WorldWideScience

Sample records for reported including improved

  1. The utility of including pathology reports in improving the computational identification of patients

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2016-01-01

    Full Text Available Background: Celiac disease (CD is a common autoimmune disorder. Efficient identification of patients may improve chronic management of the disease. Prior studies have shown searching International Classification of Diseases-9 (ICD-9 codes alone is inaccurate for identifying patients with CD. In this study, we developed automated classification algorithms leveraging pathology reports and other clinical data in Electronic Health Records (EHRs to refine the subset population preselected using ICD-9 code (579.0. Materials and Methods: EHRs were searched for established ICD-9 code (579.0 suggesting CD, based on which an initial identification of cases was obtained. In addition, laboratory results for tissue transglutaminse were extracted. Using natural language processing we analyzed pathology reports from upper endoscopy. Twelve machine learning classifiers using different combinations of variables related to ICD-9 CD status, laboratory result status, and pathology reports were experimented to find the best possible CD classifier. Ten-fold cross-validation was used to assess the results. Results: A total of 1498 patient records were used including 363 confirmed cases and 1135 false positive cases that served as controls. Logistic model based on both clinical and pathology report features produced the best results: Kappa of 0.78, F1 of 0.92, and area under the curve (AUC of 0.94, whereas in contrast using ICD-9 only generated poor results: Kappa of 0.28, F1 of 0.75, and AUC of 0.63. Conclusion: Our automated classification system presented an efficient and reliable way to improve the performance of CD patient identification.

  2. Model for safety reports including descriptive examples

    International Nuclear Information System (INIS)

    1995-12-01

    Several safety reports will be produced in the process of planning and constructing the system for disposal of high-level radioactive waste in Sweden. The present report gives a model, with detailed examples, of how these reports should be organized and what steps they should include. In the near future safety reports will deal with the encapsulation plant and the repository. Later reports will treat operation of the handling systems and the repository

  3. [Lung Abscess with Acute Empyema Which Improved after Performing by Video Assissted Thoracic Surgery( Including Pneumonotomy and Lung Abscess Drainage);Report of a Case].

    Science.gov (United States)

    Gabe, Atsushi; Nagamine, Naoji

    2017-05-01

    We herein report the case of a patient demonstrating a lung abscess with acute empyema which improved after performing pnemumonotomy and lung abscess drainage. A 60-year-old male was referred to our hospital to receive treatment for a lung abscess with acute empyema. At surgery, the lung parenchyma was slightly torn with pus leakage. After drainage of lung abscess by enlarging the injured part, curettage in the thoracic cavity and decortication were performed. The postoperative course was uneventful. Direct drainage of an abscess into the thoracic cavity is thought to be a choice for the treatment of lung abscesses.

  4. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Report of the third research co-ordination meeting of FAO/IAEA/ITALY co-ordinated research programme. Working material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    A Co-ordinated Research Programme, on ``Improvement of basic food corps in Africa through plant breeding including the use of induced mutations``, funded by the Italian Governmnet, was initiated in the Joint Division of the Food and Agriculture Organization and International Atomic Energy Agency, Vienna. The primary objective of this CRP was to breed improved varieties of staple food crops of Africa with main emphasis on the indigenous species and local cultivars. The Third Research Co-ordination Meeting (RCM) under the FAO/IAEA/ITALY Co-ordinated Research Programme was held in Nairobi, Kenya, 20-24 September 1993 in which 24 persons participated and 18 scientific reports were presented. These included reports from 10 Research Contract holders from Africa, 3 Technical Contract holders from Italy and the update on the backstopping of research carried out at the IAEA Laboratories, Seibersdorf. The reports, and conclusions and recommendations made by the participants are presented in this publication. Refs, figs, tabs.

  5. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Report of the third research co-ordination meeting of FAO/IAEA/ITALY co-ordinated research programme. Working material

    International Nuclear Information System (INIS)

    1997-01-01

    A Co-ordinated Research Programme, on ''Improvement of basic food corps in Africa through plant breeding including the use of induced mutations'', funded by the Italian Governmnet, was initiated in the Joint Division of the Food and Agriculture Organization and International Atomic Energy Agency, Vienna. The primary objective of this CRP was to breed improved varieties of staple food crops of Africa with main emphasis on the indigenous species and local cultivars. The Third Research Co-ordination Meeting (RCM) under the FAO/IAEA/ITALY Co-ordinated Research Programme was held in Nairobi, Kenya, 20-24 September 1993 in which 24 persons participated and 18 scientific reports were presented. These included reports from 10 Research Contract holders from Africa, 3 Technical Contract holders from Italy and the update on the backstopping of research carried out at the IAEA Laboratories, Seibersdorf. The reports, and conclusions and recommendations made by the participants are presented in this publication. Refs, figs, tabs

  6. IRSN annual report 2012 - including Financial report 2012

    International Nuclear Information System (INIS)

    Schuler, Matthieu; Marchal, Valerie; Albert, Marc-Gerard; Baudry, Michel; Bigot, Marie-Pierre; Charron, Sylvie; Clavelle, Stephanie; Cousinou, Patrick; Deschamps, Patrice; Delattre, Aleth; Demeillers, Didier; Dumas, Agnes; Franquard, Dominique; Goudal, Bernard; Jalouneix, Jean; Laloi, Patrick; Monti, Pascale; Richer, Gerard; Rollinger, Francois; Rouyer, Veronique; Rutschkovsky, Nathalie; Scott De Martinville, Edouard; Tharaud, Christine; Verpeaux, Jean-luc; Jaunet, Camille; Hedouin, Jean-Christophe

    2013-01-01

    This annual report for the French nuclear safety and radiation protection Institute (IRSN) addresses its organizational aspects (highlights, figures illustrating the activity, organizational chart, councils and committees), proposes a summary of activities and presentation of the strategy (transparency and communication policy, promotion of a safety and radiation protection culture). The main part addresses the activities regarding safety, nuclear security and non-proliferation, radiation protection of the environment and in terms of human health, and emergency and post-accidental situations. The last part addresses issues of efficiency (property, health, safety, environmental protection and quality, and human resources). A financial report is also proposed and contains a management report, financial statements, and an appendix to annual accounts

  7. Improving the strength of amalgams by including steel fibers

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, Calvin T. [Hendrix College, Conway, AR 72032 (United States); Van Hoose, James R. [Siemens, Orlando, FL 32826 (United States); McGill, Preston B. [Marshall Space Flight Center, EM20, Huntsville, AL 35812 (United States); Grugel, Richard N., E-mail: richard.n.grugel@nasa.gov [Marshall Space Flight Center, EM30, Huntsville, AL 35812 (United States)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer A room temperature liquid Ga-In alloy was successfully substituted for mercury. Black-Right-Pointing-Pointer Physically sound amalgams with included steel fibers can be made. Black-Right-Pointing-Pointer A small volume fraction inclusion of fibers increased strength by {approx}20%. - Abstract: Mercury amalgams, due to their material properties, are widely and successfully used in dental practice. They are, however, also well recognized as having poor tensile strength. With the possibility of expanding amalgam applications it is demonstrated that tensile strength can be increased some 20% by including a small amount of steel fibers. Furthermore, it is shown that mercury can be replaced with a room temperature liquid gallium-indium alloy. Processing, microstructures, and mechanical test results of these novel amalgams are presented and discussed in view of means to further improve their properties.

  8. Power extraction calculation improvement when local parameters are included

    Science.gov (United States)

    Flores-Mateos, L. M.; Hartnett, M.

    2016-02-01

    The improvement of the tidal resource assessment will be studied by comparing two approaches in a two-dimensional, finite difference, hydrodynamic model DIVAST-ADI; in a channel of non-varying cross-sectional area that connects two large basins. The first strategy, considers a constant trust coefficient; the second one, use the local field parameters around the turbine. These parameters are obtained after applying the open channel theory in the tidal stream and after considering the turbine as a linear momentum actuator disk. The parameters correspond to the upstream and downstream, with respect to the turbine, speeds and depths; also the blockage ratio, the wake velocity and the bypass coefficients and they have already been incorporated in the model. The figure (a) shows the numerical configuration at high tide developed with DIVAST-ADI. The experiment undertakes two open boundary conditions. The first one is a sinusoidal forcing introduced as a water level located at (I, J=1) and the second one, indicate that a zero velocity and a constant water depth were kept (I, J=362); when the turbine is introduced it is placed in the middle of the channel (I=161, J=181). The influence of the turbine in the velocity and elevation around the turbine region is evident; figure (b) and (c) shows that the turbine produces a discontinuity in the depth and velocity profile, when we plot a transect along the channel. Finally, the configuration implemented reproduced with satisfactory accuracy the quasi-steady flow condition, even without presenting shock-capturing capability. Also, the range of the parameters 0.01<α 4<0.55, $0

  9. Developing standard transmission system for radiology reporting including key images

    International Nuclear Information System (INIS)

    Kim, Seon Chil

    2007-01-01

    Development of hospital information system and Picture Archiving Communication System is not new in the medical field, and the development of internet and information technology are also universal. In the course of such development, however, it is hard to share medical information without a refined standard format. Especially in the department of radiology, the role of PACS has become very important in interchanging information with other disparate hospital information systems. A specific system needs to be developed that radiological reports are archived into a database efficiently. This includes sharing of medical images. A model is suggested in this study in which an internal system is developed where radiologists store necessary images and transmit them is the standard international clinical format, Clinical Document Architecture, and share the information with hospitals. CDA document generator was made to generate a new file format and separate the existing storage system from the new system. This was to ensure the access to required data in XML documents. The model presented in this study added a process where crucial images in reading are inserted in the CDA radiological report generator. Therefore, this study suggests a storage and transmission model for CDA documents, which is different from the existing DICOM SR. Radiological reports could be better shared, when the application function for inserting images and the analysis of standard clinical terms are completed

  10. Optimage central organised image quality control including statistics and reporting

    International Nuclear Information System (INIS)

    Jahnen, A.; Schilz, C.; Shannoun, F.; Schreiner, A.; Hermen, J.; Moll, C.

    2008-01-01

    Quality control of medical imaging systems is performed using dedicated phantoms. As the imaging systems are more and more digital, adequate image processing methods might help to save evaluation time and to receive objective results. The developed software package OPTIMAGE is focusing on this with a central approach: On one hand, OPTIMAGE provides a framework, which includes functions like database integration, DICOM data sources, multilingual user interface and image processing functionality. On the other hand, the test methods are implemented using modules which are able to process the images automatically for the common imaging systems. The integration of statistics and reporting into this environment is paramount: This is the only way to provide these functions in an interactive, user-friendly way. These features enable the users to discover degradation in performance quickly and document performed measurements easily. (authors)

  11. OPSAID improvements and capabilities report.

    Energy Technology Data Exchange (ETDEWEB)

    Halbgewachs, Ronald D.; Chavez, Adrian R.

    2011-08-01

    Process Control System (PCS) and Industrial Control System (ICS) security is critical to our national security. But there are a number of technological, economic, and educational impediments to PCS owners implementing effective security on their systems. Sandia National Laboratories has performed the research and development of the OPSAID (Open PCS Security Architecture for Interoperable Design), a project sponsored by the US Department of Energy Office of Electricity Delivery and Energy Reliability (DOE/OE), to address this issue. OPSAID is an open-source architecture for PCS/ICS security that provides a design basis for vendors to build add-on security devices for legacy systems, while providing a path forward for the development of inherently-secure PCS elements in the future. Using standardized hardware, a proof-of-concept prototype system was also developed. This report describes the improvements and capabilities that have been added to OPSAID since an initial report was released. Testing and validation of this architecture has been conducted in another project, Lemnos Interoperable Security Project, sponsored by DOE/OE and managed by the National Energy Technology Laboratory (NETL).

  12. KBS Annual Report 1983. Including summaries of technical reports issued during 1983

    International Nuclear Information System (INIS)

    1984-06-01

    The purpose of the KBS Annual Report is to inform interested organizations and individuals of the research and development work performed by the division KBS within the Swedish Nuclear Fuel Supply Co (SKBF) on the handling, treatment and final storage of nuclear wastes in Sweden. The Annual Report normally contains a presentation of the legal and organizational situation followed by an account of the progress within different areas of the R and D-work. This account also includes indications of the activities planned for the future. At the end of the report the summaries of 76 technical reports and other publications issued during the year are listed in special appendices. (K.A.E.)

  13. Recommended Resources for Planning to Evaluate Program Improvement Efforts (Including the SSIP)

    Science.gov (United States)

    National Center for Systemic Improvement at WestEd, 2015

    2015-01-01

    This document provides a list of recommended existing resources for state Part C and Part B 619 staff and technical assistance (TA) providers to utilize to support evaluation planning for program improvement efforts (including the State Systemic Improvement Plan, SSIP). There are many resources available related to evaluation and evaluation…

  14. BROMOCEA Code: An Improved Grand Canonical Monte Carlo/Brownian Dynamics Algorithm Including Explicit Atoms.

    Science.gov (United States)

    Solano, Carlos J F; Pothula, Karunakar R; Prajapati, Jigneshkumar D; De Biase, Pablo M; Noskov, Sergei Yu; Kleinekathöfer, Ulrich

    2016-05-10

    All-atom molecular dynamics simulations have a long history of applications studying ion and substrate permeation across biological and artificial pores. While offering unprecedented insights into the underpinning transport processes, MD simulations are limited in time-scales and ability to simulate physiological membrane potentials or asymmetric salt solutions and require substantial computational power. While several approaches to circumvent all of these limitations were developed, Brownian dynamics simulations remain an attractive option to the field. The main limitation, however, is an apparent lack of protein flexibility important for the accurate description of permeation events. In the present contribution, we report an extension of the Brownian dynamics scheme which includes conformational dynamics. To achieve this goal, the dynamics of amino-acid residues was incorporated into the many-body potential of mean force and into the Langevin equations of motion. The developed software solution, called BROMOCEA, was applied to ion transport through OmpC as a test case. Compared to fully atomistic simulations, the results show a clear improvement in the ratio of permeating anions and cations. The present tests strongly indicate that pore flexibility can enhance permeation properties which will become even more important in future applications to substrate translocation.

  15. 40 CFR 60.1885 - What must I include in my annual report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in my annual report...-Reporting § 60.1885 What must I include in my annual report? Summarize data collected for all pollutants and... controlling dioxins/furans or mercury emissions, include four records: (1) The average carbon feed rates...

  16. SKB annual report 1991. Including summaries of technical reports issued during 1991

    International Nuclear Information System (INIS)

    1992-05-01

    This is the annual report on the activities of the Swedish Nuclear Fuel and Waste Management Co., SKB. SKB is the owner of CLAB, the central facility for interim storage of spent nuclear fuel, located at Oskarshamn. CLAB was taken into operation in July 1985 and to the end of 1991 in total 1514 tonnes of spent fuel (measured as uranium) have been received. Transportation from the nuclear sites to CLAB is made by a special ship, M/S Sigyn. At Forsmark the final repository for Radioactive Waste (SFR) was taken into operation in April 1988. The repository is situated in crystalline rock under the Baltic Sea. The first construction phase includes rock caverns for 60000 m 3 of waste. A second phase for additional 30000 m 3 is planned to be built and commissioned around the year 2000. At the end of 1991 a total of 7900 m 3 of waste have been deposited in SFR. SKB is in charge of a comprehensive research and development programme on geological disposal of nuclear waste. The total cost for R and D during 1991 was 182.7 MSEK of which 15.9 MSEK came from participants outside Sweden. Geological site-investigations are a substantial part of the programme. SKB is also the managing participant of the international Stripa-project under OECD/NEA. Cost calculations for the total nuclear waste management system, including decommissioning of all reactors, are updated annually. The total cost is estimated to 55 billion SEK. SKB also handles matters pertaining to prospecting and enrichment as well as stockpiling of uranium as strategic reserves for the Swedish nuclear power industry. Consulting service from SKB and associated expert groups are available on a commercial basis. Information activities are an integrated and important part of the Swedish radioactive waste management system. During 1991 successful public information activities have been carried out using mobile exhibitions in a tailor-made trailer and on the SKB ship M/S Sigyn. (au)

  17. 40 CFR 60.2220 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for... Recordkeeping and Reporting § 60.2220 What must I include in the deviation report? In each report required under...

  18. 40 CFR 60.2958 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Operator Training and Qualification Recordkeeping and Reporting § 60.2958 What must I include in the deviation report? In each report...

  19. Year End Progress Report on Rattlesnake Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yaqi [Idaho National Lab. (INL), Idaho Falls, ID (United States); DeHart, Mark David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gleicher, Frederick Nathan [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ortensi, Javier [Idaho National Lab. (INL), Idaho Falls, ID (United States); Schunert, Sebastian [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    Rattlesnake is a MOOSE-based radiation transport application developed at INL to support modern multi-physics simulations. At the beginning of the last year, Rattlesnake was able to perform steady-state, transient and eigenvalue calculations for the multigroup radiation transport equations. Various discretization schemes, including continuous finite element method (FEM) with discrete ordinates method (SN) and spherical harmonics expansion method (PN) for the self-adjoint angular flux (SAAF) formulation, continuous FEM (CFEM) with SN for the least square (LS) formulation, diffusion approximation with CFEM and discontinuous FEM (DFEM), have been implemented. A separate toolkit, YAKXS, for multigroup cross section management was developed to support Rattlesnake calculations with feedback both from changes in the field variables, such as fuel temperature, coolant density, and etc., and in isotope inventory. The framework for doing nonlinear diffusion acceleration (NDA) within Rattlesnake has been set up, and both NDA calculations with SAAF-SN-CFEM scheme and Monte Carlo with OpenMC have been performed. It was also used for coupling BISON and RELAP-7 for the full-core multiphysics simulations. Within the last fiscal year, significant improvements have been made in Rattlesnake. Rattlesnake development was migrated into our internal GITLAB development environment at the end of year 2014. Since then total 369 merge requests has been accepted into Rattlesnake. It is noted that the MOOSE framework that Rattlesnake is based on is under continuous developments. Improvements made in MOOSE can improve the Rattlesnake. It is acknowledged that MOOSE developers spent efforts on patching Rattlesnake for the improvements made on the framework side. This report will not cover the code restructuring for better readability and modularity and documentation improvements, which we have spent tremendous effort on. It only details some of improvements in the following sections.

  20. AAEC report titles-cumulation 1956-1975 including author and KWIC indexes

    International Nuclear Information System (INIS)

    1976-03-01

    This publication lists all unclassified technical reports issued by the AAEC Research Establishment since 1956. It supersedes the List of Report Publications dated April 1974 and is the final cumulation of reports published between 1956 and December 1975. Future editions will list reports published from January 1976. An alphabetical author index and a KWIC index to the titles are included. (author)

  1. 40 CFR 62.15340 - What must I include in the annual report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 8 2010-07-01 2010-07-01 false What must I include in the annual... August 30, 1999 Reporting § 62.15340 What must I include in the annual report? Summarize data collected... combustion units that use activated carbon for controlling dioxins/furans or mercury emissions, include four...

  2. Quantifying reporting timeliness to improve outbreak control

    NARCIS (Netherlands)

    Bonačić Marinović, Axel; Swaan, Corien; van Steenbergen, Jim; Kretzschmar, MEE

    The extent to which reporting delays should be reduced to gain substantial improvement in outbreak control is unclear. We developed a model to quantitatively assess reporting timeliness. Using reporting speed data for 6 infectious diseases in the notification system in the Netherlands, we calculated

  3. Model for safety reports including descriptive examples; Mall foer saekerhetsrapporter med beskrivande exempel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    Several safety reports will be produced in the process of planning and constructing the system for disposal of high-level radioactive waste in Sweden. The present report gives a model, with detailed examples, of how these reports should be organized and what steps they should include. In the near future safety reports will deal with the encapsulation plant and the repository. Later reports will treat operation of the handling systems and the repository.

  4. Financing mechanisms for capital improvements : interchanges, final report, March 2010.

    Science.gov (United States)

    2010-03-01

    This report examines the use of alternative local financing mechanisms for interchange and interchange area infrastructure improvements. The financing mechanisms covered include transportation impact fees, tax increment financing, value capture finan...

  5. Financing mechanisms for capital improvements : interchanges : final report.

    Science.gov (United States)

    2010-03-01

    This report examines the use of alternative local financing mechanisms for interchange and interchange area infrastructure improvements. The financing mechanisms covered include transportation impact fees, tax increment financing, value capture finan...

  6. 40 CFR 60.3053 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance... Model Rule-Recordkeeping and Reporting § 60.3053 What must I include in the deviation report? In each...

  7. 40 CFR 60.1410 - What must I include in my annual report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in my annual report... Modification or Reconstruction is Commenced After June 6, 2001 Reporting § 60.1410 What must I include in my...) For municipal waste combustion units that use activated carbon for controlling dioxins/furans or...

  8. SKB annual report 1993. Including summaries of technical reports issued during 1993

    International Nuclear Information System (INIS)

    1994-05-01

    This is the annual report on the activities of the Swedish Nuclear and Waste Management Co., SKB. It contains in part I an overview of SKB activities in different fields. Part II gives a description of the research and development work on nuclear waste disposal performed during 1993. Lectures and publications during 1993 as well as reports issued in the SKB technical series are listed in part III. Part IV contains the summaries of all technical reports issued during 1993. SKB is the owner of CLAB, the Central Facility for Interim Storage of Spent Nuclear Fuel, located at Oskarshamn. CLAB was taken into operation in July 1985 and to the end of 1993 in total 1 885 tonnes of spent fuel (measured as uranium) have been received. Transportation from the nuclear sites to CLAB is made by a special ship, M/S Sigyn. At Forsmark the final repository for Radioactive Waste - SFR - was taken into operation in April 1988. The repository is situated in crystalline rock under the Baltic Sea. At the end of 1993 a total of 13 000 m 3 of waste have been deposited in SFR. SKB is in charge of a comprehensive research and development programme on geological disposal of nuclear waste. Some of the main areas for SKB research are: Groundwater movements; Bedrock stability; Groundwater chemistry and nuclide migration; Methods and instruments for in situ characterization of crystalline bedrock; Characterization and leaching of spent nuclear fuel; Properties of bentonite for buffer, backfilling and sealing; Radionuclide transport in biosphere and dose evaluations; Development of performance and safety assessment methodology and assessment models; Construction of an underground research laboratory

  9. SKB Annual Report 1995. Including summaries of Technical Reports issued during 1995

    International Nuclear Information System (INIS)

    1996-05-01

    The annual report covers planning, construction and operation of facilities and systems as well as research, development, demonstration work and information activities. The aim of the program is to start the permanent disposal of spent nuclear fuel around year 2008. Work is undertaken for the development of encapsulation technology on an industrial scale and for design of an encapsulation plant. The siting process for the final repository for spent fuel has started with feasibility studies in a few Swedish municipalities in order to evaluate the potential technical conditions and requirements and the influence on the region. 36 refs, figs

  10. SKB Annual Report 1995. Including summaries of Technical Reports issued during 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    The annual report covers planning, construction and operation of facilities and systems as well as research, development, demonstration work and information activities. The aim of the program is to start the permanent disposal of spent nuclear fuel around year 2008. Work is undertaken for the development of encapsulation technology on an industrial scale and for design of an encapsulation plant. The siting process for the final repository for spent fuel has started with feasibility studies in a few Swedish municipalities in order to evaluate the potential technical conditions and requirements and the influence on the region. 36 refs, figs.

  11. Fort Calhoun Station, Unit 1. Annual operation report: January-December 1977 (including environmental report)

    International Nuclear Information System (INIS)

    1978-02-01

    Net electrical energy generated in 1977 was 2,922,683.7 MWH with the generator on line 6,959.8 hours. Information is presented concerning operations, power generation, shutdowns, maintenance, changes, tests, experiments, occupational personnel radiation exposures, and primary coolant chemistry. Data on radioactive effluent releases, meteorology, environmental monitoring, and potential radiation doses to individuals for July 7, 1977 to December 31, 1977 are also included

  12. SKB Annual Report 1994. Including summaries of technical reports issued during 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    The report gives an overview of SKB activities in different fields, and a description of R and D on nuclear waste disposal performed during 1994. SKB is in charge of a comprehensive program on geological disposal of nuclear waste. The total cost for R and D 1994 was 186 MSEK of which 59 MSEK were investments in the Aespoe Hard Rock Laboratory. Some of the main areas for SKB research are: Groundwater movements; Bedrock stability; Groundwater chemistry and nuclide migration; Methods and instruments for in situ characterization of crystalline bedrock; Characterization and leaching of spent fuel; Properties of bentonite for buffer, backfilling and sealing; Radionuclide transport in biosphere and dose evaluation; Development of performance and safety assessment methodology and assessment models; Construction of an underground research laboratory. 66 figs, 6 tabs.

  13. SKB Annual Report 1994. Including summaries of technical reports issued during 1994

    International Nuclear Information System (INIS)

    1995-05-01

    The report gives an overview of SKB activities in different fields, and a description of R and D on nuclear waste disposal performed during 1994. SKB is in charge of a comprehensive program on geological disposal of nuclear waste. The total cost for R and D 1994 was 186 MSEK of which 59 MSEK were investments in the Aespoe Hard Rock Laboratory. Some of the main areas for SKB research are: Groundwater movements; Bedrock stability; Groundwater chemistry and nuclide migration; Methods and instruments for in situ characterization of crystalline bedrock; Characterization and leaching of spent fuel; Properties of bentonite for buffer, backfilling and sealing; Radionuclide transport in biosphere and dose evaluation; Development of performance and safety assessment methodology and assessment models; Construction of an underground research laboratory. 66 figs, 6 tabs

  14. Improvement of prediction ability for genomic selection of dairy cattle by including dominance effects.

    Directory of Open Access Journals (Sweden)

    Chuanyu Sun

    Full Text Available Dominance may be an important source of non-additive genetic variance for many traits of dairy cattle. However, nearly all prediction models for dairy cattle have included only additive effects because of the limited number of cows with both genotypes and phenotypes. The role of dominance in the Holstein and Jersey breeds was investigated for eight traits: milk, fat, and protein yields; productive life; daughter pregnancy rate; somatic cell score; fat percent and protein percent. Additive and dominance variance components were estimated and then used to estimate additive and dominance effects of single nucleotide polymorphisms (SNPs. The predictive abilities of three models with both additive and dominance effects and a model with additive effects only were assessed using ten-fold cross-validation. One procedure estimated dominance values, and another estimated dominance deviations; calculation of the dominance relationship matrix was different for the two methods. The third approach enlarged the dataset by including cows with genotype probabilities derived using genotyped ancestors. For yield traits, dominance variance accounted for 5 and 7% of total variance for Holsteins and Jerseys, respectively; using dominance deviations resulted in smaller dominance and larger additive variance estimates. For non-yield traits, dominance variances were very small for both breeds. For yield traits, including additive and dominance effects fit the data better than including only additive effects; average correlations between estimated genetic effects and phenotypes showed that prediction accuracy increased when both effects rather than just additive effects were included. No corresponding gains in prediction ability were found for non-yield traits. Including cows with derived genotype probabilities from genotyped ancestors did not improve prediction accuracy. The largest additive effects were located on chromosome 14 near DGAT1 for yield traits for both

  15. Benchmarking for Cost Improvement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The US Department of Energy`s (DOE) Office of Environmental Restoration and Waste Management (EM) conducted the Benchmarking for Cost Improvement initiative with three objectives: Pilot test benchmarking as an EM cost improvement tool; identify areas for cost improvement and recommend actions to address these areas; provide a framework for future cost improvement. The benchmarking initiative featured the use of four principal methods (program classification, nationwide cost improvement survey, paired cost comparison and component benchmarking). Interested parties contributed during both the design and execution phases. The benchmarking initiative was conducted on an accelerated basis. Of necessity, it considered only a limited set of data that may not be fully representative of the diverse and complex conditions found at the many DOE installations. The initiative generated preliminary data about cost differences and it found a high degree of convergence on several issues. Based on this convergence, the report recommends cost improvement strategies and actions. This report describes the steps taken as part of the benchmarking initiative and discusses the findings and recommended actions for achieving cost improvement. The results and summary recommendations, reported below, are organized by the study objectives.

  16. 40 CFR 60.2780 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and... the deviation report? In each report required under § 60.2775, for any pollutant or parameter that...

  17. Error review: Can this improve reporting performance?

    International Nuclear Information System (INIS)

    Tudor, Gareth R.; Finlay, David B.

    2001-01-01

    AIM: This study aimed to assess whether error review can improve radiologists' reporting performance. MATERIALS AND METHODS: Ten Consultant Radiologists reported 50 plain radiographs, in which the diagnoses were established. Eighteen of the radiographs were normal, 32 showed an abnormality. The radiologists were shown their errors and then re-reported the series of radiographs after an interval of 4-5 months. The accuracy of the reports to the established diagnoses was assessed. Chi-square test was used to calculate the difference between the viewings. RESULTS: On re-reporting the radiographs, seven radiologists improved their accuracy score, two had a lower score and one radiologist showed no score difference. Mean accuracy pre-education was 82.2%, (range 78-92%) and post-education was 88%, (range 76-96%). Individually, two of the radiologists showed a statistically significant improvement post-education (P < 0.01,P < 0.05). Assessing the group as a whole, there was a trend for improvement post-education but this did not reach statistical significance. Assessing only the radiographs where errors were made on the initial viewing, for the group as a whole there was a 63% improvement post-education. CONCLUSION: We suggest that radiologists benefit from error review, although there was not a statistically significant improvement for the series of radiographs in total. This is partly explained by the fact that some radiologists gave incorrect responses post-education that had initially been correct, thus masking the effect of the educational intervention. Tudor, G.R. and Finlay, D.B. (2001

  18. Improving weather predictability by including land-surface model parameter uncertainty

    Science.gov (United States)

    Orth, Rene; Dutra, Emanuel; Pappenberger, Florian

    2016-04-01

    The land surface forms an important component of Earth system models and interacts nonlinearly with other parts such as ocean and atmosphere. To capture the complex and heterogenous hydrology of the land surface, land surface models include a large number of parameters impacting the coupling to other components of the Earth system model. Focusing on ECMWF's land-surface model HTESSEL we present in this study a comprehensive parameter sensitivity evaluation using multiple observational datasets in Europe. We select 6 poorly constrained effective parameters (surface runoff effective depth, skin conductivity, minimum stomatal resistance, maximum interception, soil moisture stress function shape, total soil depth) and explore their sensitivity to model outputs such as soil moisture, evapotranspiration and runoff using uncoupled simulations and coupled seasonal forecasts. Additionally we investigate the possibility to construct ensembles from the multiple land surface parameters. In the uncoupled runs we find that minimum stomatal resistance and total soil depth have the most influence on model performance. Forecast skill scores are moreover sensitive to the same parameters as HTESSEL performance in the uncoupled analysis. We demonstrate the robustness of our findings by comparing multiple best performing parameter sets and multiple randomly chosen parameter sets. We find better temperature and precipitation forecast skill with the best-performing parameter perturbations demonstrating representativeness of model performance across uncoupled (and hence less computationally demanding) and coupled settings. Finally, we construct ensemble forecasts from ensemble members derived with different best-performing parameterizations of HTESSEL. This incorporation of parameter uncertainty in the ensemble generation yields an increase in forecast skill, even beyond the skill of the default system. Orth, R., E. Dutra, and F. Pappenberger, 2016: Improving weather predictability by

  19. Improving report writing by peer assessment using Coursera

    DEFF Research Database (Denmark)

    Christiansen, Henrik Lehrmann

    2015-01-01

    report writing. In the case of report writing active learning could include peer evaluation which is what is investigated in this paper. This paper presents a case study from the Technical University of Denmark. A course on mobile communication was redesigned to include peer evaluation as a tool......Report writing is a general engineering competence and it should therefore be part of any university engineering education to learn how to write a good report. Active leaning methods are well-known to be effective in supporting student learning; hence it should preferably also be used for teaching...... for improving report writing skills. The peer evaluation process was automated using the elearning tool Coursera. What was investigated was the improvement in report writing as well as the consistency and quality of the peer assessed grades....

  20. Improved Riccati Transfer Matrix Method for Free Vibration of Non-Cylindrical Helical Springs Including Warping

    Directory of Open Access Journals (Sweden)

    A.M. Yu

    2012-01-01

    Full Text Available Free vibration equations for non-cylindrical (conical, barrel, and hyperboloidal types helical springs with noncircular cross-sections, which consist of 14 first-order ordinary differential equations with variable coefficients, are theoretically derived using spatially curved beam theory. In the formulation, the warping effect upon natural frequencies and vibrating mode shapes is first studied in addition to including the rotary inertia, the shear and axial deformation influences. The natural frequencies of the springs are determined by the use of improved Riccati transfer matrix method. The element transfer matrix used in the solution is calculated using the Scaling and Squaring method and Pad'e approximations. Three examples are presented for three types of springs with different cross-sectional shapes under clamped-clamped boundary condition. The accuracy of the proposed method has been compared with the FEM results using three-dimensional solid elements (Solid 45 in ANSYS code. Numerical results reveal that the warping effect is more pronounced in the case of non-cylindrical helical springs than that of cylindrical helical springs, which should be taken into consideration in the free vibration analysis of such springs.

  1. Sharing reference data and including cows in the reference population improve genomic predictions in Danish Jersey.

    Science.gov (United States)

    Su, G; Ma, P; Nielsen, U S; Aamand, G P; Wiggans, G; Guldbrandtsen, B; Lund, M S

    2016-06-01

    Small reference populations limit the accuracy of genomic prediction in numerically small breeds, such like Danish Jersey. The objective of this study was to investigate two approaches to improve genomic prediction by increasing size of reference population in Danish Jersey. The first approach was to include North American Jersey bulls in Danish Jersey reference population. The second was to genotype cows and use them as reference animals. The validation of genomic prediction was carried out on bulls and cows, respectively. In validation on bulls, about 300 Danish bulls (depending on traits) born in 2005 and later were used as validation data, and the reference populations were: (1) about 1050 Danish bulls, (2) about 1050 Danish bulls and about 1150 US bulls. In validation on cows, about 3000 Danish cows from 87 young half-sib families were used as validation data, and the reference populations were: (1) about 1250 Danish bulls, (2) about 1250 Danish bulls and about 1150 US bulls, (3) about 1250 Danish bulls and about 4800 cows, (4) about 1250 Danish bulls, 1150 US bulls and 4800 Danish cows. Genomic best linear unbiased prediction model was used to predict breeding values. De-regressed proofs were used as response variables. In the validation on bulls for eight traits, the joint DK-US bull reference population led to higher reliability of genomic prediction than the DK bull reference population for six traits, but not for fertility and longevity. Averaged over the eight traits, the gain was 3 percentage points. In the validation on cows for six traits (fertility and longevity were not available), the gain from inclusion of US bull in reference population was 6.6 percentage points in average over the six traits, and the gain from inclusion of cows was 8.2 percentage points. However, the gains from cows and US bulls were not accumulative. The total gain of including both US bulls and Danish cows was 10.5 percentage points. The results indicate that sharing reference

  2. Feasibility of including fugitive PM-10 emissions estimates in the EPA emissions trends report

    International Nuclear Information System (INIS)

    Barnard, W.; Carlson, P.

    1990-09-01

    The report describes the results of Part 2 of a two part study. Part 2 was to evaluate the feasibility of developing regional emission trends for PM-10. Part 1 was to evaluate the feasibility of developing VOC emission trends, on a regional and temporal basis. These studies are part of the effort underway to improve the national emission trends. Part 1 is presented in a separate report. The categories evaluated for the feasibility of developing regional emissions estimates were: unpaved roads, paved roads, wind erosion, agricultural tilling, construction activities, feedlots, burning, landfills, mining and quarrying unpaved parking lots, unpaved airstrips and storage piles

  3. An improved technique for breast cancer irradiation including the locoregional lymph nodes

    NARCIS (Netherlands)

    Hurkmans, C. W.; Saarnak, A. E.; Pieters, B. R.; Borger, J. H.; Bruinvis, I. A.

    2000-01-01

    PURPOSE: To find an irradiation technique for locoregional irradiation of breast cancer patients which, compared with a standard technique, improves the dose distribution to the internal mammary-medial supraclavicular (IM-MS) lymph nodes. The improved technique is intended to minimize the lung dose

  4. Improving ultrasound for appendicitis through standardized reporting of secondary signs.

    Science.gov (United States)

    Partain, Kristin N; Patel, Adarsh U; Travers, Curtis; Short, Heather L; Braithwaite, Kiery; Loewen, Jonathan; Heiss, Kurt F; Raval, Mehul V

    2017-08-01

    Our aim was to implement a standardized US report that included secondary signs of appendicitis (SS) to facilitate accurate diagnosis of appendicitis and decrease the use of computed tomography (CT) and admissions for observation. A multidisciplinary team implemented a quality improvement (QI) intervention in the form of a standardized US report and provided stakeholders with monthly feedback. Outcomes including report compliance, CT use, and observation admissions were compared pretemplate and posttemplate. We identified 387 patients in the pretemplate period and 483 patients in the posttemplate period. In the posttemplate period, the reporting of SS increased from 5.4% to 79.5% (pappendicitis also improved in the posttemplate period. A focused QI initiative led to high compliance rates of utilizing the standardized US report and resulted in lower CT use and fewer admissions for observation. Study of a Diagnostic Test Level of Evidence: 1. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  6. Biospecimen Reporting for Improved Study Quality

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  7. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  8. Improved catalyzed reporter deposition, iCARD.

    Science.gov (United States)

    Lohse, Jesper; Petersen, Kenneth Heesche; Woller, Nina Claire; Pedersen, Hans Christian; Skladtchikova, Galina; Jørgensen, Rikke Malene

    2014-06-18

    Novel reporters have been synthesized with extended hydrophilic linkers that in combination with polymerizing cross-linkers result in very efficient reporter deposition. By utilizing antibodies to stain HER2 proteins in a cell line model it is demonstrated that the method is highly specific and sensitive with virtually no background. The detection of HER2 proteins in tissue was used to visualize individual antigens as small dots visible in a microscope. Image analysis-assisted counting of fluorescent or colored dots allowed assessment of relative protein levels in tissue. Taken together, we have developed novel reporters that improve the CARD method allowing highly sensitive in situ detection of proteins in tissue. Our findings suggest that in situ protein quantification in biological samples can be performed by object recognition and enumeration of dots, rather than intensity-based fluorescent or colorimetric assays.

  9. Improvement of Scratch and Wear Resistance of Polymers by Fillers Including Nanofillers

    Directory of Open Access Journals (Sweden)

    Witold Brostow

    2017-03-01

    Full Text Available Polymers have lower resistance to scratching and wear than metals. Liquid lubricants work well for metals but not for polymers nor for polymer-based composites (PBCs. We review approaches for improvement of tribological properties of polymers based on inclusion of fillers. The fillers can be metallic or ceramic—with obvious consequences for electrical resistivity of the composites. Distinctions between effectiveness of micro- versus nano-particles are analyzed. For example, aluminum nanoparticles as filler are more effective for property improvement than microparticles at the same overall volumetric concentration. Prevention of local agglomeration of filler particles is discussed along with a technique to verify the prevention.

  10. Improving the Transparency of IAEA Safeguards Reporting

    International Nuclear Information System (INIS)

    Toomey, Christopher; Hayman, Aaron M.; Wyse, Evan T.; Odlaug, Christopher S.

    2011-01-01

    In 2008, the Standing Advisory Group on Safeguards Implementation (SAGSI) indicated that the International Atomic Energy Agency's (IAEA) Safeguards Implementation Report (SIR) has not kept pace with the evolution of safeguards and provided the IAEA with a set of recommendations for improvement. The SIR is the primary mechanism for providing an overview of safeguards implementation in a given year and reporting on the annual safeguards findings and conclusions drawn by the Secretariat. As the IAEA transitions to State-level safeguards approaches, SIR reporting must adapt to reflect these evolutionary changes. This evolved report will better reflect the IAEA's transition to a more qualitative and information-driven approach, based upon State-as-a-whole considerations. This paper applies SAGSI's recommendations to the development of multiple models for an evolved SIR and finds that an SIR repurposed as a 'safeguards portal' could significantly enhance information delivery, clarity, and transparency. In addition, this paper finds that the 'portal concept' also appears to have value as a standardized information presentation and analysis platform for use by Country Officers, for continuity of knowledge purposes, and the IAEA Secretariat in the safeguards conclusion process. Accompanying this paper is a fully functional prototype of the 'portal' concept, built using commercial software and IAEA Annual Report data.

  11. Should Pharmacies Be Included in Medication Reconciliation? A Report of Recurrent Valproic Acid Toxicity

    Directory of Open Access Journals (Sweden)

    B. Tate Cutshall

    2017-03-01

    Full Text Available Including outpatient pharmacies in the medication reconciliation process upon hospital discharge is not commonly performed. This case highlights the consequences of a patient refilling a discontinued prescription for valproic acid (VPA. We present a 32-year old male found unresponsive after ingesting delayed release divalproex sodium. Cerebral edema was visualized on magnetic resonance imaging. Hemodialysis and levo-carnitine treatment led to improved mental status, and VPA was discontinued. The same patient presented with VPA overdose eight months later after he continued to fill an outdated prescription. This case highlights consequences of VPA toxicity; it also demonstrates an opportunity to improve patient safety and high-value care by collaborating with outpatient pharmacies in the medication reconciliation process upon hospital discharge.

  12. Modelling of safety barriers including human and organisational factors to improve process safety

    DEFF Research Database (Denmark)

    Markert, Frank; Duijm, Nijs Jan; Thommesen, Jacob

    2013-01-01

    It is believed that traditional safety management needs to be improved on the aspect of preparedness for coping with expected and unexpected deviations, avoiding an overly optimistic reliance on safety systems. Remembering recent major accidents, such as the Deep Water Horizon, the Texas City....... A valuable approach is the inclusion of human and organisational factors into the simulation of the reliability of the technical system using event trees and fault trees and the concept of safety barriers. This has been demonstrated e.g. in the former European research project ARAMIS (Accidental Risk...

  13. An Intervention Including an Online Game to Improve Grade 6 Students' Performance in Early Algebra

    Science.gov (United States)

    Kolovou, Angeliki; van den Heuvel-Panhuizen, Marja; Koller, Olaf

    2013-01-01

    This study investigated whether an intervention including an online game contributed to 236 Grade 6 students' performance in early algebra, that is, solving problems with covarying quantities. An exploratory quasi-experimental study was conducted with a pretest-posttest-control-group design. Students in the experimental group were asked to solve…

  14. Including RNA secondary structures improves accuracy and robustness in reconstruction of phylogenetic trees.

    Science.gov (United States)

    Keller, Alexander; Förster, Frank; Müller, Tobias; Dandekar, Thomas; Schultz, Jörg; Wolf, Matthias

    2010-01-15

    In several studies, secondary structures of ribosomal genes have been used to improve the quality of phylogenetic reconstructions. An extensive evaluation of the benefits of secondary structure, however, is lacking. This is the first study to counter this deficiency. We inspected the accuracy and robustness of phylogenetics with individual secondary structures by simulation experiments for artificial tree topologies with up to 18 taxa and for divergency levels in the range of typical phylogenetic studies. We chose the internal transcribed spacer 2 of the ribosomal cistron as an exemplary marker region. Simulation integrated the coevolution process of sequences with secondary structures. Additionally, the phylogenetic power of marker size duplication was investigated and compared with sequence and sequence-structure reconstruction methods. The results clearly show that accuracy and robustness of Neighbor Joining trees are largely improved by structural information in contrast to sequence only data, whereas a doubled marker size only accounts for robustness. Individual secondary structures of ribosomal RNA sequences provide a valuable gain of information content that is useful for phylogenetics. Thus, the usage of ITS2 sequence together with secondary structure for taxonomic inferences is recommended. Other reconstruction methods as maximum likelihood, bayesian inference or maximum parsimony may equally profit from secondary structure inclusion. This article was reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin. Reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin. For the full reviews, please go to the Reviewers' comments section.

  15. Including RNA secondary structures improves accuracy and robustness in reconstruction of phylogenetic trees

    Directory of Open Access Journals (Sweden)

    Dandekar Thomas

    2010-01-01

    Full Text Available Abstract Background In several studies, secondary structures of ribosomal genes have been used to improve the quality of phylogenetic reconstructions. An extensive evaluation of the benefits of secondary structure, however, is lacking. Results This is the first study to counter this deficiency. We inspected the accuracy and robustness of phylogenetics with individual secondary structures by simulation experiments for artificial tree topologies with up to 18 taxa and for divergency levels in the range of typical phylogenetic studies. We chose the internal transcribed spacer 2 of the ribosomal cistron as an exemplary marker region. Simulation integrated the coevolution process of sequences with secondary structures. Additionally, the phylogenetic power of marker size duplication was investigated and compared with sequence and sequence-structure reconstruction methods. The results clearly show that accuracy and robustness of Neighbor Joining trees are largely improved by structural information in contrast to sequence only data, whereas a doubled marker size only accounts for robustness. Conclusions Individual secondary structures of ribosomal RNA sequences provide a valuable gain of information content that is useful for phylogenetics. Thus, the usage of ITS2 sequence together with secondary structure for taxonomic inferences is recommended. Other reconstruction methods as maximum likelihood, bayesian inference or maximum parsimony may equally profit from secondary structure inclusion. Reviewers This article was reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber and Eugene V. Koonin. Open peer review Reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber and Eugene V. Koonin. For the full reviews, please go to the Reviewers' comments section.

  16. Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

    Science.gov (United States)

    Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

    2018-01-01

    The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

  17. Improving the safety of LWR power plants. Final report

    International Nuclear Information System (INIS)

    1980-04-01

    This report documents the results of the Study to identify current, potential research issues and efforts for improving the safety of Light Water Reactor (LWR) power plants. This final report describes the work accomplished, the results obtained, the problem areas, and the recommended solutions. Specifically, for each of the issues identified in this report for improving the safety of LWR power plants, a description is provided in detail of the safety significance, the current status (including information sources, status of technical knowledge, problem solution and current activities), and the suggestions for further research and development. Further, the issues are ranked for action into high, medium, and low priority with respect to primarily (a) improved safety (e.g. potential reduction in public risk and occupational exposure), and secondly (b) reduction in safety-related costs

  18. Improvement on a science curriculum including experimental demonstration of environmental radioactivity for secondary school students

    International Nuclear Information System (INIS)

    Watanabe, Kenji; Matsubara, Shizuo; Aiba, Yoshio; Eriguchi, Hiroshi; Kiyota, Saburo; Takeyama, Tetsuji.

    1988-01-01

    A science curriculum previously prepared for teaching environmental radioactivity was modified on the basis of the results of trial instructions in secondary schools. The main subject of the revised curriculum is an understanding of the natural radioactivity through the experimental demonstration about air-borne β and γ ray emitters. The other subjects included are the radioactive decay, the biological effects of radiation, the concept of risk-benefit balance (acceptable level) and the peaceful uses of nuclear energy and radiation. The work sheets and reference data prepared as learning materials are in two levels corresponding to the ability of students for this curriculum. (author)

  19. The surgical care improvement project and prevention of post-operative infection, including surgical site infection.

    Science.gov (United States)

    Rosenberger, Laura H; Politano, Amani D; Sawyer, Robert G

    2011-06-01

    In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention on the Surgical Infection Prevention (SIP) project, introduced in 2002. Quality improvement measures were developed to standardize processes to increase compliance. In 2006, the Surgical Care Improvement Project (SCIP) developed out of the SIP project and its process measures. These initiatives, published in the Specifications Manual for National Inpatient Quality Measures, outline process and outcome measures. This continually evolving manual is intended to provide standard quality measures to unify documentation and track standards of care. Seven of the SCIP initiatives apply to the peri-operative period: Prophylactic antibiotics should be received within 1 h prior to surgical incision (1), be selected for activity against the most probable antimicrobial contaminants (2), and be discontinued within 24 h after the surgery end-time (3); (4) euglycemia should be maintained, with well-controlled morning blood glucose concentrations on the first two post-operative days, especially in cardiac surgery patients; (6) hair at the surgical site should be removed with clippers or by depilatory methods, not with a blade; (9) urinary catheters are to be removed within the first two post-operative days; and (10) normothermia should be maintained peri-operatively. There is strong evidence that implementation of protocols that standardize practices reduce the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity as well as cost. One of the goals of the SCIP guidelines was a 25% reduction in the incidence of surgical site infections from implementation through 2010. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons and scientists, to be active

  20. Strategies for improving memory: a randomized trial of memory groups for older people, including those with mild cognitive impairment.

