We analyzed four interactive case simulation tools (ICSTs) from a statewide online clinical education program. Results have shown that ICSTs are increasingly used by HIV healthcare providers. Smart phone has become the primary usage platform for specific ICSTs. Usage patterns depend on particular ICST modules, usage stages, and use contexts. Future design of ICSTs should consider these usage patterns for more effective dissemination of clinical evidence to healthcare providers.

  9. Leveraging a Statewide Clinical Data Warehouse to Expand Boundaries of the Learning Health System.

    Science.gov (United States)

    Turley, Christine B; Obeid, Jihad; Larsen, Rick; Fryar, Katrina M; Lenert, Leslie; Bjorn, Arik; Lyons, Genevieve; Moskowitz, Jay; Sanderson, Iain

    2016-01-01

    Learning Health Systems (LHS) require accessible, usable health data and a culture of collaboration-a challenge for any single system, let alone disparate organizations, with macro- and micro-systems. Recently, the National Science Foundation described this important setting as a cyber-social ecosystem. In 2004, in an effort to create a platform for transforming health in South Carolina, Health Sciences South Carolina (HSSC) was established as a research collaboration of the largest health systems, academic medical centers and research intensive universities in South Carolina. With work beginning in 2010, HSSC unveiled an integrated Clinical Data Warehouse (CDW) in 2013 as a crucial anchor to a statewide LHS. This CDW integrates data from independent health systems in near-real time, and harmonizes the data for aggregation and use in research. With records from over 2.7 million unique patients spanning 9 years, this multi-institutional statewide clinical research repository allows integrated individualized patient-level data to be used for multiple population health and biomedical research purposes. In the first 21 months of operation, more than 2,800 de-identified queries occurred through i2b2, with 116 users. HSSC has developed and implemented solutions to complex issues emphasizing anti-competitiveness and participatory governance, and serves as a recognized model to organizations working to improve healthcare quality by extending the traditional borders of learning health systems.

  10. Preliminary concept for statewide intercity bus and rail transit system : priority corridor ranking and analysis.

    Science.gov (United States)

    2009-03-01

    This product summarizes the preliminary concept and priority corridors for development of a potential : statewide intercity bus and rail network. The concept is based upon the results of Tasks 1 through 5 of Texas : Department of Transportation Proje...

  11. The Soft Underbelly of System Change: The Role of Leadership and Organizational Climate in Turnover during Statewide Behavioral Health Reform.

    Science.gov (United States)

    Aarons, Gregory A; Sommerfeld, David H; Willging, Cathleen E

    2011-01-01

    This study examined leadership, organizational climate, staff turnover intentions, and voluntary turnover during a large-scale statewide behavioral health system reform. The initial data collection occurred nine months after initiation of the reform with a follow-up round of data collected 18 months later. A self-administered structured assessment was completed by 190 participants (administrators, support staff, providers) employed by 14 agencies. Key variables included leadership, organizational climate, turnover intentions, turnover, and reform-related financial stress ("low" versus "high") experienced by the agencies. Analyses revealed that positive leadership was related to a stronger empowering climate in both high and low stress agencies. However, the association between more positive leadership and lower demoralizing climate was evident only in high stress agencies. For both types of agencies empowering climate was negatively associated with turnover intentions, and demoralizing climate was associated with stronger turnover intentions. Turnover intentions were positively associated with voluntary turnover. Results suggest that strong leadership is particularly important in times of system and organizational change and may reduce poor climate associated with turnover intentions and turnover. Leadership and organizational context should be addressed to retain staff during these periods of systemic change.

  12. A California Statewide App to Simulate Fate of Nitrate in Irrigated Agricultural System

    Science.gov (United States)

    Diamantopoulos, E.; Walkinshaw, M.; Harter, T.; O'Geen, A. T.

    2017-12-01

    Groundwater resources are very important for California's economic development and environmental sustainability. Nitrate is by far the most widespread anthropogenic groundwater pollutant in California's mostly alluvial groundwater basins. Major sources are synthetic fertilizer and dairy manure, but also septic systems and urban wastewater effluent. Here, we evaluate agricultural soils in California according to their risk for nitrate leaching. We conducted over 1 million numerical simulations taking into account the effect of climate, crop type, irrigation and fertilization management scenarios across all 4,568 agricultural soil profiles occurring in California. The assessment was done solving 1-D Richards equation and the advection-dispersion equation numerically. This study is focused on the complex water and nitrate dynamics occurring at the shallow vadose zone (rootzone). The results of this study allow the construction of state-wide maps which can be used for the identification of high-risk regions and the design of agricultural nutrient management policy. We investigate how pollution risk can be minimized by adopting simple irrigation and fertilization methods. Furthermore, we show that these methods are more effective for the most permeable soil profiles along with high demanding crops in terms of fertilization amount and irrigation water. We also present how seasonal (winter) climate conditions contribute on nitrate leaching.

  13. Emergency Department Visits Prior to Suicide and Homicide: Linking Statewide Surveillance Systems.

    Science.gov (United States)

    Cerel, Julie; Singleton, Michael D; Brown, Margaret M; Brown, Sabrina V; Bush, Heather M; Brancado, Candice J

    2016-01-01

    Emergency departments (EDs) serve a wide range of patients who present at risk of impending suicide and homicide. Two statewide surveillance systems were probabilistically linked to understand who utilizes EDs and then dies violently within 6 weeks. Each identified case was matched with four randomly selected controls on sex, race, date of birth, resident zip code, and date of ED visit vs. date of death. Matched-pair odds ratios were estimated by conditional logistic regression to assess differences between cases and controls on reported diagnoses and expected payment sources. Of 1,599 suicides and 569 homicides in the 3-year study period, 10.7% of decedents who died by suicide (mean = 13.6 days) and 8.3% who died by homicide (mean = 16.3 days) were seen in a state ED within 6 weeks prior to death. ED attendees who died by suicide were more likely to have a diagnosis of injury/ poisoning diagnosis or mental disorder and more likely to have Medicare. Those who died by homicide were more likely to have a diagnosis of injury/poisoning and less likely to have commercial insurance. It is essential for research to further explore risk factors for imminent suicide and homicide in ED patients who present for psychiatric conditions and general injuries.

  14. A statewide teleradiology system reduces radiation exposure and charges in transferred trauma patients.

    Science.gov (United States)

    Watson, Justin J J; Moren, Alexis; Diggs, Brian; Houser, Ben; Eastes, Lynn; Brand, Dawn; Bilyeu, Pamela; Schreiber, Martin; Kiraly, Laszlo

    2016-05-01

    Trauma transfer patients routinely undergo repeat imaging because of inefficiencies within the radiology system. In 2009, the virtual private network (VPN) telemedicine system was adopted throughout Oregon allowing virtual image transfer between hospitals. The startup cost was a nominal $3,000 per hospital. A retrospective review from 2007 to 2012 included 400 randomly selected adult trauma transfer patients based on a power analysis (200 pre/200 post). The primary outcome evaluated was reduction in repeat computed tomography (CT) scans. Secondary outcomes included cost savings, emergency department (ED) length of stay (LOS), and spared radiation. All data were analyzed using Mann-Whitney U and chi-square tests. P less than .05 indicated significance. Spared radiation was calculated as a weighted average per body region, and savings was calculated using charges obtained from Oregon Health and Science University radiology current procedural terminology codes. Four-hundred patients were included. Injury Severity Score, age, ED and overall LOS, mortality, trauma type, and gender were not statistically different between groups. The percentage of patients with repeat CT scans decreased after VPN implementation: CT abdomen (13.2% vs 2.8%, P < .01) and cervical spine (34.4% vs 18.2%, P < .01). Post-VPN, the total charges saved in 2012 for trauma transfer patients was $333,500, whereas the average radiation dose spared per person was 1.8 mSV. Length of stay in the ED for patients with Injury Severity Score less than 15 transferring to the ICU was decreased (P < .05). Implementation of a statewide teleradiology network resulted in fewer total repeat CT scans, significant savings, decrease in radiation exposure, and decreased LOS in the ED for patients with less complex injuries. The potential for health care savings by widespread adoption of a VPN is significant. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Analysis of Gastric Lavage Reported to a Statewide Poison Control System.

    Science.gov (United States)

    Donkor, Jimmy; Armenian, Patil; Hartman, Isaac N; Vohra, Rais

    2016-10-01

    As decontamination trends have evolved, gastric lavage (GL) has become a rare procedure. The current information regarding use, outcomes, and complications of GL could help refine indications for this invasive procedure. We sought to determine case type, location, and complications of GL cases reported to a statewide poison control system. This is a retrospective review of the California Poison Control System (CPCS) records from 2009 to 2012. Specific substances ingested, results and complications of GL, referring hospital ZIP codes, and outcomes were examined. Nine hundred twenty-three patients who underwent GL were included in the final analysis, ranging in age from 9 months to 88 years. There were 381 single and 540 multiple substance ingestions, with pill fragment return in 27%. Five hundred thirty-six GLs were performed with CPCS recommendation, while 387 were performed without. Complications were reported for 20 cases. There were 5 deaths, all after multiple ingestions. Among survivors, 37% were released from the emergency department, 13% were admitted to hospital wards, and 48% were admitted to intensive care units. The most commonly ingested substances were nontricyclic antidepressant psychotropics (n = 313), benzodiazepines (n = 233), acetaminophen (n = 191), nonsteroidal anti-inflammatory drugs (n = 107), diphenhydramine (n = 70), tricyclic antidepressants (n = 45), aspirin (n = 45), lithium (n = 36), and antifreeze (n = 10). The geographic distribution was clustered near regions of high population density, with a few exceptions. Toxic agents for which GL was performed reflected a broad spectrum of potential hazards, some of which are not life-threatening or have effective treatments. Continuing emergency physician and poison center staff education is required to assist in patient selection. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Creating a Statewide Educational Data System for Accountability and Improvement: A Comprehensive Information and Assessment System for Making Evidence-Based Change at School, District, and Policy Levels

    Science.gov (United States)

    Felner, Robert D.; Bolton, Natalie; Seitsinger, Anne M.; Brand, Stephen; Burns, Amy

    2008-01-01

    This article reports on one ongoing statewide effort to create a high-quality data reporting and utilization system (i.e., High-Performance Learning Community [HiPlaces] Assessment) to inform educational accountability and improvement efforts system. This effort has undergoing refinement for more than a decade. The article describes the features…

  17. Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System

    Directory of Open Access Journals (Sweden)

    Rais Vohra

    2017-07-01

    Full Text Available Introduction: Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. Methods: This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. Results: The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93% with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5–20%, with 4 cases reporting methemoglobin levels between 20.2%–55%. Methylene blue was administered in 4 of the cases exhibiting major effects. Conclusion: The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products.

  18. Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System.

    Science.gov (United States)

    Vohra, Rais; Huntington, Serena; Koike, Jennifer; Le, Kevin; Geller, Richard J

    2017-08-01

    Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93%) with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5-20%), with 4 cases reporting methemoglobin levels between 20.2%-55%. Methylene blue was administered in 4 of the cases exhibiting major effects. The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products.

  19. Human bromethalin exposures reported to a U.S. Statewide Poison Control System.

    Science.gov (United States)

    Huntington, Serena; Fenik, Yelena; Vohra, Rais; Geller, Richard J

    2016-03-01

    Bromethalin is an increasingly used alternative to long-acting anticoagulant and cholecalciferol rodenticides. There are few reports of human exposures, and no existing professional society guidelines on medical management of bromethalin ingestions. The aim of this retrospective data review is to characterize bromethalin exposures reported to the California Poison Control System (CPCS) between 1997 and 2014. This is an observational retrospective case review of our statewide poison control system's electronic medical records. Following Institutional Board Review and Research Committee approvals, poison center exposures related to bromethalin were extracted using substance code and free text search strategies. Case notes of bromethalin exposures were reviewed for demographic, clinical, laboratory, and outcome information; inclusion criteria for the study was single-substance, human exposure to bromethalin. There were 129 calls related to human bromethalin exposures (three cases met exclusion criteria). The age range of cases was 7 months-90 years old, with the majority of exposures (89 cases; 70.6%), occurring in children younger than 5 years of age (median age of 2 years). Most exposures occurred in the pediatric population as a result of exploratory oral exposure. One hundred and thirteen patients (89.7%) had no effects post exposure, while 10 patients (7.9%) had a minor outcome. Adverse effects were minor, self-limited, and mostly gastrointestinal upset. There were no moderate, major, or fatal effects in our study population. The approximate ingested dose, available in six cases, ranged from 0.067 mg/kg to 0.3 mg/kg (milligrams of bromethalin ingested per kilogram of body weight), and no dose-symptom threshold could be established from this series. Exposures were not confirmed through urine or serum laboratory testing. The prognosis for most accidental ingestions appears to be excellent. However, bromethalin exposures may result in a higher number of

  20. Management systems for service providers

    International Nuclear Information System (INIS)

    Bolokonya, Herbert Chiwalo

    2015-02-01

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

  1. Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system.

    Science.gov (United States)

    Vivanti, Angela; O'Sullivan, Therese A; Porter, Jane; Hogg, Marion

    2017-09-01

    Three years following a state-wide Nutrition Care Process Terminology (NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Pre-implementation and three years post-implementation, all Queensland Government hospitals state-wide were invited to repeat a validated NCPT survey. Additionally, a separate survey sought dietetic managers' opinions regarding NCPT's use and acceptance, usefulness for patient care, role in service planning and continued use. A total of 238 dietitians completed the survey in 2011 and 82 dietitians in 2014. Use of diagnostic statement in the previous six months improved (P  0.05). Key elements in sustaining NCPT implementation over three years included ongoing management support, workshops/tutorials, discussion and mentor and peer support. The most valued resources were pocket guides, ongoing workshops/tutorials and mentor support. Dietetic managers held many positive NCPT views, however, opinions differed around the usefulness of service planning, safer practice, improving patient care and facilitating communication. Some managers would not support NCPT unless it was recommended for practice. Immediate improvements following the NCPT implementation project were sustained over three years. Moving forward, a professional focus on continuing to incorporate NCPT into standard practice will provide structure for process and outcomes assessment. © 2017 State of Queensland. Nutrition and Dietetics © 2017 Dietitians Association of Australia.

  2. 45 CFR 1355.52 - Funding authority for statewide automated child welfare information systems (SACWIS).

    Science.gov (United States)

    2010-10-01

    ... welfare information systems (SACWIS). 1355.52 Section 1355.52 Public Welfare Regulations Relating to... welfare information systems (SACWIS). (a) States may receive Federal reimbursement at the 75 percent match... information system, to the extent such system: (1) Provides for the State to collect and electronically report...

  3. Computerized provider order entry systems.

    Science.gov (United States)

    2001-01-01

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

  4. Development of a model web-based system to support a statewide quality consortium in radiation oncology.

    Science.gov (United States)

    Moran, Jean M; Feng, Mary; Benedetti, Lisa A; Marsh, Robin; Griffith, Kent A; Matuszak, Martha M; Hess, Michael; McMullen, Matthew; Fisher, Jennifer H; Nurushev, Teamour; Grubb, Margaret; Gardner, Stephen; Nielsen, Daniel; Jagsi, Reshma; Hayman, James A; Pierce, Lori J

    A database in which patient data are compiled allows analytic opportunities for continuous improvements in treatment quality and comparative effectiveness research. We describe the development of a novel, web-based system that supports the collection of complex radiation treatment planning information from centers that use diverse techniques, software, and hardware for radiation oncology care in a statewide quality collaborative, the Michigan Radiation Oncology Quality Consortium (MROQC). The MROQC database seeks to enable assessment of physician- and patient-reported outcomes and quality improvement as a function of treatment planning and delivery techniques for breast and lung cancer patients. We created tools to collect anonymized data based on all plans. The MROQC system representing 24 institutions has been successfully deployed in the state of Michigan. Since 2012, dose-volume histogram and Digital Imaging and Communications in Medicine-radiation therapy plan data and information on simulation, planning, and delivery techniques have been collected. Audits indicated >90% accurate data submission and spurred refinements to data collection methodology. This model web-based system captures detailed, high-quality radiation therapy dosimetry data along with patient- and physician-reported outcomes and clinical data for a radiation therapy collaborative quality initiative. The collaborative nature of the project has been integral to its success. Our methodology can be applied to setting up analogous consortiums and databases. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  5. Statewide Suicide Prevention Council

    Science.gov (United States)

    State Employees Statewide Suicide Prevention Council DHSS State of Alaska Home Divisions and Agencies National Suicide Prevention Lifeline Alaska Community Mental Health Centers National Survivors of Suicide Meetings Presentations 2010 Alaska Statewide Suicide Prevention Summit: Mending the Net Connect with us on

  6. A Statewide Collaboration: Ohio Level III Trauma Centers' Approach to the Development of a Benchmarking System.

    Science.gov (United States)

    Lang, Carrie L; Simon, Diane; Kilgore, Jane

    The American College of Surgeons Committee on Trauma revised the Resources for Optimal Care of the Injured Patient to include the criteria for trauma centers to participate in a risk-adjusted benchmarking system. Trauma Quality Improvement Program is currently the risk-adjusted benchmarking program sponsored by the American College of Surgeons, which will be required of all trauma centers to participate in early 2017. Prior to this, there were no risk-adjusted programs for Level III verified trauma centers. The Ohio Society of Trauma Nurse Leaders is a collaborative group made up of trauma program managers, coordinators, and other trauma leaders who meet 6 times a year. Within this group, a Level III Subcommittee was formed initially to provide a place for the Level III centers to discuss issues specific to the Level III centers. When the new requirement regarding risk-adjustment became official, the subcommittee agreed to begin reporting simple data points with the idea to risk adjust in the future.

  7. The trauma ecosystem: The impact and economics of new trauma centers on a mature statewide trauma system.

    Science.gov (United States)

    Ciesla, David J; Pracht, Etienne E; Leitz, Pablo T; Spain, David A; Staudenmayer, Kristan L; Tepas, Joseph J

    2017-06-01

    Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened alongside 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patients' profiles. A statewide data set was queried for all injury-related discharges from adult acute care hospitals using International Classification of Diseases, Ninth Revision (ICD-9) codes for 2010 and 2014. The data set, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida Department of Health in its trauma registry. Hospitals were classified as existing Level I (E1) or Level II (E2) trauma centers and new E2 (N2) centers. Five N2 centers were established 11.6 to 85.3 miles from existing centers. Field and overall trauma system triage of high-risk patients was less accurate with increased overtriage and no change in undertriage. Annual volume at N2 centers increased but did not change at E1 and E2 centers. In 2014, Patients at E1 and E2 centers were slightly older and less severely injured, while those at N2 centers were substantially younger and more severely injured than in 2010. The injured patient-payer mix changed with a decrease in self-pay and commercial patients and an increase in government-sponsored patients at E1 and E2 centers and an increase in self-pay and commercial patients with a decrease in government-sponsored patients at N2 centers. Designation of new trauma centers in a mature system was associated with a change in established trauma center demographics and economics without an improvement in trauma system triage performance. These findings suggest that the health of an entire trauma system network must be considered in the design and implementation of a regional trauma system. Therapeutic/care management study, level IV; epidemiological, level IV.

  8. The relationship between processes and outcomes for injured older adults: a study of a statewide trauma system.

    Science.gov (United States)

    Saillant, N N; Earl-Royal, E; Pascual, J L; Allen, S R; Kim, P K; Delgado, M K; Carr, B G; Wiebe, D; Holena, D N

    2017-02-01

    Age is a risk factor for death, adverse outcomes, and health care use following trauma. The American College of Surgeons' Trauma Quality Improvement Program (TQIP) has published "best practices" of geriatric trauma care; adoption of these guidelines is unknown. We sought to determine which evidence-based geriatric protocols, including TQIP guidelines, were correlated with decreased mortality in Pennsylvania's trauma centers. PA's level I and II trauma centers self-reported adoption of geriatric protocols. Survey data were merged with risk-adjusted mortality data for patients ≥65 from a statewide database, the Pennsylvania Trauma Systems Foundation (PTSF), to compare mortality outlier status and processes of care. Exposures of interest were center-specific processes of care; outcome of interest was PTSF mortality outlier status. 26 of 27 eligible trauma centers participated. There was wide variation in care processes. Four trauma centers were low outliers; three centers were high outliers for risk-adjusted mortality rates in adults ≥65. Results remained consistent when accounting for center volume. The only process associated with mortality outlier status was age-specific solid organ injury protocols (p = 0.04). There was no cumulative effect of multiple evidence-based processes on mortality rate (p = 0.50). We did not see a link between adoption of geriatric best-practices trauma guidelines and reduced mortality at PA trauma centers. The increased susceptibility of elderly to adverse consequences of injury, combined with the rapid growth rate of this demographic, emphasizes the importance of identifying interventions tailored to this population. III. Descriptive.

  9. 45 CFR 205.38 - Federal financial participation (FFP) for establishing a statewide mechanized system.

    Science.gov (United States)

    2010-10-01

    ... software or modifications thereof and associated documentation designed or developed with 90 percent FFP... system planned, designed, developed, installed, and hardware acquired, with FFP under these regulations... are being met and to determine its efficiency, economy and effectiveness. (c) If ACF suspends approval...

  10. Core to College Evaluation: Statewide Networks. Connecting Education Systems and Stakeholders to Support College Readiness

    Science.gov (United States)

    Bracco, Kathy Reeves; Klarin, Becca; Broek, Marie; Austin, Kim; Finkelstein, Neal; Bugler, Daniel; Mundry, Susan

    2014-01-01

    The Core to College initiative aims to facilitate greater coordination between K-12 and postsecondary education systems around implementation of the Common Core State Standards and aligned assessments. Core to College grants have been awarded to teams in Colorado, Florida, Hawaii, Kentucky, Louisiana, Massachusetts, North Carolina, Oregon,…

  11. 34 CFR 361.23 - Requirements related to the statewide workforce investment system.

    Science.gov (United States)

    2010-07-01

    ... technology for individuals with disabilities; (ii) The use of information and financial management systems... resources and specification of the financial responsibility of each partner of the One-Stop service delivery... the Act, this part, other Federal requirements, and State law; and (vi) The specification of...

  12. Of Needles and Haystacks: Building an Accurate Statewide Dropout Early Warning System in Wisconsin

    Science.gov (United States)

    Knowles, Jared E.

    2015-01-01

    The state of Wisconsin has one of the highest four year graduation rates in the nation, but deep disparities among student subgroups remain. To address this the state has created the Wisconsin Dropout Early Warning System (DEWS), a predictive model of student dropout risk for students in grades six through nine. The Wisconsin DEWS is in use…

  13. Design and Implementation of a Centralized Model of Clinical Education Within a Statewide Health System.

    Science.gov (United States)

    Elzy, Pamela Smith

    2016-01-01

    Today's dynamic health care environment is exceedingly complex, and health care facilities across the United States are struggling to respond to changes in technology, health care reimbursement, the Affordable Care Act, and the much-anticipated nursing shortage. Mergers, acquisitions, and integrations are the current health care reality. These are proposed to increase efficiency, efficacy, quality, satisfaction, and safety while effectively reducing cost to the consumer and stabilizing the economy of the health care system. Many of these projects fail to achieve objectives, even years after the formal change in status. Clinical education departments in merged organizations are often operated in the single-facility mindset, or contain an element of the shared services model. They are not truly integrated. Development of skills in complex analysis of current state, identification of desired scope of service and expectations of performance, and articulation of the benefits of the desired future state are all essential to nursing executive practice. This article describes an experience integrating 3 legacy education departments across 21 facilities into a centralized education system. The complexity of integration activities is illustrated and outcome measures of success are discussed. Barriers, facilitators, and risks of the project are identified and evaluated.

  14. Establishment of a Web-based System for Collection of Patient-reported Outcomes After Radical Prostatectomy in a Statewide Quality Improvement Collaborative.

    Science.gov (United States)

    Lucas, Steven M; Kim, Tae-Kyung; Ghani, Khurshid R; Miller, David C; Linsell, Susan; Starr, Jay; Peabody, James O; Hurley, Patrick; Montie, James; Cher, Michael L

    2017-09-01

    To report on the establishment of a unified, electronic patient-reported outcome (PRO) infrastructure and pilot results from the first 5 practices enrolled in the web-based collection system developed by the Michigan Urological Surgery Improvement Collaborative. Eligible patients were those undergoing radical prostatectomy of 5 academic and community practices. PRO was obtained using a validated 21-item web-based questionnaire, regarding urinary function, erection function, and sexual interest and satisfaction. Data were collected preoperatively, at 3 months, and 6 months postoperatively. Patients were provided a link via email to complete the surveys. Perioperative and PRO data were analyzed as reports for individual patients and summary performance reports for individual surgeons. Among 773 eligible patients, 688 (89%) were enrolled preoperatively. Survey completion rate was 88%, 84%, and 90% preoperatively, at 3 months, and 6 months. Electronic completion rates preoperatively, at 3 months, and 6 months were 70%, 70%, and 68%, respectively. Mean urinary function scores were 18.3, 14.3, and 16.6 (good function ≥ 17), whereas mean erection scores were 18.7, 7.3, and 9.1 (good erection score ≥ 22) before surgery, at 3 months, and 6 months. Variation was noted for erectile function among the practices. Collection of electronic PRO via this unified, web-based format was successful and provided results that reflect expected recovery and identify opportunities for improvement. This will be extended to more practices statewide to improve outcomes after radical prostatectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Differences in Readiness between Rural Hospitals and Primary Care Providers for Telemedicine Adoption and Implementation: Findings from a Statewide Telemedicine Survey

    Science.gov (United States)

    Martin, Amy Brock; Probst, Janice C.; Shah, Kyle; Chen, Zhimin; Garr, David

    2012-01-01

    Purpose: Published advantages of and challenges with telemedicine led us to examine the scope of telemedicine adoption, implementation readiness, and barriers in a southern state where adoption has been historically low. We hypothesized that rural hospitals and primary care providers (RPCPs) differ on adoption, readiness, and implementation…

  16. Evaluation of a Statewide HIV-HCV-STD Online Clinical Education Program by Healthcare Providers - A Comparison of Nursing and Other Disciplines.

    Science.gov (United States)

    Wang, Dongwen; Luque, Amneris E

    2016-01-01

    The New York State HIV-HCV-STD Clinical Education Initiative (CEI) has developed a large repository of online resources and disseminated them to a wide range of healthcare providers. To evaluate the CEI online education program and in particular to compare the self-reported measures by clinicians from different disciplines, we analyzed the data from 1,558 course completions in a study period of three months. The results have shown that the overall evaluations by the clinicians were very positive. Meanwhile, there were significant differences across the clinical disciplines. In particular, physicians and nurse practitioners were the most satisfied. In contrast, pharmacists and case/care managers recorded lower than average responses. Nurses and counselors had mixed results. Nurse practitioners' responses were very similar to physicians on most measures, but significantly different from nurses in many aspects. For more effective knowledge dissemination, online education programs should consider the unique needs by clinicians from specific disciplines.

  17. Development of a statewide transportation data warehousing and mining system under the Louisiana Transportation Information System (LATIS) Program.

    Science.gov (United States)

    2009-04-01

    The objectives of this study are to assess whether introducing a data warehousing/data mining system in Louisiana would be feasible and beneficial. The study sets out to identify the features of the most suitable system for the state as well as to ou...

  18. SYSTEM ORGANIZATION OF MATERIAL PROVIDING OF BUILDING

    Directory of Open Access Journals (Sweden)

    A. V. Rаdkеvich

    2014-04-01

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

  19. INTEGRATED INFORMATION SYSTEM ARCHITECTURE PROVIDING BEHAVIORAL FEATURE

    Directory of Open Access Journals (Sweden)

    Vladimir N. Shvedenko

    2016-11-01

    Full Text Available The paper deals with creation of integrated information system architecture capable of supporting management decisions using behavioral features. The paper considers the architecture of information decision support system for production system management. The behavioral feature is given to an information system, and it ensures extraction, processing of information, management decision-making with both automated and automatic modes of decision-making subsystem being permitted. Practical implementation of information system with behavior is based on service-oriented architecture: there is a set of independent services in the information system that provides data of its subsystems or data processing by separate application under the chosen variant of the problematic situation settlement. For creation of integrated information system with behavior we propose architecture including the following subsystems: data bus, subsystem for interaction with the integrated applications based on metadata, business process management subsystem, subsystem for the current state analysis of the enterprise and management decision-making, behavior training subsystem. For each problematic situation a separate logical layer service is created in Unified Service Bus handling problematic situations. This architecture reduces system information complexity due to the fact that with a constant amount of system elements the number of links decreases, since each layer provides communication center of responsibility for the resource with the services of corresponding applications. If a similar problematic situation occurs, its resolution is automatically removed from problem situation metamodel repository and business process metamodel of its settlement. In the business process performance commands are generated to the corresponding centers of responsibility to settle a problematic situation.

  20. WisDOT statewide customer satisfaction survey : [project brief].

    Science.gov (United States)

    2013-03-01

    The Wisconsin Department of Transportation (WisDOT) is a major public agency with numerous customers utilizing a variety of services and programs to support the entire statewide multimodal transportation system. The department also houses the Divisio...

  1. Louisiana's statewide beach cleanup

    Science.gov (United States)

    Lindstedt, Dianne M.; Holmes, Joseph C.

    1989-01-01

    Litter along Lousiana's beaches has become a well-recognized problem. In September 1987, Louisiana's first statewide beach cleanup attracted about 3300 volunteers who filled 16,000 bags with trash collected along 15 beaches. An estimated 800,173 items were gathered. Forty percent of the items were made of plastic and 11% were of polystyrene. Of all the litter collected, 37% was beverage-related. Litter from the oil and gas, commercial fishing, and maritime shipping industries was found, as well as that left by recreational users. Although beach cleanups temporarily rid Louisiana beaches of litter, the real value of the effort is in public participation and education. Civic groups, school children, and individuals have benefited by increasing their awareness of the problems of trash disposal.

  2. Effects of patient health literacy, patient engagement and a system-level health literacy attribute on patient-reported outcomes: a representative statewide survey.

    Science.gov (United States)

    Kaphingst, Kimberly A; Weaver, Nancy L; Wray, Ricardo J; Brown, Melissa L R; Buskirk, Trent; Kreuter, Matthew W

    2014-10-07

    The effects of health literacy are thought to be based on interactions between patients' skill levels and health care system demands. Little health literacy research has focused on attributes of health care organizations. We examined whether the attribute of individuals' experiences with front desk staff, patient engagement through bringing questions to a doctor visit, and health literacy skills were related to two patient-reported outcomes. We administered a telephone survey with two sampling frames (i.e., household landline, cell phone numbers) to a randomly selected statewide sample of 3358 English-speaking adult residents of Missouri. We examined two patient-reported outcomes - whether or not respondents reported knowing more about their health and made better choices about their health following their last doctor visit. Multivariable logistic regression models were used to examine the independent contributions of predictor variables (i.e., front desk staff, bringing questions to a doctor visit, health literacy skills). Controlling for self-reported health, having a personal doctor, time since last visit, number of chronic conditions, health insurance, and sociodemographic characteristics, respondents who had a good front desk experience were 2.65 times as likely (95% confidence interval [CI]: 2.13, 3.30) and those who brought questions were 1.73 times as likely (95% CI: 1.32, 2.27) to report knowing more about their health after seeing a doctor. In a second model, respondents who had a good front desk experience were 1.57 times as likely (95% CI: 1.26, 1.95) and those who brought questions were 1.66 times as likely (95% CI: 1.29, 2.14) to report making better choices about their health after seeing a doctor. Patients' health literacy skills were not associated with either outcome. Results from this representative statewide survey may indicate that one attribute of a health care organization (i.e., having a respectful workforce) and patient engagement through

  3. Alabama statewide mobility report, 2014.

    Science.gov (United States)

    2015-09-01

    This Alabama Statewide Mobility Report for 2014 is a new way to analyze interstate mobility performance over an entire year. Over half a billion speed records were acquired, stored, and analyzed for this report. These observations capture recurring c...

  4. Automated Cancer Registry Notifications: Validation of a Medical Text Analytics System for Identifying Patients with Cancer from a State-Wide Pathology Repository.

    Science.gov (United States)

    Nguyen, Anthony N; Moore, Julie; O'Dwyer, John; Philpot, Shoni

    2016-01-01

    The paper assesses the utility of Medtex on automating Cancer Registry notifications from narrative histology and cytology reports from the Queensland state-wide pathology information system. A corpus of 45.3 million pathology HL7 messages (including 119,581 histology and cytology reports) from a Queensland pathology repository for the year of 2009 was analysed by Medtex for cancer notification. Reports analysed by Medtex were consolidated at a patient level and compared against patients with notifiable cancers from the Queensland Oncology Repository (QOR). A stratified random sample of 1,000 patients was manually reviewed by a cancer clinical coder to analyse agreements and discrepancies. Sensitivity of 96.5% (95% confidence interval: 94.5-97.8%), specificity of 96.5% (95.3-97.4%) and positive predictive value of 83.7% (79.6-86.8%) were achieved for identifying cancer notifiable patients. Medtex achieved high sensitivity and specificity across the breadth of cancers, report types, pathology laboratories and pathologists throughout the State of Queensland. The high sensitivity also resulted in the identification of cancer patients that were not found in the QOR. High sensitivity was at the expense of positive predictive value; however, these cases may be considered as lower priority to Cancer Registries as they can be quickly reviewed. Error analysis revealed that system errors tended to be tumour stream dependent. Medtex is proving to be a promising medical text analytic system. High value cancer information can be generated through intelligent data classification and extraction on large volumes of unstructured pathology reports.

  5. PACS-Graz, 1985-2000: from a scientific pilot to a state-wide multimedia radiological information system

    Science.gov (United States)

    Gell, Guenther

    2000-05-01

    1971/72 began the implementation of a computerized radiological documentation system as the Department of Radiology of the University of Graz, which developed over the years into a full RIS. 1985 started a scientific cooperation with SIEMENS to develop a PACS. The two systems were linked and evolved into a highly integrated RIS-PACS for the state wide hospital system in Styria. During its lifetime the RIS, originally implemented in FORTRAN on a UNIVAC 494 mainframe migrated to a PDP15, on to a PDP11, then VAX and Alphas. The flexible original record structure with variable length fields and the powerful retrieval language were retained. The data acquisition part with the user interface was rewritten several times and many service programs have been added. During our PACS cooperation many ideas like the folder concept or functionalities of the GUI have been designed and tested and were then implemented in the SIENET product. The actual RIS/PACS supports the whole workflow in the Radiology Department. It is installed in a 2.300 bed university hospital and the smaller hospitals of the State of Styria. Modalities from different vendors are connected via DICOM to the RIS (modality worklist) and to the PACS. PACSubsystems from other vendors have been integrated. Images are distributed to referring clinics and for teleconsultation and image processing and reports are available on line to all connected hospitals. We spent great efforts to guarantee optimal support of the workflow and to ensure an enhanced cost/benefit ratio for each user (class). Another special feature is selective image distribution. Using the high level retrieval language individual filters can be constructed easily to implement any image distribution policy agreed upon by radiologists and referring clinicians.

  6. Statewide mesoscopic simulation for Wyoming.

    Science.gov (United States)

    2013-10-01

    This study developed a mesoscopic simulator which is capable of representing both city-level and statewide roadway : networks. The key feature of such models are the integration of (i) a traffic flow model which is efficient enough to : scale to larg...

  7. Successful Statewide Walking Program Websites

    Science.gov (United States)

    Teran, Bianca Maria; Hongu, Nobuko

    2012-01-01

    Statewide Extension walking programs are making an effort to increase physical activity levels in America. An investigation of all 20 of these programs revealed that 14 use websites as marketing and educational tools, which could prove useful as the popularity of Internet communities continues to grow. Website usability information and an analysis…

  8. Alcohol policy enforcement and changes in student drinking rates in a statewide public college system: a follow-up study

    Directory of Open Access Journals (Sweden)

    Harris Sion K

    2010-08-01

    Full Text Available Abstract Background Heavy alcohol use among U.S. college students is a major contributor to young adult morbidity and mortality. The aim of this study was to examine whether college alcohol policy enforcement levels predict changes in student drinking and related behaviors in a state system of public colleges and universities, following a system-wide change to a stricter policy. Methods Students and administrators at 11 Massachusetts public colleges/universities completed surveys in 1999 (N of students = 1252, one year after the policy change, and again in 2001 (N = 1074. We calculated policy enforcement scores for each school based on the reports of deans of students, campus security chiefs, and students, and examined the correlations between perceived enforcement levels and the change in student drinking rates over the subsequent two year period, after weighting the 2001 data to adjust for demographic changes in the student body. Results Overall rates of any past-30-days drinking, heavy episodic drinking, and usual heavy drinking among past-30-days drinkers were all lower in 2001 compared to 1999. School-level analyses (N = 11 found deans' baseline reports of stricter enforcement were strongly correlated with subsequent declines in heavy episodic drinking (Pearson's r = -0.73, p = 0.011. Moreover, consistently high enforcement levels across time, as reported by deans, were associated with greater declines in heavy episodic drinking. Such relationships were not found for students' and security chiefs' reports of enforcement. Marijuana use did not rise during this period of decline in heavy drinking. Conclusions Study findings suggest that stronger enforcement of a stricter alcohol policy may be associated with reductions in student heavy drinking rates over time. An aggressive enforcement stance by deans may be an important element of an effective college alcohol policy.

  9. Piloting a Statewide Home Visiting Quality Improvement Learning Collaborative.

    Science.gov (United States)

    Goyal, Neera K; Rome, Martha G; Massie, Julie A; Mangeot, Colleen; Ammerman, Robert T; Breckenridge, Jye; Lannon, Carole M

    2017-02-01

    Objective To pilot test a statewide quality improvement (QI) collaborative learning network of home visiting agencies. Methods Project timeline was June 2014-May 2015. Overall objectives of this 8-month initiative were to assess the use of collaborative QI to engage local home visiting agencies and to test the use of statewide home visiting data for QI. Outcome measures were mean time from referral to first home visit, percentage of families with at least three home visits per month, mean duration of participation, and exit rate among infants learning. A statewide data system was used to generate monthly run charts. Results Mean time from referral to first home visit was 16.7 days, and 9.4% of families received ≥3 visits per month. Mean participation was 11.7 months, and the exit rate among infants learning network, agencies tested and measured changes using statewide and internal data. Potential next steps are to develop and test new metrics with current pilot sites and a larger collaborative.

  10. Statewide Transportation Improvement program 2011-2014 : sorted by MPO and RPA.

    Science.gov (United States)

    2010-01-01

    Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC and 49 : USC. The STIP is generated to provide the Federal Highway Administration : (FHWA) and Federal Transit A...

  11. Statewide Transportation Improvement Program 2010-2013 : sorted by MPO and RPA.

    Science.gov (United States)

    2006-01-01

    Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC. The : STIP is generated to provide the Federal Highway Administration (FHWA) and : Federal Transit Administrati...

  12. Statewide Transportation Improvement Program 2012-2015 : sorted by MPO and RPA.

    Science.gov (United States)

    2011-01-01

    Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC and 49 : USC. The STIP is generated to provide the Federal Highway Administration : (FHWA) and Federal Transit A...

  13. Strategic information systems planning for health service providers.

    Science.gov (United States)

    Moriarty, D D

    1992-01-01

    There is significant opportunity for health service providers to gain competitive advantage through the innovative use of strategic information systems. This analysis presents some key strategic information systems issues that will enable managers to identify opportunities within their organizations.

  14. Electronic consultation system demonstrates educational benefit for primary care providers.

    Science.gov (United States)

    Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S

    2017-01-01

    Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

  15. Damage Detection/Locating System Providing Thermal Protection

    Science.gov (United States)

    Woodard, Stanley E. (Inventor); Jones, Thomas W. (Inventor); Taylor, Bryant D. (Inventor); Qamar, A. Shams (Inventor)

    2010-01-01

    A damage locating system also provides thermal protection. An array of sensors substantially tiles an area of interest. Each sensor is a reflective-surface conductor having operatively coupled inductance and capacitance. A magnetic field response recorder is provided to interrogate each sensor before and after a damage condition. Changes in response are indicative of damage and a corresponding location thereof.

  16. WisDOT statewide customer satisfaction survey.

    Science.gov (United States)

    2013-02-01

    The purpose of this study was to develop and initiate a new customer satisfaction tool that would establish a set of baseline : departmental performance measures and be sustainable for future use. ETC Institute completed a statewide customer : survey...

  17. Providing Access to Library Automation Systems for Students with Disabilities.

    Science.gov (United States)

    California Community Colleges, Sacramento. High-Tech Center for the Disabled.

    This document provides information on the integration of assistive computer technologies and library automation systems at California Community Colleges in order to ensure access for students with disabilities. Topics covered include planning, upgrading, purchasing, implementing and using these technologies with library systems. As information…

  18. A Statewide Partnership for Implementing Inquiry Science

    Science.gov (United States)

    Lytle, Charles

    The North Carolina Infrastructure for Science Education (NC-ISE) is a statewide partnership for implementing standards-based inquiry science using exemplary curriculum materials in the public schools of North Carolina. North Carolina is the 11th most populous state in the USA with 8,000,000 residents, 117 school districts and a geographic area of 48,718 miles. NC-ISE partners include the state education agency, local school systems, three branches of the University of North Carolina, the state mathematics and science education network, businesses, and business groups. The partnership, based upon the Science for All Children model developed by the National Science Resources Centre, was initiated in 1997 for improvement in teaching and learning of science and mathematics. This research-based model has been successfully implemented in several American states during the past decade. Where effectively implemented, the model has led to significant improvements in student interest and student learning. It has also helped reduce the achievement gap between minority and non-minority students and among students from different economic levels. A key program element of the program is an annual Leadership Institute that helps teams of administrators and teachers develop a five-year strategic plan for their local systems. Currently 33 of the117 local school systems have joined the NC-ISE Program and are in various stages of implementation of inquiry science in grades K-8.

  19. System and Method for Providing a Climate Data Persistence Service

    Science.gov (United States)

    Schnase, John L. (Inventor); Ripley, III, William David (Inventor); Duffy, Daniel Q. (Inventor); Thompson, John H. (Inventor); Strong, Savannah L. (Inventor); McInerney, Mark (Inventor); Sinno, Scott (Inventor); Tamkin, Glenn S. (Inventor); Nadeau, Denis (Inventor)

    2018-01-01

    A system, method and computer-readable storage devices for providing a climate data persistence service. A system configured to provide the service can include a climate data server that performs data and metadata storage and management functions for climate data objects, a compute-storage platform that provides the resources needed to support a climate data server, provisioning software that allows climate data server instances to be deployed as virtual climate data servers in a cloud computing environment, and a service interface, wherein persistence service capabilities are invoked by software applications running on a client device. The climate data objects can be in various formats, such as International Organization for Standards (ISO) Open Archival Information System (OAIS) Reference Model Submission Information Packages, Archive Information Packages, and Dissemination Information Packages. The climate data server can enable scalable, federated storage, management, discovery, and access, and can be tailored for particular use cases.

  20. Quantifying the Lateral Bracing Provided by Standing Steam Roof Systems

    OpenAIRE

    Sorensen, Taylor J.

    2016-01-01

    One of the major challenges of engineering is finding the proper balance between economical and safe. Currently engineers at Nucor Corporation have ignored the additional lateral bracing provided by standing seam roofing systems to joists because of the lack of methods available to quantify the amount of bracing provided. Based on the results of testing performed herein, this bracing is significant, potentially resulting in excessively conservative designs and unnecessary costs. This proje...

  1. The Use of Nuclear Generation to Provide Power System Stability

    OpenAIRE

    Heather Wyman-Pain; Yuankai Bian; Furong Li

    2016-01-01

    The decreasing use of fossil fuel power stations has a negative effect on the stability of the electricity systems in many countries. Nuclear power stations have traditionally provided minimal ancillary services to support the system but this must change in the future as they replace fossil fuel generators. This paper explains the development of the four most popular reactor types still in regular operation across the world which have formed the basis for most reactor dev...

  2. Technology scan of future traveler information systems and applications in Georgia.

    Science.gov (United States)

    2013-10-01

    Statewide traveler information provided in Georgia through its NaviGAtor/5-1-1 system is : primarily based on Intelligent Transportation Systems (ITS) related to freeway traffic : management. The purpose of this study is to evaluate traveler informat...

  3. Employee motivation in Product-Service-System providers

    DEFF Research Database (Denmark)

    Kreye, Melanie

    2016-01-01

    This research investigates how intrinsic and extrinsic motivation factors contribute to employee motivation in providers of Product-Service Systems (PSS). Employee motivation determines the quality of the delivered service and is thus an area of great importance for PSS providers. We present rich...... case-based data collected through semi-structured interviews, a survey and secondary sources. The analysis showed the particularly high importance of intrinsic and individual motivation factors such as the fulfilling nature of the work and skill development showing the ownership and pride service...... employees took in their work. Further, the organisation needs to set the context of high employee motivation by enabling flexibility and performance feedback. Our research contributes to the literature by providing a first empirical study of employee motivation in PSS providers and thus providing important...

  4. Development of a system to provide diagnostics-while-drilling.

    Energy Technology Data Exchange (ETDEWEB)

    Wise, Jack LeRoy; Jacobson, Ronald David; Finger, John Travis; Mansure, Arthur James; Knudsen, Steven Dell

    2003-06-01

    This report describes development of a system that provides high-speed, real-time downhole data while drilling. Background of the project, its benefits, major technical challenges, test planning, and test results are covered by relatively brief descriptions in the body of the report, with some topics presented in more detail in the attached appendices.

  5. Tactical emergency medical support programs: a comprehensive statewide survey.

    Science.gov (United States)

    Bozeman, William P; Morel, Benjamin M; Black, Timothy D; Winslow, James E

    2012-01-01

    Specially trained tactical emergency medical support (TEMS) personnel provide support to law enforcement special weapons and tactics (SWAT) teams. These programs benefit law enforcement agencies, officers, suspects, and citizens. TEMS programs are increasingly popular, but there are wide variations in their organization and operation and no recent data on their prevalence. We sought to measure the current prevalence and specific characteristics of TEMS programs in a comprehensive fashion in a single southeastern state. North Carolina emergency medical services (EMS) systems have county-based central EMS oversight; each system was surveyed by phone and e-mail. The presence and selected characteristics of TEMS programs were recorded. U.S. Census data were used to measure the population impact of the programs. All of the 101 EMS systems statewide were successfully contacted. Thirty-three counties (33%) have TEMS programs providing medical support to 56 local law enforcement agencies as well as state and federal agencies. TEMS programs tend to be located in more populated urban and suburban areas, serving a population base of 5.9 million people, or 64% of the state's population. Tactical medics in the majority of these programs (29/33; 88%) are not sworn law enforcement officers. Approximately one-third of county-based EMS systems in North Carolina have TEMS programs. These programs serve almost two-thirds of the state's population base, using primarily nonsworn tactical medics. Comparison with other regions of the country will be useful to demonstrate differences in prevalence and program characteristics. Serial surveillance will help track trends and measure the growth and impact of this growing subspecialty field.

  6. A concept of customer–provider relation monitoring system solution

    Directory of Open Access Journals (Sweden)

    Naděžda Chalupová

    2008-01-01

    Full Text Available The contribution deals with design of customer–provider relationship monitoring system solution with regard to needs of business managers and analytics and to possibilities of contemporaneous information and communication technologies.The attention is followed to targeted modelling, what brings possibilities of acquisition of bigger overview about things taking place in the relation. In consequence it describes the functionality of analytical systems producing these very strategically valuable models – to so-called business intelligence tools. Onward it deals with modern technologies conductive to above mentioned system implementation – with Ajax concept and with some XML applications: PMML for analytical models manipulation, XSLT for XML data transformations to various formats, SVG for representing pictures of statistical graphs etc. and MathML for description of mathematical formulas created in analytical systems.Following these basis it suggests technological solution of some parts of client–provider relationship watching and evaluating system and it discusses its potential advantages and problems, which can occur.

  7. Improving Interdisciplinary Provider Communication Through a Unified Paging System.

    Science.gov (United States)

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

    2016-06-01

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

  8. Provider and systems factors in diabetes quality of care.

    Science.gov (United States)

    Ghaznavi, Kimia; Malik, Shaista

    2012-02-01

    A gap exists in knowledge and the observed frequency with which patients with diabetes actually receive treatment for optimal cardiovascular risk reduction. Many interventions to improve quality of care have been targeted at the health systems level and provider organizations. Changes in several domains of care and investment in quality by organizational leaders are needed to make long-lasting improvements. In the studies reviewed, the most effective strategies often have multiple components, whereas the use of one single strategy, such as reminders only or an educational intervention, is less effective. More studies are needed to examine the effect of several care management strategies simultaneously, such as use of clinical information systems, provider financial incentives, and organizational model on processes of care and outcomes.

  9. Electronic health systems: challenges faced by hospital-based providers.

    Science.gov (United States)

    Agno, Christina Farala; Guo, Kristina L

    2013-01-01

    The purpose of this article is to discuss specific challenges faced by hospitals adopting the use of electronic medical records and implementing electronic health record (EHR) systems. Challenges include user and information technology support; ease of technical use and software interface capabilities; compliance; and financial, legal, workforce training, and development issues. Electronic health records are essential to preventing medical errors, increasing consumer trust and use of the health system, and improving quality and overall efficiency. Government efforts are focused on ways to accelerate the adoption and use of EHRs as a means of facilitating data sharing, protecting health information privacy and security, quickly identifying emerging public health threats, and reducing medical errors and health care costs and increasing quality of care. This article will discuss physician and nonphysician staff training before, during, and after implementation; the effective use of EHR systems' technical features; the selection of a capable and secure EHR system; and the development of collaborative system implementation. Strategies that are necessary to help health care providers achieve successful implementation of EHR systems will be addressed.

  10. Internet-based information system of digital geological data providing

    Science.gov (United States)

    Yuon, Egor; Soukhanov, Mikhail; Markov, Kirill

    2015-04-01

    One of the Russian Federal аgency of mineral resources problems is to provide the geological information which was delivered during the field operation for the means of federal budget. This information should be present in the current, conditional form. Before, the leading way of presenting geological information were paper geological maps, slices, borehole diagrams reports etc. Technologies of database construction, including distributed databases, technologies of construction of distributed information-analytical systems and Internet-technologies are intensively developing nowadays. Most of geological organizations create their own information systems without any possibility of integration into other systems of the same orientation. In 2012, specialists of VNIIgeosystem together with specialists of VSEGEI started the large project - creating the system of providing digital geological materials with using modern and perspective internet-technologies. The system is based on the web-server and the set of special programs, which allows users to efficiently get rasterized and vectorised geological materials. These materials are: geological maps of scale 1:1M, geological maps of scale 1:200 000 and 1:2 500 000, the fragments of seamless geological 1:1M maps, structural zoning maps inside the seamless fragments, the legends for State geological maps 1:200 000 and 1:1 000 000, full author's set of maps and also current materials for international projects «Atlas of geological maps for Circumpolar Arctic scale 1:5 000 000» and «Atlas of Geologic maps of central Asia and adjacent areas scale 1:2 500 000». The most interesting and functional block of the system - is the block of providing structured and well-formalized geological vector materials, based on Gosgeolkart database (NGKIS), managed by Oracle and the Internet-access is supported by web-subsystem NGKIS, which is currently based on MGS-Framework platform, developed by VNIIgeosystem. One of the leading elements

  11. Coaching and Quality Assistance in Quality Rating Improvement Systems: Approaches Used by TA Providers to Improve Quality in Early Care and Education Programs and Home-Based Settings

    Science.gov (United States)

    Smith, Sheila; Robbins, Taylor; Schneider, Will; Kreader, J. Lee; Ong, Christine

    2012-01-01

    Quality Rating Improvement Systems (QRISs) commonly offer on-site technical assistance (TA) and coaching to help early care and education settings achieve quality improvements and a higher QRIS rating. In surveys of administrators overseeing statewide QRISs, almost all states reported the use of on-site TA and coaching in both center-based and…

  12. Statewide Groundwater Recharge Modeling in New Mexico

    Science.gov (United States)

    Xu, F.; Cadol, D.; Newton, B. T.; Phillips, F. M.

    2017-12-01

    It is crucial to understand the rate and distribution of groundwater recharge in New Mexico because it not only largely defines a limit for water availability in this semi-arid state, but also is the least understood aspect of the state's water budget. With the goal of estimating groundwater recharge statewide, we are developing the Evapotranspiration and Recharge Model (ETRM), which uses existing spatial datasets to model the daily soil water balance over the state at a resolution of 250 m cell. The input datasets includes PRISM precipitation data, MODIS Normalized Difference Vegetation Index (NDVI), NRCS soils data, state geology data and reference ET estimates produced by Gridded Atmospheric Data downscalinG and Evapotranspiration Tools (GADGET). The current estimated recharge presents diffuse recharge only, not focused recharge as in channels or playas. Direct recharge measurements are challenging and rare, therefore we estimate diffuse recharge using a water balance approach. The ETRM simulated runoff amount was compared with USGS gauged discharge in four selected ephemeral channels: Mogollon Creek, Zuni River, the Rio Puerco above Bernardo, and the Rio Puerco above Arroyo Chico. Result showed that focused recharge is important, and basin characteristics can be linked with watershed hydrological response. As the sparse instruments in NM provide limited help in improving estimation of focused recharge by linking basin characteristics, the Walnut Gulch Experimental Watershed, which is one of the most densely gauged and monitored semiarid rangeland watershed for hydrology research purpose, is now being modeled with ETRM. Higher spatial resolution of field data is expected to enable detailed comparison of model recharge results with measured transmission losses in ephemeral channels. The final ETRM product will establish an algorithm to estimate the groundwater recharge as a water budget component of the entire state of New Mexico. Reference ET estimated by GADGET

  13. Motion systems providing three or four degrees of freedom

    Science.gov (United States)

    Chou, Richard C. (Inventor)

    1982-01-01

    A motion system is provided by a platform generally parallel to a base and connected thereto by a column and powered and controlled extensible members, at least three of which are connected between distributed points around the column. In a three degree of freedom device, the column is conical, rigidly supported at its base with a universal joint at its top. The points of attachment define triangles in the base and in the platform surrounding the column with one extensible member connected between each. In the four degree of freedom version, the column is modified by making it effectively a column which is pivoted or guided at the base or contains an extensible member, preferably retains its triangular shape and its universal joint connection to the platform at its apex. For stability four powered and controlled extensible members are provided between points in the base and platform distributed around the column, a preferred pattern of arrangement being a square with the column at the center.

  14. Method and Apparatus Providing Deception and/or Altered Operation in an Information System Operating System

    Science.gov (United States)

    Cohen, Fred; Rogers, Deanna T.; Neagoe, Vicentiu

    2008-10-14

    A method and/or system and/or apparatus providing deception and/or execution alteration in an information system. In specific embodiments, deceptions and/or protections are provided by intercepting and/or modifying operation of one or more system calls of an operating system.

  15. Trends in hospitalization for community-associated methicillin-resistant Staphylococcus aureus in New York City, 1997-2006: data from New York State's Statewide Planning and Research Cooperative System.

    Science.gov (United States)

    Farr, Amanda M; Aden, Brandon; Weiss, Don; Nash, Denis; Marx, Melissa A

    2012-07-01

    To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections. Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006. All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities. We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression. Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization. The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.

  16. Designing a system for patients controlling providers' access to their electronic health records: organizational and technical challenges.