    Science.gov (United States)

    Kinsella, Glynda J; Ames, David; Storey, Elsdon; Ong, Ben; Pike, Kerryn E; Saling, Michael M; Clare, Linda; Mullaly, Elizabeth; Rand, Elizabeth

    2016-01-01

    Governments are promoting the importance of maintaining cognitive health into older age to minimize risk of cognitive decline and dementia. Older people with amnestic mild cognitive impairment (aMCI) are particularly vulnerable to memory challenges in daily activities and are seeking ways to maintain independent living. To evaluate the effectiveness of memory groups for improving memory strategies and memory ability of older people, especially those with aMCI. 113 healthy older adults (HOA) and 106 adults with aMCI were randomized to a six-week memory group or a waitlist control condition. Outcome was evaluated through knowledge and use of memory strategies, memory ability (self-report and neuropsychological tests), and wellbeing. Assessments included a six-month follow-up. Using intention to treat analyses, there were intervention effects for HOA and aMCI groups in strategy knowledge (HOA: η2= 0.20; aMCI: η2= 0.06), strategy use (HOA: η2= 0.18; aMCI: η2= 0.08), and wellbeing (HOA: η2= 0.11; aMCI: η2= 0.05). There were also intervention effects in the HOA group, but not the aMCI group, in self-reported memory ability (η2= 0.06) and prospective memory tests (η2= 0.02). By six-month follow-up, gains were found on most HOA outcomes. In the aMCI group gains were found in strategy use, and by this stage, gains in prospective memory were also found. Memory groups can engage older people in techniques for maintaining cognitive health and improve memory performance, but more modest benefits are seen for older adults with aMCI.

  1. How to include frequency dependent complex permeability Into SPICE models to improve EMI filters design?

    Science.gov (United States)

    Sixdenier, Fabien; Yade, Ousseynou; Martin, Christian; Bréard, Arnaud; Vollaire, Christian

    2018-05-01

    Electromagnetic interference (EMI) filters design is a rather difficult task where engineers have to choose adequate magnetic materials, design the magnetic circuit and choose the size and number of turns. The final design must achieve the attenuation requirements (constraints) and has to be as compact as possible (goal). Alternating current (AC) analysis is a powerful tool to predict global impedance or attenuation of any filter. However, AC analysis are generally performed without taking into account the frequency-dependent complex permeability behaviour of soft magnetic materials. That's why, we developed two frequency-dependent complex permeability models able to be included into SPICE models. After an identification process, the performances of each model are compared to measurements made on a realistic EMI filter prototype in common mode (CM) and differential mode (DM) to see the benefit of the approach. Simulation results are in good agreement with the measured ones especially in the middle frequency range.

  2. Generation of complete electronic nuclear medicine reports including static, dynamic and gated images

    International Nuclear Information System (INIS)

    Beretta, M.; Pilon, R.; Mut, F.

    2002-01-01

    Aim: To develop a procedure for the creation of nuclear medicine reports containing static and dynamic images. The reason for implementing this technique is the lack of adequate solutions for an electronic format of nuclear medicine results allowing for rapid transmission via e-mail, specially in the case of dynamic and gated SPECT studies, since functional data is best presented in dynamic mode. Material and Methods: Clinical images were acquired in static, whole body, dynamic and gated mode, corresponding to bone studies, diuretic renogram, radionuclide cystography and gated perfusion SPECT, as well as respective time-activity curves. Image files were imported from a dedicated nuclear medicine computer system (Elscint XPert) to a Windows-based PC through a standard ethernet network with TCP-IP communications protocol, using a software developed by us which permits the conversion from the manufacturer's original format into a bitmap format (.bmp) compatible with commercially available PC software. For cardiac perfusion studies, background was subtracted prior to transferring to reduce the amount of information in the file; this was not done for other type of studies because useful data could be eliminated. Dynamic images were then processed using commercial software to create animated files and stored in .gif format. Static images were re-sized and stored in .jpg format. Original color or gray scale was always preserved. All the graphic material was then merged with a previously prepared report text using HTML format. The report also contained reference diagrams to facilitate interpretation. The whole report was then compressed into a self-extractable file, ready to be sent by electronic mail. Reception of the material was visually checked for data integrity including image quality by two experienced nuclear medicine physicians. Results: The report presented allows for simultaneous visualization of the text, diagrams and images either static, dynamic, gated or

  3. Advanced neuroblastoma: improved response rate using a multiagent regimen (OPEC) including sequential cisplatin and VM-26.

    Science.gov (United States)

    Shafford, E A; Rogers, D W; Pritchard, J

    1984-07-01

    Forty-two children, all over one year of age, were given vincristine, cyclophosphamide, and sequentially timed cisplatin and VM-26 (OPEC) or OPEC and doxorubicin (OPEC-D) as initial treatment for newly diagnosed stage III or IV neuroblastoma. Good partial response was achieved in 31 patients (74%) overall and in 28 (78%) of 36 patients whose treatment adhered to the chemotherapy protocol, compared with a 65% response rate achieved in a previous series of children treated with pulsed cyclophosphamide and vincristine with or without doxorubicin. Only six patients, including two of the six children whose treatment did not adhere to protocol, failed to respond, but there were five early deaths from treatment-related complications. Tumor response to OPEC, which was the less toxic of the two regimens, was at least as good as tumor response to OPEC-D. Cisplatin-induced morbidity was clinically significant in only one patient and was avoided in others by careful monitoring of glomerular filtration rate and hearing. Other centers should test the efficacy of OPEC or equivalent regimens in the treatment of advanced neuroblastoma.

  4. Improved best estimate plus uncertainty methodology, including advanced validation concepts, to license evolving nuclear reactors

    International Nuclear Information System (INIS)

    Unal, C.; Williams, B.; Hemez, F.; Atamturktur, S.H.; McClure, P.

    2011-01-01

    Research highlights: → The best estimate plus uncertainty methodology (BEPU) is one option in the licensing of nuclear reactors. → The challenges for extending the BEPU method for fuel qualification for an advanced reactor fuel are primarily driven by schedule, the need for data, and the sufficiency of the data. → In this paper we develop an extended BEPU methodology that can potentially be used to address these new challenges in the design and licensing of advanced nuclear reactors. → The main components of the proposed methodology are verification, validation, calibration, and uncertainty quantification. → The methodology includes a formalism to quantify an adequate level of validation (predictive maturity) with respect to existing data, so that required new testing can be minimized, saving cost by demonstrating that further testing will not enhance the quality of the predictive tools. - Abstract: Many evolving nuclear energy technologies use advanced predictive multiscale, multiphysics modeling and simulation (M and S) capabilities to reduce the cost and schedule of design and licensing. Historically, the role of experiments has been as a primary tool for the design and understanding of nuclear system behavior, while M and S played the subordinate role of supporting experiments. In the new era of multiscale, multiphysics computational-based technology development, this role has been reversed. The experiments will still be needed, but they will be performed at different scales to calibrate and validate the models leading to predictive simulations for design and licensing. Minimizing the required number of validation experiments produces cost and time savings. The use of multiscale, multiphysics models introduces challenges in validating these predictive tools - traditional methodologies will have to be modified to address these challenges. This paper gives the basic aspects of a methodology that can potentially be used to address these new challenges in

  5. Improved best estimate plus uncertainty methodology including advanced validation concepts to license evolving nuclear reactors

    International Nuclear Information System (INIS)

    Unal, Cetin; Williams, Brian; McClure, Patrick; Nelson, Ralph A.

    2010-01-01

    Many evolving nuclear energy programs plan to use advanced predictive multi-scale multi-physics simulation and modeling capabilities to reduce cost and time from design through licensing. Historically, the role of experiments was primary tool for design and understanding of nuclear system behavior while modeling and simulation played the subordinate role of supporting experiments. In the new era of multi-scale multi-physics computational based technology development, the experiments will still be needed but they will be performed at different scales to calibrate and validate models leading predictive simulations. Cost saving goals of programs will require us to minimize the required number of validation experiments. Utilization of more multi-scale multi-physics models introduces complexities in the validation of predictive tools. Traditional methodologies will have to be modified to address these arising issues. This paper lays out the basic aspects of a methodology that can be potentially used to address these new challenges in design and licensing of evolving nuclear technology programs. The main components of the proposed methodology are verification, validation, calibration, and uncertainty quantification. An enhanced calibration concept is introduced and is accomplished through data assimilation. The goal is to enable best-estimate prediction of system behaviors in both normal and safety related environments. To achieve this goal requires the additional steps of estimating the domain of validation and quantification of uncertainties that allow for extension of results to areas of the validation domain that are not directly tested with experiments, which might include extension of the modeling and simulation (M and S) capabilities for application to full-scale systems. The new methodology suggests a formalism to quantify an adequate level of validation (predictive maturity) with respect to required selective data so that required testing can be minimized for

  6. Improved best estimate plus uncertainty methodology including advanced validation concepts to license evolving nuclear reactors

    Energy Technology Data Exchange (ETDEWEB)

    Unal, Cetin [Los Alamos National Laboratory; Williams, Brian [Los Alamos National Laboratory; Mc Clure, Patrick [Los Alamos National Laboratory; Nelson, Ralph A [IDAHO NATIONAL LAB

    2010-01-01

    Many evolving nuclear energy programs plan to use advanced predictive multi-scale multi-physics simulation and modeling capabilities to reduce cost and time from design through licensing. Historically, the role of experiments was primary tool for design and understanding of nuclear system behavior while modeling and simulation played the subordinate role of supporting experiments. In the new era of multi-scale multi-physics computational based technology development, the experiments will still be needed but they will be performed at different scales to calibrate and validate models leading predictive simulations. Cost saving goals of programs will require us to minimize the required number of validation experiments. Utilization of more multi-scale multi-physics models introduces complexities in the validation of predictive tools. Traditional methodologies will have to be modified to address these arising issues. This paper lays out the basic aspects of a methodology that can be potentially used to address these new challenges in design and licensing of evolving nuclear technology programs. The main components of the proposed methodology are verification, validation, calibration, and uncertainty quantification. An enhanced calibration concept is introduced and is accomplished through data assimilation. The goal is to enable best-estimate prediction of system behaviors in both normal and safety related environments. To achieve this goal requires the additional steps of estimating the domain of validation and quantification of uncertainties that allow for extension of results to areas of the validation domain that are not directly tested with experiments, which might include extension of the modeling and simulation (M&S) capabilities for application to full-scale systems. The new methodology suggests a formalism to quantify an adequate level of validation (predictive maturity) with respect to required selective data so that required testing can be minimized for cost

  7. Areva - Updated Reference Document 2015 Including the 2016 half-year financial report

    International Nuclear Information System (INIS)

    2016-01-01

    Areva supplies high added-value products and services to support the operation of the global nuclear fleet. The company is present throughout the entire nuclear cycle, from uranium mining to used fuel recycling, including nuclear reactor design and operating services. Areva is recognized by utilities around the world for its expertise, its skills in cutting-edge technologies and its dedication to the highest level of safety. Areva's 40,000 employees are helping build tomorrow's energy model: supplying ever safer, cleaner and more economical energy to the greatest number of people. This Reference Document contains information on Areva's objectives, prospects and development strategies. It contains estimates of the markets, market shares and competitive position of Areva. Contents: 1 - Persons responsible; 2 - Information on operations and recent events (Overview of the Group's operations, Simplified organization chart of the Group, Implementation of the Group's strategic roadmap and Restructuring Plan, Deployment of the performance plan, Other significant transactions since the filing of the Reference Document, Review of third quarter 2016 operations, Press releases); 3 - Financial information (2016 Half-year financial report, Statutory auditors' report on the half-year financial information for the period January 1 to June 30, 2016, Unaudited consolidated pro-forma financial information, Statutory auditors' report on the pro-forma financial information); 4 - Risk factors (Risks related to the Restructuring Plan, Legal risks, Industrial and environmental risks, Operational risks, Liquidity and market risks); 5 - Cash and capital resources (Financial outlook, 12-month liquidity); 6 - Governance; 7 - Workforce - jobs (Voluntary departure plan and change in the Group's workforce, Signature of a memorandum of understanding ensuring the stability of labor agreements, Reorganization and refinancing of the Group); 8 - Share

  8. Utilities and Power - Sector Report. Malaysia: including electricity, gas, water, sewerage, telecommunications and information technology

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    This report is one of a series designed to introduce British exporters to the opportunities offered by the Malaysian market. The Seventh Malaysia Plan, covering the five year period, 1996-2000, contains an ambitious menu of infrastructure projects. Total expenditure under the Plan is envisaged at RM450 billion, of which around RM380 billion will be sourced from the private sector. This is an indication of the wealth accumulated within the Malaysian economy. The infrastructure developments identified are designed to take the country towards Vision 2020. These infrastructure developments will continue to make the country highly attractive to foreign investors, who were the catalyst for Malaysia`s explosive growth over the last few years. Malaysian Corporations have also grown rapidly and are becoming international investors and traders in their own right, including in the United Kingdom. As they expand, seeking new markets, they are looking also for partners with whom they can share technology and jointly develop projects. Such companies are often ideal partners for UK companies wishing to enter the Malaysian and Asian market. Malaysia offers opportunities to companies prepared to make the small effort to know and understand the country and its people. This report will assist companies to develop a useful understanding of the market. (author)

  9. FY 2016 Status Report: Documentation of All CIRFT Data including Hydride Reorientation Tests (Draft M2)

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jy-An John [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Materials Science and Technology Division; Wang, Hong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Materials Science and Technology Division; Jiang, Hao [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Materials Science and Technology Division; Yan, Yong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Materials Science and Technology Division; Bevard, Bruce B. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Materials Science and Technology Division; Scaglione, John M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Materials Science and Technology Division

    2016-09-04

    The first portion of this report provides a detailed description of fiscal year (FY) 2015 test result corrections and analysis updates based on FY 2016 updates to the Cyclic Integrated Reversible-Bending Fatigue Tester (CIRFT) program methodology, which is used to evaluate the vibration integrity of spent nuclear fuel (SNF) under normal conditions of transport (NCT). The CIRFT consists of a U-frame test setup and a real-time curvature measurement method. The three-component U-frame setup of the CIRFT has two rigid arms and linkages connecting to a universal testing machine. The curvature SNF rod bending is obtained through a three-point deflection measurement method. Three linear variable differential transformers (LVDTs) are clamped to the side connecting plates of the U-frame and used to capture deformation of the rod. The second portion of this report provides the latest CIRFT data, including data for the hydride reorientation test. The variations in fatigue life are provided in terms of moment, equivalent stress, curvature, and equivalent strain for the tested SNFs. The equivalent stress plot collapsed the data points from all of the SNF samples into a single zone. A detailed examination revealed that, at the same stress level, fatigue lives display a descending order as follows: H. B. Robinson Nuclear Power Station (HBR), LMK, and mixed uranium-plutonium oxide (MOX). Just looking at the strain, LMK fuel has a slightly longer fatigue life than HBR fuel, but the difference is subtle. The third portion of this report provides finite element analysis (FEA) dynamic deformation simulation of SNF assemblies . In a horizontal layout under NCT, the fuel assembly’s skeleton, which is formed by guide tubes and spacer grids, is the primary load bearing apparatus carrying and transferring vibration loads within an SNF assembly. These vibration loads include interaction forces between the SNF assembly and the canister basket walls. Therefore, the integrity of the guide

  10. Verification of Data Accuracy in Japan Congenital Cardiovascular Surgery Database Including Its Postprocedural Complication Reports.

    Science.gov (United States)

    Takahashi, Arata; Kumamaru, Hiraku; Tomotaki, Ai; Matsumura, Goki; Fukuchi, Eriko; Hirata, Yasutaka; Murakami, Arata; Hashimoto, Hideki; Ono, Minoru; Miyata, Hiroaki

    2018-03-01

    Japan Congenital Cardiovascluar Surgical Database (JCCVSD) is a nationwide registry whose data are used for health quality assessment and clinical research in Japan. We evaluated the completeness of case registration and the accuracy of recorded data components including postprocedural mortality and complications in the database via on-site data adjudication. We validated the records from JCCVSD 2010 to 2012 containing congenital cardiovascular surgery data performed in 111 facilities throughout Japan. We randomly chose nine facilities for site visit by the auditor team and conducted on-site data adjudication. We assessed whether the records in JCCVSD matched the data in the source materials. We identified 1,928 cases of eligible surgeries performed at the facilities, of which 1,910 were registered (99.1% completeness), with 6 cases of duplication and 1 inappropriate case registration. Data components including gender, age, and surgery time (hours) were highly accurate with 98% to 100% concordance. Mortality at discharge and at 30 and 90 postoperative days was 100% accurate. Among the five complications studied, reoperation was the most frequently observed, with 16 and 21 cases recorded in the database and source materials, respectively, having a sensitivity of 0.67 and a specificity of 0.99. Validation of JCCVSD database showed high registration completeness and high accuracy especially in the categorical data components. Adjudicated mortality was 100% accurate. While limited in numbers, the recorded cases of postoperative complications all had high specificities but had lower sensitivity (0.67-1.00). Continued activities for data quality improvement and assessment are necessary for optimizing the utility of these registries.

  11. System-Cost-Optimized Smart EVSE for Residential Application: Final Technical Report including Manufacturing Plan

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Charles [Delta Products, Triangle Park, NC (United States)

    2015-05-15

    In the 2nd quarter of 2012, a program was formally initiated at Delta Products to develop smart-grid-enabled Electric Vehicle Supply Equipment (EVSE) product for residential use. The project was funded in part by the U.S. Department of Energy (DOE), under award DE-OE0000590. Delta products was the prime contractor to DOE during the three year duration of the project. In addition to Delta Products, several additional supplier-partners were engaged in this research and development (R&D) program, including Detroit Edison DTE, Mercedes Benz Research and Development North America, and kVA. This report summarizes the program and describes the key research outcomes of the program. A technical history of the project activities is provided, which describes the key steps taken in the research and the findings made at successive stages in the multi-stage work. The evolution of an EVSE prototype system is described in detail, culminating in prototypes shipped to Department of Energy Laboratories for final qualification. After the program history is reviewed, the key attributes of the resulting EVSE are described in terms of functionality, performance, and cost. The results clearly demonstrate the ability of this EVSE to meet or exceed DOE's targets for this program, including: construction of a working product-intent prototype of a smart-grid-enabled EVSE, with suitable connectivity to grid management and home-energy management systems, revenue-grade metering, and related technical functions; and cost reduction of 50% or more compared to typical market priced EVSEs at the time of DOE's funding opportunity announcement (FOA), which was released in mid 2011. In addition to meeting all the program goals, the program was completed within the original budget and timeline established at the time of the award. The summary program budget and timeline, comparing plan versus actual values, is provided for reference, along with several supporting explanatory notes. Technical

  12. Umatilla River Subbasin Fish Habitat Improvement Program, 2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-05-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration agreements, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat conditions. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and re-construction aimed at improving fish habitat, through the restoration of stable channel function. This report provides a summary of Program activities for the 2005 calendar year (January 1 through December 31, 2005), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance (O&M), and (4) Monitoring and Evaluation (M&E). This report also summarizes activities associated with Program Administration, Interagency Coordination, and Public Education.

  13. HLW Salt Disposition Alternatives Identification Preconceptual Phase I Summary Report (Including Attachments)

    International Nuclear Information System (INIS)

    Piccolo, S.F.

    1999-01-01

    The purpose of this report is to summarize the process used by the Team to systematically develop alternative methods or technologies for final disposition of HLW salt. Additionally, this report summarizes the process utilized to reduce the total list of identified alternatives to an ''initial list'' for further evaluation. This report constitutes completion of the team charter major milestone Phase I Deliverable

  14. Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

    Science.gov (United States)

    Farrell, Elizabeth; Naber, Erin; Geigle, Paula

    2010-01-01

    This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

  15. Umatilla River subbasin fish habitat improvement project. Annual report 1993

    International Nuclear Information System (INIS)

    Bailey, T.D.; Laws, T.S.

    1994-05-01

    This annual report is in fulfillment of contract obligations with Bonneville Power Administration which is the funding source for the Oregon Department of Fish and Wildlife's Umatilla Basin Habitat Improvement Project. Major activities undertaken during this report period included: (1) procurement of one access easement with a private landowner, (2) design, layout, and implementation of 3.36 miles of instream structure maintenance, (3) inspection and routine maintenance of 15.1 miles of fence, (4) revegetation along 3.36 miles of stream, (5) collection and summarization of physical and biological monitoring data, (6) extensive interagency coordination, and (7) environmental education activities with local high school students

  16. Improved radioimmunotherapy of hematologic malignancies. [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Press, O.W.

    1992-03-24

    This research project proposes to develop novel new approaches of improving the radioimmunodetection and radioimmunotherapy of malignancies by augmenting retention of radioimmunoconjugates by tumor cells. The approaches shown to be effective in these laboratory experiments will subsequently be incorporated into out ongoing clinical trials in patients. Specific project objectives include: to study the rates of endocytosis, intracellular routing, and metabolic degradation of radiolabeled monoclonal antibodies targeting tumor-associated antigens on human leukemia and lymphoma cells; To examine the effects of lysosomotropic amines (e.g. chloroquine, amantadine), carboxylic ionophores (monensin, nigericin), and thioamides (propylthiouracil), on the retention of radiolabeled MoAbs by tumor cells; to examine the impact of newer radioiodination techniques (tyramine cellobiose, paraiodobenzoyl) on the metabolic degradation of radioiodinated antibodies; to compare the endocytosis, intracellular routing, and degradation of radioimmunoconjugates prepared with different radionuclides ({sup 131}Iodine, {sup 111}Indium, {sup 90}Yttrium, {sup 99m}Technetium, {sup 186}Rhenium); and to examine the utility of radioimmunoconjugates targeting oncogene products for the radioimmunotherapy and radioimmunoscintigraphy of cancer.

  17. Structured data quality reports to improve EHR data quality.

    Science.gov (United States)

    Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

    2015-12-01

    To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (pImprovement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Candida-induced prosthetic joint infection. A literature review including 72 cases and a case report.

    Science.gov (United States)

    Cobo, Fernando; Rodríguez-Granger, Javier; López, Enrique M; Jiménez, Gemma; Sampedro, Antonio; Aliaga-Martínez, Luis; Navarro-Marí, José María

    2017-02-01

    The clinical and microbiological characteristics of prosthetic joint infection (PJI) caused by Candida species is described, including 72 cases in the literature and a case of Candida glabrata infection handled at the present centre. We describe one patient and using the key words 'fungal prosthetic joint infection' and 'candida prosthetic joint infection' we searched MEDLINE (National Library of Medicine, Bethesda, MD), Web of Science, CINAHL and Cochrane systematic review databases for case reports of this condition. Out of the 73 patients, 38 were female; mean age at diagnosis was 65.7 (± SD 18) yrs; 50 had risk factors for candidal infection such as systemic disease (e.g. rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus) and/or immunosuppressive therapy in 18 (24.6%) cases, diabetes mellitus in 14 (19.1%), immunosuppression due to malignant or chronic disease in 24 (32.8%) and long-term antibiotic use in four (5.4%) patients. Infection site was the knee in 36 patients and hip in 35; pain was present in 43 patients and swelling in 23 and the mean surgery-diagnosis interval was 32 months. The most frequent species was C. albicans, followed by C. parapsilosis. The diagnosis was obtained from joint fluid aspirate in 33 cases and intra-operative samples in 16. Susceptibility to antifungals was tested in only 21 isolates. The most frequently used antifungals were fluconazole and amphotericin B. Two-stage exchange arthroplasty was performed in 30 patients and resection arthroplasty in 31; 56 patients were cured with a combination of medical and surgical treatment; one patient died from the infection. PJI caused by Candida requires a high index of suspicion; surgery with long-term antifungal therapy is recommended.

  19. Facilitating SME Financing through Improved Credit Reporting

    OpenAIRE

    International Committee on Credit Reporting

    2014-01-01

    The general principles for credit reporting were issued by the World Bank in September 2011. Since then, the World Bank and the international committee on credit reporting (ICCR) have been leading efforts towards the implementation of the general principles worldwide. This report is one of the concrete outputs of the work following the general principles. It addresses one of the most signi...

  20. Electron spin resonance studies of radiation effects. Final report, 1964-1979 (including annual progress reports for 1978 and 1979)

    International Nuclear Information System (INIS)

    Rogers, M.T.

    1979-07-01

    The discovery of new free radicals, largely in irradiated single crystals of nonmetallic solids, and the determination of the molecular and electronic structures of these paramagnetic species by electron spin resonance (ESR) spectroscopy, have been carried out using a wide variety of organic and inorganic materials. The mechanisms of production of radicals in solids, their motions, and their reactions have been investigated and some applicable general principles deduced. Emphasis has been on aliphatic free radicals from irradiated carboxylic acids and amides and their halogen-substituted derivatives, organometallic radicals and substituted cyclic hydrocarbon radicals; inorganic radicals studied include V centers, hypervalent radicals and electron adducts. Extensive investigations of paramagnetic transition metal complexes, particularly cyanides and fluorides, have been made. In all cases quantum mechanical calculations have been employed as far as possible in interpreting the data. An improved method for analyzing experimental ESR spectra of single crystals has been developed and a number of crystal structures have been determined to supplement the ESR studies. Applications of nuclear quadrupole resonance spectroscopy to the study of structure and bonding in inorganic solids have been made and a method for using nuclear magnetic relaxation data for estimating quadrupole coupling constants in liquids has been developed

  1. Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

    Science.gov (United States)

    Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

    2018-04-01

    The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

  2. Student laboratory reports: an approach to improving feedback and quality

    Science.gov (United States)

    Ellingsen, Pål Gunnar; Støvneng, Jon Andreas

    2018-05-01

    We present an ongoing effort in improving the quality of laboratory reports written by first and second year physics students. The effort involves a new approach where students are given the opportunity to submit reports at intermediate deadlines, receive feedback, and then resubmit for the final deadline. In combination with a differential grading system, instead of pass/fail, the improved feedback results in higher quality reports. Improvement in the quality of the reports is visible through the grade statistics.

  3. Complex pattern of colon cancer recurrence including a kidney metastasis: A case report

    OpenAIRE

    Waleczek, Helfried; Wente, Moritz N; Kozianka, Jürgen

    2005-01-01

    We report a case of a 77-year-old female with a local recurrence of cancer after right hemicolectomy which infiltrated the pancreatic head affording pancrea-toduodenectomy, who developed 3 years later recurrent tumor masses localized in the mesentery of the jejunum and in the lower pole of the left kidney. Partial nephrectomy and a segment resection of the small bowel were performed. Histological examination of both specimens revealed a necrotic metastasis of the primary carcinoma of the colo...

  4. Can technology improve intershift report? What the research reveals.

    Science.gov (United States)

    Strople, Bernadette; Ottani, Patricia

    2006-01-01

    Shift report is a multifaceted process that serves to provide nurses with vital patient information to facilitate clinical decisions and patient care planning. A shift report also provides nurses with a forum for functions, such as patient problem solving and collaboration. The authors conducted a literature review, which indicates that current methodologies used to collect and convey patient information are ineffective and may contribute to negative patient outcomes. Data incongruence, legal implications, time constraints augmented by the nursing shortage, and the financial impact of shift report are also addressed. The literature reveals significant rationale for pioneering new and innovative methods of shift-to-shift communication. In the report To Err is Human: Building a Safe Health System, the Institute of Medicine attributes the deaths of up to 98,000 hospitalized Americans to medical errors, including communication failures [Institute of Medicine. (1999). To err is human: Building a safe health system. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. As a result, government policy makers and health care agencies have focused their attention on determining the root cause of errors to identify preventative measures, including the use of information technology [Institute of Medicine. (2004). Keeping patients safe: Transforming the work environment of nurses. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. Under these premises, the authors examined the process of nursing shift report and how it impacts patient outcomes. The use of computer technology and wireless modes of communication is explored as a means of improving the shift report process and, subsequently, health care outcomes and patient safety.

  5. Technical report for effective estimation and improvement of quality system

    International Nuclear Information System (INIS)

    Kim, Kwan Hyun

    2000-06-01

    This technical report provides the methods on how to improve the Quality System, in R and D part. This report applies on the quality assurance(QA) programmes of the design, fabrication in nuclear projects. The organization having overall responsibility for the nuclear power item design, preservation, fabrication shall be described in this report in each stage of improvement of QA systems

  6. Report focuses on improving resilience to disasters

    Science.gov (United States)

    Showstack, Randy

    2012-08-01

    “Disaster resilience is everyone's business,” states a new report that calls for a series of local and national measures to increase resilience in the face of an increasingly costly toll from natural disasters to human lives and the economy. In 2011 natural disasters were responsible for damages in the United States exceeding $55 billion, and costs could increase with more people and structures located in harm's way and with the effects of extreme events, according to the report, Disaster Resilience: A National Imperative, issued by a committee of the U.S. National Academies on 1 August. Among the recommendations is for federal government agencies to incorporate national resilience as an organizing principle to guide federal government actions and programs. The report defines resilience as “the ability to prepare and plan for, absorb, recover from, and more successfully adapt to adverse events.”

  7. 41 CFR 102-75.125 - What information must agencies include in the title report?

    Science.gov (United States)

    2010-07-01

    ... CFR part 373, took place on the property. Hazardous substance activity includes situations where any hazardous substance was stored for one year or more, known to have been released, or disposed of on the... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What information must...

  8. International Spinal Cord Injury Core Data Set (version 2.0)-including standardization of reporting

    NARCIS (Netherlands)

    Biering-Sorensen, F.; DeVivo, M. J.; Charlifue, S.; Chen, Y.; New, P. W.; Noonan, V.; Post, M. W. M.; Vogel, L.

    Study design: The study design includes expert opinion, feedback, revisions and final consensus. Objectives: The objective of the study was to present the new knowledge obtained since the International Spinal Cord Injury (SCI) Core Data Set (Version 1.0) published in 2006, and describe the

  9. 77 FR 59986 - Johnson Controls Including Workers Whose Wages Were Reported Under IMECO LLC; North American...

    Science.gov (United States)

    2012-10-01

    ... applicable to workers and former workers of Johnson Controls, North American Refrigeration, Dixon, Illinois... to TA-W-71,663 is hereby issued as follows: All workers of Johnson Controls, including workers whose... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,663] Johnson Controls...

  10. International Spinal Cord Injury Core Data Set (version 2.0)-including standardization of reporting

    NARCIS (Netherlands)

    Biering-Sørensen, F; DeVivo, M J; Charlifue, Susan; Chen, Y; New, P.W.; Noonan, V.; Post, M W M; Vogel, L.

    STUDY DESIGN: The study design includes expert opinion, feedback, revisions and final consensus. OBJECTIVES: The objective of the study was to present the new knowledge obtained since the International Spinal Cord Injury (SCI) Core Data Set (Version 1.0) published in 2006, and describe the

  11. Figures in clinical trial reports: current practice & scope for improvement.

    Science.gov (United States)

    Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

    2007-11-19

    Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  12. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  13. Prize something, including quality. The price of supply interruption. On the search for φ. Technical report

    International Nuclear Information System (INIS)

    Baarsma, B.E.; Berkhout, P.H.G.; Hop, J.P.

    2004-04-01

    The Dutch Office of Energy Regulation (DTe) plans to adjust the present regulations with regard to regional electricity network companies. In 2002 an integrated model for pricing and quality regulations is drafted, which is expected to be implemented in 2005. This report serves as input for such a model. Quality is defined in terms of electricity supply disruptions. The aim of the study on the title subject is to determine prices for different types of power supply disruptions. The study is based on a survey among 12,400 households and nearly 2,500 small and medium-sized businesses in the Netherlands [nl

  14. Improving cancer treatment with cyclotron produced radionuclides. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.; Finn, R.D.

    1993-11-01

    This report describes our continuing long term goal of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis, treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. The program includes 3 interactive components: Radiochemistry/Cyclotron; Pharmacology; and Immunology. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Cyclotron section will be employed in the Pharmacology and Immunology sections during the next year. The development of novel radionuclides and tracers is of course useful in and of itself, but their utility is greatly enhanced by the interaction with the immunology and pharmacology components of the program.

  15. Structured reporting platform improves CAD-RADS assessment.

    Science.gov (United States)

    Szilveszter, Bálint; Kolossváry, Márton; Karády, Júlia; Jermendy, Ádám L; Károlyi, Mihály; Panajotu, Alexisz; Bagyura, Zsolt; Vecsey-Nagy, Milán; Cury, Ricardo C; Leipsic, Jonathon A; Merkely, Béla; Maurovich-Horvat, Pál

    2017-11-01

    Structured reporting in cardiac imaging is strongly encouraged to improve quality through consistency. The Coronary Artery Disease - Reporting and Data System (CAD-RADS) was recently introduced to facilitate interdisciplinary communication of coronary CT angiography (CTA) results. We aimed to assess the agreement between manual and automated CAD-RADS classification using a structured reporting platform. Five readers prospectively interpreted 500 coronary CT angiographies using a structured reporting platform that automatically calculates the CAD-RADS score based on stenosis and plaque parameters manually entered by the reader. In addition, all readers manually assessed CAD-RADS blinded to the automatically derived results, which was used as the reference standard. We evaluated factors influencing reader performance including CAD-RADS training, clinical load, time of the day and level of expertise. Total agreement between manual and automated classification was 80.2%. Agreement in stenosis categories was 86.7%, whereas the agreement in modifiers was 95.8% for "N", 96.8% for "S", 95.6% for "V" and 99.4% for "G". Agreement for V improved after CAD-RADS training (p = 0.047). Time of the day and clinical load did not influence reader performance (p > 0.05 both). Less experienced readers had a higher total agreement as compared to more experienced readers (87.0% vs 78.0%, respectively; p = 0.011). Even though automated CAD-RADS classification uses data filled in by the readers, it outperforms manual classification by preventing human errors. Structured reporting platforms with automated calculation of the CAD-RADS score might improve data quality and support standardization of clinical decision making. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Xp11.22 Microduplications Including HUWE1: Case Report and Literature Review.

    Science.gov (United States)

    Orivoli, Sonia; Pavlidis, Elena; Cantalupo, Gaetano; Pezzella, Marianna; Zara, Federico; Garavelli, Livia; Pisani, Francesco; Piccolo, Benedetta

    2016-01-01

    Xp11.22 microduplications have been reported in different patients with X-linked intellectual disability. Comparing the duplicated segments, a minimum region of overlap has been identified. Within this region, only one gene, the HUWE1 gene, coding the E3 ubiquitin protein ligase, turned out to be duplicated in all previously described patients. We provide a review of the literature on this topic, making a comparison not only of genetic aspects, but also of clinical, neurophysiological, and neuroradiological findings. Furthermore, we describe the phenotypic and molecular characterization of a case of intellectual disability in a child carrying one of the smallest Xp11.22 microduplications reported, involving the whole sequence of HUWE1 gene. Unlike previously described cases, our patient's neuroimaging showed abnormal findings; he also experienced one seizure and showed interictal electroencephalogram (EEG) epileptiform abnormalities. Given the fact that HUWE1 duplications and mutations have previously been described in several patients with X-linked cognitive impairment, our findings support the hypothesis that HUWE1 gene might be implicate in the pathogenesis of intellectual disability. Nevertheless, further investigations and a more detailed examination of patients' clinical history are needed to clear up other eventual genotype-phenotype correlations, such as the presence of epilepsy/epileptiform EEG abnormalities. Georg Thieme Verlag KG Stuttgart · New York.

  17. Improvement of the including sink material for around steel pot hot water department; Yokoka yuataribuyo nagashikomizai no kaizen

    Energy Technology Data Exchange (ETDEWEB)

    Hakiwara, R.

    1999-02-01

    As for life of steel pot, there are many rates which a place hit part occupies even in some copies. How to construct the castable which was different from other parts was examined, and it worked for high durability performance only around the hot water hit city for that. It worked for the life extension by this report to prevent spool for which to be a main damage factor thunder big fault grains were increased it was added .20% of the durability improvement could be confirmed so far more than goods as that result by adding big fault grain 40%. (translated by NEDO)

  18. Improvement in genetic evaluation of female fertility in dairy cattle using multiple-trait models including milk production traits

    DEFF Research Database (Denmark)

    Sun, C; Madsen, P; Lund, M S

    2010-01-01

    This study investigated the improvement in genetic evaluation of fertility traits by using production traits as secondary traits (MILK = 305-d milk yield, FAT = 305-d fat yield, and PROT = 305-d protein yield). Data including 471,742 records from first lactations of Denmark Holstein cows, covering...... the years of inseminations during first lactations from 1995 to 2004, were analyzed. Six fertility traits (i.e., interval in days from calving to first insemination, calving interval, days open, interval in days from first to last insemination, numbers of inseminations per conception, and nonreturn rate...... stability and predictive ability than single-trait models for all the fertility traits, except for nonreturn rate within 56 d after first service. The stability and predictive ability for the model including MILK or PROT were similar to the model including all 3 milk production traits and better than...

  19. Anesthesia report card - a customizable tool for performance improvement.

    Science.gov (United States)

    Peccora, Christian D; Gimlich, Robert; Cornell, Richard P; Vacanti, Charles A; Ehrenfeld, Jesse M; Urman, Richard D

    2014-09-01

    Measuring and providing performance feedback to physicians has gained momentum not only as a way to comply with regulatory requirements, but also as a way to improve patient care. Measurement of structural, process, and outcome metrics in a reliable, evidence-based, specialty-specific manner maximizes the probability of improving physician performance. The manner in which feedback is provided influences whether the measurement tool will be successful in changing behavior. We created an innovative reporting tool template for anesthesiology practitioners designed to provide detailed, continuous feedback covering many aspects of clinical practice. The literature regarding quality metric measurement and feedback strategies was examined to design a reporting tool that could provide high quality information and result in improved performance of clinical and academic tasks. A committee of department leaders and information technology professionals was tasked with determining the measurement criteria and infrastructure needed to generate these reports. Data was collected in a systematic, unbiased manner, and reports were populated with information from multiple databases and software systems. Feedback would be based on frequently updated information and allow for analysis of historical performance as well as comparison amongst peers. A template for an anesthesia report card was created. Categories included compliance, credentialing and qualifications, education, clinical and operating room responsibilities, and academic achievements. Physicians were able to choose to be evaluated in some of the categories and had to meet a minimum number of criteria within each category. This allowed for customization to each practitioner's practice. Criteria were derived from the measures of academic and clinical proficiency, as well as quality metrics. Criteria were objective measures and data gathering was often automated. Reports could be generated that were updated daily and provided

  20. Women convicted of a sexual offence, including child pornography production: two case reports.

    Science.gov (United States)

    Prat, S; Bertsch, I; Chudzik, L; Réveillère, Ch

    2014-03-01

    All available studies addressing the clinical and legal aspects of child pornography have systematically concerned male abusers. The social lens through which women are viewed tends to play down their responsibility in the sexual abuse of children. Unlike men, women rarely abuse children outside the close or family circle. Furthermore, they have frequently been abused themselves in their childhood. To our knowledge, no cases of women charged with sex-related offences, including child pornography, have been described in the literature. The psychopathological characteristics of female sexual abusers and of the two women in our cases tend to suggest that the deliberate downloading of child pornography images by women is unusual, as their deviant behaviour is not related to paedophile sexual arousal It is hypothesized that the act enables women perpetrators to satisfy the sexual urges of their spouse. Sexual abuse by women exists, but the nature of the abuse appears to be specific to the gender of the perpetrator. We present two cases of women charged with sexual offences concerning minors, including the production of child pornography material. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  1. Report of panel 3: Concept improvement

    International Nuclear Information System (INIS)

    Dean, S.O.; Ripin, B.H.; Batchelor, D.; Berkner, K.; Kaye, S.M.; Logan, B.G.; Marmar, E.; Navratil, G.; Ellis, W.R.; Gentle, K.W.

    1992-01-01

    The charge to Panel 3 was to look at the idea of concept improvements in the context of US DOE management of the magnetic fusion program. The panel suggested that if DOE were commited to the idea of concept improvement, it needed to overcome the existing impression it was not receptive to new ideas. In part the long time scale for development of fusion energy, coupled with the rate of change of scientific programs and research based on emerging knowledge, means that in general the program will be much different ten to twenty years in the future. To be able to meet this changing direction, the US program must maintain an openness to look at promising alternative ideas, spend money on developing the ideas, and consider funding some to intermediate development levels. Stellerator research was offered as one alternative to consider in light of present international work. The panel urged supporting the development of new concepts and ideas, as well as continued support for plasma physics basic research

  2. Skin symptoms in four ectodermal dysplasia syndromes including two case reports of Rapp-Hodgkin-Syndrome.

    Science.gov (United States)

    Knaudt, Björn; Volz, Thomas; Krug, Markus; Burgdorf, Walter; Röcken, Martin; Berneburg, Mark

    2012-01-01

    The skin, hair and nail changes in four distinct ectodermal dysplasia syndromes are compared and reviewed. These syndromes comprise Christ-Siemens-Touraine syndrome; ectrodactyly, ectodermal dysplasia and cleft lip/palate syndrome; ankyloblepharon-ectodermal defects-cleft lip/palate syndrome and Rapp-Hodgkin syndrome. A comprehensive overview of the dermatological signs and symptoms in these syndromes was generated from the database of the Ectodermal Dysplasia Network Germany, the clinical findings in the patients seen in our department and an extensive review of the literature. The findings included abnormalities of skin, sweating, hair and nails. These clinical findings are discussed in relation to the underlying molecular defects known to play a role in these four ectodermal dysplasia syndromes.

  3. A Report Card on Continuous Quality Improvement

    Science.gov (United States)

    Blumenthal, David; Kilo, Charles M.

    1998-01-01

    Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; there is a new focus on the health care customer; and many valuable projects have been inaugurated. Nevertheless, the interviews underlined the reality that the movement has not yet made a sizable impact on the U.S. health care system. Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved. PMID:9879305

  4. Improvement in Detection of Wrong-Patient Errors When Radiologists Include Patient Photographs in Their Interpretation of Portable Chest Radiographs.

    Science.gov (United States)

    Tridandapani, Srini; Olsen, Kevin; Bhatti, Pamela

    2015-12-01

    This study was conducted to determine whether facial photographs obtained simultaneously with radiographs improve radiologists' detection rate of wrong-patient errors, when they are explicitly asked to include the photographs in their evaluation. Radiograph-photograph combinations were obtained from 28 patients at the time of portable chest radiography imaging. From these, pairs of radiographs were generated. Each unique pair consisted of one new and one old (comparison) radiograph. Twelve pairs of mismatched radiographs (i.e., pairs containing radiographs of different patients) were also generated. In phase 1 of the study, 5 blinded radiologist observers were asked to interpret 20 pairs of radiographs without the photographs. In phase 2, each radiologist interpreted another 20 pairs of radiographs with the photographs. Radiologist observers were not instructed about the purpose of the photographs but were asked to include the photographs in their review. The detection rate of mismatched errors was recorded along with the interpretation time for each session for each observer. The two-tailed Fisher exact test was used to evaluate differences in mismatch detection rates between the two phases. A p value of error detection rates without (0/20 = 0%) and with (17/18 = 94.4%) photographs were different (p = 0.0001). The average interpretation times for the set of 20 radiographs were 26.45 (SD 8.69) and 20.55 (SD 3.40) min, for phase 1 and phase 2, respectively (two-tailed Student t test, p = 0.1911). When radiologists include simultaneously obtained photographs in their review of portable chest radiographs, there is a significant improvement in the detection of labeling errors. No statistically significant difference in interpretation time was observed. This may lead to improved patient safety without affecting radiologists' throughput.

  5. Improving plant bioaccumulation science through consistent reporting of experimental data.

    Science.gov (United States)

    Fantke, Peter; Arnot, Jon A; Doucette, William J

    2016-10-01

    Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent data collection and reporting requirements, the information generated is often less useful than it could be for direct applications in chemical assessments and for model development and refinement. We review existing testing guidelines, common data reporting practices, and provide recommendations for revising testing guidelines and reporting requirements to improve bioaccumulation knowledge and models. This analysis provides a list of experimental parameters that will help to develop high quality datasets and support modeling tools for assessing bioaccumulation of organic chemicals in plants and ultimately addressing uncertainty in ecological and human health risk assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Composting of soils/sediments and sludges containing toxic organics including high energy explosives. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, R.C.; Kitchens, J.F.

    1993-07-01

    Laboratory and pilot-scale experimentation were conducted to evaluate composting as an on-site treatment technology to remediate soils contaminated with hazardous waste at DOE`s PANTEX Plant. Suspected contaminated sites within the PANTEX Plant were sampled and analyzed for explosives, other organics, and inorganic wastes. Soils in drainage ditches and playas at PANTEX Plant were found to be contaminated with low levels of explosives (including RDX, HMX, PETN and TATB). Additional sites previously used for solvent disposal were heavily contaminated with solvents and transformation products of the solvent, as well as explosives and by-products of explosives. Laboratory studies were conducted using {sup 14}C-labeled explosives and {sup 14}C-labeled diacetone alcohol contaminated soil loaded into horse manure/hay composts at three rates: 20, 30, and 40%(W/W). The composts were incubated for six weeks at approximately 60{degree}C with continuous aeration. All explosives degraded rapidly and were reduced to below detection limits within 3 weeks in the laboratory studies. {sup 14}C-degradates from {sup 14}C-RDX, {sup 14}C-HMX and {sup 14}C-TATB were largely limited to {sup 14}CO{sub 2} and unextracted residue in the compost. Volatile and non-volatile {sup 14}C-degradates were found to result from {sup 14}C-PETN breakdown, but these compounds were not identified. {sup 14}C-diacetone alcohol concentrations were significantly reduced during composting. However, most of the radioactivity was volatilized from the compost as non-{sup 14}CO{sub 2} degradates or as {sup 14}C-diacetone alcohol. Pilot scale composts loaded with explosives contaminated soil at 30% (W/W) with intermittent aeration were monitored over six weeks. Data from the pilot-scale study generally was in agreement with the laboratory studies. However, the {sup 14}C-labeled TATB degraded much faster than the unlabeled TATB. Some formulations of TATB may be more resistant to composting activity than others.

  7. Low-rank coal research annual report, July 1, 1989--June 30, 1990 including quarterly report, April--June 1990

    Energy Technology Data Exchange (ETDEWEB)

    1990-11-01

    Research programs in the following areas are presented: control technology and coal preparation; advance research and technology development; combustion; liquefaction; and gasification. Sixteen projects are included. Selected items have been processed separately for inclusion in the Energy Science and Technology Database.

  8. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique.

    Science.gov (United States)

    Basheti, Iman A; Armour, Carol L; Bosnic-Anticevich, Sinthia Z; Reddel, Helen K

    2008-07-01

    To evaluate the feasibility, acceptability and effectiveness of a brief intervention about inhaler technique, delivered by community pharmacists to asthma patients. Thirty-one pharmacists received brief workshop education (Active: n=16, CONTROL: n=15). Active Group pharmacists were trained to assess and teach dry powder inhaler technique, using patient-centered educational tools including novel Inhaler Technique Labels. Interventions were delivered to patients at four visits over 6 months. At baseline, patients (Active: 53, CONTROL: 44) demonstrated poor inhaler technique (mean+/-S.D. score out of 9, 5.7+/-1.6). At 6 months, improvement in inhaler technique score was significantly greater in Active cf. CONTROL patients (2.8+/-1.6 cf. 0.9+/-1.4, p<0.001), and asthma severity was significantly improved (p=0.015). Qualitative responses from patients and pharmacists indicated a high level of satisfaction with the intervention and educational tools, both for their effectiveness and for their impact on the patient-pharmacist relationship. A simple feasible intervention in community pharmacies, incorporating daily reminders via Inhaler Technique Labels on inhalers, can lead to improvement in inhaler technique and asthma outcomes. Brief training modules and simple educational tools, such as Inhaler Technique Labels, can provide a low-cost and sustainable way of changing patient behavior in asthma, using community pharmacists as educators.

  9. Report on a collection of Hydroida from the Caribbean region, including an annotated checklist of Caribbean Hydroids

    NARCIS (Netherlands)

    Vervoort, W.

    1968-01-01

    INTRODUCTION The present report deals with a collection of Hydroids from the Zoological Museum, Munich, German Federal Republic (Zoologische Sammlung des Bayerischen Staates, München), collected during various expeditions in the Caribbean region. I have thought it advisable to include in this report

  10. The IOM report on improving diagnosis: new concepts.

    Science.gov (United States)

    Graber, Mark L

    2015-12-01

    The IOM report 'Improving Diagnosis in Health Care' represents a major advance in summarizing the problem of diagnostic error. Three new concepts in the report will be helpful in future efforts to understand and improve the diagnostic process: a new definition of diagnostic error, a new framework for understanding the diagnostic process, and a new concept of the diagnostic 'team'. This paper highlights these new concepts and their relevance to improving diagnosis.

  11. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Proceedings of a final research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    The Co-ordinated Research Programme (CRP) on Improvement of Basic Food Crops in Africa Through Plant Breeding, Including the Use of Induced Mutations, funded by the Italian Government, was initiated in 1989 in the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture. The primary objective of this CRP was to breed improved varieties of stable food crops of Africa with the main emphasis on the indigenous species and their local cultivars. The fourth and final Research Co-ordination meeting under the CRP was held in Naples, Italy from 30 October - 3 November 1995. This publication includes the reports, conclusions and recommendations made by the participants. We hope that it will be of value to researchers, students and policy makers alike in their endeavour to promote plant breeding and increase food productions in Africa. Refs, figs, tabs.

  12. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Proceedings of a final research co-ordination meeting

    International Nuclear Information System (INIS)

    1997-07-01

    The Co-ordinated Research Programme (CRP) on Improvement of Basic Food Crops in Africa Through Plant Breeding, Including the Use of Induced Mutations, funded by the Italian Government, was initiated in 1989 in the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture. The primary objective of this CRP was to breed improved varieties of stable food crops of Africa with the main emphasis on the indigenous species and their local cultivars. The fourth and final Research Co-ordination meeting under the CRP was held in Naples, Italy from 30 October - 3 November 1995. This publication includes the reports, conclusions and recommendations made by the participants. We hope that it will be of value to researchers, students and policy makers alike in their endeavour to promote plant breeding and increase food productions in Africa. Refs, figs, tabs

  13. Structured reporting of MRI of the shoulder - improvement of report quality?

    Energy Technology Data Exchange (ETDEWEB)

    Gassenmaier, Sebastian; Armbruster, Marco; Sommer, Wieland H.; Sommer, Nora N. [Ludwig-Maximilians-University (LMU), Department of Clinical Radiology, Munich (Germany); Haasters, Florian [Schoen Klinik Muenchen Harlaching, Department of Knee, Hip and Shoulder Surgery, Munich (Germany); Ludwig-Maximilians-University (LMU), Department of General, Trauma and Reconstructive Surgery, Munich (Germany); Helfen, Tobias [Ludwig-Maximilians-University (LMU), Department of General, Trauma and Reconstructive Surgery, Munich (Germany); Henzler, Thomas [University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, Heidelberg (Germany); Alibek, Sedat [Ambulatory Health Care Center Radiology and Nuclear Medicine, Fuerth (Germany); Friedrich-Alexander University, Department of Diagnostic Radiology, Erlangen-Nuremberg (Germany); Pfoerringer, Dominik [Klinikum rechts der Isar, Technical University of Munich, Department of Trauma Surgery, Munich (Germany)

    2017-10-15

    To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. (orig.)

  14. Structured reporting of MRI of the shoulder - improvement of report quality?

    International Nuclear Information System (INIS)

    Gassenmaier, Sebastian; Armbruster, Marco; Sommer, Wieland H.; Sommer, Nora N.; Haasters, Florian; Helfen, Tobias; Henzler, Thomas; Alibek, Sedat; Pfoerringer, Dominik

    2017-01-01

    To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. (orig.)

  15. Impact of a multifaceted educational intervention including serious games to improve the management of invasive candidiasis in critically ill patients.

    Science.gov (United States)

    Ferrer, R; Zaragoza, R; Llinares, P; Maseda, E; Rodríguez, A; Quindós, G

    Infections caused by Candida species are common in critically ill patients and contribute to significant morbidity and mortality. The EPICO Project (Epico 1 and Epico 2.0 studies) recently used a Delphi approach to elaborate guidelines for the diagnosis and treatment of this condition in critically ill adult patients. We aimed to evaluate the impact of a multifaceted educational intervention based on the Epico 1 and Epico 2.0 recommendations. Specialists anonymously responded to two online surveys before and after a multifaceted educational intervention consisting of 60-min educational sessions, the distribution of slide kits and pocket guides with the recommendations, and an interactive virtual case presented at a teleconference and available for online consultation. A total of 74 Spanish hospitals. Specialists of the Intensive Care Units in the participating hospitals. Specialist knowledge and reported practices evaluated using a survey. The McNemar test was used to compare the responses in the pre- and post-intervention surveys. A total of 255 and 248 specialists completed both surveys, in both periods, respectively. The pre-intervention surveys showed many specialists to be unaware of the best approach for managing invasive candidiasis. After both educational interventions, specialist knowledge and reported practices were found to be more in line with nearly all the recommendations of the Epico 1 and Epico 2.0 guidelines, except as regards de-escalation from echinocandins to fluconazole in Candida glabrata infections (p=0.055), and the duration of antifungal treatment in both candidemia and peritoneal candidiasis. This multifaceted educational intervention based on the Epico Project recommendations improved specialist knowledge of the management of invasive candidiasis in critically ill patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  16. Using Patient-Reported Information to Improve Clinical Practice.

    Science.gov (United States)

    Schlesinger, Mark; Grob, Rachel; Shaller, Dale

    2015-12-01

    To assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. Existing literature (gray and peer-reviewed) on measuring patient experience and patient-reported outcomes, identified from Medline and Cochrane databases; evaluations of pay-for-performance programs in the United States, Europe, and the Commonwealth countries. We analyzed (1) studies of pay-for-performance, to identify those including metrics for patient experience, and (2) studies of patient experience and of patient-reported outcomes to identify evidence of influence on clinical practice, whether through public reporting or private reporting to clinicians. First, we identify four forms of "patient-reported information" (PRI), each with distinctive roles shaping clinical practice: (1) patient-reported outcomes measuring self-assessed physical and mental well-being, (2) surveys of patient experience with clinicians and staff, (3) narrative accounts describing encounters with clinicians in patients' own words, and (4) complaints/grievances signaling patients' distress when treatment or outcomes fall short of expectations. Because these forms vary in crucial ways, each must be distinctively measured, deployed, and linked with financial incentives. Second, although the literature linking incentives to patients experience is limited, implementing pay-for-performance systems appears to threaten certain patient-valued aspects of health care. But incentives can be made compatible with the outcomes patients value if: (a) a sufficient portion of incentives is tied to patient-reported outcomes and experiences, (b) incentivized forms of PRI are complemented by other forms of patient feedback, and (c) health care organizations assist clinicians to interpret and respond to PRI. Finally, we identify roles for the

  17. Statistical reviewers improve reporting in biomedical articles: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Erik Cobo

    2007-03-01

    Full Text Available Although peer review is widely considered to be the most credible way of selecting manuscripts and improving the quality of accepted papers in scientific journals, there is little evidence to support its use. Our aim was to estimate the effects on manuscript quality of either adding a statistical peer reviewer or suggesting the use of checklists such as CONSORT or STARD to clinical reviewers or both.Interventions were defined as 1 the addition of a statistical reviewer to the clinical peer review process, and 2 suggesting reporting guidelines to reviewers; with "no statistical expert" and "no checklist" as controls. The two interventions were crossed in a 2x2 balanced factorial design including original research articles consecutively selected, between May 2004 and March 2005, by the Medicina Clinica (Barc editorial committee. We randomized manuscripts to minimize differences in terms of baseline quality and type of study (intervention, longitudinal, cross-sectional, others. Sample-size calculations indicated that 100 papers provide an 80% power to test a 55% standardized difference. We specified the main outcome as the increment in quality of papers as measured on the Goodman Scale. Two blinded evaluators rated the quality of manuscripts at initial submission and final post peer review version. Of the 327 manuscripts submitted to the journal, 131 were accepted for further review, and 129 were randomized. Of those, 14 that were lost to follow-up showed no differences in initial quality to the followed-up papers. Hence, 115 were included in the main analysis, with 16 rejected for publication after peer review. 21 (18.3% of the 115 included papers were interventions, 46 (40.0% were longitudinal designs, 28 (24.3% cross-sectional and 20 (17.4% others. The 16 (13.9% rejected papers had a significantly lower initial score on the overall Goodman scale than accepted papers (difference 15.0, 95% CI: 4.6-24.4. The effect of suggesting a guideline to the

  18. Improvements in scaling of counter-current imbibition recovery curves using a shape factor including permeability anisotropy

    Science.gov (United States)

    Abbasi, Jassem; Sarafrazi, Shiva; Riazi, Masoud; Ghaedi, Mojtaba

    2018-02-01

    Spontaneous imbibition is the main oil production mechanism in the water invaded zone of a naturally fractured reservoir (NFR). Different scaling equations have been presented in the literature for upscaling of core scale imbibition recovery curves to field scale matrix blocks. Various scale dependent parameters such as gravity effects and boundary influences are required to be considered in the upscaling process. Fluid flow from matrix blocks to the fracture system is highly dependent on the permeability value in the horizontal and vertical directions. The purpose of this study is to include permeability anisotropy in the available scaling equations to improve the prediction of imbibition assisted oil production in NFRs. In this paper, a commercial reservoir simulator was used to obtain imbibition recovery curves for different scenarios. Then, the effect of permeability anisotropy on imbibition recovery curves was investigated, and the weakness of the existing scaling equations for anisotropic rocks was demonstrated. Consequently, an analytical shape factor was introduced that can better scale all the curves related to anisotropic matrix blocks.

  19. Improving Manufacturing Performance in South Africa : Report of the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    1995-01-01

    Improving Manufacturing Performance in South Africa : Report of the Industrial Strategy Project. Couverture du livre Improving Manufacturing Performance in South Africa. Author(s):. Avril Joffe, David Kaplan, Raphael Kaplinsky et David Lewis. Publisher(s):. UCT Press, CRDI. January 1, 1995. ISBN: Épuisé. 264 pages.

  20. Report: EPA’s Fleet Management Program Needs Improvement

    Science.gov (United States)

    Report #15-P-0001, October 6, 2014. If oversight of the EPA’s fleet is not improved, the $6 million-per-year program could be ineffective and inefficient in supporting the agency’s mission and reporting data to the federal system.

  1. Diagnosing and reporting of occupational diseases: a quality improvement study

    NARCIS (Netherlands)

    Spreeuwers, D.; de Boer, A. G. E. M.; Verbeek, J. H. A. M.; van Beurden, M. M.; van Dijk, F. J. H.

    2008-01-01

    AIM: To assess the need for quality improvement of diagnosing and reporting of noise-induced occupational hearing loss and occupational adjustment disorder. METHODS: Performance indicators and criteria for the quality of diagnosing and reporting were developed. Self-assessment questionnaires were

  2. Improving Reports Turnaround Time: An Essential Healthcare Quality Dimension.

    Science.gov (United States)

    Khan, Mustafa; Khalid, Parwaiz; Al-Said, Youssef; Cupler, Edward; Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Turnaround time is one of the most important healthcare performance indicators. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on reducing the reports turnaround time of the neurophysiology lab from more than two weeks to only five working days for 90% of cases. The main quality improvement methodology used was the FOCUS PDCA. Using root cause analysis, Pareto analysis and qualitative survey methods, the main factors contributing to the delay of turnaround time and the suggested improvement strategies were identified and implemented, through restructuring transcriptionists daily tasks, rescheduling physicians time and alerting for new reports, engaging consultants, consistent coordination and prioritizing critical reports. After implementation; 92% of reports are verified within 5 days compared to only 6% before implementation. 7% of reports were verified in 5 days to 2 weeks and only 1% of reports needed more than 2 weeks compared to 76% before implementation.

  3. Improving global environmental management with standard corporate reporting

    Science.gov (United States)

    Kareiva, Peter M.; McNally, Brynn W.; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-01-01

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough—also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers. PMID:26082543

  4. Improving global environmental management with standard corporate reporting.

    Science.gov (United States)

    Kareiva, Peter M; McNally, Brynn W; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-06-16

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough--also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers.

  5. A review of sex differences in sexual jealousy, including self-report data, psychophysiological responses, interpersonal violence, and morbid jealousy.

    Science.gov (United States)

    Harris, Christine R

    2003-01-01

    The specific innate modular theory of jealousy hypothesizes that natural selection shaped sexual jealousy as a mechanism to prevent cuckoldry, and emotional jealousy as a mechanism to prevent resource loss. Therefore, men should be primarily jealous over a mate's sexual infidelity and women over a mate's emotional infidelity. Five lines of evidence have been offered as support: self-report responses, psychophysiological data, domestic violence (including spousal abuse and homicide), and morbid jealousy cases. This article reviews each line of evidence and finds only one hypothetical measure consistent with the hypothesis. This, however, is contradicted by a variety of other measures (including reported reactions to real infidelity). A meta-analysis of jealousy-inspired homicides, taking into account base rates for murder, found no evidence that jealousy disproportionately motivates men to kill. The findings are discussed from a social-cognitive theoretical perspective.

  6. Report: EPA Improved Its National Security Information Program, but Some Improvements Still Needed

    Science.gov (United States)

    Report #16-P-0196, June 2, 2016. The EPA will continue to improve its national security information program by completing information classification guides that can be used uniformly and consistently throughout the agency.

  7. How novice, skilled and advanced clinical researchers include variables in a case report form for clinical research: a qualitative study.

    Science.gov (United States)

    Chu, Hongling; Zeng, Lin; Fetters, Micheal D; Li, Nan; Tao, Liyuan; Shi, Yanyan; Zhang, Hua; Wang, Xiaoxiao; Li, Fengwei; Zhao, Yiming

    2017-09-18

    Despite varying degrees in research training, most academic clinicians are expected to conduct clinical research. The objective of this research was to understand how clinical researchers of different skill levels include variables in a case report form for their clinical research. The setting for this research was a major academic institution in Beijing, China. The target population was clinical researchers with three levels of experience, namely, limited clinical research experience, clinicians with rich clinical research experience and clinical research experts. Using a qualitative approach, we conducted 13 individual interviews (face to face) and one group interview (n=4) with clinical researchers from June to September 2016. Based on maximum variation sampling to identify researchers with three levels of research experience: eight clinicians with limited clinical research experience, five clinicians with rich clinical research experience and four clinical research experts. These 17 researchers had diverse hospital-based medical specialties and or specialisation in clinical research. Our analysis yields a typology of three processes developing a case report form that varies according to research experience level. Novice clinician researchers often have an incomplete protocol or none at all, and conduct data collection and publication based on a general framework. Experienced clinician researchers include variables in the case report form based on previous experience with attention to including domains or items at risk for omission and by eliminating unnecessary variables. Expert researchers consider comprehensively in advance data collection and implementation needs and plan accordingly. These results illustrate increasing levels of sophistication in research planning that increase sophistication in selection for variables in the case report form. These findings suggest that novice and intermediate-level researchers could benefit by emulating the comprehensive

  8. Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs.

    Science.gov (United States)

    Wells, Timothy S; Ozminkowski, Ronald J; McGinn, Michael P; Hawkins, Kevin; Bhattarai, Gandhi R; Serxner, Seth A; Greame, Chris

    2017-06-01

    Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes.

  9. Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2015-01-01

    Conclusion: Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects.

  10. Development of a Web-Based Quality Dashboard Including a Toolbox to Improve Pain Management in Dutch Intensive Care

    NARCIS (Netherlands)

    Roos-Blom, Marie-José; Gude, Wouter T.; de Jonge, Evert; Spijkstra, Jan Jaap; van der Veer, Sabine N.; Dongelmans, Dave A.; de Keizer, Nicolette F.

    2017-01-01

    Audit and feedback (A&F) is a common strategy to improve quality of care. Meta-analyses have indicated that A&F may be more effective in realizing desired change when baseline performance is low, it is delivered by a supervisor or colleague, it is provided frequently and in a timely manner, it is

  11. The use of a proforma improves colorectal cancer pathology reporting.

    Science.gov (United States)

    Rigby, K.; Brown, S. R.; Lakin, G.; Balsitis, M.; Hosie, K. B.

    1999-01-01

    The detail and accuracy of pathological reporting for colorectal cancer is becoming increasingly recognised as important in the overall management of the patient. However, there is criticism of the variable standards of reporting. We assessed how the use of a proforma affected the completeness of reporting within one hospital. Data on all colorectal cancer patients attending one teaching hospital has been collected prospectively over a 15 month period from 1997 to 1998. The Royal College of Surgeons/Association of Coloproctology proforma lists all items considered to be essential for a complete pathological report of colorectal cancer. Its introduction in September 1997 allowed us to compare reporting before the proforma to that after. Of 54 patients, 46 (85%) had one or more items missing from their report before introduction of the proforma compared with only 8/44 (18%) patients after the proforma (P < 0.001). Circumferential resection margins and apical node status were the items most often absent, being significantly more frequently reported after the proforma (P < 0.05 and P < 0.001, respectively). There was no difference in the median number of lymph nodes harvested after proforma introduction. The introduction of the proforma has not only resulted in improvements in reporting, but has increased the dialogue between surgical oncologists and pathologists. These features should result in improved overall management of the colorectal cancer patient. PMID:10655894

  12. Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To report the initial changes after quality-improvement programs based on STS-database in a Brazilian hospital. METHODS: Since 2011 a Brazilian hospital has joined STS-Database and in 2012 multifaceted actions based on STS reports were implemented aiming reductions in the time of mechanical ventilation and in the intensive care stay and also improvements in evidence-based perioperative therapies among patients who underwent coronary artery bypass graft surgeries. RESULTS: All the 947 patients submitted to coronary artery bypass graft surgeries from July 2011 to June 2014 were analyzed and there was an improvement in all the three target endpoints after the implementation of the quality-improvement program but the reduction in time on mechanical ventilation was not statistically significant after adjusting for prognostic characteristics. CONCLUSION: The initial experience with STS registry in a Brazilian hospital was associated with improvement in most of targeted quality-indicators.

  13. Improving the accuracy of self-assessment of practical clinical skills using video feedback--the importance of including benchmarks.

    Science.gov (United States)

    Hawkins, S C; Osborne, A; Schofield, S J; Pournaras, D J; Chester, J F

    2012-01-01

    Isolated video recording has not been demonstrated to improve self-assessment accuracy. This study examines if the inclusion of a defined standard benchmark performance in association with video feedback of a student's own performance improves the accuracy of student self-assessment of clinical skills. Final year medical students were video recorded performing a standardised suturing task in a simulated environment. After the exercise, the students self-assessed their performance using global rating scales (GRSs). An identical self-assessment process was repeated following video review of their performance. Students were then shown a video-recorded 'benchmark performance', which was specifically developed for the study. This demonstrated the competency levels required to score full marks (30 points). A further self-assessment task was then completed. Students' scores were correlated against expert assessor scores. A total of 31 final year medical students participated. Student self-assessment scores before video feedback demonstrated moderate positive correlation with expert assessor scores (r = 0.48, p benchmark performance demonstration, self-assessment scores demonstrated a very strong positive correlation with expert scores (r = 0.83, p benchmark performance in combination with video feedback may significantly improve the accuracy of students' self-assessments.

  14. Improving Communication of Diagnostic Radiology Findings through Structured Reporting

    Science.gov (United States)

    Panicek, David M.; Berk, Alexandra R.; Li, Yuelin; Hricak, Hedvig

    2011-01-01

    Purpose: To compare the content, clarity, and clinical usefulness of conventional (ie, free-form) and structured radiology reports of body computed tomographic (CT) scans, as evaluated by referring physicians, attending radiologists, and radiology fellows at a tertiary care cancer center. Materials and Methods: The institutional review board approved the study as a quality improvement initiative; no written consent was required. Three radiologists, three radiology fellows, three surgeons, and two medical oncologists evaluated 330 randomly selected conventional and structured radiology reports of body CT scans. For nonradiologists, reports were randomly selected from patients with diagnoses relevant to the physician’s area of specialization. Each physician read 15 reports in each format and rated both the content and clarity of each report from 1 (very dissatisfied or very confusing) to 10 (very satisfied or very clear). By using a previously published radiology report grading scale, physicians graded each report’s effectiveness in advancing the patient’s position on the clinical spectrum. Mixed-effects models were used to test differences between report types. Results: Mean content satisfaction ratings were 7.61 (95% confidence interval [CI]: 7.12, 8.16) for conventional reports and 8.33 (95% CI: 7.82, 8.86) for structured reports, and the difference was significant (P radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101913/-/DC1 PMID:21518775

  15. Rapid Improvement of thyroid storm-related hemodynamic collapse by aggressive anti-thyroid therapy including steroid pulse

    OpenAIRE

    Kiriyama, Hiroyuki; Amiya, Eisuke; Hatano, Masaru; Hosoya, Yumiko; Maki, Hisataka; Nitta, Daisuke; Saito, Akihito; Shiraishi, Yasuyuki; Minatsuki, Shun; Sato, Tatsuyuki; Murakami, Haruka; Uehara, Masae; Manaka, Katsunori; Makita, Noriko; Watanabe, Masafumi

    2017-01-01

    Abstract Rationale: Heart failure is relatively common in patients with hyperthyroidism, but thyrotoxic cardiomyopathy with poor left ventricular (LV) systolic function is very rare. Patient concerns: We experienced a representative case of a patient who presented with severe LV dysfunction related to thyroid storm and needed extracorporeal membrane oxygenation (ECMO) temporally. Diagnosis: Thyrotoxic cardiomyopathy. Interventions and Outcomes: Aggressive antithyroid therapy, including steroi...

  16. Novel feed including bioactive compounds from winery wastes improved broilers' redox status in blood and tissues of vital organs.

    Science.gov (United States)

    Makri, Sotiria; Kafantaris, Ioannis; Stagos, Dimitrios; Chamokeridou, Theodora; Petrotos, Konstantinos; Gerasopoulos, Konstantinos; Mpesios, Anastasios; Goutzourelas, Nikolaos; Kokkas, Stylianos; Goulas, Panagiotis; Komiotis, Dimitrios; Kouretas, Dimitrios

    2017-04-01

    Currently, there is a great interest in the production of animal feed with antioxidant activity. The aim of this study was to examine the potential antioxidant effects of a feed supplemented with grape pomace (GP), a winery by-product with high environmental load, in chickens. Broilers of 15 days post birth were separated into two groups fed either with standard diet or with diet supplemented with GP for 35 days. Blood and tissues collections were performed after feeding for 15 and 35 days with the experimental diet (i.e. at 30 and 50 days post birth). Free radical toxicity markers, namely thiobarbituric acid reactive substances, protein carbonyls, total antioxidant capacity, reduced glutathione, catalase activity and rate of H 2 O 2 decomposition were determined in blood and tissues of vital organs. The results indicated that feed supplemented with GP decreased oxidative stress-induced toxic effects and improved chickens' redox status, and so it may also improve their wellness and productivity. On the other hand, this exploitation of GP may solve problems of environmental pollution in areas with wineries. Copyright © 2017. Published by Elsevier Ltd.

  17. Improving ecological risk assessment by including bioavailability into species sensitivity distributions: An example for plants exposed to nickel in soil

    International Nuclear Information System (INIS)

    Semenzin, Elena; Temminghoff, Erwin J.M.; Marcomini, Antonio

    2007-01-01

    The variability of species sensitivity distribution (SSD) due to contaminant bioavailability in soil was explored by using nickel as metal of concern. SSDs of toxicity test results of Avena sativa L. originating from different soils and expressed as total content and available (0.01 M CaCl 2 ) extractable concentration were compared to SSDs for terrestrial plants derived from literature toxicity data. Also the 'free' nickel (Ni 2+ ) concentration was calculated and compared. The results demonstrated that SSDs based on total nickel content highly depend on the experimental conditions set up for toxicity testing (i.e. selected soil and pH value) and thus on metal bioavailability in soil, resulting in an unacceptable uncertainty for ecological risk estimation. The use in SSDs of plant toxicity data expressed as 0.01 M CaCl 2 extractable metal strongly reduced the uncertainty in the SSD curve and thus can improve the ERA procedure remarkably by taking bioavailability into account. - The use of bioavailability toxicity data can improve species sensitivity distribution (SSD) curves and thus ecological risk assessment (ERA)

  18. Improving user-insurance communication on accident reports

    OpenAIRE

    Fardoun, Habib Moussa; Alghazzawi, Daniyal M.; Paules Ciprés, Antonio

    2014-01-01

    This paper presents an easy to use methodology and system for insurance companies targeting at managing traffic accidents reports process. The main objective is to facilitate and accelerate the process of creating and finalizing the necessary accident reports in cases without mortal victims involved. The diverse entities participating in the process from the moment an accident occurs until the related final actions needed are included. Nowadays, this market is limited to the consulting platfo...

  19. Radiation-curing of acrylate composites including carbon fibres: A customized surface modification for improving mechanical performances

    International Nuclear Information System (INIS)

    Martin, Arnaud; Pietras-Ozga, Dorota; Ponsaud, Philippe; Kowandy, Christelle; Barczak, Mariusz; Defoort, Brigitte; Coqueret, Xavier

    2014-01-01

    The lower transverse mechanical properties of radiation-cured acrylate-based composites reinforced with carbon-fibre with respect to the thermosettable analogues was investigated from the viewpoint of chemical interactions at the interface between the matrix and the carbon material. XPS analysis of representative commercial carbon fibres revealed the presence of a significant amount of chemical functions potentially exerting an adverse effect on the initiation and propagation of the free radical polymerization initiated under high energy radiation. The EB-induced polymerization of n-butyl acrylate as a simple model monomer was conducted in the presence of various aromatic additives exhibiting a strong inhibiting effect, whereas thiols efficiently sensitize the initiation mechanism and undergo transfer reactions. A method based on the surface modification of sized fibres by thiomalic acid is proposed for overcoming the localized inhibition phenomenon and for improving the mechanical properties of the resulting acrylate-based composites. - Highlights: • Surface functions of C-fibres are analyzed for their effect on radical reaction. • Irradiation of nBu-acrylate in presence of aromatic additives reveals inhibition. • Thiol groups sensitize the radiation-initiated polymerization of nBu-acrylate. • Modification of C-fibres with thiomalic acid enhances composite properties

  20. An improved coupled-states approximation including the nearest neighbor Coriolis couplings for diatom-diatom inelastic collision

    Science.gov (United States)

    Yang, Dongzheng; Hu, Xixi; Zhang, Dong H.; Xie, Daiqian

    2018-02-01

    Solving the time-independent close coupling equations of a diatom-diatom inelastic collision system by using the rigorous close-coupling approach is numerically difficult because of its expensive matrix manipulation. The coupled-states approximation decouples the centrifugal matrix by neglecting the important Coriolis couplings completely. In this work, a new approximation method based on the coupled-states approximation is presented and applied to time-independent quantum dynamic calculations. This approach only considers the most important Coriolis coupling with the nearest neighbors and ignores weaker Coriolis couplings with farther K channels. As a result, it reduces the computational costs without a significant loss of accuracy. Numerical tests for para-H2+ortho-H2 and para-H2+HD inelastic collision were carried out and the results showed that the improved method dramatically reduces the errors due to the neglect of the Coriolis couplings in the coupled-states approximation. This strategy should be useful in quantum dynamics of other systems.

  1. [Productivity of doctoral programs in Psychology with Quality Mention in journal articles included in Journal Citation Reports].

    Science.gov (United States)

    Musi-Lechuga, Bertha; Olivas-Ávila, José; Castro, Angel

    2011-08-01

    The main objective of the present study was to classify doctoral programs with Quality Mention in Psychology based on their scientific productivity. For this purpose, articles in the Web of Science published by professors teaching in these doctoral programs were analyzed. In addition, we analyzed scientific journals in which these professors tend to publish more papers and the evolution in the number of papers published until 2009. Results showed that the most productive doctoral program was the Neurosciences program at the University of Oviedo. This program showed a ratio of 40 articles--published in journals included in Journal Citation Reports--by each professor. In contrast, other programs did not reach a ratio of 10 articles per professor. Regarding journals, results showed that 9 out of the 20 most popular journals are Hispanic and a gradual increase in the number of published papers was also observed. Lastly, results and implications for quality assessment are discussed.

  2. A Novel Reporting System to Improve Accuracy in Appendicitis Imaging

    Science.gov (United States)

    Godwin, Benjamin D.; Drake, Frederick T.; Simianu, Vlad V.; Shriki, Jabi E.; Hippe, Daniel S.; Dighe, Manjiri; Bastawrous, Sarah; Cuevas, Carlos; Flum, David; Bhargava, Puneet

    2015-01-01

    OBJECTIVE The purpose of this study was to ascertain if standardized radiologic reporting for appendicitis imaging increases diagnostic accuracy. MATERIALS AND METHODS We developed a standardized appendicitis reporting system that includes objective imaging findings common in appendicitis and a certainty score ranging from 1 (definitely not appendicitis) through 5 (definitely appendicitis). Four radiologists retrospectively reviewed the preoperative CT scans of 96 appendectomy patients using our reporting system. The presence of appendicitis-specific imaging findings and certainty scores were compared with final pathology. These comparisons were summarized using odds ratios (ORs) and the AUC. RESULTS The appendix was visualized on CT in 89 patients, of whom 71 (80%) had pathologically proven appendicitis. Imaging findings associated with appendicitis included appendiceal diameter (odds ratio [OR] = 14 [> 10 vs appendicitis. In this initially indeterminate group, using the standardized reporting system, radiologists assigned higher certainty scores (4 or 5) in 21 of the 28 patients with appendicitis (75%) and lower scores (1 or 2) in five of the seven patients without appendicitis (71%) (AUC = 0.90; p = 0.001). CONCLUSION Standardized reporting and grading of objective imaging findings correlated well with postoperative pathology and may decrease the number of CT findings reported as indeterminate for appendicitis. Prospective evaluation of this reporting system on a cohort of patients with clinically suspected appendicitis is currently under way. PMID:26001230

  3. Evaluation of the 235U prompt fission neutron spectrum including a detailed analysis of experimental data and improved model information

    Science.gov (United States)

    Neudecker, Denise; Talou, Patrick; Kahler, Albert C.; White, Morgan C.; Kawano, Toshihiko

    2017-09-01

    We present an evaluation of the 235U prompt fission neutron spectrum (PFNS) induced by thermal to 20-MeV neutrons. Experimental data and associated covariances were analyzed in detail. The incident energy dependence of the PFNS was modeled with an extended Los Alamos model combined with the Hauser-Feshbach and the exciton models. These models describe prompt fission, pre-fission compound nucleus and pre-equilibrium neutron emissions. The evaluated PFNS agree well with the experimental data included in this evaluation, preliminary data of the LANL and LLNL Chi-Nu measurement and recent evaluations by Capote et al. and Rising et al. However, they are softer than the ENDF/B-VII.1 (VII.1) and JENDL-4.0 PFNS for incident neutron energies up to 2 MeV. Simulated effective multiplication factors keff of the Godiva and Flattop-25 critical assemblies are further from the measured keff if the current data are used within VII.1 compared to using only VII.1 data. However, if this work is used with ENDF/B-VIII.0β2 data, simulated values of keff agree well with the measured ones.

  4. TWO-DIMENSIONAL STELLAR EVOLUTION CODE INCLUDING ARBITRARY MAGNETIC FIELDS. II. PRECISION IMPROVEMENT AND INCLUSION OF TURBULENCE AND ROTATION

    International Nuclear Information System (INIS)

    Li Linghuai; Sofia, Sabatino; Basu, Sarbani; Demarque, Pierre; Ventura, Paolo; Penza, Valentina; Bi Shaolan

    2009-01-01

    In the second paper of this series we pursue two objectives. First, in order to make the code more sensitive to small effects, we remove many approximations made in Paper I. Second, we include turbulence and rotation in the two-dimensional framework. The stellar equilibrium is described by means of a set of five differential equations, with the introduction of a new dependent variable, namely the perturbation to the radial gravity, that is found when the nonradial effects are considered in the solution of the Poisson equation. Following the scheme of the first paper, we write the equations in such a way that the two-dimensional effects can be easily disentangled. The key concept introduced in this series is the equipotential surface. We use the underlying cause-effect relation to develop a recurrence relation to calculate the equipotential surface functions for uniform rotation, differential rotation, rotation-like toroidal magnetic fields, and turbulence. We also develop a more precise code to numerically solve the two-dimensional stellar structure and evolution equations based on the equipotential surface calculations. We have shown that with this formulation we can achieve the precision required by observations by appropriately selecting the convergence criterion. Several examples are presented to show that the method works well. Since we are interested in modeling the effects of a dynamo-type field on the detailed envelope structure and global properties of the Sun, the code has been optimized for short timescales phenomena (down to 1 yr). The time dependence of the code has so far been tested exclusively to address such problems.

  5. An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.

    Science.gov (United States)

    Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan

    2014-03-20

    To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. We assessed clinicians' knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, pquality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.

  6. Improving patient safety in radiotherapy through error reporting and analysis

    International Nuclear Information System (INIS)

    Findlay, Ú.; Best, H.; Ottrey, M.

    2016-01-01

    Aim: To improve patient safety in radiotherapy (RT) through the analysis and publication of radiotherapy errors and near misses (RTE). Materials and methods: RTE are submitted on a voluntary basis by NHS RT departments throughout the UK to the National Reporting and Learning System (NRLS) or directly to Public Health England (PHE). RTE are analysed by PHE staff using frequency trend analysis based on the classification and pathway coding from Towards Safer Radiotherapy (TSRT). PHE in conjunction with the Patient Safety in Radiotherapy Steering Group publish learning from these events, on a triannual and summarised on a biennial basis, so their occurrence might be mitigated. Results: Since the introduction of this initiative in 2010, over 30,000 (RTE) reports have been submitted. The number of RTE reported in each biennial cycle has grown, ranging from 680 (2010) to 12,691 (2016) RTE. The vast majority of the RTE reported are lower level events, thus not affecting the outcome of patient care. Of the level 1 and 2 incidents reported, it is known the majority of them affected only one fraction of a course of treatment. This means that corrective action could be taken over the remaining treatment fractions so the incident did not have a significant impact on the patient or the outcome of their treatment. Analysis of the RTE reports demonstrates that generation of error is not confined to one professional group or to any particular point in the pathway. It also indicates that the pattern of errors is replicated across service providers in the UK. Conclusion: Use of the terminology, classification and coding of TSRT, together with implementation of the national voluntary reporting system described within this report, allows clinical departments to compare their local analysis to the national picture. Further opportunities to improve learning from this dataset must be exploited through development of the analysis and development of proactive risk management strategies

  7. A new safety event reporting system improves physician reporting in the surgical intensive care unit.

    Science.gov (United States)

    Schuerer, Douglas J E; Nast, Patricia A; Harris, Carolyn B; Krauss, Melissa J; Jones, Rebecca M; Boyle, Walter A; Buchman, Timothy G; Coopersmith, Craig M; Dunagan, W Claiborne; Fraser, Victoria J

    2006-06-01

    Medical errors are common, and physicians have notably been poor medical error reporters. In the SICU, reporting was generally poor and reporting by physicians was virtually nonexistent. This study was designed to observe changes in error reporting in an SICU when a new card-based system (SAFE) was introduced. Before implementation of the SAFE reporting system, education was given to all SICU healthcare providers. The SAFE system was introduced into the SICU for a 9-month period from March 2003 through November 2003, to replace an underused online system. Data were collected from the SAFE card reports and the online reporting systems during introduction, removal, and reimplementation of these cards. Reporting rates were calculated as number of reported events per 1,000 patient days. Reporting rates increased from 19 to 51 reports per 1,000 patient days after the SAFE cards were introduced into the ICU (preporting increased most, rising from 0.3 to 5.8 reports per 1,000 patient days; nursing reporting also increased from 18 to 39 reports per 1,000 patient days (both preporting declined to 0 reports per 1,000 patient days (p=0.01) and rose to 8.1 (p=0.001) when the cards were returned, similar to nursing results. A higher proportion of physician reports were events that caused harm compared with no effect (p reporting system, combined with appropriate education, improved overall reporting in the SICU, especially among physician providers. Nurses were more likely to use reporting systems than were physicians. Physician reports were more likely to be of events that caused harm.

  8. Using patient reported outcome measures in health services: A qualitative study on including people with low literacy skills and learning disabilities

    Directory of Open Access Journals (Sweden)

    Jahagirdar Deepa

    2012-11-01

    Full Text Available Abstract Background Patient reported outcome measures (PROMs are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated stakeholder views on the accessibility and use of PROMs to develop suggestions for more inclusive practice. Methods Taking PROMs recommended for chronic obstructive pulmonary disease (COPD as an example, we conducted 8 interviews with people with low literacy skills and/or learning disabilities, and 4 focus groups with 20 health professionals and people with COPD. Discussions covered the format and delivery of PROMs using the EQ-5D and St George Respiratory Questionnaire as prompts. Thematic framework analysis focused on three main themes: Accessibility, Ease of Use, and Contextual factors. Results Accessibility included issues concerning the questionnaire format, and suggestions for improvement included larger font sizes and more white space. Ease of Use included discussion about PROMs’ administration. While health professionals suggested PROMs could be completed in waiting rooms, patients preferred settings with more privacy and where they could access help from people they know. Contextual Factors included other challenges and wider issues associated with completing PROMs. While health professionals highlighted difficulties created by the system in managing patients with low literacy/learning disabilities, patient participants stressed that understanding the purpose of PROMs was important to reduce intimidation. Conclusions Adjusting PROMs’ format, giving an explicit choice of where patients can complete them, and clearly conveying PROMs’ purpose and benefit to patients may help to prevent inequality when using PROMs in health services.

  9. Report from SG 1.1: improving the performance of existing gas storages

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This report aims to identify underlying trends for improvements in the underground gas storage (UGS) industry. It highlights best practices and state-of-the-art technology used in operating gas storages. The core conclusions of this report are based on a survey, which was sent out to the member countries. A reply was received from 15 countries, represented by 22 companies/institutions, including more than 100 gas storage sites. This response represents some 30% of the total estimated world storage working volume. In the survey operators were asked to report on the following issues: - measures implemented to improve the performance, - current priorities for improvements, - most important drivers for improvement, - techniques used to analyze performance, - techniques used to optimize storage performance, - software packages used, - technology used for reservoir management, wells and surface facilities, - safety and environment. (author)

  10. Special report. New products that improve officer performance, safety.

    Science.gov (United States)

    1991-12-01

    The need for products that improve performance of security officers is counterbalanced these days by budgetary constraints. While this may limit major investments in security systems and personnel, less costly improvements or innovations might be worth considering. In this report, we will discuss four advances that may be valuable not only in hospital security, but in other industries as well. One of them, a smoke filter, was originally developed for the hotel industry. Another, a drug detection device, may replace the use of undercover agents or drug-sniffing' dogs in certain circumstances. The third new product is an economical patrol vehicle for parking facilities which might replace more costly vehicles such as golf carts or cars. The fourth product, a roving CCTV camera, is actually being tested at a Midwest medical center and may allow you to monitor areas of parking garages with cameras instead of officers on patrol.

  11. Efficiency improvements in pipeline transportation systems. Technical report, Task 3

    Energy Technology Data Exchange (ETDEWEB)

    Banks, W. F.; Horton, J. H.

    1977-01-01

    This report identifies those potential energy-conservative pipeline innovations that are most energy- and cost-effective, and formulates recommendations for the R, D, and D programs needed to exploit those opportunities. From a candidate field of over twenty classes of efficiency improvements, eight systems are recommended for pursuit. Most of these possess two highly important attributes: large potential energy savings and broad applicability outside the pipeline industry. The R, D, and D program for each improvement and the recommended immediate next step are described. The eight programs recommended for pursuit are: gas-fired combined-cycle compressor station; internally cooled internal combustion engine; methanol-coal slurry pipeline; methanol-coal slurry-fired and coal-fired engines; indirect-fired coal-burning combined-cycle pump station; fuel-cycle pump station; internal coatings in pipelines; and drag-reducing additives in liquid pipelines.

  12. Research work for improving LWR safety. 1991 annual report

    International Nuclear Information System (INIS)

    1992-08-01

    The work performed in 1991 for the PNS project centers on various phenomena of severe fuel damage and on selected aspects of a core meltdown accident, relating to aerosol behaviour and filter engineering, and to methods of assessing and minimizing the radiological impacts of a reactor accident. One paper included in this annual report summarizes the evaluation of experiments carried out in 1990 at the Wuerenlingen PROTEUS reactor. The 1991 task programme of the project for the first time included research into extreme load conditions affecting the containment in a core meltdown accident; first results are given of the experiments performed. (orig./DG) [de

  13. Final report on improved N15 analyser NOI-6e

    International Nuclear Information System (INIS)

    Meier, G.; Hollenthoner, S.

    1985-05-01

    This report gives a general view of the computerized NOI-6e nitrogen analyzer. The construction of the new prototype is described. The new version of the N15 analyzer together with the microcomputer program which has been developed improves the convenience of operation and also has high reliability. Many practical test measurements have been made. The most important result is the remarkable reduction of the standard deviation σsub(x): a standard deviation of less than 0.5% is achieved. We have not found such a low standard deviation in descriptions of similar analyzers which use emission spectroscopy

  14. DTU International Energy Report 2012: Energy efficiency improvements

    DEFF Research Database (Denmark)

    Increased energy efficiency can reduce global CO2 emissions over the period to 2050 with up to 25%. On the top of that large profits can be gained for very little investment. Energy efficiency improvements can save investment in new energy infrastructure, cut fuel costs, increase competitiveness...... and increase consumer welfare. Thus, it is natural for DTU International Energy Report 2012 to take up this issue and analyze the global, regional and national challenges in exploiting energy efficiency and promote research and development in energy efficiency....

  15. Event (error and near-miss) reporting and learning system for process improvement in radiation oncology.

    Science.gov (United States)

    Mutic, Sasa; Brame, R Scott; Oddiraju, Swetha; Parikh, Parag; Westfall, Melisa A; Hopkins, Merilee L; Medina, Angel D; Danieley, Jonathan C; Michalski, Jeff M; El Naqa, Issam M; Low, Daniel A; Wu, Bin

    2010-09-01

    evaluation of corrective measures and recognition of ineffective measures and efforts. The electronic system was relatively well accepted by personnel and resulted in minimal disruption of clinical work. Event reporting in the quarters with the fewest number of reported events, though voluntary, was almost four times greater than the most events reported in any one quarter with the paper-based system and remained consistent from the inception of the process through the date of this report. However, the acceptance was not universal, validating the need for improved education regarding reporting processes and systematic approaches to reporting culture development. Specially designed electronic event reporting systems in a radiotherapy setting can provide valuable data for process and patient safety improvement and are more effective reporting mechanisms than paper-based systems. Additional work is needed to develop methods that can more effectively utilize reported data for process improvement, including the development of standardized event taxonomy and a classification system for RT.

  16. 2003 Stewardship progress report : committed to continuous improvement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-12-01

    The stewardship initiative is a mandatory requirement for members of the Canadian Association of Petroleum Producers (CAPP). It involves performance management and benchmarking, voluntary audits and verification, as well as training and improved communication inside and outside the industry. This fourth annual progress report describes the environment, health, safety and socio-economic stewardship initiative. This report presents an aggregate of industry performance. Stewardship of Excellence awards were presented in 2003, celebrating outstanding performance by members who demonstrated their commitment to responsible development and continuous improvement within a business framework. The awards were presented in three categories, namely environment, health and safety, and socio-economic. Northrock Resources was presented with the award in the environment category for its voluntary waste gas reduction. The health and safety recognition went to Burlington Resources Canada Ltd. for superior office ergonomics, while the award in the socio-economic category was presented to Suncor Energy Inc. for Aboriginal business development. A brief overview of the achievements of each of these three companies was presented. tabs., figs.

  17. Progress report of Physics Division including Applied Mathematics and Computing Section. 1st October 1970 - 31st March 1971

    International Nuclear Information System (INIS)

    2004-01-01

    - the Critical Facility - have been assembled in France, where they are undergoing pre-shipment tests. No major problems have been reported. Civil engineering work on the cell to house the machine is well advanced and should be complete before the equipment arrives in August. A number of nuclear techniques are being considered for problems related to raw materials. These include photonuclear determination of heavy water, alpha backscattering determination of heavy minerals and the delayed neutron determination of fissile materials (author)

  18. Low-rank coal research. Final technical report, April 1, 1988--June 30, 1989, including quarterly report, April--June 1989

    Energy Technology Data Exchange (ETDEWEB)

    1989-12-31

    This work is a compilation of reports on ongoing research at the University of North Dakota. Topics include: Control Technology and Coal Preparation Research (SO{sub x}/NO{sub x} control, waste management), Advanced Research and Technology Development (turbine combustion phenomena, combustion inorganic transformation, coal/char reactivity, liquefaction reactivity of low-rank coals, gasification ash and slag characterization, fine particulate emissions), Combustion Research (fluidized bed combustion, beneficiation of low-rank coals, combustion characterization of low-rank coal fuels, diesel utilization of low-rank coals), Liquefaction Research (low-rank coal direct liquefaction), and Gasification Research (hydrogen production from low-rank coals, advanced wastewater treatment, mild gasification, color and residual COD removal from Synfuel wastewaters, Great Plains Gasification Plant, gasifier optimization).

  19. Self-Reported Health Experiences of Children Living with Congenital Heart Defects: Including Patient-Reported Outcomes in a National Cohort Study.