    Science.gov (United States)

    Leventhal, Jeremy C; Cummins, Jonathan A; Schwartz, Peter H; Martin, Douglas K; Tierney, William M

    2015-01-01

    Electronic health records (EHRs) are proliferating, and financial incentives encourage their use. Applying Fair Information Practice principles to EHRs necessitates balancing patients' rights to control their personal information with providers' data needs to deliver safe, high-quality care. We describe the technical and organizational challenges faced in capturing patients' preferences for patient-controlled EHR access and applying those preferences to an existing EHR. We established an online system for capturing patients' preferences for who could view their EHRs (listing all participating clinic providers individually and categorically-physicians, nurses, other staff) and what data to redact (none, all, or by specific categories of sensitive data or patient age). We then modified existing data-viewing software serving a state-wide health information exchange and a large urban health system and its primary care clinics to allow patients' preferences to guide data displays to providers. Patients could allow or restrict data displays to all clinicians and staff in a demonstration primary care clinic, categories of providers (physicians, nurses, others), or individual providers. They could also restrict access to all EHR data or any or all of five categories of sensitive data (mental and reproductive health, sexually transmitted diseases, HIV/AIDS, and substance abuse) and for specific patient ages. The EHR viewer displayed data via reports, data flowsheets, and coded and free text data displayed by Google-like searches. Unless patients recorded restrictions, by default all requested data were displayed to all providers. Data patients wanted restricted were not displayed, with no indication they were redacted. Technical barriers prevented redacting restricted information in free textnotes. The program allowed providers to hit a "Break the Glass" button to override patients' restrictions, recording the date, time, and next screen viewed. Establishing patient

  17. Road Map to Statewide Implementation of the Pyramid Model. Roadmap to Effective Intervention Practices #6

    Science.gov (United States)

    Dunlap, Glen; Smith, Barbara J.; Fox, Lise; Blase, Karen

    2014-01-01

    This document is a guide--a "Road Map"--for implementing widespread use of the Pyramid Model for Promoting Social Emotional Competence in Infants and Young Children (http://www.challengingbehavior.org/do/pyramid_model. htm). It is a road map of systems change. The Road Map is written for statewide systems change, although it could be…

  18. Subterranean systems provide a suitable overwintering habitat for Salamandra salamandra

    Directory of Open Access Journals (Sweden)

    Monika Balogová

    2017-09-01

    Full Text Available The fire salamander (Salamandra salamandra has been repeatedly noted to occur in natural and artificial subterranean systems. Despite the obvious connection of this species with underground shelters, their level of dependence and importance to the species is still not fully understood. In this study, we carried out long-term monitoring based on the capture-mark-recapture method in two wintering populations aggregated in extensive underground habitats. Using the POPAN model we found the population size in a natural shelter to be more than twice that of an artificial underground shelter. Survival and recapture probabilities calculated using the Cormack-Jolly-Seber model were very constant over time, with higher survival values in males than in females and juveniles, though in terms of recapture probability, the opposite situation was recorded. In addition, survival probability obtained from Cormack-Jolly-Seber model was higher than survival from POPAN model. The observed bigger population size and the lower recapture rate in the natural cave was probably a reflection of habitat complexity. Our study showed that regular visits are needed to detect the true significance of underground shelters for fire salamanders. The presence of larvae was recorded in both wintering sites, especially in bodies of water near the entrance. On the basis of previous and our observations we incline to the view, that karst areas can induce not only laying in underground shelters but also group wintering in this species. Our study highlights the strong connection of the life cycle of fire salamanders with underground shelters and their essential importance for the persistence of some populations during unfavourable conditions and breeding activity. In addition, the study introduces the POPAN and Cormac-Jolly-Seber models for estimating of population size, survival and recapture probability in wintering populations of the species, which could provide important information

  19. A method for calculating active feedback system to provide vertical

    Indian Academy of Sciences (India)

    The active feedback system is applied to control slow motions of plasma. The objective of the ... The other problem is connected with the control of plasma vertical position with active feedback system. Calculation of ... Current Issue Volume 90 ...

  20. Power system services provided by inverter connected distributed energy resources

    DEFF Research Database (Denmark)

    For the last few years there has been a significant increase of DER units in Denmark, of those units more and more are connected to the power system using inverters. These inverter connected units have the potential to support the electrical power system with various power system services. One...

  1. FINAL TECHNICAL REPORT FOR FORESTRY BIOFUEL STATEWIDE COLLABORATION CENTER (MICHIGAN)

    Energy Technology Data Exchange (ETDEWEB)

    LaCourt, Donna M.; Miller, Raymond O.; Shonnard, David R.

    2012-04-24

    A team composed of scientists from Michigan State University (MSU) and Michigan Technological University (MTU) assembled to better understand, document, and improve systems for using forest-based biomass feedstocks in the production of energy products within Michigan. Work was funded by a grant (DE-EE-0000280) from the U.S. Department of Energy (DOE) and was administered by the Michigan Economic Development Corporation (MEDC). The goal of the project was to improve the forest feedstock supply infrastructure to sustainably provide woody biomass for biofuel production in Michigan over the long-term. Work was divided into four broad areas with associated objectives: • TASK A: Develop a Forest-Based Biomass Assessment for Michigan – Define forest-based feedstock inventory, availability, and the potential of forest-based feedstock to support state and federal renewable energy goals while maintaining current uses. • TASK B: Improve Harvesting, Processing and Transportation Systems – Identify and develop cost, energy, and carbon efficient harvesting, processing and transportation systems. • TASK C: Improve Forest Feedstock Productivity and Sustainability – Identify and develop sustainable feedstock production systems through the establishment and monitoring of a statewide network of field trials in forests and energy plantations. • TASK D: Engage Stakeholders – Increase understanding of forest biomass production systems for biofuels by a broad range of stakeholders. The goal and objectives of this research and development project were fulfilled with key model deliverables including: 1) The Forest Biomass Inventory System (Sub-task A1) of feedstock inventory and availability and, 2) The Supply Chain Model (Sub-task B2). Both models are vital to Michigan’s forest biomass industry and support forecasting delivered cost, as well as carbon and energy balance. All of these elements are important to facilitate investor, operational and policy decisions. All

  2. Biota: Providing often-overlooked connections among freshwater systems

    Science.gov (United States)

    Mushet, David M.; Christensen, Jay R.; Bennett, Michah; Alexander, Laurie C.

    2017-01-01

    When we think about connections in and among aquatic systems, we typically envision clear headwater streams flowing into downstream rivers, river floodwaters spilling out onto adjacent floodplains, or groundwater connecting wetlands to lakes and streams. However, there is another layer of connectivity moving materials among freshwater systems, one with connections that are not always tied to downgradient flows of surface waters and groundwater. These movements are those of organisms, key components of virtually every freshwater system on the planet. In their movements across the landscape, biota connect aquatic systems in often-overlooked ways.

  3. Taking Stock of Private-School Choice: Scholars Review the Research on Statewide Programs

    Science.gov (United States)

    Wolf, Patrick J.; Harris, Douglas N.; Berends, Mark; Waddington, R. Joseph; Austin, Megan

    2018-01-01

    In the past few years, four states have established programs that provide public financial support to students who choose to attend a private school. These programs--a tax-credit-funded scholarship initiative in Florida and voucher programs in Indiana, Louisiana, and Ohio--offer a glimpse of what expansive statewide choice might look like. What…

  4. Readmission after treatment of Grade 3 and 4 renal injuries at a Level I trauma center: Statewide assessment using the Comprehensive Hospital Abstract Reporting System.

    Science.gov (United States)

    Winters, Brian; Wessells, Hunter; Voelzke, Bryan B

    2016-03-01

    One criticism of the existing renal trauma research is the limited outpatient follow-up after index hospitalization. We assessed readmission rates following treatment for American Association for the Surgery of Trauma (AAST) Grade 3 and 4 renal injury using the Comprehensive Hospital Abstract Reporting System (CHARS). We evaluated all patients with AAST Grade 3 and 4 renal injuries admitted to Harborview Medical Center (HMC) between 1998 and 2010, the only Level 1 trauma center in Washington state. Grade 4 renal injuries were stratified by collecting system laceration (CSL) or segmental vascular injury. Data were abstracted from the CHARS database for readmissions to any Washington state hospital within 6 months of renal injury. Clinical variables, diagnoses, and procedures were queried based on DRG International Classification of Diseases-9th Rev. codes. A total of 477 Grade 3 and 159 Grade 4 renal injuries were initially treated at HMC. On admission, 111 patients required intervention: 75 (16%) of 477 Grade 3 and 36 (23%) of 159 Grade 4 injuries. Within 6 months of index hospitalization, 86 (18%) of 477 Grade 3 and 38 (24%) of 159 Grade 4 patients were readmitted to any Washington state hospital. Eighty percent of Grade 3 injuries and 66% of Grade 4 injuries returned to HMC compared with secondary hospitals (p = 0.08). At readmission, 19 (22%) of 86 Grade 3 and 16 (42%) of 38 Grade 4 injuries had a urologic diagnosis. Subsequent procedural intervention was required on readmission in 6 (7%) of 86 Grade 3 and 5 (13%) of 38 Grade 4 renal injuries (all CSL injuries). A subset of patients treated for Grade 3 and 4 renal trauma will be readmitted for further management. While urologic diagnoses and additional procedures may be low overall, readmission to outside hospitals may preclude accurate determination of renal trauma outcomes. Based on these data, patients with Grade 4 CSL injuries seem to be at the highest risk for readmission and to require a subsequent

  5. A method for calculating active feedback system to provide vertical ...

    Indian Academy of Sciences (India)

    Slow instabilities, development time of which is proportional to the .... where (w, I) denotes the scalar (inner or dot) product of vectors w and I. Solutions ... which the system of passive conductors must satisfy. ..... In this research, the active feedback system consisting of two coils with coordi- .... a new mode becomes dominant.

  6. Delivery of State-Provided Predictive Analytics to Schools: Wisconsin's DEWS and the Proposed EWIMS Dashboard. WCER Working Paper No. 2016-3

    Science.gov (United States)

    Clune, Bill; Knowles, Jared

    2016-01-01

    Since 2012, the Wisconsin Department of Public Instruction (DPI) has maintained a statewide predictive analytics system providing schools with an early warning in middle grades of students at risk for not completing high school. DPI is considering extending and enhancing this system, known as the Dropout Early Warning System (DEWS). The proposed…

  7. Criminal Justice Profile--Statewide, 1984. Supplement to "Crime and Delinquency in California."

    Science.gov (United States)

    California State Dept. of Justice, Sacramento. Bureau of Criminal Statistics and Special Services.

    This California annual Criminal Justice Statewide Profile presents data which supplements the Bureau of Criminal Statistics' (BCS) annual Crime and Delinquency publication. This monograph summarizes and combines data pertaining to California's justice system. The profile consists of two sections. The first section consists of 12 tables displaying…

  8. Statewide improvement approach to clinician burnout: Findings from the baseline year

    Directory of Open Access Journals (Sweden)

    Heather R. Britt

    2017-12-01

    We propose a socio-ecological framework for acting on burnout, using a data-driven quality improvement paradigm enabled by a statewide coalition, to ensure that continued efforts do not rest solely at the feet of individuals or systems. Despite high burnout levels, engagement and satisfaction with work are also high, suggesting there is still hope for stemming the tide of burnout.

  9. Making an Impact Statewide to Benefit 21st-Century School Leadership

    Science.gov (United States)

    Hewitt, Kimberly Kappler; Mullen, Carol A.; Davis, Ann W.; Lashley, Carl

    2012-01-01

    How can institutions of higher education, local education agencies, and departments of education partner to build capacity for 21st-Century school leadership? The model (IMPACT V) we describe utilizes a systems-wide partnership approach to cultivate shared leadership within influenced middle and high schools statewide to leverage technology as a…

  10. California statewide model for high-speed rail

    OpenAIRE

    Outwater, Maren; Tierney, Kevin; Bradley, Mark; Sall, Elizabeth; Kuppam, Arun; Modugala, Vamsee

    2010-01-01

    The California High Speed Rail Authority (CHSRA) and the Metropolitan Transportation Commission (MTC) have developed a new statewide model to support evaluation of high-speed rail alternatives in the State of California. This statewide model will also support future planning activities of the California Department of Transportation (Caltrans). The approach to this statewide model explicitly recognizes the unique characteristics of intraregional travel demand and interregional travel demand. A...

  11. Training Sessions Provide Working Knowledge of National Animal Identification System

    Science.gov (United States)

    Glaze, J. Benton, Jr.; Ahola, Jason K.

    2010-01-01

    One in-service and two train-the-trainer workshops were conducted by University of Idaho Extension faculty, Idaho State Department of Agriculture personnel, and allied industry representatives to increase Extension educators' knowledge and awareness of the National Animal Identification System (NAIS) and related topics. Training sessions included…

  12. COMFORT PROVIDING SYSTEMS IN SPACES WITH ACOUTIC INSULATION

    Directory of Open Access Journals (Sweden)

    Grzegorz KLEKOT

    2014-12-01

    Full Text Available High capacities of currently available devices for sound registering and processing have generated a need for sound insulated spaces dedicated to exchange of confidential information. In such spaces, preventing propagation of vibroacoustic signals both by the way of air and construction elements entails complete insulation of the room. In order to meet this requirement, proper chemical composition of air and stabilized temperature conditions have to be guaranteed. The paper discusses questions related to the process of solving the task of providing thermal comfort and satisfying air quality in a room for confidential discussions. It presents prototype solutions of installations dedicated to stabilize human-friendly conditions inside a modular chamber provided with acoustic insulation.

  13. Learning Analytics across a Statewide System

    Science.gov (United States)

    Buyarski, Catherine; Murray, Jim; Torstrick, Rebecca

    2017-01-01

    This chapter explores lessons learned from two different learning analytics efforts at a large, public, multicampus university--one internally developed and one vended platform. It raises questions about how to best use analytics to support students while keeping students responsible for their own learning and success.

  14. Marine atmospheres provide a tough test for protective paint systems

    Energy Technology Data Exchange (ETDEWEB)

    Steptoe, G.G.C.

    1980-04-01

    Protective paints based on chlorinated rubber (CR) offer good resistance to salt-laden atmospheres and extreme climatic conditions, possess low moisture and oxygen permeability, and are resistant to a variety of chemicals, which allows them to counter the acidic and alkaline conditions tha arise from the corrosion of steel in salt water and from cathodic protection. Airless spray techniques allow CR paints to be applied much faster in thick coatings to large surface areas. CR paints can be formulated to produce a dry film thickness of 80-100 jm in one application. One study concluded that the extra expense for good surface preparation and high-performance paint can be regained in 2-4 yr as a result of lower maintenance costs. CR paints can be used successfully with cathodic protection; however, their tolerance to overprotection is less than that of some alternative systems; CR paints are considered to be suitable for use up to a maximum of -0.95 v. The numerous applications of CR paint include large crude carriers, offshore oil structures, oil terminals (e.g., the Flotta terminal in the Orkneys), and storage tanks.

  15. Water Quality attainment Information from Clean Water Act Statewide Statistical Surveys

    Data.gov (United States)

    U.S. Environmental Protection Agency — Designated uses assessed by statewide statistical surveys and their state and national attainment categories. Statewide statistical surveys are water quality...

  16. Water Quality Stressor Information from Clean Water Act Statewide Statistical Surveys

    Data.gov (United States)

    U.S. Environmental Protection Agency — Stressors assessed by statewide statistical surveys and their state and national attainment categories. Statewide statistical surveys are water quality assessments...

  17. 49 CFR 613.200 - Statewide transportation planning and programming.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Statewide transportation planning and programming. 613.200 Section 613.200 Transportation Other Regulations Relating to Transportation (Continued... Transportation Planning and Programming § 613.200 Statewide transportation planning and programming. The...

  18. On providing the fault-tolerant operation of information systems based on open content management systems

    Science.gov (United States)

    Kratov, Sergey

    2018-01-01

    Modern information systems designed to service a wide range of users, regardless of their subject area, are increasingly based on Web technologies and are available to users via Internet. The article discusses the issues of providing the fault-tolerant operation of such information systems, based on free and open source content management systems. The toolkit available to administrators of similar systems is shown; the scenarios for using these tools are described. Options for organizing backups and restoring the operability of systems after failures are suggested. Application of the proposed methods and approaches allows providing continuous monitoring of the state of systems, timely response to the emergence of possible problems and their prompt solution.

  19. Quality assurance systems – the difficulties in providing a global unified system for Surveyors

    OpenAIRE

    Goodhead, Tim

    2012-01-01

    This paper will analyse the difficulties in providing a global quality assurance system for Surveyors. Using case studies from the United Kingdom and elsewhere opportunities for harmonising Quality Assurance systems will be explored. The difficulties in moving towards common quality assurance systems will be analysed. Possible alternatives in the form of the development a knowledge bank of mutual agreements and top up qualifications will be investigated. The paper also looks at the role of FI...

  20. Vehicle Tracking System, Vehicle Infrastructure Provided with Vehicle Tracking System and Method for Tracking

    NARCIS (Netherlands)

    Papp, Z.; Doodeman, G.J.N.; Nelisse, M.W.; Sijs, J.; Theeuwes, J.A.C.; Driessen, B.J.F.

    2010-01-01

    A vehicle tracking system is described comprising - a plurality of sensor nodes (10) that each provide a message (D) indicative for an occupancy status of a detection area of an vehicle infrastructure monitored by said sensor node, said sensor nodes (10) being arranged in the vehicle infrastructure

  1. Statewide Transportation Engineering Warehouse for Archived Regional Data (STEWARD).

    Science.gov (United States)

    2009-12-01

    This report documents Phase III of the development and operation of a prototype for the Statewide Transportation : Engineering Warehouse for Archived Regional Data (STEWARD). It reflects the progress on the development and : operation of STEWARD sinc...

  2. Data integration for statewide transportation planning : final report

    Science.gov (United States)

    2009-08-01

    The goal of this study was to investigate the data availability, accessibility, and interoperability issues arisen from the statewide : transportation planning activities undertaken at WisDOT and to identify possible approaches for addressing these i...

  3. Statewide and Metropolitan Transportation Planning Processes : a TPCB Peer Exchange

    Science.gov (United States)

    2016-04-20

    This report highlights key recommendations and noteworthy practices identified at Statewide and Metropolitan Transportation Planning Processes Peer Exchange held on September 9-10, 2015 in Shepherdstown, West Virginia. This event was sponsored ...

  4. Nebraska Statewide Wind Integration Study: April 2008 - January 2010

    Energy Technology Data Exchange (ETDEWEB)

    EnerNex Corporation, Knoxville, Tennessee; Ventyx, Atlanta, Georgia; Nebraska Power Association, Lincoln, Nebraska

    2010-03-01

    Wind generation resources in Nebraska will play an increasingly important role in the environmental and energy security solutions for the state and the nation. In this context, the Nebraska Power Association conducted a state-wide wind integration study.

  5. Barriers, facilitators, and potential strategies for increasing HPV vaccination: A statewide assessment to inform action

    Directory of Open Access Journals (Sweden)

    Kathleen B. Cartmell

    2018-06-01

    Full Text Available Objective: The objective was to investigate how state level strategies in South Carolina could maximize HPV vaccine uptake. Design: An environmental scan identified barriers, facilitators, and strategies for improving HPV vaccination in South Carolina. Interviews were conducted with state leaders from relevant organizations such as public health agencies, medical associations, K-12 schools, universities, insurers, and cancer advocacy organizations. A thematic content analysis design was used. Digital interview files were transcribed, a data dictionary was created and data were coded using the data dictionary. Results: Thirty four interviews were conducted with state leaders. Barriers to HPV vaccination included lack of HPV awareness, lack of provider recommendation, HPV vaccine concerns, lack of access and practice-level barriers. Facilitators included momentum for improving HPV vaccination, school-entry Tdap requirement, pharmacy-based HPV vaccination, state immunization registry, HEDIS measures and HPV vaccine funding. Strategies for improving HPV vaccination fell into three categories: 1 addressing lack of awareness about the importance of HPV vaccination among the public and providers; 2 advocating for policy changes around HPV vaccine coverage, vaccine education, and pharmacy-based vaccination; and 3 coordination of efforts. Discussion: A statewide environmental scan generated a blueprint for action to be used to improve HPV vaccination in the state. Keywords: HPV, HPV vaccines, Cervical cancer, Prevention, Health systems, Barriers, Facilitators, Strategies, South Carolina

  6. WiFi RFID demonstration for resource tracking in a statewide disaster drill.

    Science.gov (United States)

    Cole, Stacey L; Siddiqui, Javeed; Harry, David J; Sandrock, Christian E

    2011-01-01

    To investigate the capabilities of Radio Frequency Identification (RFID) tracking of patients and medical equipment during a simulated disaster response scenario. RFID infrastructure was deployed at two small rural hospitals, in one large academic medical center and in two vehicles. Several item types from the mutual aid equipment list were selected for tracking during the demonstration. A central database server was installed at the UC Davis Medical Center (UCDMC) that collected RFID information from all constituent sites. The system was tested during a statewide disaster drill. During the drill, volunteers at UCDMC were selected to locate assets using the traditional method of locating resources and then using the RFID system. This study demonstrated the effectiveness of RFID infrastructure in real-time resource identification and tracking. Volunteers at UCDMC were able to locate assets substantially faster using RFID, demonstrating that real-time geolocation can be substantially more efficient and accurate than traditional manual methods. A mobile, Global Positioning System (GPS)-enabled RFID system was installed in a pediatric ambulance and connected to the central RFID database via secure cellular communication. This system is unique in that it provides for seamless region-wide tracking that adaptively uses and seamlessly integrates both outdoor cellular-based mobile tracking and indoor WiFi-based tracking. RFID tracking can provide a real-time picture of the medical situation across medical facilities and other critical locations, leading to a more coordinated deployment of resources. The RFID system deployed during this study demonstrated the potential to improve the ability to locate and track victims, healthcare professionals, and medical equipment during a region-wide disaster.

  7. 75 FR 3939 - Merit Systems Protection Board (MSPB) Provides Notice of Opportunity To File Amicus Briefs

    Science.gov (United States)

    2010-01-25

    ... MERIT SYSTEMS PROTECTION BOARD Merit Systems Protection Board (MSPB) Provides Notice of Opportunity To File Amicus Briefs AGENCY: Merit Systems Protection Board. ACTION: Notice. SUMMARY: Pursuant to 5 U.S.C. 7521 and 5 CFR 1201.131, the Merit Systems Protection Board (MSPB) is providing notice of...

  8. Tanggung Jawab Hukum Penyelenggara Sistem Elektronik (Law Responsibility of the Electronic System Providers

    Directory of Open Access Journals (Sweden)

    Abdul Salam

    2011-09-01

    Full Text Available Reviewing Edmon Makarim’s book which is about Law Responsibility of the Electronic System Providers, remind us that easiness and availability of electronic system in electronic transaction in private or public happen because the role of electronic system providers. Behind the important and central role, there is big responsibility for electronic system providers. But because of wide of definition of provision of electronic system and so many people who involve in electronic system providers, there is a question in our mind, how is the shape of responsibility of the electronic system providers if the electronic system which is held is broken and / or not in operation as it has to and bring loss to users. Which one from the electronic system providers should take the responsibility in law?

  9. Receiving recommendations and providing feedback : the user-experience of a recommender system

    NARCIS (Netherlands)

    Knijnenburg, B.P.; Willemsen, M.C.; Hirtbach, S.; Buccafurri, F.; Semeraro, G.

    2010-01-01

    This paper systematically evaluates the user experience of a recommender system. Using both behavioral data and subjective measures of user experience, we demonstrate that choice satisfaction and system effectiveness increase when a system provides personalized recommendations (compared to the same

  10. Design of a statewide radiation survey

    International Nuclear Information System (INIS)

    Nagda, N.L.; Koontz, M.D.; Rector, H.E.; Nifong, G.D.

    1989-01-01

    The Florida Institute of Phosphate Research (FIPR) recently sponsored a statewide survey to identify all significant land areas in Florida where the state's environmental radiation rule should be applied. Under this rule, newly constructed buildings must be tested for radiation levels unless approved construction techniques are used. Two parallel surveys - a land-based survey and a population-based survey - were designed and conducted to address the objective. Each survey included measurements in more than 3000 residences throughout the state. Other information sources that existed at the outset of the study, such as geologic profiles mapped by previous investigators and terrestrial uranium levels characterized through aerial gamma radiation surveys, were also examined. Initial data analysis efforts focused on determining the extent of evidence of radon potential for each of 67 counties in the state. Within 18 countries that were determined to have definite evidence of elevated radon potential, more detailed spatial analyses were conducted to identify areas of which the rule should apply. A total of 74 quadrangles delineated by the U.S. Geological Survey, representing about 7% of those constituting the state, were identified as having elevated radon potential and being subject to the rule

  11. System and Method for Providing a Climate Data Analytic Services Application Programming Interface Distribution Package

    Science.gov (United States)

    Schnase, John L. (Inventor); Duffy, Daniel Q. (Inventor); Tamkin, Glenn S. (Inventor)

    2016-01-01

    A system, method and computer-readable storage devices for providing a climate data analytic services application programming interface distribution package. The example system can provide various components. The system provides a climate data analytic services application programming interface library that enables software applications running on a client device to invoke the capabilities of a climate data analytic service. The system provides a command-line interface that provides a means of interacting with a climate data analytic service by issuing commands directly to the system's server interface. The system provides sample programs that call on the capabilities of the application programming interface library and can be used as templates for the construction of new client applications. The system can also provide test utilities, build utilities, service integration utilities, and documentation.

  12. Correspondence of biological condition models of California streams at statewide and regional scales

    Science.gov (United States)

    May, Jason T.; Brown, Larry R.; Rehn, Andrew C.; Waite, Ian R.; Ode, Peter R; Mazor, Raphael D; Schiff, Kenneth C

    2015-01-01

    We used boosted regression trees (BRT) to model stream biological condition as measured by benthic macroinvertebrate taxonomic completeness, the ratio of observed to expected (O/E) taxa. Models were developed with and without exclusion of rare taxa at a site. BRT models are robust, requiring few assumptions compared with traditional modeling techniques such as multiple linear regression. The BRT models were constructed to provide baseline support to stressor delineation by identifying natural physiographic and human land use gradients affecting stream biological condition statewide and for eight ecological regions within the state, as part of the development of numerical biological objectives for California’s wadeable streams. Regions were defined on the basis of ecological, hydrologic, and jurisdictional factors and roughly corresponded with ecoregions. Physiographic and land use variables were derived from geographic information system coverages. The model for the entire state (n = 1,386) identified a composite measure of anthropogenic disturbance (the sum of urban, agricultural, and unmanaged roadside vegetation land cover) within the local watershed as the most important variable, explaining 56 % of the variance in O/E values. Models for individual regions explained between 51 and 84 % of the variance in O/E values. Measures of human disturbance were important in the three coastal regions. In the South Coast and Coastal Chaparral, local watershed measures of urbanization were the most important variables related to biological condition, while in the North Coast the composite measure of human disturbance at the watershed scale was most important. In the two mountain regions, natural gradients were most important, including slope, precipitation, and temperature. The remaining three regions had relatively small sample sizes (n ≤ 75 sites) and had models that gave mixed results. Understanding the spatial scale at which land use and land cover affect

  13. Building Statewide Infrastructure for the Academic Support of Students With Mild Traumatic Brain Injury.

    Science.gov (United States)

    Gioia, Gerard A; Glang, Ann E; Hooper, Stephen R; Brown, Brenda Eagan

    To focus attention on building statewide capacity to support students with mild traumatic brain injury (mTBI)/concussion. Consensus-building process with a multidisciplinary group of clinicians, researchers, policy makers, and state Department of Education personnel. The white paper presents the group's consensus on the essential components of a statewide educational infrastructure to support the management of students with mTBI. The nature and recovery process of mTBI are briefly described specifically with respect to its effects on school learning and performance. State and local policy considerations are then emphasized to promote implementation of a consistent process. Five key components to building a statewide infrastructure for students with mTBI are described including (1) definition and training of the interdisciplinary school team, (2) professional development of the school and medical communities, (3) identification, assessment, and progress monitoring protocols, (4) a flexible set of intervention strategies to accommodate students' recovery needs, and (5) systematized protocols for active communication among medical, school, and family team members. The need for a research to guide effective program implementation is stressed. This guiding framework strives to assist the development of support structures for recovering students with mTBI to optimize academic outcomes. Until more evidence is available on academic accommodations and other school-based supports, educational systems should follow current best practice guidelines.

  14. Provider Profiling: A Population Health Improvement Tool for the Southeast Military Health System

    National Research Council Canada - National Science Library

    Pemberton, Phillip

    1999-01-01

    ...). Profiling with Provider Perspectives, a Primary Care Management Tool, provides the SEMHS with a standardized performance measurement system that offers feedback in a user friendly and non-threatening format...

  15. State-wide performance criteria for international safeguards

    International Nuclear Information System (INIS)

    Budlong-Sylvester, K.W.; Pilat, Joseph F.; Stanbro, W.D.

    2001-01-01

    Traditionally, the International Atomic Energy Agency (IAEA) has relied upon prescriptive criteria to guide safeguards implementation. The prospect of replacing prescriptive safeguards criteria with more flexible performance criteria would constitute a structural change in safeguards and raises several important questions. Performance criteria imply that while safeguards goals will be fixed, the means of attaining those goals will not be explicitly prescribed. What would the performance objectives be under such a system? How would they be formulated? How would performance be linked to higher level safeguards objectives? How would safeguards performance be measured State-wide? The implementation of safeguards under performance criteria would also signal a dramatic change in the manner the Agency does business. A higher degree of flexibility could, in principle, produce greater effectiveness and efficiency, but would come with a need for increased Agency responsibility in practice. To the extent that reliance on prescriptive criteria decreases, the burden of justifying actions and ensuring their transparency will rise. Would there need to be limits to safeguards implementation? What would be the basis for setting such limits? This paper addresses these and other issues and questions relating to both the formulation and the implementation of performance-based criteria.

  16. Systems and methods for providing power to a load based upon a control strategy

    Science.gov (United States)

    Perisic, Milun; Kajouke, Lateef A; Ransom, Ray M

    2013-12-24

    Systems and methods are provided for an electrical system. The electrical system includes a load, an interface configured to receive a voltage from a voltage source, and a controller configured to receive the voltage from the voltage source through the interface and to provide a voltage and current to the load. Wherein, when the controller is in a constant voltage mode, the controller provides a constant voltage to the load, when the controller is in a constant current mode, the controller provides a constant current to the load, and when the controller is in a constant power mode, the controller provides a constant power to the load.

  17. Mixed Methods for Implementation Research: Application to Evidence-Based Practice Implementation and Staff Turnover in Community Based Organizations Providing Child Welfare Services

    Science.gov (United States)

    Aarons, Gregory A.; Fettes, Danielle L.; Sommerfeld, David H.; Palinkas, Lawrence

    2013-01-01

    Many public sector services systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well-suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This paper describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. We integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research. PMID:22146861

  18. Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

    Science.gov (United States)

    Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

    2012-02-01

    Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

  19. Configurable memory system and method for providing atomic counting operations in a memory device

    Science.gov (United States)

    Bellofatto, Ralph E.; Gara, Alan G.; Giampapa, Mark E.; Ohmacht, Martin

    2010-09-14

    A memory system and method for providing atomic memory-based counter operations to operating systems and applications that make most efficient use of counter-backing memory and virtual and physical address space, while simplifying operating system memory management, and enabling the counter-backing memory to be used for purposes other than counter-backing storage when desired. The encoding and address decoding enabled by the invention provides all this functionality through a combination of software and hardware.

  20. 23 CFR 450.222 - Applicability of NEPA to statewide transportation plans and programs.

    Science.gov (United States)

    2010-04-01

    ... the Secretary concerning a long-range statewide transportation plan or STIP developed through the... 23 Highways 1 2010-04-01 2010-04-01 false Applicability of NEPA to statewide transportation plans... TRANSPORTATION PLANNING AND RESEARCH PLANNING ASSISTANCE AND STANDARDS Statewide Transportation Planning and...

  1. Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System.

    Science.gov (United States)

    Squitieri, Lee; Chung, Kevin C

    2017-07-01

    In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.

  2. Enhancing the functionality of reactor protection systems to provide diagnostic and monitoring information: The ISATTM approach

    International Nuclear Information System (INIS)

    Baldwin, J.A.; Rowe, B.J.; Jones, C.D.

    1996-01-01

    The ISAT TM architecture has been successfully implemented as the Single Channel Trip System (SCTS), part of the primary protection system of Nuclear Electric's Dungeness 'B' Advanced Gas-Cooled Reactors. The system is the first computer-based protection system licensed on a UK civil nuclear reactor. The system provides protection against single channel faults resulting in high coolant gas outlet temperature. The SCTS was designed to output data at several points in the system to an Ethernet to allow checks to be made on the operation of parts of the protection system and the system as a whole. In order to monitor the performance of this shutdown system a PC based monitoring system was developed to take input as data from the Ethernet, check its integrity and then analyze the data to provide information of the state of the system and subsystems. The SCTS monitor was basically intended to alert the operator to any fault on the safety system and indicate its source, provide a diagnosis of the cause of any trip initiated by the safety system, and log the occurrences of these incidents for later inspection. The intention was also to provide accurate real-time information on the thermocouple readings and to decrease the effort required to maintain the safety system. This paper will describe briefly the development of the ISAT TM monitoring system: how its requirements were arrived at, and how the design, code and testing were carried out to ensure approval for this application. It will then go on to report how the ISAT TM monitor has performed during its time in service: how more functionality has been added over and above its original requirements. Features of additional monitors for the SCTS and other ISAT TM systems will also be described. (author). 2 refs, 5 figs

  3. Development of statewide geriatric patients trauma triage criteria.

    Science.gov (United States)

    Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

    2011-06-01

    The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

  4. A guide for statewide impaired-driving task forces.

    Science.gov (United States)

    2009-09-01

    The purpose of the guide is to assist State officials and other stakeholders who are interested in establishing an : Impaired-Driving Statewide Task Force or who are exploring ways to improve their current Task Force. The guide : addresses issues suc...

  5. California Statewide Plug-In Electric Vehicle Infrastructure Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Melaina, Marc; Helwig, Michael

    2014-05-01

    The California Statewide Plug-In Electric Vehicle Infrastructure Assessment conveys to interested parties the Energy Commission’s conclusions, recommendations, and intentions with respect to plug-in electric vehicle (PEV) infrastructure development. There are several relatively low-risk and high-priority electric vehicle supply equipment (EVSE) deployment options that will encourage PEV sales and

  6. The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia.

    Science.gov (United States)

    Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni

    The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  7. System and Method for Providing Vertical Profile Measurements of Atmospheric Gases

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A system and method for using an air collection device to collect a continuous air sample as the device descends through the atmosphere are provided. The air...

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

    National Research Council Canada - National Science Library

    Zhao, Wei; Bettati, Riccardo; Vaidya, Nitin

    2005-01-01

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

  9. Inpatient Prospective Payment System (IPPS) Provider Summary for the Top 100 Diagnosis-Related Groups (DRG)

    Data.gov (United States)

    U.S. Department of Health & Human Services — A provider level summary of Inpatient Prospective Payment System (IPPS) discharges, average charges and average Medicare payments for the Top 100 Diagnosis-Related...

  10. Authentication of an operator-provided containment and surveillance (C and S) system

    International Nuclear Information System (INIS)

    Watkins, L.M.; Rundquist, D.E.

    1987-01-01

    Large multicomponent Operator-provided C and S systems with computer control, such as the pioneering Japanese Fast Critical Assembly Portal Monitor (FCA P/M), can efficiently meet evolving IAEA C and S requirements but they present substantial challenges to the IAEA's need to authenticate the data produced. To authenticate such systems by traditional IAEA methods would require a prohibitive expenditure of resources to ensure that each individual component is provided with credible tamper indication and that the control and interpretation of the data is appropriate. Consequently, in parallel with the FCA P/M field trial currently underway in Japan, the IAEA has initiated a programme aimed at producing resource-efficient and credible authentication of the system. Although initially focused on the P/M system, the methods under consideration are applicable to other similar Operator-provided systems

  11. Iraqi primary care system in Kurdistan region: providers' perspectives on problems and opportunities for improvement.

    Science.gov (United States)

    Shabila, Nazar P; Al-Tawil, Namir G; Al-Hadithi, Tariq S; Sondorp, Egbert; Vaughan, Kelsey

    2012-09-27

    As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers' perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq's Kurdistan region from the perspective of primary care providers. From their experience, primary care providers have a role in informing the community and

  12. Swarm Intelligence: New Techniques for Adaptive Systems to Provide Learning Support

    Science.gov (United States)

    Wong, Lung-Hsiang; Looi, Chee-Kit

    2012-01-01

    The notion of a system adapting itself to provide support for learning has always been an important issue of research for technology-enabled learning. One approach to provide adaptivity is to use social navigation approaches and techniques which involve analysing data of what was previously selected by a cluster of users or what worked for…

  13. "AfterZone:" Outcomes for Youth Participating in Providence's Citywide After-School System. Executive Summary

    Science.gov (United States)

    Kauh, Tina J.

    2011-01-01

    This executive summary highlights the main findings from our participation and outcomes analysis of the "AfterZone" initiative--a citywide system-building effort in Providence, Rhode Island, that aims to provide high-quality, accessible out-of-school-time services to middle school youth. The summary briefly defines the AfterZone's unique…

  14. An Enterprise System and a Business Simulation Provide Many Opportunities for Interdisciplinary Teaching

    Science.gov (United States)

    Kreie, Jennifer; Shannon, James; Mora-Monge, Carlo A.

    2011-01-01

    Enterprise systems provide companies with centralized data management, business process support and integrated data flow between functional areas. Thanks to academic alliances offered by companies such as SAP, Oracle, Microsoft and others, universities can also take advantage of the integrated features of enterprise system to give business…

  15. Application of Evolutionary Mechanisms of Enhancers for Development Effective Artificial Intelligence Systems for Providing Data Security

    Directory of Open Access Journals (Sweden)

    M. L. Garanina

    2010-06-01

    Full Text Available This article describes the base approaches of the methods of evolutionary mechanisms (special type of genes — enhancers for parameterizations of AI systems genotype. This method can help in increasing adaptability of AI systems for providing data security.

  16. System and method of providing quick thermal comfort with reduced energy by using directed spot conditioning

    Science.gov (United States)

    Wang, Mingyu; Kadle, Prasad S.; Ghosh, Debashis; Zima, Mark J.; Wolfe, IV, Edward; Craig, Timothy D

    2016-10-04

    A heating, ventilation, and air conditioning (HVAC) system and a method of controlling a HVAC system that is configured to provide a perceived comfortable ambient environment to an occupant seated in a vehicle cabin. The system includes a nozzle configured to direct an air stream from the HVAC system to the location of a thermally sensitive portion of the body of the occupant. The system also includes a controller configured to determine an air stream temperature and an air stream flow rate necessary to establish the desired heat supply rate for the sensitive portion and provide a comfortable thermal environment by thermally isolating the occupant from the ambient vehicle cabin temperature. The system may include a sensor to determine the location of the sensitive portion. The nozzle may include a thermoelectric device to heat or cool the air stream.

  17. Solar-energy conversion system provides electrical power and thermal control for life-support systems

    Science.gov (United States)

    Davis, B. K.

    1974-01-01

    System utilizes Freon cycle and includes boiler turbogenerator with heat exchanger, regenerator and thermal-control heat exchangers, low-pressure and boiler-feed pumps, and condenser. Exchanger may be of interest to engineers and scientists investigating new energy sources.

  18. [Data coding in the Israeli healthcare system - do choices provide the answers to our system's needs?].

    Science.gov (United States)

    Zelingher, Julian; Ash, Nachman

    2013-05-01

    The IsraeLi healthcare system has undergone major processes for the adoption of health information technologies (HIT), and enjoys high Levels of utilization in hospital and ambulatory care. Coding is an essential infrastructure component of HIT, and ts purpose is to represent data in a simplified and common format, enhancing its manipulation by digital systems. Proper coding of data enables efficient identification, storage, retrieval and communication of data. UtiLization of uniform coding systems by different organizations enables data interoperability between them, facilitating communication and integrating data elements originating in different information systems from various organizations. Current needs in Israel for heaLth data coding include recording and reporting of diagnoses for hospitalized patients, outpatients and visitors of the Emergency Department, coding of procedures and operations, coding of pathology findings, reporting of discharge diagnoses and causes of death, billing codes, organizational data warehouses and national registries. New national projects for cLinicaL data integration, obligatory reporting of quality indicators and new Ministry of Health (MOH) requirements for HIT necessitate a high Level of interoperability that can be achieved only through the adoption of uniform coding. Additional pressures were introduced by the USA decision to stop the maintenance of the ICD-9-CM codes that are also used by Israeli healthcare, and the adoption of ICD-10-C and ICD-10-PCS as the main coding system for billing purpose. The USA has also mandated utilization of SNOMED-CT as the coding terminology for the ELectronic Health Record problem list, and for reporting quality indicators to the CMS. Hence, the Israeli MOH has recently decided that discharge diagnoses will be reported using ICD-10-CM codes, and SNOMED-CT will be used to code the cLinical information in the EHR. We reviewed the characteristics, strengths and weaknesses of these two coding

  19. A comparison of the efficiency of health systems in providing life expectancy

    DEFF Research Database (Denmark)

    Lenart, Adam; Zarulli, Virginia

    The role of the national health systems is to provide health for their citizens but each country achieves it up to a different degree. The health systems are heterogeneous not only in their efficiency but in their funding, organization and management too. As it is difficult to measure...... their efficiency in absolute terms, the countries can be compared with each other. The relative efficiency of health systems can be measured by the life expectancy that they provide by taking education level and their funding structure into account. Based on data coming from the HMD, GGS, OECD and WHO, data...

  20. Criteria for the evaluation of a cloud-based hospital information system outsourcing provider.

    Science.gov (United States)

    Low, Chinyao; Hsueh Chen, Ya

    2012-12-01

    As cloud computing technology has proliferated rapidly worldwide, there has been a trend toward adopting cloud-based hospital information systems (CHISs). This study examines the critical criteria for selecting the CHISs outsourcing provider. The fuzzy Delphi method (FDM) is used to evaluate the primary indicator collected from 188 useable responses at a working hospital in Taiwan. Moreover, the fuzzy analytic hierarchy process (FAHP) is employed to calculate the weights of these criteria and establish a fuzzy multi-criteria model of CHISs outsourcing provider selection from 42 experts. The results indicate that the five most critical criteria related to CHISs outsourcing provider selection are (1) system function, (2) service quality, (3) integration, (4) professionalism, and (5) economics. This study may contribute to understanding how cloud-based hospital systems can reinforce content design and offer a way to compete in the field by developing more appropriate systems.

  1. Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems.

    Science.gov (United States)

    Meyerhoefer, Chad D; Sherer, Susan A; Deily, Mary E; Chou, Shin-Yi; Guo, Xiaohui; Chen, Jie; Sheinberg, Michael; Levick, Donald

    2018-05-16

    The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR. Data on patient satisfaction were drawn from Press Ganey surveys issued by the healthcare network through a standard process. Using multivariable models, we determined how provider satisfaction with information transmission and patient satisfaction with their care experience changed as the EHR system allowed greater information flow between OB/GYN practices and the hospital. Outpatient OB/GYN providers became more satisfied with their access to information from the inpatient perinatal triage unit once system capabilities included automatic data flow from triage back to the OB/GYN offices. Yet physicians were generally less satisfied with how the EHR affected their work processes than other clinical and non-clinical staff. Patient satisfaction dropped after initial EHR installation, and we find no evidence of increased satisfaction linked to system integration. Dissatisfaction of providers with an EHR system and difficulties incorporating EHR technology into patient care may negatively impact patient satisfaction. Care must be taken during EHR implementations to maintain good communication with patients while satisfying documentation requirements.

  2. Systemic racism moderates effects of provider racial biases on adherence to hypertension treatment for African Americans.

    Science.gov (United States)

    Greer, Tawanda M; Brondolo, Elizabeth; Brown, Porschia

    2014-01-01

    The purpose of the current study was to examine perceived exposure to systemic racism as a moderator of the effects of perceived exposure to provider racial biases on treatment adherence and mistrust of health care for a sample of African American hypertensive patients. We hypothesized that patients who endorsed high levels of systemic racism would exhibit poor adherence to hypertension treatment and increased mistrust in health care in relation to perceptions of exposure to provider racial biases. The sample consisted of 100 African American patients who ranged in age from 24 to 82 years. All were diagnosed with hypertension and were recruited from an outpatient clinic located in the Southeastern region of the United States. Moderated regression analyses were performed to test the study hypotheses. Findings revealed a positive, significant main effect for perceived provider racial biases in predicting mistrust of care. This finding suggested that an increase in mistrust of health care was associated with increased perceptions of provider biases. In predicting treatment adherence, a significant interaction revealed that patients who endorsed low and moderate degrees of exposure to systemic racism displayed poor adherence to treatment in relation to greater perceptions of provider racial biases. The overall findings suggest that patients who perceive themselves as infrequently exposed to systemic racism possess the greatest risk for nonadherence to hypertension treatment in relation to increased perceptions of provider racial biases. Implications of the findings are discussed. 2014 APA, all rights reserved

  3. Benchmarking statewide trauma mortality using Agency for Healthcare Research and Quality's patient safety indicators.

    Science.gov (United States)

    Ang, Darwin; McKenney, Mark; Norwood, Scott; Kurek, Stanley; Kimbrell, Brian; Liu, Huazhi; Ziglar, Michele; Hurst, James

    2015-09-01

    Improving clinical outcomes of trauma patients is a challenging problem at a statewide level, particularly if data from the state's registry are not publicly available. Promotion of optimal care throughout the state is not possible unless clinical benchmarks are available for comparison. Using publicly available administrative data from the State Department of Health and the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSIs), we sought to create a statewide method for benchmarking trauma mortality and at the same time also identifying a pattern of unique complications that have an independent influence on mortality. Data for this study were obtained from State of Florida Agency for Health Care Administration. Adult trauma patients were identified as having International Classification of Disease ninth edition codes defined by the state. Multivariate logistic regression was used to create a predictive inpatient expected mortality model. The expected value of PSIs was created using the multivariate model and their beta coefficients provided by the AHRQ. Case-mix adjusted mortality results were reported as observed to expected (O/E) ratios to examine mortality, PSIs, failure to prevent complications, and failure to rescue from death. There were 50,596 trauma patients evaluated during the study period. The overall fit of the expected mortality model was very strong at a c-statistic of 0.93. Twelve of 25 trauma centers had O/E ratios benchmarking method that screens at risk trauma centers in the state for higher than expected mortality. Stratifying mortality based on failure to prevent PSIs may identify areas of needed improvement at a statewide level. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Pharmacy-based statewide naloxone distribution: A novel "top-down, bottom-up" approach.

    Science.gov (United States)

    Morton, Kate J; Harrand, Brianna; Floyd, Carly Cloud; Schaefer, Craig; Acosta, Julie; Logan, Bridget Claire; Clark, Karen

    To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states. New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin. Pharmacists can play an important role in providing naloxone to individuals who use prescription opioids. Not applicable. Not applicable. A multifaceted approach was utilized in New Mexico from the top down with legislative passage of provisions for a statewide standing order and New Mexico Department of Health support for pharmacy-based naloxone delivery. A bottom up approach was also initiated with the development and implementation of a training program for pharmacists and pharmacy technicians. Naloxone Medicaid claims were used to illustrate statewide distribution and utilization of the pharmacist statewide standing order for naloxone. Percent of pharmacies dispensing naloxone in each county were calculated. Trained pharmacy staff completed a program evaluation form. Questions about quality of instruction and ability of trainer to meet stated objectives were rated on a Likert scale. There were 808 naloxone Medicaid claims from 100 outpatient pharmacies during the first half of 2016, a 9-fold increase over 2014. The "A Dose of R x eality" training program evaluation indicated that participants felt the training was free from bias and met all stated objectives (4 out of 4 on Likert scale). A multi-pronged approach coupling state and community collaboration was successful in overcoming barriers and challenges associated with pharmacy naloxone distribution and ensured its success as an effective avenue for naloxone acquisition in urban and rural communities. Copyright © 2017 American Pharmacists

  5. A correction factor for estimating statewide agricultural injuries from ambulance reports.

    Science.gov (United States)

    Scott, Erika E; Earle-Richardson, Giulia; Krupa, Nicole; Jenkins, Paul

    2011-10-01

    Agriculture ranks as one of the most hazardous industries in the nation. Agricultural injury surveillance is critical to identifying and reducing major injury hazards. Currently, there is no comprehensive system of identifying and characterizing fatal and serious non-fatal agricultural injuries. Researchers sought to calculate a multiplier for estimating the number of agricultural injury cases based on the number of times the farm box indicator was checked on the ambulance report. Farm injuries from 2007 that used ambulance transport were ascertained for 10 New York counties using two methods: (1) ambulance reports including hand-entered free text; and (2) community surveillance. The resulting multiplier that was developed from contrasting these two methods was then applied to the statewide Emergency Medical Services database to estimate the total number of agricultural injuries for New York state. There were 25,735 unique ambulance runs due to injuries in the 10 counties in 2007. Among these, the farm box was checked a total of 90 times. Of these 90, 63 (70%) were determined to be agricultural. Among injury runs where the farm box was not checked, an additional 59 cases were identified from the free text. Among these 122 cases (63 + 59), four were duplicates. Twenty-four additional unique cases were identified from the community surveillance for a total of 142. This yielded a multiplier of 142/90 = 1.578 for estimating all agricultural injuries from the farm box indicator. Sensitivity and specificity of the ambulance report method were 53.4% and 99.9%, respectively. This method provides a cost-effective way to estimate the total number of agricultural injuries for the state. However, it would not eliminate the more labor intensive methods that are required to identify of the actual individual case records. Incorporating an independent source of case ascertainment (community surveillance) increased the multiplier by 17%. Copyright © 2011 Elsevier Inc. All rights

  6. Technoeconomics analysis of a photovoltaic system to provide electricity for a household in Malaysia

    International Nuclear Information System (INIS)

    Alamsyah, T.M.I.; Kamaruzzaman Sopian; Shahrir, A

    2006-01-01

    Malaysia is very fortunate because located in the tropical region where the used of solar energy is one of the most promising renewable energy sources in the country. This paper is a study on a photovoltaic (Pv) system to provide the electricity for a single residential household. The effect of solar intensity and surface temperature variation on the amount of power provided by PV panels in selected location in Malaysia is determined in this study. The Life cycle cost analysis is conducted to compare electricity price with other energy sources in this country. It is found that providing electricity for a household by using PV system seems to be beneficial and competitive for long term investment, especially if the price of the system is decrease and the efficiency is increase

  7. An Intelligent Virtual Human System For Providing Healthcare Information And Support

    Science.gov (United States)

    2011-01-01

    healthcare system, and also to other SMs and Veterans by way of a variety of social networking tools (e.g., 2nd Life, Facebook, etc.). The user can progress... CyberPsychology and Behavior 8, 3 (2005), 187-211. [2] T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508 [4] G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8

  8. Challenges and opportunities in providing a digital protection system for the PBMR - HTR2008-58173

    International Nuclear Information System (INIS)

    Marais, J.; Ridolfo, C. F.

    2008-01-01

    The Republic of South Africa is currently developing the Pebble Bed Modular Reactor (PBMR); an advanced, fourth-generation reactor that incorporates inherent safety features, which require no human intervention and which provide an unprecedented level of nuclear safety. In addition to electrical power generation, the reactor is uniquely suited for a variety of non-traditional nuclear applications including oil sands extraction, desalination, and hydrogen production. A state-of-the-art digital Protection System for the PBMR is currently being developed in conjunction with Westinghouse Electric Company (WEC). The Protection System provides for: reactor shutdown using two different reactor trip methodologies (dropping of the control rods and insertion of Small Absorber Spheres (SASs) which are composed of boron carbide); post-event monitoring; and manual reactor shutdown, which is independent of software-based systems. The reactor shutdown and post-event instrumentation monitoring components of the Protection System are being implemented utilizing the WEC 'Common Q' platform, which is comprised of 'commercially dedicated' Programmable Logic Controllers (PLCs), colour-graphic Flat Panel Displays (FPDs) with integral touch screens, and high-speed data communication links. High reliability and availability are achieved through component redundancy, continuous automatic self-testing which is run online in a background mode, and implementation of a multi-channel system design which is tolerant to failures. The Protection System is also designed to support periodic surveillance testing through a suite of built- in computer-aided test facilities that are accessible via an FPD interface. These allow various system surveillance requirements to be readily performed in a convenient and systematic manner. This paper discusses the following topics with regard to the PBMR Protection System: development strategy, functional requirements, selection of applicable Codes and Standards

  9. Decision support system of e-book provider selection for library using Simple Additive Weighting

    Science.gov (United States)

    Ciptayani, P. I.; Dewi, K. C.

    2018-01-01

    Each library has its own criteria and differences in the importance of each criterion in choosing an e-book provider for them. The large number of providers and the different importance levels of each criterion make the problem of determining the e-book provider to be complex and take a considerable time in decision making. The aim of this study was to implement Decision support system (DSS) to assist the library in selecting the best e-book provider based on their preferences. The way of DSS works is by comparing the importance of each criterion and the condition of each alternative decision. SAW is one of DSS method that is quite simple, fast and widely used. This study used 9 criteria and 18 provider to demonstrate how SAW work in this study. With the DSS, then the decision-making time can be shortened and the calculation results can be more accurate than manual calculations.

  10. A Recommender System for an IPTV Service Provider: a Real Large-Scale Production Environment

    Science.gov (United States)

    Bambini, Riccardo; Cremonesi, Paolo; Turrin, Roberto

    In this chapter we describe the integration of a recommender system into the production environment of Fastweb, one of the largest European IP Television (IPTV) providers. The recommender system implements both collaborative and content-based techniques, suitable tailored to the specific requirements of an IPTV architecture, such as the limited screen definition, the reduced navigation capabilities, and the strict time constraints. The algorithms are extensively analyzed by means of off-line and on-line tests, showing the effectiveness of the recommender systems: up to 30% of the recommendations are followed by a purchase, with an estimated lift factor (increase in sales) of 15%.

  11. Water and sludge treatment device provided with a system for irradiating by accelerated charged particles

    International Nuclear Information System (INIS)

    Azam, Guy; Bensussan, Andre; Levaillant, Claude; Huber, Harry; Mevel, Emile; Tronc, Dominique.

    1977-01-01

    Treatment system for a fluid made up of water and sludge, provided with a system for irradiating the fluid by a beam of accelerated charged particles comprising means for obtaining a constant flow of the fluid to be treated, facilities for monitoring this flow, an irradiation channel located on the path of the beam, in which the fluid to be treated can flow, a portion of this channel having at least one window transparent to the beam of accelerated particles. A safety system associated with the system for monitoring the characteristics of the beam and with the system for monitoring the flow of the fluid to be treated, stops the flow of the fluid and the recycling of the fluid defectively treated [fr

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

    DEFF Research Database (Denmark)

    2014-01-01

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

  13. Providing Internet Access to the Ohio Career Information System for All Residents: A Feasibility Study.

    Science.gov (United States)

    Lewis, Morgan V.

    Expanded Internet access to the Ohio Career Information System (OCIS) would provide adults in Ohio who need to or wish to make career changes with the best available information about occupations, education and training programs, and financial aid. In order to determine the feasibility of improving access without cost to users, an advisory group,…

  14. Factors Predicting Oncology Care Providers' Behavioral Intention to Adopt Clinical Decision Support Systems

    Science.gov (United States)

    Wolfenden, Andrew

    2012-01-01

    The purpose of this quantitative correlation study was to examine the predictors of user behavioral intention on the decision of oncology care providers to adopt or reject the clinical decision support system. The Unified Theory of Acceptance and Use of Technology (UTAUT) formed the foundation of the research model and survey instrument. The…

  15. Evaluating RITES, a Statewide Math and Science Partnership Program

    Science.gov (United States)

    Murray, D. P.; Caulkins, J. L.; Burns, A. L.; de Oliveira, G.; Dooley, H.; Brand, S.; Veeger, A.

    2013-12-01

    The Rhode Island Technology-Enhanced Science project (RITES) is a NSF-MSP Program that seeks to improve science education by providing professional development to science teachers at the 5th through 12th grade levels. At it's heart, RITES is a complex, multifaceted project that is challenging to evaluate because of the nature of its goal: the development of a large, statewide partnership between higher education and K12 public school districts during a time when science education strategies and leadership are in flux. As a result, these difficulties often require flexibility and creativity regarding evaluation, study design and data collection. In addition, the research agenda of the project often overlaps with the evaluator's agenda, making collaboration and communication a crucial component of the project's success. In it's 5th year, RITES and it's evaluators have developed a large number of instruments, both qualitative and quantitative, to provide direction and feedback on the effectiveness of the project's activities. RITES personnel work closely with evaluators and researchers to obtain a measure of how RITES' 'theory-of-action' affects both student outcomes and teacher practice. Here we discuss measures of teacher and student content gains, student inquiry gains, and teacher implementation surveys. Using content questions based on AAAS and MOSART databases, teachers in the short courses and students in classrooms showed significant normalized learning gains with averages generally above 0.3. Students of RITES-trained teachers also outperformed their non-RITES peers on the inquiry-section of the NECAP test, and The results show, after controlling for race and economic status, a small but statistically significant increase in test scores for RITES students. Technology use in the classroom significantly increased for teachers who were 'expected implementers' where 'expected implementers' are those teachers who implemented RITES as the project was designed. This

  16. Employment status matters: a statewide survey of quality-of-life, prevention behaviors, and absenteeism and presenteeism.

    Science.gov (United States)

    Merchant, James A; Kelly, Kevin M; Burmeister, Leon F; Lozier, Matt J; Amendola, Alison; Lind, David P; KcKeen, Arlinda; Slater, Tom; Hall, Jennifer L; Rohlman, Diane S; Buikema, Brenda S

    2014-07-01

    To estimate quality-of-life (QoL), primary care, health insurance, prevention behaviors, absenteeism, and presenteeism in a statewide sample of the unemployed, self-employed, and organizationally employed. A statewide survey of 1602 Iowans included items from the Centers for Disease Control and Prevention QoL and Behavioral Risk Factor Surveillance System Survey prevention behavior questionnaires used to assess employee well-being; their indicator results are related to World Health Organization's Health and Work Performance Questionnaire-derived absenteeism and presenteeism scores. The unemployed exhibited poorer QoL and prevention behaviors; the self-employed exhibited many better QoL scores due largely to better prevention behaviors than those employed by organizations. Higher QoL measures and more prevention behaviors are associated with lower absenteeism and lower presenteeism. Employment status is related to measures of well-being, which are also associated with absenteeism and presenteeism.

  17. Child Day Care Centers, This dataset contains the licensed daycare center locations in MD. Addresses were provided by the Department of Labor Licensing and Regulation (DLLR), and geocoded using Maryland Statewide Addressing Initiative Centerline., Published in 2012, 1:2400 (1in=200ft) scale, Towson University.

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Child Day Care Centers dataset current as of 2012. This dataset contains the licensed daycare center locations in MD. Addresses were provided by the Department of...

  18. Market competition, ownership, payment systems and the performance of health care providers - a panel study among Finnish occupational health services providers.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2013-10-01

    Many health care reforms rely on competition although health care differs in many respects from the assumptions of perfect competition. Finnish occupational health services provide an opportunity to study empirically competition, ownership and payment systems and the performance of providers. In these markets employers (purchasers) choose the provider and prices are market determined. The price regulation of public providers was abolished in 1995. We had data on providers from 1992, 1995, 1997, 2000 and 2004. The unbalanced panel consisted of 1145 providers and 4059 observations. Our results show that in more competitive markets providers in general offered a higher share of medical care compared to preventive services. The association between unit prices and revenues and market environment varied according to the provider type. For-profit providers had lower prices and revenues in markets with numerous providers. The public providers in more competitive regions were more sensitive to react to the abolishment of their price regulation by raising their prices. Employer governed providers had weaker association between unit prices or revenues and competition. The market share of for-profit providers was negatively associated with productivity, which was the only sign of market spillovers we found in our study.

  19. Fundamentals of Using Battery Energy Storage Systems to Provide Primary Control Reserves in Germany

    Directory of Open Access Journals (Sweden)

    Alexander Zeh

    2016-09-01

    Full Text Available The application of stationary battery storage systems to German electrical grids can help with various storage services. This application requires controlling the charge and discharge power of such a system. For example, photovoltaic (PV home storage, uninterruptible power supply, and storage systems for providing ancillary services such as primary control reserves (PCRs represent battery applications with positive profitability. Because PCRs are essential for stabilizing grid frequency and maintaining a robust electrical grid, German transmission system operators (TSOs released strict regulations in August 2015 for providing PCRs with battery storage systems as part of regulating the International Grid Control Cooperation (IGCC region in Europe. These regulations focused on the permissible state of charge (SoC of the battery during nominal and extreme conditions. The concomitant increased capacity demand oversizing may result in a significant profitability reduction, which can be attenuated only by using an optimal parameterization of the control algorithm for energy management of the storage systems. In this paper, the sizing optimization is achieved and a recommendation for a control algorithm that includes the appropriate parameters for the requirements in the German market is given. Furthermore, the storage cost is estimated, including battery aging simulations for different aging parameter sets to allow for a realistic profitability calculation.

  20. Optimizing the Use of Storage Systems Provided by Cloud Computing Environments

    Science.gov (United States)

    Gallagher, J. H.; Potter, N.; Byrne, D. A.; Ogata, J.; Relph, J.

    2013-12-01

    Cloud computing systems present a set of features that include familiar computing resources (albeit augmented to support dynamic scaling of processing power) bundled with a mix of conventional and unconventional storage systems. The linux base on which many Cloud environments (e.g., Amazon) are based make it tempting to assume that any Unix software will run efficiently in this environment efficiently without change. OPeNDAP and NODC collaborated on a short project to explore how the S3 and Glacier storage systems provided by the Amazon Cloud Computing infrastructure could be used with a data server developed primarily to access data stored in a traditional Unix file system. Our work used the Amazon cloud system, but we strived for designs that could be adapted easily to other systems like OpenStack. Lastly, we evaluated different architectures from a computer security perspective. We found that there are considerable issues associated with treating S3 as if it is a traditional file system, even though doing so is conceptually simple. These issues include performance penalties because using a software tool that emulates a traditional file system to store data in S3 performs poorly when compared to a storing data directly in S3. We also found there are important benefits beyond performance to ensuring that data written to S3 can directly accessed without relying on a specific software tool. To provide a hierarchical organization to the data stored in S3, we wrote 'catalog' files, using XML. These catalog files map discrete files to S3 access keys. Like a traditional file system's directories, the catalogs can also contain references to other catalogs, providing a simple but effective hierarchy overlaid on top of S3's flat storage space. An added benefit to these catalogs is that they can be viewed in a web browser; our storage scheme provides both efficient access for the data server and access via a web browser. We also looked at the Glacier storage system and

  1. A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

    Science.gov (United States)

    Culler, Corinna S; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M

    2017-10-01

    School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment. Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades. Outcomes were compared in bivariate analysis, stratified by grade and income levels. A greater percentage of Chelsea students had untreated decay and severe treatment need than students statewide. Yet, fewer Chelsea third graders had severe treatment need, and more had dental sealants. There was no significant difference in the percentage of Chelsea students having severe treatment need or dental sealants by income level. Students participating in our program do not have lower decay levels than students statewide. However, they do have lower levels of severe treatment need, likely due to treatment referrals. Our results confirm that school-based prevention programs can lead to increased prevalence of dental sealants among high-risk populations. Results provide support for the establishment of full-service school-based programs in similar communities. © 2017, American School Health Association.

  2. Technical architecture of ONC-approved plans for statewide health information exchange.

    Science.gov (United States)

    Barrows, Randolph C; Ezzard, John

    2011-01-01

    ONC-approved state plans for HIE were reviewed for descriptions and depictions of statewide HIE technical architecture. Review was complicated by non-standard organizational elements and technical terminology across state plans. Findings were mapped to industry standard, referenced, and defined HIE architecture descriptions and characteristics. Results are preliminary due to the initial subset of ONC-approved plans available, the rapid pace of new ONC-plan approvals, and continuing advancements in standards and technology of HIE, etc. Review of 28 state plans shows virtually all include a direct messaging component, but for participating entities at state-specific levels of granularity (RHIO, enterprise, organization/provider). About ½ of reviewed plans describe a federated architecture, and ¼ of plans utilize a single-vendor "hybrid-federated" architecture. About 1/3 of states plan to leverage new federal and open exchange technologies (DIRECT, CONNECT, etc.). Only one plan describes a centralized architecture for statewide HIE, but others combine central and federated architectural approaches.

  3. Neighborhood Stabilization Program Data NSP1 (Statewide)

    Data.gov (United States)

    Department of Housing and Urban Development — HUD's Neighborhood Stabilization Program (www.HUD.gov/nsp) provides emergency assistance to state and local governments to acquire and redevelop foreclosed...

  4. Empowering High School Students in Scientific Careers: Developing Statewide Partnerships

    Science.gov (United States)

    Aguilar, C.; Swartz, D.

    2008-05-01

    Center for Multiscale Modeling of Atmospheric Processes (CMMAP) is a National Science Foundation Science and Technology Center focused on improving the representation of cloud processes in climate models. The Center is divided into three sections including Knowledge Transfer, Research, and Education and Diversity. The Science Education and Diversity mission is to educate and train people with diverse backgrounds in Climate and Earth System Science by enhancing teaching and learning and disseminating science results through multiple media. CMMAP is partnering with two local school districts to host an annual global climate conferences for high school students. The 2008 Colorado Global Climate Conference seeks "To educate students on global and local climate issues and empower them to se their knowledge." The conference is sponsored by CMMAP, The Governor's Energy Office, Poudre School District, Thompson School District, Clif Bar, and Ben and Jerry's Scoop Shop of Fort Collins. The conference seeks to inspire students to pursue future education and careers in science fields. Following an opening welcome from the Governor's Energy Office, Keynote Piers Sellers will discuss his experiences as an atmospheric scientist and NASA astronaut. Students will then attend 3 out of 16 breakout sessions including such sessions as "Hot poems, Cool Paintings, and the treasures of Antiquity of Climate Change", "Mitigation vs Adaptation", "Bigfoot Walks(What Size is our carbon footprint?)" "The Wedges: Reduc ing Carbon Emissions", and "We the People: Climate and Culture of Climate Change" to name a few. Using The Governor's High School Conference on the Environment sponsored by the Wisconsin Center for Environmental Education as a model we are developing statewide partnerships to bring high school students together to look at global climate issues that will impact their future and of which they can be part of the solution through their education and career paths. In addition to

  5. Trust and trust relations from the providers' perspective: the case of the healthcare system in India.

    Science.gov (United States)

    Kane, Sumit; Calnan, Michael; Radkar, Anjali

    2015-01-01

    Commentators suggest that there is an erosion of trust in the relations between different actors in the health system in India. This paper presents the results of an exploratory study of the situation of providers in an urban setting in western India, the nature of their relations in terms of trust and what influences these relations. The data on relationships of trust were collected through interviews and focus group discussions with key informants, including public and private providers, regulators, managers and societal actors, such as patients/citizens, politicians and the media.

  6. Creating a smart application system to provide a beneficial maintenance service for elderly drivers

    Directory of Open Access Journals (Sweden)

    Jung Sebin

    2017-01-01

    Full Text Available As overall population ages, elderly drivers have become a larger percentage of the driving population. With this trend, a lot of vehicle systems have been improved for elderly’s safety and convenience using different advanced technologies. However, elderly drivers have often paid more money than other drivers in a car-repair shop due to their lack of knowledge about vehicle systems with modern technologies. Given this fact, developing a tool to diminish this disadvantage and to help elderly drivers maintain their cars with confidence and with minimal cost is necessary. Therefore, this research work mainly focuses on suggesting a system concept on user-interface application, which is connected to a smart phone or a tablet to provide beneficial services anywhere. For the research outcome, diverse research activities – surveys, interviews with small focus groups, observations of the focus groups, and discussions – has been conducted to understand the elderly driver’s difficulties and behaviours regarding vehicle maintenance, to investigate what specific problems make them uncomfortable in repair shops, and to demonstrate how new system-concepts could be developed for the elderly. Furthermore, we conclude that adequate system-concepts for the elderly would offer elderly drivers convenient vehicle repair and maintenance and provide them a confident driving experience.

  7. [A web information system for enhancing management and improving special care services provided to dependent persons].

    Science.gov (United States)

    Alvarez-Bermejo, J A; Hernández-Capel, D M; Belmonte-Ureña, L J; Roca-Piera, J

    2009-01-01

    Ensuring the quality of services provided in centres where dependent persons are seen by specialist services, by improving and enhancing how information -salary, control of tasks, patients' records, etc.- is shared between staff and carers. A web information system has been developed and experimentally deployed to accomplish this. The accuracy of the system was evaluated by assessing how confident the employees were with it rather than relying on statistical data. It was experimentally deployed since January 2009 in Asociación de Personas con Discapacidad "El Saliente" that manages several day centres in Almeria, for dependent persons over 65 years old, particularly those affected by Alzheimer' disease. Incidence data was collected during the experimental period. A total of 84% of the employees thought that the system helped to manage documents, administrative duties, etc., and 92.4% said they could attend to really important tasks because the system was responsible for alerting them of every task, such as medication timetables, checking all patients were present (to prevent an Alzheimer affected person leaving the centre) etc. During this period the incidences reported were reduced by about a 30%, although data is still partially representative. As the life expectancy of the population gets longer, these centres will increase. Providing systems such as the one presented here would be of great help for administrative duties (sensitive data protection...) as well as ensuring high quality care and attention.

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

    International Nuclear Information System (INIS)

    Genser, J.R.

    1992-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Motivation and reward systems in service provision: exploring motivators for people providing engineering services

    OpenAIRE

    Kreye, Melanie; Nandrup-Bus, Troels

    2015-01-01

    It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being ...

  11. Comprehensive Statewide Plan for Postsecondary Education

    Science.gov (United States)

    Nebraska's Coordinating Commission for Postsecondary Education, 2016

    2016-01-01

    The constitution and statutes of Nebraska assign the Coordinating Commission for Postsecondary Education the responsibility for comprehensive planning for postsecondary education in Nebraska. The purpose of the "Comprehensive Plan for Postsecondary Education" is to provide direction for the future of postsecondary education in Nebraska.…

  12. 23 CFR 450.216 - Development and content of the statewide transportation improvement program (STIP).

    Science.gov (United States)

    2010-04-01

    ... Programming § 450.216 Development and content of the statewide transportation improvement program (STIP). (a... Equity Bonus funds; (5) Emergency relief projects (except those involving substantial functional...

  13. A statewide partnership for reducing readmissions.

    Science.gov (United States)

    Landman, James H

    2013-06-01

    Three core programs have heped reduce reedrmissions in Illinois hospitals: Projct BOOST (better Outcomem by Optimizing Safe Transitions), whih focuses on redesigning hospital discharge processes and improving transitions of care. HP3: Hospitalist Program Peak Performance which provides ducational resources, motivation, and a process improvement structure for hospitalist programs. Communications and Palliative Care, which teaches physicians and dclinicians how to work with paients to define their goal of care and identify options to improve their quality of life.

  14. DJFS: Providing Highly Reliable and High‐Performance File System with Small‐Sized

    Directory of Open Access Journals (Sweden)

    Junghoon Kim

    2017-11-01

    Full Text Available File systems and applications try to implement their own update protocols to guarantee data consistency, which is one of the most crucial aspects of computing systems. However, we found that the storage devices are substantially under‐utilized when preserving data consistency because they generate massive storage write traffic with many disk cache flush operations and force‐unit‐access (FUA commands. In this paper, we present DJFS (Delta‐Journaling File System that provides both a high level of performance and data consistency for different applications. We made three technical contributions to achieve our goal. First, to remove all storage accesses with disk cache flush operations and FUA commands, DJFS uses small‐sized NVRAM for a file system journal. Second, to reduce the access latency and space requirements of NVRAM, DJFS attempts to journal compress the differences in the modified blocks. Finally, to relieve explicit checkpointing overhead, DJFS aggressively reflects the checkpoint transactions to file system area in the unit of the specified region. Our evaluation on TPC‐C SQLite benchmark shows that, using our novel optimization schemes, DJFS outperforms Ext4 by up to 64.2 times with only 128 MB of NVRAM.

  15. Benefits to the Europa Clipper Mission Provided by the Space Launch System

    Science.gov (United States)

    Creech, Stephen D.; Patel, Keyur

    2013-01-01

    The National Aeronautics and Space Administration's (NASA's) proposed Europa Clipper mission would provide an unprecedented look at the icy Jovian moon, and investigate its environment to determine the possibility that it hosts life. Focused on exploring the water, chemistry, and energy conditions on the moon, the spacecraft would examine Europa's ocean, ice shell, composition and geology by performing 32 low-altitude flybys of Europa from Jupiter orbit over 2.3 years, allowing detailed investigations of globally distributed regions of Europa. In hopes of expediting the scientific program, mission planners at NASA's Jet Propulsion Laboratory are working with the Space Launch System (SLS) program, managed at Marshall Space Flight Center. Designed to be the most powerful launch vehicle ever flown, SLS is making progress toward delivering a new capability for exploration beyond Earth orbit. The SLS rocket will offer an initial low-Earth-orbit lift capability of 70 metric tons (t) beginning with a first launch in 2017 and will then evolve into a 130 t Block 2 version. While the primary focus of the development of the initial version of SLS is on enabling human exploration missions beyond low Earth orbit using the Orion Multi-Purpose Crew Vehicle, the rocket offers unique benefits to robotic planetary exploration missions, thanks to the high characteristic energy it provides. This paper will provide an overview of both the proposed Europa Clipper mission and the Space Launch System vehicle, and explore options provided to the Europa Clipper mission for a launch within a decade by a 70 t version of SLS with a commercially available 5-meter payload fairing, through comparison with a baseline of current Evolved Expendable Launch Vehicle (EELV) capabilities. Compared to that baseline, a mission to the Jovian system could reduce transit times to less than half, or increase mass to more than double, among other benefits. In addition to these primary benefits, the paper will

  16. Selecting healthcare information systems provided by third-party vendors: a mind map beyond the manuals.

    Science.gov (United States)

    Gortzis, Lefteris G

    2010-01-01

    The selection of a new healthcare information system (HIS) has always been a daunting process for clinicians, health care providers and policy makers. The objective of this study is to present the lessons learned and the main findings from several relevant case studies to support this process. Data were collected by retrospectively reviewing the summative results of three well-established systems, acquiring feedback from two E.U. projects, and conducting semi-structured interviews with a number of collaborators involved in electronic healthcare interventions. Selection issues were identified and classified into the following five categories: (i) data creation, (ii) data management, (iii) data sharing, (iv) data presentation and (v) modules management. A mind map was also structured to provide a more manageable list of issues concerning the most common electronic clinical technologies (e-CT). The vendor manual is intended as an overview of the merchandise e-CT and therefore has limited potential in supporting effectively the selection process of a new HIS. The present classification and the mind map - based on lessons learned - provide a ready-to-use toolkit for supporting the HIS selection process when healthcare organisations are unable to employ research development groups to lay the groundwork for building a new HIS from scratch.

  17. Benefits of Demand Side Response in Providing Frequency Response Service in the Future GB Power System

    Directory of Open Access Journals (Sweden)

    Fei eTeng

    2015-08-01

    Full Text Available The demand for ancillary service is expected to increase significantly in the future GB electricity system due to high penetration of wind. In particular, the need for frequency response, required to deal with sudden frequency drops following a loss of generator, will increase because of the limited inertia capability of wind plants. This paper quantifies the requirements for primary frequency response and analyses the benefits of frequency response provision from DSR. The results show dramatic changes in frequency response requirements driven by high penetration of wind. Case studies carried out by using an advanced stochastic generation scheduling model suggest that the provision of frequency response from DSR could greatly reduce the system operation cost, wind curtailment and carbon emissions in the future GB system characterised by high penetration of wind. Furthermore, the results demonstrate that the benefit of DSR shows significant diurnal and seasonal variation, whereas an even more rapid (instant delivery of frequency response from DSR could provide significant additional value. Our studies also indicate that the competing technologies to DSR, namely battery storage and more flexible generation could potentially reduce its value by up to 35%, still leaving significant room to deploy DSR as frequency response provider.

  18. Improved fixation quality provided by a Bessel beacon in an adaptive optics system.

    Science.gov (United States)

    Lambert, Andrew J; Daly, Elizabeth M; Dainty, Christopher J

    2013-07-01

    We investigate whether a structured probe beam that creates the beacon for use in a retinal imaging adaptive optics system can provide useful side effects. In particular we investigate whether a Bessel beam that is seen by the subject as a set of concentric rings has a dampening effect on fixation variations of the subject under observation. This calming effect would allow longer periods of observation, particularly for patients with abnormal fixation. An experimental adaptive optics system developed for retinal imaging is used to monitor the fluctuations in aberrations for artificial and human subjects. The probe beam is alternated between a traditional beacon and one provided by a Bessel beam created by SLM. Time-frequency analysis is used to indicate the differences in power and time variation during fixation depending on whether the Bessel beam or the traditional beacon is employed. Comparison is made with the response for an artificial eye to discount systemic variations. Significant evidence is accrued to indicate the reduced fluctuations in fixation when the Bessel beam is employed to create the beacon. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  19. Using hydropower to complement wind energy: a hybrid system to provide firm power

    Energy Technology Data Exchange (ETDEWEB)

    Jaramillo, O.A.; Borja, M.A.; Huacuz, J.M. [Instituto de Investigaciones Electricas, Morelos (Mexico). Energias No Convencionales

    2004-09-01

    This paper presents a theoretical study of how wind power can be complemented by hydropower. A conceptual framework is provided for a hybrid power station that produces constant power output without the intermittent fluctuations inherent when using wind power. Two hypothetical facilities are considered as case studies. One of them is a hydropower plant located on the ''Presidente Benito Juarez'' dam in Jalapa del Marques, Oaxaca, Mexico. The other hypothetical facility is a wind farm located near ''La Venta's', an area in Juchitan, Oaxaca, Mexico. The wind-hydro-power system is a combined wind and hydro power plant in a region that is rich in both resources. The model shows that the hybrid plant could provide close to 20 MW of firm power to the electrical distribution system. On a techno-economic basis, we obtain the levelized production cost of the hybrid system. Taking into account two different discount rates of 7% and 10%, figures for levelized production cost are developed. (author)

  20. Use of a Novel Accounting and Grouping Method for Major Trunk Injury-Analysis of Data from a Statewide Trauma Financial Survey.

    Science.gov (United States)

    Joubert, Kyla D; Mabry, Charles D; Kalkwarf, Kyle J; Betzold, Richard D; Spencer, Horace J; Spinks, Kara M; Porter, Austin; Karim, Saleema; Robertson, Ronald D; Sutherland, Michael J; Maxson, Robert T

    2016-09-01

    Major trunk trauma is common and costly, but comparisons of costs between trauma centers (TCs) are rare. Understanding cost is essential to improve quality, manage trauma service lines, and to facilitate institutional commitment for trauma. We have used results of a statewide trauma financial survey of Levels I to IV TC to develop a useful grouping method for costs and clinical characteristics of major trunk trauma. The trauma financial survey collected billing and clinical data on 75 per cent of the state trauma registry patients for fiscal year 2012. Cost was calculated by separately accounting for embedded costs of trauma response and verification, and then adjusting reasonable costs from the Medicare cost report for each TC. The cost-to-charge ratios were then recalculated and used to determine uniform cost estimates for each patient. From the 13,215 patients submitted for the survey, we selected 1,094 patients with major trunk trauma: lengths of stay ≥ 48 hours and a maximum injury of AIS ≥3 for either thorax or abdominal trauma. These patients were then divided into three Injury Severity Score (ISS) groups of 9 to 15, 16 to 24, or 25+ to stratify patients into similar injury groups for analysis of cost and cost drivers. For abdominal injury, average total cost for patients with ISS 9 to 15 was $17,429. Total cost and cost per day increased with severity of injury, with $51,585 being the total cost for those with ISS 25. Similar trends existed for thoracic injury. Use of the Medicare cost report and cost-to-charge ratios to compute uniform costs with an innovative grouping method applied to data collected across a statewide trauma system provides unique information regarding cost and outcomes, which affects quality improvement, trauma service line management, and decisions on TC participation.

  1. Illinois statewide gas utility plan, 1993-2002. Volume 1. Executive summary

    International Nuclear Information System (INIS)

    1992-12-01

    The second Illinois Statewide Natural Gas Utility Plan is a continuation of the Least-Cost Planning effort introduced by the Public Utilities Act of 1986. The purpose of the Plan, like its predecessor, is to provide a framework and a set of policies which will allow and encourage local distribution companies to develop least-cost plans consistent with the goals of the Act: to provide efficient, environmentally sound, reliable, and equitable public utility service at the least possible cost. The Plan assesses natural gas demand and supply under five scenarios for the period 1993-2002. Key issues related to the development of least-cost natural gas plans are identified, and policies for addressing the issues are developed. The rationale and potential for natural gas demand side management (DSM) programs and policies are explored, and recommendations made with respect to utility DSM capability-building and DSM cost-recovery

  2. Level and Intensity of Early Intervention Services for Infants and Toddlers with Disabilities: The Impact of Child, Family, System, and Community-Level Factors on Service Provision

    Science.gov (United States)

    Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony

    2009-01-01

    Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…

  3. The Economic Potential of Three Nuclear-Renewable Hybrid Energy Systems Providing Thermal Energy to Industry

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, Mark [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cutler, Dylan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Flores-Espino, Francisco [National Renewable Energy Lab. (NREL), Golden, CO (United States); Stark, Greg [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jenkin, Thomas [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-12-01

    This report is one of a series of reports that Idaho National Laboratory and National Renewable Energy Laboratory are producing to investigate the technical and economic aspects of nuclear-renewable hybrid energy systems (N-R HESs). Previous reports provided results of an analysis of two N-R HES scenarios. This report builds that analysis with a Texas-synthetic gasoline scenario providing the basis in which the N-R HES sells heat directly to an industrial customer. Subsystems were included that convert electricity to heat, thus allowing the renewable energy subsystem to generate heat and benefit from that revenue stream. Nuclear and renewable energy sources are important to consider in the energy sector's evolution because both are considered to be clean and non-carbon-emitting energy sources.

  4. The Economic Potential of Three Nuclear-Renewable Hybrid Energy Systems Providing Thermal Energy to Industry

    International Nuclear Information System (INIS)

    Ruth, Mark; Cutler, Dylan; Flores-Espino, Francisco; Stark, Greg; Jenkin, Thomas

    2016-01-01

    This report is one of a series of reports that Idaho National Laboratory and National Renewable Energy Laboratory are producing to investigate the technical and economic aspects of nuclear-renewable hybrid energy systems (N-R HESs). Previous reports provided results of an analysis of two N-R HES scenarios. This report builds that analysis with a Texas-synthetic gasoline scenario providing the basis in which the N-R HES sells heat directly to an industrial customer. Subsystems were included that convert electricity to heat, thus allowing the renewable energy subsystem to generate heat and benefit from that revenue stream. Nuclear and renewable energy sources are important to consider in the energy sector's evolution because both are considered to be clean and non-carbon-emitting energy sources.

  5. Hospital Consumer Assessment of Healthcare Providers and Systems: An Ethical Leadership Dilemma to Satisfy Patients.

    Science.gov (United States)

    Piper, Llewellyn E; Tallman, Erin

    2016-01-01

    This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.

  6. Core drilling provides information about Santa Fe Group aquifer system beneath Albuquerque's West Mesa

    Science.gov (United States)

    Allen, B.D.; Connell, S.D.; Hawley, J.W.; Stone, B.D.

    1998-01-01

    Core samples from the upper ???1500 ft of the Santa Fe Group in the Albuquerque West Mesa area provide a first-hand look at the sediments and at subsurface stratigraphic relationships in this important part of the basin-fill aquifer system. Two major hydrostratigraphic subunits consisting of a lower coarse-grained, sandy interval and an overlying fine-grained, interbedded silty sand and clay interval lie beneath the water table at the 98th St core hole. Borehole electrical conductivity measurements reproduce major textural changes observed in the recovered cores and support subsurface correlations of hydrostratigraphic units in the Santa Fe Group aquifer system based on geophysical logs. Comparison of electrical logs from the core hole and from nearby city wells reveals laterally consistent lithostratigraphic patterns over much of the metropolitan area west of the Rio Grande that may be used to delineate structural and related stratigraphic features that have a direct bearing on the availability of ground water.

  7. Motivation and reward systems in service provision: exploring motivators for people providing engineering services

    DEFF Research Database (Denmark)

    Kreye, Melanie; Nandrup-Bus, Troels

    2015-01-01

    It is becoming a distinctive feature for manufacturing firms to compete strategically through service provision. In relation to reward systems the aim of this thesis is to investigate what motivates employees of servitized manufacturing firms when providing engineering services and why. Through...... quantitative and qualitative data collection with an international company within the European healthcare sector, the findings show that key motivating factors were to “delight” the customer and being able to take responsibility and accountability for ones work. Service employees were found to feel proud...

  8. Healing or harming? Healthcare provider interactions with injured workers and insurers in workers' compensation systems.

    Science.gov (United States)

    Kilgour, Elizabeth; Kosny, Agnieszka; McKenzie, Donna; Collie, Alex

    2015-03-01

    Healthcare providers (HCPs) are influential in the injured worker's recovery process and fulfil many roles in the delivery of health services. Interactions between HCPs and insurers can also affect injured workers' engagement in rehabilitation and subsequently their recovery and return to work. Consideration of the injured workers' perceptions and experiences as consumers of medical and compensation services can provide vital information about the quality, efficacy and impact of such systems. The aim of this systematic review was to identify and synthesize published qualitative research that focused on the interactions between injured workers, HCPs and insurers in workers' compensation systems in order to identify processes or interactions which impact injured worker recovery. A search of six electronic databases for literature published between 1985 and 2012 revealed 1,006 articles. Screening for relevance identified 27 studies which were assessed for quality against set criteria. A final 13 articles of medium and high quality were retained for data extraction. Findings were synthesized using a meta-ethnographic approach. Injured workers reported that HCPs could play both healing and harming roles in their recovery. Supportive patient-centred interaction with HCPs is important for injured workers. Difficult interactions between HCPs and insurers were highlighted in themes of adversarial relations and organisational pressures. Insurer and compensation system processes exerted an influence on the therapeutic relationship. Recommendations to improve relationships included streamlining administrative demands and increasing education and communication between the parties. Injured workers with long term complex injuries experience difficulties with healthcare in the workers' compensation context. Changes in insurer administrative demands and compensation processes could increase HCP participation and job satisfaction. This in turn may improve injured worker recovery

  9. Low carbon technologies as providers of operational flexibility in future power systems

    International Nuclear Information System (INIS)

    Pavić, Ivan; Capuder, Tomislav; Kuzle, Igor

    2016-01-01

    Highlights: • Mixed integer linear programming model for provision of multiple services from EV. • EV energy and reserve services provision effects on power system operation. • Impacts of conventional unit’s decommission on system’s operation and flexibility. • Assessment of power system’s flexibility under different wind generation polices. - Abstract: The paper presents a unit commitment model, based on mixed integer linear programming, capable of assessing the impact of electric vehicles (EV) on provision of ancillary services in power systems with high share of renewable energy sources (RES). The analyses show how role of different conventional units changes with integration of variable and uncertain RES and how introducing a flexible sources on the demand side, in this case EV, impact the traditional provision of spinning/contingency reserve services. In addition, technical constraints of conventional units, such as nuclear, gas or coal, limit the inherit flexibility of the system which results in curtailing clean renewable sources and inefficient operation. Following on that, sensitivity analyses of operational cost and wind curtailment shows which techno-economic constraints impact the flexibility of the high RES systems the most and how integration of more flexible units or decommission of conventional nuclear, coal and gas driven power plants would impact the system’s operation. Finally, two different wind generation polices (wind penalization and wind turbines as reserve providers) have been analysed in terms of operational flexibility through different stages of conventional unit’s decommission and compared with the same analyses when EV were used as reserve providers.

  10. From Demonstration System to Prototype: ShakeAlert Beta Users Provide Feedback to Improve Alert Delivery

    Science.gov (United States)

    Strauss, J. A.; Vinci, M.; Steele, W. P.; Allen, R. M.; Hellweg, M.

    2013-12-01

    Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds to minutes of warning prior to ground shaking at a given location. The goal and purpose of such a system is to reduce the damage, costs, and casualties resulting from an earthquake. A prototype earthquake early warning system (ShakeAlert) is in development by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, and the USGS. Events are published to the UserDisplay--ShakeAlert's Java based graphical interface, which is being tested by a small group of beta users throughout California. The beta users receive earthquake alerts in real-time and are providing feedback on their experiences. For early warning alerts to be useful, people, companies, and institutions must know beforehand what actions they will perform when they receive the information. Beta user interactions allow the ShakeAlert team to discern: which alert delivery options are most effective, what changes would make the UserDisplay more useful in a pre-disaster situation, and most importantly, what actions users plan to take for various scenarios. We also collect feedback detailing costs of implementing actions and challenges within the beta user organizations, as well as anticipated benefits and savings. Thus, creating a blueprint for a fully operational system that will meet the needs of the public. New California users as well as the first group of Pacific Northwest users are slated to join the ShakeAlert beta test group in the fall of 2013.

  11. A stochastic simulation model for reliable PV system sizing providing for solar radiation fluctuations

    International Nuclear Information System (INIS)

    Kaplani, E.; Kaplanis, S.

    2012-01-01

    Highlights: ► Solar radiation data for European cities follow the Extreme Value or Weibull distribution. ► Simulation model for the sizing of SAPV systems based on energy balance and stochastic analysis. ► Simulation of PV Generator-Loads-Battery Storage System performance for all months. ► Minimum peak power and battery capacity required for reliable SAPV sizing for various European cities. ► Peak power and battery capacity reduced by more than 30% for operation 95% success rate. -- Abstract: The large fluctuations observed in the daily solar radiation profiles affect highly the reliability of the PV system sizing. Increasing the reliability of the PV system requires higher installed peak power (P m ) and larger battery storage capacity (C L ). This leads to increased costs, and makes PV technology less competitive. This research paper presents a new stochastic simulation model for stand-alone PV systems, developed to determine the minimum installed P m and C L for the PV system to be energy independent. The stochastic simulation model developed, makes use of knowledge acquired from an in-depth statistical analysis of the solar radiation data for the site, and simulates the energy delivered, the excess energy burnt, the load profiles and the state of charge of the battery system for the month the sizing is applied, and the PV system performance for the entire year. The simulation model provides the user with values for the autonomy factor d, simulating PV performance in order to determine the minimum P m and C L depending on the requirements of the application, i.e. operation with critical or non-critical loads. The model makes use of NASA’s Surface meteorology and Solar Energy database for the years 1990–2004 for various cities in Europe with a different climate. The results obtained with this new methodology indicate a substantial reduction in installed peak power and battery capacity, both for critical and non-critical operation, when compared to

  12. New approaches to provide ride-through for critical loads in electric power distribution systems

    Science.gov (United States)

    Montero-Hernandez, Oscar C.

    2001-07-01

    The extensive use of electronic circuits has enabled modernization, automation, miniaturization, high quality, low cost, and other achievements regarding electric loads in the last decades. However, modern electronic circuits and systems are extremely sensitive to disturbances from the electric power supply. In fact, the rate at which these disturbances happen is considerable as has been documented in recent years. In response to the power quality concerns presented previously, this dissertation is proposing new approaches to provide ride-through for critical loads during voltage disturbances with emphasis on voltage sags. In this dissertation, a new approach based on an AC-DC-AC system is proposed to provide ride-through for critical loads connected in buildings and/or an industrial system. In this approach, a three-phase IGBT inverter with a built in Dc-link voltage regulator is suitably controlled along with static by-pass switches to provide continuous power to critical loads. During a disturbance, the input utility source is disconnected and the power from the inverter is connected to the load. The remaining voltage in the AC supply is converted to DC and compensated before being applied to the inverter and the load. After detecting normal utility conditions, power from the utility is restored to the critical load. In order to achieve an extended ride-through capability a second approach is introduced. In this case, the Dc-link voltage regulator is performed by a DC-DC Buck-Boost converter. This new approach has the capability to mitigate voltage variations below and above the nominal value. In the third approach presented in this dissertation, a three-phase AC to AC boost converter is investigated. This converter provides a boosting action for the utility input voltages, right before they are applied to the load. The proposed Pulse Width Modulation (PWM) control strategy ensures independent control of each phase and compensates for both single-phase or poly

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

    International Nuclear Information System (INIS)

    Beraldo O, B.; Paixao, L.; Donato da S, S.; Araujo T, M. H.; Nogueira, M. S.

    2014-08-01

    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 G ) is the dosimetric quantity used in quality control of the mammographic systems. The aim of this work is to validate D 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 G values were derived from the incident air kerma (K 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 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 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). This work contributes to

  14. 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

  15. The Drupal Environmental Information Management System Provides Standardization, Flexibility and a Platform for Collaboration

    Science.gov (United States)

    Gries, C.; Vanderbilt, K.; Reid, D.; Melendez-Colom, E.; San Gil, I.

    2013-12-01

    Over the last five years several Long-Term Ecological Research (LTER) sites have collaboratively developed a standardized yet flexible approach to ecological information management based on the open source Drupal content management system. These LTER sites adopted a common data model for basic metadata necessary to describe data sets, but also used for site management and web presence. Drupal core functionality provides web forms for easy management of information stored in this data model. Custom Drupal extensions were developed to generate XML files conforming to the Ecological Metadata Language (EML) for contribution to the LTER Network Information System (NIS) and other data archives. Each LTER site then took advantage of the flexibility Drupal provides to develop its unique web presence, choosing different themes and adding additional content to the websites. By nature, information presented is highly interlinked which can easily be modeled in Drupal entities and is further supported by a sophisticated tagging system (Fig. 1). Therefore, it is possible to provide the visitor with many different entry points to the site specific information presented. For example, publications and datasets may be grouped for each scientist, for each research project, for each major research theme at the site, making the information presented more accessible for different visitors. Experience gained during the early years was recently used to launch a complete re-write for upgrading to Drupal 7. LTER sites from multiple academic institutions pooled resources in order to partner with professional Drupal developers. Highlights of the new developments are streamlined data entry, improved EML output and integrity, support of IM workflows, a faceted data set search, a highly configurable data exploration tool with intelligent filtering and data download, and, for the mobile age, a responsive web design theme. Seven custom modules and a specific installation profile were developed

  16. Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.

    Science.gov (United States)

    Jung, Hye-Young; Gichoya, Judy Wawira; Vest, Joshua R

    2017-02-01

    An increasing number of technologies allow providers to access the results of imaging studies. This study examined differences in access of radiology images compared with text-only reports through a health information exchange system by health care professionals. The study sample included 157,256 historical sessions from a health information exchange system that enabled 1,670 physicians and non-physicians to access text-based reports and imaging over the period 2013 to 2014. The primary outcome was an indicator of access of an imaging study instead of access of a text-only report. Multilevel mixed-effects regression models were used to estimate the association between provider and session characteristics and access of images compared with text-only reports. Compared with primary care physicians, specialists had an 18% higher probability of accessing actual images instead of text-only reports (β = 0.18; P < .001). Compared with primary care practice settings, the probability of accessing images was 4% higher for specialty care practices (P < .05) and 8% lower for emergency departments (P < .05). Radiologists, orthopedists, and neurologists accounted for 79% of all the sessions with actual images accessed. Orthopedists, radiologists, surgeons, and pulmonary disease specialists accessed imaging more often than text-based reports only. Consideration for differences in the need to access images compared with text-only reports based on the type of provider and setting of care are needed to maximize the benefits of image sharing for patient care. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Health insurance system and provider payment reform in the Republic of Macedonia

    Directory of Open Access Journals (Sweden)

    Doncho M. Donev

    2009-03-01

    Full Text Available This article gives an insight to the current health insurance system in the Republic of Macedonia. Special emphasis is given to the specificities and practice of both obligatory and voluntary health insurance, to the scope of the insured persons and their benefits and obligations, the way of calculating and payment of the contributions and the other sources of revenues for health insurance, user participation in health care expenses, payment to the health care providers and some other aspects of realization of health insurance in practice. According to the Health Insurance Law, which was adopted in March 2000, a person can become an insured to the Health Insurance Fund on various modalities. More than 90% of the citizens are eligible to the obligatory health insurance, which provides a broad scope of basic health care benefits. Till end of 2008 payroll contributions were equal to 9.2%, and from January 1st, 2009 are equal to 7.5% of gross earned wages and almost 60% of health sector revenues are derived from them. Within the autonomy and scope of activities of the Health Insurance Fund the structures of the revenues and expenditures are presented. Health financing and reform of the payment to health care providers are of high importance within the ongoing health care reform in Macedonia. It is expected that the newly introduced methods of payments at the primary health care level (capitation and at the hospital sector (global budgeting, DRGs will lead to increased equity, efficiency and quality of health care in hospitals and overall system

  18. Characteristics of electronic patient-provider messaging system utilisation in an urban health care organisation

    Directory of Open Access Journals (Sweden)

    Sean Patrick Mikles

    2014-12-01

    Full Text Available Introduction Research suggests that electronic messaging can improve patient engagement. Studies indicate that a ‘digital divide’ may exist, where certain patient populations may be using electronic messaging less frequently. This study aims to determine which patient characteristics are associated with different levels of usage of an electronic patient-provider messaging system in a diverse urban population.Methods Cross-sectional electronic health record data were extracted for patients 10 years of age or older who live in New York City and who visited a set of clinics between 1 July 2011 and 30 June 2012. Regression analyses determined which participant characteristics were associated with the sending of electronic messages.Results Older, female, English-speaking participants of white race who received more messages, had any diagnoses, more office visits and a provider who sent messages were more likely to send more messages. Non-Millennial, non-white participants who received fewer messages, had more office visits, any diagnoses, a provider who saw fewer patients with patient portal accounts, lived in a low socioeconomic status neighbourhood, and did not have private insurance were more likely to send zero messages.Conclusion This study found significant differences in electronic messaging usage based on demographic, socioeconomic and health-related patient characteristics. Future studies are needed to support these results and determine the causes of observed associations.

  19. PROVIDING QUALITY OF ELECTRIC POWER IN ELECTRIC POWER SYSTEM IN PARALLEL OPERATION WITH WIND TURBINE

    Directory of Open Access Journals (Sweden)

    Yu. A. Rolik

    2016-01-01

    Full Text Available The problem of providing electric power quality in the electric power systems (EPS that are equipped with sufficiently long air or cable transmission lines is under consideration. This problem proved to be of particular relevance to the EPS in which a source of electrical energy is the generator of wind turbines since the wind itself is an instable primary energy source. Determination of the degree of automation of voltage regulation in the EPS is reduced to the choice of methods and means of regulation of power quality parameters. The concept of a voltage loss and the causes of the latter are explained by the simplest power system that is presented by a single-line diagram. It is suggested to regulate voltage by means of changing parameters of the network with the use of the method of reducing loss of line voltage by reducing its reactance. The latter is achieved by longitudinal capacitive compensation of the inductive reactance of the line. The effect is illustrated by vector diagrams of currents and voltages in the equivalent circuits of transmission lines with and without the use of longitudinal capacitive compensation. The analysis of adduced formulas demonstrated that the use of this method of regulation is useful only in the systems of power supply with a relatively low power factor (cosφ < 0.7 to 0.9. This power factor is typical for the situation of inclusion the wind turbine with asynchronous generator in the network since the speed of wind is instable. The voltage regulation fulfilled with the aid of the proposed method will make it possible to provide the required quality of the consumers’ busbars voltage in this situation. In is turn, it will make possible to create the necessary conditions for the economical transmission of electric power with the lowest outlay of reactive power and the lowest outlay of active power losses.

  20. The Challenge of Providing Safe Water with an Intermittently Supplied Piped Water Distribution System

    Science.gov (United States)

    Kumpel, E.; Nelson, K. L.

    2012-12-01

    An increasing number of urban residents in low- and middle-income countries have access to piped water; however, this water is often not available continuously. 84% of reporting utilities in low-income countries provide piped water for fewer than 24 hours per day (van den Berg and Danilenko, 2010), while no major city in India has continuous piped water supply. Intermittent water supply leaves pipes vulnerable to contamination and forces households to store water or rely on alternative unsafe sources, posing a health threat to consumers. In these systems, pipes are empty for long periods of time and experience low or negative pressure even when water is being supplied, leaving them susceptible to intrusion from sewage, soil, or groundwater. Households with a non-continuous supply must collect and store water, presenting more opportunities for recontamination. Upgrading to a continuous water supply, while an obvious solution to these challenges, is currently out of reach for many resource-constrained utilities. Despite its widespread prevalence, there are few data on the mechanisms causing contamination in an intermittent supply and the frequency with which it occurs. Understanding the impact of intermittent operation on water quality can lead to strategies to improve access to safe piped water for the millions of people currently served by these systems. We collected over 100 hours of continuous measurements of pressure and physico-chemical water quality indicators and tested over 1,000 grab samples for indicator bacteria over 14 months throughout the distribution system in Hubli-Dharwad, India. This data set is used to explore and explain the mechanisms influencing water quality when piped water is provided for a few hours every 3-5 days. These data indicate that contamination occurs along the distribution system as water travels from the treatment plant to reservoirs and through intermittently supplied pipes to household storage containers, while real

  1. Consumer assessment of healthcare providers and systems surgical care survey: benefits and challenges.

    Science.gov (United States)

    Schulz, Kristine A; Rhee, John S; Brereton, Jean M; Zema, Carla L; Witsell, David L

    2012-10-01

    To describe the feasibility and initial results of the implementation of a continuous quality improvement project using the newly available Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS), in a small cohort of otolaryngology-head and neck surgery practices. Prospective observational study using a newly validated health care consumer survey. Two community-based and 2 university-based otolaryngology-head and neck surgery outpatient clinic practices. Fourteen board-certified otolaryngology, head and neck surgeons from 4 practice sites voluntarily participated in this project. All adult patients scheduled for surgery during a 12-month period were asked to complete the S-CAHPS survey through an electronic data capture (EDC) system 7 to 28 days after surgery. The surgeons were not directly involved in administration or collection of survey data. Three sites successfully implemented the S-CAHPS project. A 39.9% response rate was achieved for the cohort of surgical patients entered into the EDC system. While most patients rated their surgeons very high (mean of 9.5 or greater out of 10), subanalysis revealed there is variability among sites and surgeons in communication practices. From these data, a potential surgeon Quality Improvement report was developed that highlights priority areas to improve surgeon-patient rapport. The S-CAHPS survey can be successfully implemented in most otolaryngology practices, and our initial work holds promise for how the survey can be best deployed and analyzed for the betterment of both the surgeon and the patient.

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

    Science.gov (United States)

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

    2014-01-01

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

  3. The smoking ban next door: do hospitality businesses in border areas have reduced sales after a statewide smoke-free policy?

    Science.gov (United States)

    Klein, Elizabeth G; Hood, Nancy E

    2015-01-01

    Despite numerous studies demonstrating no significant economic effects on hospitality businesses following a statewide smoke-free (SF) policy, regional concerns suggest that areas near states without SF policies may experience a loss of hospitality sales across the border. The present study evaluated the impact of Ohio's statewide SF policy on taxable restaurant and bar sales in border and non-border areas. Spline regression analysis was used to assess changes in monthly taxable sales at the county level in full-service restaurants and bars in Ohio. Data were analyzed from four years prior to policy implementation to three years post-policy. Change in the differences in the slope of taxable sales for border (n = 21) and non-border (n = 67) counties were evaluated for changes following the statewide SF policy enforcement, adjusted for unemployment rates, general trends in the hospitality sector, and seasonality. After adjusting for covariates, there was no statistically significant change in the difference in slope for taxable sales for either restaurants (β = 0.9, p = 0.09) or bars (β = 0.2, p = 0.07) following the SF policy for border areas compared to non-border areas of Ohio. Border regions in Ohio did not experience a significant change in bar and restaurant sales compared to non-border areas following a statewide SF policy. Results support that Ohio's statewide SF policy did not impact these two areas differently, and provide additional evidence for the continued use of SF policies to provide protection from exposure to secondhand smoke for both workers and the general public. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. An Assistive Technology System that Provides Personalized Dressing Support for People Living with Dementia: Capability Study.

    Science.gov (United States)

    Burleson, Winslow; Lozano, Cecil; Ravishankar, Vijay; Lee, Jisoo; Mahoney, Diane

    2018-05-01

    Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals). This laboratory study evaluated the DRESS prototype's capacity to detect dressing events. These events were engaged in by 11 healthy participants simulating common correct and incorrect dressing scenarios. The events ranged from donning a shirt and pants inside out or backwards to partial dressing-typical issues that challenge a PWD and their caregivers. A set of expected detections for correct dressing was prepared via video analysis of all participants' dressing behaviors. In the initial phases of donning either shirts or pants, the DRESS prototype missed only 4 out of 388 expected detections. The prototype's ability to recognize other missing detections varied across conditions. There were also some unexpected detections such as detection of the inside of a shirt as it was being put on. Throughout the study, detection of dressing events was adversely affected by the relatively smaller effective size of the markers at greater distances. Although the DRESS prototype incorrectly identified 10 of 22 cases for shirts, the prototype preformed significantly better for pants, incorrectly identifying only 5 of 22 cases. Further analyses identified opportunities to improve the

  5. Characteristics and Effects of a Statewide STEM Program

    Directory of Open Access Journals (Sweden)

    Jeffrey D. Weld

    2015-10-01

    Full Text Available A comprehensive statewide STEM (science, technology, engineering, mathematics reform initiative enters its fifth year in the U.S. state of Iowa. A significant proportion of the state’s pre K-12 students and teachers participate in one or more of the twenty programs offered, ranging from classroom curricular innovations to teacher professional development, and from community STEM festivals to career exploration events. An external, inter-university evaluation consortium measures annual progress of the initiative through the Iowa STEM Monitoring Project. Results show citizens to be increasingly aware of and supporting of STEM education; students to be increasingly interested in STEM as well as outperforming nonparticipating peers on state math and science tests; and teachers more confident and knowledgeable in teaching STEM. Iowa’s STEM initiative has garnered national acclaim though challenges remain with regard to expanding the participation of learners of diversity, as well as ensuring the long-term sustainability of the programs and structures that define Iowa’s statewide STEM initiative.

  6. A Statewide Survey for Container-Breeding Mosquitoes in Mississippi.

    Science.gov (United States)

    Goddard, Jerome; Moraru, Gail M; Mcinnis, Sarah J; Portugal, J Santos; Yee, Donald A; Deerman, J Hunter; Varnado, Wendy C

    2017-09-01

    Container-breeding mosquitoes are important in public health due to outbreaks of Zika, chikungunya, and dengue viruses. This paper documents the distribution of container-breeding mosquito species in Mississippi, with special emphasis on the genus Aedes. Five sites in each of the 82 Mississippi counties were sampled monthly between May 1 and August 31, 2016, and 50,109 mosquitoes in 14 species were collected. The most prevalent and widely distributed species found was Ae. albopictus, being found in all 82 counties, especially during July. A recent invasive, Ae. japonicus, seems to be spreading rapidly in Mississippi since first being discovered in the state in 2011. The most abundant Culex species collected were Cx. quinquefasciatus (found statewide), Cx. salinarius (almost exclusively in the southern portion of the state), and Cx. restuans (mostly central and southern Mississippi). Another relatively recent invasive species, Cx. coronator, was found in 20 counties, predominantly in the southern one-third of the state during late summer. Co-occurrence data of mosquito species found in the artificial containers were also documented and analyzed. Lastly, even though we sampled extensively in 410 sites across Mississippi, no larval Ae. aegypti were found. These data represent the first modern statewide survey of container species in Mississippi, and as such, allows for better public health readiness for emerging diseases and design of more effective vector control programs.

  7. System Statement of Tasks of Calculating and Providing the Reliability of Heating Cogeneration Plants in Power Systems

    Science.gov (United States)

    Biryuk, V. V.; Tsapkova, A. B.; Larin, E. A.; Livshiz, M. Y.; Sheludko, L. P.

    2018-01-01

    A set of mathematical models for calculating the reliability indexes of structurally complex multifunctional combined installations in heat and power supply systems was developed. Reliability of energy supply is considered as required condition for the creation and operation of heat and power supply systems. The optimal value of the power supply system coefficient F is based on an economic assessment of the consumers’ loss caused by the under-supply of electric power and additional system expences for the creation and operation of an emergency capacity reserve. Rationing of RI of the industrial heat supply is based on the use of concept of technological margin of safety of technological processes. The definition of rationed RI values of heat supply of communal consumers is based on the air temperature level iside the heated premises. The complex allows solving a number of practical tasks for providing reliability of heat supply for consumers. A probabilistic model is developed for calculating the reliability indexes of combined multipurpose heat and power plants in heat-and-power supply systems. The complex of models and calculation programs can be used to solve a wide range of specific tasks of optimization of schemes and parameters of combined heat and power plants and systems, as well as determining the efficiency of various redundance methods to ensure specified reliability of power supply.

  8. A statewide consortium's adoption of a unified nursing curriculum: evaluation of the first two years.

    Science.gov (United States)

    Tse, Alice M; Niederhauser, Victoria; Steffen, John J; Magnussen, Lois; Morrisette, Nova; Polokoff, Rachael; Chock, Johnelle

    2014-01-01

    This article provides an evaluation of the first two years of implementation of a statewide nursing consortium (SNC) curriculum on nursing faculty work life, teaching productivity, and quality of education. In response to the call for nursing education reform, the SNC incorporated new approaches to competency-based, student-centered learning and clinical education. Faculty and two cohorts of students were measured at three points over the first two years of the curriculum implementation. The expected positive impact of the SNC was documented at the start of the first year, but not sustained. Students reported having more confidence in their clinical skills at the start of the first year, yet demonstrated significantly less confidence in their ability after two years. Faculty indicated that the SNC allowed greater opportunity for collaboration, but that the experience did not alter their classroom performance or satisfaction beyond the first year.

  9. Current status of system development to provide databases of nuclides migration

    International Nuclear Information System (INIS)

    Sasamoto, Hiroshi; Yoshida, Yasushi; Isogai, Takeshi; Suyama, Tadahiro; Shibata, Masahiro; Yui, Mikazu; Jintoku, Takashi

    2005-01-01

    JNC has developed databases of nuclides migration for safety assessment of high-level radioactive waste (HLW) repository, and they have been used in the second progress report to present the technical reliability of HLW geological disposal system in Japan. The technical level and applicability of databases have been highly evaluated even overseas. To provide the databases broadly over the world and to promote the use of the databases, we have performed the followings: 1) development of tools to convert the database format from geochemical code PHREEQE to PHREEQC, GWB and EQ3/6 and 2) set up a web site (http://migrationdb.jnc.go.jp) which enables the public to access to the databases. As a result, the number of database users has significantly increased. Additionally, a number of useful comments from the users can be applied to modification and/or update of databases. (author)

  10. The dynamic information architecture system : a simulation framework to provide interoperability for process models

    International Nuclear Information System (INIS)

    Hummel, J. R.; Christiansen, J. H.

    2002-01-01

    As modeling and simulation becomes a more important part of the day-to-day activities in industry and government, organizations are being faced with the vexing problem of how to integrate a growing suite of heterogeneous models both within their own organizations and between organizations. The Argonne National Laboratory, which is operated by the University of Chicago for the United States Department of Energy, has developed the Dynamic Information Architecture System (DIAS) to address such problems. DIAS is an object-oriented, subject domain independent framework that is used to integrate legacy or custom-built models and applications. In this paper we will give an overview of the features of DIAS and give examples of how it has been used to integrate models in a number of applications. We shall also describe some of the key supporting DIAS tools that provide seamless interoperability between models and applications

  11. Towards automated statewide land cover mapping in Wisconsin using satellite remote sensing and GIS techniques

    International Nuclear Information System (INIS)

    Cosentino, B.L.; Lillesand, T.M.

    1991-01-01

    Attention is given to an initial research project being performed by the University of Wisconsin-Madison, Environmental Remote Sensing Center in conjunction with seven local, state, and federal agencies to implement automated statewide land cover mapping using satellite remote sensing and geographical information system (GIS) techniques. The basis, progress, and future research needs for this mapping program are presented. The research efforts are directed toward strategies that integrate satellite remote sensing and GIS techniques in the generation of land cover data for multiple users of land cover information. The project objectives are to investigate methodologies that integrate satellite data with other imagery and spatial data resident in emerging GISs in the state for particular program needs, and to develop techniques that can improve automated land cover mapping efficiency and accuracy. 10 refs

  12. Towards the Use of Unmanned Aerial Systems for Providing Sustainable Services in Smart Cities

    Directory of Open Access Journals (Sweden)

    Enrique Moguel

    2017-12-01

    Full Text Available Sustainability is at the heart of many application fields where the use of Unmanned Aerial Systems (UAS is becoming more and more important (e.g., agriculture, fire detection and prediction, environmental surveillance, mapping, etc.. However, their usage and evolution are highly conditioned by the specific application field they are designed for, and thus, they cannot be easily reused among different application fields. From this point of view, being that they are not multipurpose, we can say that they are not fully sustainable. Bearing this in mind, the objective of this paper is two-fold: on the one hand, to identify the whole set of features that must be provided by a UAS to be considered sustainable and to show that there is no UAS satisfying all these features; on the other hand, to present an open and sustainable UAS architecture that may be used to build UAS on demand to provide the features needed in each application field. Since this architecture is mainly based on software and hardware adaptability, it contributes to the technical sustainability of cities.

  13. How do patients and providers react to different incentives in the Chinese multiple health security systems?

    Science.gov (United States)

    Zhang, Chun-Yu; Hashimoto, Hideki

    2015-03-05

    China has achieved universal health insurance coverage. This study examined how patients and hospitals react to the different designs of the plans and to monitoring of patients by the local authority in the Chinese multiple health security schemes. The sample for analysis consisted of 1006 orthopedic inpatients who were admitted between January and December 2011 at a tertiary teaching hospital located in Beijing. We conducted general linear regression analyses to investigate whether medical expenditure and length of stay differed according to the different incentives. Patients under plans with lower copayment rates consumed significantly more medication compared with those under plans with higher copayment rates. Under plans with an annual ceiling for insurance coverage, patients spent significantly more in the second half of the year than in the first half of the year. The length of stay was shorter among patients when there were government monitoring and a penalty to the hospital service provider. Our results indicate that the different designs and monitoring of the health security systems in China cause opportunistic behavior by patients and providers. Reformation is necessary to reduce those incentives, and improve equity and efficiency in healthcare use.