    Science.gov (United States)

    Knowles, Rachel Louise; Tadic, Valerija; Hogan, Ailbhe; Bull, Catherine; Rahi, Jugnoo Sangeeta; Dezateux, Carol

    2016-01-01

    Understanding children's views about living with congenital heart defects (CHDs) is fundamental to supporting their successful participation in daily life, school and peer relationships. As an adjunct to a health and quality of life outcomes questionnaire, we asked school-age children who survived infant heart procedures to describe their experiences of living with CHDs. In a UK-wide cohort study, children aged 10 to 14 years with CHDs self-completed postal questionnaires that included an open question about having a 'heart problem'. We compared the characteristics of children with more and less severe cardiac diagnoses and, through collaborative inductive content analysis, investigated the subjective experiences and coping strategies described by children in both clinical severity groups. Text and/or drawings were returned by 436 children (246 boys [56%], mean age 12.1 years [SD 1.0; range 10-14]); 313 had less severe (LS) and 123 more severe (MS) cardiac diagnoses. At the most recent hospital visit, a higher proportion of the MS group were underweight (more than two standard deviations below the mean for age) or cyanosed (underweight: MS 20.0%, LS 9.9%; cyanosed: MS 26.2%, LS 3.5%). Children in the MS group described concerns about social isolation and feeling 'different', whereas children with less severe diagnoses often characterised their CHD as 'not a big thing'. Some coping strategies were common to both severity groups, including managing health information to avoid social exclusion, however only children in the LS group considered their CHD 'in the past' or experienced a sense of survivorship. Children's reported experiences were not dependent on their cardiac diagnosis, although there were clear qualitative differences by clinical severity group. Children's concerns emphasised social participation and our findings imply a need to shift the clinical focus from monitoring cardiac function to optimising participation. We highlight the potential for informing

  20. Applying the model of Goal-Directed Behavior, including descriptive norms, to physical activity intentions: A contribution to improving the Theory of Planned Behavior

    Science.gov (United States)

    The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contributed to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) ap...

  1. INTERIM REPORT IMPROVED METHODS FOR INCORPORATING RISK IN DECISION MAKING

    Energy Technology Data Exchange (ETDEWEB)

    Clausen, M. J.; Fraley, D. W.; Denning, R. S.

    1980-08-01

    This paper reports observations and preliminary investigations in the first phase of a research program covering methodologies for making safety-related decisions. The objective has been to gain insight into NRC perceptions of the value of formal decision methods, their possible applications, and how risk is, or may be, incorporated in decision making. The perception of formal decision making techniques, held by various decision makers, and what may be done to improve them, were explored through interviews with NRC staff. An initial survey of decision making methods, an assessment of the applicability of formal methods vis-a-vis the available information, and a review of methods of incorporating risk and uncertainty have also been conducted.

  2. Organising a manuscript reporting quality improvement or patient safety research.

    Science.gov (United States)

    Holzmueller, Christine G; Pronovost, Peter J

    2013-09-01

    Peer-reviewed publication plays important roles in disseminating research findings, developing generalisable knowledge and garnering recognition for authors and institutions. Nonetheless, many bemoan the whole manuscript writing process, intimidated by the arbitrary and somewhat opaque conventions. This paper offers practical advice about organising and writing a manuscript reporting quality improvement or patient safety research for submission to a peer-reviewed journal. Each section of the paper discusses a specific manuscript component-from title, abstract and each section of the manuscript body, through to reference list and tables and figures-explaining key principles, offering content organisation tips and providing an example of how this section may read. The paper also offers a checklist of common mistakes to avoid in a manuscript.

  3. Biological effects of DNA repair, including mutagenesis. Progress report, August 15, 1982-August 1, 1983. COO-3571-23

    International Nuclear Information System (INIS)

    Hutchinson, F.

    1983-01-01

    The research supported by this contract for the period covered by this report has concerned mechanisms in mutagenesis. Specifically, the work has been aimed at determining the lesions in DNA formed by particular mutagenic agents which lead to mutations, and to characterization of the pathways by which these lesions lead to changes in the sequence of bases in the genomic DNA

  4. Hallucinogens and Dissociative Drugs, Including LSD, PCP, Ketamine, Dextromethorphan. National Institute on Drug Abuse Research Report Series.

    Science.gov (United States)

    National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

    Research is developing a clearer picture of the dangers of mind-altering drugs. The goal of this report is to present the latest information to providers to help them strengthen their prevention and treatment efforts. A description is presented of dissociative drugs, and consideration is given as to why people take hallucinogens. The physical…

  5. Progress report of Physics Division including Applied Mathematics and Computing Section. 1st April 1970 - 30th September 1970

    International Nuclear Information System (INIS)

    2004-01-01

    Several of the senior staff of the Division have assisted in the assessment of the tenders for the proposed Jervis Bay power station. This has involved studies on light water moderated reactor systems where our experience has been limited. Several of the questions raised by the tenders are considered important and effort on these topics will continue when the assessment is complete. Major effort, other than for the Jervis Bay Project, has been devoted to the improvement of facilities and the construction of the critical facility. Studies relevant to an improved understanding of MOATA have continued to support the proposed power uprating to 100 W. The increasing number of shielding (neutron and gamma) problems referred to the Division has resulted in the procurement of several specialised codes and data libraries. These are now operational on our IBM 360 computer, and several problems are being investigated

  6. Innovative improvements of thermal response tests - Final report

    Energy Technology Data Exchange (ETDEWEB)

    Poppei, J.; Schwarz, R. [AF-Colenco Ltd, Baden (Switzerland); Peron, H.; Silvani, C; Steinmann, G.; Laloui, L. [Swiss Federal Institute of Technology, Laboratoire de Mecanique des Sols, Lausanne (Switzerland); Wagner, R.; Lochbuehler, T.; Rohner, E. [Geowatt AG, Zuerich (Switzerland)

    2008-12-15

    This illustrated final report for Swiss Federal Office of Energy (SFOE) takes a look at innovative improvements to thermal response tests that are used to investigate the thermo-physical properties of the ground for the purpose of dimensioning borehole heat exchangers. Recent technical developments in the borehole investigation tools area provide a promising prerequisite for improved estimates of thermal conductivity. A mini-module developed at the Swiss Federal Institute of Technology EPFL which is suitable for fast and flexible thermal response testing is discussed as is a wireless miniature data logger for continuous temperature recordings in borehole heat exchangers up to a depth of 350 m. This allows high-resolution vertical temperature profiling in boreholes. International state-of-the-art methods are reviewed. The adaptations to the analytical methods necessary for the effective application of these tools are discussed and numerical methods available are looked at. The testing of the methods developed and their results are discussed, as is the influence of ground-water flow.

  7. Using patient reported outcome measures in health services: A qualitative study on including people with low literacy skills and learning disabilities

    NARCIS (Netherlands)

    Jahagirdar, D.; Kroll, T.; Ritchie, K.; Wyke, S.

    2012-01-01

    ABSTRACT: BACKGROUND: Patient reported outcome measures (PROMs) are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated

  8. Reporting Guidelines and Checklists Improve the Reliability and Rigor of Research Reports.

    Science.gov (United States)

    Abbott, J Haxby

    2016-03-01

    The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) requires the use of robust research reporting guidelines for all research report submissions, including the newly adopted RECORD (REporting of studies Conducted using Observational Routinely-collected health Data) statement. We remind authors submitting research to JOSPT to identify the appropriate guideline and checklist for their study design, and to submit a completely and accurately completed checklist with their manuscript. J Orthop Sports Phys Ther 2016;46(3):130. doi:10.2519/jospt.2016.0105.

  9. Using crowdsourcing to prioritize bicycle network improvements : final report.

    Science.gov (United States)

    2016-04-01

    Effort to improve the bicycle route network using crowdsourced data is a powerful means : of incorporating citizens in infrastructure improvement decisions, which will improve : livability by maximizing the benefit of the bicycle infrastructure fundi...

  10. Summaries of reports of the 30. Conference on low-temperature physics. Pt. 1. Fundamental questions of superconductivity including HTSC

    International Nuclear Information System (INIS)

    1994-01-01

    Thesis of reporsts of the 30th Conference on low-temperature physics are presented. Fundamental problems of superconductivity are discussed including HTSC in bulk crystals, in thin films of Josephson junctions, ceramics and heterostructures. Specific features of superconductor structure and magnetic properties and also different mechanisms of superconductivity are analyzed

  11. Improving plant bioaccumulation science through consistent reporting of experimental data

    DEFF Research Database (Denmark)

    Fantke, Peter; Arnot, Jon A.; Doucette, William J.

    2016-01-01

    Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new...... experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never......-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent...

  12. Improving energy audit process and report outcomes through planning initiatives

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  13. BER-3.2 report: Methodology for justification and optimization of protective measures including a case study

    International Nuclear Information System (INIS)

    Hedemann Jensen, P.; Sinkko, K.; Walmod-Larsen, O.; Gjoerup, H.L.; Salo, A.

    1992-07-01

    This report is a part of the Nordic BER-3 project's work to propose and harmonize Nordic intervention levels for countermeasures in case of nuclear accidents. This report focuses on the methodology for justification and optimization of protective measures in case of a reactor accident situation with a large release of fission products to the environment. The down-wind situation is very complicated. The dose to the exposed society is almost unpredictable. The task of the radiation protection experts: To give advice to the decision makers on averted doses by the different actions at hand in the situation - is complicated. That of the decision makers is certainly more: On half of the society they represent, they must decide if they wish to follow the advices from their radiation protection experts or if they wish to add further arguments - economical or political (or personal) - into their considerations before their decisions are taken. Two analysis methods available for handling such situations: cost-benefit analysis and multi-attribute utility analysis are described in principle and are utilized in a case study: The impacts of a Chernobyl-like accident on the Swedish island of Gotland in the Baltic Sea are analyzed with regard to the acute consequences. The use of the intervention principles found in international guidance (IAEA 91, ICRP 91), which can be summarized as the principles of justification, optimization and avoidance of unacceptable doses, are described. How to handle more intangible factors of a psychological or political character is indicated. (au) (6 tabs., 3 ills., 17 refs.)

  14. Use of computational fluid dynamics codes for safety analysis of nuclear reactor systems, including containment. Summary report of a technical meeting

    International Nuclear Information System (INIS)

    2003-11-01

    Safety analysis is an important tool for justifying the safety of nuclear power plants. Typically, this type of analysis is performed by means of system computer codes with one dimensional approximation for modelling real plant systems. However, in the nuclear area there are issues for which traditional treatment using one dimensional system codes is considered inadequate for modelling local flow and heat transfer phenomena. There is therefore increasing interest in the application of three dimensional computational fluid dynamics (CFD) codes as a supplement to or in combination with system codes. There are a number of both commercial (general purpose) CFD codes as well as special codes for nuclear safety applications available. With further progress in safety analysis techniques, the increasing use of CFD codes for nuclear applications is expected. At present, the main objective with respect to CFD codes is generally to improve confidence in the available analysis tools and to achieve a more reliable approach to safety relevant issues. An exchange of views and experience can facilitate and speed up progress in the implementation of this objective. Both the International Atomic Energy Agency (IAEA) and the Nuclear Energy Agency of the Organisation for Economic Co-operation and Development (OECD/NEA) believed that it would be advantageous to provide a forum for such an exchange. Therefore, within the framework of the Working Group on the Analysis and Management of Accidents of the NEA's Committee on the Safety of Nuclear Installations, the IAEA and the NEA agreed to jointly organize the Technical Meeting on the Use of Computational Fluid Dynamics Codes for Safety Analysis of Reactor Systems, including Containment. The meeting was held in Pisa, Italy, from 11 to 14 November 2002. The publication constitutes the report of the Technical Meeting. It includes short summaries of the presentations that were made and of the discussions as well as conclusions and

  15. Model-driven approach to data collection and reporting for quality improvement.

    Science.gov (United States)

    Curcin, Vasa; Woodcock, Thomas; Poots, Alan J; Majeed, Azeem; Bell, Derek

    2014-12-01

    Continuous data collection and analysis have been shown essential to achieving improvement in healthcare. However, the data required for local improvement initiatives are often not readily available from hospital Electronic Health Record (EHR) systems or not routinely collected. Furthermore, improvement teams are often restricted in time and funding thus requiring inexpensive and rapid tools to support their work. Hence, the informatics challenge in healthcare local improvement initiatives consists of providing a mechanism for rapid modelling of the local domain by non-informatics experts, including performance metric definitions, and grounded in established improvement techniques. We investigate the feasibility of a model-driven software approach to address this challenge, whereby an improvement model designed by a team is used to automatically generate required electronic data collection instruments and reporting tools. To that goal, we have designed a generic Improvement Data Model (IDM) to capture the data items and quality measures relevant to the project, and constructed Web Improvement Support in Healthcare (WISH), a prototype tool that takes user-generated IDM models and creates a data schema, data collection web interfaces, and a set of live reports, based on Statistical Process Control (SPC) for use by improvement teams. The software has been successfully used in over 50 improvement projects, with more than 700 users. We present in detail the experiences of one of those initiatives, Chronic Obstructive Pulmonary Disease project in Northwest London hospitals. The specific challenges of improvement in healthcare are analysed and the benefits and limitations of the approach are discussed. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Sequential Magnetic Resonance Imaging Finding of Intramedullary Spinal Cord Abscess including Diffusion Weighted Image: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Jae Eun; Lee, Seung Young; Cha, Sang Hoon; Cho, Bum Sang; Jeon, Min Hee; Kang, Min Ho [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2011-04-15

    Intramedullary spinal cord abscess (ISCA) is a rare infection of the central nervous system. We describe the magnetic resonance imaging (MRI) findings, including the diffusion-weighted imaging (DWI) findings, of ISCA in a 78-year-old man. The initial conventional MRI of the thoracic spine demonstrated a subtle enhancing nodule accompanied by significant edema. On the follow-up MRI after seven days, the nodule appeared as a ring-enhancing nodule. The non-enhancing central portion of the nodule appeared hyperintense on DWI with a decreased apparent diffusion coefficient (ADC) value on the ADC map. We performed myelotomy and surgical drainage, and thick, yellowish pus was drained

  17. A Quantitative Assessment of the Reporting Quality of Herbal Medicine Research: The Road to Improvement.

    Science.gov (United States)

    Naumann, Ken

    2018-02-01

    To quantify different aspects of the quality of reporting of herbal medicine clinical trials, to determine how that quality is affecting the conclusions of meta-analyses, and to target areas for improvement in future herbal medicine research reporting. The Electronic databases PubMed, Academic Search Premier, ScienceDirect, and Alt HealthWatch were searched for meta-analyses of herbal medicines in refereed journals and Cochrane Reviews in the years 2000-2004 and 2010-2014. The search was limited to meta-analyses of randomized controlled trials involving humans and published in English. Judgments and descriptions within the meta-analyses were used to report on risks of bias in the included clinical trials and the meta-analyses themselves. Out of 3264 citations, 9 journal-published meta-analyses were selected from 2000 to 2004, 116 from 2010 to 2014, and 44 Cochrane Reviews from 2010 to 2014. Across both time frames and categories of publication, herbal medicines include a significant number of clinical trials that do not meet the recommended standards for clinical trial reporting. This quantitative assessment identified significant publication bias and other bias risks that may be due to inadequate trial design or incomplete reporting of outcomes. Suggested improvements to herbal medicine clinical trial reporting are discussed.

  18. Conceptual design report -- Gasification Product Improvement Facility (GPIF)

    Energy Technology Data Exchange (ETDEWEB)

    Sadowski, R.S.; Skinner, W.H.; House, L.S.; Duck, R.R. [CRS Sirrine Engineers, Inc., Greenville, SC (United States); Lisauskas, R.A.; Dixit, V.J. [Riley Stoker Corp., Worcester, MA (United States); Morgan, M.E.; Johnson, S.A. [PSI Technology Co., Andover, MA (United States). PowerServe Div.; Boni, A.A. [PSI-Environmental Instruments Corp., Andover, MA (United States)

    1994-09-01

    The problems heretofore with coal gasification and IGCC concepts have been their high cost and historical poor performance of fixed-bed gasifiers, particularly on caking coals. The Gasification Product Improvement Facility (GPIF) project is being developed to solve these problems through the development of a novel coal gasification invention which incorporates pyrolysis (carbonization) with gasification (fixed-bed). It employs a pyrolyzer (carbonizer) to avoid sticky coal agglomeration caused in the conventional process of gradually heating coal through the 400 F to 900 F range. In so doing, the coal is rapidly heated sufficiently such that the coal tar exists in gaseous form rather than as a liquid. Gaseous tars are then thermally cracked prior to the completion of the gasification process. During the subsequent endothermic gasification reactions, volatilized alkali can become chemically bound to aluminosilicates in (or added to) the ash. To reduce NH{sub 3} and HCN from fuel born nitrogen, steam injection is minimized, and residual nitrogen compounds are partially chemically reduced in the cracking stage in the upper gasifier region. Assuming testing confirms successful deployment of all these integrated processes, future IGCC applications will be much simplified, require significantly less mechanical components, and will likely achieve the $1,000/kWe commercialized system cost goal of the GPIF project. This report describes the process and its operation, design of the plant and equipment, site requirements, and the cost and schedule. 23 refs., 45 figs., 23 tabs.

  19. Umatilla River Subbasin Fish Habitat Improvement Program, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-02-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and reconstruction aimed at improving fish habitat, by restoring stable channel function. This report provides a summary of Program activities for the 2004 calendar year (January 1 through December 31, 2004), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance, and (4) Monitoring and Evaluation. This report also summarizes Program Administrative, Interagency Coordination, and Public Education activities.

  20. Fuel performance improvement program. Quarterly/annual progress report, October 1977--September 1978

    International Nuclear Information System (INIS)

    Crouthamel, C.E.

    1978-10-01

    This quarterly/annual report reviews and summarizes the activities performed in support of the Fuel Performance Improvement Program (FPIP) during Fiscal Year 1978 with emphasis on those activities that transpired during the quarter ending September 30, 1978. Significant progress has been made in achieving the primary objectives of the program, i.e., to demonstrate commercially viable fuel concepts with improved fuel - cladding interaction (FCI) behavior. This includes out-of-reactor experiments to support the fuel concepts being evaluated, initiation of instrumented test rod experiments in the Halden Boiling Water Reactor (HBWR), and fabrication of the first series of demonstration rods for irradiation in the Big Rock Point Reactor

  1. Performance evaluation of alternative fuel/engine concepts 1990- 1995. Final report including addendum of diesel vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Nylund, N.O.; Ikonen, M.; Kytoe, M.; Lappi, M.; Westerholm, M.; Laurikko, J. [VTT Energy, Espoo (Finland). Energy Use

    1996-12-31

    Annex V within the IEA Agreement on Alternative Motor Fuels is the first subtask to generate new experimental data. The objective of the task is to generate information on the emission potential of alternative fuels in severe operating conditions and to evaluate new emission measurement methods. The work was carried out in three phases, Engine Tests, Vehicle Tests and Addendum of Diesel Vehicles. The work was carried out at VTT (Technical Research Centre of Finland) as a cost shared operation. Participants were Belgium (Parts Two and Three), Canada (Parts One and Two), Finland, Italy (Part One), Japan, the Netherlands Sweden and USA. The United Kingdom also joined at the end of the Annex. The work included 143 different vehicle/fuel/temperature combinations. FTP type emission tests were run on 14 vehicles powered with different gasoline compositions, methanol (M50 and M85), ethanol (E85), LPG, CNG and diesel. Both regulated and unregulated emission components were measured using the most up-to-date emissions measurement technology. The results indicated, that today`s advanced gasoline vehicles must be considered rather clean. Diesel is comparable with gasoline in the case of CO and HC. M85 gives low emissions in warm conditions, but unburned methanol must be controlled. Natural gas and LPG are inherently clean fuels which, using up-to-date engine technology, give low emissions in all conditions. (orig.) (29 refs.)

  2. Integrated approach towards the application of horizontal wells to improve waterflooding performance. Annual report

    Energy Technology Data Exchange (ETDEWEB)

    Kelkar, M.; Liner, C.; Kerr, D.

    1995-05-01

    This annual report describes the progress during the second year of the project on Integrated Approach Towards the Application of Horizontal Wells to Improve Waterflooding Performance. This project is funded under the Department of Energy`s Class I program which is targeted towards improving the reservoir performance of mature oil fields located in fluvial-dominated deltaic deposits. The project involves an integrated approach to characterize the reservoir followed by the drilling of horizontal injection wells to improve production performance. The type of data we have integrated include cross bore hole seismic surveys, geological interpretation based on logs and cores, and engineering information. This report covers the second phase of the project which includes a detailed reservoir description of the field by integrating all the available information, followed by flow simulation of the Self Unit under various operating conditions. Based on an examination of the various operating parameters, we observed that the best possible solution to improve the Self Unit performance is to recomplete and stimulate most of the wells followed by an increase in the water injection rate. Drilling of horizontal injection well, although helpful in improving the performance, was not found to be economically feasible. The proposed reservoir management plan will be implemented shortly.

  3. Accounting for failures may improve precision: evidence supporting improved validity of self-reported condom use.

    Science.gov (United States)

    Crosby, Richard; Salazar, Laura F; DiClemente, Ralph J; Yarber, William L; Caliendo, Angela M; Staples-Horne, Michelle

    2005-08-01

    To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens. Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted. The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71-3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13-11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms. Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.

  4. CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions

    Science.gov (United States)

    2011-01-01

    Background Web-based and mobile health interventions (also called “Internet interventions” or "eHealth/mHealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The Consolidated Standards of Reporting Trials (CONSORT) statement was developed to improve the suboptimal reporting of randomized controlled trials (RCTs). While the CONSORT statement can be applied to provide broad guidance on how eHealth and mHealth trials should be reported, RCTs of web-based interventions pose very specific issues and challenges, in particular related to reporting sufficient details of the intervention to allow replication and theory-building. Objective To develop a checklist, dubbed CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), as an extension of the CONSORT statement that provides guidance for authors of eHealth and mHealth interventions. Methods A literature review was conducted, followed by a survey among eHealth experts and a workshop. Results A checklist instrument was constructed as an extension of the CONSORT statement. The instrument has been adopted by the Journal of Medical Internet Research (JMIR) and authors of eHealth RCTs are required to submit an electronic checklist explaining how they addressed each subitem. Conclusions CONSORT-EHEALTH has the potential to improve reporting and provides a basis for evaluating the validity and applicability of eHealth trials. Subitems describing how the intervention should be reported can also be used for non-RCT evaluation reports. As part of the development process, an evaluation component is essential; therefore, feedback from authors will be solicited, and a before-after study will evaluate whether reporting has been improved

  5. Report on the Observance of Standards and Codes, Accounting and Auditing : Module B - Institutional Framework for Corporate Financial Reporting, B.1 Commercial Enterprises (including SMEs)

    OpenAIRE

    World Bank

    2017-01-01

    The purpose of this report is to gain an understanding of the general financial reporting and audit requirements for commercial enterprises in a jurisdiction as established by law or other regulation (for example, companies’ act). Commercial enterprises are defined as companies established with a profit-making objective that do not issue equity and debt on a public exchange, are not financ...

  6. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  7. Foundations for Improvements to Passive Detection Systems - Final Report

    International Nuclear Information System (INIS)

    Labov, S E; Pleasance, L; Sokkappa, P; Craig, W; Chapline, G; Frank, M; Gronberg, J; Jernigan, J G; Johnson, S; Kammeraad, J; Lange, D; Meyer, A; Nelson, K; Pohl, B; Wright, D; Wurtz, R

    2004-01-01

    This project explores the scientific foundation and approach for improving passive detection systems for plutonium and highly enriched uranium in real applications. Sources of gamma-ray radiation of interest were chosen to represent a range of national security threats, naturally occurring radioactive materials, industrial and medical radiation sources, and natural background radiation. The gamma-ray flux emerging from these sources, which include unclassified criticality experiment configurations as surrogates for nuclear weapons, were modeled in detail. The performance of several types of gamma-ray imaging systems using Compton scattering were modeled and compared. A mechanism was created to model the combine sources and background emissions and have the simulated radiation ''scene'' impinge on a model of a detector. These modeling tools are now being used in various projects to optimize detector performance and model detector sensitivity in complex measuring environments. This study also developed several automated algorithms for isotope identification from gamma-ray spectra and compared these to each other and to algorithms already in use. Verification testing indicates that these alternative isotope identification algorithms produced less false positive and false negative results than the ''GADRAS'' algorithms currently in use. In addition to these algorithms that used binned spectra, a new approach to isotope identification using ''event mode'' analysis was developed. Finally, a technique using muons to detect nuclear material was explored

  8. A State-of-the-Art Report on Technologies of Volume Reduction and Self-Disposal for Large Metal Wastes including the Steam Generator of Nuclear Power Plants

    International Nuclear Information System (INIS)

    Lee, Kune Woo; Choi, W. K.; Kim, G. Y.

    2009-06-01

    This report focuses on technologies of volume reduction and self-disposal for large metal wastes including the steam generator of nuclear power plants. This report consists of the cases of treatments and foreign and domestic technologies for steam generator replacement

  9. Support for reporting guidelines in surgical journals needs improvement: A systematic review.

    Science.gov (United States)

    Agha, Riaz A; Barai, Ishani; Rajmohan, Shivanchan; Lee, Seon; Anwar, Mohammed O; Fowler, Alexander J; Orgill, Dennis P; Altman, Douglas G

    2017-09-01

    Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047-8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the 73 (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Quantify and improve PEM fuel cell durability. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Grahl-Madsen, L.; Odgaard, M.; Munksgaard Nielsen, R. (IRD Fuel Cell A/S, Svendborg (Denmark)); Li, Q.; Jensen, Jens Oluf (Technical Univ. of Denmark, Dept. of Chemistry, Kgs. Lyngby (Denmark)); Andersen, Shuang Ma; Speder, J.; Skou, E. (Syddansk Univ. (SDU), Odense (Denmark))

    2010-07-01

    The aim of the present project is to systematically quantify and improve the durability of the PEM FC including the following three PEM FC variants: LT PEM FC, DMFC, and HT PEM FC. Different factors influencing dissolution properties of noble metal catalyst platinum and platinum-ruthenium alloy has been studied. The dissolution was found to increase by increasing the CV cycle upper potential limit, number of potential cycles, solution acidity, oxygen partial pressure, involvement of chloride, and temperature. Ruthenium was found to deteriorate ten (10) times faster than platinum catalyst; and carbon supported catalyst (Pt: 20%, Ru: up to 100%) deteriorate ten (10) times faster than non-supported catalyst (Pt: 2%, Ru: 30%) at the same condition. Loss of sulphonic acid groups and fluoride from perfluorinated sulfonic acid membrane was confirmed by different techniques, which locally leads to loss of acidity, and consequently enhances dissolution of noble metal catalyst. Degradation of Nafion ionomer in the electrode was enhanced by noble metal catalyst and the thermal decomposition properties has synergetic effect with carbon degradation. Hydrophobicity of GDL and electrode on GDL were found to degrade e.g. radical attack, oxidation, and physical wear out. The very top micro surface structure turned out to be responsible for wetting property after chemical ageing. Optimal catalyst and ionomer ratio is also reflected in contact angle value, which can be understood in terms of catalyst/carbon - ionomer affinity and layered structure. Long-term tested and 'virgin' LT PEM MEAs have been characterised with respect to SEM, TEM, EDS, and XRD. Both failed and well-functioning MEAs have been characterised. The Post Mortem analysis has shown and quantified degradation mechanisms like catalyst growth and carbon corrosion. Furthermore, the effect of fuel starvation was shown by pronounced Ru-catalyst band within the membrane. The catalyst coarsening observed after

  11. Making Residents Part of the Safety Culture: Improving Error Reporting and Reducing Harms.

    Science.gov (United States)

    Fox, Michael D; Bump, Gregory M; Butler, Gabriella A; Chen, Ling-Wan; Buchert, Andrew R

    2017-01-30

    Reporting medical errors is a focus of the patient safety movement. As frontline physicians, residents are optimally positioned to recognize errors and flaws in systems of care. Previous work highlights the difficulty of engaging residents in identification and/or reduction of medical errors and in integrating these trainees into their institutions' cultures of safety. The authors describe the implementation of a longitudinal, discipline-based, multifaceted curriculum to enhance the reporting of errors by pediatric residents at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center. The key elements of this curriculum included providing the necessary education to identify medical errors with an emphasis on systems-based causes, modeling of error reporting by faculty, and integrating error reporting and discussion into the residents' daily activities. The authors tracked monthly error reporting rates by residents and other health care professionals, in addition to serious harm event rates at the institution. The interventions resulted in significant increases in error reports filed by residents, from 3.6 to 37.8 per month over 4 years (P error reporting correlated with a decline in serious harm events, from 15.0 to 8.1 per month over 4 years (P = 0.01). Integrating patient safety into the everyday resident responsibilities encourages frequent reporting and discussion of medical errors and leads to improvements in patient care. Multiple simultaneous interventions are essential to making residents part of the safety culture of their training hospitals.

  12. Using Organization Development To Improve School Climate. Report No. 17.

    Science.gov (United States)

    Gottfredson, Gary D.; Gottfredson, Denise C.

    This paper presents and illustrates some principles for organizational development approaches to improving school climate. It discusses a specific structure for facilitating school improvement entitled Program Development Evaluation, and it illustrates the use of school climate assessments for school diagnosis and the evaluation of improvement…

  13. Case Report: Improved Homonymous Hemianopia with Hyperbaric Oxygen Therapy

    Science.gov (United States)

    2017-06-29

    in the visual fields was noted at 13 treatments, but approximately 50% improvement was demonstrated in the right eye after 30 treatments with less...significant objective improvement of a fixed neurologic deficit following an ischemic brain injury. Various hypotheses exist regarding the recovery of

  14. AEL Continuous School Improvement Questionnaire. User Manual and Technical Report.

    Science.gov (United States)

    Meehan, Merrill L.; Cowley, Kimberly S.; Craig, James R.; Balow, Nancy; Childers, Robert D.

    The Continuous School Improvement Questionnaire (CSIQ) developed by the AEL helps a school staff gauge its performance on six dimensions related to continuous school improvement. Each member of the staff responds to the CSIQ individually. Although results might be used at the district or regional level, the most widely intended unit for applying…

  15. Improvement of a portable high-energy radiographic inspection system: Final report

    International Nuclear Information System (INIS)

    Owen, R.D.

    1987-02-01

    This report describes the development of miniaturized linear accelerator (MINAC) technology, including descriptions of all major developments sponsored by EPRI subsequent to previously sponsored work. In addition, this report describes MINAC-related developments in both real-time x-ray imaging and radiographic image data processing systems which were sponsored by EPRI concurrently. The objectives of this program have been to achieve modifications identified as desirable improvements to the basic ''MINAC 3'' equipment; to expand the range and effectiveness of MINAC applications through design improvements, achievement of wider energy/output capabilities, and the development of suitable imaging and digital processing technologies; and to provide technical information on high-energy radiographic equipment useful to scientists, educators, institutions, NDE technicians and others who may benefit from detailed information on the special equipment. Program, equipment and technical descriptions are followed by conclusions and recommendations for future work

  16. A water-based training program that include perturbation exercises to improve stepping responses in older adults: study protocol for a randomized controlled cross-over trial

    Directory of Open Access Journals (Sweden)

    Tsedek Irit

    2008-08-01

    Full Text Available Abstract Background Gait and balance impairments may increase the risk of falls, the leading cause of accidental death in the elderly population. Fall-related injuries constitute a serious public health problem associated with high costs for society as well as human suffering. A rapid step is the most important protective postural strategy, acting to recover equilibrium and prevent a fall from initiating. It can arise from large perturbations, but also frequently as a consequence of volitional movements. We propose to use a novel water-based training program which includes specific perturbation exercises that will target the stepping responses that could potentially have a profound effect in reducing risk of falling. We describe the water-based balance training program and a study protocol to evaluate its efficacy (Trial registration number #NCT00708136. Methods/Design The proposed water-based training program involves use of unpredictable, multi-directional perturbations in a group setting to evoke compensatory and volitional stepping responses. Perturbations are made by pushing slightly the subjects and by water turbulence, in 24 training sessions conducted over 12 weeks. Concurrent cognitive tasks during movement tasks are included. Principles of physical training and exercise including awareness, continuity, motivation, overload, periodicity, progression and specificity were used in the development of this novel program. Specific goals are to increase the speed of stepping responses and improve the postural control mechanism and physical functioning. A prospective, randomized, cross-over trial with concealed allocation, assessor blinding and intention-to-treat analysis will be performed to evaluate the efficacy of the water-based training program. A total of 36 community-dwelling adults (age 65–88 with no recent history of instability or falling will be assigned to either the perturbation-based training or a control group (no training

  17. Yakima Habitat Improvement Project Master Plan, Technical Report 2003.

    Energy Technology Data Exchange (ETDEWEB)

    Golder Associates, Inc.

    2003-04-22

    result of the planning effort leading to this Master Plan, a Technical Working Group (TWG) was established that represents most, if not all, fish and wildlife agencies/interests in the subbasin. This TWG met regularly throughout the planning process to provide input and review and was instrumental in the development of this plan. Preparation of this plan included the development of a quantitative prioritization process to rank 40,000 parcels within the Urban Growth Area based on the value of fish and wildlife habitat each parcel provided. Biological and physical criteria were developed and applied to all parcels through a GIS-based prioritization model. In the second-phase of the prioritization process, the TWG provided local expert knowledge and review of the properties. In selecting the most critical areas within the Urban Growth Area for protection, this project assessed the value of fish and wildlife habitat on the Yakima River. Well-developed habitat acquisition efforts (e.g., Yakima River Basin Water Enhancement Project by the Bureau of Reclamation and Yakama Nation acquisition projects) are already underway on the Yakima River mainstem. These efforts, however, face several limitations in protection of floodplain function that could be addressed through the support of the Yakima Habitat Improvement Project. This Master Plan integrates tributary habitat acquisition efforts with those ongoing on the Yakima River to best benefit fish and wildlife in the Urban Growth Area. The parcel ranking process identified 25 properties with the highest fish and wildlife value for habitat acquisition in the Yakima Urban Area. These parcels contain important fish and wildlife corridors on Ahtanum and Wide Hollow Creeks and the Naches River. The fifteen highest-ranking parcels of the 25 parcels identified were considered very high priority for protection of fish and wildlife habitat. These 15 parcels were subsequently grouped into four priority acquisition areas. This Master Plan

  18. Improvement of gamma-ray Sn transport calculations including coherent and incoherent scatterings and secondary sources of bremsstrahlung and fluorescence: Determination of gamma-ray buildup factors

    International Nuclear Information System (INIS)

    Kitsos, S.; Diop, C.M.; Assad, A.; Nimal, J.C.; Ridoux, P.

    1996-01-01

    Improvements of gamma-ray transport calculations in S n codes aim at taking into account the bound-electron effect of Compton scattering (incoherent), coherent scattering (Rayleigh), and secondary sources of bremsstrahlung and fluorescence. A computation scheme was developed to take into account these phenomena by modifying the angular and energy transfer matrices, and no modification in the transport code has been made. The incoherent and coherent scatterings as well as the fluorescence sources can be strictly treated by the transfer matrix change. For bremsstrahlung sources, this is possible if one can neglect the charged particles path as they pass through the matter (electrons and positrons) and is applicable for the energy range of interest for us (below 10 MeV). These improvements have been reported on the kernel attenuation codes by the calculation of new buildup factors. The gamma-ray buildup factors have been carried out for 25 natural elements up to 30 mean free paths in the energy range between 15 keV and 10 MeV

  19. Matrix Summaries Improve Research Reports: Secondary Analyses Using Published Literature

    Science.gov (United States)

    Zientek, Linda Reichwein; Thompson, Bruce

    2009-01-01

    Correlation matrices and standard deviations are the building blocks of many of the commonly conducted analyses in published research, and AERA and APA reporting standards recommend their inclusion when reporting research results. The authors argue that the inclusion of correlation/covariance matrices, standard deviations, and means can enhance…

  20. Improving Numeracy and Literacy: Evaluation Report and Executive Summary

    Science.gov (United States)

    Worth, Jack; Sizmur, Juliet; Ager, Rob; Styles, Ben

    2015-01-01

    The project, "Oxford Improving Numeracy and Literacy Programme," was delivered by Oxford University Department of Education. This evaluation tested two different initiatives with Year 2 children: "Mathematics and Reasoning" and "Literacy and Morphemes." The "Mathematics and Reasoning" programme aimed to…

  1. BWR Servicing and Refueling Improvement Program: Phase I summary report

    Energy Technology Data Exchange (ETDEWEB)

    Perry, D.R.

    1978-09-01

    Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was to identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development.

  2. BWR Servicing and Refueling Improvement Program: Phase I summary report

    International Nuclear Information System (INIS)

    Perry, D.R.

    1978-09-01

    Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was to identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development

  3. Conflicting race/ethnicity reports: lessons for improvement in data quality.

    Science.gov (United States)

    Webster, Pamela S; Fulton, John P; Sampangi, Swathi

    2013-01-01

    To learn the frequency of conflicting race/ethnicity reports, to examine patterns of conflicting reports, and to identify possible avenues for data quality improvement. As part of the Data Improvement Project on Patient Ethnicity and Race (DIPPER), an analysis of conflicting race/ethnicity reports for cancer cases was conducted. Using matched hospital discharge data and central cancer registry data from 2009, the race/ethnicity of patients in the 2 datasets were compared. Those with conflicting reports ("mismatched") were examined more closely. From a sample of 2,356 patients, 187 had conflicting reports for their race (7.9%) and 357 had conflicting reports for their ethnicity (15% was thus developed). In the 2009 hospital discharge data, an unknown response occurred nearly twice as often for Hispanic ethnicity as for race. Almost 85% of the mismatched race cases were classified as non-white in the hospital discharge data and white in the central cancer registry data. The most common ethnicity mismatch was coded unknown by the hospital but non-Hispanic by the registry. Hospital cancer registrars occasionally lack easy access to race and, more often, ethnicity data. More attention should be given to discrepancies (including allowing staff to flag and verify existing data), and staff training should improve both perceived and real data accuracy. In the future, hospitals and registries would be better served by pairing race and ethnicity together in the electronic medical record. This would ensure quick, easy access for cancer registrars. Perhaps standard setters should add ethnicity to the gold standard criteria for registries.

  4. Improved Barriers to Turbine Engine Fragments: Final Annual Report

    National Research Council Canada - National Science Library

    Shockey, Donald

    2002-01-01

    This final annual technical report describes the progress rnade during year 4 of the SPI International Phase II effort to develop a computational capability for designing lightweight fragment barriers...

  5. Chemical Weapons Improved Response Program. 2000 Summary Report

    National Research Council Canada - National Science Library

    2000-01-01

    The purpose of this summary report is to inform members of the first responder and emergency management communities about the on-going activities, initiatives, and lessons learned from the Chemical...

  6. Report: Improvements Needed in Key EPA Information System Security Practices

    Science.gov (United States)

    Report #10-P-0146, June 15, 2010. Williams Adley found that EPA program offices lacked evidence that they planned and executed tests of information system security controls as required by federal requirements.

  7. Report: EPA Needs to Improve Continuity of Operations Planning

    Science.gov (United States)

    Report #10-P-0017, October 27, 2009. EPA has limited assurance that it can successfully maintain continuity of operations and execute its mission essential functions during a significant national event such as a pandemic influenza outbreak.

  8. Agencies Need Improved Financial Data Reporting for Private Security Contractors

    National Research Council Canada - National Science Library

    Warren, David R; Bianco, Michael A; Nasser, Waheed; Kusman, Richard R; Shafer, James; Venner, Jason; Walls, Lovell Q; Wright, Samson J

    2008-01-01

    .... The objective of this report was to determine the extent to which federal agencies have systematically captured financial data for private security services in Iraq since 2003, and to identify...

  9. Improved patient-reported health impact of multiple sclerosis

    DEFF Research Database (Denmark)

    Macdonell, Richard; Nagels, Guy; Laplaud, David-Axel

    2016-01-01

    BACKGROUND: Multiple sclerosis (MS) is a debilitating disease that negatively impacts patients' lives. OBJECTIVE: ENABLE assessed the effect of long-term prolonged-release (PR) fampridine (dalfampridine extended release in the United States) treatment on patient-perceived health impact in patients...... with MS with walking impairment. METHODS: ENABLE was a 48-week, open-label, Phase 4 study of PR-fampridine 10 mg twice daily. Patients who showed any improvement in Timed 25-Foot Walk walking speed at weeks 2 and 4 and any improvement in 12-item MS Walking Scale score at week 4 remained on treatment....... The primary endpoint was change from baseline in 36-Item Short-Form Health Survey (SF-36) physical component summary (PCS) score. RESULTS: At week 4, 707/901 (78.5%) patients met the criteria to remain on treatment. Patients on treatment demonstrated significant and clinically meaningful improvements in SF-36...

  10. Improving Bioscience Research Reporting: The ARRIVE Guidelines for Reporting Animal Research

    Directory of Open Access Journals (Sweden)

    Carol Kilkenny

    2014-02-01

    Full Text Available In the last decade the number of bioscience journals has increased enormously, with many filling specialised niches reflecting new disciplines and technologies. The emergence of open-access journals has revolutionised the publication process, maximising the availability of research data. Nevertheless, a wealth of evidence shows that across many areas, the reporting of biomedical research is often inadequate, leading to the view that even if the science is sound, in many cases the publications themselves are not “fit for purpose”, meaning that incomplete reporting of relevant information effectively renders many publications of limited value as instruments to inform policy or clinical and scientific practice [1–21]. A recent review of clinical research showed that there is considerable cumulative waste of financial resources at all stages of the research process, including as a result of publications that are unusable due to poor reporting [22]. It is unlikely that this issue is confined to clinical research [2–14,16–20].

  11. NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 10: Summary report to phase 3 academic library respondents including frequency distributions

    Science.gov (United States)

    Pinelli, Thomas E.; Kennedy, John M.; White, Terry F.

    1991-01-01

    Phase 3 of a 4 part study was undertaken to study the use of scientific and technical information (STI) in the academic aerospace community. Phase 3 of this project used three questionnaires that were sent to three groups (i.e., faculty, librarians, and students) in the academic aerospace community. Specific attention was paid to the types of STI used and the methods in which academic users acquire STI. The responses of the academic libraries are focussed on herein. Demographic information on academic aerospace libraries is provided. Data regarding NASA interaction with academic aerospace libraries is also included, as is the survey instrument.

  12. IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    William M. Bond; Salih Ersayin

    2007-03-30

    This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency of individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern

  13. Despite 2007 law requiring FDA hotline to be included in print drug ads, reporting of adverse events by consumers still low.

    Science.gov (United States)

    Du, Dongyi; Goldsmith, John; Aikin, Kathryn J; Encinosa, William E; Nardinelli, Clark

    2012-05-01

    In 2007 the federal government began requiring drug makers to include in their print direct-to-consumer advertisements information for consumers on how to contact the Food and Drug Administration directly, either by phone or through the agency's website, to report any adverse events that they experienced after taking a prescription drug. Adverse events can range from minor skin problems like itching to serious injuries or illness that result in hospitalization, permanent disability, or even death. Even so, current rates of adverse event reporting are low. We studied adverse event reports about 123 drugs that came from patients before and after the enactment of the print advertising requirement and estimated that requirement's impact with model simulations. We found that if monthly spending on print direct-to-consumer advertising increased from zero to $7.7 million per drug, the presence of the Food and Drug Administration contact information tripled the increase in patient-reported adverse events, compared to what would have happened in the absence of the law. However, the absolute monthly increase was fewer than 0.24 reports per drug, suggesting that the public health impact of the increase was small and that the adverse event reporting rate would still be low. The study results suggest that additional measures, such as more publicity about the Adverse Event Reporting System or more consumer education, should be considered to promote patient reporting of adverse events.

  14. Feedback from incident reporting: information and action to improve patient safety.

    Science.gov (United States)

    Benn, J; Koutantji, M; Wallace, L; Spurgeon, P; Rejman, M; Healey, A; Vincent, C

    2009-02-01

    Effective feedback from incident reporting systems in healthcare is essential if organisations are to learn from failures in the delivery of care. Despite the wide-scale development and implementation of incident reporting in healthcare, studies in the UK suggest that information concerning system vulnerabilities could be better applied to improve operational safety within organisations. In this article, the findings and implications of research to identify forms of effective feedback from incident reporting are discussed, to promote best practices in this area. The research comprised a mixed methods review to investigate mechanisms of effective feedback for healthcare, drawing upon experience within established reporting programmes in high-risk industry and transport domains. Systematic searches of published literature were undertaken, and 23 case studies describing incident reporting programmes with feedback were identified for analysis from the international healthcare literature. Semistructured interviews were undertaken with 19 subject matter experts across a range of domains, including: civil aviation, maritime, energy, rail, offshore production and healthcare. In analysis, qualitative information from several sources was synthesised into practical requirements for developing effective feedback in healthcare. Both action and information feedback mechanisms were identified, serving safety awareness, improvement and motivational functions. The provision of actionable feedback that visibly improved systems was highlighted as important in promoting future reporting. Fifteen requirements for the design of effective feedback systems were identified, concerning: the role of leadership, the credibility and content of information, effective dissemination channels, the capacity for rapid action and the need for feedback at all levels of the organisation, among others. Above all, the safety-feedback cycle must be closed by ensuring that reporting, analysis and

  15. A call to improve sampling methodology and reporting in young novice driver research.

    Science.gov (United States)

    Scott-Parker, B; Senserrick, T

    2017-02-01

    Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Improving Employability Skills, Enriching Our Economy. Case Study Report

    Science.gov (United States)

    National Foundation for Educational Research, 2015

    2015-01-01

    This report has been produced by four organisations--the National Foundation for Educational Research, South East Strategic Leaders, London Councils and the London Enterprise Panel. It is based on research into how secondary schools, colleges, SMEs (small and medium-sized enterprises) and micro-businesses in London and the South East work together…

  17. The effect of the SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines on reporting standards in the quality improvement literature: a before-and-after study.

    Science.gov (United States)

    Howell, Victoria; Schwartz, Amanda Eva; O'Leary, James Daniel; Mc Donnell, Conor

    2015-06-01

    The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pimprovement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Improved application of the electrophoretic tissue clearing technology, CLARITY, to intact solid organs including brain, pancreas, liver, kidney, lung, and intestine.

    Science.gov (United States)

    Lee, Hyunsu; Park, Jae-Hyung; Seo, Incheol; Park, Sun-Hyun; Kim, Shin

    2014-12-21

    Mapping of tissue structure at the cellular, circuit, and organ-wide scale is important for understanding physiological and biological functions. A bio-electrochemical technique known as CLARITY used for three-dimensional anatomical and phenotypical mapping within transparent intact tissues has been recently developed. This method provided a major advance in understanding the structure-function relationships in circuits of the nervous system and organs by using whole-body clearing. Thus, in the present study, we aimed to improve the original CLARITY procedure and developed specific CLARITY protocols for various intact organs. We determined the optimal conditions for reducing bubble formation, discoloration, and depositing of black particles on the surface of tissue, which allowed production of clearer organ images. We also determined the appropriate replacement cycles of clearing solution for each type of organ, and convincingly demonstrated that 250-280 mA is the ideal range of electrical current for tissue clearing. We then acquired each type of cleared organs including brain, pancreas, liver, lung, kidney, and intestine. Additionally, we determined the images of axon fibers of hippocampal region, the Purkinje layer of cerebellum, and vessels and cellular nuclei of pancreas. CLARITY is an innovative biochemical technology for the structural and molecular analysis of various types of tissue. We developed improved CLARITY methods for clearing of the brain, pancreas, lung, intestine, liver, and kidney, and identified the appropriate experimental conditions for clearing of each specific tissue type. These optimized methods will be useful for the application of CLARITY to various types of organs.