  14. Towards the Use of Unmanned Aerial Systems for Providing Sustainable Services in Smart Cities.

    Science.gov (United States)

    Moguel, Enrique; Conejero, José M; Sánchez-Figueroa, Fernando; Hernández, Juan; Preciado, Juan C; Rodríguez-Echeverría, Roberto

    2017-12-27

    Sustainability is at the heart of many application fields where the use of Unmanned Aerial Systems (UAS) is becoming more and more important (e.g., agriculture, fire detection and prediction, environmental surveillance, mapping, etc.). However, their usage and evolution are highly conditioned by the specific application field they are designed for, and thus, they cannot be easily reused among different application fields. From this point of view, being that they are not multipurpose, we can say that they are not fully sustainable. Bearing this in mind, the objective of this paper is two-fold: on the one hand, to identify the whole set of features that must be provided by a UAS to be considered sustainable and to show that there is no UAS satisfying all these features; on the other hand, to present an open and sustainable UAS architecture that may be used to build UAS on demand to provide the features needed in each application field. Since this architecture is mainly based on software and hardware adaptability, it contributes to the technical sustainability of cities.

  15. Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings.

    Science.gov (United States)

    Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael

    2016-01-01

    Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.

  16. 9: ADAPTATION OF PREGNANCY RISK ASSESSMENT MONITORING SYSTEM (PRAMS) AND PROVIDE A MODEL ON IT

    Science.gov (United States)

    Kharaghani, Roghieh; Shariati, Mohammad; Keramat, Afsaneh; Yunesian, Masud; Moghisi, Alireza

    2017-01-01

    Background and aims A surveillance system helps to detect epidemics and the pattern of the problems incidence in the community and it is essential part of evidence based decision making process. This study aimed to adapt of PRAMS and provide a model on it. Methods This study was performed in 7 steps as follows: Surveillance systems in pregnancy were reviewed and appropriate system was selected for Iran by nominal group technique. Two comparative studies were conducted to determine the similarities and differences between Iran and the selected community. PRAMS method and system were adapted based on the results of the comparative studies and experts opinions. The study tool was adapted. A field trial was conducted to assess adapted PRAMS feasibility based on TELOS (technical, economic, legal, operational, and schedule) model in the city of Shahriar, located in the west of Tehran, and to compare data collection methods. Then, based on the results and consultation with related executive managers, the final model of PRAMS was suggested for Iranian health system. Results Review of the surveillance systems in pregnancy, identified six models. The results of the nominal group technique showed that, the appropriate model for Iran is PRAMS. Based on the comparative studies and expert opinions, the appropriate system and method for program was as follows: the sampling frame was composed of data in thyroid screening forms and hospital records, the sampling method was systematic, data collection methods were home and phone based surveys, and participants were women within 2 to 6 months postpartum who had a live or still birth. The study tool was adapted. Thirty-seven health volunteers collected the data in this study (technical feasibility). Any home based completed questionnaire cost 2.45 and a phone cost 1.89 USD. Many indices were achieved from the study, which were worth much more than the expenses (economic feasibility). The project was consistent with legal requirements

  17. VOLTTRON-Based System for Providing Ancillary Services with Residential Building Loads

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Xin

    2016-07-01

    Ancillary services entail controlled modulation of building equipment to maintain a stable balance of generation and load in the power system. Ancillary services include frequency regulation and contingency reserves, whose acting time ranges from several seconds to several minutes. Many pilot studies have been implemented to use industrial loads to provide ancillary services, and some have explored services from commercial building loads or electric vehicle charging loads. Residential loads, such as space conditioning and water heating, represent a largely untapped resource for providing ancillary services. The residential building sector accounts for a significant fraction of the total electricity use in the United States. Many loads in residential buildings are flexible and could potentially be curtailed or shifted at the request of the grid. However, there are many barriers that prevent residential loads being widely used for ancillary services. One of the major technical barriers is the lack of communication capabilities between end-use devices and the grid. End-use devices need to be able to receive the automatic generation control (AGC) signal from the grid operator and supply certain types of telemetry to verify response. With the advance of consumer electronics, communication-enabled, or 'connected,' residential equipment has emerged to overcome the communication barrier. However, these end-use devices have introduced a new interoperability challenge due to the existence of numerous standards and communication protocols among different end devices. In this paper, we present a VOLTTRON-based system that overcomes these technical challenges and provides ancillary services with residential loads. VOLTTRON is an open-source control and sensing platform for building energy management, facilitating interoperability solutions for end devices. We have developed drivers to communicate and control different types of end devices through standard

  18. Contracting private sector providers for public sector health services in Jalisco, Mexico: perspectives of system actors

    Directory of Open Access Journals (Sweden)

    González Luz

    2009-10-01

    Full Text Available Abstract Introduction Contracting out health services is a strategy that many health systems in the developing world are following, despite the lack of decisive evidence that this is the best way to improve quality, increase efficiency and expand coverage. A large body of literature has appeared in recent years focusing on the results of several contracting strategies, but very few papers have addressed aspects of the managerial process and how this can affect results. Case description This paper describes and analyses the perceptions and opinions of managers and workers about the benefits and challenges of the contracting model that has been in place for almost 10 years in the State of Jalisco, Mexico. Both qualitative and quantitative information was collected. An open-ended questionnaire was used to obtain information from a group of managers, while information provided by a self-selected group of workers was collected via a closed-ended questionnaire. The analysis contrasted the information obtained from each source. Discussion and Evaluation Findings show that perceptions of managers and workers vary for most of the items studied. For managers the model has been a success, as it has allowed for expansion of coverage based on a cost-effective strategy, while for workers the model also possesses positive elements but fails to provide fair labour relationships, which negatively affects their performance. Conclusion Perspectives of the two main groups of actors in Jalisco's contracting model are important in the design and adjustment of an adequate contracting model that includes managerial elements to give incentives to worker performance, a key element necessary to achieve the model's ultimate objectives. Lessons learnt from this study could be relevant for the experience of contracting models in other developing countries.

  19. Curriculum providing cognitive knowledge and problem-solving skills for anesthesia systems-based practice.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2010-12-01

    Residency programs accredited by the ACGME are required to teach core competencies, including systems-based practice (SBP). Projects are important for satisfying this competency, but the level of knowledge and problem-solving skills required presupposes a basic understanding of the field. The responsibilities of anesthesiologists include the coordination of patient flow in the surgical suite. Familiarity with this topic is crucial for many improvement projects. A course in operations research for surgical services was originally developed for hospital administration students. It satisfies 2 of the Institute of Medicine's core competencies for health professionals: evidence-based practice and work in interdisciplinary teams. The course lasts 3.5 days (eg, 2 weekends) and consists of 45 cognitive objectives taught using 7 published articles, 10 lectures, and 156 computer-assisted problem-solving exercises based on 17 case studies. We tested the hypothesis that the cognitive objectives of the curriculum provide the knowledge and problem-solving skills necessary to perform projects that satisfy the SBP competency. Standardized terminology was used to define each component of the SBP competency for the minimum level of knowledge needed. The 8 components of the competency were examined independently. Most cognitive objectives contributed to at least 4 of the 8 core components of the SBP competency. Each component of SBP is addressed at the minimum requirement level of exemplify by at least 6 objectives. There is at least 1 cognitive objective at the level of summarize for each SBP component. A curriculum in operating room management can provide the knowledge and problem-solving skills anesthesiologists need for participation in projects that satisfy the SBP competency.

  20. Performance evaluation of hospitals that provide care in the public health system, Brazil.

    Science.gov (United States)

    Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

    2015-01-01

    OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

  1. Performance evaluation of hospitals that provide care in the public health system, Brazil

    Directory of Open Access Journals (Sweden)

    Marcelo Cristiano de Azevedo Ramos

    2015-01-01

    Full Text Available OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities, 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

  2. Mediated interruptions of anaesthesia providers using predictions of workload from anaesthesia information management system data.

    Science.gov (United States)

    Epstein, R H; Dexter, F

    2012-09-01

    Perioperative interruptions generated electronically from anaesthesia information management systems (AIMS) can provide useful feedback, but may adversely affect task performance if distractions occur at inopportune moments. Ideally such interruptions would occur only at times when their impact would be minimal. In this study of AIMS data, we evaluated the times of comments, drugs, fluids and periodic assessments (e.g. electrocardiogram diagnosis and train-of-four) to develop recommendations for the timing of interruptions during the intraoperative period. The 39,707 cases studied were divided into intervals between: 1) enter operating room; 2) induction; 3) intubation; 4) surgical incision; and 5) end surgery. Five-minute intervals of no documentation were determined for each case. The offsets from the start of each interval when >50% of ongoing cases had completed initial documentation were calculated (MIN50). The primary endpoint for each interval was the percentage of all cases still ongoing at MIN50. Results were that the intervals from entering the operating room to induction and from induction to intubation were unsuitable for interruptions confirming prior observational studies of anaesthesia workload. At least 13 minutes after surgical incision was the most suitable time for interruptions with 92% of cases still ongoing. Timing was minimally affected by the type of anaesthesia, surgical facility, surgical service, prone positioning or scheduled case duration. The implication of our results is that for mediated interruptions, waiting at least 13 minutes after the start of surgery is appropriate. Although we used AIMS data, operating room information system data is also suitable.

  3. 44 CFR 65.14 - Remapping of areas for which local flood protection systems no longer provide base flood protection.

    Science.gov (United States)

    2010-10-01

    ... local flood protection systems no longer provide base flood protection. 65.14 Section 65.14 Emergency... § 65.14 Remapping of areas for which local flood protection systems no longer provide base flood... process of restoring a flood protection system that was: (i) Constructed using Federal funds; (ii...

  4. Robotics and telecommunication systems to provide better access to ultrasound expertise in the OR.

    Science.gov (United States)

    Angelini, L; Papaspyropoulos, V

    2000-01-01

    Surgery has begun to evolve as a result of the intense use of technological innovations. The result of this is better services for patients and enormous opportunities for the producers of biomedical instruments. The surgeon and the technologist are fast becoming allies in applying the latest developments of robotics, image treatment, simulation, sensors and telecommunications to surgery, in particular to the emerging field of minimally-invasive surgery. Ultrasonography is at present utilised both for diagnostic and therapeutic purposes in various fields. Intraoperative US examination can be of primary importance, especially when dealing with space-occupying lesions. The widening use of minimally-invasive surgery has furthered the development of US for use during this type of surgery. The success of a US examination requires not only a correct execution of the procedure, but also a correct interpretation of the images. We describe two projects that combine robotics and telecommunication systems to provide better access to US expertise in the operating room. The Midstep project has as its object the realisation of two robotic arms, one for the distant control of the US probe during laparoscopic surgery and the second to perform tele-interventional US. The second project, part of the Strategic CNR Project-'Robotics in Surgery', involves the realisation of a common platform for tracking and targeting surgical instruments in video-assisted surgery.

  5. Conception and realization of a PV system provided with a sun tracker operating at dual axis

    Directory of Open Access Journals (Sweden)

    Khalil Kassmi

    2016-06-01

    Full Text Available In this paper, we present the conception, the realization and the experimentation of  a photovoltaic (PV system provided with a sun tracker reliable and low cost operating at dual axis. The tracker's role is to orient the PV generator, whose weight may reach 9 Kg, perpendicular to the sun with very good accuracy. This tracking  based on the use of four LDR sensors, which detect the intensity of light scattered by the sun a processing unit, from  command and control (UTCC, which manages all of the sun tracking tasks (the end detection of parcours, regulation of the power supplied by the PV panels (Command MPPT, ... . The results obtained show a significant improvement of the energy produced, compared to conventional PV installations where generators are fixed and oriented south at a  tilt 45°. During a day of operation, improvement could reach 41% and consumption of the tracking does not exceed 0.55% of the energy production produced by the PV generator (an improvement of 5 % compared to existing trackers.

  6. Overproduction of alpha chains provides a proton-insensitive component to the bluefish hemoglobin system.

    Science.gov (United States)

    Bonaventura, Celia; Godette, Gerald; Stevens, Robert; Brenowitz, Michael; Henkens, Robert

    2005-12-09

    Expression of alpha and beta chains and their post-translational assembly into alpha(2)beta(2) tetramers is fundamental to the formation and function of most vertebrate hemoglobins. There is a strong evolutionary bias that favors expression of equal amounts of the two types of chains, because cooperativity, pH sensitivity, and anionic control of function occurs only for the alpha(2)beta(2) tetramers. Remarkably, an over-production of alpha chains, as in the pathological condition known as beta thalassemia in humans, is adaptive rather than pathological in the bluefish hemoglobin system. The thalassemia of the bluefish is a novel means of providing for oxygen uptake and delivery when low pH conditions incapacitate the highly pH-sensitive Root effect hemoglobins of the fish. Although fish often have pH-insensitive along with highly pH-sensitive hemoglobins, having pH-insensitive alpha chain monomers in circulation is an unusual structural variation. The role of bluefish alpha chains in oxygen transport is enabled by their remarkably lower oxygen affinity relative to human alpha chains. This is the first reported case of a thalassemic condition that is maintained in a species as an adaptive advantage.

  7. The rare and undiagnosed diseases diagnostic service - application of massively parallel sequencing in a state-wide clinical service.

    Science.gov (United States)

    Baynam, Gareth; Pachter, Nicholas; McKenzie, Fiona; Townshend, Sharon; Slee, Jennie; Kiraly-Borri, Cathy; Vasudevan, Anand; Hawkins, Anne; Broley, Stephanie; Schofield, Lyn; Verhoef, Hedwig; Walker, Caroline E; Molster, Caron; Blackwell, Jenefer M; Jamieson, Sarra; Tang, Dave; Lassmann, Timo; Mina, Kym; Beilby, John; Davis, Mark; Laing, Nigel; Murphy, Lesley; Weeramanthri, Tarun; Dawkins, Hugh; Goldblatt, Jack

    2016-06-11

    The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services delivered through Genetic Services of Western Australia (GSWA). GSWA has provided a state-wide service for clinical genetic care for 28 years and it serves a population of 2.5 million people across a geographical area of 2.5milion Km(2). Within this context, GSWA has established a clinically integrated genomic diagnostic platform in partnership with other public health system managers and service providers, including but not limited to the Office of Population Health Genomics, Diagnostic Genomics (PathWest Laboratories) and with executive level support from the Department of Health. Herein we describe report presents the components of this service that are most relevant to the heterogeneity of paediatric clinical genetic care. Briefly the platform : i) offers multiple options including non-genetic testing; monogenic and genomic (targeted in silico filtered and whole exome) analysis; and matchmaking; ii) is delivered in a patient-centric manner that is resonant with the patient journey, it has multiple points for entry, exit and re-entry to allow people access to information they can use, when they want to receive it; iii) is synchronous with precision phenotyping methods; iv) captures new knowledge, including multiple expert review; v) is integrated with current translational genomic research activities and best practice; and vi) is designed for flexibility for interactive generation of, and integration with, clinical research for diagnostics, community engagement, policy and models of care. The RUDDS has been established as part of routine clinical genetic services and is thus sustainable, equitably managed and seeks to translate new knowledge into efficient diagnostics and improved health for the whole community.

  8. New Mexico statewide geothermal energy program. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Icerman, L.; Parker, S.K. (ed.)

    1988-04-01

    This report summarizes the results of geothermal energy resource assessment work conducted by the New Mexico Statewide Geothermal Energy Program during the period September 7, 1984, through February 29, 1988, under the sponsorship of the US Dept. of Energy and the State of New Mexico Research and Development Institute. The research program was administered by the New Mexico Research and Development Institute and was conducted by professional staff members at New Mexico State University and Lightning Dock Geothermal, Inc. The report is divided into four chapters, which correspond to the principal tasks delineated in the above grant. This work extends the knowledge of the geothermal energy resource base in southern New Mexico with the potential for commercial applications.

  9. 47 CFR 76.1503 - Carriage of video programming providers on open video systems.

    Science.gov (United States)

    2010-10-01

    ... service showing that the Notice of Intent has been served on all local cable franchising authorities... video programming provider within five business days of receiving a written request from the provider...

  10. System to provide 3D information on geological anomaly zone in deep subsea

    Science.gov (United States)

    Kim, W.; Kwon, O.; Kim, D.

    2017-12-01

    The study on building the ultra long and deep subsea tunnel of which length is 50km and depth is 200m at least, respectively, is underway in Korea. To analyze the geotechnical information required for designing and building subsea tunnel, topographic/geologiccal information analysis using 2D seabed geophysical prospecting and topographic, geologic, exploration and boring data were analyzed comprehensively and as a result, automation method to identify the geological structure zone under seabed which is needed to design the deep and long seabed tunnel was developed using geostatistical analysis. In addition, software using 3D visualized ground information to provide the information includes Gocad, MVS, Vulcan and DIMINE. This study is intended to analyze the geological anomaly zone for ultra deep seabed l and visualize the geological investigation result so as to develop the exclusive system for processing the ground investigation information which is convenient for the users. Particularly it's compatible depending on file of geophysical prospecting result and is realizable in Layer form and for 3D view as well. The data to be processed by 3D seabed information system includes (1) deep seabed topographic information, (2) geological anomaly zone, (3) geophysical prospecting, (4) boring investigation result and (5) 3D visualization of the section on seabed tunnel route. Each data has own characteristics depending on data and interface to allow interlocking with other data is granted. In each detail function, input data is displayed in a single space and each element is selectable to identify the further information as a project. Program creates the project when initially implemented and all output from detail information is stored by project unit. Each element representing detail information is stored in image file and is supported to store in text file as well. It also has the function to transfer, expand/reduce and rotate the model. To represent the all elements in

  11. Implementing Statewide Severe Maternal Morbidity Review: The Illinois Experience.

    Science.gov (United States)

    Koch, Abigail R; Roesch, Pamela T; Garland, Caitlin E; Geller, Stacie E

    2018-03-07

    Severe maternal morbidity (SMM) rates in the United States more than doubled between 1998 and 2010. Advanced maternal age and chronic comorbidities do not completely explain the increase in SMM or how to effectively address it. The Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists have called for facility-level multidisciplinary review of SMM for potential preventability and have issued implementation guidelines. Within Illinois, SMM was identified as any intensive or critical care unit admission and/or 4 or more units of packed red blood cells transfused at any time from conception through 42 days postpartum. All cases meeting this definition were counted during statewide surveillance. Cases were selected for review on the basis of their potential to yield insights into factors contributing to preventable SMM or best practices preventing further morbidity or death. If the SMM review committee deemed a case potentially preventable, it identified specific factors associated with missed opportunities and made actionable recommendations for quality improvement. Approximately 1100 cases of SMM were identified from July 1, 2016, to June 30, 2017, yielding a rate of 76 SMM cases per 10 000 pregnancies. Reviews were conducted on 142 SMM cases. Most SMM cases occurred during delivery hospitalization and more than half were delivered by cesarean section. Hemorrhage was the primary cause of SMM (>50% of the cases). Facility-level SMM review was feasible and acceptable in statewide implementation. States that are planning SMM reviews across obstetric facilities should permit ample time for translation of recommendations to practice. Although continued maternal mortality reviews are valuable, they are not sufficient to address the increasing rates of SMM and maternal death. In-depth multidisciplinary review offers the potential to identify factors associated with SMM and interventions to prevent women from moving along the

  12. Beyond compliance using environmental, health and safety management information systems (EMISs) to provide quantified competitive advantages

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, J.V.; Mayer, G.

    1999-07-01

    In the last 20 years, federal, state and local regulations have provided regulatory incentives for industry to better manage environmental, health and safety (EHS) practices. In order for voluntary EHS management practices to move beyond compliance and continue improving, specific, quantifiable benefits must result. That is, companies must achieve some competitive advantage from implementing EHS improvements that are considered voluntary. Recently, many private companies and public agencies have been giving significant consideration toward the implementation of an EHS management information system (EMIS). Currently considered voluntary, the automation of EHS data collection, storage, retrieval and reporting is subject to the same benefit expectations that other EHS improvements are subject to. The benefits resulting from an EMIS typically result from a reduction in either direct or indirect costs. Direct costs, consisting primarily of labor hours, permit fees, disposal costs, etc., are definable and easily to quantify. Indirect costs, which are comprised of reduced risks and liabilities, are less easily quantifiable. In fact, many have abandoned hope of ever quantifying expected benefits from indirect costs, and simply lump all indirect benefits into a qualitative, catch-all category called intangible benefits. However, by statistically analyzing individual risk events over an expected project life, anticipated benefits can be objectively and accurately quantified. Through the use of a case study, this paper will describe the process of quantifying direct and indirect benefits resulting from the implementation of an EMIS. The paper will describe the application of a statistical model to estimate indirect benefits and will demonstrate how the results of the benefit quantification can be used to make sound, business based decisions based on a required rate of return/return on investment.

  13. An Information System for Brownfield Regeneration: providing customised information according to stakeholders' characteristics and needs.

    Science.gov (United States)

    Rizzo, Erika; Pizzol, Lisa; Zabeo, Alex; Giubilato, Elisa; Critto, Andrea; Cosmo, Luca; Marcomini, Antonio

    2018-07-01

    In the EU brownfield presence is still considered a widespread problem. Even though, in the last decades, many research projects and initiatives developed a wealth of methods, guidelines, tools and technologies aimed at supporting brownfield regeneration. However, this variety of products had and still has a limited practical impact on brownfield revitalisation success, because they are not used in their entire potential due to their scarce visibility. Also, another problem that stakeholders face is finding customised information. To overcome this non-visibility and not-sufficient customisation of information, the Information System for Brownfield Regeneration (ISBR) has been developed, based on Artificial Neural Networks, which allows understanding stakeholders' information needs by providing tailored information. The ISBR has been tested by stakeholders from the EU project TIMBRE case studies, located in the Czech Republic, Germany, Poland and Romania. Data gained during tests allowed to understand stakeholders' information needs. Overall, stakeholders showed to be concerned first on remediation aspects, then on benchmarking information, which are valuable to improve practices in the complex field of brownfield regeneration, and then on the relatively new issue of sustainability applied to brownfield regeneration and remediation. Mature markets confirmed their interest for remediation-related aspects, highlighting the central role that risk assessment plays in the process. Emerging markets showed to seek information and tools for strategic and planning issues, like brownfield inventories and georeferenced data sets. Results led to conclude that a new improved platform, combining the ISBR functionalities with geo-referenced ones, would be useful and could represent a further research application. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study.

    Science.gov (United States)

    Hu, Zhongkai; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

    2015-01-13

    An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine's Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple "anchoring" demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a

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

    DEFF Research Database (Denmark)

    Bašić, Hrvoje; Dragicevic, Tomislav; Pandžić, Hrvoje

    2017-01-01

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

  16. Study of the tomographic image quality provided by a conical beam system kilo voltage

    International Nuclear Information System (INIS)

    Garayoa Roca, J.; Castro Tejero, P.

    2011-01-01

    Imaging systems play an increasingly important role in radiotherapy, and to ensure the quality of the process, you must know the characteristics and limitations of available imaging systems. In this study we sought to evaluate the image quality of an IGRT system based on a kilo voltage cone beam.

  17. Renaissance: A revolutionary approach for providing low-cost ground data systems

    Science.gov (United States)

    Butler, Madeline J.; Perkins, Dorothy C.; Zeigenfuss, Lawrence B.

    1996-01-01

    The NASA is changing its attention from large missions to a greater number of smaller missions with reduced development schedules and budgets. In relation to this, the Renaissance Mission Operations and Data Systems Directorate systems engineering process is presented. The aim of the Renaissance approach is to improve system performance, reduce cost and schedules and meet specific customer needs. The approach includes: the early involvement of the users to define the mission requirements and system architectures; the streamlining of management processes; the development of a flexible cost estimation capability, and the ability to insert technology. Renaissance-based systems demonstrate significant reuse of commercial off-the-shelf building blocks in an integrated system architecture.

  18. Technical needs and research opportunities provided by projected aeronautical and space systems

    Science.gov (United States)

    Noor, Ahmed K.

    1992-01-01

    The overall goal of the present task is to identify the enabling and supporting technologies for projected aeronautical and space systems. A detailed examination was made of the technical needs in the structures, dynamics and materials areas required for the realization of these systems. Also, the level of integration required with other disciplines was identified. The aeronautical systems considered cover the broad spectrum of rotorcraft; subsonic, supersonic and hypersonic aircraft; extremely high-altitude aircraft; and transatmospheric vehicles. The space systems considered include space transportation systems; spacecrafts for near-earth observation; spacecrafts for planetary and solar exploration; and large space systems. A monograph is being compiled which summarizes the results of this study. The different chapters of the monograph are being written by leading experts from governmental laboratories, industry and universities.

  19. Providing Power Supply to Other Use Cases Integrated in the System of Public Lighting

    OpenAIRE

    Perko, Jurica; Topić, Danijel; Šljivac, Damir

    2017-01-01

    Smart city is an attractive way of making the city more livable through intelligent solutions that are enabled by information and communication technology. Regarding the lighting system, it achieves the perfect balance between beautiful city ambience and preserving the darkness that makes cities more livable. As a smart city component, a public lighting system offers much more than light itself. Integration of other use cases has given a new dimension to the public lighting system in visual a...

  20. 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); Gagnon, Pieter J [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.

  1. General Fund Enterprise Business System Did Not Provide Required Financial Information

    Science.gov (United States)

    2012-03-26

    Management of the General Fund Enterprise Business System,” January 14, 2008 Army AAA Report No. A-2010-0187- FFM , “General Fund Enterprise Business System...A-2009-0232- FFM , “General Fund Enterprise Business System – Federal Financial Management Improvement Act Compliance, Examination of Releases...1.4.1, 1.4.2, 1.4.3, and 1.4.4 Requirements,” September 30, 2009 AAA Report No. A-2009-0231- FFM , “General Fund Enterprise Business System – Federal

  2. Provider Payment Trends and Methods in the Massachusetts Health Care System

    OpenAIRE

    Allison Barrett; Timothy Lake

    2010-01-01

    This report investigates provider payment methods in Massachusetts. Payments include fee-for-service, the predominant model; global payments, which pay providers a single fee for all or most required services during a contract period; and pay-for-performance models, which layer quality incentives onto payments.

  3. Substance abuse treatment management information systems: balancing federal, state, and service provider needs.

    Science.gov (United States)

    Camp, J M; Krakow, M; McCarty, D; Argeriou, M

    1992-01-01

    There is increased interest in documenting the characteristics and treatment outcomes of clients served with Alcohol, Drug Abuse, and Mental Health Block Grant funds. The evolution of federal client-based management systems for substance abuse treatment services demonstrates that data collection systems are important but require continued support. A review of the Massachusetts substance abuse management information system illustrates the utility of a client-based data set. The development and implementation of a comprehensive information system require overcoming organizational barriers and project delays, fostering collaborative efforts among staff from diverse agencies, and employing considerable resources. In addition, the need to develop mechanisms for increasing the reliability of the data and ongoing training for the users is presented. Finally, three applications of the management information system's role in shaping policy are reviewed: developing services for special populations (communities of color, women, and pregnant substance abusers, and injection drug users), utilizing MIS data for evaluation purposes, and determining funding allocations.

  4. NASA's Robotics Mining Competition Provides Undergraduates Full Life Cycle Systems Engineering Experience

    Science.gov (United States)

    Stecklein, Jonette

    2017-01-01

    NASA has held an annual robotic mining competition for teams of university/college students since 2010. This competition is yearlong, suitable for a senior university engineering capstone project. It encompasses the full project life cycle from ideation of a robot design to actual tele-operation of the robot in simulated Mars conditions mining and collecting simulated regolith. A major required element for this competition is a Systems Engineering Paper in which each team describes the systems engineering approaches used on their project. The score for the Systems Engineering Paper contributes 25% towards the team's score for the competition's grand prize. The required use of systems engineering on the project by this competition introduces the students to an intense practical application of systems engineering throughout a full project life cycle.

  5. Provide a model to improve the performance of intrusion detection systems in the cloud

    OpenAIRE

    Foroogh Sedighi

    2016-01-01

    High availability of tools and service providers in cloud computing and the fact that cloud computing services are provided by internet and deal with public, have caused important challenges for new computing model. Cloud computing faces problems and challenges such as user privacy, data security, data ownership, availability of services, and recovery after breaking down, performance, scalability, programmability. So far, many different methods are presented for detection of intrusion in clou...

  6. NASA's Functional Task Test: Providing Information for an Integrated Countermeasure System

    Science.gov (United States)

    Bloomberg, J. J.; Feiveson, A. H.; Laurie, S. S.; Lee, S. M. C.; Mulavara, A. P.; Peters, B. T.; Platts, S. H.; Ploutz-Snyder, L. L.; Reschke, M. F.; Ryder, J. W.; hide

    2015-01-01

    Exposure to the microgravity conditions of spaceflight causes astronauts to experience alterations in multiple physiological systems. These physiological changes include sensorimotor disturbances, cardiovascular deconditioning, and loss of muscle mass and strength. Some or all of these changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on a planetary surface. The goals of the Functional Task Test (FTT) study were to determine the effects of spaceflight on functional tests that are representative of critical exploration mission tasks and to identify the key physiological factors that contribute to decrements in performance. The FTT was comprised of seven functional tests and a corresponding set of interdisciplinary physiological measures targeting the sensorimotor, cardiovascular and muscular changes associated with exposure to spaceflight. Both Shuttle and ISS crewmembers participated in this study. Additionally, we conducted a supporting study using the FTT protocol on subjects before and after 70 days of 6? head-down bed rest. The bed rest analog allowed us to investigate the impact of body unloading in isolation on both functional tasks and on the underlying physiological factors that lead to decrements in performance, and then to compare them with the results obtained in our spaceflight study. Spaceflight data were collected on three sessions before flight, on landing day (Shuttle only) and 1, 6 and 30 days after landing. Bed rest subjects were tested three times before bed rest and immediately after getting up from bed rest as well as 1, 6, and 12 days after reambulation. We have shown that for Shuttle, ISS and bed rest subjects, functional tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for

  7. Development of a statewide motorcycle safety plan for Texas : technical report.

    Science.gov (United States)

    2013-02-01

    The objective of this research project was to develop a statewide plan to reduce motorcycle crashes and : injuries in the state of Texas. The project included a review of published literature on current and proposed : countermeasures for reducing the...

  8. An open-loop, physiologic model-based decision support system can provide appropriate ventilator settings

    DEFF Research Database (Denmark)

    Karbing, Dan Stieper; Spadaro, Savino; Dey, Nilanjan

    2018-01-01

    OBJECTIVES: To evaluate the physiologic effects of applying advice on mechanical ventilation by an open-loop, physiologic model-based clinical decision support system. DESIGN: Prospective, observational study. SETTING: University and Regional Hospitals' ICUs. PATIENTS: Varied adult ICU population...

  9. 75 FR 25885 - The Merit Systems Protection Board (MSPB) is Providing Notice of the Opportunity to File Amicus...

    Science.gov (United States)

    2010-05-10

    ... MERIT SYSTEMS PROTECTION BOARD The Merit Systems Protection Board (MSPB) is Providing Notice of the Opportunity to File Amicus Briefs in the Matter of Larry L. Evans v. Department of Veterans Affairs, MSPB Docket Number AT-3330-09-0953- I-1. AGENCY: Merit Systems Protection Board. ACTION: Notice...

  10. 75 FR 20007 - The Merit Systems Protection Board (MSPB) Is Providing Notice of the Opportunity To File Amicus...

    Science.gov (United States)

    2010-04-16

    ... MERIT SYSTEMS PROTECTION BOARD The Merit Systems Protection Board (MSPB) Is Providing Notice of the Opportunity To File Amicus Briefs in the Matter of Hyginus U. Aguzie v. Office of Personnel Management, MSPB Docket Number DC-0731- 09-0261-R-1 AGENCY: Merit Systems Protection Board. ACTION: Notice...

  11. 75 FR 6728 - The Merit Systems Protection Board (MSPB) is Providing Notice of the Opportunity to File Amicus...

    Science.gov (United States)

    2010-02-10

    ... MERIT SYSTEMS PROTECTION BOARD The Merit Systems Protection Board (MSPB) is Providing Notice of the Opportunity to File Amicus Briefs in the Matters of Conyers v. Department of Defense, Docket No...: Merit Systems Protection Board. ACTION: Notice. SUMMARY: On January 25, 2010, the MSPB published in the...

  12. METHODS OF PROVIDING NOISE IMMUNITY IN AUTOMOBILE ANTI-THEFT SYSTEM CONTROL

    Directory of Open Access Journals (Sweden)

    Frolov, V.

    2013-06-01

    Full Text Available In modern ani-theft systems they use frequency and phase modulation. Since the width of the signal is limited, it is possible to intercept the signal and then switch off the alarm at the right time.To ensure the noise immunity and secrecy manufacturers use more sophisticated codes using the methods of cryptography. Significant increase in noise immunity in modern ani-theft systems is possible using broadband signals.

  13. Providing data science support for systems pharmacology and its implications to drug discovery.

    Science.gov (United States)

    Hart, Thomas; Xie, Lei

    2016-01-01

    The conventional one-drug-one-target-one-disease drug discovery process has been less successful in tracking multi-genic, multi-faceted complex diseases. Systems pharmacology has emerged as a new discipline to tackle the current challenges in drug discovery. The goal of systems pharmacology is to transform huge, heterogeneous, and dynamic biological and clinical data into interpretable and actionable mechanistic models for decision making in drug discovery and patient treatment. Thus, big data technology and data science will play an essential role in systems pharmacology. This paper critically reviews the impact of three fundamental concepts of data science on systems pharmacology: similarity inference, overfitting avoidance, and disentangling causality from correlation. The authors then discuss recent advances and future directions in applying the three concepts of data science to drug discovery, with a focus on proteome-wide context-specific quantitative drug target deconvolution and personalized adverse drug reaction prediction. Data science will facilitate reducing the complexity of systems pharmacology modeling, detecting hidden correlations between complex data sets, and distinguishing causation from correlation. The power of data science can only be fully realized when integrated with mechanism-based multi-scale modeling that explicitly takes into account the hierarchical organization of biological systems from nucleic acid to proteins, to molecular interaction networks, to cells, to tissues, to patients, and to populations.

  14. Sewer System Management Plan.

    Energy Technology Data Exchange (ETDEWEB)

    Holland, Robert C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-08-01

    A Sewer System Management Plan (SSMP) is required by the State Water Resources Control Board (SWRCB) Order No. 2006-0003-DWQ Statewide General Waste Discharge Requirements (WDR) for Sanitary Sewer Systems (General Permit). DOE, National Nuclear Security Administration (NNSA), Sandia Field Office has filed a Notice of Intent to be covered under this General Permit. The General Permit requires a proactive approach to reduce the number and frequency of sanitary sewer overflows (SSOs) within the State. SSMPs must include provisions to provide proper and efficient management, operation, and maintenance of sanitary sewer systems and must contain a spill response plan.

  15. Mass spectrometer provided with an optical system for separating neutron particles against charged particles

    Energy Technology Data Exchange (ETDEWEB)

    Reeher, J R; Story, M S; Smith, R D

    1977-03-03

    This invention concerns a mass spectrometer with an ion focusing optical system that efficiently separates the charged and neutral particles. It concerns an apparatus that can be used in ionisation areas operating at relatively high pressure (> 10/sup -2/ Torr). The invention relates more particularly to a mass spectrometer with an inlet device for the samples to be identified, a sample ionisation system for forming charged and neutral particles, a mass analyser and an optical system for focusing the ions formed in the mass analyser. The optics include several conducting components of which at least one has sides formed of grids, in the direction of the axis, towards the analyser the optics forming a potential well along the axis. The selected charged particles are focused in the analyser and the remaining particles can escape by the openings in the conducting grids.

  16. Laboratory technical services provides business opportunities for supervisory control and data acquisition systems

    International Nuclear Information System (INIS)

    Ballard, W.

    1994-01-01

    The author presents some additional information about what he considers are some really great opportunities for the business community to participate in developing the greatest scientific project in the history of mankind. Facility Engineering Services is part of Laboratory Technical Services. As part of this group, it has the responsibility to direct the construction of interim facilities, scientific labs, production process, cooling towers, cooling ponds and the operation and control of SSC Laboratory conventional support systems. These operations and controls will be accomplished through the employment of a Supervisory Control and Data Acquisition system (SCADA)

  17. A Systems Engineering Approach in Providing Air Defense Support to Ground Combat Vehicle Maneuver Forces

    Science.gov (United States)

    2015-03-01

    Characteristics ...20 Table 2. Summary of M6 Linebacker, Pantsir S1 and Stormer Characteristics ............22 Table 3. Mapping of Operational Activities...MAD Systems Examples of tracked oblique-launched MAD systems include the M6 Linebacker (converted back to BFV M2A2 ODS since 2005), Stormer , and...Summa1y ofM6 Linebacker, Pantsir S1 and St01mer Characteristics M6 Linebacker Pantsir Sl Stormer Missile StingerRMP 9M335 Starstreak Ran2e (km) 8

  18. Maternal Healthcare Providers in Uttar Pradesh, India: How to Position Informal Practitioners within the System?

    Directory of Open Access Journals (Sweden)

    Chesta Sharma

    2014-12-01

    Full Text Available To understand the knowledge and services of informal providers and to explore their role in addressing the human resource gap in Uttar Pradesh, India, within the context of maternal health.The study is exploratory in nature, conducted in four blocks of four districts of Uttar Pradesh state, India. Semi-structured interviews were conducted with 114 informal providers.More than one-third (38% providers have some formal education and unrecognized degrees. Approximately three-fourths (74% of them have more than 5 years of work experience. They also provide delivery and in-patient services and have basic equipment available. However, they lack essential knowledge about maternal health. They have mixed opinion about their contribution towards maternal health but the only ones available. Therefore, despite lacking requisite knowledge, training and services, they become indispensable due to lack of emergency and timely public health services, and being the only ones existing in the community.Informal sector practitioners are a critical link in reaching out to population for health services in developing countries. As opposed to the general notion, they possess years of formal education, experience, informal trainings along with trust of communities. Thus, it becomes important to accept their presence and manage them to the best of their abilities even for specialized care like maternal health.

  19. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    Science.gov (United States)

    Dixon, Decia Nicole

    2009-01-01

    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  20. Enhancing the functionality of reactor protection systems to provide diagnostic and monitoring information: The ISAT{sup TM} approach

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, J A; Rowe, B J [AEA Technology, Winfrith (United Kingdom); Jones, C D [Nuclear Electric Ltd., Kent (United Kingdom). Dungeness ` B` Power Station

    1997-12-31

    The ISAT{sup TM} architecture has been successfully implemented as the Single Channel Trip System (SCTS), part of the primary protection system of Nuclear Electric`s Dungeness `B` Advanced Gas-Cooled Reactors. The system is the first computer-based protection system licensed on a UK civil nuclear reactor. The system provides protection against single channel faults resulting in high coolant gas outlet temperature. The SCTS was designed to output data at several points in the system to an Ethernet to allow checks to be made on the operation of parts of the protection system and the system as a whole. In order to monitor the performance of this shutdown system a PC based monitoring system was developed to take input as data from the Ethernet, check its integrity and then analyze the data to provide information of the state of the system and subsystems. The SCTS monitor was basically intended to alert the operator to any fault on the safety system and indicate its source, provide a diagnosis of the cause of any trip initiated by the safety system, and log the occurrences of these incidents for later inspection. The intention was also to provide accurate real-time information on the thermocouple readings and to decrease the effort required to maintain the safety system. This paper will describe briefly the development of the ISAT{sup TM} monitoring system: how its requirements were arrived at, and how the design, code and testing were carried out to ensure approval for this application. It will then go on to report how the ISAT{sup TM} monitor has performed during its time in service: how more functionality has been added over and above its original requirements. Features of additional monitors for the SCTS and other ISAT{sup TM} systems will also be described. (author). 2 refs, 5 figs.

  1. Using Case-Based Reasoning to Improve the Quality of Feedback Provided by Automated Grading Systems

    Science.gov (United States)

    Kyrilov, Angelo; Noelle, David C.

    2014-01-01

    Information technology is now ubiquitous in higher education institutions worldwide. More than 85% of American universities use e-learning systems to supplement traditional classroom activities while some have started offering Massive Online Open Courses (MOOCs), which are completely online. An obvious benefit of these online tools is their…

  2. Systems and Methods for Providing Energy to Support Missions in Near Earth Space

    Science.gov (United States)

    Fork, Richard (Inventor)

    2015-01-01

    A system has a plurality of spacecraft in orbit around the earth for collecting energy from the Sun in space, using stimulated emission to configure that energy as well defined states of the optical field and delivering that energy efficiently throughout the region of space surrounding Earth.

  3. Implementation of a portable electronic system for providing pain relief to patellofemoral pain syndrome patients

    Science.gov (United States)

    Chang Chien, Jia-Ren; Lin, Guo-Hong; Hsu, Ar-Tyan

    2011-10-01

    In this study, a portable electromyogram (EMG) system and a stimulator are developed for patellofemoral pain syndrome patients, with the objective of reducing the pain experienced by these patients; the patellar pain is caused by an imbalance between the vastus medialis obliquus (VMO) and the vastus lateralis (VL). The EMG measurement circuit and the electrical stimulation device proposed in this study are specifically designed for the VMO and the VL; they are capable of real-time waveform recording, possess analyzing functions, and can upload their measurement data to a computer for storage and analysis. The system can calculate and record the time difference between the EMGs of the VMO and the VL, as well as the signal strengths of both the EMGs. As soon as the system detects the generation of the EMG of the VL, it quickly calculates and processes the event and stimulates the VMO as feedback through electrical stimulation units, in order to induce its contraction. The system can adjust the signal strength, time length, and the sequence of the electrical stimulation, both manually and automatically. The output waveform of the electrical stimulation circuit is a dual-phase asymmetrical pulse waveform. The primary function of the electrical simulation circuit is to ensure that the muscles contract effectively. The performance of the device can be seen that the width of each pulse is 20-1000 μs, the frequency of each pulse is 10-100 Hz, and current strength is 10-60 mA.

  4. The Nicaraguan farmers’ association PAC: from providing international aid to reorganizing the local production system

    NARCIS (Netherlands)

    G.M. Gómez (Georgina)

    2014-01-01

    textabstractThe benefits of the inclusion of small farmers in the South and their associations in global production networks are still contested. The rules governing the behaviour of actors, decision-making and the distribution of benefits form a system of governance that actors build in relation to

  5. MODELING QUEUING SYSTEM OF INTERACTION BETWEEN TERMINAL DEVICES AND SERVICES PROVIDERS IN THE BANK

    Directory of Open Access Journals (Sweden)

    Ivan A. Mnatsakanyan

    2014-01-01

    Full Text Available The article focuses on the development of mathematical models and tools to optimize the system of queuing at the bank. The article discusses the mathematical aspects that will achieve redistribution of transaction flow, reduce the time of the request in the queue, increase the bank’s profit and gain competitive advantage.

  6. NMR system and method having a permanent magnet providing a rotating magnetic field

    Science.gov (United States)

    Schlueter, Ross D [Berkeley, CA; Budinger, Thomas F [Berkeley, CA

    2009-05-19

    Disclosed herein are systems and methods for generating a rotating magnetic field. The rotating magnetic field can be used to obtain rotating-field NMR spectra, such as magic angle spinning spectra, without having to physically rotate the sample. This result allows magic angle spinning NMR to be conducted on biological samples such as live animals, including humans.

  7. Modular Biopower System Providing Combined Heat and Power for DoD Installations

    Science.gov (United States)

    2013-12-01

    industry surged with new exploration and tertiary recovery techniques ( fracking and so forth). In the first quarter of 2012, we received permission to...itself on demand, with its hydraulically operated moving floor using system generated power. We required a bit less than two woodchip deliveries per

  8. Toward a new payment system for inpatient rehabilitation. Part II: Reimbursing providers.

    Science.gov (United States)

    Saitto, Carlo; Marino, Claudia; Fusco, Danilo; Arcà, Massimo; Perucci, Carlo A

    2005-09-01

    The major fault with existing reimbursement systems lies in their failure to discriminate for the effectiveness of stay, both when paying per day and when paying per episode of treatment. We sought to define an average length of effective stay and recovery trends by impairment category, to design a prospective payment system that takes into account costs and expected recovery trends, and to compare the calculated reimbursement with the predicted costs estimated in a previous study (Saitto C, Marino C, Fusco D, et al. A new prospective payment system for inpatient rehabilitation. Part I: predicting resource consumption. Med Care. 2005;43:844-855). We considered all rehabilitation admissions from 5 Italian inpatient facilities during a 12-month period for which total cost of care had already been estimated and daily cost predicted through regression model. We ascertained recovery trends by impairment category through repeated MDS-PAC schedules and factorial analysis of functional status. We defined effective stay and daily resource consumption by impairment category and used these parameters to calculate reimbursement for the admission. We compared our reimbursement with predicted cost through regression analysis and evaluated the goodness of fit through residual analysis. We calculated reimbursement for 2079 admissions. The r(2) values for the reimbursement to cost correlation ranged from 0.54 in the whole population to 0.56 for "multiple trauma" to 0.85 for "other medical disorders." The best fit was found in the central quintiles of the cost and severity distributions. For each impairment category, we determined the number of days of effective hospital stay and the trends of functional gain. We demonstrated, at least within the Italian health care system, the feasibility of a reimbursement system that matches costs with functional recovery. By linking reimbursement to effective stay adjusted for trends of functional gain, we suggest it is possible to avoid both

  9. Manchester Coding Option for SpaceWire: Providing Choices for System Level Design

    Science.gov (United States)

    Rakow, Glenn; Kisin, Alex

    2014-01-01

    This paper proposes an optional coding scheme for SpaceWire in lieu of the current Data Strobe scheme for three reasons. First reason is to provide a straightforward method for electrical isolation of the interface; secondly to provide ability to reduce the mass and bend radius of the SpaceWire cable; and thirdly to provide a means for a common physical layer over which multiple spacecraft onboard data link protocols could operate for a wide range of data rates. The intent is to accomplish these goals without significant change to existing SpaceWire design investments. The ability to optionally use Manchester coding in place of the current Data Strobe coding provides the ability to DC balanced the signal transitions unlike the SpaceWire Data Strobe coding; and therefore the ability to isolate the electrical interface without concern. Additionally, because the Manchester code has the clock and data encoded on the same signal, the number of wires of the existing SpaceWire cable could be optionally reduced by 50. This reduction could be an important consideration for many users of SpaceWire as indicated by the already existing effort underway by the SpaceWire working group to reduce the cable mass and bend radius by elimination of shields. However, reducing the signal count by half would provide even greater gains. It is proposed to restrict the data rate for the optional Manchester coding to a fixed data rate of 10 Megabits per second (Mbps) in order to make the necessary changes simple and still able to run in current radiation tolerant Field Programmable Gate Arrays (FPGAs). Even with this constraint, 10 Mbps will meet many applications where SpaceWire is used. These include command and control applications and many instruments applications with have moderate data rate. For most NASA flight implementations, SpaceWire designs are in rad-tolerant FPGAs, and the desire to preserve the heritage design investment is important for cost and risk considerations. The

  10. JSBML 1.0: providing a smorgasbord of options to encode systems biology models

    DEFF Research Database (Denmark)

    Rodriguez, Nicolas; Thomas, Alex; Watanabe, Leandro

    2015-01-01

    JSBML, the official pure Java programming library for the Systems Biology Markup Language (SBML) format, has evolved with the advent of different modeling formalisms in systems biology and their ability to be exchanged and represented via extensions of SBML. JSBML has matured into a major, active...... open-source project with contributions from a growing, international team of developers who not only maintain compatibility with SBML, but also drive steady improvements to the Java interface and promote ease-of-use with end users. Source code, binaries and documentation for JSBML can be freely...... obtained under the terms of the LGPL 2.1 from the website http://sbml.org/Software/JSBML. More information about JSBML can be found in the user guide at http://sbml.org/Software/JSBML/docs/. jsbml-development@googlegroups.com or andraeger@eng.ucsd.edu Supplementary data are available at Bioinformatics...

  11. The use of processes evaporation and condensation to provide a suitable operating environment of systems

    Energy Technology Data Exchange (ETDEWEB)

    Kolková, Zuzana, E-mail: zuzana.kolkova@rc.uniza.sk [University of Žilina, Research centre, Univerzitná 8215/1, 010 26 Žilina (Slovakia); Holubčík, Michal, E-mail: michal.holubcik@fstroj.uniza.sk; Malcho, Milan, E-mail: milan.malcho@fstroj.uniza.sk [University of Žilina, Faculty of Mechanical Engineering, Department of Power Engineering, Univerzitná 8215/1, 010 26 Žilina (Slovakia)

    2016-06-30

    All electronic components which exhibit electrical conductor resistance, generates heat when electricity is passed (Joule - Lenz’s Law). The generated heat is necessary to take into surrounding environment. To reduce the operating temperature of electronic components are used various types of cooling in electronic devices. The released heat is removed from the outside of the device in several ways, either alone or in combination. Intensification of cooling electronic components is in the use of heat transfer through phase changes. From the structural point of view it is important to create a cooling system which would be able to drain the waste heat converter for each mode of operation device. Another important criterion is the reliability of the cooling, and it is appropriate to choose cooling system, which would not contain moving elements. In this article, the issue tackled by the phase change in the heat pipe.

  12. Programming with models: modularity and abstraction provide powerful capabilities for systems biology.

    Science.gov (United States)

    Mallavarapu, Aneil; Thomson, Matthew; Ullian, Benjamin; Gunawardena, Jeremy

    2009-03-06

    Mathematical models are increasingly used to understand how phenotypes emerge from systems of molecular interactions. However, their current construction as monolithic sets of equations presents a fundamental barrier to progress. Overcoming this requires modularity, enabling sub-systems to be specified independently and combined incrementally, and abstraction, enabling generic properties of biological processes to be specified independently of specific instances. These, in turn, require models to be represented as programs rather than as datatypes. Programmable modularity and abstraction enables libraries of modules to be created, which can be instantiated and reused repeatedly in different contexts with different components. We have developed a computational infrastructure that accomplishes this. We show here why such capabilities are needed, what is required to implement them and what can be accomplished with them that could not be done previously.

  13. The use of processes evaporation and condensation to provide a suitable operating environment of systems

    Science.gov (United States)

    Kolková, Zuzana; Holubčík, Michal; Malcho, Milan

    2016-06-01

    All electronic components which exhibit electrical conductor resistance, generates heat when electricity is passed (Joule - Lenz's Law). The generated heat is necessary to take into surrounding environment. To reduce the operating temperature of electronic components are used various types of cooling in electronic devices. The released heat is removed from the outside of the device in several ways, either alone or in combination. Intensification of cooling electronic components is in the use of heat transfer through phase changes. From the structural point of view it is important to create a cooling system which would be able to drain the waste heat converter for each mode of operation device. Another important criterion is the reliability of the cooling, and it is appropriate to choose cooling system, which would not contain moving elements. In this article, the issue tackled by the phase change in the heat pipe.

  14. A Lightweight AV System for Providing a Faithful and Spatially Manipulable Visual Hand Representation

    OpenAIRE

    Pusch , Andreas; Martin , Olivier; Coquillart , Sabine

    2011-01-01

    Session: Developing new tools and technologies - Abstracts to be published in a regular issue of the journal Cyberpsychology, Behavior and Social Networking (indexed in MedLine and PsychInfo): http://online.liebertpub.com/loi/CYBER; International audience; This paper introduces the technical foundations of a system designed to embed a lightweight, faithful and spatially manipulable representation of the user's hand into an otherwise virtual world (aka Augmented Virtuality, AV). A highly intui...

  15. System and Method for Providing Web-Based Remote Application Service

    OpenAIRE

    Shuen-Tai Wang; Yu-Ching Lin; Hsi-Ya Chang

    2017-01-01

    With the development of virtualization technologies, a new type of service named cloud computing service is produced. Cloud users usually encounter the problem of how to use the virtualized platform easily over the web without requiring the plug-in or installation of special software. The object of this paper is to develop a system and a method enabling process interfacing within an automation scenario for accessing remote application by using the web browser. To meet this challenge, we have ...

  16. An Analysis of the Feedback Provided from the Marine Corps Combat Readiness Evaluation System.

    Science.gov (United States)

    1983-12-01

    view of management control as that adapted by researchers in cybernetics, account - S -ing, and management information systems--those that concentrate...Conscious Style--concerned with costs but not with meeting a budget. (4) Non- Accounting Style--not concerned with meeting a budget or with costs . (Ref. 21...34 California Manacement Review, Vol. XXII, No. 2, Winter 1979, p. 50-59. 44. Horngren , Charles T. Ph.D., CPA, Introduction to Manage- [. . -ment Accounting

  17. Testing Solutions of the Protection Systems Provided with Delay Maximum Current Relays

    Directory of Open Access Journals (Sweden)

    Horia BALAN

    2017-12-01

    Full Text Available Relay protection is one of the main forms of automation control of electro energy systems, having as primary aims fault detection and disconnection of the faulty element in order to avoid the extent of damages and the as fast as possible recovery to the normal operation regime for the rest of the system. Faults that occur in the electro energy system can be classified considering on one hand their causes and on the other their types, but in the vast majority of cases the causes of the faults are combined. Further, considering their nature, faults are classified in faults due to the insulation’s damage, in faults due to the destruction of the integrity of the circuits and faults determined by interruptions. With respect to their nature, faults are short circuits, earthing faults and phases interruptions. At the same time, considering their type, faults are divided in transversal and longitudinal ones. The paper presents a testing solution of the delayed maximal current relays using a T3000 ISA Test measuring equipment.

  18. What the shark immune system can and cannot provide for the expanding design landscape of immunotherapy.

    Science.gov (United States)

    Criscitiello, Michael F

    2014-07-01

    Sharks have successfully lived in marine ecosystems, often atop food chains as apex predators, for nearly one and a half billion years. Throughout this period they have benefitted from an immune system with the same fundamental components found in terrestrial vertebrates like man. Additionally, sharks have some rather extraordinary immune mechanisms which mammals lack. In this review the author briefly orients the reader to sharks, their adaptive immunity, and their important phylogenetic position in comparative immunology. The author also differentiates some of the myths from facts concerning these animals, their cartilage, and cancer. From thereon, the author explores some of the more remarkable capabilities and products of shark lymphocytes. Sharks have an isotype of light chain-less antibodies that are useful tools in molecular biology and are moving towards translational use in the clinic. These special antibodies are just one of the several tricks of shark lymphocyte antigen receptor systems. While shark cartilage has not helped oncology patients, shark immunoglobulins and T cell receptors do offer exciting novel possibilities for immunotherapeutics. Much of the clinical immunology developmental pipeline has turned from traditional vaccines to passively delivered monoclonal antibody-based drugs for targeted depletion, activation, blocking and immunomodulation. The immunogenetic tools of shark lymphocytes, battle-tested since the dawn of our adaptive immune system, are well poised to expand the design landscape for the next generation of immunotherapy products.

  19. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of ambulatory surgical center ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey....

  20. Using Model-Based System Engineering to Provide Artifacts for NASA Project Life-Cycle and Technical Reviews Presentation

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    This is the presentation for the AIAA Space conference in September 2017. It highlights key information from Using Model-Based Systems Engineering to Provide Artifacts for NASA Project Life-cycle and Technical Reviews paper.

  1. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital outpatient department ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS)...