  19. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement.

    Science.gov (United States)

    2014-10-01

    Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public (such as live birth) nor on the harms, including maternal risks during pregnancy and fetal anomalies. This is complicated by the multiple participants in infertility trials which may include a woman (mother), a man (father), and a third individual if successful, their offspring (child), who is also the desired outcome of treatment. The primary outcome of interest and many adverse events occur after cessation of infertility treatment and during pregnancy and the puerperium, which creates a unique burden of follow-up for clinical trial investigators and participants. In 2013, because of the inconsistencies in trial reporting and the unique aspects of infertility trials not adequately addressed by existing Consolidated Standards of Reporting Trials (CONSORT) statements, we convened a consensus conference in Harbin, China, with the aim of planning modifications to the CONSORT checklist to improve the quality of reporting of clinical trials testing infertility treatment. The consensus group recommended that the preferred primary outcome of all infertility trials is live birth (defined as any delivery of a live infant after ≥20 weeks' gestation) or cumulative live birth, defined as the live birth per women over a defined time period (or number of treatment cycles). In addition, harms to all participants should be systematically collected and reported, including during the intervention, any resulting pregnancy, and the neonatal period. Routine information should be collected and reported on both male and female participants in the trial. We propose to track the change in quality that these guidelines may produce in published trials testing infertility treatments. Our ultimate goal is to increase the transparency of benefits and risks of infertility treatments to provide better medical care to affected individuals and couples

  20. Fort St. Vrain improvement program plan. Draft final report

    International Nuclear Information System (INIS)

    1980-03-01

    The restraints are described which inhibit the Fort St. Vrain (FSV) Nuclear Power Station, a high temperature gas cooled reactor (HTGR) plant, from achieving full power operation with high availability. The actions necessary to overcome these restraints are outlined. The restraints originated from problems in both hardware related and institutional areas. The report summarizes what has been accomplished, what is currently being done, and what should be done to resolve the problems

  1. Improving the Efficient of Ernie Turner Center. Final Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Fredeen, Amy

    2011-03-21

    The objective of this project was to complete the specifications and drawings for a variable speed kitchen exhaust system and the boiler heating system which when implemented will improve the heating efficiency of the building. The design work was focused in two key areas: kitchen ventilation and heating for the Ernie Turner Center building (ETC). RSA completed design work and issued a set of 100% drawings. RSA also worked with a cost estimator to put together a detailed cost estimate for the project. The design components are summarized.

  2. [Financial incentives in improving healthcare quality. SESPAS Report 2012].

    Science.gov (United States)

    Eirea Eiras, Carlos; Ortún Rubio, Vicente

    2012-03-01

    We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

    Science.gov (United States)

    Ivanovic, Jelena; Anstee, Caitlin; Ramsay, Tim; Gilbert, Sebastien; Maziak, Donna E; Shamji, Farid M; Sundaresan, R Sudhir; Villeneuve, P James; Seely, Andrew J E

    2015-10-01

    Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon's clinical performance. Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. Copyright © 2015 The Society of Thoracic

  4. Natural Propagation and Habitat Improvement, Volume 1, Oregon, 1986 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Stuart, Amy

    1987-01-01

    This report describes activities implemented for fisheries habitat improvement work on priority drainages in the Clackamas and Hood River sub-basins. Separate abstracts have been prepared for the reports on individual projects. (ACR)

  5. Management Report: Improvements Needed in IRS's Accounting Procedures and Internal Controls

    National Research Council Canada - National Science Library

    2002-01-01

    ... with requirements of the Federal Financial Management Improvement Act of 1996. A separate report on the implementation status of recommendations from our prior IRS financial audits and related financial management reports will be issued shortly...

  6. IMPROVING THE REPORTING OF THERAPEUTIC EXERCISE INTERVENTIONS IN REHABILITATION RESEARCH.

    Science.gov (United States)

    Page, Phil; Hoogenboom, Barb; Voight, Michael

    2017-04-01

    The foundation of evidence-based practice lies in clinical research, which is based on the utilization of the scientific method. The scientific method requires that all details of the experiment be provided in publications to support replication of the study in order to evaluate and validate the results. More importantly, clinical research can only be translated into practice when researchers provide explicit details of the study. Too often, rehabilitation exercise intervention studies lack the appropriate detail to allow clinicians to replicate the exercise protocol in their patient populations. Therefore, the purpose of this clinical commentary is to provide guidelines for optimal reporting of therapeutic exercise interventions in rehabilitation research. 5.

  7. Improved nuclear gage development - phase i and ii. Interim report

    International Nuclear Information System (INIS)

    Chan, E.L.; Champion, F.C.; Castanon, D.R.; Chang, J.C.; Hannon, J.B.

    1976-09-01

    This report contains Phase I and II of an investigation covering the design and construction of a prototype nuclear-moisture-density backscatter gage. Gage development was based upon the analysis of several factors which affect gage performance. This research indicated that the prototype gage measurements are approximately equivalent to measurements obtained by a commercial transmission gage. The implication of this research finding concerns the qualification of the backscatter test method as a valid, reliable, and expedient procedure for determining in-situ soil conditions

  8. Improved Controls for Fusion RF Systems. Final technical report

    International Nuclear Information System (INIS)

    Casey, Jeffrey A.

    2011-01-01

    We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way that they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration

  9. Improved Controls for Fusion RF Systems. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Casey, Jeffrey A. [Rockfield Research Inc., Las Vegas, NV (United States)

    2011-11-08

    We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way that they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration.

  10. Valve-stem-packing improvement study. Final report

    International Nuclear Information System (INIS)

    Adey, C.W.; Klein, J.J.

    1982-08-01

    By employing questionnaires and face-to-face interviews with valve and valve packing manufacturers, as well as nuclear plant personnel, an understanding of valve stem packing leakage problems from each of the three viewpoints was developed. This information, in-house experience, and available technical literature were used to develop specific recommendations for valve manufacturers, valve packing manufacturers, and nuclear plant valve users. It was generally recommended that each these groups make better use of graphite packing. The questionnaires and interviews indicated that increased usage of graphite packing over the last few years has reduced the incidence of valve packing problems. To confirm this, a survey of Licensee Event Reports (LERs) from 1972 to 1980 was undertaken using the keywords Valve and Packing. A statistical analysis of the LER data confirms that the adoption of graphite packing has significantly reduced valve stem leakage

  11. Financial Improvement and Audit Readiness (FIAR) Plan Status Report

    Science.gov (United States)

    2011-05-01

    depreciation must include the cost of significant amounts of costly government furnished material (e.g., titanium hardware) and equipment (e.g., aircraft...Figure I-1. DoD Mission Critical Assets (FY 2010 $ in Millions)  Asset Type  Historical Cost  Accumulated  Depreciation   Net Book Value  Military...principles ( GAAP ). Given the number of worldwide existing assets without sufficient evidence to support acquisition cost, this is a daunting and costly

  12. Quality improvement in depression care in the Netherlands: the Depression Breakthrough Collaborative. A quality improvement report.

    NARCIS (Netherlands)

    Franx, G.C.; Meeuwissen, J.A.; Sinnema, H.; Spijker, J.; Huyser, J.; Wensing, M.J.P.; Lange, J.

    2009-01-01

    BACKGROUND: Improving the healthcare for patients with depression is a priority health policy across the world. Roughly, two major problems can be identified in daily practice: (1) the content of care is often not completely consistent with recommendations in guidelines and (2) the organization of

  13. A novel synthetic quantification standard including virus and internal report targets: application for the detection and quantification of emerging begomoviruses on tomato

    OpenAIRE

    Péréfarres, Frédéric; Hoareau, Murielle; Chiroleu, Frédéric; Reynaud, Bernard; Dintinger, Jacques; Lett, Jean-Michel

    2011-01-01

    Abstract Background Begomovirus is a genus of phytopathogenic single-stranded DNA viruses, transmitted by the whitefly Bemisia tabaci. This genus includes emerging and economically significant viruses such as those associated with Tomato Yellow Leaf Curl Disease, for which diagnostic tools are needed to prevent dispersion and new introductions. Five real-time PCRs with an internal tomato reporter gene were developed for accurate detection and quantification of monopartite begomoviruses, inclu...

  14. Final Scientific Report - "Improved Fuel Efficiency from Nanocomposite Tire Tread"

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Andrew Myers

    2005-12-30

    Rolling resistance, a measure of the energy lost as a tire rotates while moving, is a significant source of power and fuel loss. Recently, low rolling resistant tires have been formulated by adding silica to tire tread. These "Green Tires" (so named from the environmental advantages of lower emissions and improved fuel economy) have seen some commercial success in Europe, where high fuel prices and performance drive tire selection. Unfortunately, the higher costs of the silica and a more complicated manufacturing process have prevented significant commercialization - and the resulting fuel savings - in the U.S. In this project, TDA Research, Inc. (TDA) prepared an inexpensive alternative to silica that leads to tire components with lower rolling resistance. These new tire composite materials were processed with traditional rubber processing equipment. We prepared specially designed nanoparticle additives, based on a high purity, inorganic mineral whose surface can be easily modified for compatibility with tire tread formulations. Our nanocomposites decreased energy losses to hysteresis, the loss of energy from the compression and relaxation of an elastic material, by nearly 20% compared to a blank SBR sample. We also demonstrated better performance than a leading silica product, with easier production of our final rubber nanocomposite.

  15. Development of a comprehensive survey of sexuality issues including a self-report version of the International Spinal Cord Injury sexual function basic data sets.

    Science.gov (United States)

    New, P W; Currie, K E

    2016-08-01

    Questionnaire development, validation and completion. Develop comprehensive survey of sexuality issues including validated self-report versions of the International Spinal Cord Injury male sexual function and female sexual and reproductive function basic data sets (SR-iSCI-sexual function). People with spinal cord damage (SCD) living in the community, Australia from August 2013 to June 2014. An iterative process involving rehabilitation medicine clinicians, a nurse specialising in sexuality issues in SCD and people with SCD who developed a comprehensive survey that included the SR-iSCI-sexual function. Participants recruitment through spinal rehabilitation review clinic and community organisations that support people with SCD. Surveys completed by 154 people. Most were male (n=101, 65.6%). Respondents' median age was 50 years (interquartile range (IQR) 38-58), and they were a median of 10 years (IQR 4-20) after the onset of SCD. Sexual problems unrelated to SCD were reported by 12 (8%) respondents, and 114 (n=75.5%) reported sexual problems because of SCD. Orgasms were much less likely (χ(2)=13.1, P=0.006) to be normal in males (n=5, 5%) compared with females (n=11, 22%). Males had significantly worse (χ(2)=26.0, P=0.001) psychogenic genital functioning (normal n=9, 9%) than females (normal n=13, 26%) and worse (χ(2)=10.8, P=0.013) reflex genital functioning. Normal ejaculation was reported in only three (3%) men. Most (n=26, 52%) women reported reduced or absent menstruation pattern since SCD. The SR-iSCI-sexual function provides a useful tool for researchers and clinicians to collect information regarding patient-reported sexual functioning after SCD and to facilitate comparative studies.

  16. Global hydrobelts: improved reporting scale for water-related issues?

    Science.gov (United States)

    Meybeck, M.; Kummu, M.; Dürr, H. H.

    2012-08-01

    Questions related to water such as its availability, water needs or stress, or management, are mapped at various resolutions at the global scale. They are reported at many scales, mostly along political or continental boundaries. As such, they ignore the fundamental heterogeneity of the hydroclimate and the natural boundaries of the river basins. Here, we describe the continental landmasses according to eight global-scale hydrobelts strictly limited by river basins, defined at a 30' (0.5°) resolution. The belts were defined and delineated, based primarily on the annual average temperature (T) and runoff (q), to maximise interbelt differences and minimise intrabelt variability. The belts were further divided into 29 hydroregions based on continental limits. This new global puzzle defines homogeneous and near-contiguous entities with similar hydrological and thermal regimes, glacial and postglacial basin histories, endorheism distribution and sensitivity to climate variations. The Mid-Latitude, Dry and Subtropical belts have northern and southern analogues and a general symmetry can be observed for T and q between them. The Boreal and Equatorial belts are unique. The hydroregions (median size 4.7 Mkm2) contrast strongly, with the average q ranging between 6 and 1393 mm yr-1 and the average T between -9.7 and +26.3 °C. Unlike the hydroclimate, the population density between the North and South belts and between the continents varies greatly, resulting in pronounced differences between the belts with analogues in both hemispheres. The population density ranges from 0.7 to 0.8 p km-2 for the North American Boreal and some Australian hydroregions to 280 p km-2 for the Asian part of the Northern Mid-Latitude belt. The combination of population densities and hydroclimate features results in very specific expressions of water-related characteristics in each of the 29 hydroregions. Our initial tests suggest that hydrobelt and hydroregion divisions are often more

  17. Nutrition Report Cards: an opportunity to improve school lunch selection.

    Directory of Open Access Journals (Sweden)

    Brian Wansink

    Full Text Available OBJECTIVE: To explore the feasibility and implementation efficiency of Nutritional Report Cards (NRCs in helping children make healthier food choices at school. METHODS: Pilot testing was conducted in a rural New York school district (K-12. Over a five-week period, 27 parents received a weekly e-mail containing a NRC listing how many meal components (fruits, vegetables, starches, milk, snacks, and a-la-carte foods their child selected. We analyzed choices of students in the NRC group vs. the control group, both prior to and during the intervention period. Point-of-sale system data for a-la-carte items was analyzed using Generalized Least Squares regressions with clustered standard errors. RESULTS: NRCs encouraged more home conversations about nutrition and more awareness of food selections. Despite the small sample, the NRC was associated with reduced selection of some items, such as the percentage of those selecting cookies which decreased from 14.3 to 6.5 percent. Additionally, despite requiring new keys on the check-out registers to generate the NRC, checkout times increased by only 0.16 seconds per transaction, and compiling and sending the NRCs required a total weekly investment of 30 minutes of staff time. CONCLUSIONS: This test of concept suggests that NRCs are a feasible and inexpensive tool to guide children towards healthier choices.

  18. Programme Reporting Standards (PRS for improving the reporting of sexual, reproductive, maternal, newborn, child and adolescent health programmes

    Directory of Open Access Journals (Sweden)

    Anna E. Kågesten

    2017-08-01

    , collaborative process, including methods to incorporate input from SRMNCAH stakeholders. The World Health Organization will develop a document that explains the items in greater detail, and will also apply the PRS to on-going initiatives. We welcome continuous input from the field, while it is being used, to improve its relevance and usefulness.

  19. The Space Situational Assessment Report to Improve Public Awareness in China

    Science.gov (United States)

    Li, Hongbo; Zhang, Qi; Xie, Zebing; Wei, Xiangwang; Wang, Tao

    For improvement of public awareness of the impact of space activities in China, a Space Situational Assessment Report 2013 will be issued in March 2014. More than ten Chinese main medium are invited for a special press conference. The Space Situational Assessment Report aims to introduce international space activities to Chinese public, and provide a common, comprehensive knowledge base to support the development of national policies and international security cooperation of outer space. The full report organizes international space activities until 2013 according to three parts those are Foundations, Strategies and Environment, including nine chapters, such as Space laws and policies; Space facility and equipment; Institutions and Human Resource; Military space, Civil space and Commercial space; Natural space environment; Space situational awareness, etc. A kind of Space Situational Assessment Index System is presented as a globally-focused analytic framework that defines, measures, and ranks national space activity. To use for a variety of public themes, different assessment indexes are constituted by scores of individual qualitative and quantitative metrics based on the Index System. Three research organizaitons of space sciences and technologies collaborated on the Space Situational Assessment Report. It is a scholarly and ungovernmental work.

  20. Improved Hydrogen Gas Getters for TRU Waste -- Final Report

    International Nuclear Information System (INIS)

    Mark Stone; Michael Benson; Christopher Orme; Thomas Luther; Eric Peterson

    2005-01-01

    Alpha radiolysis of hydrogenous waste and packaging materials generates hydrogen gas in radioactive storage containers. For that reason, the Nuclear Regulatory Commission limits the flammable gas (hydrogen) concentration in the Transuranic Package Transporter-II (TRUPACT-II) containers to 5 vol% of hydrogen in air, which is the lower explosion limit. Consequently, a method is needed to prevent the build up of hydrogen to 5 vol% during the storage and transport of the TRUPACT-II containers (up to 60 days). One promising option is the use of hydrogen getters. These materials scavenge hydrogen from the gas phase and irreversibly bind it in the solid phase. One proven getter is a material called 1,4-bis (phenylethynyl) benzene, or DEB, characterized by the presence of carbon-carbon triple bonds. Carbon may, in the presence of suitable precious metal catalysts such as palladium, irreversibly react with and bind hydrogen. In the presence of oxygen, the precious metal may also eliminate hydrogen by catalyzing the formation of water. This reaction is called catalytic recombination. DEB has the needed binding rate and capacity for hydrogen that potentially could be generated in the TRUPACT II. Phases 1 and 2 of this project showed that uncoated DEB performed satisfactorily in lab scale tests. Based upon these results, Phase 3, the final project phase, included larger scale testing. Test vessels were scaled to replicate the ratio between void space in the inner containment vessel of a TRUPACT-II container and a payload of seven 55-gallon drums. The tests were run with an atmosphere of air for 63.9 days at ambient temperature (15-27 C) and a scaled hydrogen generation rate of 2.60E-07 moles per second (0.35 cc/min). A second type of getter known as VEI, a proprietary polymer hydrogen getter characterized by carbon-carbon double bonds, was also tested in Phase 3. Hydrogen was successfully ''gettered'' by both getter systems. Hydrogen concentrations remained below 5 vol% (in

  1. Improved Hydrogen Gas Getters for TRU Waste -- Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Mark Stone; Michael Benson; Christopher Orme; Thomas Luther; Eric Peterson

    2005-09-01

    Alpha radiolysis of hydrogenous waste and packaging materials generates hydrogen gas in radioactive storage containers. For that reason, the Nuclear Regulatory Commission limits the flammable gas (hydrogen) concentration in the Transuranic Package Transporter-II (TRUPACT-II) containers to 5 vol% of hydrogen in air, which is the lower explosion limit. Consequently, a method is needed to prevent the build up of hydrogen to 5 vol% during the storage and transport of the TRUPACT-II containers (up to 60 days). One promising option is the use of hydrogen getters. These materials scavenge hydrogen from the gas phase and irreversibly bind it in the solid phase. One proven getter is a material called 1,4-bis (phenylethynyl) benzene, or DEB, characterized by the presence of carbon-carbon triple bonds. Carbon may, in the presence of suitable precious metal catalysts such as palladium, irreversibly react with and bind hydrogen. In the presence of oxygen, the precious metal may also eliminate hydrogen by catalyzing the formation of water. This reaction is called catalytic recombination. DEB has the needed binding rate and capacity for hydrogen that potentially could be generated in the TRUPACT II. Phases 1 and 2 of this project showed that uncoated DEB performed satisfactorily in lab scale tests. Based upon these results, Phase 3, the final project phase, included larger scale testing. Test vessels were scaled to replicate the ratio between void space in the inner containment vessel of a TRUPACT-II container and a payload of seven 55-gallon drums. The tests were run with an atmosphere of air for 63.9 days at ambient temperature (15-27°C) and a scaled hydrogen generation rate of 2.60E-07 moles per second (0.35 cc/min). A second type of getter known as VEI, a proprietary polymer hydrogen getter characterized by carbon-carbon double bonds, was also tested in Phase 3. Hydrogen was successfully “gettered” by both getter systems. Hydrogen concentrations remained below 5 vol% (in

  2. Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members.

    Science.gov (United States)

    Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C

    2011-03-01

    The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge. To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered. Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity. The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements. A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.

  3. Counterfeit Parts: DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk

    Science.gov (United States)

    2016-02-01

    agencies and contractors we met with stated that they have encountered counterfeit parts less frequently in the DOD supply chain , in part, because...the DOD supply chain as a method to prevent further counterfeiting.22 DOD and industry officials noted that timely reporting of...COUNTERFEIT PARTS DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk Report to Congressional Committees

  4. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1991-1995 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.; Flagg, Thomas A.; Mahnken, Conrad V.W.

    1996-08-01

    In this report, the National Marine Fisheries Service (NMFS), in collaboration with the Bonneville Power Administration (BPA), the Washington State Department of Fish and Wildlife (WDFW), and the US Fish and Wildlife Service (USFWS), presents research findings and guidelines for development and evaluation of innovative culture techniques to increase postrelease survival of hatchery fish. The Natural Rearing Enhancement System (NATURES) described in this report is a collection of experimental approaches designed to produce hatchery-reared chinook salmon (Oncorhynchus tshawytscha) that exhibit wild-like behavior, physiology, and morphology. The NATURES culture research for salmonids included multiple tests to develop techniques such as: raceways equipped with cover, structure, and natural substrates to promote development of proper body camouflage coloration; feed-delivery systems that condition fish to orient to the bottom rather than the surface of the rearing vessel; predator conditioning of fish to train them to avoid predators; and supplementing diets with natural live foods to improve foraging ability. The underlying assumptions are that NATURES will: (1) promote the development of natural cryptic coloration and antipredator behavior; (2) increase postrelease foraging efficiency; (3) improve fish health and condition by alleviating chronic, artificial rearing habitat-induced stress; and (4) reduce potential genetic selection pressures induced by the conventional salmon culture environment. A goal in using NATURES is to provide quality fish for rebuilding depleted natural runs.

  5. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1996-1998 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.

    2001-09-13

    This report covers the 1996-1998 Natural Rearing Enhancement System (NATURES) research for increasing hatchery salmon postrelease survival and producing fish with more wild-like behavior, physiology, and morphology prior to release. Experiments were conducted evaluating automatic subsurface feeders; natural diets; exercise systems; seminatural raceway habitat enriched with cover, structure, and substrate; and predator avoidance conditioning for hatchery salmonids. Automatic subsurface feed delivery systems did not affect chinook salmon depth distribution or vulnerability to avian predators. Live-food diets only marginally improved the ability of chinook salmon to capture prey in stream enclosures. A prototype exercise system that can be retrofitted to raceways was developed, however, initial testing indicated that severe amounts of exercise may increase in culture mortality. Rearing chinook salmon in seminatural raceway habitat with gravel substrate, woody debris structure, and overhead cover improved coloration and postrelease survival without impacting in-culture health or survival. Steelhead fry reared in enriched environments with structure, cover, and point source feeders dominated and outcompeted conventionally reared fish. Exposing chinook salmon to caged predators increased their postrelease survival. Chinook salmon showed an antipredator response to chemical stimuli from injured conspecifics and exhibited acquired predator recognition following exposure to paired predator-prey stimuli. The report also includes the 1997 Natural Rearing System Workshop proceedings.

  6. Improving the reporting of clinical trials of infertility treatments (IMPRINT): modifying the CONSORT statement†‡.

    Science.gov (United States)

    Legro, Richard S; Wu, Xiaoke; Barnhart, Kurt T; Farquhar, Cynthia; Fauser, Bart C J M; Mol, Ben

    2014-10-10

    Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public (such as live birth) nor on the harms, including maternal risks during pregnancy and fetal anomalies. This is complicated by the multiple participants in infertility trials which may include a woman (mother), a man (father), and result in a third individual if successful, their offspring (child), who is also the desired outcome of treatment. The primary outcome of interest and many adverse events occur after cessation of infertility treatment and during pregnancy and the puerperium, which create a unique burden of follow-up for clinical trial investigators and participants. In 2013, because of the inconsistencies in trial reporting and the unique aspects of infertility trials not adequately addressed by existing Consolidated Standards of Reporting Trials (CONSORT) statements, we convened a consensus conference in Harbin, China, with the aim of planning modifications to the CONSORT checklist to improve the quality of reporting of clinical trials testing infertility treatment. The consensus group recommended that the preferred primary outcome of all infertility trials is live birth (defined as any delivery of a live infant ≥20 weeks gestations) or cumulative live birth, defined as the live birth per women over a defined time period (or number of treatment cycles). In addition, harms to all participants should be systematically collected and reported, including during the intervention, any resulting pregnancy, and during the neonatal period. Routine information should be collected and reported on both male and female participants in the trial. We propose to track the change in quality that these guidelines may produce in published trials testing infertility treatments. Our ultimate goal is to increase the transparency of benefits and risks of infertility treatments to provide better medical care to affected individuals and

  7. Hearing children's voices? Including children's perspectives on their experiences of domestic violence in welfare reports prepared for the English courts in private family law proceedings.

    Science.gov (United States)

    Macdonald, Gillian S

    2017-03-01

    This research examined Children and Family Court Advisory and Support Service (Cafcass) reports prepared for private family court proceedings in domestic violence cases in England. The research found that in cases where children's accounts identified them as victims of violence, these disclosures regularly disappeared from report recommendations. Particular discourses regarding 'child welfare' and 'contact' were identified, which routinely impacted on the ways in which children's voices were taken into account. Whilst culturally there has undoubtedly been an influential move towards including children's perspectives in decision-making that affects them, how these views are interpreted and represented is subject to adult 'gate-keeping' and powerful cultural and professional ideologies regarding 'child welfare' and 'post-separation family relationships'. This research found that the unrelenting influence of deeply embedded beliefs regarding the preservation or promotion of relationships with fathers continues to have the effect of marginalising issues of safeguarding, including children's voiced experiences of violence, in all but the most exceptional of cases. Rather, safeguarding concerns in respect of domestic violence and child abuse were persistently overshadowed by a dominant presumption of the overall benefits of contact with fathers. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  8. Evolution of poor reporting and inadequate methods over time in 20 920 randomised controlled trials included in Cochrane reviews: research on research study.

    Science.gov (United States)

    Dechartres, Agnes; Trinquart, Ludovic; Atal, Ignacio; Moher, David; Dickersin, Kay; Boutron, Isabelle; Perrodeau, Elodie; Altman, Douglas G; Ravaud, Philippe

    2017-06-08

    Objective  To examine how poor reporting and inadequate methods for key methodological features in randomised controlled trials (RCTs) have changed over the past three decades. Design  Mapping of trials included in Cochrane reviews. Data sources  Data from RCTs included in all Cochrane reviews published between March 2011 and September 2014 reporting an evaluation of the Cochrane risk of bias items: sequence generation, allocation concealment, blinding, and incomplete outcome data. Data extraction  For each RCT, we extracted consensus on risk of bias made by the review authors and identified the primary reference to extract publication year and journal. We matched journal names with Journal Citation Reports to get 2014 impact factors. Main outcomes measures  We considered the proportions of trials rated by review authors at unclear and high risk of bias as surrogates for poor reporting and inadequate methods, respectively. Results  We analysed 20 920 RCTs (from 2001 reviews) published in 3136 journals. The proportion of trials with unclear risk of bias was 48.7% for sequence generation and 57.5% for allocation concealment; the proportion of those with high risk of bias was 4.0% and 7.2%, respectively. For blinding and incomplete outcome data, 30.6% and 24.7% of trials were at unclear risk and 33.1% and 17.1% were at high risk, respectively. Higher journal impact factor was associated with a lower proportion of trials at unclear or high risk of bias. The proportion of trials at unclear risk of bias decreased over time, especially for sequence generation, which fell from 69.1% in 1986-1990 to 31.2% in 2011-14 and for allocation concealment (70.1% to 44.6%). After excluding trials at unclear risk of bias, use of inadequate methods also decreased over time: from 14.8% to 4.6% for sequence generation and from 32.7% to 11.6% for allocation concealment. Conclusions  Poor reporting and inadequate methods have decreased over time, especially for sequence generation

  9. Natural Propagation and Habitat Improvement, Volume I, Oregon, 1984 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Rod

    1986-02-01

    This volume contains reports on habitat improvement and fisheries enhancement projects conducted in the following subbasins: (1) Clackamas River; (2) Hood River; :(3) Deschutes River; (4) John Day River; (5) Umatilla River; and (6) Grande Ronde River. (ACR)

  10. Report: Agency-Wide Application of Region 7 NPDES Program Process Improvements Could Increase EPA Efficiency

    Science.gov (United States)

    Report #11-P-0315, July 6, 2011. Although Region 7 NPDES Kaizen event participants continued to follow up on the commitments and action items identified, no single authority was responsible for tracking the process improvement outcomes.

  11. Report: EPA Needs to Improve Management Practices to Ensure a Successful Customer Technology Solutions Project

    Science.gov (United States)

    Report #10-P-0194, August 23, 2010. Although EPA indicated it could avoid spending more than $115.4 million over 8.5 years by consolidating the desktop computing environment, improved management practices are needed.

  12. Report: Improved Management Practices Needed to Increase Use of Exchange Network

    Science.gov (United States)

    Report #2007-P-00030, August 20, 2007. EPA established a partnership with the Exchange Network’s governance bodies to assist them with accomplishing Network initiatives, more improvements are needed to ensure Network partners fully utilize the Network.

  13. Motivators and barriers to using patient experience reports for performance improvement

    NARCIS (Netherlands)

    Geissler, K.H.; Friedberg, M.W.; SteelFisher, G.K.; Schneider, E.C.

    2013-01-01

    Increasingly, patient experience surveys are available to provide performance feedback to physician groups. However, limited published literature addresses factors influencing use of these reports for performance improvement. To address this gap, we conducted semistructured interviews with leaders

  14. Report: Office of Research and Development Needs to Improve Its Method of Measuring Administrative Savings

    Science.gov (United States)

    Report #11-P-0333, July 14, 2011. ORD’s efforts to reduce its administrative costs are noteworthy, but ORD needs to improve its measurement mechanism for assessing the effectiveness of its initiatives to reduce administrative costs.

  15. Improvement of the structure of reports of Ukrainian higher educational institutions in terms of deregulation and state authority decentralization

    Directory of Open Access Journals (Sweden)

    V.S. Ambarchian

    2015-09-01

    Full Text Available Improvement of the structure and content of financial and budgetary reports of domestic higher educational institutions, enhance of financial statements completeness in order to enable citizens to control a university activity. During the research both general scientific and specific scientific economic methods were implemented. The general methods include induction, deduction, analogy and comparison. Among specific methods of economic research grouping, table method, graphical method, method of informational and logical analysis were used. The paper characterizes legal documents which regulate the process of university financial statements preparation and presentation in different countries. Financial reports of Ukrainian, American and British universities are compared. The author determines the major directions of improvement of the structure and content of domestic university reports with the purpose of their completeness enhancing. As a result of the research performed the proper recommendations of improvement of domestic universities reporting are suggested. The author conforms the reporting information with the Managerial report which discloses the information about the reporting period achievements and the efficiency of budget resources expenditure.

  16. SU-F-T-163: Improve Proton Therapy Efficiency: Report of a Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Y [Procure Proton Therapy Center, Oklahoma City, OK (United States); Flanz, J [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Mah, D [Procure Treatment Center, Somerset, NJ (United States); Pankuch, M; Kreydick, B [Northwestern Medicine Proton Center, Warrenville, IL (United States); Beltran, C [Mayo Clinic, Rochester, MN (United States); Robison, B; Schreuder, A [Provision Healthcare Partners, Knoxville, TN (United States)

    2016-06-15

    Purpose: The technology of proton therapy, especially the pencil beam scanning technique, is evolving very quickly. However, the efficiency of proton therapy seems to lag behind conventional photon therapy. The purpose of the abstract is to report on the findings of a workshop on improvement of QA, planning and treatment efficiency in proton therapy. Methods: A panel of physicists, clinicians, and vendor representatives from over 18 institutions in the United States and internationally were convened in Knoxville, Tennessee in November, 2015. The panel discussed several topics on how to improve proton therapy efficiency, including 1) lean principle and failure mode and effects analysis, 2) commissioning and machine QA, 3) treatment planning, optimization and evaluation, 4) patient positioning and IGRT, 5) vendor liaison and machine availability, and 6) staffing, education and training. Results: The relative time needed for machine QA, treatment planning & check in proton therapy was found to range from 1 to 2.5 times of that in photon therapy. Current status in proton QA, planning and treatment was assessed. Key areas for efficiency improvement, such as elimination of unnecessary QA items or steps and development of efficient software or hardware tools, were identified. A white paper to summarize our findings is being written. Conclusion: It is critical to improve efficiency by developing reliable proton beam lines, efficient software tools on treatment planning, optimization and evaluation, and dedicated proton QA device. Conscious efforts and collaborations from both industry leaders and proton therapy centers are needed to achieve this goal and further advance the technology of proton therapy.

  17. Efficacy of humidity retention bags for the reduced adsorption and improved cleaning of tissue proteins including prion-associated amyloid to surgical stainless steel surfaces.

    Science.gov (United States)

    Secker, T J; Pinchin, H E; Hervé, R C; Keevil, C W

    2015-01-01

    Increasing drying time adversely affects attachment of tissue proteins and prion-associated amyloid to surgical stainless steel, and reduces the efficacy of commercial cleaning chemistries. This study tested the efficacy of commercial humidity retention bags to reduce biofouling on surgical stainless steel and to improve subsequent cleaning. Surgical stainless steel surfaces were contaminated with ME7-infected brain homogenates and left to dry for 15 to 1,440 min either in air, in dry polythene bags or within humidity retention bags. Residual contamination pre/post cleaning was analysed using Thioflavin T/SYPRO Ruby dual staining and microscope analysis. An increase in biofouling was observed with increased drying time in air or in sealed dry bags. Humidity retention bags kept both protein and prion-associated amyloid minimal across the drying times both pre- and post-cleaning. Therefore, humidity bags demonstrate a cheap, easy to implement solution to improve surgical instrument reprocessing and to potentially reduce associated hospital acquired infections.

  18. Uranium potential of southwestern New Mexico (southern Hidalgo County), including observations on crystallization history of lavas and ash tuffs and the release of uranium from them. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Walton, A.W.; Salter, T.L.; Zetterlund, D.

    1980-08-01

    Geological environments present in southwestern New Mexico include thick sequences of sedimentary rock including limestone, conglomerates, sandstone, and shale: igneous intrusions with associated metal deposits; caldera centers, margins, and outflow facies; and basins with marginal faults and thick late Cenozoic sedimentary fillings. Predominant rock types are Paleozoic carbonates, Mesozoic terrigeneous rocks and carbonates, and Cenozoic volcanic rocks and basin-filling terrigeneous rocks. Consideration of information available in Preliminary Reconnaissance Reports and in Hydrogeochemical and Stream Reconnaissance Reports together with 347 new whole rock chemical analyses points to three areas of anomalous uranium abundance in Hidalgo County, New Mexico. The area has experienced three major periods of igneous activity in Phanerozoic time: one associated with the Laramide cycle of the Late Cretaceous and early Tertiary, mid-Tertiary cycle of silicic volcanism with abundant calderas, and a late Tertiary cycle of mafic volcanism. Silicic volcanic rocks are the most common exposed rock type in the area, and the most enriched in uranium (range, 0.4 to 19 ppM). The most likely source for any uranium ore-forming solutions lies with this cycle of volcanism. Solutions might have been introduced during volcanism or formed later by groundwater leaching of cooled volcanic rocks. Results indicate that groundwater leaching of cooled volcanic rocks was not an effective means of mobilizing uranium in the area. Study of several rhyolite lava flows indicates that they were emplaced in supercooled condition and may have crystallized completely at temperatures well below their liquids, or they may have warmed as crystallization released latent heat. Statistical comparison of the uranium concentration revealed no differences between vitrophyres and associated felsites.

  19. Uranium potential of southwestern New Mexico (southern Hidalgo County), including observations on crystallization history of lavas and ash tuffs and the release of uranium from them. Final report

    International Nuclear Information System (INIS)

    Walton, A.W.; Salter, T.L.; Zetterlund, D.

    1980-08-01

    Geological environments present in southwestern New Mexico include thick sequences of sedimentary rock including limestone, conglomerates, sandstone, and shale: igneous intrusions with associated metal deposits; caldera centers, margins, and outflow facies; and basins with marginal faults and thick late Cenozoic sedimentary fillings. Predominant rock types are Paleozoic carbonates, Mesozoic terrigeneous rocks and carbonates, and Cenozoic volcanic rocks and basin-filling terrigeneous rocks. Consideration of information available in Preliminary Reconnaissance Reports and in Hydrogeochemical and Stream Reconnaissance Reports together with 347 new whole rock chemical analyses points to three areas of anomalous uranium abundance in Hidalgo County, New Mexico. The area has experienced three major periods of igneous activity in Phanerozoic time: one associated with the Laramide cycle of the Late Cretaceous and early Tertiary, mid-Tertiary cycle of silicic volcanism with abundant calderas, and a late Tertiary cycle of mafic volcanism. Silicic volcanic rocks are the most common exposed rock type in the area, and the most enriched in uranium (range, 0.4 to 19 ppM). The most likely source for any uranium ore-forming solutions lies with this cycle of volcanism. Solutions might have been introduced during volcanism or formed later by groundwater leaching of cooled volcanic rocks. Results indicate that groundwater leaching of cooled volcanic rocks was not an effective means of mobilizing uranium in the area. Study of several rhyolite lava flows indicates that they were emplaced in supercooled condition and may have crystallized completely at temperatures well below their liquids, or they may have warmed as crystallization released latent heat. Statistical comparison of the uranium concentration revealed no differences between vitrophyres and associated felsites

  20. Consumers' Interest In Provider Ratings Grows, And Improved Report Cards And Other Steps Could Accelerate Their Use.

    Science.gov (United States)

    Findlay, Steven D

    2016-04-01

    Encouraging patients and consumers to use data and other information in choosing health care providers is an important way to enhance patient engagement and improve the quality of care. The growing use of technology, including smart phones and near-ubiquitous Internet access, provides consumers with easy access to websites that collect and report assessments and ratings of providers, primarily physicians and hospitals. In addition to new technology, recent laws and changes in society and the delivery of care are laying the foundation for greater use by consumers of provider performance report cards. Such use could be accelerated if the shortcomings of current report card efforts were addressed. Recommendations include making online report cards easier to use and more understandable, engaging, substantive, and relevant to consumers' health and medical concerns and choices. Project HOPE—The People-to-People Health Foundation, Inc.

  1. Challenges of implementation and implementation research: Learning from an intervention study designed to improve tumor registry reporting

    Directory of Open Access Journals (Sweden)

    Ann Scheck McAlearney

    2016-08-01

    Full Text Available Objectives: Implementation of interventions designed to improve the quality of medical care often proceeds differently from what is planned. Improving existing conceptual models to better understand the sources of these differences can help future projects avoid these pitfalls and achieve desired effectiveness. To inform an adaptation of an existing theoretical model, we examined unanticipated changes that occurred in an intervention designed to improve reporting of adjuvant therapies for breast cancer patients at a large, urban academic medical center. Methods: Guided by the complex innovation implementation conceptual framework, our study team observed and evaluated the implementation of an intervention designed to improve reporting to a tumor registry. Findings were assessed against the conceptual framework to identify boundary conditions and modifications that could improve implementation effectiveness. Results: The intervention successfully increased identification of the managing medical oncologist and treatment reporting. During implementation, however, unexpected external challenges including hospital acquisitions of community practices and practices’ responses to government incentives to purchase electronic medical record systems led to unanticipated changes and associated threats to implementation. We present a revised conceptual model that incorporates the sources of these unanticipated challenges. Conclusion: This report of our experience highlights the importance of monitoring implementation over time and accounting for changes that affect both implementation and measurement of intervention impact. In this article, we use our study to examine the challenges of implementation research in health care, and our experience can help future implementation efforts.

  2. Including indigestible carbohydrates in the evening meal of healthy subjects improves glucose tolerance, lowers inflammatory markers, and increases satiety after a subsequent standardized breakfast

    DEFF Research Database (Denmark)

    Nilsson, A.C.; Ostman, E.M.; Holst, Jens Juul

    2008-01-01

    Low-glycemic index (GI) foods and foods rich in whole grain are associated with reduced risk of type 2 diabetes and cardiovascular disease. We studied the effect of cereal-based bread evening meals (50 g available starch), varying in GI and content of indigestible carbohydrates, on glucose...... tolerance and related variables after a subsequent standardized breakfast in healthy subjects (n = 15). At breakfast, blood was sampled for 3 h for analysis of blood glucose, serum insulin, serum FFA, serum triacylglycerides, plasma glucagon, plasma gastric-inhibitory peptide, plasma glucagon-like peptide-1...... based bread (ordinary, high-amylose- or beta-glucan-rich genotypes) or an evening meal with white wheat flour bread (WWB) enriched with a mixture of barley fiber and resistant starch improved glucose tolerance at the subsequent breakfast compared with unsupplemented WWB (P

  3. Tiotropium improves lung function, exacerbation rate, and asthma control, independent of baseline characteristics including age, degree of airway obstruction, and allergic status

    DEFF Research Database (Denmark)

    Kerstjens, Huib A M; Moroni-Zentgraf, Petra; Tashkin, Donald P

    2016-01-01

    performed in parallel in patients with severe symptomatic asthma. Exploratory subgroup analyses of peak forced expiratory volume in 1 s (FEV1), trough FEV1, time to first severe exacerbation, time to first episode of asthma worsening, and seven-question Asthma Control Questionnaire responder rate were......BACKGROUND: Many patients with asthma remain symptomatic despite treatment with inhaled corticosteroids (ICS) with or without long-acting β2-agonists (LABAs). Tiotropium add-on to ICS plus a LABA has been shown to improve lung function and reduce exacerbation risk in patients with symptomatic...... asthma. OBJECTIVE: To determine whether the efficacy of tiotropium add-on therapy is dependent on patients' baseline characteristics. METHODS: Two randomized, double-blind, parallel-group, twin trials (NCT00772538 and NCT00776984) of once-daily tiotropium Respimat(®) 5 μg add-on to ICS plus a LABA were...

  4. Progress report on first year of WP5.2. Including detailed description of planned research for WP 5.2

    Energy Technology Data Exchange (ETDEWEB)

    Ellemers, N.; Van Dijk, E.; Terwel, B.; De Vries, G. [Leiden University, Leiden (Netherlands)

    2010-10-15

    This document contains the progress report on the first half year of the CATO-2 WP5.2 PhD project 'Framing effects in communication about CCS'. In the first few months a literature study has been conducted, both on (factors that influence) public perceptions and acceptance of CCS, and on framing. In the last two month, a first study was designed. This study consists of an experiment designed to examine how framing a company's involvement in CCS in terms of economic benefits and/or CSR of the organization affects the corporate image, trust, and perceived 'greenwashing' (deceit). Furthermore, this experiment serves to test the quality of newly developed questionnaires to measure these variables. In addition, this document contains a detailed description of the research planned for WP5.2 written by senior (CATO-2) researchers from January 2010 on. The objective of the research planned for WP5.2 is to examine whether framing of communications by an organization can improve the perceived credibility and trustworthiness of the organization and the information provided. This issue will be examined by a combination of experimental studies and a survey-type study.

  5. Nuclear Weapons Sustainment: Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency

    Science.gov (United States)

    2015-12-01

    Enhance Transparency Report to Congressional Committees December 2015 GAO-16-23 United States Government Accountability Office United...SUSTAINMENT Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency Why GAO Did This Study DOD and DOE are...modernization plans and (2) complete, transparent information on the methodologies used to develop those estimates. GAO analyzed the departments

  6. Improvement of visual field defects after focal resection for occipital lobe epilepsy: case report.

    Science.gov (United States)

    Yamamoto, Takahiro; Hamasaki, Tadashi; Nakamura, Hideo; Yamada, Kazumichi

    2018-03-01

    Improvement of visual field defects after surgical treatment for occipital lobe epilepsy is rare. Here, the authors report on a 24-year-old man with a 15-year history of refractory epilepsy that developed after he had undergone an occipital craniotomy to remove a cerebellar astrocytoma at the age of 4. His seizures started with an elementary visual aura, followed by secondary generalized tonic-clonic convulsion. Perimetry revealed left-sided incomplete hemianopia, and MRI showed an old contusion in the right occipital lobe. After evaluation with ictal video-electroencephalography, electrocorticography, and mapping of the visual cortex with subdural electrodes, the patient underwent resection of the scarred tissue, including the epileptic focus at the occipital lobe. After surgery, he became seizure free and his visual field defect improved gradually. In addition, postoperative 123 I-iomazenil (IMZ) SPECT showed partly normalized IMZ uptake in the visual cortex. This case is a practical example suggesting that neurological deficits attributable to the functional deficit zone can be remedied by successful focal resection.

  7. Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

    Science.gov (United States)

    Bunch, K J; Allin, B; Jolly, M; Hardie, T; Knight, M

    2018-05-16

    To develop a core metric set to monitor the quality of maternity care. Delphi process followed by a face-to-face consensus meeting. English maternity units. Three representative expert panels: service designers, providers and users. Maternity care metrics judged important by participants. Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re-scored the metrics. In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third- and fourth-degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score improvement. Achieving consensus on core metrics for monitoring the quality of maternity care. © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  8. Consumption of Dairy Yogurt Containing Lactobacillus paracasei ssp. paracasei, Bifidobacterium animalis ssp. lactis and Heat-Treated Lactobacillus plantarum Improves Immune Function Including Natural Killer Cell Activity

    Science.gov (United States)

    Lee, Ayoung; Lee, Young Ju; Yoo, Hye Jin; Kim, Minkyung; Chang, Yeeun; Lee, Dong Seog; Lee, Jong Ho

    2017-01-01

    The aim of this study was to investigate the impact of consuming dairy yogurt containing Lactobacillus paracasei ssp. paracasei (L. paracasei), Bifidobacterium animalis ssp. lactis (B. lactis) and heat-treated Lactobacillus plantarum (L. plantarum) on immune function. A randomized, open-label, placebo-controlled study was conducted on 200 nondiabetic subjects. Over a twelve-week period, the test group consumed dairy yogurt containing probiotics each day, whereas the placebo group consumed milk. Natural killer (NK) cell activity, interleukin (IL)-12 and immunoglobulin (Ig) G1 levels were significantly increased in the test group at twelve weeks compared to baseline. Additionally, the test group had significantly greater increases in serum NK cell activity and interferon (IFN)-γ and IgG1 than placebo group. Daily consumption of dairy yogurt containing L. paracasei, B. lactis and heat-treated L. plantarum could be an effective option to improve immune function by enhancing NK cell function and IFN-γ concentration (ClinicalTrials.gov: NCT03051425). PMID:28561762

  9. Consumption of Dairy Yogurt Containing Lactobacillus paracasei ssp. paracasei, Bifidobacterium animalis ssp. lactis and Heat-Treated Lactobacillus plantarum Improves Immune Function Including Natural Killer Cell Activity

    Directory of Open Access Journals (Sweden)

    Ayoung Lee

    2017-05-01

    Full Text Available The aim of this study was to investigate the impact of consuming dairy yogurt containing Lactobacillus paracasei ssp. paracasei (L. paracasei, Bifidobacterium animalis ssp. lactis (B. lactis and heat-treated Lactobacillus plantarum (L. plantarum on immune function. A randomized, open-label, placebo-controlled study was conducted on 200 nondiabetic subjects. Over a twelve-week period, the test group consumed dairy yogurt containing probiotics each day, whereas the placebo group consumed milk. Natural killer (NK cell activity, interleukin (IL-12 and immunoglobulin (Ig G1 levels were significantly increased in the test group at twelve weeks compared to baseline. Additionally, the test group had significantly greater increases in serum NK cell activity and interferon (IFN-γ and IgG1 than placebo group. Daily consumption of dairy yogurt containing L. paracasei, B. lactis and heat-treated L. plantarum could be an effective option to improve immune function by enhancing NK cell function and IFN-γ concentration (ClinicalTrials.gov: NCT03051425.