  2. FINANCIAL SYSTEM OF JAPAN: THE LEGAL REGULATION OF DISPUTES BETWEEN FINANCIAL SERVICES PROVIDERS AND CONSUMERS

    Directory of Open Access Journals (Sweden)

    E. E. Frolova

    2018-01-01

    Full Text Available Purpose: the article examines the main problems associated the regulatory acts of Japan – The Financial Instruments and Exchange Act, The Banking Act, The  Insurance Business Act, lists the types of financial disputes subject to alternative settlement, identified the parties to the financial dispute. To achieve this goal, the article must solve the following tasks: to determine whether there are institutions in Japan that provide services for resolving financial disputes; to investigate the main problems associated with the definition of the concept and types of financial dispute, the conditions for the transfer of a financial dispute to the competent authority.Methods: this article is based on an interdisciplinary concept of research, which allowed to distinguish the distinctive features of the legal regulation of the settlement of financial disputes in Malaysia.Results: acts of Japan – The Financial Instruments and Exchange Act, The Banking Act, The Insurance Business Act, – refer to financial disputes – disputes resolved by "Designated Dispute Resolution Organizations", the so-called "financial DDRO". Financial disputes are disputes between suppliers and consumers of financial services. The Financial Instruments and Exchange Act details the persons, whose activities fall within the definition of financial provider services. A brief list of financial service providers is available on the website of Japan's main financial regulator, the Financial Services Agency. The list include: Japanese banking institutions, branches and representative offices of foreign banks, business operators of financial instruments, insurance companies, trust companies, financial markets, foreign audit firms. However, unlike other countries of the Asia-Pacific region, consumers of financial services can be both physical and legal entities.Conclusions and Relevance: the materials presented in the article show the special role of "Designated Dispute Resolution

  3. Progressive taxation as a tool for providing the budget system stability

    Directory of Open Access Journals (Sweden)

    Margarita A. Vakhtina

    2016-01-01

    Full Text Available Objective to consider the alternative additional sources of income of the state budget in the framework of the action plan of the Russian government to provide socioeconomic stability of the country in 2016. Methods comparative and dynamic analysis classification and typology description and measurements including using the tools of institutional Economics the data were interpreted using tables. Results it is shown that due to the lack of financial resources the government has to make unpopular decisions that reduce the level of social support of the population for the near future. The adopted laws stipulating the principles of address character and needs when providing regional measures of social support increase the risks of poverty and inequality. The analysis has been made of the ranking position of Russia and member countries of the Organization for Economic Cooperation and Development in terms of GDP per capita human development index and quality of life index. The article grounds the need for institutional change to facilitate transition to progressive taxation and redistribution of the tax burden from the poor and middle classes to the super rich. The flat personal income tax rate has not led to the desired results of growing tax revenues in the budget. Russia is still among the top ten states with the largest tax evasion losses. The weak redistributive mechanisms including a flat scale of personal income tax regressive social security contributions and low property taxes lead to stagnation inequality underfunding of education and health. Scientific novelty the article proves the conclusion about need of institutional transformations associated with changing the current tax policy priorities. The transition to a progressive scale of income and wealth taxation promotes the transfer of tax burden from the middle and poor to the rich. These measures can provide a double economic effect. On the one hand the principle of effective taxation

  4. Accelerator-driven thermal fission systems may provide energy supply advantages

    International Nuclear Information System (INIS)

    Linford, R.K.

    1992-01-01

    This presentation discusses the energy supply advantages of using accelerator-driven thermal fission systems. Energy supply issues as related to cost, fuel supply stability, environmental impact, and safety are reviewed. It is concluded that the Los Alamos Accelerator Transmutation of Waste (ATW) concept, discussed here, has the following advantages: improved safety in the form of low inventory and subcriticality; reduced high-level radioactive waste management timescales for both fission products and actinides; and a very long-term fuel supply requiring no enrichment

  5. Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership.

    Science.gov (United States)

    Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James

    2009-01-01

    The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care.

  6. ANALYSIS OF THE ENERGY SYSTEM BALANCE EFFICIENCY PROVIDED WITH THE DIFFERENT GROUPS OF GENERATING PLANTS

    Directory of Open Access Journals (Sweden)

    O. Maksymovа

    2017-12-01

    Full Text Available Currently methods of efficiency analysis are being developed and applied, based on optimization tasks for various types and modes. Usually, the optimization criterion for these objectives is efficiency that can be calculated in various ways, for which there is no concurrent views. The target function based on minimization of given cost that allows comparing options with the same useful effect is used to search for the best indicators of power plants operated within the system. Marginal costs on the amount of difference in the useful effect are introduced to the target function in case of various useful effects. The criterion of selecting the best power plant from an economic point of view is the difference between the reduced costs of the considered and the basic options, but this approach does not allow using the results for long-term projections. Such approach depends on the situation and does not reflect the real costs. The value of the target function to optimize the effectiveness of the technical-economic method is not "marginal" and does not allow assessing the impact of various processes on the overall option efficiency. Therefore, the development of the efficiency criterion that considers the changing needs of the energy system is relevant for analyzing the power plant.

  7. A Novel Resource Management Method of Providing Operating System as a Service for Mobile Transparent Computing

    Directory of Open Access Journals (Sweden)

    Yonghua Xiong

    2014-01-01

    Full Text Available This paper presents a framework for mobile transparent computing. It extends the PC transparent computing to mobile terminals. Since resources contain different kinds of operating systems and user data that are stored in a remote server, how to manage the network resources is essential. In this paper, we apply the technologies of quick emulator (QEMU virtualization and mobile agent for mobile transparent computing (MTC to devise a method of managing shared resources and services management (SRSM. It has three layers: a user layer, a manage layer, and a resource layer. A mobile virtual terminal in the user layer and virtual resource management in the manage layer cooperate to maintain the SRSM function accurately according to the user’s requirements. An example of SRSM is used to validate this method. Experiment results show that the strategy is effective and stable.

  8. A novel resource management method of providing operating system as a service for mobile transparent computing.

    Science.gov (United States)

    Xiong, Yonghua; Huang, Suzhen; Wu, Min; Zhang, Yaoxue; She, Jinhua

    2014-01-01

    This paper presents a framework for mobile transparent computing. It extends the PC transparent computing to mobile terminals. Since resources contain different kinds of operating systems and user data that are stored in a remote server, how to manage the network resources is essential. In this paper, we apply the technologies of quick emulator (QEMU) virtualization and mobile agent for mobile transparent computing (MTC) to devise a method of managing shared resources and services management (SRSM). It has three layers: a user layer, a manage layer, and a resource layer. A mobile virtual terminal in the user layer and virtual resource management in the manage layer cooperate to maintain the SRSM function accurately according to the user's requirements. An example of SRSM is used to validate this method. Experiment results show that the strategy is effective and stable.

  9. Can a return to Glass-Steagall provide financial stability in the US financial system?

    Directory of Open Access Journals (Sweden)

    Jan Kregel

    2010-01-01

    Full Text Available In the immediate aftermath of the current financial crisis in the United States the response has been to resolve small and medium size banks, while large banks experiencing financial trouble have been given both direct and indirect government support. This, however, has resulted in a number of larger banks absorbing smaller ones, creating an even smaller number of even larger banks that dominate the financial system. This article deals first with a comparison of the problems created by “too big to fail†financial institutions. The second section deals with the possible restoration of Glass-Steagall type legislation as a means of restoring single-function financial institutions. It concludes that alternatives to separation of functions will have to be found to deal with multifunction financial institutions since most lending activity requires securities markets activities.

  10. AskFuse Origins: System Barriers to Providing the Research That Public Health Practice and Policy Partners Say They Need

    Science.gov (United States)

    Rushmer, Rosemary; Shucksmith, Janet

    2018-01-01

    In this paper the development of askFuse is used as a case study to illustrate contextual and system barriers to universities providing useful, usable and timely research evidence in response to local practice and policy partners' stated public health research needs. Entrenched systems (research excellence framework, academic career pathways,…

  11. A System to Provide Real-Time Collaborative Situational Awareness by Web Enabling a Distributed Sensor Network

    Science.gov (United States)

    Panangadan, Anand; Monacos, Steve; Burleigh, Scott; Joswig, Joseph; James, Mark; Chow, Edward

    2012-01-01

    In this paper, we describe the architecture of both the PATS and SAP systems and how these two systems interoperate with each other forming a unified capability for deploying intelligence in hostile environments with the objective of providing actionable situational awareness of individuals. The SAP system works in concert with the UICDS information sharing middleware to provide data fusion from multiple sources. UICDS can then publish the sensor data using the OGC's Web Mapping Service, Web Feature Service, and Sensor Observation Service standards. The system described in the paper is able to integrate a spatially distributed sensor system, operating without the benefit of the Web infrastructure, with a remote monitoring and control system that is equipped to take advantage of SWE.

  12. Systems analysis of transcriptome data provides new hypotheses about Arabidopsis root response to nitrate treatments

    Directory of Open Access Journals (Sweden)

    Javier eCanales

    2014-02-01

    Full Text Available Nitrogen (N is an essential macronutrient for plant growth and development. Plants adapt to changes in N availability partly by changes in global gene expression. We integrated publicly available root microarray data under contrasting nitrate conditions to identify new genes and functions important for adaptive nitrate responses in Arabidopsis thaliana roots. Overall, more than two thousand genes exhibited changes in expression in response to nitrate treatments in Arabidopsis thaliana root organs. Global regulation of gene expression by nitrate depends largely on the experimental context. However, despite significant differences from experiment to experiment in the identity of regulated genes, there is a robust nitrate response of specific biological functions. Integrative gene network analysis uncovered relationships between nitrate-responsive genes and eleven highly co-expressed gene clusters (modules. Four of these gene network modules have robust nitrate responsive functions such as transport, signaling and metabolism. Network analysis hypothesized G2-like transcription factors are key regulatory factors controlling transport and signaling functions. Our meta-analysis highlights the role of biological processes not studied before in the context of the nitrate response such as root hair development and provides testable hypothesis to advance our understanding of nitrate responses in plants.

  13. The Core Flight System (cFS) Community: Providing Low Cost Solutions for Small Spacecraft

    Science.gov (United States)

    McComas, David; Wilmot, Jonathan; Cudmore, Alan

    2016-01-01

    In February 2015 the NASA Goddard Space Flight Center (GSFC) completed the open source release of the entire Core Flight Software (cFS) suite. After the open source release a multi-NASA center Configuration Control Board (CCB) was established that has managed multiple cFS product releases. The cFS was developed and is being maintained in compliance with the NASA Class B software development process requirements and the open source release includes all Class B artifacts. The cFS is currently running on three operational science spacecraft and is being used on multiple spacecraft and instrument development efforts. While the cFS itself is a viable flight software (FSW) solution, we have discovered that the cFS community is a continuous source of innovation and growth that provides products and tools that serve the entire FSW lifecycle and future mission needs. This paper summarizes the current state of the cFS community, the key FSW technologies being pursued, the development/verification tools and opportunities for the small satellite community to become engaged. The cFS is a proven high quality and cost-effective solution for small satellites with constrained budgets.

  14. Visualizing the Immune System: Providing Key Insights into HIV/SIV Infections

    Directory of Open Access Journals (Sweden)

    Jacob D. Estes

    2018-03-01

    Full Text Available Immunological inductive tissues, such as secondary lymphoid organs, are composed of distinct anatomical microenvironments for the generation of immune responses to pathogens and immunogens. These microenvironments are characterized by the compartmentalization of highly specialized immune and stromal cell populations, as well as the presence of a complex network of soluble factors and chemokines that direct the intra-tissue trafficking of naïve and effector cell populations. Imaging platforms have provided critical contextual information regarding the molecular and cellular interactions that orchestrate the spatial microanatomy of relevant cells and the development of immune responses against pathogens. Particularly in HIV/SIV disease, imaging technologies are of great importance in the investigation of the local interplay between the virus and host cells, with respect to understanding viral dynamics and persistence, immune responses (i.e., adaptive and innate inflammatory responses, tissue structure and pathologies, and changes to the surrounding milieu and function of immune cells. Merging imaging platforms with other cutting-edge technologies could lead to novel findings regarding the phenotype, function, and molecular signatures of particular immune cell targets, further promoting the development of new antiviral treatments and vaccination strategies.

  15. Systems analysis of transcriptional data provides insights into muscle's biological response to botulinum toxin.

    Science.gov (United States)

    Mukund, Kavitha; Mathewson, Margie; Minamoto, Viviane; Ward, Samuel R; Subramaniam, Shankar; Lieber, Richard L

    2014-11-01

    This study provides global transcriptomic profiling and analysis of botulinum toxin A (BoNT-A)-treated muscle over a 1-year period. Microarray analysis was performed on rat tibialis anterior muscles from 4 groups (n = 4/group) at 1, 4, 12, and 52 weeks after BoNT-A injection compared with saline-injected rats at 12 weeks. Dramatic transcriptional adaptation occurred at 1 week with a paradoxical increase in expression of slow and immature isoforms, activation of genes in competing pathways of repair and atrophy, impaired mitochondrial biogenesis, and increased metal ion imbalance. Adaptations of the basal lamina and fibrillar extracellular matrix (ECM) occurred by 4 weeks. The muscle transcriptome returned to its unperturbed state 12 weeks after injection. Acute transcriptional adaptations resemble denervated muscle with some subtle differences, but resolved more quickly compared with denervation. Overall, gene expression across time correlates with the generally accepted BoNT-A time course and suggests that the direct action of BoNT-A in skeletal muscle is relatively rapid. © 2014 Wiley Periodicals, Inc.

  16. DC microgrids with energy storage systems and demand response for providing support to frequency regulation of electrical power systems

    DEFF Research Database (Denmark)

    Basic, Hrvoje; Dragicevic, Tomislav; Pandzic, Hrvoje

    2017-01-01

    Frequency regulation of electric power systems efficiency depends on response time and on power reserves for frequency regulation. As integration of non-dispatchable renewable generation in the power system results with increased need for power reserves from fast responding power units, the idea ...

  17. Systems Factorial Technology provides new insights on global-local information processing in autism spectrum disorders.

    Science.gov (United States)

    Johnson, Shannon A; Blaha, Leslie M; Houpt, Joseph W; Townsend, James T

    2010-02-01

    Previous studies of global-local processing in autism spectrum disorders (ASDs) have indicated mixed findings, with some evidence of a local processing bias, or preference for detail-level information, and other results suggesting typical global advantage, or preference for the whole or gestalt. Findings resulting from this paradigm have been used to argue for or against a detail focused processing bias in ASDs, and thus have important theoretical implications. We applied Systems Factorial Technology, and the associated Double Factorial Paradigm (both defined in the text), to examine information processing characteristics during a divided attention global-local task in high-functioning individuals with an ASD and typically developing controls. Group data revealed global advantage for both groups, contrary to some current theories of ASDs. Information processing models applied to each participant revealed that task performance, although showing no differences at the group level, was supported by different cognitive mechanisms in ASD participants compared to controls. All control participants demonstrated inhibitory parallel processing and the majority demonstrated a minimum-time stopping rule. In contrast, ASD participants showed exhaustive parallel processing with mild facilitatory interactions between global and local information. Thus our results indicate fundamental differences in the stopping rules and channel dependencies in individuals with an ASD.

  18. Outline of a future security system to provide physical protection of nuclear installations

    International Nuclear Information System (INIS)

    Rossnagel, A.

    1984-01-01

    Nuclear energy, within three or four decades, may become a main pillar of the world's energy supply. The author discusses the problems entailed by the necessity to protect nuclear facilities against assaults, and whether this can be ensured without interference with civic rights. The method applied by the author to show the significance of the problems is to explain the current situation, and to compare it with a plausible outline of the developments to be expected over the next 50 years. He shows the hazards to be taken into account due to criminal actions by persons from outside, or by persons working in nuclear facilities. A main problem is the fact that the security system to be set up has to encompass not only the nuclear installation itself, but also the surrounding area, and the measures to be taken will have an impact on the society, which necessarily will curtail personal freedom. The author presumes that the necessity to guarantee physical protection of nuclear facilities will lead to a modification of the meaning of basic rights, and states his anxiety that security for nuclear installations might affect our concept of freedom. (HSCH) [de

  19. Dual winch nuclear fuel transfer system providing more reliable fuel transfer during refueling operations

    International Nuclear Information System (INIS)

    Meuschke, R.E.; Harper, M.J.; Stefko, D.J.

    1991-01-01

    This paper describes a nuclear power plant having an auxiliary building, a containment building having the wall, a track extending through a transfer tube within the containment wall, and a fuel transfer system for moving fuel assemblies along the track between the auxiliary building side and the containment building side of the containment wall. It comprises: a car having wheels for movement along spaced rails of the track and further having a carrying basket for one or more fuel assemblies; winch means located on the auxiliary building side of the containment wall and above the water level existing over the track during refueling operations to drive the car along the track; first cable means and second cable means extending substantially vertically downward from the winch means to the tack level; first sheave means for directing the first and the second cable means substantially in the horizontal direction along the track; means for securing the first cable means to the car so that winch pulling force on the first cable means drives the car away from the containment building; second sheave means located near the containment end of the transfer tube

  20. Revisiting Peruvian anchovy ( Engraulis ringens) trophodynamics provides a new vision of the Humboldt Current system

    Science.gov (United States)

    Espinoza, Pepe; Bertrand, Arnaud

    2008-10-01

    The Peruvian anchovy or anchoveta ( Engraulis ringens) forages on plankton and is a main prey for marine mammals, seabirds, fish, and fishers, and is therefore a key element of the food web in the Humboldt Current system (HCS). Here, we present results from the analysis of 21,203 anchoveta stomach contents sampled during 23 acoustic surveys over the period 1996-2003. Prey items were identified to the genus level, and the relative dietary importance of different prey was assessed by determination of their carbon content. Variability in stomach fullness was examined relative to the diel cycle, the distance from the coast, sea surface temperature, and latitude, using generalized additive models (GAMs). Whereas phytoplankton largely dominated anchoveta diets in terms of numerical abundance and comprised >99% of ingested prey items, the carbon content of prey items indicated that zooplankton was by far the most important dietary component, with euphausiids contributing 67.5% of dietary carbon followed by copepods (26.3%). Stomach fullness data showed that anchoveta feed mainly during daytime between 07h00 and 18h00, although night-time feeding also made a substantial contribution to total food consumption. Stomach fullness also varied with latitude, distance from the coast, and temperature, but with substantial variability indicating a high degree of plasticity in anchoveta feeding behaviour. The results suggest an ecological role for anchoveta that challenges current understanding of its position in the foodweb, the functioning of the HCS, and trophic models of the HCS.

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

    Science.gov (United States)

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

    2017-10-01

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

  2. Vein networks in hydrothermal systems provide constraints for the monitoring of active volcanoes.

    Science.gov (United States)

    Cucci, Luigi; Di Luccio, Francesca; Esposito, Alessandra; Ventura, Guido

    2017-03-10

    Vein networks affect the hydrothermal systems of many volcanoes, and variations in their arrangement may precede hydrothermal and volcanic eruptions. However, the long-term evolution of vein networks is often unknown because data are lacking. We analyze two gypsum-filled vein networks affecting the hydrothermal field of the active Lipari volcanic Island (Italy) to reconstruct the dynamics of the hydrothermal processes. The older network (E1) consists of sub-vertical, N-S striking veins; the younger network (E2) consists of veins without a preferred strike and dip. E2 veins have larger aperture/length, fracture density, dilatancy, and finite extension than E1. The fluid overpressure of E2 is larger than that of E1 veins, whereas the hydraulic conductance is lower. The larger number of fracture intersections in E2 slows down the fluid movement, and favors fluid interference effects and pressurization. Depths of the E1 and E2 hydrothermal sources are 0.8 km and 4.6 km, respectively. The decrease in the fluid flux, depth of the hydrothermal source, and the pressurization increase in E2 are likely associated to a magma reservoir. The decrease of fluid discharge in hydrothermal fields may reflect pressurization at depth potentially preceding hydrothermal explosions. This has significant implications for the long-term monitoring strategy of volcanoes.

  3. Providing Hemostatic and Blood Conservation Options for Jehovah's Witness Patients in a Large Medical System.

    Science.gov (United States)

    Bai, Yu; Castillo, Brian S; Tchakarov, Amanda; Escobar, Miguel A; Cotton, Bryan A; Holcomb, John B; Brown, Robert E

    2016-12-01

    People of the Jehovah's Witness faith believe that they shall "abstain from blood." Because of this belief, we encounter the challenges from Jehovah's Witness patients who actively seek medical care for themselves and their children, but refuse the transfusion of blood products, which may result in increased morbidity and mortality in this patient population. With the development/availability of new hemostatic/coagulation products and the advances in medical technology, we, in collaboration with our clinical colleagues and our local Jehovah's Witness leadership, have developed a clinical guideline comprising medical protocol and surgical strategy for patients refusing blood products. Included in the medical protocol is an informative handout on related details to help treating physicians and patients make informed decisions about transfusion alternatives. Together, we have entered the medical protocol into the entire Memorial Hermann Hospital's electronic system. We report the detailed development and implementation process in order to share our experience and encourage others to develop their own management plan for this patient population. © 2016 by the Association of Clinical Scientists, Inc.

  4. Assessment of systems for paying health care providers in Vietnam: implications for equity, efficiency and expanding effective health coverage.

    Science.gov (United States)

    Phuong, Nguyen Khanh; Oanh, Tran Thi Mai; Phuong, Hoang Thi; Tien, Tran Van; Cashin, Cheryl

    2015-01-01

    Provider payment arrangements are currently a core concern for Vietnam's health sector and a key lever for expanding effective coverage and improving the efficiency and equity of the health system. This study describes how different provider payment systems are designed and implemented in practice across a sample of provinces and districts in Vietnam. Key informant interviews were conducted with over 100 health policy-makers, purchasers and providers using a structured interview guide. The results of the different payment methods were scored by respondents and assessed against a set of health system performance criteria. Overall, the public health insurance agency, Vietnam Social Security (VSS), is focused on managing expenditures through a complicated set of reimbursement policies and caps, but the incentives for providers are unclear and do not consistently support Vietnam's health system objectives. The results of this study are being used by the Ministry of Health and VSS to reform the provider payment systems to be more consistent with international definitions and good practices and to better support Vietnam's health system objectives.

  5. Multiplex Amplification Refractory Mutation System PCR (ARMS-PCR) provides sequencing independent typing of canine parvovirus.

    Science.gov (United States)

    Chander, Vishal; Chakravarti, Soumendu; Gupta, Vikas; Nandi, Sukdeb; Singh, Mithilesh; Badasara, Surendra Kumar; Sharma, Chhavi; Mittal, Mitesh; Dandapat, S; Gupta, V K

    2016-12-01

    Canine parvovirus-2 antigenic variants (CPV-2a, CPV-2b and CPV-2c) ubiquitously distributed worldwide in canine population causes severe fatal gastroenteritis. Antigenic typing of CPV-2 remains a prime focus of research groups worldwide in understanding the disease epidemiology and virus evolution. The present study was thus envisioned to provide a simple sequencing independent, rapid, robust, specific, user-friendly technique for detecting and typing of presently circulating CPV-2 antigenic variants. ARMS-PCR strategy was employed using specific primers for CPV-2a, CPV-2b and CPV-2c to differentiate these antigenic types. ARMS-PCR was initially optimized with reference positive controls in two steps; where first reaction was used to differentiate CPV-2a from CPV-2b/CPV-2c. The second reaction was carried out with CPV-2c specific primers to confirm the presence of CPV-2c. Initial validation of the ARMS-PCR was carried out with 24 sequenced samples and the results were matched with the sequencing results. ARMS-PCR technique was further used to screen and type 90 suspected clinical samples. Randomly selected 15 suspected clinical samples that were typed with this technique were sequenced. The results of ARMS-PCR and the sequencing matched exactly with each other. The developed technique has a potential to become a sequencing independent method for simultaneous detection and typing of CPV-2 antigenic variants in veterinary disease diagnostic laboratories globally. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Early Peritonitis in a Large Peritoneal Dialysis Provider System in Colombia.

    Science.gov (United States)

    Vargas, Edgar; Blake, Peter G; Sanabria, Mauricio; Bunch, Alfonso; López, Patricia; Vesga, Jasmín; Buitrago, Alberto; Astudillo, Kindar; Devia, Martha; Sánchez, Ricardo

    ♦ BACKGROUND: Peritonitis is the most important complication of peritoneal dialysis (PD), and early peritonitis rate is predictive of the subsequent course on PD. Our aim was to calculate the early peritonitis rate and to identify characteristics and predisposing factors in a large nationwide PD provider network in Colombia. ♦ METHODS: This was a historical observational cohort study of all adult patients starting PD between January 1, 2012, and December 31, 2013, in 49 renal facilities in the Renal Therapy Services in Colombia. We studied the peritonitis rate in the first 90 days of treatment, its causative micro-organisms, its predictors and its variation with time on PD and between individual facilities. ♦ RESULTS: A total of 3,525 patients initiated PD, with 176 episodes of peritonitis during 752 patient-years of follow-up for a rate of 0.23 episodes per patient year equivalent to 1 every 52 months. In 41 of 49 units, the rate was better than 1 per 33 months, and in 45, it was better than 1 per 24 months. Peritonitis rates did not differ with age, ethnicity, socioeconomic status, or PD modality. We identified high incidence risk periods at 2 to 5 weeks after initiation of PD and again at 10 to 12 weeks. ♦ CONCLUSION: An excellent peritonitis rate was achieved across a large nationwide network. This occurred in the context of high nationwide PD utilization and despite high rates of socioeconomic deprivation. We propose that a key factor in achieving this was a standardized approach to management of patients. Copyright © 2017 International Society for Peritoneal Dialysis.

  7. [Quality of service provided to heart surgery patients of the Unified Health System-SUS].

    Science.gov (United States)

    Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes

    2010-01-01

    To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (Pquality of service with: gender, in empathy (P= 0.04) and age, in reliability (P = 0.02). There was no significant association between ECC and quality of service. Service quality was satisfactory. The patient demonstrated a high expectation to hospital medical service. Women present a higher perception of quality in empathy and younger people in reliability. The use of ECC is not related to service quality in this sample. The data obtained in this study suggest that the quality of this health service can be monitored through the periodical application of the SERVQUAL scale.

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

    Science.gov (United States)

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

    2018-04-01

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

  9. A Statewide Private Microwave Wide Area Network for Real-time Natural Hazard Monitoring

    Science.gov (United States)

    Williams, M. C.; Kent, G.; Smith, K. D.; Plank, G.; Slater, D.; Torrisi, J.; Presser, R.; Straley, K.

    2013-12-01

    The Nevada Seismological Laboratory (NSL) at the University of Nevada, Reno, operates the Nevada Seismic Network, a collection of ground motion instruments installed throughout Nevada and California, for the purposes of detecting, locating, and notifying the public of earthquakes in the state. To perform these tasks effectively, NSL has designed and built a statewide wireless microwave wide-area network (WAN) in order to receive ground motion data in near real-time. This network consists of radio access points, backhauls, and backbone communication sites transmitting time-series, images, and datalogger diagnostics to our data center servers in Reno. This privately managed communication network greatly reduces the dependence on third-party infrastructure (e.g. commercial cellular networks), and is vital for emergency management response and system uptime. Any individual seismograph or data collection device is networked through a wireless point-to-multipoint connection to a remote access point (AP) using a low-cost radio/routerboard combination. Additional point-to-point connections from AP's to radio backhauls and/or mountaintop backbone sites allow the Data Center in Reno to communicate with and receive data directly from each datalogger. Dataloggers, radios, and routers can be configured using tablets on-site, or via desktop computers at the Data Center. Redundant mountaintop links can be added to the network and facilitate the re-routing of data (similar to a meshed network) in the event of a faulty, failing, or noisy communication site. All routers, radios, and servers, including those at the Data Center, have redundant power and can operate independently in the event of a grid power or public Internet outage. A managed server room at the Data Center processes earthquake data for notifications and acts as a data source for remote users. Consisting of about 500 hosts, and spanning hundreds of miles, this WAN provides network operators access to each router and

  10. Transaction of long-term power purchasing contract by independent power providers in wholesale and retail competitive system

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hoon [Korea Energy Economics Institute, Euiwang (Korea)

    1998-12-01

    In general, the restructuring starts with separation and division of power sector from the existing monopolist as the cases of Thailand and Malaysia. When the power provider is separated and divided, it becomes an independent power provider. The existing regional electricity provider carries out the supplying function to end-users buying electricity from several separated and divided providers. Therefore, the existing regional electricity providers give up the power generation business but become a demand monopolist in wholesale market. The competition system capable of applying during the separation period is the Generation Pool. With the Generation Pool, it is able to promote competition of power generation sector effectively and there is no need to have an extra step such as long-term power purchasing contract. In fact, Latin America and Chile have been managed the power market for more than 10 years with the competition system by the Generation Pool. 9 refs.

  11. Opportunistic mammography screening provides effective detection rates in a limited resource healthcare system.

    Science.gov (United States)

    Teh, Yew-Ching; Tan, Gie-Hooi; Taib, Nur Aishah; Rahmat, Kartini; Westerhout, Caroline Judy; Fadzli, Farhana; See, Mee-Hoong; Jamaris, Suniza; Yip, Cheng-Har

    2015-05-15

    Breast cancer is the leading cause of cancer deaths in women world-wide. In low and middle income countries, where there are no population-based mammographic screening programmes, late presentation is common, and because of inadequate access to optimal treatment, survival rates are poor. Mammographic screening is well-studied in high-income countries in western populations, and because it has been shown to reduce breast cancer mortality, it has become part of the healthcare systems in such countries. However the performance of mammographic screening in a developing country is largely unknown. This study aims to evaluate the performance of mammographic screening in Malaysia, a middle income country, and to compare the stage and surgical treatment of screen-detected and symptomatic breast cancer. A retrospective review of 2510 mammograms performed from Jan to Dec 2010 in a tertiary medical centre is carried out. The three groups identified are the routine (opportunistic) screening group, the targeted (high risk) screening group and the diagnostic group. The performance indicators of each group is calculated, and stage at presentation and treatment between the screening and diagnostic group is analyzed. The cancer detection rate in the opportunistic screening group, targeted screening group, and the symptomatic group is 0.5 %, 1.25 % and 26 % respectively. The proportion of ductal carcinoma in situ is 23.1 % in the two screening groups compared to only 2.5 % in the diagnostic group. Among the opportunistic screening group, the cancer detection rate was 0.2 % in women below 50 years old compared to 0.65 % in women 50 years and above. The performance indicators are within international standards. Early-staged breast cancer (Stage 0-2) were 84.6 % in the screening groups compared to 61.1 % in the diagnostic group. From the results, in a setting with resource constraints, targeted screening of high risk individuals will give a higher yield, and if more resources are

  12. Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory.

    Science.gov (United States)

    Rahimi, Bahlol; Timpka, Toomas; Vimarlund, Vivian; Uppugunduri, Srinivas; Svensson, Mikael

    2009-12-31

    Computerized provider order entry (CPOE) systems have been introduced to reduce medication errors, increase safety, improve work-flow efficiency, and increase medical service quality at the moment of prescription. Making the impact of CPOE systems more observable may facilitate their adoption by users. We set out to examine factors associated with the adoption of a CPOE system for inter-organizational and intra-organizational care. The diffusion of innovation theory was used to understand physicians' and nurses' attitudes and thoughts about implementation and use of the CPOE system. Two online survey questionnaires were distributed to all physicians and nurses using a CPOE system in county-wide healthcare organizations. The number of complete questionnaires analyzed was 134 from 200 nurses (67.0%) and 176 from 741 physicians (23.8%). Data were analyzed using descriptive-analytical statistical methods. More nurses (56.7%) than physicians (31.3%) stated that the CPOE system introduction had worked well in their clinical setting (P system not adapted to their specific professional practice (P = system (P = 0.041). We found that in particular the received relative advantages of the CPOE system were estimated to be significantly (P systems are introduced as a response to the present limitations in paper-based systems. In consequence, user expectations are often high on their relative advantages as well as on a low level of complexity. Building CPOE systems therefore requires designs that can provide rather important additional advantages, e.g. by preventing prescription errors and ultimately improving patient safety and safety of clinical work. The decision-making process leading to the implementation and use of CPOE systems in healthcare therefore has to be improved. As any change in health service settings usually faces resistance, we emphasize that CPOE system designers and healthcare decision-makers should continually collect users' feedback about the systems, while

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

    Science.gov (United States)

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

    2011-01-01

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

  14. Type III CRISPR-Cas systems can provide redundancy to counteract viral escape from type I systems.

    Science.gov (United States)

    Silas, Sukrit; Lucas-Elio, Patricia; Jackson, Simon A; Aroca-Crevillén, Alejandra; Hansen, Loren L; Fineran, Peter C; Fire, Andrew Z; Sánchez-Amat, Antonio

    2017-08-17

    CRISPR-Cas-mediated defense utilizes information stored as spacers in CRISPR arrays to defend against genetic invaders. We define the mode of target interference and role in antiviral defense for two CRISPR-Cas systems in Marinomonas mediterranea . One system (type I-F) targets DNA. A second system (type III-B) is broadly capable of acquiring spacers in either orientation from RNA and DNA, and exhibits transcription-dependent DNA interference. Examining resistance to phages isolated from Mediterranean seagrass meadows, we found that the type III-B machinery co-opts type I-F CRISPR-RNAs. Sequencing and infectivity assessments of related bacterial and phage strains suggests an 'arms race' in which phage escape from the type I-F system can be overcome through use of type I-F spacers by a horizontally-acquired type III-B system. We propose that the phage-host arms race can drive selection for horizontal uptake and maintenance of promiscuous type III interference modules that supplement existing host type I CRISPR-Cas systems.

  15. State Systems Change Spotlight: Nevada. Transforming State Systems to Improve Outcomes for Children with Disabilities

    Science.gov (United States)

    Ruedel, Kristin; Nelson, Gena; Bailey, Tessie; Pierce, Jennifer

    2018-01-01

    Data show that effective and ongoing communication and evaluation can have a positive impact on local and statewide systems change. Local and statewide systems change requires ongoing communication and evaluation. The Nevada Department of Education (NDE) used a communication protocol to support implementation of the Assess-Plan-Teach (APT) model.…

  16. Statewide dissemination of a rural, non-chain restaurant intervention: adoption, implementation and maintenance

    Science.gov (United States)

    Nothwehr, F.; Haines, H.; Chrisman, M.; Schultz, U.

    2014-01-01

    The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States, the study targeted randomly selected, non-chain, family-style restaurants. Owners were recruited through mail, then telephone follow-up. Data were collected through telephone at baseline, and 3, 6, 12 and 18 months post-adoption. Using mixed methods, measures captured the program adoption rate, characteristics of adopters and non-adopters, program implementation and maintenance issues, and owner and customer satisfaction. Analyses involved descriptive statistics and summaries of qualitative data. The program adoption rate was 28%. Adopters were similar to responding non-adopters demographically, but varied in attitudes. The majority of restaurants maintained the program for at least 12 months. Adopters and their customers expressed satisfaction with the program. With some adjustments, the RE-AIM model was helpful in guiding evaluation of this process. Results provide implications for future dissemination of this and other programs with regard to research procedures and potential barriers that may be encountered. Research on alternative strategies for widespread dissemination of such programs is needed in this and other settings. PMID:24650944

  17. Addressing College Drinking as a Statewide Public Health Problem: Key Findings From the Maryland Collaborative.

    Science.gov (United States)

    Arria, Amelia M; Jernigan, David H

    2018-03-01

    Excessive drinking among college students is a serious and pervasive public health problem. Although much research attention has focused on developing and evaluating evidence-based practices to address college drinking, adoption has been slow. The Maryland Collaborative to Reduce College Drinking and Related Problems was established in 2012 to bring together a network of institutions of higher education in Maryland to collectively address college drinking by using both individual-level and environmental-level evidence-based approaches. In this article, the authors describe the findings of this multilevel, multicomponent statewide initiative. To date, the Maryland Collaborative has succeeded in providing a forum for colleges to share knowledge and experiences, strengthen existing strategies, and engage in a variety of new activities. Administration of an annual student survey has been useful for guiding interventions as well as evaluating progress toward the Maryland Collaborative's goal to measurably reduce high-risk drinking and its radiating consequences on student health, safety, and academic performance and on the communities surrounding college campuses. The experiences of the Maryland Collaborative exemplify real-world implementation of evidence-based approaches to reduce this serious public health problem.

  18. Tobacco Smoke Pollution in Hospitality Venues Before and After Passage of Statewide Smoke-Free Legislation.

    Science.gov (United States)

    Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L; Travers, Mark J

    2017-03-01

    In 2012, North Dakota enacted a comprehensive statewide law prohibiting smoking in enclosed public places. Disparities in tobacco control exist in rural areas. This study's objective was to determine the extent to which the passage of a comprehensive, statewide, smoke-free law in a predominantly rural state influenced tobacco smoke pollution in rural and nonrural venues. A longitudinal cohort design study comparing the levels of tobacco smoke pollution before and after passage of the statewide smoke-free law was conducted in 64 restaurants and bars statewide in North Dakota. Particulate matter with a median aerodynamic diameter of <2.5 μm (a valid atmospheric marker of tobacco smoke pollution) was assessed. A significant 83% reduction in tobacco smoke pollution levels occurred after passage of the law. Significant reductions in tobacco smoke pollution levels occurred in each of the rural categories; however, no difference by rurality was noted in the analysis after passage of the law, in contrast to the study before passage. To our knowledge, this was the largest, single, rural postlaw study globally. A comprehensive statewide smoke-free law implemented in North Dakota dramatically decreased the level of tobacco smoke pollution in bars and restaurants. © 2016 The Authors. Public Health Nursing Published by Wiley Periodicals, Inc.

  19. Mix of power system flexibility means providing 50 % wind power penetration in the Danish power system in 2030

    DEFF Research Database (Denmark)

    Nørgård, Per Bromand; Lund, H.; Mathiesen, B.V.

    2008-01-01

    Time series simulations of an example of a realistic modified energy system in Denmark 2030, assuming no internal power transmission bottlenecks, indicates that it is both technical possible and economic feasible to maintain the energy balance on hourly basis, even with a wind power penetration...

  20. Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence.

    Science.gov (United States)

    Javadi, D; Feldhaus, I; Mancuso, A; Ghaffar, A

    2017-01-01

    This paper seeks to review the available evidence to determine whether a systems approach is employed in the implementation and evaluation of task shifting for mental health using lay providers in low- and middle-income countries, and to highlight system-wide effects of task-shifting strategies in order to better inform efforts to strength community mental health systems. Pubmed, CINAHL, and Cochrane Library databases were searched. Articles were screened by two independent reviewers with a third reviewer resolving discrepancies. Two stages of screens were done to ensure sensitivity. Studies were analysed using the World Health Organization's building blocks framework with the addition of a community building block, and systems thinking characteristics to determine the extent to which system-wide effects had been considered. Thirty studies were included. Almost all studies displayed positive findings on mental health using task shifting. One study showed no effect. No studies explicitly employed systems thinking tools, but some demonstrated systems thinking characteristics, such as exploring various stakeholder perspectives, capturing unintended consequences, and looking across sectors for system-wide impact. Twenty-five of the 30 studies captured elements other than the most directly relevant building blocks of service delivery and health workforce. There is a lack of systematic approaches to exploring complexity in the evaluation of task-shifting interventions. Systems thinking tools should support evidence-informed decision making for a more complete understanding of community-based systems strengthening interventions for mental health.

  1. State-of-the-art incore detector system provides operational and safety benefits: Example, Hanford N Reactor

    International Nuclear Information System (INIS)

    Toffer, H.

    1988-08-01

    A presentation on the operational and safety benefits that can be derived from a state-of-the-art incore neutron monitoring system has been prepared for the DOE/ANL training course on ''The Potential Safety Impact of New and Emerging Technologies on the Operation of DOE Nuclear Facilities.'' Advanced incore neutron flux monitoring systems have been installed in some commercial reactors and should be considered for any new reactor designs or as backfits to existing plants. The recent installation of such a system at the Hanford N Reactor is used as an example in this presentation. Unfortunately, N Reactor has been placed in a cold standby condition and the full core incore system has not been tested under power conditions. Nevertheless, the evaluations that preceded the installation of the full core system provide interesting insight into the operational and safety benefits that could be expected

  2. POSSIBILITY OF IMPROVING EXISTING STANDARDS AND METHODOLOGIES FOR AUDITING INFORMATION SYSTEMS TO PROVIDE E-GOVERNMENT SERVICES

    Directory of Open Access Journals (Sweden)

    Евгений Геннадьевич Панкратов

    2014-03-01

    Full Text Available This article analyzes the existing methods of e-government systems audit, their shortcomings are examined.  The approaches to improve existing techniques and adapt them to the specific characteristics of e-government systems are suggested. The paper describes the methodology, providing possibilities of integrated assessment of information systems. This methodology uses systems maturity models and can be used in the construction of e-government rankings, as well as in the audit of their implementation process. Maturity models are based on COBIT, COSO methodologies and models of e-government, developed by the relevant committee of the UN. The methodology was tested during the audit of information systems involved in the payment of temporary disability benefits. The audit was carried out during analysis of the outcome of the pilot project for the abolition of the principle of crediting payments for disability benefits.DOI: http://dx.doi.org/10.12731/2218-7405-2014-2-5

  3. The Role of Security Concerns in Determining Information Systems/Technology Activities Outsourced to Offshore Service Providers in India

    Science.gov (United States)

    Ocholi, Smart

    2012-01-01

    Based on research studies, the Information System/Technology (IS/T) outsourcing industry in India is reasoned to maintain the status quo of providing IS/T services at the lower level of the IS/T value chain. The 2006 study conducted by Walsh supported the 2001 findings by Arora, Arunachalam, Asundi, and Fernandes that India-based IS /T service…

  4. User-centered development and testing of a monitoring system that provides feedback regarding physical functioning to elderly people

    Science.gov (United States)

    Vermeulen, Joan; Neyens, Jacques CL; Spreeuwenberg, Marieke D; van Rossum, Erik; Sipers, Walther; Habets, Herbert; Hewson, David J; de Witte, Luc P

    2013-01-01

    Purpose To involve elderly people during the development of a mobile interface of a monitoring system that provides feedback to them regarding changes in physical functioning and to test the system in a pilot study. Methods and participants The iterative user-centered development process consisted of the following phases: (1) selection of user representatives; (2) analysis of users and their context; (3) identification of user requirements; (4) development of the interface; and (5) evaluation of the interface in the lab. Subsequently, the monitoring and feedback system was tested in a pilot study by five patients who were recruited via a geriatric outpatient clinic. Participants used a bathroom scale to monitor weight and balance, and a mobile phone to monitor physical activity on a daily basis for six weeks. Personalized feedback was provided via the interface of the mobile phone. Usability was evaluated on a scale from 1 to 7 using a modified version of the Post-Study System Usability Questionnaire (PSSUQ); higher scores indicated better usability. Interviews were conducted to gain insight into the experiences of the participants with the system. Results The developed interface uses colors, emoticons, and written and/or spoken text messages to provide daily feedback regarding (changes in) weight, balance, and physical activity. The participants rated the usability of the monitoring and feedback system with a mean score of 5.2 (standard deviation 0.90) on the modified PSSUQ. The interviews revealed that most participants liked using the system and appreciated that it signaled changes in their physical functioning. However, usability was negatively influenced by a few technical errors. Conclusion Involvement of elderly users during the development process resulted in an interface with good usability. However, the technical functioning of the monitoring system needs to be optimized before it can be used to support elderly people in their self-management. PMID

  5. Using Model-Based Systems Engineering To Provide Artifacts for NASA Project Life-Cycle and Technical Reviews

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    The ability of systems engineers to use model-based systems engineering (MBSE) to generate self-consistent, up-to-date systems engineering products for project life-cycle and technical reviews is an important aspect for the continued and accelerated acceptance of MBSE. Currently, many review products are generated using labor-intensive, error-prone approaches based on documents, spreadsheets, and chart sets; a promised benefit of MBSE is that users will experience reductions in inconsistencies and errors. This work examines features of SysML that can be used to generate systems engineering products. Model elements, relationships, tables, and diagrams are identified for a large number of the typical systems engineering artifacts. A SysML system model can contain and generate most systems engineering products to a significant extent and this paper provides a guide on how to use MBSE to generate products for project life-cycle and technical reviews. The use of MBSE can reduce the schedule impact usually experienced for review preparation, as in many cases the review products can be auto-generated directly from the system model. These approaches are useful to systems engineers, project managers, review board members, and other key project stakeholders.

  6. Physicians' and Nurses' Opinions about the Impact of a Computerized Provider Order Entry System on Their Workflow.

    Science.gov (United States)

    Ayatollahi, Haleh; Roozbehi, Masoud; Haghani, Hamid

    2015-01-01

    In clinical practices, the use of information technology, especially computerized provider order entry (CPOE) systems, has been found to be an effective strategy to improve patient care. This study aimed to compare physicians' and nurses' views about the impact of CPOE on their workflow. This case study was conducted in 2012. The potential participants included all physicians (n = 28) and nurses (n = 145) who worked in a teaching hospital. Data were collected using a five-point Likert-scale questionnaire and were analyzed using SPSS version 18.0. The results showed a significant difference between physicians' and nurses' views about the impact of the system on interorganizational workflow (p = .001) and working relationships between physicians and nurses (p = .017). Interorganizational workflow and working relationships between care providers are important issues that require more attention. Before a CPOE system is designed, it is necessary to identify workflow patterns and hidden structures to avoid compromising quality of care and patient safety.

  7. Use of electronic personal health record systems to encourage HIV screening: an exploratory study of patient and provider perspectives

    Directory of Open Access Journals (Sweden)

    McInnes D Keith

    2011-08-01

    Full Text Available Abstract Background When detected, HIV can be effectively treated with antiretroviral therapy. Nevertheless in the U.S. approximately 25% of those who are HIV-infected do not know it. Much remains unknown about how to increase HIV testing rates. New Internet outreach methods have the potential to increase disease awareness and screening among patients, especially as electronic personal health records (PHRs become more widely available. In the US Department of Veterans' Affairs medical care system, 900,000 veterans have indicated an interest in receiving electronic health-related communications through the PHR. Therefore we sought to evaluate the optimal circumstances and conditions for outreach about HIV screening. In an exploratory, qualitative research study we examined patient and provider perceptions of Internet-based outreach to increase HIV screening among veterans who use the Veterans Health Administration (VHA health care system. Findings We conducted two rounds of focus groups with veterans and healthcare providers at VHA medical centers. The study's first phase elicited general perceptions of an electronic outreach program to increase screening for HIV, diabetes, and high cholesterol. Using phase 1 results, outreach message texts were drafted and then presented to participants in the second phase. Analysis followed modified grounded theory. Patients and providers indicated that electronic outreach through a PHR would provide useful information and would motivate patients to be screened for HIV. Patients believed that electronic information would be more convenient and understandable than information provided verbally. Patients saw little difference between messages about HIV versus about diabetes and cholesterol. Providers, however, felt patients would disapprove of HIV-related messages due to stigma. Providers expected increased workload from the electronic outreach, and thus suggested adding primary care resources and devising

  8. Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory

    Directory of Open Access Journals (Sweden)

    Timpka Toomas

    2009-12-01

    Full Text Available Abstract Background Computerized provider order entry (CPOE systems have been introduced to reduce medication errors, increase safety, improve work-flow efficiency, and increase medical service quality at the moment of prescription. Making the impact of CPOE systems more observable may facilitate their adoption by users. We set out to examine factors associated with the adoption of a CPOE system for inter-organizational and intra-organizational care. Methods The diffusion of innovation theory was used to understand physicians' and nurses' attitudes and thoughts about implementation and use of the CPOE system. Two online survey questionnaires were distributed to all physicians and nurses using a CPOE system in county-wide healthcare organizations. The number of complete questionnaires analyzed was 134 from 200 nurses (67.0% and 176 from 741 physicians (23.8%. Data were analyzed using descriptive-analytical statistical methods. Results More nurses (56.7% than physicians (31.3% stated that the CPOE system introduction had worked well in their clinical setting (P P = P = 0.041. We found that in particular the received relative advantages of the CPOE system were estimated to be significantly (P P Conclusions Qualifications for CPOE adoption as defined by three attributes of diffusion of innovation theory were not satisfied in the study setting. CPOE systems are introduced as a response to the present limitations in paper-based systems. In consequence, user expectations are often high on their relative advantages as well as on a low level of complexity. Building CPOE systems therefore requires designs that can provide rather important additional advantages, e.g. by preventing prescription errors and ultimately improving patient safety and safety of clinical work. The decision-making process leading to the implementation and use of CPOE systems in healthcare therefore has to be improved. As any change in health service settings usually faces resistance

  9. Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region.

    Science.gov (United States)

    Barbarito, Fulvio; Pinciroli, Francesco; Mason, John; Marceglia, Sara; Mazzola, Luca; Bonacina, Stefano

    2012-08-01

    Information technologies (ITs) have now entered the everyday workflow in a variety of healthcare providers with a certain degree of independence. This independence may be the cause of difficulty in interoperability between information systems and it can be overcome through the implementation and adoption of standards. Here we present the case of the Lombardy Region, in Italy, that has been able, in the last 10 years, to set up the Regional Social and Healthcare Information System, connecting all the healthcare providers within the region, and providing full access to clinical and health-related documents independently from the healthcare organization that generated the document itself. This goal, in a region with almost 10 millions citizens, was achieved through a twofold approach: first, the political and operative push towards the adoption of the Health Level 7 (HL7) standard within single hospitals and, second, providing a technological infrastructure for data sharing based on interoperability specifications recognized at the regional level for messages transmitted from healthcare providers to the central domain. The adoption of such regional interoperability specifications enabled the communication among heterogeneous systems placed in different hospitals in Lombardy. Integrating the Healthcare Enterprise (IHE) integration profiles which refer to HL7 standards are adopted within hospitals for message exchange and for the definition of integration scenarios. The IHE patient administration management (PAM) profile with its different workflows is adopted for patient management, whereas the Scheduled Workflow (SWF), the Laboratory Testing Workflow (LTW), and the Ambulatory Testing Workflow (ATW) are adopted for order management. At present, the system manages 4,700,000 pharmacological e-prescriptions, and 1,700,000 e-prescriptions for laboratory exams per month. It produces, monthly, 490,000 laboratory medical reports, 180,000 radiology medical reports, 180

  10. Environmental Data Store: A Web-Based System Providing Management and Exploitation for Multi-Data-Type Environmental Data

    Science.gov (United States)

    Ji, P.; Piasecki, M.

    2012-12-01

    With the rapid growth in data volumes, data diversity and data demands from multi-disciplinary research effort, data management and exploitation are increasingly facing significant challenges for environmental scientific community. We describe Environmental data store (EDS), a system we are developing that is a web-based system following an open source implementation to manage and exploit multi-data-type environmental data. EDS provides repository services for the six fundamental data types, which meet the demands of multi-disciplinary environmental research. These data types are: a) Time Series Data, b) GeoSpatial data, c) Digital Data, d) Ex-Situ Sampling data, e) Modeling Data, f) Raster Data. Through data portal, EDS allows for efficient consuming these six types of data placed in data pool, which is made up of different data nodes corresponding to different data types, including iRODS, ODM, THREADS, ESSDB, GeoServer, etc.. EDS data portal offers unified submission interface for the above different data types; provides fully integrated, scalable search across content from the above different data systems; also features mapping, analysis, exporting and visualization, through integration with other software. EDS uses a number of developed systems, follows widely used data standards, and highlights the thematic, semantic, and syntactic support on the submission and search, in order to advance multi-disciplinary environmental research. This system will be installed and develop at the CrossRoads initiative at the City College of New York.

  11. Influencing Anesthesia Provider Behavior Using Anesthesia Information Management System Data for Near Real-Time Alerts and Post Hoc Reports.

    Science.gov (United States)

    Epstein, Richard H; Dexter, Franklin; Patel, Neil

    2015-09-01

    In this review article, we address issues related to using data from anesthesia information management systems (AIMS) to deliver near real-time alerts via AIMS workstation popups and/or alphanumeric pagers and post hoc reports via e-mail. We focus on reports and alerts for influencing the behavior of anesthesia providers (i.e., anesthesiologists, anesthesia residents, and nurse anesthetists). Multiple studies have shown that anesthesia clinical decision support (CDS) improves adherence to protocols and increases financial performance through facilitation of billing, regulatory, and compliance documentation; however, improved clinical outcomes have not been demonstrated. We inform developers and users of feedback systems about the multitude of concerns to consider during development and implementation of CDS to increase its effectiveness and to mitigate its potentially disruptive aspects. We discuss the timing and modalities used to deliver messages, implications of outlier-only versus individualized feedback, the need to consider possible unintended consequences of such feedback, regulations, sustainability, and portability among systems. We discuss statistical issues related to the appropriate evaluation of CDS efficacy. We provide a systematic review of the published literature (indexed in PubMed) of anesthesia CDS and offer 2 case studies of CDS interventions using AIMS data from our own institution illustrating the salient points. Because of the considerable expense and complexity of maintaining near real-time CDS systems, as compared with providing individual reports via e-mail after the fact, we suggest that if the same goal can be accomplished via delayed reporting versus immediate feedback, the former approach is preferable. Nevertheless, some processes require near real-time alerts to produce the desired improvement. Post hoc e-mail reporting from enterprise-wide electronic health record systems is straightforward and can be accomplished using system

  12. A new multiphasic buffer system for benzyldimethyl-n-hexadecylammonium chloride polyacrylamide gel electrophoresis of proteins providing efficient stacking.

    Science.gov (United States)

    Kramer, Michael L

    2006-02-01

    Acidic PAGE systems using cationic detergents such as benzyldimethyl-n-hexadecylammonium chloride (16-BAC) or CTAB have proven useful for the detection of methoxy esters sensitive to alkaline pH, resolving basic proteins such as histones and membrane proteins. However, the interesting phosphate-based system suffered from poor stacking, resulting in broadened bands and long running times. Therefore, a new 16-BAC PAGE system based on the theory of moving boundary electrophoresis with properties comparable to the classical SDS-PAGE system was designed. As a result a new multiphasic analytical 16-BAC PAGE system providing efficient stacking and significantly shorter running times is presented here. It is based on acetic acid and methoxyacetic acid as common ion constituents. This PAGE system takes advantage of the additional counter stacking effect due to a cross boundary electrophoresis system resulting from the selected buffer constituents. Furthermore, the concentration of 16-BAC was optimized by determining its previously unknown CMC. Due to efficient focusing of the introduced tracking dye, methyl green, termination of electrophoresis can now be more easily followed as compared to the Schlieren line.

  13. Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island.

    Science.gov (United States)

    Wylie, Matthew C; Baier, Rosa R; Gardner, Rebekah L

    2014-10-01

    Although electronic health record use improves healthcare delivery, adoption into clinical practice is incomplete. We sought to identify the extent of adoption in Rhode Island and the characteristics of physicians and electronic health records associated with positive experience. We performed a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey 2009 to 2013. Survey questions included provider and practice demographics, health record information, and Likert-type scaled questions regarding how electronic health record use affected clinical practice. The survey response rate ranged from 50% to 65%, with 62% in 2013. Increasing numbers of physicians in Rhode Island use an electronic health record. In 2013, 81% of physicians used one, and adoption varied by clinical subspecialty. Most providers think that electronic health record use improves billing and quality improvement but has not improved job satisfaction. Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P electronic health record introduction (P electronic health record vendors most frequently used in Rhode Island, 5 were associated with improved job satisfaction. We report the largest statewide study of electronic health record adoption to date. We found increasing physician use in Rhode Island, and the extent of adoption varies by subspecialty. Although older physicians are less likely to be positive about electronic health record adoption, longer and more sophisticated use are associated with more positive opinions, suggesting acceptance will grow over time. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Challenges to Providing a Successful Central Configuration Service to Support CERN’s New Controls Diagnostics and Monitoring System

    CERN Document Server

    Makonnen, Z; Zaharieva, Z

    2014-01-01

    The Controls Diagnostic and Monitoring service (DIAMON) provides monitoring and diagnostics tools to the operators in the CERN Control Centre. A recent reengineering presented the opportunity to restructure its data management and to integrate it with the central Controls Configuration Service (CCS). The CCS provides the Configuration Management for the Controls System for all accelerators at CERN. The new facility had to cater for the configuration management of all agents monitored by DIAMON, (>3000 computers of different types), provide deployment information, relations between metrics, and historical information. In addition, it had to be integrated into the operational CCS, while ensuring stability and data coherency. An important design decision was to largely reuse the existing infrastructure in the CCS and adapt the DIAMON data management to it e.g. by using the device/property model through a Virtual Devices framework to model the DIAMON agents. This article will show how these challenging requiremen...

  15. Porous TiO₂-Based Gas Sensors for Cyber Chemical Systems to Provide Security and Medical Diagnosis.

    Science.gov (United States)

    Galstyan, Vardan

    2017-12-19

    Gas sensors play an important role in our life, providing control and security of technical processes, environment, transportation and healthcare. Consequently, the development of high performance gas sensor devices is the subject of intense research. TiO₂, with its excellent physical and chemical properties, is a very attractive material for the fabrication of chemical sensors. Meanwhile, the emerging technologies are focused on the fabrication of more flexible and smart systems for precise monitoring and diagnosis in real-time. The proposed cyber chemical systems in this paper are based on the integration of cyber elements with the chemical sensor devices. These systems may have a crucial effect on the environmental and industrial safety, control of carriage of dangerous goods and medicine. This review highlights the recent developments on fabrication of porous TiO₂-based chemical gas sensors for their application in cyber chemical system showing the convenience and feasibility of such a model to provide the security and to perform the diagnostics. The most of reports have demonstrated that the fabrication of doped, mixed and composite structures based on porous TiO₂ may drastically improve its sensing performance. In addition, each component has its unique effect on the sensing properties of material.