  10. Consumption of Dairy Yogurt Containing Lactobacillus paracasei ssp. paracasei, Bifidobacterium animalis ssp. lactis and Heat-Treated Lactobacillus plantarum Improves Immune Function Including Natural Killer Cell Activity.

    Science.gov (United States)

    Lee, Ayoung; Lee, Young Ju; Yoo, Hye Jin; Kim, Minkyung; Chang, Yeeun; Lee, Dong Seog; Lee, Jong Ho

    2017-05-31

    The aim of this study was to investigate the impact of consuming dairy yogurt containing Lactobacillus paracasei ssp. paracasei ( L. paracasei ), Bifidobacterium animalis ssp. lactis ( B. lactis ) and heat-treated Lactobacillus plantarum ( L. plantarum ) on immune function. A randomized, open-label, placebo-controlled study was conducted on 200 nondiabetic subjects. Over a twelve-week period, the test group consumed dairy yogurt containing probiotics each day, whereas the placebo group consumed milk. Natural killer (NK) cell activity, interleukin (IL)-12 and immunoglobulin (Ig) G1 levels were significantly increased in the test group at twelve weeks compared to baseline. Additionally, the test group had significantly greater increases in serum NK cell activity and interferon (IFN)-γ and IgG1 than placebo group. Daily consumption of dairy yogurt containing L. paracasei , B. lactis and heat-treated L. plantarum could be an effective option to improve immune function by enhancing NK cell function and IFN-γ concentration (ClinicalTrials.gov: NCT03051425).

  11. Specific Physician Orders Improve Pain Detection and Pain Reports in Nursing Home Residents: Preliminary Data.

    Science.gov (United States)

    Monroe, Todd B; Misra, Sumathi; Habermann, Ralf C; Dietrich, Mary S; Bruehl, Stephen P; Cowan, Ronald L; Newhouse, Paul A; Simmons, Sandra F

    2015-10-01

    Despite evidence that many nursing home residents' pain is poorly managed, reasons for this poor management remain unanswered. The aim of this study was to determine if specific order sets related to pain assessment would improve pain management in nursing home (NH) residents. Outcomes included observed nurse pain assessment queries and resident reports of pain. The pretest/post-test study was performed in a 240-bed for-profit nursing home in the mid-southern region of the United States and participants were 43 nursing home residents capable of self-consent. Medical chart abstraction was performed during a 2-week (14-day) period before the implementation of specific order sets for pain assessment (intervention) and a 2-week (14-day) period after the intervention. Trained research assistants observed medication administration passes and performed participant interviews after each medication pass. One month after intervention implementation, 1 additional day of observations was conducted to determine data reliability. Nurses were observed to ask residents about pain more frequently, and nurses continued to ask about pain at higher rates 1 month after the intervention was discontinued. The proportion of residents who reported pain also significantly increased in response to increased nurse queries (e.g., "Do you have any pain right now?"), which underscores the importance of nurses directly asking residents about pain. Notably 70% of this long-stay NH population only told the nurses about their pain symptoms when asked directly. Findings uncover that using specific pain order sets seems to improve the detection of pain, which should be a routine part of nursing assessment. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  12. Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

    Science.gov (United States)

    Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

    Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

  13. Does enhanced regulation improve EIA report quality? Lessons from South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Sandham, L.A., E-mail: luke.sandham@nwu.ac.za [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa); Heerden, A.J. van [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa); Jones, C.E. [School of Environment and Development, University of Manchester, Oxford Road, Manchester, M13 9PL (United Kingdom); Retief, F.P.; Morrison-Saunders, A.N. [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa)

    2013-01-15

    Recently, various EIA systems have been subjected to system review processes with a view to improve performance. Many of these reviews resulted in some form of legislative reform. The South African Environmental Impact Assessment (EIA) regulations were modified in 2006 with the express intent to improve EIA effectiveness. In order to evaluate to what extent the desired outcome was achieved, the quality of EIA reports produced under the 2006 regulations was investigated for comparative analysis with the preceding regime. A sample of EIA reports from the two legislative regimes was reviewed using an adapted version of a well established method known colloquially as the 'Lee and Colley' review package. Despite some improvements in certain aspects, overall report quality has decreased slightly from the 1997 EIA regime. It therefore appears that the modifications to the regulations, often heralded as the solution to improvements in performance have not resulted in improved quality of EIA reports. - Highlights: Black-Right-Pointing-Pointer EIA regulations in South Africa were revised and became more comprehensive in 2006. Black-Right-Pointing-Pointer The report quality of a sample of EIAs was reviewed using the Lee and Colley review package. Black-Right-Pointing-Pointer Report quality showed a slight decline from the previous regulatory regime. Black-Right-Pointing-Pointer EIA good practice needs flexibility rather than over-detailed regulation.

  14. Does enhanced regulation improve EIA report quality? Lessons from South Africa

    International Nuclear Information System (INIS)

    Sandham, L.A.; Heerden, A.J. van; Jones, C.E.; Retief, F.P.; Morrison-Saunders, A.N.

    2013-01-01

    Recently, various EIA systems have been subjected to system review processes with a view to improve performance. Many of these reviews resulted in some form of legislative reform. The South African Environmental Impact Assessment (EIA) regulations were modified in 2006 with the express intent to improve EIA effectiveness. In order to evaluate to what extent the desired outcome was achieved, the quality of EIA reports produced under the 2006 regulations was investigated for comparative analysis with the preceding regime. A sample of EIA reports from the two legislative regimes was reviewed using an adapted version of a well established method known colloquially as the “Lee and Colley” review package. Despite some improvements in certain aspects, overall report quality has decreased slightly from the 1997 EIA regime. It therefore appears that the modifications to the regulations, often heralded as the solution to improvements in performance have not resulted in improved quality of EIA reports. - Highlights: ► EIA regulations in South Africa were revised and became more comprehensive in 2006. ► The report quality of a sample of EIAs was reviewed using the Lee and Colley review package. ► Report quality showed a slight decline from the previous regulatory regime. ► EIA good practice needs flexibility rather than over-detailed regulation.

  15. Diabetes technology: improving care, improving patient-reported outcomes and preventing complications in young people with Type 1 diabetes.

    Science.gov (United States)

    Prahalad, P; Tanenbaum, M; Hood, K; Maahs, D M

    2018-04-01

    With the evolution of diabetes technology, those living with Type 1 diabetes are given a wider arsenal of tools with which to achieve glycaemic control and improve patient-reported outcomes. Furthermore, the use of these technologies may help reduce the risk of acute complications, such as severe hypoglycaemia and diabetic ketoacidosis, as well as long-term macro- and microvascular complications. In addition, diabetes technology can have a beneficial impact on psychosocial health by reducing the burden of diabetes. Unfortunately, diabetes goals are often unmet and people with Type 1 diabetes too frequently experience acute and long-term complications of this condition, in addition to often having less than ideal psychosocial outcomes. Increasing realization of the importance of patient-reported outcomes is leading to diabetes care delivery becoming more patient-centred. Diabetes technology in the form of medical devices, digital health and big data analytics have the potential to improve clinical care and psychosocial support, resulting in lower rates of acute and chronic complications, decreased burden of diabetes care, and improved quality of life. © 2018 Diabetes UK.

  16. Carcinoma showing thymus-like elements of the thyroid gland: report of three cases including one case with breast cancer history.

    Science.gov (United States)

    Zhang, Guanjun; Liu, Xi; Huang, Wei; Li, Xiaofeng; Johnstone, Marianne; Deng, Yuan; Ke, Yongqiang; Nunes, Quentin M; Wang, Hongyan; Wang, Yili; Zhang, Xuebin

    2015-01-01

    Carcinoma showing thymus-like elements (CASTLE) is a rare malignant tumor of the thyroid or adjacent neck soft tissues, whose histogenesis is still debated. It may resemble other primary or metastatic poorly differentiated tumors histologically and the differential diagnosis is crucial for CASTLE has a better prognosis. However, CASTLE as a second primary tumor has not been reported in the literature. We report three cases of thyroid CASTLE, including a unique tumor following breast-conserving surgery for early-stage breast invasive carcinoma. There were two female and one male. All three tumors were located in the right lobe of the thyroid, and one tumor showed extension into the surrounding soft tissue. Histologically, all tumors showed expansive growth and consisted of cords, nests or sheets of epithelial cells divided into irregularly shaped lobules by fibrous connective tissue with lymphoplasmacytic infiltration. Focal squamous differentiation resembling Hassall's corpuscles were observed. All cases stained positively for CD5, CD117, high molecular weight cytokeratin, cytokeratin, P63, carcinoembryonic antigen and epithelial membrane antigen. Positive staining for Bcl-2 in two cases and chromogranin A in one case was noted. Ki-67 expression ranged from 15 to 25%. Thyroid transcription factor and CD3 were negative. There was no evidence of recurrent or metastatic disease at following surgery. These features demonstrated CASTLE may arise from branchial pouch remnants, the thyroid solid cell nests. CASTLE is a rare entity, awareness of its occurrence as a second primary tumor is important to avoid overtreatment because it is associated with a favorable prognosis.

  17. A novel synthetic quantification standard including virus and internal report targets: application for the detection and quantification of emerging begomoviruses on tomato.

    Science.gov (United States)

    Péréfarres, Frédéric; Hoareau, Murielle; Chiroleu, Frédéric; Reynaud, Bernard; Dintinger, Jacques; Lett, Jean-Michel

    2011-08-05

    Begomovirus is a genus of phytopathogenic single-stranded DNA viruses, transmitted by the whitefly Bemisia tabaci. This genus includes emerging and economically significant viruses such as those associated with Tomato Yellow Leaf Curl Disease, for which diagnostic tools are needed to prevent dispersion and new introductions. Five real-time PCRs with an internal tomato reporter gene were developed for accurate detection and quantification of monopartite begomoviruses, including two strains of the Tomato yellow leaf curl virus (TYLCV; Mld and IL strains), the Tomato leaf curl Comoros virus-like viruses (ToLCKMV-like viruses) and the two molecules of the bipartite Potato yellow mosaic virus. These diagnostic tools have a unique standard quantification, comprising the targeted viral and internal report amplicons. These duplex real-time PCRs were applied to artificially inoculated plants to monitor and compare their viral development. Real-time PCRs were optimized for accurate detection and quantification over a range of 2 × 10(9) to 2 × 10(3) copies of genomic viral DNA/μL for TYLCV-Mld, TYLCV-IL and PYMV-B and 2 × 10(8) to 2 × 10(3) copies of genomic viral DNA/μL for PYMV-A and ToLCKMV-like viruses. These real-time PCRs were applied to artificially inoculated plants and viral loads were compared at 10, 20 and 30 days post-inoculation. Different patterns of viral accumulation were observed between the bipartite and the monopartite begomoviruses. Interestingly, PYMV accumulated more viral DNA at each date for both genomic components compared to all the monopartite viruses. Also, PYMV reached its highest viral load at 10 dpi contrary to the other viruses (20 dpi). The accumulation kinetics of the two strains of emergent TYLCV differed from the ToLCKMV-like viruses in the higher quantities of viral DNA produced in the early phase of the infection and in the shorter time to reach this peak viral load. To detect and quantify a wide range of begomoviruses, five duplex

  18. A novel synthetic quantification standard including virus and internal report targets: application for the detection and quantification of emerging begomoviruses on tomato

    Directory of Open Access Journals (Sweden)

    Lett Jean-Michel

    2011-08-01

    Full Text Available Abstract Background Begomovirus is a genus of phytopathogenic single-stranded DNA viruses, transmitted by the whitefly Bemisia tabaci. This genus includes emerging and economically significant viruses such as those associated with Tomato Yellow Leaf Curl Disease, for which diagnostic tools are needed to prevent dispersion and new introductions. Five real-time PCRs with an internal tomato reporter gene were developed for accurate detection and quantification of monopartite begomoviruses, including two strains of the Tomato yellow leaf curl virus (TYLCV; Mld and IL strains, the Tomato leaf curl Comoros virus-like viruses (ToLCKMV-like viruses and the two molecules of the bipartite Potato yellow mosaic virus. These diagnostic tools have a unique standard quantification, comprising the targeted viral and internal report amplicons. These duplex real-time PCRs were applied to artificially inoculated plants to monitor and compare their viral development. Results Real-time PCRs were optimized for accurate detection and quantification over a range of 2 × 109 to 2 × 103 copies of genomic viral DNA/μL for TYLCV-Mld, TYLCV-IL and PYMV-B and 2 × 108 to 2 × 103 copies of genomic viral DNA/μL for PYMV-A and ToLCKMV-like viruses. These real-time PCRs were applied to artificially inoculated plants and viral loads were compared at 10, 20 and 30 days post-inoculation. Different patterns of viral accumulation were observed between the bipartite and the monopartite begomoviruses. Interestingly, PYMV accumulated more viral DNA at each date for both genomic components compared to all the monopartite viruses. Also, PYMV reached its highest viral load at 10 dpi contrary to the other viruses (20 dpi. The accumulation kinetics of the two strains of emergent TYLCV differed from the ToLCKMV-like viruses in the higher quantities of viral DNA produced in the early phase of the infection and in the shorter time to reach this peak viral load. Conclusions To detect and

  19. Diagnostic terminology for urinary cytology reports including the new subcategories 'atypical urothelial cells of undetermined significance' (AUC-US) and 'cannot exclude high grade' (AUC-H).

    Science.gov (United States)

    Piaton, E; Decaussin-Petrucci, M; Mege-Lechevallier, F; Advenier, A-S; Devonec, M; Ruffion, A

    2014-02-01

    We studied whether atypical, non-superficial urothelial cells (AUC) could be separated into new subcategories including AUC 'of undetermined significance' (AUC-US) and 'cannot exclude high grade'' (AUC-H) in order to help to standardize urine cytopathology reports, as it is widely accepted in the Bethesda system for gynaecological cytopathology. We investigated whether AUC-US and AUC-H, defined by distinctive cytological criteria, might be separated with statistical significance according to actual diagnosis and follow-up data. A series of 534 cyto-histological comparisons taken in 139 patients, including 221 AUC at various steps of their clinical history was studied. There were 513 (96.1%) postcystoscopy and 469 (87.8%) ThinPrep® liquid-based specimens (95.9% and 89.1% of AUC cases, respectively). Patients viewed between 1999 and 2011 had histological control in a 0- to 6-months delay and were followed-up during an additional 5.9 ± 9.2 (0- to 56-) months period. The 221 AUC represented 0.8-2% of the specimens viewed during the study period. Among AUC-H cases, 70 out of 185 (37.8%) matched with high-grade lesions, compared with 3 of 38 (8.3%) of AUC-US cases (P = 0.0003). Conservatively treated patients with AUC-H more frequently developed high-grade lesions than those with AUC-US (54.1% versus 16.7%, P = 0.0007) with a 17.6-months mean delay. Nuclear hyperchromasia, a nuclear to cytoplasm (N/C) ratio > 0.7 and the combination of both were the more informative diagnostic criteria, all with P < 0.01. We conclude that the new subcategories could help to standardize urine cytopathology reports and contribute to the patient's management, provided it is validated by multicentric studies. © 2013 John Wiley & Sons Ltd.

  20. Uses of tuberculosis mortality surveillance to identify programme errors and improve database reporting.

    Science.gov (United States)

    Selig, L; Guedes, R; Kritski, A; Spector, N; Lapa E Silva, J R; Braga, J U; Trajman, A

    2009-08-01

    In 2006, 848 persons died from tuberculosis (TB) in Rio de Janeiro, Brazil, corresponding to a mortality rate of 5.4 per 100 000 population. No specific TB death surveillance actions are currently in place in Brazil. Two public general hospitals with large open emergency rooms in Rio de Janeiro City. To evaluate the contribution of TB death surveillance in detecting gaps in TB control. We conducted a survey of TB deaths from September 2005 to August 2006. Records of TB-related deaths and deaths due to undefined causes were investigated. Complementary data were gathered from the mortality and TB notification databases. Seventy-three TB-related deaths were investigated. Transmission hazards were identified among firefighters, health care workers and in-patients. Management errors included failure to isolate suspected cases, to confirm TB, to correct drug doses in underweight patients and to trace contacts. Following the survey, 36 cases that had not previously been notified were included in the national TB notification database and the outcome of 29 notified cases was corrected. TB mortality surveillance can contribute to TB monitoring and evaluation by detecting correctable and specific programme- and hospital-based care errors, and by improving the accuracy of TB database reporting. Specific local and programmatic interventions can be proposed as a result.

  1. Peer-Assisted Analysis of Resident Feedback Improves Clinical Teaching: A Case Report.

    Science.gov (United States)

    Mai, Christine L; Baker, Keith

    2017-07-01

    Anesthesiologists play an important role in educating future clinicians. Yet few residency programs incorporate teaching skills into faculty development. Consequently, many anesthesiologists have limited training to supervise and educate residents. In turn, these attendings may receive negative feedback and poor evaluations from residents without a means to effectively improve. Peer-assisted teaching between faculty members may serve as a strategy to improve teaching skills. We report a case of peer-assisted analysis of resident feedback to identify specific areas of concern that were targeted for improvement. This approach resulted in improved teaching scores and feedback for the faculty member.

  2. Rationale and design of three observational, prospective cohort studies including biobanking to evaluate and improve diagnostics, management strategies and risk stratification in venous thromboembolism: the VTEval Project.

    Science.gov (United States)

    Frank, Bernd; Ariza, Liana; Lamparter, Heidrun; Grossmann, Vera; Prochaska, Jürgen H; Ullmann, Alexander; Kindler, Florentina; Weisser, Gerhard; Walter, Ulrich; Lackner, Karl J; Espinola-Klein, Christine; Münzel, Thomas; Konstantinides, Stavros V; Wild, Philipp S

    2015-07-01

    Venous thromboembolism (VTE) with its two manifestations deep vein thrombosis (DVT) and pulmonary embolism (PE) is a major public health problem. The VTEval Project aims to investigate numerous research questions on diagnosis, clinical management, treatment and prognosis of VTE, which have remained uncertain to date. The VTEval Project consists of three observational, prospective cohort studies on VTE comprising cohorts of individuals with a clinical suspicion of acute PE (with or without DVT), with a clinical suspicion of acute DVT (without symptomatic PE) and with an incidental diagnosis of VTE (PE or DVT). The VTEval Project expects to enrol a total of approximately 2000 individuals with subsequent active and passive follow-up investigations over a time period of 5 years per participant. Time points for active follow-up investigations are at months 3, 6, 12, 24 and 36 after diagnosis (depending on the disease cohort); passive follow-up investigations via registry offices and the cancer registry are performed 48 and 60 months after diagnosis for all participants. Primary short-term outcome is defined by overall mortality (PE-related death and all other causes of death), primary long-term outcome by symptomatic VTE (PE-related death, recurrence of non-fatal PE or DVT). The VTEval Project includes three 'all-comer' studies and involves the standardised acquisition of high-quality data, covering the systematic assessment of VTE including symptoms, risk profile, psychosocial, environmental and lifestyle factors as well as clinical and subclinical disease, and it builds up a large state-of-the-art biorepository containing various materials from serial blood samplings. The VTEval Project has been approved by the local data safety commissioner and the responsible ethics committee (reference no. 837.320.12 (8421-F)). Trial results will be published in peer-reviewed journals and presented at national and international scientific meetings. NCT02156401. Published by the

  3. Colombia Mi Pronostico Flood Application: Updating and Improving the Mi Pronostico Flood Web Application to Include an Assessment of Flood Risk

    Science.gov (United States)

    Rushley, Stephanie; Carter, Matthew; Chiou, Charles; Farmer, Richard; Haywood, Kevin; Pototzky, Anthony, Jr.; White, Adam; Winker, Daniel

    2014-01-01

    Colombia is a country with highly variable terrain, from the Andes Mountains to plains and coastal areas, many of these areas are prone to flooding disasters. To identify these risk areas NASA's Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) was used to construct a digital elevation model (DEM) for the study region. The preliminary risk assessment was applied to a pilot study area, the La Mosca River basin. Precipitation data from the National Aeronautics and Space Administration (NASA) Tropical Rainfall Measuring Mission (TRMM)'s near-real-time rainfall products as well as precipitation data from the Instituto de Hidrologia, Meteorologia y Estudios Ambientales (the Institute of Hydrology, Meteorology and Environmental Studies, IDEAM) and stations in the La Mosca River Basin were used to create rainfall distribution maps for the region. Using the precipitation data and the ASTER DEM, the web application, Mi Pronóstico, run by IDEAM, was updated to include an interactive map which currently allows users to search for a location and view the vulnerability and current weather and flooding conditions. The geospatial information was linked to an early warning system in Mi Pronóstico that can alert the public of flood warnings and identify locations of nearby shelters.

  4. Can use of an administrative database improve accuracy of hospital-reported readmission rates?

    Science.gov (United States)

    Edgerton, James R; Herbert, Morley A; Hamman, Baron L; Ring, W Steves

    2018-05-01

    Readmission rates after cardiac surgery are being used as a quality indicator; they are also being collected by Medicare and are tied to reimbursement. Accurate knowledge of readmission rates may be difficult to achieve because patients may be readmitted to different hospitals. In our area, 81 hospitals share administrative claims data; 28 of these hospitals (from 5 different hospital systems) do cardiac surgery and share Society of Thoracic Surgeons (STS) clinical data. We used these 2 sources to compare the readmissions data for accuracy. A total of 45,539 STS records from January 2008 to December 2016 were matched with the hospital billing data records. Using the index visit as the start date, the billing records were queried for any subsequent in-patient visits for that patient. The billing records included date of readmission and hospital of readmission data and were compared with the data captured in the STS record. We found 1153 (2.5%) patients who had STS records that were marked "No" or "missing," but there were billing records that showed a readmission. The reported STS readmission rate of 4796 (10.5%) underreported the readmission rate by 2.5 actual percentage points. The true rate should have been 13.0%. Actual readmission rate was 23.8% higher than reported by the clinical database. Approximately 36% of readmissions were to a hospital that was a part of a different hospital system. It is important to know accurate readmission rates for quality improvement processes and institutional financial planning. Matching patient records to an administrative database showed that the clinical database may fail to capture many readmissions. Combining data with an administrative database can enhance accuracy of reporting. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  5. Including irrigation in niche modelling of the invasive wasp Vespula germanica (Fabricius) improves model fit to predict potential for further spread.

    Science.gov (United States)

    de Villiers, Marelize; Kriticos, Darren J; Veldtman, Ruan

    2017-01-01

    The European wasp, Vespula germanica (Fabricius) (Hymenoptera: Vespidae), is of Palaearctic origin, being native to Europe, northern Africa and Asia, and introduced into North America, Chile, Argentina, Iceland, Ascension Island, South Africa, Australia and New Zealand. Due to its polyphagous nature and scavenging behaviour, V. germanica threatens agriculture and silviculture, and negatively affects biodiversity, while its aggressive nature and venomous sting pose a health risk to humans. In areas with warmer winters and longer summers, queens and workers can survive the winter months, leading to the build-up of large nests during the following season; thereby increasing the risk posed by this species. To prevent or prepare for such unwanted impacts it is important to know where the wasp may be able to establish, either through natural spread or through introduction as a result of human transport. Distribution data from Argentina and Australia, and seasonal phenology data from Argentina were used to determine the potential distribution of V. germanica using CLIMEX modelling. In contrast to previous models, the influence of irrigation on its distribution was also investigated. Under a natural rainfall scenario, the model showed similarities to previous models. When irrigation is applied, dry stress is alleviated, leading to larger areas modelled climatically suitable compared with previous models, which provided a better fit with the actual distribution of the species. The main areas at risk of invasion by V. germanica include western USA, Mexico, small areas in Central America and in the north-western region of South America, eastern Brazil, western Russia, north-western China, Japan, the Mediterranean coastal regions of North Africa, and parts of southern and eastern Africa.

  6. Including irrigation in niche modelling of the invasive wasp Vespula germanica (Fabricius improves model fit to predict potential for further spread.

    Directory of Open Access Journals (Sweden)

    Marelize de Villiers

    Full Text Available The European wasp, Vespula germanica (Fabricius (Hymenoptera: Vespidae, is of Palaearctic origin, being native to Europe, northern Africa and Asia, and introduced into North America, Chile, Argentina, Iceland, Ascension Island, South Africa, Australia and New Zealand. Due to its polyphagous nature and scavenging behaviour, V. germanica threatens agriculture and silviculture, and negatively affects biodiversity, while its aggressive nature and venomous sting pose a health risk to humans. In areas with warmer winters and longer summers, queens and workers can survive the winter months, leading to the build-up of large nests during the following season; thereby increasing the risk posed by this species. To prevent or prepare for such unwanted impacts it is important to know where the wasp may be able to establish, either through natural spread or through introduction as a result of human transport. Distribution data from Argentina and Australia, and seasonal phenology data from Argentina were used to determine the potential distribution of V. germanica using CLIMEX modelling. In contrast to previous models, the influence of irrigation on its distribution was also investigated. Under a natural rainfall scenario, the model showed similarities to previous models. When irrigation is applied, dry stress is alleviated, leading to larger areas modelled climatically suitable compared with previous models, which provided a better fit with the actual distribution of the species. The main areas at risk of invasion by V. germanica include western USA, Mexico, small areas in Central America and in the north-western region of South America, eastern Brazil, western Russia, north-western China, Japan, the Mediterranean coastal regions of North Africa, and parts of southern and eastern Africa.

  7. Wetland Biomass Production: emergent aquatic management options and evaluations. A final subcontract report. [Includes a bibliography containing 686 references on Typha from biological abstracts

    Energy Technology Data Exchange (ETDEWEB)

    Pratt, D.C.; Dubbe, D.R.; Garver, E.G.; Linton, P.J.

    1984-07-01

    The high yield potential and attractive chemical composition of Typha make it a particularly viable energy crop. The Minnesota research effort has demonstrated that total annual biomass yields equivalent to 30 dry tonnes/ha (13 tons/acre) are possible in planted stands. This compares with yields of total plant material between 9 and 16 dry tonnes/ha (4 to 7 tons/acre) in a typical Minnesota corn field. At least 50% of the Typha plant is comprised of a belowground rhizome system containing 40% starch and sugar. This high level of easily fermentable carbohydrate makes rhizomes an attractive feedstock for alcohol production. The aboveground portion of the plant is largely cellulose, and although it is not easily fermentable, it can be gasified or burned. This report is organized in a manner that focuses on the evaluation of the management options task. Results from stand management research performed at the University of Minnesota during 1982 and 1983 are integrated with findings from an extensive survey of relevant emergent aquatic plant research and utilization. These results and findings are then arranged in sections dealing with key steps and issues that need to be dealt with in the development of a managed emergent aquatic bio-energy system. A brief section evaluating the current status of rhizome harvesting is also included along with an indexed bibliography of the biology, ecology, and utilization of Typha which was completed with support from this SERI subcontract. 686 references, 11 figures, 17 tables.

  8. Nephrogenic diabetes insipidus in a patient with L1 syndrome: a new report of a contiguous gene deletion syndrome including L1CAM and AVPR2.

    Science.gov (United States)

    Knops, Noël B B; Bos, Krista K; Kerstjens, Mieke; van Dael, Karin; Vos, Yvonne J

    2008-07-15

    We report on an infant boy with congenital hydrocephalus due to L1 syndrome and polyuria due to diabetes insipidus. We initially believed his excessive urine loss was from central diabetes insipidus and that the cerebral malformation caused a secondary insufficient pituitary vasopressin release. However, he failed to respond to treatment with a vasopressin analogue, which pointed to nephrogenic diabetes insipidus (NDI). L1 syndrome and X-linked NDI are distinct clinical disorders caused by mutations in the L1CAM and AVPR2 genes, respectively, located in adjacent positions in Xq28. In this boy we found a deletion of 61,577 basepairs encompassing the entire L1CAM and AVPR2 genes and extending into intron 7 of the ARHGAP4 gene. To our knowledge this is the first description of a patient with a deletion of these three genes. He is the second patient to be described with L1 syndrome and NDI. During follow-up he manifested complications from the hydrocephalus and NDI including global developmental delay and growth failure with low IGF-1 and hypothyroidism. 2008 Wiley-Liss, Inc.

  9. Structured pathology reporting improves the macroscopic assessment of rectal tumour resection specimens.

    Science.gov (United States)

    King, Simon; Dimech, Margaret; Johnstone, Susan

    2016-06-01

    We examined whether introduction of a structured macroscopic reporting template for rectal tumour resection specimens improved the completeness and efficiency in collecting key macroscopic data elements. Fifty free text (narrative) macroscopic reports retrieved from 2012 to 2014 were compared with 50 structured macroscopic reports from 2013 to 2015, all of which were generated at John Hunter Hospital, Newcastle, NSW. The six standard macroscopic data elements examined in this study were reported in all 50 anatomical pathology reports using a structured macroscopic reporting dictation template. Free text reports demonstrated significantly impaired data collection when recording intactness of mesorectum (p<0.001), relationship to anterior peritoneal reflection (p=0.028) and distance of tumour to the non-peritonealised circumferential margin (p<0.001). The number of words used was also significantly (p<0.001) reduced using pre-formatted structured reports compared to free text reports. The introduction of a structured reporting dictation template improves data collection and may reduce the subsequent administrative burden when macroscopically evaluating rectal resections. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  10. Critical evaluation as an aid to improved report writing: a case study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-05-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents. They were given opportunities to practise using the framework both through exemplars and through evaluating the work of their peers. They also carried out self-assessment. The authors' analysis of this novel approach shows that most students responded well to it and benefited from it. Lessons are drawn from this work for others who wish to improve their students' report writing skills.

  11. Protocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials.

    Science.gov (United States)

    Welch, Vivian; Jull, J; Petkovic, J; Armstrong, R; Boyer, Y; Cuervo, L G; Edwards, Sjl; Lydiatt, A; Gough, D; Grimshaw, J; Kristjansson, E; Mbuagbaw, L; McGowan, J; Moher, D; Pantoja, T; Petticrew, M; Pottie, K; Rader, T; Shea, B; Taljaard, M; Waters, E; Weijer, C; Wells, G A; White, H; Whitehead, M; Tugwell, P

    2015-10-21

    Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies.

  12. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2002-2003.

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Sheryl

    2004-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near the present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville Confederated

  13. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2001-2002.

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Sheryl

    2003-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near the present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville Confederated

  14. How do aggregated patient-reported outcome measures data stimulate health care improvement? A realist synthesis

    Science.gov (United States)

    Dalkin, Sonia; Gibbons, Elizabeth; Wright, Judy; Valderas, Jose Maria; Meads, David; Black, Nick

    2017-01-01

    Objectives Internationally, there has been considerable debate about the role of data in supporting quality improvement in health care. Our objective was to understand how, why and in what circumstances the feedback of aggregated patient-reported outcome measures data improved patient care. Methods We conducted a realist synthesis. We identified three main programme theories underlying the use of patient-reported outcome measures as a quality improvement strategy and expressed them as nine ‘if then’ propositions. We identified international evidence to test these propositions through searches of electronic databases and citation tracking, and supplemented our synthesis with evidence from similar forms of performance data. We synthesized this evidence through comparing the mechanisms and impact of patient-reported outcome measures and other performance data on quality improvement in different contexts. Results Three programme theories were identified: supporting patient choice, improving accountability and enabling providers to compare their performance with others. Relevant contextual factors were extent of public disclosure, use of financial incentives, perceived credibility of the data and the practicality of the results. Available evidence suggests that patients or their agents rarely use any published performance data when selecting a provider. The perceived motivation behind public reporting is an important determinant of how providers respond. When clinicians perceived that performance indicators were not credible but were incentivized to collect them, gaming or manipulation of data occurred. Outcome data do not provide information on the cause of poor care: providers needed to integrate and interpret patient-reported outcome measures and other outcome data in the context of other data. Lack of timeliness of performance data constrains their impact. Conclusions Although there is only limited research evidence to support some widely held theories of how

  15. Molecular and Parasitological Survey of Bovine Piroplasms in the Black Sea Region, Including the First Report of Babesiosis Associated with Babesia divergens in Turkey.

    Science.gov (United States)

    Aktas, M; Ozubek, S

    2015-11-01

    Clinical cases of babesiosis were evaluated, and the frequency of bovine Babesia and Theileria parasites was determined in cattle. Blood samples and thin blood smears were collected from 23 cattle exhibiting clinical signs of babesiosis. In addition, tick and blood samples were collected from 100 apparently healthy cattle cograzing from the same area. Egg masses obtained from fully engorged female ticks were included. DNA isolated from blood and tick samples was screened for Babesia and Theileria by reverse line blot assay. Piroplasms compatible with Babesia spp. were observed microscopically for symptomatic cattle as circular, oval, elongated, or pear-shaped bodies. Parasitemia ranged from 0.08 to 0.9% for Babesia bovis, 2.5 to 15.4% for Babesia bigemina, and 7.4% for Babesia divergens. Reverse line blot showed positivity in 13 (13%) of the sampled clinically normal cattle and revealed the presence of three Babesia species. Babesia bovis was the most prevalent (9/100, 9%), followed by Babesia occultans (3/100, 3%) and B. bigemina (1/100, 1%). One animal infected with B. bigemina was also infected with B. bovis. The single animal infected with B. divergens showed symptoms of babesiosis. Ticks were identified as Rhipicephalus annulatus, Rhipicephalus turanicus, and Ixodes ricinus. One female R. annulatus and its egg mass were infected with B. bigemina. Neither Theileria annulata nor Theileria buffeli/orientalis infections were observed in cattle or ticks. This is the first report of clinical babesiosis caused by B. divergens in cattle from Turkey. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  17. Report: Controls and Oversight Needed to Improve Administration of EPA’s Customer Service Lines

    Science.gov (United States)

    Report #13-P-0432, September 26, 2013. The EPA has a variety of resources—including telephone hotlines, Web clearinghouses, and other online reference information—which the OIG has categorized as customer service lines (CSLs).

  18. Closing the quality gap: revisiting the state of the science (vol. 5: public reporting as a quality improvement strategy).

    Science.gov (United States)

    Totten, Annette M; Wagner, Jesse; Tiwari, Arpita; O'Haire, Christen; Griffin, Jessica; Walker, Miranda

    2012-07-01

    The goal of this review was to evaluate the effectiveness of public reporting of health care quality information as a quality improvement strategy. We sought to determine if public reporting results in improvements in health care delivery and patient outcomes. We also considered whether public reporting affects the behavior of patients or of health care providers. Finally we assessed whether the characteristics of the public reports and the context affect the impact of public reports. Articles available between 1980 and 2011 were identified through searches of the following bibliographical databases: MEDLINE®, Embase, EconLit, PsychINFO, Business Source Premier, CINAHL, PAIS, Cochrane Database of Systematic Reviews, EPOC Register of Studies, DARE, NHS EED, HEED, NYAM Grey Literature Report database, and other sources (experts, reference lists, and gray literature). We screened citations based on inclusion and exclusion criteria developed based on our definition of public reporting. We initially did not exclude any studies based on study design. Of the 11,809 citations identified through title and abstract triage, we screened and reviewed 1,632 articles. A total of 97 quantitative and 101 qualitative studies were included, abstracted, entered into tables, and evaluated. The heterogeneity of outcomes as well as methods prohibited formal quantitative synthesis. Systematic reviews were used to identify studies, but their conclusions were not incorporated into this review. For most of the outcomes, the strength of the evidence available to assess the impact of public reporting was moderate. This was due in part to the methodological challenges researchers face in designing and conducting research on the impact of population-level interventions. Public reporting is associated with improvement in health care performance measures such as those included in Nursing Home Compare. Almost all identified studies found no evidence or only weak evidence that public reporting

  19. AMCP Partnership Forum: Improving Quality, Value, and Outcomes with Patient-Reported Outcomes.

    Science.gov (United States)

    2018-03-01

    manufacturers should engage key stakeholders early and throughout the drug development process to ensure the most valid and representative PROs and patient populations will be included. To streamline the PRO collection process, participants suggested engaging pharmacists and other providers who may have more frequent interaction with patients. Participants also recommended that PRO collection and analysis should use common technology platforms, streamline components of clinician care to reduce workflow, and be integrated with claims data to provider payers a better understanding of patient health in real time. Finally, additional work should be done to develop patient-reported outcome measures that contain relevant measures for all healthcare stakeholders. While significant challenges remain in PRO development and adoption, participants agreed that greater use can only be achieved through collaboration and patient-centered care. The AMCP Partnership Forum titled "Improving Quality, Value, and Outcomes with Patient-Reported Outcomes" and the development of this proceedings report were supported by Amgen, Boehringer Ingelheim Pharmaceuticals, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals, Novo Nordisk, Precision for Value, Premier, Sanofi, Takeda Pharmaceuticals USA, and Xcenda.

  20. Design report on SCDAP/RELAP5 model improvements - debris bed and molten pool behavior

    International Nuclear Information System (INIS)

    Allison, C.M.; Rempe, J.L.; Chavez, S.A.

    1994-11-01

    The SCDAP/RELAP5/MOD3 computer code is designed to describe the overall reactor coolant system thermal-hydraulic response, core damage progression, and in combination with VICTORIA, fission product release and transport during severe accidents. Improvements for existing debris bed and molten pool models in the SCDAP/RELAP5/MOD3.1 code are described in this report. Model improvements to address (a) debris bed formation, heating, and melting; (b) molten pool formation and growth; and (c) molten pool crust failure are discussed. Relevant data, existing models, proposed modeling changes, and the anticipated impact of the changes are discussed. Recommendations for the assessment of improved models are provided

  1. Effects of a proposed quality improvement process in the proportion of the reported ultrasound findings unsupported by stored images.

    Science.gov (United States)

    Schenone, Mauro; Ziebarth, Sarah; Duncan, Jose; Stokes, Lea; Hernandez, Angela

    2018-02-05

    To investigate the proportion of documented ultrasound findings that were unsupported by stored ultrasound images in the obstetric ultrasound unit, before and after the implementation of a quality improvement process consisting of a checklist and feedback. A quality improvement process was created involving utilization of a checklist and feedback from physician to sonographer. The feedback was based on findings of the physician's review of the report and images using a check list. To assess the impact of this process, two groups were compared. Group 1 consisted of 58 ultrasound reports created prior to initiation of the process. Group 2 included 65 ultrasound reports created after process implementation. Each chart was reviewed by a physician and a sonographer. Findings considered unsupported by stored images by both reviewers were used for analysis, and the proportion of unsupported findings was compared between the two groups. Results are expressed as mean ± standard error. A p value of improvement process implementation. Thus, we present a simple yet effective quality improvement process to reduce unsupported ultrasound findings.

  2. Improvements of the cash-flow statement control function in financial reporting

    Directory of Open Access Journals (Sweden)

    Metka Duhovnik

    2008-06-01

    Full Text Available On the basis of deductive considerations applying professional judgement, the article focuses on the additional value of accounting information that can be given to the users of fi nancial statements by a properly prepared statement of cash fl ows. It is based on the fi nding that the professional literature is inconsistent in distinguishing liquidity and profi tability information, and consequently also in distinguishing between the ratios calculated on that basis. It therefore stimulates an improvement in the quality of accounting information with a direct statement of cash fl ows, based on tracing instead of calculating the actual cash fl ow. On the basis of fi nancial statements, including a direct statement of cash fl ows, the ratio analysis of fi nancial statements should be approached from both aspects of profi tability and cash return. The cash fl ow ratios would serve as a control mechanism over the assumptions used when preparing the balance sheet and income statement within the chosen financial reporting framework.

  3. Communicating the Improvements Developed from Critical Incident Reports is an Essential Part of CIRS.

    Science.gov (United States)

    Hubertus, J; Piehlmeier, W; Heinrich, M

    2016-09-01

    The Critical Incident Reporting System (CIRS) is a tool for employees to report anonymously of near misses. Its efficiency and improvement of safety is proved by many studies. Our department introduced CIRS in 2009 and it is used frequently. As the number of reports decreased over time we asked for factors responsible for the reduced use. All employees had access to CIRS and have been trained in several courses of instruction. Accomplished results and consequences were published in biannual newsletters. In 2014 we initiated an anonymous employee attitude survey to ask for their experience and satisfaction with CIRS. 88 near misses were reported since 2009. 44 (50%) reports were classified as RS1, 34 (38.6%) as RS2, and 10 (11.4%) as RS3. No RS4 reports were notified. Most reports concerned problems with administration of medication (n=26; 29.5%) and problems with technical devices (n=18; 20.5%). 75 (83%) of our employees participated in the survey. 64 (86.5%) discerned that CIRS is anonymous. 31 (41.9%) reported already a near miss. Of note, two-third didn't realize an improvement following their report. On the other hand, only half of the pollees stated to read the newsletter. Even if efficiency and advantages of CIRS are proved and undeniable, sufficient and perpetual feedback of results and improvements developed by the CIRS team and regular trainings of the employees are mandatory for the success of CIRS. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Feasibility study on improving SO/sub 2/ abatement economics through improvements in byproduct utilization. Final report. 2 Volumes

    Energy Technology Data Exchange (ETDEWEB)

    1984-01-17

    This study was undertaken to assess the technical feasibility of improving SO/sub 2/ abatement economics through improvements in byproduct utilization, and to recommend the most appropriate strategy for fostering the development and commericalization of such technology. Existing byproduct technology was reviewed and the potential for new technology assessed. This was done by a literature review and a survey of individuals and organizations actively engaged in this area. The assessment is confined to technical aspects only. This phase of the study concludes that there is a wide range of abatement byproduct technology, at various stages of development, which if appropriately exploited, offers the potential of improving byproduct utility and value, and hence the economics of Canadian SO/sub 2/ abatement. The second phase of this study addresses the problem of the most effective strategy for ensuring the development and commercialization of appropriate byproduct technology. This is based on discussions with individuals and organizations involved in the field, and assessment of the motivation and potential effectiveness of alternative approaches within the context of a diverse Canadian industry, the technology status in Canada and the national need. Includes 51-page bibliography. 400 refs., 14 tabs.

  5. Risk of Bias in Reports of In Vivo Research: A Focus for Improvement.

    Directory of Open Access Journals (Sweden)

    Malcolm R Macleod

    2015-10-01

    Full Text Available The reliability of experimental findings depends on the rigour of experimental design. Here we show limited reporting of measures to reduce the risk of bias in a random sample of life sciences publications, significantly lower reporting of randomisation in work published in journals of high impact, and very limited reporting of measures to reduce the risk of bias in publications from leading United Kingdom institutions. Ascertainment of differences between institutions might serve both as a measure of research quality and as a tool for institutional efforts to improve research quality.

  6. Reporting Data with "Over-the-Counter" Data Analysis Supports Improves Educators' Data Analyses

    Science.gov (United States)

    Rankin, Jenny Grant

    2014-01-01

    The benefits of making data-informed decisions to improve learning rely on educators correctly interpreting given data. Many educators routinely misinterpret data, even at districts with proactive support for data use. The tool most educators use for data analyses, which is an information technology data system or its reports, typically reports…

  7. Incomplete reporting of enhanced recovery elements and its impact on achieving quality improvement

    DEFF Research Database (Denmark)

    Day, R W; Fielder, S; Calhoun, J

    2015-01-01

    per cent), length of stay (47, 94 per cent) and mortality (45, 90 per cent). CONCLUSION: The current standard of reporting is frequently incomplete. To transfer knowledge and facilitate implementation of pathways that demonstrate improvements in perioperative care and recovery, a consistent structured...

  8. Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

    DEFF Research Database (Denmark)

    Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens

    2008-01-01

    Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5) Gr...

  9. The Graduation Cliff: Improving the Post-School Outcomes of Students with Disabilities. Summary Report

    Science.gov (United States)

    McFadden, Erica Skogebo; Daugherty, David B.; Lee, Sang Eun; Fisher, Kim W.; Hack, Anthony; Spyra, Ed

    2015-01-01

    There is a federal movement to improve student outcomes targeting some of these predictors in several recently launched initiatives, but where does Arizona stand? What are we currently doing to move the needle, and what do we still need to do? This report prepared for the Arizona Developmental Disabilities Planning Council has two objectives: (1)…

  10. Additional guidance for including nuclear safety equivalency in the Canister Storage Building and Cold Vacuum Drying Facility final safety analysis report

    Energy Technology Data Exchange (ETDEWEB)

    Garvin, L.J.

    1997-05-20

    This document provides guidance for the production of safety analysis reports that must meet both DOE Order 5480.23 and STD 3009, and be in compliance with the DOE regulatory policy that imposes certain NRC requirements.

  11. Additional guidance for including nuclear safety equivalency in the Canister Storage Building and Cold Vacuum Drying Facility final safety analysis report

    International Nuclear Information System (INIS)

    Garvin, L.J.

    1997-01-01

    This document provides guidance for the production of safety analysis reports that must meet both DOE Order 5480.23 and STD 3009, and be in compliance with the DOE regulatory policy that imposes certain NRC requirements

  12. Licensee Event Report System. Evaluation of first year results, and recommendations for improvements. Supplement No. 2

    International Nuclear Information System (INIS)

    1985-09-01

    This report describes an evaluation of an industry-wide sample of Licensee Event Reports (LERs) that was conducted to determine whether or not these LERs were prepared in accordance with the requirements set forth in 10 CFR 50.73. The study was performed at the Idaho National Engineering Laboratory (INEL), by EG and G, Inc. This evaluation (NUREG/CR-4178) indicated that although the overall quality of the LERs was good, many LERs failed to meet all of the requirements. This report presents the methodology that was used to evaluate the LERs, the conclusions reached concerning problem areas in the reports, and suggestions as to how the overall quality and completeness of reports can be improved

  13. The effects of performance criteria including accounting, market, and economy on the quality of financial reporting: A case study on Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Mohammad Mahdi Hosseini

    2013-01-01

    Full Text Available This research studies the effects of performance criteria (accounting, market and economy on the quality of financial reporting in Iran. To evaluate the variable financial reporting quality, the scores given to each company are applied based on the checklist introduced by Iranian Association of Certified Public Accountants and used for the disclosure of the information of the annual financial statements of companies. The statistical population of this research consists of the companies listed on Tehran Stock Exchange over the period 2006-2011. This research, which is classified as applied research, uses the methods of multivariate regression test. The data and hypotheses of this research are analyzed and tested using correlation test and means difference test. The results of the tests conducted on 99 companies indicate that there is a significant and positive relation between the rate of return on equity and the equality of financial reporting. There is also a significant and positive relation between earnings per share and the equality of financial reporting. However, there is no relationship between QTOBIN and the equality of financial reporting. Finally, our results indicate there is a significant and positive relation between market value-added and the equality of financial reporting.

  14. Improving the security of electricity supply - report by a rapporteur ad int

    International Nuclear Information System (INIS)

    Forsten, J.; Lehtonen, M.