  16. Porous TiO2-Based Gas Sensors for Cyber Chemical Systems to Provide Security and Medical Diagnosis

    Science.gov (United States)

    2017-01-01

    Gas sensors play an important role in our life, providing control and security of technical processes, environment, transportation and healthcare. Consequently, the development of high performance gas sensor devices is the subject of intense research. TiO2, with its excellent physical and chemical properties, is a very attractive material for the fabrication of chemical sensors. Meanwhile, the emerging technologies are focused on the fabrication of more flexible and smart systems for precise monitoring and diagnosis in real-time. The proposed cyber chemical systems in this paper are based on the integration of cyber elements with the chemical sensor devices. These systems may have a crucial effect on the environmental and industrial safety, control of carriage of dangerous goods and medicine. This review highlights the recent developments on fabrication of porous TiO2-based chemical gas sensors for their application in cyber chemical system showing the convenience and feasibility of such a model to provide the security and to perform the diagnostics. The most of reports have demonstrated that the fabrication of doped, mixed and composite structures based on porous TiO2 may drastically improve its sensing performance. In addition, each component has its unique effect on the sensing properties of material. PMID:29257076

  17. User-centered development and testing of a monitoring system that provides feedback regarding physical functioning to elderly people

    Directory of Open Access Journals (Sweden)

    Vermeulen J

    2013-08-01

    Full Text Available Joan Vermeulen,1 Jacques CL Neyens,1 Marieke D Spreeuwenberg,1 Erik van Rossum,1,2 Walther Sipers,3 Herbert Habets,3 David J Hewson,4 Luc P de Witte1,2 1School for Public Health and Primary Care (CAPHRI, Maastricht University, Maastricht, The Netherlands; 2Research Center for Technology in Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands; 3Expertise Center for Elderly Care, Orbis Medical Center, Sittard, The Netherlands; 4Institute Charles Delaunay, Université de Technologie de Troyes, Troyes, France Purpose: To involve elderly people during the development of a mobile interface of a monitoring system that provides feedback to them regarding changes in physical functioning and to test the system in a pilot study. Methods and participants: The iterative user-centered development process consisted of the following phases: (1 selection of user representatives; (2 analysis of users and their context; (3 identification of user requirements; (4 development of the interface; and (5 evaluation of the interface in the lab. Subsequently, the monitoring and feedback system was tested in a pilot study by five patients who were recruited via a geriatric outpatient clinic. Participants used a bathroom scale to monitor weight and balance, and a mobile phone to monitor physical activity on a daily basis for six weeks. Personalized feedback was provided via the interface of the mobile phone. Usability was evaluated on a scale from 1 to 7 using a modified version of the Post-Study System Usability Questionnaire (PSSUQ; higher scores indicated better usability. Interviews were conducted to gain insight into the experiences of the participants with the system. Results: The developed interface uses colors, emoticons, and written and/or spoken text messages to provide daily feedback regarding (changes in weight, balance, and physical activity. The participants rated the usability of the monitoring and feedback system with a mean score of 5

  18. Autonomous urban reconnaissance ingress system (AURIS): providing a tactically relevant autonomous door-opening kit for unmanned ground vehicles

    Science.gov (United States)

    Shane, David J.; Rufo, Michael A.; Berkemeier, Matthew D.; Alberts, Joel A.

    2012-06-01

    The Autonomous Urban Reconnaissance Ingress System (AURIS™) addresses a significant limitation of current military and first responder robotics technology: the inability of reconnaissance robots to open doors. Leveraging user testing as a baseline, the program has derived specifications necessary for military personnel to open doors with fielded UGVs (Unmanned Ground Vehicles), and evaluates the technology's impact on operational mission areas: duration, timing, and user patience in developing a tactically relevant, safe, and effective system. Funding is provided through the US ARMY Tank Automotive Research, Development and Engineering Center (TARDEC) and the project represents a leap forward in perception, autonomy, robotic implements, and coordinated payload operation in UGVs. This paper describes high level details of specification generation, status of the last phase of development, an advanced view of the system autonomy capability, and a short look ahead towards the ongoing work on this compelling and important technology.

  19. Patient and provider perspectives on quality and health system effectiveness in a transition economy: evidence from Ukraine.

    Science.gov (United States)

    Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R

    2014-08-01

    Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies

  20. The applicability of constructivist user studies: how can constructivist inquiry inform service providers and systems designers? Constructivist inquiry, Case study, Systems design, User behaviour

    Directory of Open Access Journals (Sweden)

    Alison Pickard

    2004-01-01

    Full Text Available This paper has attempted to clarify the ways in which individual, holistic case studies, produced via the process of constructivist inquiry, can be tested for trustworthiness and applied to other, similar situations. Service providers and systems designers need contextual information concerning their users in order to design and provide systems and services that will function effectively and efficiently within those contexts. Abstract models can only provide abstract insight into human behaviour and this is rarely sufficient detail upon which to base the planning and delivery of a service. The methodological issues which surround the applicability of individual, holistic case studies are discussed, explaining the concept of 'contextual applicability.' The relevance and usefulness of in-depth case study research to systems designers and service providers is highlighted.

  1. 2011-2013 Indiana Statewide Imagery and LiDAR Program: Lake Michigan Watershed Counties

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Indiana's Statewide LiDAR data is produced at 1.5-meter average post spacing for all 92 Indiana Counties covering more than 36,420 square miles. New LiDAR data was...

  2. Effects of Road Salt on Connecticut's Groundwater: A Statewide Centennial Perspective.

    Science.gov (United States)

    Cassanelli, James P; Robbins, Gary A

    2013-01-01

    This study examined the extent to which development and road salting has affected Connecticut's groundwater. We gathered water quality data from different time periods between 1894 and the present and analyzed the data using maps generated with ESRI ArcGIS. Historical reports illustrate a statewide baseline trend of decreasing chloride concentration northward across the State (average, 2 ppm). Since then, statewide chloride concentrations in ground water have increased by more than an order of magnitude on average. Analysis indicates spatial correlation between chloride impacts and major roadways. Furthermore, increases in statewide chloride concentration parallel increases in road salt application. Projected trends suggest that statewide baseline concentrations will increase by an amount equal to five times background levels between the present and the year 2030. The analytical process outlined herein can be readily applied to any region to investigate salt impacts on large spatial and temporal scales. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  3. Statewide Dissemination of a Rural, Non-Chain Restaurant Intervention: Adoption, Implementation and Maintenance

    Science.gov (United States)

    Nothwehr, F.; Haines, H.; Chrisman, M.; Schultz, U.

    2014-01-01

    The obesity epidemic calls for greater dissemination of nutrition-related programs, yet there remain few studies of the dissemination process. This study, guided by elements of the RE-AIM model, describes the statewide dissemination of a simple, point-of-purchase restaurant intervention. Conducted in rural counties of the Midwest, United States,…

  4. Hawai'i Youth at Risk? Conceptual Challenges in Communicating a Statewide Mentoring Initiative.

    Science.gov (United States)

    Pollard, Vincent Kelly

    This paper discusses several issues considered as part of a statewide mentoring initiative. It is divided into three sections. The first section summarizes the key issues associated with short-term mentoring and mentoring in a longer-term, socially transformative context. Data from Comprehensive School Alienation Program is discussed concerning…

  5. Results of the 1992 State-Wide Business and Industry Survey.

    Science.gov (United States)

    Jarrett, Carole, Comp.; And Others

    As part of an effort to develop courses and programs that reflect California business and industry's current and future needs, two studies were performed by Solano Community College to examine statewide trends and issues related to office automation and marketing and management. In conducting the study of office automation, 5,000 surveys were…

  6. A case study: planning a statewide information resource for health professionals: an evidence-based approach

    Science.gov (United States)

    Chew, Katherine; Watson, Linda; Parker, Mary

    2009-01-01

    Question: What is the best approach for implementing a statewide electronic health library (eHL) to serve all health professionals in Minnesota? Setting: The research took place at the University of Minnesota Health Sciences Libraries. Methods: In January 2008, the authors began planning a statewide eHL for health professionals following the five-step process for evidence-based librarianship: formulating the question, finding the best evidence, appraising the evidence, assessing costs and benefits, and evaluating the effectiveness of resulting actions. Main Results: The authors identified best practices for developing a statewide eHL for health professionals relating to audience or population served, information resources, technology and access, funding model, and implementation and sustainability. They were compared to the mission of the eHL project to drive strategic directions by developing recommendations. Conclusion: EBL can guide the planning process for a statewide eHL, but findings must be tailored to the local environment to address information needs and ensure long-term sustainability. PMID:19851487

  7. A Multilevel, Statewide Investigation of School District Anti-Bullying Policy Quality and Student Bullying Involvement

    Science.gov (United States)

    Gower, Amy L.; Cousin, Molly; Borowsky, Iris W.

    2017-01-01

    Background: Although nearly all states in the United States require school districts to adopt anti-bullying policies, little research examines the effect of these policies on student bullying and health. Using a statewide sample, we investigated associations between the quality of school district anti-bullying policies and student bullying…

  8. Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals

    OpenAIRE

    Rood, Brian A.; Puckett, Julia A.; Pantalone, David W.; Bradford, Judith B.

    2015-01-01

    Transgender individuals experience violence and discrimination, which, in addition to gender transitioning, are established correlates of psychological distress. In a statewide sample of 350 transgender adults, we investigated whether a history of violence and discrimination increased the odds of reporting lifetime suicidal ideation (SI) and whether differences in SI were predicted by gender transition status. Violence, discrimination, and transition status significantly predicted SI. Compare...

  9. Contracting for Statewide Student Achievement Tests: A Review. Department of Public Instruction 98-4.

    Science.gov (United States)

    Wisconsin State Legislative Audit Bureau, Madison.

    The Wisconsin legislature has required the Department of Public Instruction to adopt or approve standardized tests for statewide use to measure student attainment of knowledge and concepts in grades 4, 8, and 10. Although school districts generally gave high ratings to the contents of TerraNova (McGraw Hill), the testing instrument most recently…

  10. A Similarity-Ranking Method on Semantic Computing for Providing Information-Services in Station-Concierge System

    Directory of Open Access Journals (Sweden)

    Motoki Yokoyama

    2017-07-01

    Full Text Available The prevalence of smartphones and wireless broadband networks have been progressing as a new Railway infomration environment. According to the spread of such devices and information technology, various types of information can be obtained from databases connected to the Internet. One scenario of obtaining such a wide variety of information resources is in the phase of user’s transportation. This paper proposes an information provision system, named the Station Concierge System that matches the situation and intention of passengers. The purpose of this system is to estimate the needs of passengers like station staff or hotel concierge and to provide information resources that satisfy user’s expectations dynamically. The most important module of the system is constructed based on a new information ranking method for passenger intention prediction and service recommendation. This method has three main features, which are (1 projecting a user to semantic vector space by using her current context, (2 predicting the intention of a user based on selecting a semantic vector subspace, and (3 ranking the services by a descending order of relevant scores to the user’ intention. By comparing the predicted results of our method with those of two straightforward computation methods, the experimental studies show the effectiveness and efficiency of the proposed method. Using this system, users can obtain transit information and service map that dynamically matches their context.

  11. IEEE 802.15.4 Frame Aggregation Enhancement to Provide High Performance in Life-Critical Patient Monitoring Systems.

    Science.gov (United States)

    Akbar, Muhammad Sajjad; Yu, Hongnian; Cang, Shuang

    2017-01-28

    In wireless body area sensor networks (WBASNs), Quality of Service (QoS) provision for patient monitoring systems in terms of time-critical deadlines, high throughput and energy efficiency is a challenging task. The periodic data from these systems generates a large number of small packets in a short time period which needs an efficient channel access mechanism. The IEEE 802.15.4 standard is recommended for low power devices and widely used for many wireless sensor networks applications. It provides a hybrid channel access mechanism at the Media Access Control (MAC) layer which plays a key role in overall successful transmission in WBASNs. There are many WBASN's MAC protocols that use this hybrid channel access mechanism in variety of sensor applications. However, these protocols are less efficient for patient monitoring systems where life critical data requires limited delay, high throughput and energy efficient communication simultaneously. To address these issues, this paper proposes a frame aggregation scheme by using the aggregated-MAC protocol data unit (A-MPDU) which works with the IEEE 802.15.4 MAC layer. To implement the scheme accurately, we develop a traffic patterns analysis mechanism to understand the requirements of the sensor nodes in patient monitoring systems, then model the channel access to find the performance gap on the basis of obtained requirements, finally propose the design based on the needs of patient monitoring systems. The mechanism is initially verified using numerical modelling and then simulation is conducted using NS2.29, Castalia 3.2 and OMNeT++. The proposed scheme provides the optimal performance considering the required QoS.

  12. On the assessment of performance and emissions characteristics of a SI engine provided with a laser ignition system

    Science.gov (United States)

    Birtas, A.; Boicea, N.; Draghici, F.; Chiriac, R.; Croitoru, G.; Dinca, M.; Dascalu, T.; Pavel, N.

    2017-10-01

    Performance and exhaust emissions of spark ignition engines are strongly dependent on the development of the combustion process. Controlling this process in order to improve the performance and to reduce emissions by ensuring rapid and robust combustion depends on how ignition stage is achieved. An ignition system that seems to be able for providing such an enhanced combustion process is that based on plasma generation using a Q-switched solid state laser that delivers pulses with high peak power (of MW-order level). The laser-spark devices used in the present investigations were realized using compact diffusion-bonded Nd:YAG/Cr4+:YAG ceramic media. The laser igniter was designed, integrated and built to resemble a classical spark plug and therefore it could be mounted directly on the cylinder head of a passenger car engine. In this study are reported the results obtained using such ignition system provided for a K7M 710 engine currently produced by Renault-Dacia, where the standard calibrations were changed towards the lean mixtures combustion zone. Results regarding the performance, the exhaust emissions and the combustion characteristics in optimized spark timing conditions, which demonstrate the potential of such an innovative ignition system, are presented.

  13. Benefits of Demand-Side Response in Providing Frequency Response Service in the Future GB Power System

    Energy Technology Data Exchange (ETDEWEB)

    Teng, Fei, E-mail: fei.teng09@imperial.ac.uk; Aunedi, Marko; Pudjianto, Danny; Strbac, Goran [Department of Electrical and Electronic Engineering, Imperial College London, London (United Kingdom)

    2015-08-18

    The demand for ancillary service is expected to increase significantly in the future Great Britain (GB) electricity system due to high penetration of wind. In particular, the need for frequency response, required to deal with sudden frequency drops following a loss of generator, will increase because of the limited inertia capability of wind plants. This paper quantifies the requirements for primary frequency response and analyses the benefits of frequency response provision from demand-side response (DSR). The results show dramatic changes in frequency response requirements driven by high penetration of wind. Case studies carried out by using an advanced stochastic generation scheduling model suggest that the provision of frequency response from DSR could greatly reduce the system operation cost, wind curtailment, and carbon emissions in the future GB system characterized by high penetration of wind. Furthermore, the results demonstrate that the benefit of DSR shows significant diurnal and seasonal variation, whereas an even more rapid (instant) delivery of frequency response from DSR could provide significant additional value. Our studies also indicate that the competing technologies to DSR, namely battery storage, and more flexible generation could potentially reduce its value by up to 35%, still leaving significant room to deploy DSR as frequency response provider.

  14. Research Involving Health Providers and Managers: Ethical Issues Faced by Researchers Conducting Diverse Health Policy and Systems Research in Kenya.

    Science.gov (United States)

    Molyneux, Sassy; Tsofa, Benjamin; Barasa, Edwine; Nyikuri, Mary Muyoka; Waweru, Evelyn Wanjiku; Goodman, Catherine; Gilson, Lucy

    2016-12-01

    There is a growing interest in the ethics of Health Policy and Systems Research (HPSR), and especially in areas that have particular ethical salience across HPSR. Hyder et al (2014) provide an initial framework to consider this, and call for more conceptual and empirical work. In this paper, we respond by examining the ethical issues that arose for researchers over the course of conducting three HPSR studies in Kenya in which health managers and providers were key participants. All three studies involved qualitative work including observations and individual and group interviews. Many of the ethical dilemmas researchers faced only emerged over the course of the fieldwork, or on completion, and were related to interactions and relationships between individuals operating at different levels or positions in health/research systems. The dilemmas reveal significant ethical challenges for these forms of HPSR, and show that potential 'solutions' to dilemmas often lead to new issues and complications. Our experiences support the value of research ethics frameworks, and suggest that these can be enriched by incorporating careful consideration of context embedded social relations into research planning and conduct. Many of these essential relational elements of ethical practice, and of producing quality data, are given stronger emphasis in social science research ethics than in epidemiological, clinical or biomedical research ethics, and are particularly relevant where health systems are understood as social and political constructs. We conclude with practical and research implications. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

  15. Benefits of Demand-Side Response in Providing Frequency Response Service in the Future GB Power System

    International Nuclear Information System (INIS)

    Teng, Fei; Aunedi, Marko; Pudjianto, Danny; Strbac, Goran

    2015-01-01

    The demand for ancillary service is expected to increase significantly in the future Great Britain (GB) electricity system due to high penetration of wind. In particular, the need for frequency response, required to deal with sudden frequency drops following a loss of generator, will increase because of the limited inertia capability of wind plants. This paper quantifies the requirements for primary frequency response and analyses the benefits of frequency response provision from demand-side response (DSR). The results show dramatic changes in frequency response requirements driven by high penetration of wind. Case studies carried out by using an advanced stochastic generation scheduling model suggest that the provision of frequency response from DSR could greatly reduce the system operation cost, wind curtailment, and carbon emissions in the future GB system characterized by high penetration of wind. Furthermore, the results demonstrate that the benefit of DSR shows significant diurnal and seasonal variation, whereas an even more rapid (instant) delivery of frequency response from DSR could provide significant additional value. Our studies also indicate that the competing technologies to DSR, namely battery storage, and more flexible generation could potentially reduce its value by up to 35%, still leaving significant room to deploy DSR as frequency response provider.

  16. Effectiveness of a Statewide Abusive Head Trauma Prevention Program in North Carolina.

    Science.gov (United States)

    Zolotor, Adam J; Runyan, Desmond K; Shanahan, Meghan; Durrance, Christine Piette; Nocera, Maryalice; Sullivan, Kelly; Klevens, Joanne; Murphy, Robert; Barr, Marilyn; Barr, Ronald G

    2015-12-01

    Abusive head trauma (AHT) is a serious condition, with an incidence of approximately 30 cases per 100,000 person-years in the first year of life. To assess the effectiveness of a statewide universal AHT prevention program. In total, 88.29% of parents of newborns (n = 405 060) in North Carolina received the intervention (June 1, 2009, to September 30, 2012). A comparison of preintervention and postintervention was performed using nurse advice line telephone calls regarding infant crying (January 1, 2005, to December 31, 2010). A difference-in-difference analysis compared AHT rates in the prevention program state with those of other states before and after the implementation of the program (January 1, 2000, to December 31, 2011). The Period of PURPLE Crying intervention, developed by the National Center on Shaken Baby Syndrome, was delivered by nurse-provided education, a DVD, and a booklet, with reinforcement by primary care practices and a media campaign. Changes in proportions of telephone calls for crying concerns to a nurse advice line and in AHT rates per 100,000 infants after the intervention (June 1, 2009, to September 30, 2011) in the first year of life using hospital discharge data for January 1, 2000, to December 31, 2011. In the 2 years after implementation of the intervention, parental telephone calls to the nurse advice line for crying declined by 20% for children younger than 3 months (rate ratio, 0.80; 95% CI, 0.73-0.87; P programmatic efforts and evaluation are needed to demonstrate an effect on AHT rates.

  17. Peer Crowd Identification and Adolescent Health Behaviors: Results From a Statewide Representative Study.

    Science.gov (United States)

    Jordan, Jeffrey W; Stalgaitis, Carolyn A; Charles, John; Madden, Patrick A; Radhakrishnan, Anjana G; Saggese, Daniel

    2018-02-01

    Peer crowds are macro-level subcultures that share similarities across geographic areas. Over the past decade, dozens of studies have explored the association between adolescent peer crowds and risk behaviors, and how they can inform public health efforts. However, despite the interest, researchers have not yet reported on crowd size and risk levels from a representative sample, making it difficult for practitioners to apply peer crowd science to interventions. The current study reports findings from the first statewide representative sample of adolescent peer crowd identification and health behaviors. Weighted data were analyzed from the 2015 Virginia Youth Survey of Health Behaviors ( n = 4,367). Peer crowds were measured via the I-Base Survey™, a photo-based peer crowd survey instrument. Frequencies and confidence intervals of select behaviors including tobacco use, substance use, nutrition, physical activity, and violence were examined to identify high- and low-risk crowds. Logistic regression was used to calculate adjusted odds ratios for each crowd and behavior. Risky behaviors clustered in two peer crowds. Hip Hop crowd identification was associated with substance use, violence, and some depression and suicidal behaviors. Alternative crowd identification was associated with increased risk for some substance use behaviors, depression and suicide, bullying, physical inactivity, and obesity. Mainstream and, to a lesser extent, Popular, identities were associated with decreased risk for most behaviors. Findings from the first representative study of peer crowds and adolescent behavior identify two high-risk groups, providing critical insights for practitioners seeking to maximize public health interventions by targeting high-risk crowds.

  18. 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...

  19. Statewide Quality Improvement Initiative to Reduce Early Elective Deliveries and Improve Birth Registry Accuracy.

    Science.gov (United States)

    Kaplan, Heather C; King, Eileen; White, Beth E; Ford, Susan E; Fuller, Sandra; Krew, Michael A; Marcotte, Michael P; Iams, Jay D; Bailit, Jennifer L; Bouchard, Jo M; Friar, Kelly; Lannon, Carole M

    2018-04-01

    To evaluate the success of a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data accuracy rapidly and at scale in Ohio. Between February 2013 and March 2014, participating hospitals were involved in a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data. This initiative was designed as a learning collaborative model (group webinars and a single face-to-face meeting) and included individual quality improvement coaching. It was implemented using a stepped wedge design with hospitals divided into three balanced groups (waves) participating in the initiative sequentially. Birth registry data were used to assess hospital rates of nonmedically indicated inductions at less than 39 weeks of gestation. Comparisons were made between groups participating and those not participating in the initiative at two time points. To measure birth registry accuracy, hospitals conducted monthly audits comparing birth registry data with the medical record. Associations were assessed using generalized linear repeated measures models accounting for time effects. Seventy of 72 (97%) eligible hospitals participated. Based on birth registry data, nonmedically indicated inductions at less than 39 weeks of gestation declined in all groups with implementation (wave 1: 6.2-3.2%, Pinitiative, they saw significant decreases in rates of early elective deliveries as compared with wave 3 (control; P=.018). All waves had significant improvement in birth registry accuracy (wave 1: 80-90%, P=.017; wave 2: 80-100%, P=.002; wave 3: 75-100%, Pinitiative enabled statewide spread of change strategies to decrease early elective deliveries and improve birth registry accuracy over 14 months and could be used for rapid dissemination of other evidence-based obstetric care practices across states or hospital systems.

  20. Making non-discrimination and equal opportunity a reality in Kenya's health provider education system: results of a gender analysis.

    Science.gov (United States)

    Newman, Constance; Kimeu, Anastasiah; Shamblin, Leigh; Penders, Christopher; McQuide, Pamela A; Bwonya, Judith

    2011-01-01

    IntraHealth International's USAID-funded Capacity Kenya project conducted a performance needs assessment of the Kenya health provider education system in 2010. Various stakeholders shared their understandings of the role played by gender and identified opportunities to improve gender equality in health provider education. Findings suggest that occupational segregation, sexual harassment and discrimination based on pregnancy and family responsibilities present problems, especially for female students and faculty. To grow and sustain its workforce over the long term, Kenyan human resource leaders and managers must act to eliminate gender-based obstacles by implementing existing non-discrimination and equal opportunity policies and laws to increase the entry, retention and productivity of students and faculty. Families and communities must support girls' schooling and defer early marriage. All this will result in a fuller pool of students, faculty and matriculated health workers and, ultimately, a more robust health workforce to meet Kenya's health challenges.

  1. Web-Based Self-Service Systems for Managed IT Support: Service Provider Perspectives of Stakeholder-Based Issues

    Science.gov (United States)

    Cooper, Vanessa A.; Lichtenstein, Sharman; Smith, Ross

    This chapter explores the provision of after-sales information technology (IT) support services using Web-based self-service systems (WSSs) in a business-to-business (B2B) context. A recent study conducted at six large multi-national IT support organisations revealed a number of critical success factors (CSFs) and stakeholder-based issues. To better identify and understand these important enablers and barriers, we explain how WSSs should be considered within a complex network of service providers, business partners and customer firms. The CSFs and stakeholder-based issues are discussed. The chapter highlights that for more successful service provision using WSSs, IT service providers should collaborate more effectively with enterprise customers and business partners and should better integrate their WSSs.

  2. A novel system for providing compatible blood to patients during surgery: "self-service" electronic blood banking by nursing staff.

    Science.gov (United States)

    Cheng, G; Chiu, D S; Chung, A S; Wong, H F; Chan, M W; Lui, Y K; Choy, F M; Chan, J C; Chan, A H; Lam, S T; Fan, T C

    1996-04-01

    A good blood bank must be able to provide compatible blood units promptly to operating room patients with minimal wastage. A "self-service" by nursing staff blood banking system that is safe, efficient, and well-accepted has been developed. Specific blood units are no longer assigned to surgical patients who have a negative pretransfusion antibody screen, irrespective of the type of surgery. A computer-generated list of the serial numbers of all group-identical blood units currently in the blood bank inventory is provided for each patient. The units themselves are not labeled with a patient's name. The group O list will be provided for group O patients, the group A list for group A patients, and so forth. Should the patient require transfusion during surgery, the operating room nurses go to the refrigerator, remove any group-identical unit, and check the serial number of the unit against the serial numbers on the patient's list. If the serial number is on that list, the blood bank will accept responsibility for compatibility. The system was implemented in 1995. Since implementation, a total of 2154 patients have undergone operations at this hospital. Thirty-two patients received more than 10 units of red cells each. There were no transfusion errors. The crossmatch-to-transfusion ratio was reduced from 1.67 to 1.12. Turnaround time for supplying additional or urgent units to patients in operating room was shortened from 33 to 2.5 minutes. There was no incidence of a blood unit's serial number not being on the list. Work by nurses and technical staff was reduced by nearly 50 percent. The "self-service" (by nursing staff) blood banking system described is safe and efficient. It saves staff time and can be easily set up.

  3. AN OVERVIEW AT MACROECONOMIC LEVEL THROUGH ACCOUNTING FIGURES PROVIDED BY THE ECB ASSESSMENT ON EUROZONE BANKING SYSTEM

    Directory of Open Access Journals (Sweden)

    Olivera Ecaterina OROS

    2014-05-01

    Full Text Available Along with the main macroeconomic indicators, the credit risk indicators became an important leverage in monitoring and evaluating the standard of living at a national level and the country’s economic evolution. These two types of indicators show a strong interconnection, and the correct assessment of the credit risk indicators becomes a must. As a consequence, the central banks and the main regulators in the Europe aria provided for a strict monitoring of such indicators and further on, for constant update of the banking supervisory regulations. In October 2013, the European Central bank (ECB issued the Note of Comprehensive Assessment that will be carried out during 2014, on the Euro-zone1 banking system. The outcome of the assessment will impact not only the accounting figures of the banking system, but also might change the macroeconomic overview of Euro-zone and the IASB's Conceptual Framework for Financial Reporting.

  4. Integrating the Radiology Information System with Computerised Provider Order Entry: The Impact on Repeat Medical Imaging Investigations.

    Science.gov (United States)

    Vecellio, Elia; Georgiou, Andrew

    2016-01-01

    Repeat and redundant procedures in medical imaging are associated with increases in resource utilisation and labour costs. Unnecessary medical imaging in some modalities, such as X-Ray (XR) and Computed Tomography (CT) is an important safety issue because it exposes patients to ionising radiation which can be carcinogenic and is associated with higher rates of cancer. The aim of this study was to assess the impact of implementing an integrated Computerised Provider Order Entry (CPOE)/Radiology Information System (RIS)/Picture Archiving and Communications System (PACS) system on the number of XR and CT imaging procedures (including repeat imaging requests) for inpatients at a large metropolitan hospital. The study found that patients had an average 0.47 fewer XR procedures and 0.07 fewer CT procedures after the implementation of the integrated system. Part of this reduction was driven by a lower rate of repeat procedures: the average inpatient had 0.13 fewer repeat XR procedures within 24-hours of the previous identical XR procedure. A similar decrease was not evident for repeat CT procedures. Reduced utilisation of imaging procedures (especially those within very short intervals from the previous identical procedure, which are more likely to be redundant) has implications for the safety of patients and the cost of medical imaging services.

  5. The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services.

    Science.gov (United States)

    Brown, Kathleen M; Hirshon, Jon Mark; Alcorta, Richard; Weik, Tasmeen S; Lawner, Ben; Ho, Shiu; Wright, Joseph L

    2014-01-01

    In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidence-based prehospital pain management protocol developed using this model process. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review Committee (PRC) of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The PRC recommended revisions to the Maryland protocol that reflected recommendations in the EBG: weight-based dosing and repeat dosing of morphine. A training curriculum was developed and implemented using Maryland's online Learning Management System and successfully accessed by 3,941 paramedics and 15,969 BLS providers. Field providers submitted electronic patient care reports to the MIEMSS statewide prehospital database. Inclusion criteria were injured or burned patients transported by Maryland ambulances to Maryland hospitals whose electronic patient care records included data for level of EMS provider training during a 12-month preimplementation period and a 12-month postimplementation period from September 2010 through March 2012. We compared the percentage of patients receiving pain scale assessments and morphine, as well as the dose of morphine administered and the use of naloxone as a rescue medication for opiate use, before and after the protocol change. No differences were seen in the percentage of patients who had a pain score documented or the percent of patients receiving morphine before and after the protocol change, but there was a significant increase in the total dose and dose in mg/kg administered per patient. During the postintervention phase, patients received an 18% higher total morphine dose and a 14.9% greater mg/kg dose. We demonstrated that the implementation of a revised

  6. Inactivated Influenza Vaccine That Provides Rapid, Innate-Immune-System-Mediated Protection and Subsequent Long-Term Adaptive Immunity.

    Science.gov (United States)

    Chua, Brendon Y; Wong, Chinn Yi; Mifsud, Edin J; Edenborough, Kathryn M; Sekiya, Toshiki; Tan, Amabel C L; Mercuri, Francesca; Rockman, Steve; Chen, Weisan; Turner, Stephen J; Doherty, Peter C; Kelso, Anne; Brown, Lorena E; Jackson, David C

    2015-10-27

    The continual threat to global health posed by influenza has led to increased efforts to improve the effectiveness of influenza vaccines for use in epidemics and pandemics. We show in this study that formulation of a low dose of inactivated detergent-split influenza vaccine with a Toll-like receptor 2 (TLR2) agonist-based lipopeptide adjuvant (R4Pam2Cys) provides (i) immediate, antigen-independent immunity mediated by the innate immune system and (ii) significant enhancement of antigen-dependent immunity which exhibits an increased breadth of effector function. Intranasal administration of mice with vaccine formulated with R4Pam2Cys but not vaccine alone provides protection against both homologous and serologically distinct (heterologous) viral strains within a day of administration. Vaccination in the presence of R4Pam2Cys subsequently also induces high levels of systemic IgM, IgG1, and IgG2b antibodies and pulmonary IgA antibodies that inhibit hemagglutination (HA) and neuraminidase (NA) activities of homologous but not heterologous virus. Improved primary virus nucleoprotein (NP)-specific CD8(+) T cell responses are also induced by the use of R4Pam2Cys and are associated with robust recall responses to provide heterologous protection. These protective effects are demonstrated in wild-type and antibody-deficient animals but not in those depleted of CD8(+) T cells. Using a contact-dependent virus transmission model, we also found that heterologous virus transmission from vaccinated mice to naive mice is significantly reduced. These results demonstrate the potential of adding a TLR2 agonist to an existing seasonal influenza vaccine to improve its utility by inducing immediate short-term nonspecific antiviral protection and also antigen-specific responses to provide homologous and heterologous immunity. The innate and adaptive immune systems differ in mechanisms, specificities, and times at which they take effect. The innate immune system responds within hours of

  7. The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative.

    Science.gov (United States)

    Chang, Victor; Schwalb, Jason M; Nerenz, David R; Pietrantoni, Lisa; Jones, Sharon; Jankowski, Michelle; Oja-Tebbe, Nancy; Bartol, Stephen; Abdulhak, Muwaffak

    2015-12-01

    have been entered into the registry. This number reflects 4824 eligible cases with confirmed surgery dates. Of these 4824 eligible cases, 3338 cases went beyond the 120-day window and were considered eligible for the extraction of surgical details, 90-day outcomes, and adverse events. Among these 3338 patients, there are a total of 2469 lumbar cases, 862 cervical cases, and 7 combined procedures that were entered into the registry. CONCLUSIONS In addition to functioning as a registry, MSSIC is also meant to be a platform for quality improvement with the potential for future initiatives and best practices to be implemented statewide in order to improve quality and lower costs. With its current rate of recruitment and expansion, MSSIC will provide a robust platform as a regional prospective registry. Its unique funding model, which is supported by BCBSM/BCN, will help ensure its longevity and viability, as has been observed in other CQIs that have been active for several years.

  8. Developing a tool to assess motivation among health service providers working with public health system in India.

    Science.gov (United States)

    Purohit, Bhaskar; Maneskar, Abhishek; Saxena, Deepak

    2016-04-14

    Addressing the shortage of health service providers (doctors and nurses) in rural health centres remains a huge challenge. The lack of motivation of health service providers to serve in rural areas is one of the major reasons for such shortage. While many studies have aimed at analysing the reasons for low motivation, hardly any studies in India have focused on developing valid and reliable tools to measure motivation among health service providers. Hence, the objective of the study was to test and develop a valid and reliable instrument to assess the motivation of health service providers working with the public health system in India and the extent to which the motivation factors included in the study motivate health service providers to perform better at work. The present study adapted an already developed tool on motivation. The reliability and validity of the tool were established using different methods. The first stage of the tool development involved content development and assessment where, after a detailed literature review, a predeveloped tool with 19 items was adapted. However, in light of the literature review and pilot test, the same tool was modified to suit the local context by adding 7 additional items so that the final modified tool comprised of 26 items. A correlation matrix was applied to check the pattern of relationships among the items. The total sample size for the study was 154 health service providers from one Western state in India. To understand the sampling adequacy, the Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett's test of sphericity were applied and finally factor analysis was carried out to calculate the eigenvalues and to understand the relative impact of factors affecting motivation. A correlation matrix value of 0.017 was obtained narrating multi-co-linearity among the observations. Based on initial factor analysis, 8 out of 26 study factors were excluded from the study components with a cutoff range of less than

  9. Single Intravenous Dose of Novel Flurbiprofen-Loaded Proniosome Formulations Provides Prolonged Systemic Exposure and Anti-inflammatory Effect.

    Science.gov (United States)

    Verma, Preeti; Prajapati, Sunil K; Yadav, Rajbharan; Senyschyn, Danielle; Shea, Peter R; Trevaskis, Natalie L

    2016-11-07

    hydrated proniosomes can prolong systemic drug exposure over 3 days and provide a sustained therapeutic effect. The developed proniosomes represent a novel approach to treat acute pain and inflammation with the potential to be administered as a single intravenous dose by a clinician at the time of injury or surgery that provides adequate relief for several days and reduces fluctuations in therapy. Similar systems loaded with different drugs have potential for broader application in anesthesia, anti-infective, antiemetic, and cancer therapy.

  10. Plant lighting system with five wavelength-band light-emitting diodes providing photon flux density and mixing ratio control

    Directory of Open Access Journals (Sweden)

    Yano Akira

    2012-11-01

    Full Text Available Abstract Background Plant growth and development depend on the availability of light. Lighting systems therefore play crucial roles in plant studies. Recent advancements of light-emitting diode (LED technologies provide abundant opportunities to study various plant light responses. The LED merits include solidity, longevity, small element volume, radiant flux controllability, and monochromaticity. To apply these merits in plant light response studies, a lighting system must provide precisely controlled light spectra that are useful for inducing various plant responses. Results We have developed a plant lighting system that irradiated a 0.18 m2 area with a highly uniform distribution of photon flux density (PFD. The average photosynthetic PFD (PPFD in the irradiated area was 438 micro-mol m–2 s–1 (coefficient of variation 9.6%, which is appropriate for growing leafy vegetables. The irradiated light includes violet, blue, orange-red, red, and far-red wavelength bands created by LEDs of five types. The PFD and mixing ratio of the five wavelength-band lights are controllable using a computer and drive circuits. The phototropic response of oat coleoptiles was investigated to evaluate plant sensitivity to the light control quality of the lighting system. Oat coleoptiles irradiated for 23 h with a uniformly distributed spectral PFD (SPFD of 1 micro-mol m–2 s–1 nm–1 at every peak wavelength (405, 460, 630, 660, and 735 nm grew almost straight upwards. When they were irradiated with an SPFD gradient of blue light (460 nm peak wavelength, the coleoptiles showed a phototropic curvature in the direction of the greater SPFD of blue light. The greater SPFD gradient induced the greater curvature of coleoptiles. The relation between the phototropic curvature (deg and the blue-light SPFD gradient (micro-mol m–2 s–1 nm–1 m–1 was 2 deg per 1 micro-mol m–2 s–1 nm–1 m–1. Conclusions The plant lighting system, with a computer with a

  11. Introduction of the levonorgestrel intrauterine system in Kenya through mobile outreach: review of service statistics and provider perspectives.

    Science.gov (United States)

    Hubacher, David; Akora, Vitalis; Masaba, Rose; Chen, Mario; Veena, Valentine

    2014-02-01

    The levonorgestrel intrauterine system (LNG IUS) was developed over 30 years ago, but the product is currently too expensive for widespread use in many developing countries. In Kenya, one organization has received donated commodities for 5 years, providing an opportunity to assess impact and potential future role of the product. We reviewed service statistics on insertions of the LNG IUS, copper intrauterine device (IUD), and subdermal implant from 15 mobile outreach teams during the 2011 calendar year. To determine the impact of the LNG IUS introduction, we analyzed changes in uptake and distribution of the copper IUD and subdermal implant by comparing periods of time when the LNG IUS was available with periods when it was not available. In addition, we interviewed 27 clinicians to assess their views of the product and of its future role. When the LNG IUS was not available, intrauterine contraception accounted for 39% of long-acting method provision. The addition of the LNG IUS created a slight rise in intrauterine contraception uptake (to 44%) at the expense of the subdermal implant, but the change was only marginally significant (P = .08) and was largely attributable to the copper IUD. All interviewed providers felt that the LNG IUS would increase uptake of long-acting methods, and 70% felt that the noncontraceptive benefits of the product are important to clients. The LNG IUS was well-received among providers and family planning clients in this population in Kenya. Although important changes in service statistics were not apparent from this analysis (perhaps due to the small quantity of LNG IUS that was available), provider enthusiasm for the product was high. This finding, above all, suggests that a larger-scale introduction effort would have strong support from providers and thus increase the chances of success. Adding another proven and highly acceptable long-acting contraceptive technology to the method mix could have important reproductive health

  12. A Mathematical Model of Metabolism and Regulation Provides a Systems-Level View of How Escherichia coli Responds to Oxygen

    Directory of Open Access Journals (Sweden)

    Michael eEderer

    2014-03-01

    Full Text Available The efficient redesign of bacteria for biotechnological purposes, such as biofuel production, waste disposal or specific biocatalytic functions, requires a quantitative systems-level understanding of energy supply, carbon and redox metabolism. The measurement of transcript levels, metabolite concentrations and metabolic fluxes per se gives an incomplete picture. An appreciation of the interdependencies between the different measurement values is essential for systems-level understanding. Mathematical modeling has the potential to provide a coherent and quantitative description of the interplay between gene expression, metabolite concentrations and metabolic fluxes. Escherichia coli undergoes major adaptations in central metabolism when the availability of oxygen changes. Thus, an integrated description of the oxygen response provides a benchmark of our understanding of carbon, energy and redox metabolism. We present the first comprehensive model of the central metabolism of E. coli that describes steady-state metabolism at different levels of oxygen availability. Variables of the model are metabolite concentrations, gene expression levels, transcription factor activities, metabolic fluxes and biomass concentration. We analyze the model with respect to the production capabilities of central metabolism of E. coli. In particular, we predict how precursor and biomass concentration are affected by product formation.

  13. Beam shaping to provide round and square-shaped beams in optical systems of high-power lasers

    Science.gov (United States)

    Laskin, Alexander; Laskin, Vadim

    2016-05-01

    Optical systems of modern high-power lasers require control of irradiance distribution: round or square-shaped flat-top or super-Gaussian irradiance profiles are optimum for amplification in MOPA lasers and for thermal load management while pumping of crystals of solid-state ultra-short pulse lasers to control heat and minimize its impact on the laser power and beam quality while maximizing overall laser efficiency, variable profiles are also important in irradiating of photocathode of Free Electron lasers (FEL). It is suggested to solve the task of irradiance re-distribution using field mapping refractive beam shapers like piShaper. The operational principle of these devices presumes transformation of laser beam intensity from Gaussian to flat-top one with high flatness of output wavefront, saving of beam consistency, providing collimated output beam of low divergence, high transmittance, extended depth of field, negligible residual wave aberration, and achromatic design provides capability to work with ultra-short pulse lasers having broad spectrum. Using the same piShaper device it is possible to realize beams with flat-top, inverse Gauss or super Gauss irradiance distribution by simple variation of input beam diameter, and the beam shape can be round or square with soft edges. This paper will describe some design basics of refractive beam shapers of the field mapping type and optical layouts of their applying in optical systems of high-power lasers. Examples of real implementations and experimental results will be presented as well.

  14. Seven novel probe systems for real-time PCR provide absolute single-base discrimination, higher signaling, and generic components.

    Science.gov (United States)

    Murray, James L; Hu, Peixu; Shafer, David A

    2014-11-01

    We have developed novel probe systems for real-time PCR that provide higher specificity, greater sensitivity, and lower cost relative to dual-labeled probes. The seven DNA Detection Switch (DDS)-probe systems reported here employ two interacting polynucleotide components: a fluorescently labeled probe and a quencher antiprobe. High-fidelity detection is achieved with three DDS designs: two internal probes (internal DDS and Flip probes) and a primer probe (ZIPR probe), wherein each probe is combined with a carefully engineered, slightly mismatched, error-checking antiprobe. The antiprobe blocks off-target detection over a wide range of temperatures and facilitates multiplexing. Other designs (Universal probe, Half-Universal probe, and MacMan probe) use generic components that enable low-cost detection. Finally, single-molecule G-Force probes employ guanine-mediated fluorescent quenching by forming a hairpin between adjacent C-rich and G-rich sequences. Examples provided show how these probe technologies discriminate drug-resistant Mycobacterium tuberculosis mutants, Escherichia coli O157:H7, oncogenic EGFR deletion mutations, hepatitis B virus, influenza A/B strains, and single-nucleotide polymorphisms in the human VKORC1 gene. Copyright © 2014 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  15. DESYCO: a Decision Support System to provide climate services for coastal stakeholders dealing with climate change impacts.

    Science.gov (United States)

    Torresan, S.; Gallina, V.; Giannini, V.; Rizzi, J.; Zabeo, A.; Critto, A.; Marcomini, A.

    2012-04-01

    At the international level climate services are recognized as innovative tools aimed at providing and distributing climate data and information according to the needs of end-users. Furthermore, needs-based climate services are extremely effective to manage climate risks and take advantage of the opportunities associated with climate change impacts. To date, climate services are mainly related to climate models that supply climate data (e.g. temperature, precipitations) at different spatial and time scales. However, there is a significant gap of tools aimed at providing information about risks and impacts induced by climate change and allowing non-expert stakeholders to use both climate-model and climate-impact data. DESYCO is a GIS-Decision Support System aimed at the integrated assessment of multiple climate change impacts on vulnerable coastal systems (e.g. beaches, river deltas, estuaries and lagoons, wetlands, agricultural and urban areas). It is an open source software that manages different input data (e.g. raster or shapefiles) coming from climate models (e.g. global and regional climate projections) and high resolution impact models (e.g. hydrodynamic, hydrological and biogeochemical simulations) in order to provide hazard, exposure, susceptibility, risk and damage maps for the identification and prioritization of hot-spot areas and to provide a basis for the definition of coastal adaptation and management strategies. Within the CLIM-RUN project (FP7) DESYCO is proposed as an helpful tool to bridge the gap between climate data and stakeholder needs and will be applied to the coastal area of the North Adriatic Sea (Italy) in order to provide climate services for local authorities involved in coastal zone management. Accordingly, a first workshop was held in Venice (Italy) with coastal authorities, climate experts and climate change risk experts, in order to start an iterative exchange of information about the knowledge related to climate change, climate

  16. GUIdock-VNC: using a graphical desktop sharing system to provide a browser-based interface for containerized software.

    Science.gov (United States)

    Mittal, Varun; Hung, Ling-Hong; Keswani, Jayant; Kristiyanto, Daniel; Lee, Sung Bong; Yeung, Ka Yee

    2017-04-01

    Software container technology such as Docker can be used to package and distribute bioinformatics workflows consisting of multiple software implementations and dependencies. However, Docker is a command line-based tool, and many bioinformatics pipelines consist of components that require a graphical user interface. We present a container tool called GUIdock-VNC that uses a graphical desktop sharing system to provide a browser-based interface for containerized software. GUIdock-VNC uses the Virtual Network Computing protocol to render the graphics within most commonly used browsers. We also present a minimal image builder that can add our proposed graphical desktop sharing system to any Docker packages, with the end result that any Docker packages can be run using a graphical desktop within a browser. In addition, GUIdock-VNC uses the Oauth2 authentication protocols when deployed on the cloud. As a proof-of-concept, we demonstrated the utility of GUIdock-noVNC in gene network inference. We benchmarked our container implementation on various operating systems and showed that our solution creates minimal overhead. © The Authors 2017. Published by Oxford University Press.

  17. Efficient transportation for Vermont : optimal statewide transit networks.

    Science.gov (United States)

    2011-01-01

    "Public transit systems are receiving increased attention as viable solutions to problems with : transportation system robustness, energy-efficiency and equity. The over-reliance on a single : mode, the automobile, is a threat to system robustness. I...

  18. Evaluating health information technology: provider satisfaction with an HIV-specific, electronic clinical management and reporting system.

    Science.gov (United States)

    Magnus, Manya; Herwehe, Jane; Andrews, Laura; Gibson, Laura; Daigrepont, Nathan; De Leon, Jordana M; Hyslop, Newton E; Styron, Steven; Wilcox, Ronald; Kaiser, Michael; Butler, Michael K

    2009-02-01

    Health information technology (HIT) offers the potential to improve care for persons living with HIV. Provider satisfaction with HIT is essential to realize benefits, yet its evaluation presents challenges. An HIV-specific, electronic clinical management and reporting system was implemented in Louisiana's eight HIV clinics, serving over 7500. A serial cross-sectional survey was administered at three points between April 2002 and July 2005; qualitative methods were used to augment quantitative. Multivariable methods were used to characterize provider satisfaction. The majority of the sample (n = 196; T1 = 105; T2 = 46; T3 = 45) was female (80.0%), between ages of 25 and 50 years (68.3%), frequent providers at that clinic (53.7% more than 4 days per week), and had been at the same clinic for a year or more (85.0%). Improvements in satisfaction were observed in patient tracking ( p 0.05), current viral load decreased at each time point (mean 4.0 [SD 5.6], 2.9 [2.5], 1.8 [2.6], p = 0.08], current antiretroviral status decreased at each time point (mean 3.9 [SD 4.7], 2.9 [3.7], 1.5 [1.1], p < 0.04), history of antiretroviral use decreased at each time point (mean 15.1 [SD 21.9], 6.0 [5.4], 5.4 [7.2], p < 0.04]. Time savings were realized, averaging 16.1 minutes per visit ( p < 0.04). Providers were satisfied with HIT in multiple domains, and significant time savings were realized.

  19. The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

    Science.gov (United States)

    Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

    2016-09-01

    To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

  20. A narrative account of implementation lessons learnt from the dissemination of an up-scaled state-wide child obesity management program in Australia: PEACH™ (Parenting, Eating and Activity for Child Health) Queensland.

    Science.gov (United States)

    Croyden, Debbie L; Vidgen, Helen A; Esdaile, Emma; Hernandez, Emely; Magarey, Anthea; Moores, Carly J; Daniels, Lynne

    2018-03-13

    PEACH™QLD translated the PEACH™ Program, designed to manage overweight/obesity in primary school-aged children, from efficacious RCT and small scale community trial to a larger state-wide program. This paper describes the lessons learnt when upscaling to universal health coverage. The 6-month, family-focussed program was delivered in Queensland, Australia from 2013 to 2016. Its implementation was planned by researchers who developed the program and conducted the RCT, and experienced project managers and practitioners across the health continuum. The intervention targeted parents as the agents of change and was delivered via parent-only group sessions. Concurrently, children attended fun, non-competitive activity sessions. Sessions were delivered by facilitators who received standardised training and were employed by a range of service providers. Participants were referred by health professionals or self-referred in response to extensive promotion and marketing. A pilot phase and a quality improvement framework were planned to respond to emerging challenges. Implementation challenges included engagement of the health system; participant recruitment; and engagement. A total of 1513 children (1216 families) enrolled, with 1122 children (919 families) in the face-to-face program (105 groups in 50 unique venues) and 391 children (297 families) in PEACH™ Online. Self-referral generated 68% of enrolments. Unexpected, concurrent and, far-reaching public health system changes contributed to poor program uptake by the sector (only 56 [53%] groups delivered by publicly-funded health organisations) requiring substantial modification of the original implementation plan. Process evaluation during the pilot phase and an ongoing quality improvement framework informed program adaptations that included changing from fortnightly to weekly sessions aligned with school terms, revision of parent materials, modification of eligibility criteria to include healthy weight children and

  1. Development of a central data warehouse for statewide ITS and transportation data in Florida phase III : final report.

    Science.gov (United States)

    2009-12-15

    This report documents Phase III of the development and operation of a prototype for the Statewide Transportation : Engineering Warehouse for Archived Regional Data (STEWARD). It reflects the progress on the development and : operation of STEWARD sinc...

  2. [Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts].

    Science.gov (United States)

    Roig, Francesc; Saigí, Francesc

    2011-01-01

    Despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Thiamine primed defense provides reliable alternative to systemic fungicide carbendazim against sheath blight disease in rice (Oryza sativa L.).

    Science.gov (United States)

    Bahuguna, Rajeev Nayan; Joshi, Rohit; Shukla, Alok; Pandey, Mayank; Kumar, J

    2012-08-01

    A novel pathogen defense strategy by thiamine priming was evaluated for its efficacy against sheath blight pathogen, Rhizoctonia solani AG-1A, of rice and compared with that of systemic fungicide, carbendazim (BCM). Seeds of semidwarf, high yielding, basmati rice variety Vasumati were treated with thiamine (50 mM) and BCM (4 mM). The pot cultured plants were challenge inoculated with R. solani after 40 days of sowing and effect of thiamine and BCM on rice growth and yield traits was examined. Higher hydrogen peroxide content, total phenolics accumulation, phenylalanine ammonia lyase (PAL) activity and superoxide dismutase (SOD) activity under thiamine treatment displayed elevated level of systemic resistance, which was further augmented under challenging pathogen infection. High transcript level of phenylalanine ammonia lyase (PAL) and manganese superoxide dismutase (MnSOD) validated mode of thiamine primed defense. Though minimum disease severity was observed under BCM treatment, thiamine produced comparable results, with 18.12 per cent lower efficacy. Along with fortifying defense components and minor influence on photosynthetic pigments and nitrate reductase (NR) activity, thiamine treatment significantly reduced pathogen-induced loss in photosynthesis, stomatal conductance, chlorophyll fluorescence, NR activity and NR transcript level. Physiological traits affected under pathogen infection were found signatory for characterizing plant's response under disease and were detectable at early stage of infection. These findings provide a novel paradigm for developing alternative, environmentally safe strategies to control plant diseases. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. Cost-effectiveness analysis of a statewide media campaign to promote adolescent physical activity.

    Science.gov (United States)

    Peterson, Michael; Chandlee, Margaret; Abraham, Avron

    2008-10-01

    A cost-effectiveness analysis of a statewide social marketing campaign was performed using a statewide surveillance survey distributed to 6th through 12th graders, media production and placement costs, and 2000 census data. Exposure to all three advertisements had the highest impact on both intent and behavior with 65.6% of the respondents considering becoming more active and 58.3% reporting becoming more active. Average cost of the entire campaign was $4.01 per person to see an ad, $7.35 per person to consider being more active, and $8.87 per person to actually become more active, with billboards yielding the most positive cost-effectiveness. Findings highlight market research as an essential part of social marketing campaigns and the importance of using multiple marketing modalities to enhance cost-effectiveness and impact.

  5. A task force model for statewide change in nursing education: building quality and safety.

    Science.gov (United States)

    Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona

    2013-01-01

    The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S

    2015-01-01

    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream

  7. SU-E-T-571: Newly Emerging Integrated Transmission Detector Systems Provide Online Quality Assurance of External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D; Chung, E; Hess, C; Stern, R; Benedict, S [UC Davis Cancer Center, Sacramento, CA (United States)

    2015-06-15

    Purpose: Two newly emerging transmission detectors positioned upstream from the patient have been evaluated for online quality assurance of external beam radiotherapy. The prototype for the Integral Quality Monitor (IQM), developed by iRT Systems GmbH (Koblenz, Germany) is a large-area ion chamber mounted on the linac accessory tray to monitor photon fluence, energy, beam shape, and gantry position during treatment. The ion chamber utilizes a thickness gradient which records variable response dependent on beam position. The prototype of Delta4 Discover™, developed by ScandiDos (Uppsala, Sweden) is a linac accessory tray mounted 4040 diode array that measures photon fluence during patient treatment. Both systems are employable for patient specific QA prior to treatment delivery. Methods: Our institution evaluated the reproducibility of measurements using various beam types, including VMAT treatment plans with both the IQM ion chamber and the Delta4 Discover diode array. Additionally, the IQM’s effect on photon fluence, dose response, simulated beam error detection, and the accuracy of the integrated barometer, thermometer, and inclinometer were characterized. The evaluated photon beam errors are based on the annual tolerances specified in AAPM TG-142. Results: Repeated VMAT treatments were measured with 0.16% reproducibility by the IQM and 0.55% reproducibility by the Delta4 Discover. The IQM attenuated 6, 10, and 15 MV photon beams by 5.43±0.02%, 4.60±0.02%, and 4.21±0.03% respectively. Photon beam profiles were affected <1.5% in the non-penumbra regions. The IQM’s ion chamber’s dose response was linear and the thermometer, barometer, and inclinometer agreed with other calibrated devices. The device detected variations in monitor units delivered (1%), field position (3mm), single MLC leaf positions (13mm), and photon energy. Conclusion: We have characterized two new transmissions detector systems designed to provide in-vivo like measurements upstream

  8. Use of Order Sets in Inpatient Computerized Provider Order Entry Systems: A Comparative Analysis of Usage Patterns at Seven Sites

    Science.gov (United States)

    Wright, Adam; Feblowitz, Joshua C.; Pang, Justine E.; Carpenter, James D.; Krall, Michael A.; Middleton, Blackford; Sittig, Dean F.