    2002-07-01

    The storms 'Pyry' and 'Janika', which swept over Finland in October-November 2001, caused serious damages to the operability of electric systems and led to long-term and extensive interruptions in electricity supply especially in Pirkanmaa, Central Home, Poijat-Hame and in the Uusimaa region. Although the security of electricity supply in Finland has in general been on a high level, the needs of customers concerning the quality of electrical power are constantly growing, and the operational reliability of the distribution networks will thereby have to be developed. The Rapporteur ad int. appointed by the Ministry of Trade and Industry on 21 November 2001 considers that such a scheme complementing the price reduction under the Electricity Market Act should be set up that would require a fixed compensation from the distribution network operators in the case of non deliverance of electricity. The fixed compensation should be paid automatically for e.g. interruptions lasting over 12 hours. The sum would depend on the length of the interruption and on the customer's annual rate of the network service fee. The Rapporteur also gives a number of other recommendations for improving the situation. Each distribution network operator is to choose the means of improvement on a technical-economical basis. The required level in the design, construction, operation and maintenance of an electrical network should guarantee that the interruptions in electricity supply would not exceed six hours even in exceptional circumstances. Ensuring electrical safety is of prime importance in disturbance situations. Shortening the interruption times and improving the quality of electricity call for sustained investment planning and activities. The distribution network operators should draw up a ten-year action plan. including measures aiming to reduce interruptions and the related timetables. To be able to keep the interruption times short in extensive cases of disturbance, the distribution

  15. Dementia post-radiotherapy: improvement with acetylcholinesterase inhibitor A case report

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Damin

    Full Text Available Abstract Cognitive decline associated with radiotherapy is a progressive complication that affects many patients submitted to this form of treatment. The lack of an effective treatment drives research for new treatment options to improve the quality of life of patients with this disorder. We report the case of a 64 year-old man who developed a severe dementia of the frontal subcortical type, which was associated with subcortical frontal lesions and appeared as a late complication of radiotherapy used to treat a pituitary tumor. After many pharmacological attempts to improve his cognitive and behavioral problems, the patient showed a significant improvement in the cognitive, functional and behavioral impairments after treatment with an acetylcholinesterase inhibitor. This report discusses hypotheses for the positive effect of this treatment.

  16. Urgent need to improve the quality of case report in traditional Chinese medicine: Assessment on reporting quality of 3,417 cases.

    Science.gov (United States)

    Fu, Shu-Fei; Kun, Wai; Zeng, Xiao-Xi; Zhang, Li; Cheng, Chung-Wah; Song, Lisa; Zhong, Linda Li-Dan; Lin, Jia; Wang, Yong-Yan; Shang, Hong-Cai; Bian, Zhao-Xia

    2016-06-01

    To survey the reporting quality of traditional Chinese medicine (TCM) case reports published in recent years and understand the common problems. The assessment results would lay the foundation for the development of recommendations for case report in Chinese medicine. This survey determined the reporting quality of cases with Chinese herbal decoction, Chinese proprietary medicine, acupuncture, moxibustion and other traditional therapies published in 20 core medical journals of China by searching the China Academic Journals Full-text Database from 2006 to 2010. Fifty survey items in 16 domains were used to determine the reporting quality. One point was assigned to each item (Yes=1 point; No=0 point), and total score was 50 points. The domain of treatment was assessed independently, ranging from 2 to 9 items for different TCM interventions. The total of 1,858 case reports, covering 3,417 cases were included to analyze from 13 out of 20 core medical journals of China. There were 74.8% of them did not identify the nature of study in title, while 73.9% did not comprise an abstract. Incomplete reporting was found in discussions/ comment, and only 38.9% had made recommendations or take-away messages. Figures and tables were infrequently used. Three cases cited the full names of patients, but without declaring that any consent was obtained. Over 90% reported the symptoms and signs of TCM, and characteristics on tongue and pulse, but less than 50% did mention other medical history and diagnostic rationale. More than 90% treatments of the included cases were herbal decoction, with clear reporting on the ingredients and dosages. However, the reporting rate of the dosages of each ingredient was just 48.4%. Almost none reported the quality control of crude herbs, manufacturers and lot numbers of herbal proprietary medicine. Besides, advices and precautions on diet, emotions and living were rare to be illustrated. Systematic reporting recommendations are urged to develop for

  17. Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times.

    Science.gov (United States)

    Andriole, Katherine P; Prevedello, Luciano M; Dufault, Allen; Pezeshk, Parham; Bransfield, Robert; Hanson, Richard; Doubilet, Peter M; Seltzer, Steven E; Khorasani, Ramin

    2010-03-01

    Radiology report signature time (ST) can be a substantial component of total report turnaround time. Poor turnaround time resulting from lengthy ST can adversely affect patient care. The combination of technology adoption with financial incentive was evaluated to determine if ST improvement can be augmented and sustained. This prospective study was performed at a 751-bed, urban, tertiary care adult teaching hospital. Test-site imaging volume approximated 48,000 examinations per month. The radiology department has 100 trainees and 124 attending radiologists serving multiple institutions. Over a study period of 4 years and 4 months, three interventions focused on radiologist signature performance were implemented: 1) a notification paging application that alerted radiologists when reports were ready for signature, 2) a picture archiving and communications systems (PACS)-integrated speech recognition report generation system, and 3) a departmental financial incentive to reward radiologists semiannually for ST performance. Signature time was compared before and after the interventions. Wilcoxon and linear regression statistical analyses were used to assess the significance of trends. Technology adoption (paging plus speech recognition) reduced median ST from >5 to 24 to 15 to 18 hours (P financial incentive further improved 80th-percentile ST to 4 to 8 hours (P Technology interventions coupled with financial incentive can result in synergistic and sustainable improvement in radiologist report-signing behavior. The addition of a financial incentive leads to better performance than that achievable through technology alone.

  18. Improvement in the incident reporting and investigation procedures using process excellence (DMAI2C) methodology

    International Nuclear Information System (INIS)

    Miles, Elizabeth N.

    2006-01-01

    In 1996, Health and Safety introduced an incident investigation process called Learning to Look ( C) to Johnson and Johnson. This process provides a systematic way of analyzing work-related injuries and illness, uncovers root cause that leads to system defects, and points to viable solutions. The process analyzed involves three steps: investigation and reporting of the incident, determination of root cause, and development and implementation of a corrective action plan. The process requires the investigators to provide an initial communication for work-related serious injuries and illness as well as lost workday cases to Corporate Headquarters within 72h of the incident with a full investigative report to follow within 10 days. A full investigation requires a written report, a cause-result logic diagram (CRLD), a corrective action plan (CAP) and a report of incident costs (SafeCost) all due to be filed electronically. It is incumbent on the principal investigator and his or her investigative teams to assemble the various parts of the investigation and to follow up with the relevant parties to ensure corrective actions are implemented, and a full report submitted to Corporate executives. Initial review of the system revealed that the process was not working as designed. A number of reports were late, not signed by the business leaders, and in some instances, all cause were not identified. Process excellence was the process used to study the issue. The team used six sigma DMAI 2 C methodologies to identify and implement system improvements. The project examined the breakdown of the critical aspects of the reporting and investigation process that lead to system errors. This report will discuss the study findings, recommended improvements, and methods used to monitor the new improved process

  19. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    International Nuclear Information System (INIS)

    Jaimes, Camilo; Murcia, Diana J.; Miguel, Karen; DeFuria, Cathryn; Sagar, Pallavi; Gee, Michael S.

    2018-01-01

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  20. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    Energy Technology Data Exchange (ETDEWEB)

    Jaimes, Camilo [Massachusetts General Hospital, Harvard Medical School, Division of Neuroradiology, Department of Radiology, Boston, MA (United States); Murcia, Diana J. [Massachusetts General Hospital, Harvard Medical School, Division of Abdominal Imaging, Department of Radiology, Boston, MA (United States); Miguel, Karen; DeFuria, Cathryn [Massachusetts General Hospital, Harvard Medical School, Quality and Safety Office, Department of Radiology, Boston, MA (United States); Sagar, Pallavi; Gee, Michael S. [Massachusetts General Hospital for Children, Harvard Medical School, Division of Pediatric Imaging, Department of Radiology, Boston, MA (United States)

    2018-01-15

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  1. How to improve the validity of sexual behaviour reporting: systematic review of questionnaire delivery modes in developing countries.

    Science.gov (United States)

    Langhaug, Lisa F; Sherr, Lorraine; Cowan, Frances M

    2010-03-01

    To systematically review comparative research from developing countries on the effects of questionnaire delivery mode. We searched Medline, EMbase and PsychINFO and ISSTDR conference proceedings. Randomized control trials and quasi-experimental studies were included if they compared two or more questionnaire delivery modes, were conducted in a developing country, reported on sexual behaviours and occurred after 1980. A total of 28 articles reporting on 26 studies met the inclusion criteria. Heterogeneity of reported trial outcomes between studies made it inappropriate to combine trial outcomes. Eighteen studies compared audio computer-assisted survey instruments (ACASI) or its derivatives [personal digital assistant (PDA) or computer-assisted personal interview (CAPI)] against another self-administered questionnaires, face-to-face interviews or random response technique. Despite wide variation in geography and populations sampled, there was strong evidence that computer-assisted interviews lowered item-response rates and raised rates of reporting sensitive behaviours. ACASI also improved data entry quality. A wide range of sexual behaviours were reported including vaginal, oral, anal and/or forced sex, age of sexual debut, condom use at first and/or last sex. Validation of self-reports using biomarkers was rare. These data reaffirm that questionnaire delivery modes do affect self-reported sexual behaviours and that use of ACASI can significantly reduce reporting bias. Its acceptability and feasibility in developing country settings should encourage researchers to consider its use when conducting sexual health research. Triangulation of self-reported data using biomarkers is recommended. Standardizing sexual behaviour measures would allow for meta-analysis.

  2. Leveraging health information exchange to improve population health reporting processes: lessons in using a collaborative-participatory design process.

    Science.gov (United States)

    Revere, Debra; Dixon, Brian E; Hills, Rebecca; Williams, Jennifer L; Grannis, Shaun J

    2014-01-01

    Surveillance, or the systematic monitoring of disease within a population, is a cornerstone function of public health. Despite significant investment in information technologies (IT) to improve the public's health, health care providers continue to rely on manual, spontaneous reporting processes that can result in incomplete and delayed surveillance activities. Participatory design principles advocate including real users and stakeholders when designing an information system to ensure high ecological validity of the product, incorporate relevance and context into the design, reduce misconceptions designers can make due to insufficient domain expertise, and ultimately reduce barriers to adoption of the system. This paper focuses on the collaborative and informal participatory design process used to develop enhanced, IT-enabled reporting processes that leverage available electronic health records in a health information exchange to prepopulate notifiable-conditions report forms used by public health authorities. Over nine months, public health stakeholders, technical staff, and informatics researchers were engaged in a multiphase participatory design process that included public health stakeholder focus groups, investigator-engineering team meetings, public health survey and census regarding high-priority data elements, and codesign of exploratory prototypes and final form mock-ups. A number of state-mandated report fields that are not highly used or desirable for disease investigation were eliminated, which allowed engineers to repurpose form space for desired and high-priority data elements and improve the usability of the forms. Our participatory design process ensured that IT development was driven by end user expertise and needs, resulting in significant improvements to the layout and functionality of the reporting forms. In addition to informing report form development, engaging with public health end users and stakeholders through the participatory design

  3. Incident Reporting to Improve Patient Safety: The Effects of Process Variance on Pediatric Patient Safety in the Emergency Department.

    Science.gov (United States)

    OʼConnell, Karen J; Shaw, Kathy N; Ruddy, Richard M; Mahajan, Prashant V; Lichenstein, Richard; Olsen, Cody S; Funai, Tomohiko; Blumberg, Stephen; Chamberlain, James M

    2018-04-01

    Medical errors threaten patient safety, especially in the pediatric emergency department (ED) where overcrowding, multiple handoffs, and workflow interruptions are common. Errors related to process variance involve situations that are not consistent with standard ED operations or routine patient care. We performed a planned subanalysis of the Pediatric Emergency Care Applied Research Network incident reporting data classified as process variance events. Confidential deidentified incident reports (IRs) were collected and classified by 2 independent investigators. Events categorized as process variance were then subtyped for severity and contributing factors. Data were analyzed using descriptive statistics. The study intention was to describe and measure reported medical errors related to process variance in 17 EDs in the Pediatric Emergency Care Applied Research Network from 2007 to 2008. Between July 2007 and June 2008, 2906 eligible reports were reviewed. Process variance events were identified in 15.4% (447/2906). The majority were related to patient flow (35.4%), handoff communication (17.2%), and patient identification errors (15.9%). Most staff involved included nurses (47.9%) and physicians (28%); trainees were infrequently reported. The majority of events did not result in harm (65.7%); 17.9% (80/447) of cases were classified as unsafe conditions but did not reach the patient. Temporary harm requiring further treatment or hospitalization was reported in 5.6% (25/447). No events resulted in permanent harm, near death, or death. Contributing factors included human factors (92.1%), in particular handoff communication, interpersonal skills, and compliance with established procedures, and system-level errors (18.1%), including unclear or unavailable policies and inadequate staffing levels. Although process variance events accounted for approximately 1 in 6 reported safety events, very few led to patient harm. Because human and system-level factors contributed to

  4. Nephrogenic diabetes insipidus in a patient with L1 syndrome : A new report of a contiguous gene deletion syndrome including L1CAM and AVPR2

    NARCIS (Netherlands)

    Knops, Noel B. B.; Bos, Krista K.; Kerstjens, Mieke; van Dael, Karin; Vos, Yvonne J.

    2008-01-01

    We report on.in infant boy \\vitli congenital hydrocephatLis CILle to 1.1 syndrorne and p0lyUria dne to diabetes itisipidtis. We initially believed Ins excessive Lirine loss was froin central diabetes insipidLIS and diat the cerebral inalforniation caused a secondary insufficient pitnitary

  5. Improving gross motor function and postural control with hippotherapy in children with Down syndrome: case reports.

    Science.gov (United States)

    Champagne, Danielle; Dugas, Claude

    2010-11-01

    The purpose of this case report is to describe the impact of an 11-week hippotherapy program on the gross motor functions of two children (respectively 28 and 37 months old) diagnosed with Down syndrome. Hippotherapy is a strategy that uses the horse's motion to stimulate and enhance muscle contraction and postural control. The children were assessed by the Gross Motor Function Measure (GMFM) and accelerometry. The results indicate that both children improved on many dimensions of the GMFM. Power spectral analysis of the acceleration signals showed improvement in postural control of either the head or trunk, because the children adopted two different adaptative strategies to perturbation induced by the moving horse.

  6. Fuel utilization improvements in a once-through PWR fuel cycle. Final report on Task 6

    International Nuclear Information System (INIS)

    Dabby, D.

    1979-06-01

    In studying the position of the United States Department of Energy, Non-proliferation Alternative Systems Assessment Program, this report determines the uranium saving associated with various improvement concepts applicable to a once-through fuel cycle of a standard four-loop Westinghouse Pressurized Water Reactor. Increased discharged fuel burnup from 33,000 to 45,000 MWD/MTM could achieve a 12% U 3 O 8 saving by 1990. Improved fuel management schemes combined with coastdown to 60% power, could result in U 3 O 8 savings of 6%

  7. Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.

    Science.gov (United States)

    Zingmond, David S; Parikh, Punam; Louie, Rachel; Lichtensztajn, Daphne Y; Ponce, Ninez; Hasnain-Wynia, Romana; Gomez, Scarlett Lin

    2015-08-01

    To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US Census Summary File 2. We examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. Metrics were created to measure root mean squared differences (RMSD) by hospital between reported R/E distribution and R/E estimates using R/E distribution within each patient's zip code of residence. RMSD comparisons were made to corresponding "gold standard" facility-level measures within the maternal cohort for California and six comparison states. Maternal birth hospitalization (linked to the state birth registry) and cancer cohort records linked to preceding and subsequent hospitalizations. Hospital discharges were linked to the corresponding Census zip code tabulation area using patient zip code. Overall agreement between the PDD and the gold standard for the maternal cohort was 86 percent for the combined R/E measure and 71 percent for race alone. The RMSD measure is modestly correlated with the summary level gold standard measure for R/E (r = 0.44). The RMSD metric revealed general improvement in data agreement and completeness across states. "Other" and "unknown" categories were inconsistently applied within inpatient databases. Comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting. Further work should focus on using more granular geocoded data for estimates and tracking data to improve hospital collection of R/E data. © Health Research and Educational Trust.

  8. Improving clinical cognitive testing: report of the AAN Behavioral Neurology Section Workgroup.

    Science.gov (United States)

    Daffner, Kirk R; Gale, Seth A; Barrett, A M; Boeve, Bradley F; Chatterjee, Anjan; Coslett, H Branch; D'Esposito, Mark; Finney, Glen R; Gitelman, Darren R; Hart, John J; Lerner, Alan J; Meador, Kimford J; Pietras, Alison C; Voeller, Kytja S; Kaufer, Daniel I

    2015-09-08

    To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment. © 2015 American Academy of Neurology.

  9. Performance improvement of silicon nitride ball bearings by ion implantation. CRADA final report

    International Nuclear Information System (INIS)

    Williams, J.M.; Miner, J.

    1998-01-01

    The present report summarizes technical results of CRADA No. ORNL 92-128 with the Pratt and Whitney Division of United Technologies Corporation. The stated purpose of the program was to assess the 3effect of ion implantation on the rolling contact performance of engineering silicon nitride bearings, to determine by post-test analyses of the bearings the reasons for improved or reduced performance and the mechanisms of failure, if applicable, and to relate the overall results to basic property changes including but not limited to swelling, hardness, modulus, micromechanical properties, and surface morphology. Forty-two control samples were tested to an intended runout period of 60 h. It was possible to supply only six balls for ion implantation, but an extended test period goal of 150 h was used. The balls were implanted with C-ions at 150 keV to a fluence of 1.1 x 10 17 /cm 2 . The collection of samples had pre-existing defects called C-cracks in the surfaces. As a result, seven of the control samples had severe spalls before reaching the goal of 60 h for an unacceptable failure rate of 0.003/sample-h. None of the ion-implanted samples experienced engineering failure in 150 h of testing. Analytical techniques have been used to characterize ion implantation results, to characterize wear tracks, and to characterize microstructure and impurity content. In possible relation to C-cracks. It is encouraging that ion implantation can mitigate the C-crack failure mode. However, the practical implications are compromised by the fact that bearings with C-cracks would, in no case, be acceptable in engineering practice, as this type of defect was not anticipated when the program was designed. The most important reason for the use of ceramic bearings is energy efficiency

  10. Improved techniques for fluid diversion in oil recovery. First annual report

    Energy Technology Data Exchange (ETDEWEB)

    Seright, R.S.

    1993-12-01

    This three-year project has two general objectives. The first objective is to compare the effectiveness of gels in fluid diversion with those of other types of processes. Several different types of fluid-diversion processes are being compared, including those using gels, foams, emulsions, and particulates. The ultimate goals of these comparisons are to (1) establish which of these processes are most effective in a given application, and (2) determine whether aspects of one process can be combined with those of other processes to improve performance. Analyses and experiments are being performed to verify which materials are the most effective in entering and blocking high-permeability zones. Another objective of the project is to identify the mechanisms by which materials (particularly gels) selectively reduce permeability to water more than to oil. This report describes work performed during the first year of the project. Following the introduction, Chapters 2 through 5 present several surveys concerning field applications of gel treatments. Based on the results of the surveys, guidelines are proposed in Chapter 5 for the selection of candidates for gel treatments (both injection wells and production wells). Chapters 6, 7, 8, and 11 discuss theoretical work that was performed during the project. Chapter 6 examines whether Hall plots indicated selectivity during gelant placement. Chapter 7 discusses several important theoretical aspects of gel treatments in production wells with water-coning problems. Chapter 8 considers exploitation of density differences during gelant placement. Chapter 11 presents a preliminary consideration of the use of precipitates as blocking agents. Chapters 9 and 10 detail the experimental work for the project. Chapter 9 describes an experimental investigation of gelant placement in fractured systems. Chapter 10 describes experiments that probe the mechanisms for disproportionate permeability reduction by gels.

  11. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

    Science.gov (United States)

    Reid, Kathryn J; Baron, Kelly Glazer; Lu, Brandon; Naylor, Erik; Wolfe, Lisa; Zee, Phyllis C

    2010-10-01

    To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration 5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (pimprovements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.

  12. Breast calcifications. A standardized mammographic reporting and data system to improve positive predictive value

    International Nuclear Information System (INIS)

    Perugini, G.; Bonzanini, B.; Valentino, C.

    1999-01-01

    The purpose of this work is to investigate the usefulness of a standardized reporting and data system in improving the positive predictive value of mammography in breast calcifications. Using the Breast Imaging Reporting and Data System lexicon developed by the American College of Radiology, it is defined 5 descriptive categories of breast calcifications and classified diagnostic suspicion of malignancy on a 3-grade scale (low, intermediate and high). Two radiologists reviewed 117 mammographic studies selected from those of the patients submitted to surgical biopsy for mammographically detected calcifications from January 1993 to December 1997, and classified them according to the above criteria. The positive predictive value was calculated for all examinations and for the stratified groups. Defining a standardized system for assessing and describing breast calcifications helps improve the diagnostic accuracy of mammography in clinical practice [it

  13. Facilitating Improvements in Laboratory Report Writing Skills with Less Grading: A Laboratory Report Peer-Review Process

    Directory of Open Access Journals (Sweden)

    Jennifer R. Brigati

    2015-02-01

    Full Text Available Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading. T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading. While the grading process described here does not lead to statistically significant gains (or reductions in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings.

  14. Facilitating improvements in laboratory report writing skills with less grading: a laboratory report peer-review process.

    Science.gov (United States)

    Brigati, Jennifer R; Swann, Jerilyn M

    2015-05-01

    Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading). T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading). While the grading process described here does not lead to statistically significant gains (or reductions) in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings.

  15. Facilitating Improvements in Laboratory Report Writing Skills with Less Grading: A Laboratory Report Peer-Review Process†

    Science.gov (United States)

    Brigati, Jennifer R.; Swann, Jerilyn M.

    2015-01-01

    Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading). T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading). While the grading process described here does not lead to statistically significant gains (or reductions) in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings. PMID:25949758

  16. Symptomatic improvement reported after receiving Reiki at a cancer infusion center.

    Science.gov (United States)

    Marcus, Dawn A; Blazek-O'Neill, Betsy; Kopar, Jennifer L

    2013-03-01

    To evaluate patient-perceived benefits from receiving Reiki at a cancer infusion center. During a 6-month period, adults at a university hospital receiving Reiki through volunteer services were invited to complete a survey asking about perceived changes after Reiki. Changes in pain, mood, distress, sleep, and appetite were rated on a 5-point scale from no benefit to great benefit. Surveys were distributed after completing treatment and were returned in postage-paid envelops. A total of 145 surveys were completed (34.5% response rate), with 47 participants seen in the cancer infusion center and 98 in other areas of the hospital. Reiki was rated as a positive experience by 94% at the cancer center and 93% of others, with 92% at the cancer center and 86% of others interested in receiving additional Reiki sessions. Symptomatic improvement was similar for people at the cancer center and others, respectively, with much to great improvement for 89% and 86% for relaxation, 75% and 75% for anxiety/worry, 81% and 78% for improved mood, 43% and 35% for improved sleep, 45% and 49% for reduced pain, 38% and 43% for reduced isolation/loneliness, 75% and 63% for improved attitude, and 30% and 30% for improved appetite. Response was unaffected by previous exposure to Reiki, massage, or other touch therapy. Reiki results in a broad range of symptomatic benefits, including improvements in common cancer-related symptoms.

  17. Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function.

    Science.gov (United States)

    Alexander, Angel M; Flynn, Kathryn E; Hahn, Elizabeth A; Jeffery, Diana D; Keefe, Francis J; Reeve, Bryce B; Schultz, Wesley; Reese, Jennifer Barsky; Shelby, Rebecca A; Weinfurt, Kevin P

    2014-08-01

    There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy. This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy. We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System(®) (PROMIS(®) ) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy. In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item. Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension. Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development. © 2014 International Society for Sexual Medicine.

  18. Protecting and improving health through the radiological sciences. A report to the Surgeon General

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1966-04-01

    This is the third in a series of reports prepared by the-National Advisory Committee on Radiation for the Surgeon General of the Public Health Service. The first two were directed to the broad responsibilities of the Service in the field of radiation control and to problems concerned with the protection of the public against undue radiation exposure from contamination of the environment with radioactive materials. In this report the Committee traces the remarkable growth that has taken place in the uses of ionizing radiation in the health professions, in industry, and in other walks of life. It also notes a number of emerging problems which not only are of importance from the point of view of radiation protection, but also, if not alleviated, threaten the quality of medical care in the United States and the translation of the advances of atomic research into needed benefits for the people. These problems include (a) serious weaknesses in academic departments of radiology which have restricted efforts to provide adequate instruction of medical and post-doctoral students in the clinical applications of ionizing radiation, including radiation protection; and (b) an increasingly severe shortage of manpower in all branches of the radiological sciences. The magnitude and complexity of these problems are sufficiently great that a concerted effort is needed by the Public Health Service to correct them. The alleviation of the problems just cited is but a part of a more comprehensive series of responsibilities faced by the Service in the radiological sciences. The Service must play an important role in the prevention of undue exposure of the population from medical, occupational, and environmental sources of ionizing radiation; at the same time, it must actively support the development and application of radiological methods in the diagnosis and treatment of diseases. In order that the Service may effectively meet its enlarging responsibilities in the radiological sciences

  19. Protecting and improving health through the radiological sciences. A report to the Surgeon General

    International Nuclear Information System (INIS)

    1966-04-01

    This is the third in a series of reports prepared by the-National Advisory Committee on Radiation for the Surgeon General of the Public Health Service. The first two were directed to the broad responsibilities of the Service in the field of radiation control and to problems concerned with the protection of the public against undue radiation exposure from contamination of the environment with radioactive materials. In this report the Committee traces the remarkable growth that has taken place in the uses of ionizing radiation in the health professions, in industry, and in other walks of life. It also notes a number of emerging problems which not only are of importance from the point of view of radiation protection, but also, if not alleviated, threaten the quality of medical care in the United States and the translation of the advances of atomic research into needed benefits for the people. These problems include (a) serious weaknesses in academic departments of radiology which have restricted efforts to provide adequate instruction of medical and post-doctoral students in the clinical applications of ionizing radiation, including radiation protection; and (b) an increasingly severe shortage of manpower in all branches of the radiological sciences. The magnitude and complexity of these problems are sufficiently great that a concerted effort is needed by the Public Health Service to correct them. The alleviation of the problems just cited is but a part of a more comprehensive series of responsibilities faced by the Service in the radiological sciences. The Service must play an important role in the prevention of undue exposure of the population from medical, occupational, and environmental sources of ionizing radiation; at the same time, it must actively support the development and application of radiological methods in the diagnosis and treatment of diseases. In order that the Service may effectively meet its enlarging responsibilities in the radiological sciences

  20. Measuring the Success of Changes to Existing Business Intelligence Solutions to Improve Business Intelligence Reporting

    OpenAIRE

    Dedić, Nedim; Stanier, Clare

    2016-01-01

    Evaluating the success of changes to an existing Business Intelligence (BI) environment means that there is a need to compare the level of user satisfaction with the original and amended versions of the application. The focus of this paper is on producing an evaluation tool, which can be used to measure the success of changes to existing BI solutions to support improved BI reporting. The paper identifies the users involved in the BI process and investigates what is meant by satisfaction in th...

  1. Improved uranium-utilization program, Phase I. First semiannual report, September 1979-March 1980

    International Nuclear Information System (INIS)

    Hopkins, G.C.

    1980-11-01

    The Improved Uranium Utilization Program includes a Phase I evaluation of BWR design alternatives which have potential to reduce uranium ore requirements in once-through fuel cycles. The Phase I project is evaluating the alternatives in detail, including considerations of reliability, performance, manufacturing, safety and economics; is establishing implementation development requirements, costs and schedules; is selecting the most promising alternatives; and is developing detailed plans for Phase II projects for implementation. Emphasis is being placed on developing practical alternatives which can be demonstrated at the earliest possible date in existing operating BWR nuclear power stations. Priority is being given to alternatives which have the maximum payoff, measured by reduction of the nation's uranium resource requirements, on the shortest schedule. Alternatives included in current evaluations are: improved refueling and control rod pattern optimization, spectral shift, extended burnup, reduction in gadolinia residual, axial blanket optimization, reconstitution, and combinations of these alternatives

  2. Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function.

    Science.gov (United States)

    Wikstrom, Erik A; McKeon, Patrick O

    2017-04-01

      Therapeutic modalities that stimulate sensory receptors around the foot-ankle complex improve chronic ankle instability (CAI)-associated impairments. However, not all patients have equal responses to these modalities. Identifying predictors of treatment success could improve clinician efficiency when treating patients with CAI.   To conduct a response analysis on existing data to identify predictors of improved self-reported function in patients with CAI.   Secondary analysis of a randomized controlled clinical trial.   Sports medicine research laboratories.   Fifty-nine patients with CAI, which was defined in accordance with the International Ankle Consortium recommendations.   Participants were randomized into 3 treatment groups (plantar massage [PM], ankle-joint mobilization [AJM], or calf stretching [CS]) that received six 5-minute treatments over 2 weeks.   Treatment success, defined as a patient exceeding the minimally clinically important difference of the Foot and Ankle Ability Measure-Sport (FAAM-S).   Patients with ≤5 recurrent sprains and ≤82.73% on the Foot and Ankle Ability Measure had a 98% probability of having a meaningful FAAM-S improvement after AJM. As well, ≥5 balance errors demonstrated 98% probability of meaningful FAAM-S improvements from AJM. Patients <22 years old and with ≤9.9 cm of dorsiflexion had a 99% probability of a meaningful FAAM-S improvement after PM. Also, those who made ≥2 single-limb-stance errors had a 98% probability of a meaningful FAAM-S improvement from PM. Patients with ≤53.1% on the FAAM-S had an 83% probability of a meaningful FAAM-S improvement after CS.   Each sensory-targeted ankle-rehabilitation strategy resulted in a unique combination of predictors of success for patients with CAI. Specific indicators of success with AJM were deficits in self-reported function, single-limb balance, and <5 previous sprains. Age, weight-bearing-dorsiflexion restrictions, and single-limb balance

  3. Summary report of the consultants' meeting on improvement of the standard cross sections for light elements

    International Nuclear Information System (INIS)

    Carlson, A.D.; Muir, D.W.; Pronyaev, V.G.

    2001-06-01

    This report summarizes the results of the Consultants' Meeting on Improvement of the Standard Cross Sections for Light Elements. The approaches and computer programs used for evaluation of neutron standard cross sections and their uncertainties were presented by the participants. Special attention was paid to the reasons for strong uncertainty reduction observed in the model fits. The meeting participants discussed the plan of the INDC recommended Co-ordinated Research Project (CRP) on 'Improvement of the Standard Cross Sections for Light Elements'. This CRP will address the problem of uncertainty reduction along with other methodological improvements needed in order to produce a new, and internationally accepted, evaluation of neutron standard cross sections for light elements. (author)

  4. Adherence to antiretroviral therapy and clinical outcomes among young adults reporting high-risk sexual behavior, including men who have sex with men, in coastal Kenya.

    Science.gov (United States)

    Graham, Susan M; Mugo, Peter; Gichuru, Evanson; Thiong'o, Alexander; Macharia, Michael; Okuku, Haile S; van der Elst, Elise; Price, Matthew A; Muraguri, Nicholas; Sanders, Eduard J

    2013-05-01

    African men who have sex with men (MSM) face significant stigma and barriers to care. We investigated antiretroviral therapy (ART) adherence among high-risk adults, including MSM, participating in a clinic-based cohort. Survival analysis was used to compare attrition across patient groups. Differences in adherence, weight gain, and CD4 counts after ART initiation were assessed. Among 250 HIV-1-seropositive adults, including 108 MSM, 15 heterosexual men, and 127 women, patient group was not associated with attrition. Among 58 participants who were followed on ART, 40 % of MSM had less than 95 % adherence, versus 28.6 % of heterosexual men and 11.5 % of women. Although MSM gained less weight after ART initiation than women (adjusted difference -3.5 kg/year), CD4 counts did not differ. More data are needed on barriers to adherence and clinical outcomes among African MSM, to ensure that MSM can access care and derive treatment and prevention benefits from ART.

  5. Improving balance, mobility, and dual-task performance in an adolescent with cerebral palsy: A case report.

    Science.gov (United States)

    Fisher-Pipher, Sarah; Kenyon, Lisa K; Westman, Marci

    2017-07-01

    Improving functional mobility is often a desired outcome for adolescents with cerebral palsy (CP). Traditional neurorehabilitation approaches are frequently directed at impairments; however, improvements may not be carried over into functional mobility. The purpose of this case report was to describe the examination, intervention, and outcomes of a task-oriented physical therapy intervention program to improve dynamic balance, functional mobility, and dual-task performance in an adolescent with CP. The participant was a 15-year-old girl with spastic triplegic CP (Gross Motor Classification System Level II). Examination procedures included the Canadian Occupational Performance Measure, 6-minute walk test, Muscle Power Sprint Test, 10 x 5-meter sprint test, Timed Up and Down Stairs Test, Gross Motor Function Measure, Gillette Functional Assessment Questionnaire, and functional lower extremity strength tests. Intervention focused on task-oriented dynamic balance and mobility tasks that incorporated coordination and speed demands as well as task-specific lower extremity and trunk strengthening activities. Dual task demands were integrated into all intervention activities. Post-intervention testing revealed improvements in cardiovascular endurance, anaerobic power, agility, stair climbing, gross motor skills, and mobility. The participant appeared to benefit from a task-oriented program to improve dynamic balance, functional mobility, and dual-task performance.

  6. A Nephrology Fellows' Communication Skills Course: An Educational Quality Improvement Report.

    Science.gov (United States)

    Cohen, Robert A; Jackson, Vicki A; Norwich, Diana; Schell, Jane O; Schaefer, Kristen; Ship, Amy N; Sullivan, Amy M

    2016-08-01

    Nephrology fellows need expertise navigating challenging conversations with patients throughout the course of advanced kidney disease. However, evidence shows that nephrologists receive inadequate training in this area. This study assessed the effectiveness of an educational quality improvement intervention designed to enhance fellows' communication with patients who have advanced kidney disease. Quality improvement project. Full-day annual workshops (2013-2014) using didactics, discussion, and practice with simulated patients. Content focused on delivering bad news, acknowledging emotion, discussing care goals in dialysis decision making when prognosis is uncertain, and addressing dialysis therapy withdrawal and end of life. Participants were first-year nephrology fellows from 2 Harvard-affiliated training programs (N=26). Study assessed the effectiveness of an intervention designed to enhance fellows' communication skills. Primary outcomes were changes in self-reported patient communication skills, attitudes, and behaviors related to discussing disease progression, prognostic uncertainty, dialysis therapy withdrawal, treatments not indicated, and end of life; responding to emotion; eliciting patient goals and values; and incorporating patient goals into recommendations. Surveys measured prior training, pre- and postcourse perceived changes in skills and values, and reported longer term (3-month) changes in communication behaviors, using both closed- and open-ended items. Response rates were 100% (pre- and postsurveys) and 68% (follow-up). Participants reported improvement in all domains, with an overall mean increase of 1.1 (summed average scores: precourse, 2.8; postcourse, 3.9 [1-5 scale; 5 = "extremely well prepared"]; Pskills taught, such as "Ask-Tell-Ask" and using open-ended questions. Self-reported data may overestimate actual changes; small sample size and the programs' affiliation with a single medical school may limit generalizability. A day

  7. Improving knowledge management through the support of image examination and data annotation using DICOM structured reporting.

    Science.gov (United States)

    Torres, José Salavert; Damian Segrelles Quilis, J; Espert, Ignacio Blanquer; García, Vicente Hernandez

    2012-12-01

    An important effort has been invested on improving the image diagnosis process in different medical areas using information technologies. The field of medical imaging involves two main data types: medical imaging and reports. Developments based on the DICOM standard have demonstrated to be a convenient and widespread solution among the medical community. The main objective of this work is to design a Web application prototype that will be able to improve diagnosis and follow-on of breast cancer patients. It is based on TRENCADIS middleware, which provides a knowledge-oriented storage model composed by federated repositories of DICOM image studies and DICOM-SR medical reports. The full structure and contents of the diagnosis reports are used as metadata for indexing images. The TRENCADIS infrastructure takes full advantage of Grid technologies by deploying multi-resource grid services that enable multiple views (reports schemes) of the knowledge database. The paper presents a real deployment of such Web application prototype in the Dr. Peset Hospital providing radiologists with a tool to create, store and search diagnostic reports based on breast cancer explorations (mammography, magnetic resonance, ultrasound, pre-surgery biopsy and post-surgery biopsy), improving support for diagnostics decisions. A technical details for use cases (outlining enhanced multi-resource grid services communication and processing steps) and interactions between actors and the deployed prototype are described. As a result, information is more structured, the logic is clearer, network messages have been reduced and, in general, the system is more resistant to failures. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Study of amended reports to evaluate and improve surgical pathology processes.

    Science.gov (United States)

    Meier, Frederick A; Varney, Ruan C; Zarbo, Richard J

    2011-09-01

    : Amended surgical pathology reports record defects in the process of transforming tissue specimens into diagnostic information. : Systematic study of amended reports tests 2 hypotheses: (a) that tracking amendment frequencies and the distribution of amendment types reveals relevant aspects of quality in surgical pathology's daily transformation of specimens into diagnoses and (b) that such tracking measures the effect, or lack of effect, of efforts to improve surgical pathology processes. : We applied a binary definition of altered reports as either amendments or addenda and a taxonomy of defects that caused amendments as misidentifications, specimen defects, misinterpretations, and report defects. During the introduction of a LEAN process improvement approach-the Henry Ford Productions System-we followed trends in amendment rates and defect fractions to (a) evaluate specific interventions, (b) sort case-by-case root causes of misidentifications, specimen defects, and misinterpretations, and (c) audit the ongoing accuracy of the classification of changed reports. LEAN is the management and production system of the Toyota Motor Corporation that promotes continuous improvement; it considers wasted resources expended for purposes other than creating value for end customers and targets such expenditures for elimination. : Introduction of real-time editing of amendments saw annual amendment rates increase from 4.8/1000 to 10.1/1000 and then decrease in an incremental manner to 5.6/1000 as Henry Ford Productions System-specific interventions were introduced. Before introduction of HFPS interventions, about a fifth of the amendments were due to misidentifications, a 10th were due to specimen defects, a quarter due to misinterpretation, and almost half were due to report defects. During the period of the initial application of HFPS, the fraction of amendments due to misidentifications decreased as those due to report defects increased, in a statistically linked manner. As

  9. Self-reported activity in tortured refugees with long-term sequelae including pain and the impact of foot pain from falanga - a cross-sectional study

    DEFF Research Database (Denmark)

    Prip, Karen; Persson, Ann L; Sjölund, Bengt H

    2011-01-01

    , among them pain and mobility problems. All had been subjected to various forms of physical and psychological torture and 71 victims had also suffered falanga. Main outcome measures used were: the Disability Rating Index (DRI; 12 items) to assess self-reported capacity to carry out daily activities......; for falanga victims, a specific foot assessment of sensory function in the feet. Results. All patients perceived clear activity limitations according to the DRI. The falanga victims' feet were categorised according to the type of foot pain: stimulus-independent pain; stimulus-evoked pain; no pain. The two...... of victims who had chronic pain for at least 5 years after torture, all perceived activity limitations, but pain from falanga had a greater overall impact on disability assessed in terms of daily activities....

  10. Report: EPA Is Taking Steps to Improve State Drinking Water Program Reviews and Public Water Systems Compliance Data

    Science.gov (United States)

    Report #17-P-0326, July 18, 2017. The EPA is taking action to improve oversight tools used to determine whether public water systems are monitoring and reporting drinking water quality in accordance with the Safe Drinking Water Act.

  11. Reports of unintended consequences of financial incentives to improve management of hypertension.

    Directory of Open Access Journals (Sweden)

    Sylvia J Hysong

    Full Text Available Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT of financial incentives.We conducted a qualitative observational study nested within a larger RCT of financial incentives to improve hypertension care. We conducted 30-minute telephone interviews with primary care personnel at facilities participating in the RCT housed at12 geographically dispersed Veterans Affairs Medical Centers nationwide. Participants answered questions about unintended effects, clinic team dynamics, organizational impact on care delivery, study participation. We employed a blend of inductive and deductive qualitative techniques for analysis.Sixty-five participants were recruited from RCT enrollees and personnel not enrolled in the larger RCT, plus one primary care leader per site.Emergent themes included possible patient harm, emphasis on documentation over improving care, reduced professional morale, and positive spillover. All discussions of unintended consequences involving patient harm were only concerns, not actual events. Several unintended consequences concerned ancillary initiatives for quality improvement (e.g., practice guidelines and performance measurement systems rather than financial incentives.Many unintended consequences of financial incentives noted were either only concerns or attributable to ancillary quality-improvement initiatives. Actual unintended consequences included improved documentation of care without necessarily improving actual care, and positive unintended consequences.Clinicaltrials.gov Identifier: NCT

  12. Technical specification improvements to containment heat removal and emergency core cooling systems: Final report

    International Nuclear Information System (INIS)

    Sullivan, W.P.; Ha, C.; Pentzien, D.C.; Visweswaran, S.

    1988-07-01

    This report presents the results of an analysis for technical specification improvements to the emergency core cooling systems (ECCS) and containment heat removal systems (EPRI Research Project 2142-3). The objective of this project is to further develop a reliability- and risk-based methodology to provide improvements by considering groups of surveillance test intervals and allowed out-of-service times jointly. This was done for the technical specifications for the ECCS, containment heat removal equipment, and supporting systems of a boiling water reactor plant. The project (1) developed a methodology for optimizing groups of surveillance test intervals and allowed out-of-service times jointly, (2) applied the methodology in a case study of a specific operating plant, Hatch-2, and (3) evaluated benefits of the application. The results of the case study demonstrate that beneficial technical specification improvements can be realized with application of the methodology. By tightening a small group of sensitive surveillance test intervals (STIs) and allowed out-of-service times (AOTs), a larger group of less sensitive STIs and AOTs can be extended resulting in an overall plant operating cost improvement without reducing the plant safety. The reliability- and risk-based methodology and results from this project can be effectively applied for technical specification improvements at other operating plants

  13. No improvement in the reporting of clinical trial subgroup effects in high-impact general medical journals.

    Science.gov (United States)

    Gabler, Nicole B; Duan, Naihua; Raneses, Eli; Suttner, Leah; Ciarametaro, Michael; Cooney, Elizabeth; Dubois, Robert W; Halpern, Scott D; Kravitz, Richard L

    2016-07-16

    When subgroup analyses are not correctly analyzed and reported, incorrect conclusions may be drawn, and inappropriate treatments provided. Despite the increased recognition of the importance of subgroup analysis, little information exists regarding the prevalence, appropriateness, and study characteristics that influence subgroup analysis. The objective of this study is to determine (1) if the use of subgroup analyses and multivariable risk indices has increased, (2) whether statistical methodology has improved over time, and (3) which study characteristics predict subgroup analysis. We randomly selected randomized controlled trials (RCTs) from five high-impact general medical journals during three time periods. Data from these articles were abstracted in duplicate using standard forms and a standard protocol. Subgroup analysis was defined as reporting any subgroup effect. Appropriate methods for subgroup analysis included a formal test for heterogeneity or interaction across treatment-by-covariate groups. We used logistic regression to determine the variables significantly associated with any subgroup analysis or, among RCTs reporting subgroup analyses, using appropriate methodology. The final sample of 416 articles reported 437 RCTs, of which 270 (62 %) reported subgroup analysis. Among these, 185 (69 %) used appropriate methods to conduct such analyses. Subgroup analysis was reported in 62, 55, and 67 % of the articles from 2007, 2010, and 2013, respectively. The percentage using appropriate methods decreased over the three time points from 77 % in 2007 to 63 % in 2013 (p < 0.05). Significant predictors of reporting subgroup analysis included industry funding (OR 1.94 (95 % CI 1.17, 3.21)), sample size (OR 1.98 per quintile (1.64, 2.40), and a significant primary outcome (OR 0.55 (0.33, 0.92)). The use of appropriate methods to conduct subgroup analysis decreased by year (OR 0.88 (0.76, 1.00)) and was less common with industry funding (OR 0.35 (0.18, 0

  14. Widely Assumed but Thinly Tested: Do Employee Volunteers' Self-Reported Skill Improvements Reflect the Nature of Their Volunteering Experiences?

    Science.gov (United States)

    Jones, David A

    2016-01-01

    An increasing number of companies use corporate volunteering programs (CVPs) to support and coordinate their employees' efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers' self-reported skill development reflects the characteristics of the volunteers and their volunteering experiences. Study participants were 74 employee volunteers who completed a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit's records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of 10 work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were moderated by the employee volunteers' self-efficacy about improving their work

  15. Widely Assumed but Thinly Tested: Do Employee Volunteers' Self-Reported Skill Improvements Reflect the Nature of Their Volunteering Experiences?

    Science.gov (United States)

    Jones, David A.

    2016-01-01

    An increasing number of companies use corporate volunteering programs (CVPs) to support and coordinate their employees' efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers' self-reported skill development reflects the characteristics of the volunteers and their volunteering experiences. Study participants were 74 employee volunteers who completed a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit's records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of 10 work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were moderated by the employee volunteers' self-efficacy about improving their work

  16. Report of Increasing Overdose Deaths that include Acetyl Fentanyl in Multiple Counties of the Southwestern Region of the Commonwealth of Pennsylvania in 2015-2016.

    Science.gov (United States)

    Dwyer, Jessica B; Janssen, Jennifer; Luckasevic, Todd M; Williams, Karl E

    2018-01-01

    Acetyl fentanyl is a Schedule I controlled synthetic opioid that is becoming an increasingly detected "designer drug." Routine drug screening procedures in local forensic toxicology laboratories identified a total of 41 overdose deaths associated with acetyl fentanyl within multiple counties of the southwestern region of the state of Pennsylvania. The range, median, mean, and standard deviation of blood acetyl fentanyl concentrations for these 41 cases were 0.13-2100 ng/mL, 11 ng/mL, 169.3 ng/mL, and 405.3 ng/mL, respectively. Thirty-six individuals (88%) had a confirmed history of substance abuse, and all but one case (96%) were ruled multiple drug toxicities. This report characterizes this localized trend of overdose deaths associated with acetyl fentanyl and provides further evidence supporting an alarmingly concentrated opiate and opioid epidemic of both traditional and novel drugs within this region of the United States. © 2017 American Academy of Forensic Sciences.