    2012-01-01

    Background Many computerized provider order entry (CPOE) systems include the ability to create electronic order sets: collections of clinically-related orders grouped by purpose. Order sets promise to make CPOE systems more efficient, improve care quality and increase adherence to evidence-based guidelines. However, the development and implementation of order sets can be expensive and time-consuming and limited literature exists about their utilization. Methods Based on analysis of order set usage logs from a diverse purposive sample of seven sites with commercially- and internally-developed inpatient CPOE systems, we developed an original order set classification system. Order sets were categorized across seven non-mutually exclusive axes: admission/discharge/transfer (ADT), perioperative, condition-specific, task-specific, service-specific, convenience, and personal. In addition, 731 unique subtypes were identified within five axes: four in ADT (S=4), three in perioperative, 144 in condition-specific, 513 in task-specific, and 67 in service-specific. Results Order sets (n=1,914) were used a total of 676,142 times at the participating sites during a one-year period. ADT and perioperative order sets accounted for 27.6% and 24.2% of usage respectively. Peripartum/labor, chest pain/Acute Coronary Syndrome/Myocardial Infarction and diabetes order sets accounted for 51.6% of condition-specific usage. Insulin, angiography/angioplasty and arthroplasty order sets accounted for 19.4% of task-specific usage. Emergency/trauma, Obstetrics/Gynecology/Labor Delivery and anesthesia accounted for 32.4% of service-specific usage. Overall, the top 20% of order sets accounted for 90.1% of all usage. Additional salient patterns are identified and described. Conclusion We observed recurrent patterns in order set usage across multiple sites as well as meaningful variations between sites. Vendors and institutional developers should identify high-value order set types through concrete

  9. Evaluation of a statewide science inservice and outreach program: Teacher and student outcomes

    Science.gov (United States)

    Lott, Kimberly Hardiman

    Alabama Science in Motion (ASIM) is a statewide in-service and outreach program designed to provide in-service training for teachers in technology and content knowledge. ASIM is also designed to increase student interest in science and future science careers. The goals of ASIM include: to complement, enhance and facilitate implementation of the Alabama Course of Study: Science, to increase student interest in science and scientific careers, and to provide high school science teachers with curriculum development and staff development opportunities that will enhance their subject-content expertise, technology background, and instructional skills. This study was conducted to evaluate the goals and other measurable outcomes of the chemistry component of ASIM. Data were collected from 19 chemistry teachers and 182 students that participated in ASIM and 6 chemistry teachers and 42 students that do not participate in ASIM using both surveys and student records. Pre-treatment Chi-Square tests revealed that the teachers did not differ in years of chemistry teaching experience, major in college, and number of classes other than chemistry taught. Pre-treatment Chi-Square tests revealed that the students did not differ in age, ethnicity, school classification, or school type. The teacher survey used measured attitudes towards inquiry-based teaching, frequency of technology used by teacher self-report and perceived teaching ability of chemistry topics from the Alabama Course of Study-Science. The student surveys used were the Test of Science Related Attitudes (TOSRA) and a modified version of the Test of Integrated Process Skills (TIPS). The students' science scores from the Stanford Achievement Test (SAT-9) were also obtained from student records. Analysis of teacher data using a MANOVA design revealed that participation in ASIM had a significantly positive effect on teacher attitude towards inquiry-based teaching and the frequency of technology used; however, there was no

  10. Staff turnover in statewide implementation of ACT: relationship with ACT fidelity and other team characteristics

    OpenAIRE

    Rollins, Angela L.; Salyers, Michelle P.; Tsai, Jack; Lydick, Jennifer M.

    2010-01-01

    Staff turnover on assertive community treatment (ACT) teams is a poorly understood phenomenon. This study examined annual turnover and fidelity data collected in a statewide implementation of ACT over a 5-year period. Mean annual staff turnover across all observations was 30.0%. Turnover was negatively correlated with overall fidelity at Year 1 and 3. The team approach fidelity item was negatively correlated with staff turnover at Year 3. For 13 teams with 3 years of follow-up data, turnover ...

  11. Patient, Provider, and System Factors Associated With Failure to Follow-Up Elevated Glucose Results in Patients Without Diagnosed Diabetes

    Directory of Open Access Journals (Sweden)

    Michael E. Bowen

    2017-08-01

    Full Text Available Background: Although elevated glucose values are strongly associated with undiagnosed diabetes, they are frequently overlooked. Patient, provider, and system factors associated with failure to follow-up elevated glucose values in electronic medical records (EMRs are not well described. Methods: We conducted a chart review in a comprehensive EMR with a patient portal and results management features. Established primary care patients with no known diagnosis of diabetes and ≥ 1 glucose value >125 mg/dL were included. Follow-up failure was defined as (1 no documented comment on the glucose value or result communication to the patient within 30 days or (2 no hemoglobin A 1c (HbA 1c ordered within 30 days or resulted within 12 months. Associations were examined using Wilcoxon and χ 2 tests. Results: Of 150 charts reviewed, 97 met inclusion criteria. The median glucose was 133 mg/dL, and 20% of patients had multiple values >125 mg/dL. Only 36% of elevated glucose values were followed up. No associations were observed between patient characteristics, diabetes risk factors, or provider characteristics and follow-up failures. Automated flagging of glucose values ≥140 mg/dL by highlighting them red in the EMR was not associated with improved follow-up (46% vs 32%; P = .19. Even when follow-up occurred (n = 35, only 31% completed gold standard diabetes testing (HbA 1c within 12 months. Of the resulted HbA 1c tests (n = 11, 55% were in the prediabetes range (5.7%-6.4%. Conclusions: Two-thirds of elevated glucose values were not followed up, despite EMR features facilitating results management. Greater understanding of the results management process and improved EMR functionalities to support results management are needed.

  12. The second EURADOS intercomparison of national network systems used to provide early warning of a nuclear accident

    International Nuclear Information System (INIS)

    Saez-Vergara, J. C.; Thompson, I. M. G.; Gurriaran, R.; Dombrowski, H.; Funck, E.; Neumaier, S.

    2007-01-01

    In 1999 and 2002, the EURADOS Working Group on Environmental Monitoring organised two European intercomparison exercises of national network systems used to provide early warning in case of a nuclear accident. In total, 12 European countries, represented by more than 40 scientists, participated in these two intercomparisons with more than 35 different dose rate detectors. In addition, an in situ gamma spectrometry intercomparison was performed by a group of European scientists during the 2002 exercise. Results of these spectrometry measurements will be reported elsewhere. This report summarises the results of the second intercomparison, performed in 2002, at the environmental dosimetry facilities of the Physikalisch-Technische Bundesanstalt (PTB) in Germany. The unique combination of the ultra-low background Underground Laboratory (UDO) and two free-field sites (a floating platform on a lake showing an almost pure cosmic radiation field and a free-field gamma ray irradiation facility) provide the particular opportunity to precisely quantify the inherent background of the detectors and to calibrate them almost free of any background and traceable to PTB's primary standards. In addition, the intercomparison comprised investigations on the energy and dose rate dependence of the detectors' response to gamma radiation as well as on the response to cosmic radiation. Finally, the sensitivity of the detector systems to small dose rate variations, similar to that caused by a passing overhead radioactive plume, was studied under realistic free-field conditions. Following the Council Directive 96/29/EURATOM, the participants of the 2002 intercomparison were asked to report their results in terms of the operational quantity ambient dose equivalent, H*(10). Although the verification of the individual calibrations showed smaller discrepancies than those in the 1999 intercomparison, in a few cases, these discrepancies would be still unacceptably high in the case of a real

  13. Statewide screening for low-level radioactive waste shallow land burial sites

    International Nuclear Information System (INIS)

    Staub, W.P.; Cannon, J.B.; Stratton, L.E.

    1984-01-01

    A methodology was developed for statewide low-level waste site screening based on NRC site selection criteria. The methodology and criteria were tested in Tennessee to determine their effectiveness in narrowing the choice of sites for more intensive localized site screening. The statewide screening methodology entailed two steps. The first step was to select one or more physiographic provinces wherein sites meeting the criteria were most likely to be found. The second step was to select one or more suitable outcrop bands from within the most favorable physiographic provinces. These selections were based entirely on examination of existing literature and maps at scales no larger than 1:250,000. The statewide screening project identified only one suitable physiographic province (the Mississippi Embayment region) and one favorable outcrop band (the Coon Creek Formation) within a three county area of western Tennessee. Ground water monitoring and predictability proved to be the most difficult criterion to meet. This criterion alone eliminated other outcrop bands in the Mississippi Embayment as well as the Eastern Highland Rim and Western Highland Rim physiographic provinces. Other provinces failed to meet several screening criteria. 3 references, 3 figures, 1 table

  14. Providing all global energy with wind, water, and solar power, Part II: Reliability, system and transmission costs, and policies

    International Nuclear Information System (INIS)

    Delucchi, Mark A.; Jacobson, Mark Z.

    2011-01-01

    This is Part II of two papers evaluating the feasibility of providing all energy for all purposes (electric power, transportation, and heating/cooling), everywhere in the world, from wind, water, and the sun (WWS). In Part I, we described the prominent renewable energy plans that have been proposed and discussed the characteristics of WWS energy systems, the global demand for and availability of WWS energy, quantities and areas required for WWS infrastructure, and supplies of critical materials. Here, we discuss methods of addressing the variability of WWS energy to ensure that power supply reliably matches demand (including interconnecting geographically dispersed resources, using hydroelectricity, using demand-response management, storing electric power on site, over-sizing peak generation capacity and producing hydrogen with the excess, storing electric power in vehicle batteries, and forecasting weather to project energy supplies), the economics of WWS generation and transmission, the economics of WWS use in transportation, and policy measures needed to enhance the viability of a WWS system. We find that the cost of energy in a 100% WWS will be similar to the cost today. We conclude that barriers to a 100% conversion to WWS power worldwide are primarily social and political, not technological or even economic. - Research highlights: → We evaluate the feasibility of global energy supply from wind, water, and solar energy. → WWS energy can be supplied reliably and economically to all energy-use sectors. → The social cost of WWS energy generally is less than the cost of fossil-fuel energy. → Barriers to 100% WWS power worldwide are socio-political, not techno-economic.

  15. ARABIC TRANSLATION AND ADAPTATION OF THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) PATIENT SATISFACTION SURVEY INSTRUMENT.

    Science.gov (United States)

    Dockins, James; Abuzahrieh, Ramzi; Stack, Martin

    2015-01-01

    To translate and adapt an effective, validated, benchmarked, and widely used patient satisfaction measurement tool for use with an Arabic-speaking population. Translation of survey's items, survey administration process development, evaluation of reliability, and international benchmarking Three hundred-bed tertiary care hospital in Jeddah, Saudi Arabia. 645 patients discharged during 2011 from the hospital's inpatient care units. INTERVENTIONS; The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was translated into Arabic, a randomized weekly sample of patients was selected, and the survey was administered via telephone during 2011 to patients or their relatives. Scores were compiled for each of the HCAHPS questions and then for each of the six HCAHPS clinical composites, two non-clinical items, and two global items. Clinical composite scores, as well as the two non-clinical and two global items were analyzed for the 645 respondents. Clinical composites were analyzed using Spearman's correlation coefficient and Cronbach's alpha to demonstrate acceptable internal consistency for these items and scales demonstrated acceptable internal consistency for the clinical composites. (Spearman's correlation coefficient = 0.327 - 0.750, P quarterly to US national averages with results that closely paralleled the US benchmarks. . The Arabic translation and adaptation of the HCAHPS is a valid, reliable, and feasible tool for evaluation and benchmarking of inpatient satisfaction in Arabic speaking populations.

  16. Simulator with integrated HW and SW for prediction of thermal comfort to provide feedback to the climate control system

    Science.gov (United States)

    Pokorný, Jan; Kopečková, Barbora; Fišer, Jan; JÍcha, Miroslav

    2018-06-01

    The aim of the paper is to assemble a simulator for evaluation of thermal comfort in car cabins in order to give a feedback to the HVAC (heating, ventilation and air conditioning) system. The HW (hardware) part of simulator is formed by thermal manikin Newton and RH (relative humidity), velocity and temperature probes. The SW (software) part consists of the Thermal Comfort Analyser (using ISO 14505-2) and Virtual Testing Stand of Car Cabin defining the heat loads of car cabin. Simulator can provide recommendation for the climate control how to improve thermal comfort in cabin by distribution and directing of air flow, and also by amount of ventilation power to keep optimal temperature inside a cabin. The methods of evaluation of thermal comfort were verified by tests with 10 test subjects for summer (summer clothing, ambient air temperature 30 °C, HVAC setup: +24 °C auto) and winter conditions (winter clothing, ambient air temperature -5 °C, HVAC setup: +18 °C auto). The tests confirmed the validity of the thermal comfort evaluation using the thermal manikin and ISO 14505-2.

  17. Simulator with integrated HW and SW for prediction of thermal comfort to provide feedback to the climate control system

    Directory of Open Access Journals (Sweden)

    Pokorný Jan

    2018-01-01

    Full Text Available The aim of the paper is to assemble a simulator for evaluation of thermal comfort in car cabins in order to give a feedback to the HVAC (heating, ventilation and air conditioning system. The HW (hardware part of simulator is formed by thermal manikin Newton and RH (relative humidity, velocity and temperature probes. The SW (software part consists of the Thermal Comfort Analyser (using ISO 14505-2 and Virtual Testing Stand of Car Cabin defining the heat loads of car cabin. Simulator can provide recommendation for the climate control how to improve thermal comfort in cabin by distribution and directing of air flow, and also by amount of ventilation power to keep optimal temperature inside a cabin. The methods of evaluation of thermal comfort were verified by tests with 10 test subjects for summer (summer clothing, ambient air temperature 30 °C, HVAC setup: +24 °C auto and winter conditions (winter clothing, ambient air temperature -5 °C, HVAC setup: +18 °C auto. The tests confirmed the validity of the thermal comfort evaluation using the thermal manikin and ISO 14505-2.

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

    Science.gov (United States)

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

    2015-06-01

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

  19. A statewide review of postnatal care in private hospitals in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Forster Della A

    2010-05-01

    Full Text Available Abstract Background Concerns have been raised in Australia and internationally regarding the quality and effectiveness of hospital postnatal care, although Australian women receiving postnatal care in the private maternity sector rate their satisfaction with care more highly than women receiving public maternity care. In Victoria, Australia, two-thirds of women receive their maternity care in the public sector and the remainder in private health care sector. A statewide review of public hospital postnatal care in Victoria from the perspective of care providers found many barriers to care provision including the busyness of postnatal wards, inadequate staffing and priority being given to other episodes of care; however the study did not include private hospitals. The aim of this study was replicate the review in the private sector, to explore the structure and organisation of postnatal care in private hospitals and identify those aspects of care potentially impacting on women's experiences and maternal and infant care. This provides a more complete overview of the organisational structures and processes in postnatal care in all Victorian hospitals from the perspective of care providers. Methods A mixed method design was used. A structured postal survey was sent to all Victorian private hospitals (n = 19 and key informant interviews were undertaken with selected clinical midwives, maternity unit managers and obstetricians (n = 11. Survey data were analysed using descriptive statistics and interview data analysed thematically. Results Private hospital care providers report that postnatal care is provided in very busy environments, and that meeting the aims of postnatal care (breastfeeding support, education of parents and facilitating rest and recovery for women following birth was difficult in the context of increased acuity of postnatal care; prioritising of other areas over postnatal care; high midwife-to-woman ratios; and the number and

  20. Statewide GIS mapping of recurring congestion corridors : final report.

    Science.gov (United States)

    2009-07-01

    Recurring congestion occurs when travel demand reaches or exceeds the available roadway : capacity. This project developed an interactive geographic information system (GIS) map of the : recurring congestion corridors (labeled herein as hotspots) in ...

  1. Remote maintenance systems requirements are being developed to provide design guidelines for machine components, to define maintenance interfaces, and to quantify maintenance equipment and procedures needed

    International Nuclear Information System (INIS)

    Spampinato, P.T.; Tabor, M.A.

    1988-01-01

    Remote maintenance systems requirements are being developed to provide design guidelines for machine components, to define maintenance interfaces, and to quantify maintenance equipment and procedures needed

  2. Hanford statewide groundwater flow and transport model calibration report

    International Nuclear Information System (INIS)

    Law, A.; Panday, S.; Denslow, C.; Fecht, K.; Knepp, A.

    1996-04-01

    This report presents the results of the development and calibration of a three-dimensional, finite element model (VAM3DCG) for the unconfined groundwater flow system at the Hanford Site. This flow system is the largest radioactively contaminated groundwater system in the United States. Eleven groundwater plumes have been identified containing organics, inorganics, and radionuclides. Because groundwater from the unconfined groundwater system flows into the Columbia River, the development of a groundwater flow model is essential to the long-term management of these plumes. Cost effective decision making requires the capability to predict the effectiveness of various remediation approaches. Some of the alternatives available to remediate groundwater include: pumping contaminated water from the ground for treatment with reinjection or to other disposal facilities; containment of plumes by means of impermeable walls, physical barriers, and hydraulic control measures; and, in some cases, management of groundwater via planned recharge and withdrawals. Implementation of these methods requires a knowledge of the groundwater flow system and how it responds to remedial actions

  3. Promoting Nutrition and Wellness Statewide through an Electronic Newsletter

    Science.gov (United States)

    Bahl, Morgan; Francis, Sarah L.

    2016-01-01

    The "Words on Wellness" (WOW) newsletter was designed as an electronic newsletter intended to provide research-based nutrition and wellness information to Iowans. An evaluation was conducted to assess to what extent the newsletter is being used by its readership and whether readers are making lifestyle changes as a result. Those who…

  4. Results of Statewide TerraNova Testing, Fall 1998.

    Science.gov (United States)

    La Marca, Paul M.

    This summary provides key findings about state, district, and school level performance on the TerraNova examinations (CTB/McGraw Hill) in Nevada in 1998-1999. The TerraNova tests are used to assess students in grades 4, 8, and 10 as stipulated by Nevada law. Within this summary, a description of performance as measured by national percentile…

  5. Hawaii DAR Dealer Reporting System Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In 2000 January, the Hawaii Division of Aquatic Resources (DAR) implemented a computerized data processing system for fish dealer data collected state-wide. Hawaii...

  6. Salary and Ranking and Teacher Turnover: A Statewide Study

    Science.gov (United States)

    Garcia, Cynthia Martinez; Slate, John R.; Delgado, Carmen Tejeda

    2009-01-01

    This study examined three years of data obtained from the Academic Excellence Indicator System of the State of Texas regarding teacher turnover rate and teacher salary. Across all public school districts, teacher salary was consistently negatively related to teacher turnover; that is, where salary was lower, turnover rate was higher When data were…

  7. Effect Of A “No Superuser Opioid Prescription” Policy On ED Visits And Statewide Opioid Prescription

    Directory of Open Access Journals (Sweden)

    Zachary P. Kahler

    2017-07-01

    Full Text Available Introduction: The U.S. opioid epidemic has highlighted the need to identify patients at risk of opioid abuse and overdose. We initiated a novel emergency department- (ED based interventional protocol to transition our superuser patients from the ED to an outpatient chronic pain program. The objective was to evaluate the protocol’s effect on superusers’ annual ED visits. Secondary outcomes included a quantitative evaluation of statewide opioid prescriptions for these patients, unique prescribers of controlled substances, and ancillary testing. Methods: Patients were referred to the program with the following inclusion criteria: ≥ 6 visits per year to the ED; at least one visit identified by the attending physician as primarily driven by opioid-seeking behavior; and a review by a committee comprising ED administration and case management. Patients were referred to a pain management clinic and informed that they would no longer receive opioid prescriptions from visits to the ED for chronic pain complaints. Electronic medical record (EMR alerts notified ED providers of the patient’s referral at subsequent visits. We analyzed one year of data pre- and post-referral. Results: A total of 243 patients had one year of data post-referral for analysis. Median annual ED visits decreased from 14 to 4 (58% decrease, 95% CI [50 to 66]. We also found statistically significant decreases for these patients’ state prescription drug monitoring program (PDMP opioid prescriptions (21 to 13, total unique controlled-substance prescribers (11 to 7, computed tomography imaging (2 to 0, radiographs (5 to 1, electrocardiograms (12 to 4, and labs run (47 to 13. Conclusion: This program and the EMR-based alerts were successful at decreasing local ED visits, annual opioid prescriptions, and hospital resource allocation for this population of patients. There is no evidence that these patients diverted their visits to neighboring EDs after being informed that they

  8. Validation of a risk stratification tool for fall-related injury in a state-wide cohort.

    Science.gov (United States)

    McCoy, Thomas H; Castro, Victor M; Cagan, Andrew; Roberson, Ashlee M; Perlis, Roy H

    2017-02-06

    A major preventable contributor to healthcare costs among older individuals is fall-related injury. We sought to validate a tool to stratify such risk based on readily available clinical data, including projected medication adverse effects, using state-wide medical claims data. Sociodemographic and clinical features were drawn from health claims paid in the state of Massachusetts for individuals aged 35-65 with a hospital admission for a period spanning January-December 2012. Previously developed logistic regression models of hospital readmission for fall-related injury were refit in a testing set including a randomly selected 70% of individuals, and examined in a training set comprised of the remaining 30%. Medications at admission were summarised based on reported adverse effect frequencies in published medication labelling. The Massachusetts health system. A total of 68 764 hospitalised individuals aged 35-65 years. Hospital readmission for fall-related injury defined by claims code. A total of 2052 individuals (3.0%) were hospitalised for fall-related injury within 90 days of discharge, and 3391 (4.9%) within 180 days. After recalibrating the model in a training data set comprised of 48 136 individuals (70%), model discrimination in the remaining 30% test set yielded an area under the receiver operating characteristic curve (AUC) of 0.74 (95% CI 0.72 to 0.76). AUCs were similar across age decades (0.71 to 0.78) and sex (0.72 male, 0.76 female), and across most common diagnostic categories other than psychiatry. For individuals in the highest risk quartile, 11.4% experienced fall within 180 days versus 1.2% in the lowest risk quartile; 57.6% of falls occurred in the highest risk quartile. This analysis of state-wide claims data demonstrates the feasibility of predicting fall-related injury requiring hospitalisation using readily available sociodemographic and clinical details. This translatable approach to stratification allows for identification of

  9. Global Precipitation Measurement (GPM) Mission: Precipitation Processing System (PPS) GPM Mission Gridded Text Products Provide Surface Precipitation Retrievals

    Science.gov (United States)

    Stocker, Erich Franz; Kelley, O.; Kummerow, C.; Huffman, G.; Olson, W.; Kwiatkowski, J.

    2015-01-01

    In February 2015, the Global Precipitation Measurement (GPM) mission core satellite will complete its first year in space. The core satellite carries a conically scanning microwave imager called the GPM Microwave Imager (GMI), which also has 166 GHz and 183 GHz frequency channels. The GPM core satellite also carries a dual frequency radar (DPR) which operates at Ku frequency, similar to the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar, and a new Ka frequency. The precipitation processing system (PPS) is producing swath-based instantaneous precipitation retrievals from GMI, both radars including a dual-frequency product, and a combined GMIDPR precipitation retrieval. These level 2 products are written in the HDF5 format and have many additional parameters beyond surface precipitation that are organized into appropriate groups. While these retrieval algorithms were developed prior to launch and are not optimal, these algorithms are producing very creditable retrievals. It is appropriate for a wide group of users to have access to the GPM retrievals. However, for researchers requiring only surface precipitation, these L2 swath products can appear to be very intimidating and they certainly do contain many more variables than the average researcher needs. Some researchers desire only surface retrievals stored in a simple easily accessible format. In response, PPS has begun to produce gridded text based products that contain just the most widely used variables for each instrument (surface rainfall rate, fraction liquid, fraction convective) in a single line for each grid box that contains one or more observations.This paper will describe the gridded data products that are being produced and provide an overview of their content. Currently two types of gridded products are being produced: (1) surface precipitation retrievals from the core satellite instruments GMI, DPR, and combined GMIDPR (2) surface precipitation retrievals for the partner constellation

  10. Health insurance system and payments provided to patients for the management of severe acute pancreatitis in Japan

    OpenAIRE

    Yoshida, Masahiro; Takada, Tadahiro; Kawarada, Yoshifumi; Hirata, Koichi; Mayumi, Toshihiko; Sekimoto, Miho; Hirota, Masahiko; Kimura, Yasutoshi; Takeda, Kazunori; Isaji, Shuji; Koizumi, Masaru; Otsuki, Makoto; Matsuno, Seiki

    2006-01-01

    The health insurance system in Japan is based upon the Universal Medical Care Insurance System, which gives all citizens the right to join an insurance scheme of their own choice, as guaranteed by the provisions of Article 25 of the Constitution of Japan, which states: ?All people shall have the right to maintain the minimum standards of wholesome and cultured living.? The health care system in Japan includes national medical insurance, nursing care for the elderly, and government payments fo...

  11. Providers' perceptions of the implementation of a performance measurement system for substance abuse treatment: A process evaluation of the Service Quality Measures initiative.

    Science.gov (United States)

    Myers, Bronwyn; Williams, Petal Petersen; Johnson, Kim; Govender, Rajen; Manderscheid, Ron; Koch, J Randy

    2016-02-22

    In South Africa, concerns exist about the quality of substance abuse treatment. We developed a performance measurement system, known as the Service Quality Measures (SQM) initiative, to monitor the quality of treatment and assess efforts to improve quality of care. In 2014, the SQM system was implemented at six treatment sites to evaluate how implementation protocols could be improved in preparation for wider roll-out. To describe providers' perceptions of the feasibility and acceptability of implementing the SQM system, including barriers to and facilitators of implementation. We conducted 15 in-depth interviews (IDIs) with treatment providers from six treatment sites (two sites in KwaZulu-Natal and four in the Western Cape). Providers were asked about their experiences in implementing the system, the perceived feasibility of the system, and barriers to implementation. All IDIs were audio-recorded and transcribed verbatim. A framework approach was used to analyse the data. Providers reported that the SQM system was feasible to implement and acceptable to patients and providers. Issues identified through the IDIs included a perceived lack of clarity about sequencing of key elements in the implementation of the SQM system, questions on integration of the system into clinical care pathways, difficulties in tracking patients through the system, and concerns about maximising patient participation in the process. Findings suggest that the SQM system is feasible to implement and acceptable to providers, but that some refinements to the implementation protocols are needed to maximise patient participation and the likelihood of sustained implementation.

  12. Simulated performance of the Thermo Active Building System (TABS) with respect to the provided thermal comfort and primary energy use

    DEFF Research Database (Denmark)

    Kolarik, Jakub; Olesen, Bjarne W.; Toftum, Jørn

    2009-01-01

    The central module of an office building conditioned by a Thermo Active Building System (TABS) coupled with constant volume ventilation was evaluated by means of dynamic computer simulations. Additionally, the same building model was simulated with a conventional all air VAV ventilation system fo...

  13. Understanding Providers' Interaction with Graphical User Interface Pertaining to Clinical Document Usage in an Electronic Health Record System

    Science.gov (United States)

    Rizvi, Rubina Fatima

    2017-01-01

    Despite high Electronic Health Record (EHR) system adoption rates by hospital and office-based practices, many users remain highly dissatisfied with the current state of EHRs. Sub-optimal EHR usability as a result of insufficient incorporation of User-Centered Design (UCD) approach during System Development Life Cycle process (SDLC) is considered…

  14. Status of and changes in water quality monitored for the Idaho statewide surface-water-quality network, 1989—2002

    Science.gov (United States)

    Hardy, Mark A.; Parliman, Deborah J.; O'Dell, Ivalou

    2005-01-01

    The Idaho statewide surface-water-quality monitoring network consists of 56 sites that have been monitored from 1989 through 2002 to provide data to document status and changes in the quality of Idaho streams. Sampling at 33 sites has covered a wide range of flows and seasons that describe water-quality variations representing both natural conditions and human influences. Targeting additional high- or low-flow sampling would better describe conditions at 20 sites during hydrologic extremes. At the three spring site types, sampling covered the range of flow conditions from 1989 through 2002 well. However, high flows at these sites since 1989 were lower than historical high flows as a result of declining ground-water levels in the Snake River Plain. Summertime stream temperatures at 45 sites commonly exceeded 19 and 22 degrees Celsius, the Idaho maximum daily mean and daily maximum criteria, respectively, for the protection of coldwater aquatic life. Criteria exceedances in stream basins with minimal development suggest that such high temperatures may occur naturally in many Idaho streams. Suspended-sediment concentrations were generally higher in southern Idaho than in central and northern Idaho, and network data suggest that the turbidity criteria are most likely to be exceeded at sites in southern Idaho and other sections of the Columbia Plateaus geomorphic province. This is probably because this province has more fine-grained soils that are subject to erosion and disturbance by land uses than the Northern Rocky Mountains province of northern and central

  15. Enhancing Clinical Content and Race/Ethnicity Data in Statewide Hospital Administrative Databases: Obstacles Encountered, Strategies Adopted, and Lessons Learned.

    Science.gov (United States)

    Pine, Michael; Kowlessar, Niranjana M; Salemi, Jason L; Miyamura, Jill; Zingmond, David S; Katz, Nicole E; Schindler, Joe

    2015-08-01

    Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. Grantees faced common challenges, including recruiting data partners and ensuring their continued effective participation, acquiring and validating the accuracy and utility of new data elements, and linking data from multiple sources to create internally consistent enhanced administrative databases. Successful strategies to overcome these challenges included aggressively engaging with providers of critical sources of data, emphasizing potential benefits to participants, revising requirements to lessen burdens associated with participation, maintaining continuous communication with participants, being flexible when responding to participants' difficulties in meeting program requirements, and paying scrupulous attention to preparing data specifications and creating and implementing protocols for data auditing, validation, cleaning, editing, and linking. In addition to common challenges, grantees also had to contend with unique challenges from local environmental factors that shaped the strategies they adopted. The creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources. Excellent communication, flexibility, and attention to detail are essential ingredients in accomplishing this task. Additional research is needed to develop strategies for maintaining these databases when initial funding is exhausted. © Health Research and Educational Trust.

  16. [Comparison of the systems used for providing local anesthesia in dentistry--the Wand (Milestone Scientific) and Injex (Rosch)].

    Science.gov (United States)

    Zarzecka, Joanna; Gończowski, Krzysztof; Kesek, Barbara; Darczuk, Dagmara; Zapała, Jan

    2006-01-01

    Local anesthesia is one of the basic and the most often executed interventions in dentistry. This procedure is very stressful for the patients because it is combined with pain. The new systems for delivering local anesthesia in dentistry have revolutionized the technique considerably by its simplify as well as reduction in pain. this study presents the comparison between the local anesthesia delivery systems used in dentistry--The Wand and Injex, taking into consideration pain intensity during performing anesthesia and the intensification of fear before executed anesthesia with the given system. the Visual Analogue Scale (VAS), verbal scale and questionnaires were used to evaluate pain and fear. On the basis of our investigations it can be concluded that there were statistically important differences between men and women in fear intensity combined with the anesthesia procedure--men were less afraid than women. The patients who were anaesthetized with system The WAND declared less fear before similar anesthesia in future. The average value of intensity of pain analyzed with both verbal and visual scales during anaesthetizing with the system Injex (independently from sex) was statistically significantly higher than for system The WAND--respectively 0.57 and 8.55 for The WAND, 2.02 and 32.18 for Injex (p = 0.001). on the basis of the results of this study it can be concluded that the less stressful and painful local anesthesia delivery system is the WAND.

  17. Service provider perceptions of transitioning from audio to video capability in a telehealth system: a qualitative evaluation

    OpenAIRE

    Clay-Williams, Robyn; Baysari, Melissa; Taylor, Natalie; Zalitis, Dianne; Georgiou, Andrew; Robinson, Maureen; Braithwaite, Jeffrey; Westbrook, Johanna

    2017-01-01

    Background Telephone consultation and triage services are increasingly being used to deliver health advice. Availability of high speed internet services in remote areas allows healthcare providers to move from telephone to video telehealth services. Current approaches for assessing video services have limitations. This study aimed to identify the challenges for service providers associated with transitioning from audio to video technology. Methods Using a mixed-method, qualitative approach, w...

  18. California drug courts: outcomes, costs and promising practices: an overview of Phase II in a statewide study.

    Science.gov (United States)

    Carey, Shannon M; Finigan, Michael; Crumpton, Dave; Waller, Mark

    2006-11-01

    The rapid expansion of drug courts in California and the state's uncertain fiscal climate highlighted the need for definitive cost information on drug court programs. This study focused on creating a research design that can be utilized for statewide and national cost-assessment of drug courts by conducting in-depth case studies of the costs and benefits in nine adult drug courts in California. A Transactional Institutional Costs Analysis (TICA) approach was used, allowing researchers to calculate costs based on every individual's transactions within the drug court or the traditional criminal justice system. This methodology also allows the calculation of costs and benefits by agency (e.g., Public Defender's office, court, District Attorney). Results in the nine sites showed that the majority of agencies save money in processing an offender though drug court. Overall, for these nine study sites, participation in drug court saved the state over 9 million dollars in criminal justice and treatment costs due to lower recidivism in drug court participants. Based on the lessons learned in Phases I and II, Phase III of this study focuses on the creation of a web-based drug court cost self-evaluation tool (DC-CSET) that drug courts can use to determine their own costs and benefits.

  19. The Challenges Associated with Accounting for the Army's Force Provider (FP) System when Deployed in Support of Military Operations

    National Research Council Canada - National Science Library

    Correia, Carlos A; Horner, Allen; McLaughlin, James; Stewardson, Donald

    2008-01-01

    .... The analysis will address the inherent challenges associated with accountability of the FP System when deployed and decommissioned to undergo RESET, the lack of a singular management and decision...

  20. A mathematical model of metabolism an regulation provides a systems-level view of how Escherichia coli responds to oxigen

    NARCIS (Netherlands)

    Ederer, M.; Steinsiek, S.; Stagge, S.; Rolfe, M.D.; ter Beek, A.; Knies, D.; Teixeira De Mattos, M.J.; Sauter, T.; Green, J.; Poole, R.K.; Bettenbrock, K.; Sawodny, O.

    2014-01-01

    The efficient redesign of bacteria for biotechnological purposes, such as biofuel production, waste disposal or specific biocatalytic functions, requires a quantitative systems-level understanding of energy supply, carbon, and redox metabolism. The measurement of transcript levels, metabolite

  1. Determining Threshold Distance Providing Less Interference for Wireless Medical Implant Communication Systems in Coexisting Environments under Shadow Fading Conditions

    Directory of Open Access Journals (Sweden)

    Selman KULAÇ

    2017-08-01

    Full Text Available Important interference problems will be able to be encountered especially close areas to the hospitals where wireless implantable medical systems' communication traffic occurs heavily in near future. It is possible that these interferences could cause wireless implant devices to malfunction and harmful effects on patients. In this study, it is proposed to determine threshold distance in order to get less interference for wireless implantable medical systems under shadow fading conditions where MICS band and MetAids band users coexist intensely simultaneously. In this method, threshold power according to the \\cite{FCC} is pulled down by adding extra distance margin in order to minimize the interference effects to the MICS systems using confidence interval calculations. Because received signal strength just below the monitoring threshold power according to the \\cite{FCC} brings about much more interferences for the MICS systems even if listen-before-talk technique is applied.

  2. The World Health Organization's Basic Radiological System (WHO-BRS). How to provide a better service with less cost

    International Nuclear Information System (INIS)

    Gomez Crespo, G.; Hanson, G.P.

    1986-01-01

    This article describes the application of the World Health Organization - Basic Radiological System (WHO-BRS) in Latin America in particular in Colombia. Various aspects of the radiological system are discussed including the X-ray equipment, radiation safety, training, manuals for operating and maintenance of the equipments, supply of spare parts, etc. The difficulties encountered in applying medical radiography in Latin America are pointed out. 6 refs

  3. Lessons learnt from an international intercomparison of national network systems used to provide early warning of a nuclear accident

    International Nuclear Information System (INIS)

    Saez-Vergara, J.C.; Thompson, I.M.G.; Funck, E.; Andersen, C.E.; Neumaier, S.; Botter-Jensen, L.

    2003-01-01

    As part of the European Research Council's Fourth Framework Programme, the EURADOS Action Group on Monitoring of External Exposures held an intercomparison of national network systems. This took place during May/June 1999 at the Riso Natural Environmental Radiation Measurement Station in Denmark and at the Underground Laboratory for Dosimetry and Spectrometry of the Physikalisch-Technische Bundesanstalt in Germany. The network systems are used continuously to monitor radiation levels throughout a country in order to give early warning of nuclear accidents having transboundary implications. The radiation levels measured are used to estimate the radiation risks to people arising from the accident. Seven European countries participated in the intercomparison with detector systems used in their national network systems as well as with detectors being developed for future use. Since different radiation quantities were measured by the systems (namely exposure, air kerma and ambient dose equivalent), the initial analysis of the intercomparison results was made in terms of the quantity air kerma rate. This report completes the analysis of the results and these are given in terms of air kerma rate in order to be consistent with the preliminary report. In addition, in some cases the results are also given in terms of the quantity measured by each national network system. The experience gained from this intercomparison is used to help organise a follow-up intercomparison to be held at the PTB Braunschweig in September 2002 and in which a further seven or eight countries from Europe will participate. (author)

  4. A California statewide three-dimensional seismic velocity model from both absolute and differential times

    Science.gov (United States)

    Lin, G.; Thurber, C.H.; Zhang, H.; Hauksson, E.; Shearer, P.M.; Waldhauser, F.; Brocher, T.M.; Hardebeck, J.

    2010-01-01

    We obtain a seismic velocity model of the California crust and uppermost mantle using a regional-scale double-difference tomography algorithm. We begin by using absolute arrival-time picks to solve for a coarse three-dimensional (3D) P velocity (VP) model with a uniform 30 km horizontal node spacing, which we then use as the starting model for a finer-scale inversion using double-difference tomography applied to absolute and differential pick times. For computational reasons, we split the state into 5 subregions with a grid spacing of 10 to 20 km and assemble our final statewide VP model by stitching together these local models. We also solve for a statewide S-wave model using S picks from both the Southern California Seismic Network and USArray, assuming a starting model based on the VP results and a VP=VS ratio of 1.732. Our new model has improved areal coverage compared with previous models, extending 570 km in the SW-NE directionand 1320 km in the NW-SE direction. It also extends to greater depth due to the inclusion of substantial data at large epicentral distances. Our VP model generally agrees with previous separate regional models for northern and southern California, but we also observe some new features, such as high-velocity anomalies at shallow depths in the Klamath Mountains and Mount Shasta area, somewhat slow velocities in the northern Coast Ranges, and slow anomalies beneath the Sierra Nevada at midcrustal and greater depths. This model can be applied to a variety of regional-scale studies in California, such as developing a unified statewide earthquake location catalog and performing regional waveform modeling.

  5. Coordination of care in the Chinese health care systems: a gap analysis of service delivery from a provider perspective.

    Science.gov (United States)

    Wang, Xin; Birch, Stephen; Zhu, Weiming; Ma, Huifen; Embrett, Mark; Meng, Qingyue

    2016-10-12

    Increases in health care utilization and costs, resulting from the rising prevalence of chronic conditions related to the aging population, is exacerbated by a high level of fragmentation that characterizes health care systems in China. There have been several pilot studies in China, aimed at system-level care coordination and its impact on the full integration of health care system, but little is known about their practical effects. Huangzhong County is one of the pilot study sites that introduced organizational integration (a dimension of integrated care) among health care institutions as a means to improve system-level care coordination. The purposes of this study are to examine the effect of organizational integration on system-level care coordination and to identify factors influencing care coordination and hence full integration of county health care systems in rural China. We chose Huangzhong and Hualong counties in Qinghai province as study sites, with only Huangzhong having implemented organizational integration. A mixed methods approach was used based on (1) document analysis and expert consultation to develop Best Practice intervention packages; (2) doctor questionnaires, identifying care coordination from the perspective of service provision. We measured service provision with gap index, overlap index and over-provision index, by comparing observed performance with Best Practice; (3) semi-structured interviews with Chiefs of Medicine in each institution to identify barriers to system-level care coordination. Twenty-nine institutions (11 at county-level, 6 at township-level and 12 at village-level) were selected producing surveys with a total of 19 schizophrenia doctors, 23 diabetes doctors and 29 Chiefs of Medicine. There were more care discontinuities for both diabetes and schizophrenia in Huangzhong than in Hualong. Overall, all three index scores (measuring service gaps, overlaps and over-provision) showed similar tendencies for the two conditions

  6. Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

    Science.gov (United States)

    Gemeda, Desta Hiko; Sime, Abiot Girma; Hajito, Kifle Woldemichael; Gelalacha, Benti Deresa; Tafese, Wubit; Gebrehiwot, Tsegaye Tewelde

    2016-01-01

    Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance.

  7. Staff turnover in statewide implementation of ACT: relationship with ACT fidelity and other team characteristics.

    Science.gov (United States)

    Rollins, Angela L; Salyers, Michelle P; Tsai, Jack; Lydick, Jennifer M

    2010-09-01

    Staff turnover on assertive community treatment (ACT) teams is a poorly understood phenomenon. This study examined annual turnover and fidelity data collected in a statewide implementation of ACT over a 5-year period. Mean annual staff turnover across all observations was 30.0%. Turnover was negatively correlated with overall fidelity at Year 1 and 3. The team approach fidelity item was negatively correlated with staff turnover at Year 3. For 13 teams with 3 years of follow-up data, turnover rates did not change over time. Most ACT staff turnover rates were comparable or better than other turnover rates reported in the mental health and substance abuse literature.

  8. Predictors of Suicidal Ideation in a Statewide Sample of Transgender Individuals.

    Science.gov (United States)

    Rood, Brian A; Puckett, Julia A; Pantalone, David W; Bradford, Judith B

    2015-09-01

    Transgender individuals experience violence and discrimination, which, in addition to gender transitioning, are established correlates of psychological distress. In a statewide sample of 350 transgender adults, we investigated whether a history of violence and discrimination increased the odds of reporting lifetime suicidal ideation (SI) and whether differences in SI were predicted by gender transition status. Violence, discrimination, and transition status significantly predicted SI. Compared with individuals with no plans to transition, individuals with plans or who were living as their identified gender reported greater odds of lifetime SI. We discuss implications for SI disparities using Meyer's minority stress model.

  9. Impact of a radio frequency management information system on the process and timing of providing respiratory care services.

    Science.gov (United States)

    Stoller, James K; Kester, Lucy; Orens, Douglas K; McCarthy, Kevin

    2002-08-01

    Although radio frequency (RF) systems have proliferated and are designed to simplify care delivery in many clinical settings, little information is available on the impact of such RF systems on the delivery of patient care. Having used a hand-held-device-based management information system in our Respiratory Therapy Section for 16 years, we assessed the impact of an RF system on the delivery of respiratory therapy (RT) services. A single nursing unit dedicated to pulmonary and ear, nose, and throat care was selected for the RF system trial. Baseline (pre-RF) data were collected over 2 separate 1-month intervals (February 1999 and February 2000). The main outcome measures were (1) the amount of time needed at the beginning of the shift to organize and assign orders for RT services, (2) the time interval between notification of an RT consult order and completion of the RT consult, and (3) the time interval between notification of an RT treatment order and completion of the RT treatment. The activities required for organizing and assigning the orders were manually timed. Starting 6 weeks after therapists were trained to use the RF system, similar data were collected while using the RF system for two 1-month intervals (February and March 2001). The mean +/- SD time interval between receiving an RT consult order and completing the consult was reduced from 7.8 +/- 18.9 h to 2.8 +/- 2.4 h (p = 0.002). The percentage of patients who waited longer than 8 hours between receipt of a consult order and completion of the consult decreased from 18% to 4.7% (p = 0.026). The total time required for organizing and assigning RT work was reduced from 81.6 min to 43.6 min. The RF system had several advantages over the hand-held-device-based system: (1) shorter interval between the order for and completion of an RT consult, (2) lower percentage of patients for whom the interval between the order and the consult exceeded 8 hours, and (3) less time required to make shift assignments

  10. Real time alert system: a disease management system leveraging health information exchange.

    Science.gov (United States)

    Anand, Vibha; Sheley, Meena E; Xu, Shawn; Downs, Stephen M

    2012-01-01

    Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA's performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Our results show that RTA was successfully able to deliver "just in time" patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient's asthma related emergency room admission so further follow up can happen in near real time.

  11. Methodical approaches to providing sustainable development of the transport industry management system based on self-organization

    Science.gov (United States)

    Belyantseva, Oksana; Panenkov, Andrey; Safonova, Nataliya

    2017-10-01

    Current conditions of the cognitive economy formation demand to take into account the leading role of information, knowledge and human capital in the development of the transport industry management system. The article substantiates the conceptual approach to the self-organization of a management system on the basis of innovative changes. Human capital is the key aspect of self-organization, so the directions of improving the workforce quality are justified. Basing on the information-innovative genesis of the process of self-organization, the authors justified the necessity of preventing asymmetric information. For this pupose the actions against the resistance to innovations were proposed. The implementation of certain measures contributes to the effective development of the transport management system.

  12. Efficiency of the system of management accounting and reporting in a medical organization when providing dental care to the population

    Directory of Open Access Journals (Sweden)

    Gaidarov G.M.

    2018-03-01

    Full Text Available In modern conditions, the justification of managerial decisions in a medical organization requires the introduction of a detailed system of management accounting, the most important element of which is the correctness and legality of writing-off of medical preparations and supplies, especially with respect to resource-intensive types of medical care, in particular, dental care. Purpose of the study: evaluation of the effectiveness of the system of management accounting and reporting developed and implemented in the Department of Therapeutic Dentistry of the ISMU aimed at the rational and effective use of limited financial resources in modern conditions. Methods. The study used an economic method to analyze the actual costs incurred in the provision of dental services in medical organizations in Irkutsk, participating in the provision of medical care in the MHI system. Results. The use of the developed and implemented system of management accounting and reporting for the dental medical organization on the basis of the results of the implementation for the period January-October 2017 resulted in a reduction in the actual costs for a single completed case of dental care and almost a twofold reduction in the cost of medicines. However, even the implementation of these measures was not capable of bringing actual expenditures into full compliance with the normative volume of financing in the MHI system, especially taking into account the phased increase in the level of wages of medics. Conclusion. The internal environment and the accounting and reporting policy of the medical organization are undoubtedly of great importance in solving the problems of rational and effective use of financial resources, but the state’s provision of sufficient level of tariffs for medical care in the MHI system plays a key role.

  13. Lessons learnt from an international intercomparison of national network systems used to provide early warning of a nuclear accident

    DEFF Research Database (Denmark)

    Saez-Vergara, J.C.; Thompson, I.M.G.; Funck, E.

    2003-01-01

    and at the Underground Laboratory for Dosimetry and Spectrometry (UDO) of the Physikalisch-Technische Bundesanstalt (PTB) in Germany. The network systems are used continuously to monitor radiation levels throughout a country in order to give early warning of nuclear accidents having transboundary implications...... in order to be consistent with the preliminary report. In addition, in some cases the results are also given in terms of the quantity measured by each national network system. The experience gained from this intercomparison is used to help organise a follow-up intercomparison to be held at the PTB...

  14. Providing Health Sciences Services in a Joint-Use Distributed Learning Library System: An Organizational Case Study.

    Science.gov (United States)

    Enslow, Electra; Fricke, Suzanne; Vela, Kathryn

    2017-01-01

    The purpose of this organizational case study is to describe the complexities librarians face when serving a multi-campus institution that supports both a joint-use library and expanding health sciences academic partnerships. In a system without a centralized health science library administration, liaison librarians are identifying dispersed programs and user groups and collaborating to define their unique service and outreach needs within a larger land-grant university. Using a team-based approach, health sciences librarians are communicating to integrate research and teaching support, systems differences across dispersed campuses, and future needs of a new community-based medical program.

  15. Quantifying the role of National Forest system lands in providing surface drinking water supply for the Southern United States

    Science.gov (United States)

    Peter Caldwell; Corinne Muldoon; Chelcy Ford-Miniat; Erika Cohen; Suzanne Krieger; Ge Sun; Steven McNulty; Paul V. Bolstad

    2014-01-01

    Forests and water are inextricably linked, and people are dependent on forested lands to provide clean, reliable water supplies for drinking and to support local economies. These water supplies are at risk of degradation from a growing population, continued conversion of forests to other land uses, and climate change. Given the variety of threats to surface water, it...

  16. Transphosphorylation of E. coli proteins during production of recombinant protein kinases provides a robust system to characterize kinase specificity

    Science.gov (United States)

    Protein kinase specificity is of fundamental importance to pathway regulation and signal transduction. Here, we report a convenient system to monitor the activity and specificity of recombinant protein kinases expressed in E.coli. We apply this to the study of the cytoplasmic domain of the plant rec...

  17. Extending the Domain Name System (DNS) to Provide Geographical Addressing Towards Vehicular Ad-Hoc Networks (VANETs)

    NARCIS (Netherlands)

    Fioreze, Tiago; Heijenk, Geert

    2011-01-01

    Geographical addressing is a key communication paradigm in emerging Intelligent Transportation Systems (ITS). In this paper, we address the issue of how to direct messages to roadside units (RSUs) in order to have them forwarded by the RSUs to the on-board units (OBUs) of vehicles in a certain

  18. CONCEPTUAL BASES OF FORMING THE SYSTEM OF FINANCIAL AND ECONOMIC PROVIDING SOCIAL PROTECTION INVOLUNTARILY DISPLACED PERSONS WITH CLUSTER APPROACH

    Directory of Open Access Journals (Sweden)

    Svitlana Kropelnytska

    2017-08-01

    Full Text Available The article systematizes approaches to financial support and social adaptation of internally displaced persons (IDPs as well as their social protection, that is based on the analysis of legal framework, situation and sources of financial and social support to the EU member states of the IDPs in Ukraine and their social security. The study of the IDPs situation and the assessment of the required resources are based on a cluster approach, which defines optimal set of problem areas requiring priority social and financial support. This allowed to develop practical recommendations for the development of a comprehensive, transparent and unified policy of social protection through the development of a conceptual framework for the financial and economic provision of social protection IDPs, which will be the basic solution to the problems of social and financial provision forced migrants in Ukraine. Key words: forced migrants, internally displaced persons, cluster, social policy, social protection, social providing, financial providing.

  19. Intra-session repeatability of iridocorneal angle measurements provided by a Scheimpflug photography-based system in healthy eyes

    OpenAIRE

    Ruiz-Belda, Clara; Piñero, David P.; Ruiz Fortes, Pedro; Soto-Negro, Roberto; Moya, Myriam; Pérez Cambrodí, Rafael J.; Artola, Alberto

    2016-01-01

    Purpose: The purpose of this study was to evaluate intra-session repeatability of measurements of the iridocorneal angle at different meridians in the nasal and temporal areas in healthy eyes using the Sirius Scheimpflug photography-based system in glaucoma analysis mode. Methods: A total of 43 eyes of 43 patients ranging in age from 36 to 79 years were enrolled in the study. All eyes received a comprehensive ophthalmologic examination including a complete anterior segment analysis with the C...

  20. Ultrasound Indoor Positioning System Based on a Low-Power Wireless Sensor Network Providing Sub-Centimeter Accuracy

    Directory of Open Access Journals (Sweden)

    Ángel De la Torre

    2013-03-01

    Full Text Available This paper describes the TELIAMADE system, a new indoor positioning system based on time-of-flight (TOF of ultrasonic signal to estimate the distance between a receiver node and a transmitter node. TELIAMADE system consists of a set of wireless nodes equipped with a radio module for communication and a module for the transmission and reception of ultrasound. The access to the ultrasonic channel is managed by applying a synchronization algorithm based on a time-division multiplexing (TDMA scheme. The ultrasonic signal is transmitted using a carrier frequency of 40 kHz and the TOF measurement is estimated by applying a quadrature detector to the signal obtained at the A/D converter output. Low sampling frequencies of 17.78 kHz or even 12.31 kHz are possible using quadrature sampling in order to optimize memory requirements and to reduce the computational cost in signal processing. The distance is calculated from the TOF taking into account the speed of sound. An excellent accuracy in the estimation of the TOF is achieved using parabolic interpolation to detect of maximum of the signal envelope at the matched filter output. The signal phase information is also used for enhancing the TOF measurement accuracy. Experimental results show a root mean square error (rmse less than 2 mm and a standard deviation less than 0.3 mm for pseudorange measurements in the range of distances between 2 and 6 m. The system location accuracy is also evaluated by applying multilateration. A sub-centimeter location accuracy is achieved with an average rmse of 9.6 mm.

  1. Ultrasound indoor positioning system based on a low-power wireless sensor network providing sub-centimeter accuracy.

    Science.gov (United States)

    Medina, Carlos; Segura, José Carlos; De la Torre, Ángel

    2013-03-13

    This paper describes the TELIAMADE system, a new indoor positioning system based on time-of-flight (TOF) of ultrasonic signal to estimate the distance between a receiver node and a transmitter node. TELIAMADE system consists of a set of wireless nodes equipped with a radio module for communication and a module for the transmission and reception of ultrasound. The access to the ultrasonic channel is managed by applying a synchronization algorithm based on a time-division multiplexing (TDMA) scheme. The ultrasonic signal is transmitted using a carrier frequency of 40 kHz and the TOF measurement is estimated by applying a quadrature detector to the signal obtained at the A/D converter output. Low sampling frequencies of 17.78 kHz or even 12.31 kHz are possible using quadrature sampling in order to optimize memory requirements and to reduce the computational cost in signal processing. The distance is calculated from the TOF taking into account the speed of sound. An excellent accuracy in the estimation of the TOF is achieved using parabolic interpolation to detect of maximum of the signal envelope at the matched filter output. The signal phase information is also used for enhancing the TOF measurement accuracy. Experimental results show a root mean square error (rmse) less than 2 mm and a standard deviation less than 0.3 mm for pseudorange measurements in the range of distances between 2 and 6 m. The system location accuracy is also evaluated by applying multilateration. A sub-centimeter location accuracy is achieved with an average rmse of 9.6 mm.

  2. Development of a computer-aided clinical patient education system to provide appropriate individual nursing care for psychiatric patients.

    Science.gov (United States)

    Tseng, Kuan-Jui; Liou, Tsan-Hon; Chiu, Hung-Wen

    2012-06-01

    A lot of researches have proven that health education can help patients to maintain and improve their health. And it also shortens the time staying in hospital to save medication resource. Because the patients are willing to get healthcare knowledge to enhance the ability of self-care, they pay more attention to the health education. In Taiwan, the clinical nurses play an important role in patient education, and the health education take most time in their daily work. Such work includes the collection, production and delivery of education materials. To generate the correct and customized health education material is the key of success of patient education. In this study, we established a computer-aided health education contents generating system for psychiatric patients by integrating the databases for disease, medicine and nursing knowledge to assist nurse generating the customized health education document suitable for different patients. This system was evaluated by clinical nurses in usability and feasibility. This system is helpful for nurse to carry out the clinical health education to patients and further to encourage patient to pay attention to self-health.

  3. Adaptation of Fusarium oxysporum and Fusarium dimerum to the specific aquatic environment provided by the water systems of hospitals.

    Science.gov (United States)

    Steinberg, Christian; Laurent, Julie; Edel-Hermann, Véronique; Barbezant, Marie; Sixt, Nathalie; Dalle, Frédéric; Aho, Serge; Bonnin, Alain; Hartemann, Philippe; Sautour, Marc

    2015-06-01

    Members of the Fusarium group were recently detected in water distribution systems of several hospitals in the world. An epidemiological investigation was conducted over 2 years in hospital buildings in Dijon and Nancy (France) and in non-hospital buildings in Dijon. The fungi were detected only within the water distribution systems of the hospital buildings and also, but at very low concentrations, in the urban water network of Nancy. All fungi were identified as Fusarium oxysporum species complex (FOSC) and Fusarium dimerum species complex (FDSC) by sequencing part of the translation elongation factor 1-alpha (TEF-1α) gene. Very low diversity was found in each complex, suggesting the existence of a clonal population for each. Density and heterogeneous distributions according to buildings and variability over time were explained by episodic detachments of parts of the colony from biofilms in the pipes. Isolates of these waterborne populations as well as soilborne isolates were tested for their ability to grow in liquid medium in the presence of increasing concentrations of sodium hypochlorite, copper sulfate, anti-corrosion pipe coating, at various temperatures (4°-42 °C) and on agar medium with amphotericin B and voriconazole. The waterborne isolates tolerated higher sodium hypochlorite and copper sulfate concentrations and temperatures than did soilborne isolates but did not show any specific resistance to fungicides. In addition, unlike waterborne isolates, soilborne isolates did not survive in water even supplemented with glucose, while the former developed in the soil as well as soilborne isolates. We concluded the existence of homogeneous populations of FOSC and FDSC common to all contaminated hospital sites. These populations are present at very low densities in natural waters, making them difficult to detect, but they are adapted to the specific conditions offered by the complex water systems of public hospitals in Dijon and Nancy and probably other

  4. Avoiding a knowledge gap in a multiethnic statewide social marketing campaign: is cultural tailoring sufficient?

    Science.gov (United States)

    Buchthal, O Vanessa; Doff, Amy L; Hsu, Laura A; Silbanuz, Alice; Heinrich, Katie M; Maddock, Jay E

    2011-03-01

    In 2007, the State of Hawaii, Healthy Hawaii Initiative conducted a statewide social-marketing campaign promoting increased physical activity and nutrition. The campaign included substantial formative research to develop messages tailored for Hawaii's multiethnic Asian and Pacific Islander populations. The authors conducted a statewide random digital dialing telephone survey to assess the campaign's comparative reach among individuals with different ethnicities and different levels of education and income. This analysis suggests that the intervention was successful in reaching its target ethnic audiences. However, a knowledge gap related to the campaign appeared among individuals with incomes less than 130% of the poverty level and those with less than a high school education. These results varied significantly by message and the communication channel used. Recall of supermarket-based messages was significantly higher among individuals below 130% of the poverty level and those between 18 and 35 years of age, 2 groups that showed consistently lower recall of messages in other channels. Results suggest that cultural tailoring for ethnic audiences, although important, is insufficient for reaching low-income populations, and that broad-based social marketing campaigns should consider addressing socioeconomic status-related channel preferences in formative research and campaign design.

  5. Preventing child maltreatment: Examination of an established statewide home-visiting program.

    Science.gov (United States)

    Chaiyachati, Barbara H; Gaither, Julie R; Hughes, Marcia; Foley-Schain, Karen; Leventhal, John M

    2018-05-01

    Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut's home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P home visiting. First substantiations also occurred later in the child's life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53-1.02, P = .06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Improving Accuracy and Relevance of Race/Ethnicity Data: Results of a Statewide Collaboration in Hawaii.

    Science.gov (United States)

    Pellegrin, Karen L; Miyamura, Jill B; Ma, Carolyn; Taniguchi, Ronald

    2016-01-01

    Current race/ethnicity categories established by the U.S. Office of Management and Budget are neither reliable nor valid for understanding health disparities or for tracking improvements in this area. In Hawaii, statewide hospitals have collaborated to collect race/ethnicity data using a standardized method consistent with recommended practices that overcome the problems with the federal categories. The purpose of this observational study was to determine the impact of this collaboration on key measures of race/ethnicity documentation. After this collaborative effort, the number of standardized categories available across hospitals increased from 6 to 34, and the percent of inpatients with documented race/ethnicity increased from 88 to 96%. This improved standardized methodology is now the foundation for tracking population health indicators statewide and focusing quality improvement efforts. The approach used in Hawaii can serve as a model for other states and regions. Ultimately, the ability to standardize data collection methodology across states and regions will be needed to track improvements nationally.

  7. Experience of an association as 'recipient' of information material provided through communication systems based on e-technologies

    International Nuclear Information System (INIS)

    Roussel, C.

    2006-01-01

    The IDEMU, or Urban Ecology Institute was created in 1995 as a non profit association to contribute to the development of training and information on the know-how related to environment and energy in urban areas. The Institute has had to set up a system of internet watch to keep up with evolutions in relevant domains such technologies, law, society, state policies and computer sciences. Among the various tools used for active research we have: research and meta research motors, specialised and generalized press, news-groups, import of the full content of selected web-sites and forum with data exchange

  8. Appraising the Early-est earthquake monitoring system for tsunami alerting at the Italian Candidate Tsunami Service Provider

    Science.gov (United States)

    Bernardi, F.; Lomax, A.; Michelini, A.; Lauciani, V.; Piatanesi, A.; Lorito, S.

    2015-09-01

    In this paper we present and discuss the performance of the procedure for earthquake location and characterization implemented in the Italian Candidate Tsunami Service Provider at the Istituto Nazionale di Geofisica e Vulcanologia (INGV) in Rome. Following the ICG/NEAMTWS guidelines, the first tsunami warning messages are based only on seismic information, i.e., epicenter location, hypocenter depth, and magnitude, which are automatically computed by the software Early-est. Early-est is a package for rapid location and seismic/tsunamigenic characterization of earthquakes. The Early-est software package operates using offline-event or continuous-real-time seismic waveform data to perform trace processing and picking, and, at a regular report interval, phase association, event detection, hypocenter location, and event characterization. Early-est also provides mb, Mwp, and Mwpd magnitude estimations. mb magnitudes are preferred for events with Mwp ≲ 5.8, while Mwpd estimations are valid for events with Mwp ≳ 7.2. In this paper we present the earthquake parameters computed by Early-est between the beginning of March 2012 and the end of December 2014 on a global scale for events with magnitude M ≥ 5.5, and we also present the detection timeline. We compare the earthquake parameters automatically computed by Early-est with the same parameters listed in reference catalogs. Such reference catalogs are manually revised/verified by scientists. The goal of this work is to test the accuracy and reliability of the fully automatic locations provided by Early-est. In our analysis, the epicenter location, hypocenter depth and magnitude parameters do not differ significantly from the values in the reference catalogs. Both mb and Mwp magnitudes show differences to the reference catalogs. We thus derived correction functions in order to minimize the differences and correct biases between our values and the ones from the reference catalogs. Correction of the Mwp

  9. Hospital catering systems and their impact on the sensorial profile of foods provided to older patients in the UK.

    Science.gov (United States)

    Mavrommatis, Yiannis; Moynihan, Paula J; Gosney, Margot A; Methven, Lisa

    2011-08-01

    Impaired sensorial perception is very common in older people and low sensorial quality of foods is associated with decreased appetite and dietary intake. Hospital undernutrition in older patients could be linked to sensorial quality of hospital food if the quality were low or inappropriate for older people. The aim of this study was to examine changes in the sensorial quality of different foods that occur as a result of the food journey (i.e. freezing, regeneration, etc.) in the most common hospital catering systems in the UK. A trained sensory panel assessed sensorial descriptors of certain foods with and without the hospital food journey as it occurs in the in-house and cook/freeze systems. The results showed effects of the food journey on a small number of sensorial descriptors related to flavour, appearance and mouthfeel. The majority of these effects were due to temperature changes, which caused accumulation of condensation. A daily variation in sensorial descriptors was also detected and in some cases it was greater than the effect of the food journey. This study has shown that changes occur in the sensory quality of meals due to hospital food journeys, however these changes were small and are not expected to substantially contribute to acceptability or have a major role in hospital malnutrition. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. DNA barcoding discriminates freshwater fishes from southeastern Nigeria and provides river system-level phylogeographic resolution within some species.

    Science.gov (United States)

    Nwani, Christopher D; Becker, Sven; Braid, Heather E; Ude, Emmanuel F; Okogwu, Okechukwu I; Hanner, Robert

    2011-10-01

    Fishes are the main animal protein source for human beings and play a vital role in aquatic ecosystems and food webs. Fish identification can be challenging, especially in the tropics (due to high diversity), and this is particularly true for larval forms or fragmentary remains. DNA barcoding, which uses the 5' region of the mitochondrial cytochrome c oxidase subunit I (COI) as a target gene, is an efficient method for standardized species-level identification for biodiversity assessment and conservation, pending the establishment of reference sequence libraries. In this study, fishes were collected from three rivers in southeastern Nigeria, identified morphologically, and imaged digitally. DNA was extracted, PCR-amplified, and the standard barcode region was bidirectionally sequenced for 363 individuals belonging to 70 species in 38 genera. All specimen provenance data and associated sequence information were recorded in the barcode of life data systems (BOLD; www.barcodinglife.org ). Analytical tools on BOLD were used to assess the performance of barcoding to identify species. Using neighbor-joining distance comparison, the average genetic distance was 60-fold higher between species than within species, as pairwise genetic distance estimates averaged 10.29% among congeners and only 0.17% among conspecifics. Despite low levels of divergence within species, we observed river system-specific haplotype partitioning within eight species (11.4% of all species). Our preliminary results suggest that DNA barcoding is very effective for species identification of Nigerian freshwater fishes.

  11. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

    Science.gov (United States)

    Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

    2015-10-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.

  12. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges

    Science.gov (United States)

    Johnson, Jennifer E.; Schonbrun, Yael Chatav; Peabody, Marlanea E.; Shefner, Ruth T.; Fernandes, Karen M.; Rosen, Rochelle K.; Zlotnick, Caron

    2014-01-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24–72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided. PMID:24595815

  13. [Cost analysis of radiotherapy provided in inpatient setting -  testing potential predictors for a new prospective payment system].

    Science.gov (United States)

    Sedo, J; Bláha, M; Pavlík, T; Klika, P; Dušek, L; Büchler, T; Abrahámová, J; Srámek, V; Slampa, P; Komínek, L; Pospíšil, P; Sláma, O; Vyzula, R

    2014-01-01

    As a part of the development of a new prospective payment model for radiotherapy we analyzed data on costs of care provided by three comprehensive cancer centers in the Czech Republic. Our aim was to find a combination of variables (predictors) which could be used to sort hospitalization cases into groups according to their costs, with each group having the same reimbursement rate. We tested four variables as possible predictors -  number of fractions, stage of disease, radiotherapy technique and diagnostic group. We analyzed 7,440 hospitalization cases treated in three comprehensive cancer centers from 2007 to 2011. We acquired data from the I COP database developed by Institute of Biostatistics and Analyses of Masaryk University in cooperation with oncology centers that contains records from the National Oncological Registry along with data supplied by healthcare providers to insurance companies for the purpose of retrospective reimbursement. When comparing the four variables mentioned above we found that number of fractions and radiotherapy technique were much stronger predictors than the other two variables. Stage of disease did not prove to be a relevant indicator of cost distinction. There were significant differences in costs among diagnostic groups but these were mostly driven by the technique of radiotherapy and the number of fractions. Within the diagnostic groups, the distribution of costs was too heterogeneous for the purpose of the new payment model. The combination of number of fractions and radiotherapy technique appears to be the most appropriate cost predictors to be involved in the prospective payment model proposal. Further analysis is planned to test the predictive value of intention of radiotherapy in order to determine differences in costs between palliative and curative treatment.

  14. A nanomedicine-promising approach to provide an appropriate colon-targeted drug delivery system for 5-fluorouracil

    Directory of Open Access Journals (Sweden)

    Singh S

    2015-11-01

    Full Text Available Sima Singh,1,* Niranjan G Kotla,2,* Sonia Tomar,3 Balaji Maddiboyina,4 Thomas J Webster,5,6 Dinesh Sharma,7 Omprakash Sunnapu2 1Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, 2Technologies for the Advancement of Science, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore, Karnataka, 3Department of Pharmaceutics, Ram Gopal College of Pharmacy, Rohtak, Haryana, 4Department of Pharmaceutics, Maharishi Markandeshwar University, Mullana, Ambala, Haryana, India; 5Department of Chemical Engineering, Northeastern University, Boston, MA, USA; 6Center of Excellence for Advanced Materials Research, King Abdulaziz University, Jeddah, Saudi Arabia; 7Ranbaxy Laboratory Ltd, Gurgaon, Haryana, India *These authors contributed equally to this work Abstract: Targeted drug delivery plays a significant role in disease treatment associated with the colon, affording therapeutic responses for a prolonged period of time with low side effects. Colorectal cancer is the third most common cancer in both men and women with an estimated 102,480 cases of colon cancer and 40,340 cases of rectal cancer in 2013 as reported by the American Cancer Society. In the present investigation, we developed an improved oral delivery system for existing anticancer drugs meant for colon cancer via prebiotic and probiotic approaches. The system comprises three components, namely, nanoparticles of drug coated with natural materials such as guar gum, xanthan gum (that serve as prebiotics, and probiotics. The natural gums play a dual role of protecting the drug in the gastric as well as intestinal conditions to allow its release only in the colon. In vitro results obtained from these experiments indicated the successful targeted delivery of 5-fluorouracil to the colon. Electron microscopy results demonstrated that the prepared nanoparticles were spherical in shape and 200 nm in size. The in vitro release data

  15. TECHNOLOGICAL ELEMENTS OF THE SYSTEM OF STRATEGIC PLANNING AS TOOLS FOR PROVIDING THE ECONOMIC DEVELOPMENT OF THE SERVICES SPHERE

    Directory of Open Access Journals (Sweden)

    V. V. Gromov

    2015-01-01

    Full Text Available Topicality article is to determine the composition of the technological elements of the strategic planning system, the interaction of which is aimed at achieving the planned economic results in the changing factors influence macro microenvironments on the activities of institutions and economic activities of services. The articles structurally is made on the basis of respect for the logical sequence of interactions of technological elements of strategic planning and combat their negative factors of external and internal environment. Active interaction of technological elements of strategic planning tools is to ensure long-term development planning authorities of economic entities, economic activities service sector for sustainable economic growth. Contribution of the author in the scope of this article is to generalize the definition of the target composition and installation of technological elements of strategic planning and development institutions and industry components of the service sector.

  16. A systems genetics approach provides a bridge from discovered genetic variants to biological pathways in rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Hirofumi Nakaoka

    Full Text Available Genome-wide association studies (GWAS have yielded novel genetic loci underlying common diseases. We propose a systems genetics approach to utilize these discoveries for better understanding of the genetic architecture of rheumatoid arthritis (RA. Current evidence of genetic associations with RA was sought through PubMed and the NHGRI GWAS catalog. The associations of 15 single nucleotide polymorphisms and HLA-DRB1 alleles were confirmed in 1,287 cases and 1,500 controls of Japanese subjects. Among these, HLA-DRB1 alleles and eight SNPs showed significant associations and all but one of the variants had the same direction of effect as identified in the previous studies, indicating that the genetic risk factors underlying RA are shared across populations. By receiver operating characteristic curve analysis, the area under the curve (AUC for the genetic risk score based on the selected variants was 68.4%. For seropositive RA patients only, the AUC improved to 70.9%, indicating good but suboptimal predictive ability. A simulation study shows that more than 200 additional loci with similar effect size as recent GWAS findings or 20 rare variants with intermediate effects are needed to achieve AUC = 80.0%. We performed the random walk with restart (RWR algorithm to prioritize genes for future mapping studies. The performance of the algorithm was confirmed by leave-one-out cross-validation. The RWR algorithm pointed to ZAP70 in the first rank, in which mutation causes RA-like autoimmune arthritis in mice. By applying the hierarchical clustering method to a subnetwork comprising RA-associated genes and top-ranked genes by the RWR, we found three functional modules relevant to RA etiology: "leukocyte activation and differentiation", "pattern-recognition receptor signaling pathway", and "chemokines and their receptors".These results suggest that the systems genetics approach is useful to find directions of future mapping strategies to illuminate

  17. Monitoring and use of antimycotic (micafungin for systemic use provided by the pharmacy of Marsala Hospital, Italy

    Directory of Open Access Journals (Sweden)

    Fabio Venturella

    2016-06-01

    Full Text Available Micafungin is an antimycotic drug and represents an important addition to the available therapies for the treatment of systemic fungal infections. Micafungin is used: in the treatment of invasive candidiasis, oesophageal and prophylaxis of Candida infections. It inhibits, in a non-competitive way, the synthesis of 1,3-β-D-glucan, a component of fungal cell wall and is rapidly distributed into the tissues. It has a high-rate respectful bond with plasma protein, which is independent from the concentration of the drug. It is metabolized through the liver, being not subject to intense metabolic transformations until the excretion. There is no evidence of systemic accumulation after repeated use. The steady-state is reached in 4-5 days. Medical records examined at the pharmacy of Marsala Hospital highlight that, from 01/06/2014 to 01/08/2014, in this hospital 12 vials were used by the hospitalized patients in the Department of Intensive Care: 8 patients between 75 and 83 years old had a body weight (BW higher than 40 kg; 3 patients between 40 and 60 years of age had a BW higher than 40 kg, and one 17 year-old patient had a BW of 40 kg. Two patients needed a dose increase, while for the other 10 patients the first dose resulted sufficient. Mycamine® was used for the treatment of hypovolemic post-operative shock. The most recorded adverse reactions were anemia, hypokalemia, hypomagnesemia, phlebitis, nausea, liver problems. Given the different weight of the subjects, the dosage was different.

  18. Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests.

    Science.gov (United States)

    Claret, Pierre-Géraud; Bobbia, Xavier; Macri, Francesco; Stowell, Andrew; Motté, Antony; Landais, Paul; Beregi, Jean-Paul; de La Coussaye, Jean-Emmanuel

    2016-06-01

    The adoption of computerized physician order entry is an important cornerstone of using health information technology (HIT) in health care. The transition from paper to computer forms presents a change in physicians' practices. The main objective of this study was to investigate the impact of implementing a computer-based order entry (CPOE) system without clinical decision support on the number of radiographs ordered for patients admitted in the emergency department. This single-center pre-/post-intervention study was conducted in January, 2013 (before CPOE period) and January, 2014 (after CPOE period) at the emergency department at Nîmes University Hospital. All patients admitted in the emergency department who had undergone medical imaging were included in the study. Emergency department admissions have increased since the implementation of CPOE (5388 in the period before CPOE implementation vs. 5808 patients after CPOE implementation, p=.008). In the period before CPOE implementation, 2345 patients (44%) had undergone medical imaging; in the period after CPOE implementation, 2306 patients (40%) had undergone medical imaging (p=.008). In the period before CPOE, 2916 medical imaging procedures were ordered; in the period after CPOE, 2876 medical imaging procedures were ordered (p=.006). In the period before CPOE, 1885 radiographs were ordered; in the period after CPOE, 1776 radiographs were ordered (pmedical imaging did not vary between the two periods. Our results show a decrease in the number of radiograph requests after a CPOE system without clinical decision support was implemented in our emergency department. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. A GIS-Enabled, Michigan-Specific, Hierarchical Groundwater Modeling and Visualization System

    Science.gov (United States)

    Liu, Q.; Li, S.; Mandle, R.; Simard, A.; Fisher, B.; Brown, E.; Ross, S.

    2005-12-01

    Efficient management of groundwater resources relies on a comprehensive database that represents the characteristics of the natural groundwater system as well as analysis and modeling tools to describe the impacts of decision alternatives. Many agencies in Michigan have spent several years compiling expensive and comprehensive surface water and groundwater inventories and other related spatial data that describe their respective areas of responsibility. However, most often this wealth of descriptive data has only been utilized for basic mapping purposes. The benefits from analyzing these data, using GIS analysis functions or externally developed analysis models or programs, has yet to be systematically realized. In this talk, we present a comprehensive software environment that allows Michigan groundwater resources managers and frontline professionals to make more effective use of the available data and improve their ability to manage and protect groundwater resources, address potential conflicts, design cleanup schemes, and prioritize investigation activities. In particular, we take advantage of the Interactive Ground Water (IGW) modeling system and convert it to a customized software environment specifically for analyzing, modeling, and visualizing the Michigan statewide groundwater database. The resulting Michigan IGW modeling system (IGW-M) is completely window-based, fully interactive, and seamlessly integrated with a GIS mapping engine. The system operates in real-time (on the fly) providing dynamic, hierarchical mapping, modeling, spatial analysis, and visualization. Specifically, IGW-M allows water resources and environmental professionals in Michigan to: * Access and utilize the extensive data from the statewide groundwater database, interactively manipulate GIS objects, and display and query the associated data and attributes; * Analyze and model the statewide groundwater database, interactively convert GIS objects into numerical model features

  20. A Multi-Period Optimization Model for Service Providers Using Online Reservation Systems: An Application to Hotels.

    Science.gov (United States)

    Xu, Ming; Jiao, Yan; Li, Xiaoming; Cao, Qingfeng; Wang, Xiaoyang

    2015-01-01

    This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS) customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations.

  1. A Multi-Period Optimization Model for Service Providers Using Online Reservation Systems: An Application to Hotels

    Science.gov (United States)

    Xu, Ming; Jiao, Yan; Li, Xiaoming; Cao, Qingfeng; Wang, Xiaoyang

    2015-01-01

    This paper presents a multi-period optimization model for high margin and zero salvage products in online distribution channels with classifying customers based on number of products required. Taking hotel customers as an example, one is regular customers who reserve rooms for one day, and the other is long term stay (LTS) customers who reserve rooms for a number of days. LTS may guarantee a specific amount of demand and generate opportunity income for a certain number of periods, meanwhile with risk of punishment incurred by overselling. By developing an operational optimization model and exploring the effects of parameters on optimal decisions, we suggest that service providers should make decisions based on the types of customers, number of products required, and duration of multi-period to reduce the loss of reputation and obtain more profit; at the same time, multi-period buying customers should buy products early. Finally, the paper conducts a numerical experiment, and the results are consistent with prevailing situations. PMID:26147663

  2. A Promising Approach to Provide Appropriate Colon Target Drug Delivery Systems of Vancomycin HCL: Pharmaceutical and Microbiological Studies

    Directory of Open Access Journals (Sweden)

    Kadria A. Elkhodairy

    2014-01-01

    Full Text Available Vancomycin HCl was prepared as orally administered colon target drug delivery tablets for systemic therapy. Tablet matrices containing 10–60% of tablet weight of guar gum (F1–F6 were prepared by direct compression and subjected to in vitro release studies to explore their sustained release in the colon. Various synthetic and natural polymers were incorporated to F6 to modify the drug release rate. Different 15 matrix tablet formulations (F6–F20 were enteric coated with hydroxypropyl methyl cellulose phthalate. F6, F13 and F20 showed promising sustained release results having median dissolution time (MDT values: 8.25, 7.97, and 7.64, respectively. Microbiological assay was performed to test the efficacy of F6, F13, and F20 to inhibit clinical Staphylococcus aureus (SA isolates. Bactericidal activity of F6 was reached after 2, 4, and 24 hours of incubation against MSSA 18, MRSA 29, and MRSA 11 strains, respectively, while it was reached within 6–8 hours in case of F13, and F20 against all strains tested. F13 enhanced log microbial reduction by 1.74, 0.65 and 2.4 CFU/mL compared to F6 while it was 1, 2.57 and 1.57 compared to F20 against MSSA18, MRSA11 and MRSA29, respectively. Vancomycin HCl tablets displayed a promising sustained release in vitro and microbiological inhibitory action on all isolates tested.

  3. Long, paired A'A/Pahoehoe flows of Mauna Loa: Volcanological significance and insights they provide into volcano plumbing systems

    Science.gov (United States)

    Rowland, Scott K.; Walker, George P. L.

    1987-01-01

    The long lava flows of Mauna Loa, Hawaii have been cited as Earth's closed analogs to the large Martian flows. It is therefore important to understand the flow mechanics and characteristics of the Mauna Loa flows and to make use of these in an attempt to gain insights into Martian eruptive processes. Two fundamentally different kinds of long lava flows can be distinguished on Hawaiian volcanoes as in Martian flows. The two kinds may have identical initial viscosities, chemical compositions, flow lengths, and flow volumes, but their flow mechanisms and thermal energy budgets are radically different. One travels a distance set by the discharge rate as envisaged by Walker and Wadge, and the other travels a distance set mainly by the eruption duration and ground slope. In the Mauna Loa lavas, yield strength becomes an important flow morphology control only in the distal part of a'a lavas. The occurrence of paired flows on Mauna Loa yields insights into the internal plumbing systems of the volcano, and it is significant that all of the volume of the a'a flow must be stored in a magma chamber before eruption, while none of the volume of the pahoehoe needs to be so stored. Differentiation between the two kinds of flows on images of Martian volcanoes is possible and hence an improved understanding of these huge structures is acquired.

  4. Long, paired A'A/Pahoehoe flows of Mauna Loa: Volcanological significance and insights they provide into volcano plumbing systems

    International Nuclear Information System (INIS)

    Rowland, S.K.; Walker, G.P.L.

    1987-01-01

    The long lava flows of Mauna Loa, Hawaii have been cited as Earth's closed analogs to the large Martian flows. It is therefore important to understand the flow mechanics and characteristics of the Mauna Loa flows and to make use of these in an attempt to gain insights into Martian eruptive processes. Two fundamentally different kinds of long lava flows can be distinguished on Hawaiian volcanoes as in Martian flows. The two kinds may have identical initial viscosities, chemical compositions, flow lengths, and flow volumes, but their flow mechanisms and thermal energy budgets are radically different. One travels a distance set by the discharge rate as envisaged by Walker and Wadge, and the other travels a distance set mainly by the eruption duration and ground slope. In the Mauna Loa lavas, yield strength becomes an important flow morphology control only in the distal part of a'a lavas. The occurrence of paired flows on Mauna Loa yields insights into the internal plumbing systems of the volcano, and it is significant that all of the volume of the a'a flow must be stored in a magma chamber before eruption, while none of the volume of the pahoehoe needs to be so stored. Differentiation between the two kinds of flows on images of Martian volcanoes is possible and hence an improved understanding of these huge structures is acquired

  5. A promising approach to provide appropriate colon target drug delivery systems of vancomycin HCL: pharmaceutical and microbiological studies.

    Science.gov (United States)

    Elkhodairy, Kadria A; Afifi, Samar A; Zakaria, Azza S

    2014-01-01

    Vancomycin HCl was prepared as orally administered colon target drug delivery tablets for systemic therapy. Tablet matrices containing 10-60% of tablet weight of guar gum (F1-F6) were prepared by direct compression and subjected to in vitro release studies to explore their sustained release in the colon. Various synthetic and natural polymers were incorporated to F6 to modify the drug release rate. Different 15 matrix tablet formulations (F6-F20) were enteric coated with hydroxypropyl methyl cellulose phthalate. F6, F13 and F20 showed promising sustained release results having median dissolution time (MDT) values: 8.25, 7.97, and 7.64, respectively. Microbiological assay was performed to test the efficacy of F6, F13, and F20 to inhibit clinical Staphylococcus aureus (SA) isolates. Bactericidal activity of F6 was reached after 2, 4, and 24 hours of incubation against MSSA 18, MRSA 29, and MRSA 11 strains, respectively, while it was reached within 6-8 hours in case of F13, and F20 against all strains tested. F13 enhanced log microbial reduction by 1.74, 0.65 and 2.4 CFU/mL compared to F6 while it was 1, 2.57 and 1.57 compared to F20 against MSSA18, MRSA11 and MRSA29, respectively. Vancomycin HCl tablets displayed a promising sustained release in vitro and microbiological inhibitory action on all isolates tested.

  6. How a College System Joined a TV Network

    Science.gov (United States)

    McAuliffe, Daniel G.

    1978-01-01

    Describes the evolution of a state-wide "TV College" system in Connecticut, including centralized administrative development, course selection and evaluation, scheduling, promotion and advertising, fee structures, and budgeting processes. (RT)

  7. Undergraduate Research and Economic Development: A Systems Approach in Wisconsin

    Science.gov (United States)

    Van Galen, Dean; Schneider-Rebozo, Lissa; Havholm, Karen; Andrews, Kris

    2015-01-01

    This chapter presents the state of Wisconsin and the University of Wisconsin System as an ongoing case study for best practices in systematic, intentional, statewide programming and initiatives connecting undergraduate research and economic development.

  8. Project of an information integrated system to provide support to the regulatory control of the radioactive waste inventory

    International Nuclear Information System (INIS)

    Christovao, Marilia Tavares

    2005-05-01

    Sources and radioactive waste deriving from industry activities, medical practice and other areas are collected, received, and stored as waste on Brazilian Nuclear Energy Commission (CNEN) Institutes, that also generate, treat and store their own radioactive waste. The object of this project is to present an Integrated Information System named SICORR, having as guidelines, the referred processes to the radioactive waste regulatory control, under the responsibility of the Radioactive Waste Division (DIREJ), the General Coordination of Licensing and Control (CGLC), the Directorate of Safety and Radiation Protection (DRS) and the CNEN. The main objective of the work was reached, once the project SICORR modeling considers the radioactive waste control inventory, enclosing the treatment and integration of the radioactive waste and the radionuclides data and processes; the installations that produce, use, transport or store radiation sources data; and, CNEN Institutes responsible for the radioactive waste management data. The SICORR functions or essential modules involve the data treatment, integration, standardization and consistency between the processes. The SICORR specification and the analysis results are registered in documents, Software Specification Proposal (PESw) and Software Requirements Specification (ERSw), and are presented in text, in diagrams and user interfaces. Use cases have been used in the SICORR context diagram. The user interfaces for each use case have been detailed, defining the graphical layout, the relationships description with other interfaces, the interface details properties and the commands and the product entrances and exits. For objects radioactive waste and radionuclides, states diagrams have been drawn. The activities diagram represents the business model process. The class diagram represents the static objects and relationships that exist between them, under the specification point of view. The class diagram have been determined

  9. Results of development and field tests of a radar-tracer system providing meteorological support to modeling hazardous technological releases

    International Nuclear Information System (INIS)

    Shershakov, V.M.; Zukov, G.P.; Kosykh, V.S.

    2003-01-01

    Full text: Radar support to systems of automated radiation monitoring requires dealing with determination of geometric characteristics of air release of radionuclides. For doing this, an air release can be labeled by chaff propagating in the air similarly to particles of radioactive substance. Then, a chaff suspension can be treated as a spatially distributed radar target and thus be detected by a radar. For a number of years the Science and Production Association 'Typhoon' of Roshydromet, Obninsk has been developing a radar tracer system (RTS) for meteorological support of modeling hazardous technological releases. In September -December 2002 experiments were conducted to test the RTS in field. This presentation contains preliminary results of testing this system. A total of 9 experiments pursuing different goals were carried out. Of them 6 experiments were conducted approximately 6 km south-west of Obninsk in the vicinity of the village of Potresovo. The first three experiments were aimed at working out interaction between the MR and LDU and assessing the chaff cloud observation distance. In doing this, radar information was not transmitted from the MR to the CCS. In the last three experiments radar information was transmitted to the CCS by cell communication lines using telephones Siemens S35 with in-built modems. The CCS was deployed in building 4/25 of SPA 'Typhoon'. All information received in the CCS was put an a map. Three experiments were conducted in the area of the Kursk NPP as part of preparations for training exercises near the village of Makarovka about 7 km north-west of the city of Kurchatov. In the first two experiments radar information from the MR was passed by cell communication channels to the CCS deployed in the laboratory of external radiation monitoring of the Kursk nuclear power plant. Experiment 3 was a demonstration and arranged during the emergency response exercises at the Kursk NPP. The MR was based on the site of the external

  10. Portable traffic management system smart work zone application : operational test evaluation report

    Science.gov (United States)

    1997-05-01

    As part of its statewide Intelligent Transportation System (ITS), The Minnesota Department of Transportation (Mn/DOT) sponsored an operational test of the Portable Traffic Management System (PTMS) in a work zone application in cooperation with its pr...

  11. An Annual Report to the Legislature on Oregon Public Schools. Oregon Statewide Report Card. 2014-2015

    Science.gov (United States)

    Oregon Department of Education, 2015

    2015-01-01

    The Oregon Statewide Report Card is an annual publication required by law (ORS 329.115), which reports on the state of public schools and their progress towards the goals of the Oregon Educational Act for the 21st Century. The purpose of the Oregon Report Card is to monitor trends among school districts and Oregon's progress toward achieving the…

  12. Changes in Obesity Awareness, Obesity Identification, and Self-Assessment of Health: Results from a Statewide Public Education Campaign

    Science.gov (United States)

    Tsai, Adam G.; Boyle, Tracy F.; Hill, James O.; Lindley, Corina; Weiss, Karl

    2014-01-01

    Background: Due to the high prevalence of obesity, individuals may be desensitized to weight as a personal health concern. Purpose: To evaluate changes in obesity awareness associated with a statewide public education campaign in Colorado. Methods: Cross-sectional random digit dial telephone surveys (n = 1,107 pre, n = 1101 post) were conducted…

  13. Results from a Multi-Modal Program Evaluation of a Four Year Statewide Juvenile Sex Offender Treatment and Reentry Program

    Science.gov (United States)

    Underwood, Lee A.; Dailey, Frances L. L.; Merino, Carrie; Crump, Yolanda

    2015-01-01

    The results of the Program Evaluation show the OJJ Statewide Sex Offender Treatment program is exceptionally productive in meeting over 90% of its established performance markers. These markers included successful screening and assessment of risk and psychosocial needs, completion of initial and master treatment plans, establishment of sex…

  14. Filling the Void: The Roles of a Local Applied Research Center and a Statewide Workforce Training Consortium

    Science.gov (United States)

    Perniciaro, Richard C.; Nespoli, Lawrence A.; Anbarasan, Sivaraman

    2015-01-01

    This chapter describes the development of an applied research center at Atlantic Cape Community College and a statewide workforce training consortium run by the community college sector in New Jersey. Their contributions to the economic development mission of the colleges as well as their impact on the perception of community colleges by…

  15. A Guide to Effective Statewide Laws/Policies: Preventing Discrimination against LGBT Students in K-12 Schools.

    Science.gov (United States)

    Lambda Legal Defense and Education Fund, New York, NY.

    This document presents guidance for stopping discrimination, harassment, and violence against lesbian, gay, bisexual, and transgender (LGBT) students in schools. Section 1, "Lambda Legal Defense and Education Fund on the Legal Considerations for Creating and Changing Statewide Laws and Policies," discusses the various types of statewide…

  16. SU-D-BRF-05: A Novel System to Provide Real-Time Image-Guidance for Intrauterine Tandem Insertion and Placement

    Energy Technology Data Exchange (ETDEWEB)

    Price, M; Fontenot, J [pF Biomedical Solutions LLC, Baton Rouge, LA (United States)

    2014-06-01

    Purpose: To develop a system that provides real-time image-guidance for intrauterine tandem insertion and placement for brachytherapy. Methods: The conceptualized system consists of an intrauterine tandem with a transparent, lensed tip, a flexible miniature fiber optic scope, light source and interface for CCD coupling. The tandem tip was designed to act as a lens providing a wide field-of-view (FOV) with minimal image distortion and focus length appropriate for the application. The system is designed so that once inserted, the image-guidance component of the system can be removed and brachytherapy can be administered without interfering with source transport or disturbing tandem placement. Proof-of-principle studies were conducted to assess the conceptualized system's (1) lens functionality (clarity, focus and FOV) (2) and ability to visualize the cervical os of a female placed in the lithotomy position. Results: A prototype of this device was constructed using a commercial tandem modified to incorporate a transparent tip that internally coupled with a 1.9mm diameter fiber optic cable. The 900mm-long cable terminated at an interface that provided illumination as well as facilitated visualization of patient anatomy on a computer. The system provided a 23mm FOV with a focal length of 1cm and provided clear visualization of the cervix, cervical fornix and cervical os. The optical components of the system are easily removed without perturbing the position of a tandem placed in a common fixation clamp. Conclusion: Clinicians frequently encounter difficulty inserting an intrauterine tandem through the cervical os, circumventing fibrotic tissue or masses within the uterus, and positioning the tandem without perforating the uterus. To mitigate these challenges, we have designed and conducted proof-of- principle studies to discern the utility of a prototype device that provides real-time image-guidance for intrauterine tandem placement using fiber optic components.

  17. Development of a State-Wide 3-D Seismic Tomography Velocity Model for California

    Science.gov (United States)

    Thurber, C. H.; Lin, G.; Zhang, H.; Hauksson, E.; Shearer, P.; Waldhauser, F.; Hardebeck, J.; Brocher, T.

    2007-12-01

    We report on progress towards the development of a state-wide tomographic model of the P-wave velocity for the crust and uppermost mantle of California. The dataset combines first arrival times from earthquakes and quarry blasts recorded on regional network stations and travel times of first arrivals from explosions and airguns recorded on profile receivers and network stations. The principal active-source datasets are Geysers-San Pablo Bay, Imperial Valley, Livermore, W. Mojave, Gilroy-Coyote Lake, Shasta region, Great Valley, Morro Bay, Mono Craters-Long Valley, PACE, S. Sierras, LARSE 1 and 2, Loma Prieta, BASIX, San Francisco Peninsula and Parkfield. Our beta-version model is coarse (uniform 30 km horizontal and variable vertical gridding) but is able to image the principal features in previous separate regional models for northern and southern California, such as the high-velocity subducting Gorda Plate, upper to middle crustal velocity highs beneath the Sierra Nevada and much of the Coast Ranges, the deep low-velocity basins of the Great Valley, Ventura, and Los Angeles, and a high- velocity body in the lower crust underlying the Great Valley. The new state-wide model has improved areal coverage compared to the previous models, and extends to greater depth due to the data at large epicentral distances. We plan a series of steps to improve the model. We are enlarging and calibrating the active-source dataset as we obtain additional picks from investigators and perform quality control analyses on the existing and new picks. We will also be adding data from more quarry blasts, mainly in northern California, following an identification and calibration procedure similar to Lin et al. (2006). Composite event construction (Lin et al., in press) will be carried out for northern California for use in conventional tomography. A major contribution of the state-wide model is the identification of earthquakes yielding arrival times at both the Northern California Seismic

  18. Costs and effects of a state-wide health promotion program in primary schools in Germany - the Baden-Württemberg Study: A cluster-randomized, controlled trial.

    Directory of Open Access Journals (Sweden)

    Dorothea Kesztyüs

    Full Text Available To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program "Join the Healthy Boat" in primary schools in Germany.Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER to identify the costs per case of averted abdominal obesity were calculated.The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]. The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group.This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases.German Clinical Trials Register (DRKS, Freiburg University, Germany, DRKS-ID: DRKS00000494.

  19. Concept development and techno-economic assessment for a solar home system using lithium-ion battery for developing regions to provide electricity for lighting and electronic devices

    International Nuclear Information System (INIS)

    Zubi, Ghassan; Dufo-López, Rodolfo; Pardo, Nicolás; Pasaoglu, Guzay

    2016-01-01

    Highlights: • Solar home systems using light emitting diode lamps could substitute kerosene lamps. • This implies major improvement in life quality in developing regions. • The economic advantage of solar home systems is substantial and incremental. • This shift implies a cut of more than 200 mega tons of carbon dioxide annually. • Implementation barriers can be overcome by early consideration in system engineering. - Abstract: Around 18% of the world’s population still don’t have access to electricity, most of them living in rural areas in South Asia, Southeast Asia, and Sub-Saharan Africa. Kerosene lamps are widely used for lighting in these regions, but imply a big number of disadvantages including low light quality, reduced indoor air quality and safety concerns. Furthermore, the consumption of kerosene for lighting is very energy inefficient and implies a relatively high cost for the added value it provides, while its price volatility is a major concern for dependant developing regions. Global carbon dioxide emissions from kerosene lamps exceed 200 mega tons annually. A solar home system using light emitting diode lamps provides an effective solution for this problem. This paper elaborates such a solar home system while focusing on overcoming implementation barriers including lack of technical support and affordability. An evolutionary techno-economic assessment, considering the time period 2015–2030, is provided for the proposed system. This emphasizes not only the existing but also the increasing advantage of solar home systems over kerosene lamps.

  20. Field tests experience from 1.6MW/400kWh Li-ion battery energy storage system providing primary frequency regulation service

    DEFF Research Database (Denmark)

    Swierczynski, Maciej Jozef; Stroe, Daniel Ioan; Stan, Ana-Irina

    2013-01-01

    Lithium-ion battery energy storage systems (BESSs) represent suitable alternatives to conventional generating units for providing primary frequency regulation on the Danish market. This paper presents aspects concerning the operation of the BESSs in the Danish energy market while providing upwards...... on the BESS demonstrator located in Western Denmark and initial results are introduced and discussed. These measurements can be used to validate models for battery ageing during realistic operation or to develop the diagnostic tools for the BESS....

  1. Effects of the DRG-based prospective payment system operated by the voluntarily participating providers on the cesarean section rates in Korea.

    Science.gov (United States)

    Lee, Kwangsoo; Lee, Sangil

    2007-05-01

    This study explored the effects of the diagnosis-related group (DRG)-based prospective payment system (PPS) operated by voluntarily participating organizations on the cesarean section (CS) rates, and analyzed whether the participating health care organizations had similar CS rates despite the varied participation periods. The study sample included delivery claims data from the Korean national health insurance program for the year 2003. Risk factors were identified and used in the adjustment model to distinguish the main reason for CS. Their risk-adjusted CS rates were compared by the reimbursement methods, and the organizations' internal and external environments were controlled. The final risk-adjustment model for the CS rates meets the criteria for an effective model. There were no significant differences of CS rates between providers in the DRG and fee-for-service system after controlling for organizational variables. The CS rates did not vary significantly depending on the providers' DRG participation periods. The results provide evidence that the DRG payment system operated by volunteering health care organizations had no impact on the CS rates, which can lower the quality of care. Although the providers joined the DRG system in different years, there were no differences in the CS rates among the DRG providers. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.

  2. Variations in statewide water quality of New Jersey streams, water years 1998-2009

    Science.gov (United States)

    Heckathorn, Heather A.; Deetz, Anna C.

    2012-01-01

    Statistical analyses were conducted for six water-quality constituents measured at 371 surface-water-quality stations during water years 1998-2009 to determine changes in concentrations over time. This study examined year-round concentrations of total dissolved solids, dissolved nitrite plus nitrate, dissolved phosphorus, total phosphorus, and total nitrogen; concentrations of dissolved chloride were measured only from January to March. All the water-quality data analyzed were collected by the New Jersey Department of Environmental Protection and the U.S. Geological Survey as part of the cooperative Ambient Surface-Water-Quality Monitoring Network. Stations were divided into groups according to the 1-year or 2-year period that the stations were part of the Ambient Surface-Water-Quality Monitoring Network. Data were obtained from the eight groups of Statewide Status stations for water years 1998, 1999, 2000, 2001-02, 2003-04, 2005-06, 2007-08, and 2009. The data from each group were compared to the data from each of the other groups and to baseline data obtained from Background stations unaffected by human activity that were sampled during the same time periods. The Kruskal-Wallis test was used to determine whether median concentrations of a selected water-quality constituent measured in a particular 1-year or 2-year group were different from those measured in other 1-year or 2-year groups. If the median concentrations were found to differ among years or groups of years, then Tukey's multiple comparison test on ranks was used to identify those years with different or equal concentrations of water-quality constituents. A significance level of 0.05 was selected to indicate significant changes in median concentrations of water-quality constituents. More variations in the median concentrations of water-quality constituents were observed at Statewide Status stations (randomly chosen stations scattered throughout the State of New Jersey) than at Background stations

  3. Developing a statewide public health initiative to reduce infant mortality in Oklahoma.

    Science.gov (United States)

    Dooley, Suzanna; Patrick, Paul; Lincoln, Alicia; Cline, Janette

    2014-01-01

    The Preparing for a Lifetime, It's Everyone's Responsibility initiative was developed to improve the health and well- being of Oklahoma's mothers and infants. The development phase included systematic data collection, extensive data analysis, and multi-disciplinary partnership development. In total, seven issues (preconception/interconception health, tobacco use, postpartum depression, breastfeeding, infant safe sleep, preterm birth, and infant injury prevention) were identified as crucial to addressing infant mortality in Oklahoma. Workgroups were created to focus on each issue. Data and media communications workgroups were added to further partner commitment and support for policy and programmatic changes across multiple agencies and programs. Leadership support, partnership, evaluation, and celebrating small successes were important factors that lead to large scale adoption and support for the state-wide initiative to reduce infant mortality.

  4. Developing and maintaining state-wide adolescent pregnancy prevention coalitions: a preliminary investigation.

    Science.gov (United States)

    Nezlek, J B; Galano, J

    1993-09-01

    This paper presents the results of a study of state-wide adolescent pregnancy prevention coalitions. Key informants in five states throughout the southern United States were given semi-structured interviews regarding the adolescent pregnancy prevention coalitions in their states. From these interviews and other documents, conclusions were drawn regarding the nature and importance of the environments within which these coalitions operate, the universe of activities in which coalitions engage, and the stages of development of these coalitions. Katz and Kahn's model of social organizations served as the basis for understanding coalitions in terms of these three considerations. Future research should consider the utility of organizational models that can explain more fully the organization--committee hybrid structure that tends to characterize these coalitions.

  5. Who cares and how much? The imputed economic contribution to the Canadian healthcare system of middle-aged and older unpaid caregivers providing care to the elderly.

    Science.gov (United States)

    Hollander, Marcus J; Liu, Guiping; Chappell, Neena L

    2009-01-01

    Canadians provide significant amounts of unpaid care to elderly family members and friends with long-term health problems. While some information is available on the nature of the tasks unpaid caregivers perform, and the amounts of time they spend on these tasks, the contribution of unpaid caregivers is often hidden. (It is recognized that some caregiving may be for short periods of time or may entail matters better described as "help" or "assistance," such as providing transportation. However, we use caregiving to cover the full range of unpaid care provided from some basic help to personal care.) Aggregate estimates of the market costs to replace the unpaid care provided are important to governments for policy development as they provide a means to situate the contributions of unpaid caregivers within Canada's healthcare system. The purpose of this study was to obtain an assessment of the imputed costs of replacing the unpaid care provided by Canadians to the elderly. (Imputed costs is used to refer to costs that would be incurred if the care provided by an unpaid caregiver was, instead, provided by a paid caregiver, on a direct hour-for-hour substitution basis.) The economic value of unpaid care as understood in this study is defined as the cost to replace the services provided by unpaid caregivers at rates for paid care providers.

  6. Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits.

    Science.gov (United States)

    Zlotnick, Cheryl; Tam, Tammy; Ye, Yu

    2017-10-01

    Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

  7. Measurement of fine particles and smoking activity in a statewide survey of 36 California Indian casinos

    Science.gov (United States)

    Jiang, Ru O-Ting; Cheng, Ka I-Chung; Acevedo-Bolton, Viviana; Klepeis, Neil E; Repace, James L; Ott, Wayne R; Hildemann, Lynn M

    2011-01-01

    Despite California's 1994 statewide smoking ban, exposure to secondhand smoke (SHS) continues in California's Indian casinos. Few data are available on exposure to airborne fine particles (PM2.5) in casinos, especially on a statewide basis. We sought to measure PM2.5 concentrations in Indian casinos widely distributed across California, exploring differences due to casino size, separation of smoking and non-smoking areas, and area smoker density. A selection of 36 out of the 58 Indian casinos throughout California were each visited for 1–3 h on weekend or holiday evenings, using two or more concealed monitors to measure PM2.5 concentrations every 10 s. For each casino, the physical dimensions and the number of patrons and smokers were estimated. As a preliminary assessment of representativeness, we also measured eight casinos in Reno, NV. The average PM2.5 concentration for the smoking slot machine areas (63 μg/m3) was nine times as high as outdoors (7 μg/m3), whereas casino non-smoking restaurants (29 μg/m3) were four times as high. Levels in non-smoking slot machine areas varied: complete physical separation reduced concentrations almost to outdoor levels, but two other separation types had mean levels that were 13 and 29 μg/m3, respectively, higher than outdoors. Elevated PM2.5 concentrations in casinos can be attributed primarily to SHS. Average PM2.5 concentrations during 0.5–1 h visits to smoking areas exceeded 35 μg/m3 for 90% of the casino visits. PMID:20160761

  8. Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach

    OpenAIRE

    Agyepong, Irene A; Aryeetey, Geneieve C; Nonvignon, Justice; Asenso-Boadi, Francis; Dzikunu, Helen; Antwi, Edward; Ankrah, Daniel; Adjei-Acquah, Charles; Esena, Reuben; Aikins, Moses; Arhinful, Daniel K

    2014-01-01

    Background Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured ...

  9. Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

    Science.gov (United States)

    McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

    2012-10-01

    To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management

  10. An e-health driven laboratory information system to support HIV treatment in Peru: E-quity for laboratory personnel, health providers and people living with HIV

    Directory of Open Access Journals (Sweden)

    Caballero N Patricia

    2009-12-01

    Full Text Available Abstract Background Peru has a concentrated HIV epidemic with an estimated 76,000 people living with HIV (PLHIV. Access to highly active antiretroviral therapy (HAART expanded between 2004-2006 and the Peruvian National Institute of Health was named by the Ministry of Health as the institution responsible for carrying out testing to monitor the effectiveness of HAART. However, a national public health laboratory information system did not exist. We describe the design and implementation of an e-health driven, web-based laboratory information system - NETLAB - to communicate laboratory results for monitoring HAART to laboratory personnel, health providers and PLHIV. Methods We carried out a needs assessment of the existing public health laboratory system, which included the generation and subsequent review of flowcharts of laboratory testing processes to generate better, more efficient streamlined processes, improving them and eliminating duplications. Next, we designed NETLAB as a modular system, integrating key security functions. The system was implemented and evaluated. Results The three main components of the NETLAB system, registration, reporting and education, began operating in early 2007. The number of PLHIV with recorded CD4 counts and viral loads increased by 1.5 times, to reach 18,907. Publication of test results with NETLAB took an average of 1 day, compared to a pre-NETLAB average of 60 days. NETLAB reached 2,037 users, including 944 PLHIV and 1,093 health providers, during its first year and a half. The percentage of overall PLHIV and health providers who were aware of NETLAB and had a NETLAB password has also increased substantially. Conclusion NETLAB is an effective laboratory management tool since it is directly integrated into the national laboratory system and streamlined existing processes at the local, regional and national levels. The system also represents the best possible source of timely laboratory information for

  11. Creating an Effective System of Education to Prepare Future Human Resources within the Context Provided by the Global Shift toward a "Green Economy"

    Science.gov (United States)

    Dudin, Mikhail Nikolaevich; Frolova, Evgenia Evgenevna; Kucherenko, Petr Aleksandrovich; Samusenko, Tatyana Mikhailovna; Voikova, Natalya Andreevna

    2016-01-01

    This article explores the major aspects of putting together effective national systems of education oriented toward providing academic instruction to the population and preparing future human resources for work within the economy in specific alignment with the concept of environmental responsibility (or that of "green economy"). The…

  12. Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

    Science.gov (United States)

    Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

    2015-01-01

    The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

  13. Usability and feasibility of a mobile health system to provide comprehensive antenatal care in low-income countries: PANDA mHealth pilot study in Madagascar.

    Science.gov (United States)

    Benski, Anne Caroline; Stancanelli, Giovanna; Scaringella, Stefano; Herinainasolo, Josea Léa; Jinoro, Jéromine; Vassilakos, Pierre; Petignat, Patrick; Schmidt, Nicole C

    2017-06-01

    Background Madagascar's maternal health mortality ratio in 2013 was 478 deaths per 100,000 live births. Most deaths are related to direct complications during pregnancy and childbirth and could be reduced by providing comprehensive antenatal care (ANC). Objective The objective of the study was to assess the usability and feasibility of a mobile health system (mHealth) to provide high-quality ANC, according to World Health Organization (WHO) recommendations. Methods PANDA (Pregnancy And Newborn Diagnostic Assessment) is an easy-to-use mHealth system that uses affordable communications technology to support diagnosis and health care worker decision-making regarding ANC. From January to March 2015, a cross-sectional pilot study was conducted in Ambanja District, Madagascar, in which ANC using PANDA was provided to 100 pregnant women. The collected data were transmitted to a database in the referral hospital to create individual electronic patient records. Accuracy and completeness of the data were closely controlled. The PANDA software was assessed and the number of abnormal results, treatments performed, and participants requiring referral to health care facilities were monitored. Results The PANDA system facilitated creation of individual electronic patient records that included socio-demographic and medical data for 100 participants. Duration of ANC visits averaged 29.6 min. Health care providers were able to collect all variables (100%) describing personal and medical data. No major technical problems were encountered and no data were lost. During 17 ANC visits (17%), an alert function was generated to highlight abnormal clinical results requiring therapy or referral to an affiliated hospital. Participants' acceptability of the system was very high. Conclusion This pilot study proved the usability and feasibility of the PANDA mHealth system to conduct complete and standardised ANC visits according to WHO guidelines, thus providing a promising solution to

  14. Integrating GPS, GYRO, vehicle speed sensor, and digital map to provide accurate and real-time position in an intelligent navigation system

    Science.gov (United States)

    Li, Qingquan; Fang, Zhixiang; Li, Hanwu; Xiao, Hui

    2005-10-01

    The global positioning system (GPS) has become the most extensively used positioning and navigation tool in the world. Applications of GPS abound in surveying, mapping, transportation, agriculture, military planning, GIS, and the geosciences. However, the positional and elevation accuracy of any given GPS location is prone to error, due to a number of factors. The applications of Global Positioning System (GPS) positioning is more and more popular, especially the intelligent navigation system which relies on GPS and Dead Reckoning technology is developing quickly for future huge market in China. In this paper a practical combined positioning model of GPS/DR/MM is put forward, which integrates GPS, Gyro, Vehicle Speed Sensor (VSS) and digital navigation maps to provide accurate and real-time position for intelligent navigation system. This model is designed for automotive navigation system making use of Kalman filter to improve position and map matching veracity by means of filtering raw GPS and DR signals, and then map-matching technology is used to provide map coordinates for map displaying. In practical examples, for illustrating the validity of the model, several experiments and their results of integrated GPS/DR positioning in intelligent navigation system will be shown for the conclusion that Kalman Filter based GPS/DR integrating position approach is necessary, feasible and efficient for intelligent navigation application. Certainly, this combined positioning model, similar to other model, can not resolve all situation issues. Finally, some suggestions are given for further improving integrated GPS/DR/MM application.

  15. An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

    Science.gov (United States)

    Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

    2012-02-01

    Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

  16. Tablet and Face-to-Face Hybrid Professional Development: Providing Earth Systems Science Educators Authentic Research Opportunities through The GLOBE Program at Purdue University

    Science.gov (United States)

    Wegner, K.; Branch, B. D.; Smith, S. C.

    2013-12-01

    The Global Learning and Observations to Benefit the Environment (GLOBE) program is a worldwide hands-on, primary and secondary school-based science and education program (www.globe.gov). GLOBE's vision promotes and supports students, teachers and scientists to collaborate on inquiry-based authentic science investigations of the environment and the Earth system working in close partnership with NASA, NOAA and NSF Earth System Science Projects (ESSP's) in study and research about the dynamics of Earth's environment. GLOBE Partners conduct face-to-face Professional Development in more than 110 countries, providing authentic scientific research experience in five investigation areas: atmosphere, earth as a system, hydrology, land cover, and soil. This presentation will provide a sample for a new framework of Professional Development that was implemented in July 2013 at Purdue University lead by Mr. Steven Smith who has tested GLOBE training materials for future training. The presentation will demonstrate how institutions can provide educators authentic scientific research opportunities through various components, including: - Carrying out authentic research investigations - Learning how to enter their authentic research data into the GLOBE database and visualize it on the GLOBE website - Learn how to access to NASA's Earth System Science resources via GLOBE's new online 'e-Training Program' - Exploring the connections of their soil protocol measurements and the history of the soil in their area through iPad soils app - LIDAR data exposure, Hydrology data exposure

  17. Frequency of Hand Decontamination of Intraoperative Providers and Reduction of Postoperative Healthcare-Associated Infections: A Randomized Clinical Trial of a Novel Hand Hygiene System.

    Science.gov (United States)

    Koff, Matthew D; Brown, Jeremiah R; Marshall, Emily J; O'Malley, A James; Jensen, Jens T; Heard, Stephen O; Longtine, Karen; O'Neill, Melissa; Longtine, Jaclyn; Houston, Donna; Robison, Cindy; Moulton, Eric; Patel, Hetal M; Loftus, Randy W

    2016-08-01

    BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); Phand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.

  18. Evaluation of the acceptability and usability of a decision support system to encourage safe and effective use of opioid therapy for chronic, noncancer pain by primary care providers.

    Science.gov (United States)

    Trafton, Jodie; Martins, Susana; Michel, Martha; Lewis, Eleanor; Wang, Dan; Combs, Ann; Scates, Naquell; Tu, Samson; Goldstein, Mary K

    2010-04-01

    To develop and evaluate a clinical decision support system (CDSS) named Assessment and Treatment in Healthcare: Evidenced-Based Automation (ATHENA)-Opioid Therapy, which encourages safe and effective use of opioid therapy for chronic, noncancer pain. CDSS development and iterative evaluation using the analysis, design, development, implementation, and evaluation process including simulation-based and in-clinic assessments of usability for providers followed by targeted system revisions. Volunteers provided detailed feedback to guide improvements in the graphical user interface, and content and design changes to increase clinical usefulness, understandability, clinical workflow fit, and ease of completing guideline recommended practices. Revisions based on feedback increased CDSS usability ratings over time. Practice concerns outside the scope of the CDSS were also identified. Usability testing optimized the CDSS to better address barriers such as lack of provider education, confusion in dosing calculations and titration schedules, access to relevant patient information, provider discontinuity, documentation, and access to validated assessment tools. It also highlighted barriers to good clinical practice that are difficult to address with CDSS technology in its current conceptualization. For example, clinicians indicated that constraints on time and competing priorities in primary care, discomfort in patient-provider communications, and lack of evidence to guide opioid prescribing decisions impeded their ability to provide effective, guideline-adherent pain management. Iterative testing was essential for designing a highly usable and acceptable CDSS; however, identified barriers may limit the impact of the ATHENA-Opioid Therapy system and other CDSS on clinical practices and outcomes unless CDSS are paired with parallel initiatives to address these issues.

  19. State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1999-2006 (NODC Accession 0013723)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...

  20. State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1973-1998 (NODC Accession 0013724)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...