  17. Mandatory Reporting? Issues to consider when developing legislation and policy to improve discovery of child abuse

    Directory of Open Access Journals (Sweden)

    Emma Davies

    2014-10-01

    Full Text Available Article by Dr Emma Davies (School of Law, Liverpool John Moores University, Associate Professor Ben Mathews (School of Law, Queensland University of Technology and Professor John Read (Institute of Psychology, Health and Society, University of Liverpool. In the United Kingdom, recent investigations into child sexual abuse occurring within schools, the Catholic Church and the British Broadcasting Corporation, have intensified debate on ways to improve the discovery of child sexual abuse, and child maltreatment generally. One approach adopted in other jurisdictions to better identify cases of severe child maltreatment is the introduction of some form of legislative mandatory reporting to require designated persons to report known and suspected cases. The debate in England has raised the prospect of whether adopting a strategy of some kind of mandatory reporting law is advisable. The purpose of this article is to add to this debate by identifying fundamental principles, issues and complexities underpinning policy and even legislative developments in the interests of children and society. The article will first highlight the data on the hidden nature of child maltreatment and the background to the debate. Secondly, it will identify some significant gaps in knowledge that need to be filled. Thirdly, the article will summarise the barriers to reporting abuse and neglect. Fourthly, we will identify a range of options for, and clarify the dilemmas in developing, legislative mandatory reporting, addressing two key issues: who should be mandated to report, and what types of child maltreatment should they be required to report? Finally, we draw attention to some inherently different goals and competing interests, both between and within the various institutions involved in the safeguarding of children and the criminal prosecution of some offenders. Based on this analysis we offer some concluding observations that we hope contribute to informed and careful

  18. Characterization and Alteration of Wettability States of Alaskan Reserviors to Improve Oil Recovery Efficiency (including the within-scope expansion based on Cyclic Water Injection - a pulsed waterflood for Enhanced Oil Recovery)

    Energy Technology Data Exchange (ETDEWEB)

    Abhijit Dandekar; Shirish Patil; Santanu Khataniar

    2008-12-31

    Numerous early reports on experimental works relating to the role of wettability in various aspects of oil recovery have been published. Early examples of laboratory waterfloods show oil recovery increasing with increasing water-wetness. This result is consistent with the intuitive notion that strong wetting preference of the rock for water and associated strong capillary-imbibition forces gives the most efficient oil displacement. This report examines the effect of wettability on waterflooding and gasflooding processes respectively. Waterflood oil recoveries were examined for the dual cases of uniform and non-uniform wetting conditions. Based on the results of the literature review on effect of wettability and oil recovery, coreflooding experiments were designed to examine the effect of changing water chemistry (salinity) on residual oil saturation. Numerous corefloods were conducted on reservoir rock material from representative formations on the Alaska North Slope (ANS). The corefloods consisted of injecting water (reservoir water and ultra low-salinity ANS lake water) of different salinities in secondary as well as tertiary mode. Additionally, complete reservoir condition corefloods were also conducted using live oil. In all the tests, wettability indices, residual oil saturation, and oil recovery were measured. All results consistently lead to one conclusion; that is, a decrease in injection water salinity causes a reduction in residual oil saturation and a slight increase in water-wetness, both of which are comparable with literature observations. These observations have an intuitive appeal in that water easily imbibes into the core and displaces oil. Therefore, low-salinity waterfloods have the potential for improved oil recovery in the secondary recovery process, and ultra low-salinity ANS lake water is an attractive source of injection water or a source for diluting the high-salinity reservoir water. As part of the within-scope expansion of this project

  19. Molecular resolution of the family Dreissenidae (Mollusca: Bivalvia) with emphasis on Ponto-Caspian species, including first report of Mytilopsis leucophaeata in the Black Sea basin.

    Science.gov (United States)

    Therriault, Thomas W; Docker, Margaret F; Orlova, Marina I; Heath, Daniel D; MacIsaac, Hugh J

    2004-03-01

    Considerable uncertainty exists in determination of the phylogeny among extant members of the Dreissenidae, especially those inhabiting the Ponto-Caspian basin, as multiple systematic revisions based on morphological characteristics have failed to resolve relationships within this group of bivalves. In this study we use DNA sequence analyses of two mitochondrial gene fragments, 16S rRNA and cytochrome c oxidase subunit I (COI), to determine phylogenetic relationships among Dreissena rostriformis, D. bugensis, D. polymorpha, D. stankovici, Congeria kusceri, and Mytilopsis leucophaeata. Dreissena stankovici was determined to represent a sister taxa to D. polymorpha and both are more closely related to other extant Dreissena species than Congeria or Mytilopsis. Sequence divergence between D. rostriformis and D. bugensis was relatively low (0.3-0.4%), suggesting that these two taxa constitute a single species. However, environmental differences suggest two races of D. rostriformis, a brackish water race (rostriformis) and a freshwater race (bugensis). Spread of bugensis-type individuals into habitats in the Caspian Sea that are occupied by rostriformis-type individuals may create novel hybridization opportunities. Species-specific molecular markers also were developed in this study since significant intraspecific variation in morphological features complicates dreissenid identification. Using two gene fragments (nuclear 28S and 16S), we identified restriction fragment length polymorphisms (RFLPs) that distinguish among D. rostriformis/bugensis, D. polymorpha, and D. stankovici and revealed the presence of a cryptic invader to the Black Sea basin, Mytilopsis leucophaeata. This is the first report of this North American native in southern Europe.

  20. A case report of two male siblings with autism and duplication of Xq13-q21, a region including three genes predisposing for autism.

    Science.gov (United States)

    Wentz, Elisabet; Vujic, Mihailo; Kärrstedt, Ewa-Lotta; Erlandsson, Anna; Gillberg, Christopher

    2014-05-01

    Autism spectrum disorder, severe behaviour problems and duplication of the Xq12 to Xq13 region have recently been described in three male relatives. To describe the psychiatric comorbidity and dysmorphic features, including craniosynostosis, of two male siblings with autism and duplication of the Xq13 to Xq21 region, and attempt to narrow down the number of duplicated genes proposed to be leading to global developmental delay and autism. We performed DNA sequencing of certain exons of the TWIST1 gene, the FGFR2 gene and the FGFR3 gene. We also performed microarray analysis of the DNA. In addition to autism, the two male siblings exhibited severe learning disability, self-injurious behaviour, temper tantrums and hyperactivity, and had no communicative language. Chromosomal analyses were normal. Neither of the two siblings showed mutations of the sequenced exons known to produce craniosynostosis. The microarray analysis detected an extra copy of a region on the long arm of chromosome X, chromosome band Xq13.1-q21.1. Comparison of our two cases with previously described patients allowed us to identify three genes predisposing for autism in the duplicated chromosomal region. Sagittal craniosynostosis is also a new finding linked to the duplication.

  1. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    International Nuclear Information System (INIS)

    Cohen, Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-01-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O ampersand M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O ampersand M Improvement Program. O ampersand M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O ampersand M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O ampersand M costs was achieved. Based on the lessons learned, an optimum solar- field O ampersand M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O ampersand M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts

  2. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Cohen Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-06-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O&M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O&M Improvement Program. O&M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O&M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O&M costs was achieved. Based on the lessons learned, an optimum solar- field O&M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O&M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts.

  3. Reported care giver strategies for improving drinking water for young children.

    Science.gov (United States)

    McLennan, John D; Farrelly, Ashley

    2010-11-01

    Care givers may engage in a variety of strategies to try and improve drinking water for children. However, the pattern of these efforts is not well known, particularly for young children in high-risk situations. The objective of this study was to determine care giver-reported strategies for young children with (1) undernutrition and (2) living in an unplanned poor peri-urban community in the Dominican Republic. Practices reported by care givers of young children from a community and clinic group were extracted from interviews conducted between 2004 and 2008 (n = 563). These results were compared to two previous similar samples interviewed in 1997 (n = 341). Bottled water is currently the most prevalent reported strategy for improving drinking water for young children. Its use increased from 6% to 69% in the community samples over the last decade and from 13% to 79% in the clinic samples. Boiling water continues to be a common strategy, particularly for the youngest children, though its overall use has decreased over time. Household-level chlorination is infrequently used and has dropped over time. Care givers are increasingly turning to bottled water in an attempt to provide safe drinking water for their children. While this may represent a positive trend for protecting children from water-transmitted diseases, it may represent an inefficient approach to safe drinking water provision that may place a financial burden on low-income families.

  4. Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

    Science.gov (United States)

    Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

    2014-07-01

    Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (pcontrol limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Improvement in patient–reported outcomes after group poetry therapy of women with breast cancer

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Gozashti

    2017-07-01

    Full Text Available Background: One of the best ways of achieving the patients’ views and expectations about the effects of a therapeutic or palliative intervention on their quality of life is using PatientReported Outcome Measures (PROMs. Poetry therapy as a psychotherapy intervention has been used for palliation of stressful conditions of several chronic diseases and disabilities. In the present study, we aimed to evaluate the effectiveness of group poetry therapy on the quality of life measures in women with breast cancer.Methods: A total of 30 women with breast cancer, undergoing chemotherapy at a referral center in the north of Iran, participated in the current quasi-experimental before-after study conducted in 2016. The study protocol included eight weekly sessions of group poetry therapy using poems from the great Persian poets. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30 was completed by the patients before beginning group poetry therapy and, twice more, one week and two months after the last session. Items of the questionnaire were manually scored and then analyzed using appropriate statistical tests in IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.Results: A total of 28 patients participated in all the group poetry therapy sessions and completed the questionnaire. The mean and standard deviation of age were 45±66. The changes in the score of quality of life from 51.8 to 65.5 and 69 were observed to be significant in the one-week and two-month follow ups (both with P=0.002. Also, changes in symptom score from 34.5 to 23.7 (P=0.01 and functional score from 65.6 to 77.2 (P=0.01 in the two-month follow up were found to be statistically significant.Conclusion: Based on the findings of the study, it can be concluded that group poetry therapy, as a psychotherapy approach, can be used to improve quality of life in breast cancer patients.

  6. Final priority; technical assistance to improve state data capacity--National Technical Assistance Center to improve state capacity to accurately collect and report IDEA data. Final priority.

    Science.gov (United States)

    2013-05-20

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Technical Assistance to Improve State Data Capacity program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus attention on an identified national need to provide technical assistance (TA) to States to improve their capacity to meet the data collection and reporting requirements of the Individuals with Disabilities Education Act (IDEA). We intend this priority to establish a TA center to improve State capacity to accurately collect and report IDEA data (Data Center).

  7. Powerplant productivity improvement study: policy analysis and incentive assessment. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-05-01

    Policy options that the Illinois Commerce Commission might adopt in order to promote improved power plant productivity for existing units in Illinois are identified and analyzed. These policy options would generally involve either removing existing disincentives and/or adding direct incentives through the regulatory process. The following activities are reported: in-depth review of existing theoretical and empirical literature in the areas of power plant reliability, regulatory utility efficiency and performance incentives, and impacts of various regulatory mechanisms such as the Fuel Adjustment Clauses on productivity; contacts with other state public utility commissions known to be investigating or implementing productivity improvement incentive mechanisms; documentation and analysis of incentive mechanisms adopted or under consideration in other states; analysis of current regulatory practice in Illinois as it relates to power plant productivity incentives and disincentives; identification of candidate incentive mechanisms for consideration by the Illinois Commerce Commission; and analysis and evaluation of these candidates. 72 references, 8 figures.

  8. Improvement of post-hypoxic action myoclonus with levetiracetam add-on therapy: A case report

    Directory of Open Access Journals (Sweden)

    Božić Ksenija

    2014-01-01

    Full Text Available Introduction. Chronic post-anoxic myoclonus, also known as Lance-Adams syndrome, may develop following hypoxic brain injury, and is resistant to pharmacological therapy. Case report. The patient we presented developed post-anoxic action myoclonus with severe, completely incapacitating myoclonic jerks. Myoclonus did not respond to the treatment with commonly used agents, i.e. valproate and clonazepam alone or in combination. Improvement of the action myoclonus was observed only after adding levetiracetam. Conclusion. Although Lance-Adams syndrome may not be fully curable at this point, levetiracetam appears to be a promising agent that can significantly improve functional level and overall quality of life of patients with this disorder.

  9. Improved vacuum sealing drainage in the treatment of gas gangrene: a case report.

    Science.gov (United States)

    Liu, Zhaofa; Zhao, Dewei; Wang, Benjie

    2015-01-01

    In this case, improved vacuum sealing drainage was used for gas gangrene treatment, which is different from traditional therapies of gas gangrene and this is the first report of using improved vacuum sealing drainage to treat gas gangrene. The patient was a 12-year-old Asian Male who was presented to the Emergency Department with a one-day history of left femoral progressing swelling, paining and fevering. Four days ago, rusty iron bars were plugged into the muscle of the left femoral when he played. Then he was taken to the local clinic and injected with tetanus antitoxin. A diagnosis of gas gangrene was made and modified vacuum sealing drainage device was used after thorough debridement. After two weeks' treatment, left femoral was kept and gas gangrene was cured successfully.

  10. Improving the creation and reporting of structured findings during digital pathology review

    Directory of Open Access Journals (Sweden)

    Ida Cervin

    2016-01-01

    Full Text Available Background: Today, pathology reporting consists of many separate tasks, carried out by multiple people. Common tasks include dictation during case review, transcription, verification of the transcription, report distribution, and report the key findings to follow-up registries. Introduction of digital workstations makes it possible to remove some of these tasks and simplify others. This study describes the work presented at the Nordic Symposium on Digital Pathology 2015, in Linköping, Sweden. Methods: We explored the possibility to have a digital tool that simplifies image review by assisting note-taking, and with minimal extra effort, populates a structured report. Thus, our prototype sees reporting as an activity interleaved with image review rather than a separate final step. We created an interface to collect, sort, and display findings for the most common reporting needs, such as tumor size, grading, and scoring. Results: The interface was designed to reduce the need to retain partial findings in the head or on paper, while at the same time be structured enough to support automatic extraction of key findings for follow-up registry reporting. The final prototype was evaluated with two pathologists, diagnosing complicated partial mastectomy cases. The pathologists experienced that the prototype aided them during the review and that it created a better overall workflow. Conclusions: These results show that it is feasible to simplify the reporting tasks in a way that is not distracting, while at the same time being able to automatically extract the key findings. This simplification is possible due to the realization that the structured format needed for automatic extraction of data can be used to offload the pathologists′ working memory during the diagnostic review.

  11. Report on a programme of testing and improving the geosphere models used within SYVAC

    International Nuclear Information System (INIS)

    Broyd, T.W.; Deaves, D.M.; Gibson, A.E.; Rutledge, K.W.

    1985-03-01

    A number of geosphere models for use with the SYVAC (System Variability Analysis Code) computer program have been developed, and are described in various previous reports. The SYVAC computer program provides an assessment of the dose effect to man resulting from buried wastes, using a series of submodels to represent transport processes in the vault, geosphere and biosphere. The work reported herein describes a programme of testing and improvements carried out on these models. It is concluded that the individual solution methods work well within stated parametric limits, and that further development studies should await a commitment to use SYVAC for the radiological assessment of specific named sites. The exception to this general rule may be the consideration of overall time scales and time stepping methods used within SYVAC. (author)

  12. CDC's Prevention Status Reports: Monitoring the Status of Public Health Policies and Practices for Improved Performance and Accountability.

    Science.gov (United States)

    Young, Andrea C; Lowry, Garry; Mumford, Karen; Graaf, Christine

    Increasing the adoption and implementation of evidence-based policies and practices is a key strategy for improving public health. Although there is widespread agreement about the importance of implementing evidence-based public health policies and practices, there are gaps between what has been shown to be effective and what is implemented at the state level. The Centers for Disease Control and Prevention (CDC) developed the Prevention Status Reports (PSRs), a performance measurement system, to highlight evidence-based public health policies and practices and catalyze state performance and quality improvement efforts across the nation. CDC selected a set of 10 topics representing some of the most important public health challenges in the nation. Stakeholders, including state health departments and other partners, helped conceptualize the PSRs and informed the development of the PSR framework, which provides an organizational structure for the system. CDC subject matter experts developed criteria for selecting policies and practices, indicators for each policy and practice, and a criteria-based rating system for each indicator. The PSRs were developed for all 50 states and the District of Columbia. The PSRs were developed and serve as a performance measurement system for monitoring the adoption, reach, and implementation fidelity of evidence-based public health policies and practices nationwide. The PSRs include 33 policy and practice indicators across the 10 health topics. They use a simple 3-level rating system-green, yellow, and red-to report the extent to which each state (and the District of Columbia) has implemented the policy or practice in accordance with supporting evidence or expert recommendations. Results from aggregate analyses show positive change or improvement. The PSRs are a unique part of CDC's work to improve the performance and accountability of the public health system, serving as both a monitoring tool and a call to action to improve health

  13. Innovation in diabetes care: improving consumption of healthy food through a "chef coaching" program: a case report.

    Science.gov (United States)

    Polak, Rani; Dill, Diana; Abrahamson, Martin J; Pojednic, Rachele M; Phillips, Edward M

    2014-11-01

    Nutrition therapy as part of lifestyle care is recommended for people with type 2 diabetes. However, most people with diabetes do not follow this guideline. Changing eating habits involves obtaining knowledge and building practical skills such as shopping, meal preparation, and food storage. Just as fitness coaches use their specific knowledge base in fitness to enhance the effectiveness of their coaching, credentialed chefs trained as health coaches might combine their culinary expertise with coaching in order to improve clients' food choices and lifestyles. This report documents the case of a 55-year-old white male physician, single and living alone, who was recently diagnosed with type 2 diabetes and reported chronic stress, sedentary behavior, and unhealthy eating habits. He participated in a chef coaching program of 8 weekly one-on-one 30-minute coaching sessions via Skype delivered by a chef trained as a health coach. During the first five meetings, the patient's goals were primarily culinary; however, with his success in accomplishing these goals, the patient progressed and expanded his goals to include other lifestyle domains, specifically exercise and work-life balance. At the end of the program, the patient had improved both his nutritional and exercise habits, his confidence in further self-care improvement, and his health parameters such as HgA1c (8.8% to 6.7%; normal implement them so that they eat better and, further, has the potential to help them improve their overall self-care. We intend to further develop chef coaching and assess its potential as we learn from its implementation.

  14. Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

    Directory of Open Access Journals (Sweden)

    Rebecca Rhead

    Full Text Available As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence.Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560 provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates.94.3% (528/560 and 92.7% (519/560 of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well.Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that

  15. Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

    Science.gov (United States)

    Rhead, Rebecca; Masimirembwa, Collen; Cooke, Graham; Takaruza, Albert; Nyamukapa, Constance; Mutsimhi, Cosmas; Gregson, Simon

    2016-01-01

    As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence. Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560) provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates. 94.3% (528/560) and 92.7% (519/560) of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well. Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that ART adherence

  16. Aggregate analysis of regulatory authority assessors' comments to improve the quality of periodic safety update reports.

    Science.gov (United States)

    Jullian, Sandra; Jaskiewicz, Lukasz; Pfannkuche, Hans-Jürgen; Parker, Jeremy; Lalande-Luesink, Isabelle; Lewis, David J; Close, Philippe

    2015-09-01

    Marketing authorization holders (MAHs) are expected to provide high-quality periodic safety update reports (PSURs) on their pharmaceutical products to health authorities (HAs). We present a novel instrument aiming at improving quality of PSURs based on standardized analysis of PSUR assessment reports (ARs) received from the European Union HAs across products and therapeutic areas. All HA comments were classified into one of three categories: "Request for regulatory actions," "Request for medical and scientific information," or "Data deficiencies." The comments were graded according to their impact on patients' safety, the drug's benefit-risk profile, and the MAH's pharmacovigilance system. A total of 476 comments were identified through the analysis of 63 PSUR HA ARs received in 2013 and 2014; 47 (10%) were classified as "Requests for regulatory actions," 309 (65%) as "Requests for medical and scientific information," and 118 (25%) comments were related to "Data deficiencies." The most frequent comments were requests for labeling changes (35 HA comments in 19 ARs). The aggregate analysis revealed commonly raised issues and prompted changes of the MAH's procedures related to the preparation of PSURs. The authors believe that this novel instrument based on the evaluation of PSUR HA ARs serves as a valuable mechanism to enhance the quality of PSURs and decisions about optimization of the use of the products and, therefore, contributes to improve further the MAH's pharmacovigilance system and patient safety. Copyright © 2015 John Wiley & Sons, Ltd.

  17. Anterior capsulotomy improves persistent developmental stuttering with a psychiatric disorder: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Zhang SZ

    2014-04-01

    Full Text Available Shizhen Zhang,* Peng Li,* Zhujun Zhang, Wei WangDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China *These authors contributed equally to this workAbstract: Stuttering is characterized by disrupted fluency of verbal expression, and occurs mostly in children. Persistent developmental stuttering (PDS may occur in adults. Reports of the surgical management of PDS are limited. Here we present the case of a 28-year-old man who had had PDS since the age of 7 years, was diagnosed with depression and anxiety disorder at the age of 24 years, and had physical concomitants. He underwent a bilateral anterior capsulotomy 4 years after the diagnosis. Over one year of follow-up, his physical concomitants resolved, and significant improvements in his psychiatric disorders and PDS were observed. To the best of our knowledge, this is the first report of simultaneous improvement in a patient's PDS and psychiatric disorder after a bilateral anterior capsulotomy.Keywords: persistent developmental stuttering, psychiatric disorders, anterior capsulotomy

  18. Invited review: Recommendations for reporting intervention studies on reproductive performance in dairy cattle: Improving design, analysis, and interpretation of research on reproduction.

    Science.gov (United States)

    Lean, Ian J; Lucy, Matthew C; McNamara, John P; Bradford, Barry J; Block, Elliot; Thomson, Jennifer M; Morton, John M; Celi, Pietro; Rabiee, Ahmad R; Santos, José E P; Thatcher, William W; LeBlanc, Stephen J

    2016-01-01

    Abundant evidence from the medical, veterinary, and animal science literature demonstrates that there is substantial room for improvement of the clarity, completeness, and accuracy of reporting of intervention studies. More rigorous reporting guidelines are needed to improve the quality of data available for use in comparisons of outcomes (or meta-analyses) of multiple studies. Because of the diversity of factors that affect reproduction and the complexity of interactions between these, a systematic approach is required to design, conduct, and analyze basic and applied studies of dairy cattle reproduction. Greater consistency, clarity, completeness, and correctness of design and reporting will improve the value of each report and allow for greater depth of evaluation in meta-analyses. Each of these benefits will improve understanding and application of current knowledge and better identify questions that require additional modeling or primary research. The proposed guidelines and checklist will aid in the design, conduct, analysis, and reporting of intervention studies. We propose an adaptation of the REFLECT (Reporting Guidelines for Randomized Controlled Trials for Livestock and Food Safety) statement to provide guidelines and a checklist specific to reporting intervention studies in dairy cattle reproduction. Furthermore, we provide recommendations that will assist investigators to produce studies with greater internal and external validity that can more often be included in systematic reviews and global meta-analyses. Such studies will also assist the development of models to describe the physiology of reproduction. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  19. Using a web-based image quality assurance reporting system to improve image quality.

    Science.gov (United States)

    Czuczman, Gregory J; Pomerantz, Stuart R; Alkasab, Tarik K; Huang, Ambrose J

    2013-08-01

    The purpose of this study is to show the impact of a web-based image quality assurance reporting system on the rates of three common image quality errors at our institution. A web-based image quality assurance reporting system was developed and used beginning in April 2009. Image quality endpoints were assessed immediately before deployment (period 1), approximately 18 months after deployment of a prototype reporting system (period 2), and approximately 12 months after deployment of a subsequent upgraded department-wide reporting system (period 3). A total of 3067 axillary shoulder radiographs were reviewed for correct orientation, 355 shoulder CT scans were reviewed for correct reformatting of coronal and sagittal images, and 346 sacral MRI scans were reviewed for correct acquisition plane of axial images. Error rates for each review period were calculated and compared using the Fisher exact test. Error rates of axillary shoulder radiograph orientation were 35.9%, 7.2%, and 10.0%, respectively, for the three review periods. The decrease in error rate between periods 1 and 2 was statistically significant (p < 0.0001). Error rates of shoulder CT reformats were 9.8%, 2.7%, and 5.8%, respectively, for the three review periods. The decrease in error rate between periods 1 and 2 was statistically significant (p = 0.03). Error rates for sacral MRI axial sequences were 96.5%, 32.5%, and 3.4%, respectively, for the three review periods. The decrease in error rates between periods 1 and 2 and between periods 2 and 3 was statistically significant (p < 0.0001). A web-based system for reporting image quality errors may be effective for improving image quality.

  20. Embedded Sensors and Controls to Improve Component Performance and Reliability Conceptual Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Kisner, R.; Melin, A.; Burress, T.; Fugate, D.; Holcomb, D.; Wilgen, J.; Miller, J.; Wilson, D.; Silva, P.; Whitlow, L.; Peretz, F.

    2012-09-15

    The objective of this project is to demonstrate improved reliability and increased performance made possible by deeply embedding instrumentation and controls (I&C) in nuclear power plant (NPP) components and systems. The project is employing a highly instrumented canned rotor, magnetic bearing, fluoride salt pump as its I&C technology demonstration platform. I&C is intimately part of the basic millisecond-by-millisecond functioning of the system; treating I&C as an integral part of the system design is innovative and will allow significant improvement in capabilities and performance. As systems become more complex and greater performance is required, traditional I&C design techniques become inadequate and more advanced I&C needs to be applied. New I&C techniques enable optimal and reliable performance and tolerance of noise and uncertainties in the system rather than merely monitoring quasistable performance. Traditionally, I&C has been incorporated in NPP components after the design is nearly complete; adequate performance was obtained through over-design. By incorporating I&C at the beginning of the design phase, the control system can provide superior performance and reliability and enable designs that are otherwise impossible. This report describes the progress and status of the project and provides a conceptual design overview for the platform to demonstrate the performance and reliability improvements enabled by advanced embedded I&C.

  1. Improvement in self-reported confidence in nurses' professional skills in the emergency department.

    Science.gov (United States)

    Rautava, Veli-Pekka; Palomäki, Erika; Innamaa, Tapio; Perttu, Mika; Lehto, Päivi; Palomäki, Ari

    2013-03-05

    The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (pskills of nurses. This improvement was especially

  2. Improvement in self-reported confidence in nurses’ professional skills in the emergency department

    Science.gov (United States)

    2013-01-01

    Background The aim of this study was to assess nurses’ self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Methods Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software. During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses’ skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Results Nurses’ self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (pskills of nurses. This

  3. Improvement of nuclear reactor component materials by application of hot isostatic processing (HIP). Survey report on Phase 1

    International Nuclear Information System (INIS)

    Mueller, J.J.

    1975-12-01

    The report summarizes the results of an EPRI-sponsored state-of-the-art survey of hot isostatic processing (HIP). The purpose of the study was to identify potential nuclear plant applications of HIP with high pay-off through improvement in component quality and reliability. The survey shows that HIP will reduce cost and manufacturing time and improve quality and ease of nondestructive examination of all castings for which porosity is a problem. Nuclear valves are a prime example. Tubing, pipe, and sheet and bar present other possibilities of somewhat less immediate promise. This report includes a review of some of the EPRI motivations for undertaking this research; a brief explanation of HIP, the survey methodology exployed; the basic operations in the processes studied; a review of the historical applications of HIP to problem areas consistent with those addressed in the survey; the results of the survey and associated analyses of the problems; and the recommendations and justifications for the Phase II program

  4. Development of a natural rearing system to improve supplemental fish quality: 1996-1998: final report; TOPICAL

    International Nuclear Information System (INIS)

    Maynard, Desmond J.

    2001-01-01

    This report covers the 1996-1998 Natural Rearing Enhancement System (NATURES) research for increasing hatchery salmon postrelease survival and producing fish with more wild-like behavior, physiology, and morphology prior to release. Experiments were conducted evaluating automatic subsurface feeders; natural diets; exercise systems; seminatural raceway habitat enriched with cover, structure, and substrate; and predator avoidance conditioning for hatchery salmonids. Automatic subsurface feed delivery systems did not affect chinook salmon depth distribution or vulnerability to avian predators. Live-food diets only marginally improved the ability of chinook salmon to capture prey in stream enclosures. A prototype exercise system that can be retrofitted to raceways was developed, however, initial testing indicated that severe amounts of exercise may increase in culture mortality. Rearing chinook salmon in seminatural raceway habitat with gravel substrate, woody debris structure, and overhead cover improved coloration and postrelease survival without impacting in-culture health or survival. Steelhead fry reared in enriched environments with structure, cover, and point source feeders dominated and outcompeted conventionally reared fish. Exposing chinook salmon to caged predators increased their postrelease survival. Chinook salmon showed an antipredator response to chemical stimuli from injured conspecifics and exhibited acquired predator recognition following exposure to paired predator-prey stimuli. The report also includes the 1997 Natural Rearing System Workshop proceedings

  5. Quality Improvement in Pediatric Endoscopy: A Clinical Report From the NASPGHAN Endoscopy Committee.

    Science.gov (United States)

    Kramer, Robert E; Walsh, Catharine M; Lerner, Diana G; Fishman, Douglas S

    2017-07-01

    The current era of healthcare reform emphasizes the provision of effective, safe, equitable, high-quality, and cost-effective care. Within the realm of gastrointestinal endoscopy in adults, renewed efforts are in place to accurately define and measure quality indicators across the spectrum of endoscopic care. In pediatrics, however, this movement has been less-defined and lacks much of the evidence-base that supports these initiatives in adult care. A need, therefore, exists to help define quality metrics tailored to pediatric practice and provide a toolbox for the development of robust quality improvement (QI) programs within pediatric endoscopy units. Use of uniform standards of quality reporting across centers will ensure that data can be compared and compiled on an international level to help guide QI initiatives and inform patients and their caregivers of the true risks and benefits of endoscopy. This report is intended to provide pediatric gastroenterologists with a framework for the development and implementation of endoscopy QI programs within their own centers, based on available evidence and expert opinion from the members of the NASPGHAN Endoscopy Committee. This clinical report will require expansion as further research pertaining to endoscopic quality in pediatrics is published.

  6. Combining bimodal presentation schemes and buzz groups improves clinical reasoning and learning at morning report.

    Science.gov (United States)

    Balslev, Thomas; Rasmussen, Astrid Bruun; Skajaa, Torjus; Nielsen, Jens Peter; Muijtjens, Arno; De Grave, Willem; Van Merriënboer, Jeroen

    2014-12-11

    Abstract Morning reports offer opportunities for intensive work-based learning. In this controlled study, we measured learning processes and outcomes with the report of paediatric emergency room patients. Twelve specialists and 12 residents were randomised into four groups and discussed the same two paediatric cases. The groups differed in their presentation modality (verbal only vs. verbal + text) and the use of buzz groups (with vs. without). The verbal interactions were analysed for clinical reasoning processes. Perceptions of learning and judgment of learning were reported in a questionnaire. Diagnostic accuracy was assessed by a 20-item multiple-choice test. Combined bimodal presentation and buzz groups increased the odds ratio of clinical reasoning to occur in the discussion of cases by a factor of 1.90 (p = 0.013), indicating superior reasoning for buzz groups working with bimodal materials. For specialists, a positive effect of bimodal presentation was found on perceptions of learning (p presentation on diagnostic accuracy was noted in the specialists (p presentation and buzz group discussion of emergency cases improves clinicians' clinical reasoning and learning.

  7. Training attention improves decision making in individuals with elevated self-reported depressive symptoms.

    Science.gov (United States)

    Cooper, Jessica A; Gorlick, Marissa A; Denny, Taylor; Worthy, Darrell A; Beevers, Christopher G; Maddox, W Todd

    2014-06-01

    Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work has reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the present study, participants were required to learn to maximize reward during decision making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli prior to performing the decision-making task (n = 20; active training). The active-training group was compared to two other groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n = 22; placebo training) and a control group with low levels of depressive symptoms (n = 33; nondepressive control). The placebo-training depressive group performed worse and switched between options more than did the nondepressive controls on the reward maximization task. However, depressives that received active training performed as well as the nondepressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction errors, leading to more frequent switching. The nondepressive control and active-training depressive groups showed similar learning from positive and negative prediction errors, leading to less-frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli.

  8. Image-Rich Radiology Reports: A Value-Based Model to Improve Clinical Workflow.

    Science.gov (United States)

    Patel, Bhavik N; Lopez, Jose M; Jiang, Brian G; Roth, Christopher J; Nelson, Rendon C

    2017-01-01

    To determine the value of image-rich radiology reports (IRRR) by evaluating the interest and preferences of referring physicians, potential impact on clinical workflow, and the willingness of radiologists to create them. Referring physicians and radiologists were interviewed in this prospective, HIPAA-compliant study. Subject willingness to participate in the study was determined by an e-mail. A single investigator conducted all interviews using a standard questionnaire. All subjects reviewed a video mockup demonstration of IRRR and three methods for viewing embedded images, as follows: (1) clickable hyperlinks to access a scrollable stack of images, (2) scrollable and enlargeable small-image thumbnails, and (3) scrollable but not enlargeable medium-sized images. Questionnaire responses, free comments, and general impressions were captured and analyzed. Seventy-two physicians (36 clinicians, 36 radiologists) were interviewed. Thirty-one clinicians (86%) expressed interest in using IRRR. Seventy-seven percent of subjects believed IRRR would improve communication. Ten clinicians (28%) preferred method 1, 18 (50%) preferred method 2, and 8 (22%) preferred method 3 for embedding images. Thirty clinicians (83%) stated that IRRR would improve efficiency. Twenty-two radiologists (61%) preferred selecting a tool button with a mouse and right-clicking images to embed them, 13 (36%) preferred pressing a function key, and 11 (31%) preferred dictating series and image numbers. The average time radiologists were willing to expend for embedding images was 66.7 seconds. Referring physicians and radiologist both believe IRRR would add value by improving communication with the potential to improve the workflow efficiency of referring physicians. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  9. Improved clinical documentation leads to superior reportable outcomes: An accurate representation of patient's clinical status.

    Science.gov (United States)

    Elkbuli, Adel; Godelman, Steven; Miller, Ashley; Boneva, Dessy; Bernal, Eileen; Hai, Shaikh; McKenney, Mark

    2018-05-01

    Clinical documentation can be an underappreciated. Trauma Centers (TCs) are now routinely evaluated for quality performance. TCs with poor documentation may not accurately reflect actual injury burden or comorbidities and can impact accuracy of mortality measures. Markers exist to adjust crude death rates for injury severity: observed over expected deaths (O/E) adjust for injury; Case Mix Index (CMI) reflects disease burden, and Severity of Illness (SOI) measures organ dysfunction. We aim to evaluate the impact of implementing a Clinical Documentation Improvement Program (CDIP) on reported outcomes. Review of 2-years of prospectively collected data for trauma patients, during the implementation of CDIP. A two-group prospective observational study design was used to evaluate the pre-implementation and the post-implementation phase of improved clinical documentation. T-test and Chi-Squared were used with significance defined as p deaths out of 1419 (3.45%), while post-implementation period, had 38 deaths out of 1454 (2.61%), (non-significant). There was however, a significant difference between O/E ratios. In the pre-phase, the O/E was 1.36 and 0.70 in the post-phase (p < 0.001). The two groups also differed on CMI with a pre-group mean of 2.48 and a post-group of 2.87 (p < 0.001), indicating higher injury burden in the post-group. SOI started at 2.12 and significantly increased to 2.91, signifying more organ system dysfunction (p < 0.018). Improved clinical documentation results in improved accuracy of measures of mortality, injury severity, and comorbidities and a more accurate reflection in O/E mortality ratios, CMI, and SOI. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. The Medicare Cost Report and the limits of hospital accountability: improving financial accounting data.

    Science.gov (United States)

    Kane, N M; Magnus, S A

    2001-02-01

    Health policy makers, legislators, providers, payers, and a broad range of other players in the health care market routinely seek information on hospital financial performance. Yet the data at their disposal are limited, especially since hospitals' audited financial statements--the "gold standard" in hospital financial reporting--are not publicly available in many states. As a result, the Medicare Cost Report (MCR), filed annually by most U.S. hospitals in order to receive payment for treating Medicare patients, has become the primary public source of hospital financial information. However, financial accounting elements in the MCR are unreliable, poorly defined, and lacking in critical detail. Comparative analyses of MCRs and matched, audited financial statements reveal long-standing problems with the MCR's data, including major differences in reported profits; variations in the reporting of both revenues and expenses; an absence of relevant details, such as charity care, bad debt, operating versus nonoperating income, and affiliate transactions; an inconsistent classification of changes in net assets; and a failure to provide cash flow statements. Because of these problems, MCR financial data give only a limited and often inaccurate picture of the financial position of hospitals. Audited financial statements provide a more complete perspective, enabling analysts to address important questions left unanswered by the MCR data. Regulatory action is needed to create a national database of financial information based upon audited statements.

  11. Training on Movement Figure-Ground Discrimination Remediates Low-Level Visual Timing Deficits in the Dorsal Stream, Improving High-Level Cognitive Functioning, Including Attention, Reading Fluency, and Working Memory

    Directory of Open Access Journals (Sweden)

    Teri Lawton

    2017-05-01

    Full Text Available The purpose of this study was to determine whether neurotraining to discriminate a moving test pattern relative to a stationary background, figure-ground discrimination, improves vision and cognitive functioning in dyslexics, as well as typically-developing normal students. We predict that improving the speed and sensitivity of figure-ground movement discrimination (PATH to Reading neurotraining acts to remediate visual timing deficits in the dorsal stream, thereby improving processing speed, reading fluency, and the executive control functions of attention and working memory in both dyslexic and normal students who had PATH neurotraining more than in those students who had no neurotraining. This prediction was evaluated by measuring whether dyslexic and normal students improved on standardized tests of cognitive skills following neurotraining exercises, more than following computer-based guided reading (Raz-Kids (RK. The neurotraining used in this study was visually-based training designed to improve magnocellular function at both low and high levels in the dorsal stream: the input to the executive control networks coding working memory and attention. This approach represents a paradigm shift from the phonologically-based treatment for dyslexia, which concentrates on high-level speech and reading areas. This randomized controlled-validation study was conducted by training the entire second and third grade classrooms (42 students for 30 min twice a week before guided reading. Standardized tests were administered at the beginning and end of 12-weeks of intervention training to evaluate improvements in academic skills. Only movement-discrimination training remediated both low-level visual timing deficits and high-level cognitive functioning, including selective and sustained attention, reading fluency and working memory for both dyslexic and normal students. Remediating visual timing deficits in the dorsal stream revealed the causal role of visual

  12. Training on Movement Figure-Ground Discrimination Remediates Low-Level Visual Timing Deficits in the Dorsal Stream, Improving High-Level Cognitive Functioning, Including Attention, Reading Fluency, and Working Memory.

    Science.gov (United States)

    Lawton, Teri; Shelley-Tremblay, John

    2017-01-01

    The purpose of this study was to determine whether neurotraining to discriminate a moving test pattern relative to a stationary background, figure-ground discrimination, improves vision and cognitive functioning in dyslexics, as well as typically-developing normal students. We predict that improving the speed and sensitivity of figure-ground movement discrimination ( PATH to Reading neurotraining) acts to remediate visual timing deficits in the dorsal stream, thereby improving processing speed, reading fluency, and the executive control functions of attention and working memory in both dyslexic and normal students who had PATH neurotraining more than in those students who had no neurotraining. This prediction was evaluated by measuring whether dyslexic and normal students improved on standardized tests of cognitive skills following neurotraining exercises, more than following computer-based guided reading ( Raz-Kids ( RK )). The neurotraining used in this study was visually-based training designed to improve magnocellular function at both low and high levels in the dorsal stream: the input to the executive control networks coding working memory and attention. This approach represents a paradigm shift from the phonologically-based treatment for dyslexia, which concentrates on high-level speech and reading areas. This randomized controlled-validation study was conducted by training the entire second and third grade classrooms (42 students) for 30 min twice a week before guided reading. Standardized tests were administered at the beginning and end of 12-weeks of intervention training to evaluate improvements in academic skills. Only movement-discrimination training remediated both low-level visual timing deficits and high-level cognitive functioning, including selective and sustained attention, reading fluency and working memory for both dyslexic and normal students. Remediating visual timing deficits in the dorsal stream revealed the causal role of visual movement

  13. Training on Movement Figure-Ground Discrimination Remediates Low-Level Visual Timing Deficits in the Dorsal Stream, Improving High-Level Cognitive Functioning, Including Attention, Reading Fluency, and Working Memory

    Science.gov (United States)

    Lawton, Teri; Shelley-Tremblay, John

    2017-01-01

    The purpose of this study was to determine whether neurotraining to discriminate a moving test pattern relative to a stationary background, figure-ground discrimination, improves vision and cognitive functioning in dyslexics, as well as typically-developing normal students. We predict that improving the speed and sensitivity of figure-ground movement discrimination (PATH to Reading neurotraining) acts to remediate visual timing deficits in the dorsal stream, thereby improving processing speed, reading fluency, and the executive control functions of attention and working memory in both dyslexic and normal students who had PATH neurotraining more than in those students who had no neurotraining. This prediction was evaluated by measuring whether dyslexic and normal students improved on standardized tests of cognitive skills following neurotraining exercises, more than following computer-based guided reading (Raz-Kids (RK)). The neurotraining used in this study was visually-based training designed to improve magnocellular function at both low and high levels in the dorsal stream: the input to the executive control networks coding working memory and attention. This approach represents a paradigm shift from the phonologically-based treatment for dyslexia, which concentrates on high-level speech and reading areas. This randomized controlled-validation study was conducted by training the entire second and third grade classrooms (42 students) for 30 min twice a week before guided reading. Standardized tests were administered at the beginning and end of 12-weeks of intervention training to evaluate improvements in academic skills. Only movement-discrimination training remediated both low-level visual timing deficits and high-level cognitive functioning, including selective and sustained attention, reading fluency and working memory for both dyslexic and normal students. Remediating visual timing deficits in the dorsal stream revealed the causal role of visual movement

  14. Improving disclosure and consent: "is it safe?": new ethics for reporting personal exposures to environmental chemicals.

    Science.gov (United States)

    Brody, Julia Green; Morello-Frosch, Rachel; Brown, Phil; Rudel, Ruthann A; Altman, Rebecca Gasior; Frye, Margaret; Osimo, Cheryl A; Pérez, Carla; Seryak, Liesel M

    2007-09-01

    The recent flood of research concerning pollutants in personal environmental and biological samples-blood, urine, breastmilk, household dust and air, umbilical cord blood, and other media-raises questions about whether and how to report results to individual study participants. Clinical medicine provides an expert-driven framework, whereas community-based participatory research emphasizes participants' right to know and the potential to inform action even when health effects are uncertain. Activist efforts offer other models. We consider ethical issues involved in the decision to report individual results in exposure studies and what information should be included. Our discussion is informed by our experience with 120 women in a study of 89 pollutants in homes and by interviews with other researchers and institutional review board staff.

  15. Cognitive Behavioral Treatment to Improve Adherence to Hemodialysis Fluid Restrictions: A Case Report

    Directory of Open Access Journals (Sweden)

    Heather M. Anson

    2009-01-01

    Full Text Available This case report describes outpatient psychological treatment targeting adherence to fluid restrictions in a hemodialysis patient. The consequences of nonadherence to fluid restrictions in hemodialysis patients range from minor discomfort to increased hospitalizations and mortality rates. In addition, when patients chronically fail to adhere, they may no longer be candidates for kidney transplant. The interventions focused on polydipsia, characterized by excessive fluid intake. The methods involved 11-sessions of individual psychotherapy incorporating strategies including increasing awareness, decreasing motivation, increasing effort, engaging in competing events, conducting thought stopping, breaking repetitive routines, eliciting social support, and receiving reinforcement. Results demonstrated that the patient successfully restricted his fluid intake at or below recommended levels 83% of days after fading of treatment began. This case report demonstrates the success of cognitive behavioral treatment strategies with a nonpsychiatric hemodialysis patient.

  16. A report on developing a checklist to assess company plans focused on improving safety awareness, safe behaviour and safety culture: final report

    NARCIS (Netherlands)

    Steijger, N.; Starren, H.; Keus, M.; Gort, J.; Vervoort, M.

    2003-01-01

    This report describes the process of developing a checklist to asses company plans focused on improving safety awareness, safe behaviour and safety culture. These plans are part of a programme initiated by the Ministry of Social Affairs and Employment aiming at improving the safety performance of

  17. Improving Robustness Assessment Methodologies for Structures Impacted by Missiles (IRIS-2012) - Final Report

    International Nuclear Information System (INIS)

    Orbovic, Neb; Blahoainu, Andrei; Sagals, Genadis; Tarallo, Francois; Rambach, Jean-Mathieu; Huerta, Alejandro; White, Andrew; Nevander, Olli; ); Riera, Jorge Daniel; Krauthammer, Ted; Krutzik, Norbert; Arros, Jorma; Rouqand, Alain; Stangenberg, Friedhelm; Schwer, Leonard E.

    2014-01-01

    This report documents the results and conclusions of the second phase of the Integrity and Ageing of Components and Structures Working Group (WGIAGE) activity 'Improving Robustness assessment of structures Impacted by missiles', called IRIS-2012. The objective of the activity was to conduct a post-test benchmark study to improve models and evaluation techniques used in IRIS-2010. The benchmark was open to the new participants and some of IRIS-2010 participants did not take part of IRIS-2012. For this reason the team numbers in two benchmarks are different and to make direct comparisons it is necessary to have both lists. For IRIS-2010 benchmark a series of repeated test was performed: two bending rupture tests and three punching rupture tests. For IRIS-2012 and based on recommendation from IRIS-2010, tri-axial tests and Brazilian tensile test were additionally performed in order to calibrate constitutive models. The benchmark was officially launched in February 2012 with the participation of twenty six teams from twenty different institutions (Safety Authorities, TSOs, Utilities, Vendors, Research Institutes and Consulting Companies), from ten different countries from Europe, North America and Asia (plus 1 international organisation). A three day workshop was convened in October 2012 in Ottawa, Ontario, Canada where each participating team presented and discussed their results and performed simulations. Based on IRIS-2010 results and recommendations, OECD/NEA members recognized that there was a need to continue the work on understanding and improving simulation of structural impact. The goal of the new IRIS-2012 benchmark was to: 1) Update and improve existing FE models, for teams that participated in IRIS-2010, or to create new models for new participants. In order to improve FE models it was requested to: Simulate uni-axial unconfined concrete test and tri-axial concrete tests, using the results provided by IRSN, as well as the Brazilian test (concrete tensile

  18. Report: investigation concerning environmental improvement expenditures (1974 survey commissioned by Environmental Agency)

    Energy Technology Data Exchange (ETDEWEB)

    1975-08-01

    Environmental improvement expenditures were calculated from a pilot model for environmental conservation. An average cost for pollution elimination was postulated, and expenditures for lowering a pollution factor by one unit were calculated for construction, amortization, and operation. The pilot model consists of two sectors: economic activities sector (macromodel of Japanese economy, including factors based on industrial production, energy expenditures, and fuel consumption) and pollution factor sector, consisting of 5 pollution factors (sulfur oxides; nitrogen oxides; biological oxygen demand; general wastes; industrial wastes), their causes, treatment, amounts of emission, and target standards. External factors such as population changes and automobile usage are also included. Industries were divided into 20 groups for purposes of setting up a matrix for environmental improvement expenditures. Based on 1972 data, operational costs for desulfurization were calculated to be $410/S ton (direct desulfurization), and $760/S ton (indirect desulfurization), with the weighted averaged value being $609/S ton. Average construction costs for direct and indirect processes were calculated to be $5100/S Kg/hour. Average amortization costs were calculated to be $118/S ton.

  19. Summary report of the third research co-ordination meeting on improvement of the standard cross sections

    International Nuclear Information System (INIS)

    Carlson, A.D.; Hale, G.M.; Pronyaev, V.G.

    2004-11-01

    Results were discussed that have been obtained during two and a half years of work under the Coordinated Research Project (CRP) on Improvement of the Standard Cross Sections. Major attention was focused on reducing the ambiguity between different R-matrix fits; seeking consensus between participants about what approach should be used to minimize the effect of Peelle's Pertinent Puzzle; procedures for combining the results of the R-matrix model with non-model fits; and determining the reactions and energies where smoothing should be used. The proposed timetable includes the release of the standard cross section tables by 18 November 2004 and preparing a draft report with a detailed description of the evaluation procedure by 30 April 2005. (author)

  20. Remarkable Improvement of Nail Changes in Alopecia Areata Universalis with 10 Months of Treatment with Tofacitinib: A Case Report

    Directory of Open Access Journals (Sweden)

    Sineida Berbert Ferreira

    2016-10-01

    Full Text Available Alopecia areata (AA is a chronic, autoimmune disease. The main symptom is massive hair loss, localized or diffuse, in the scalp and the whole body. However, nails may also be involved, and brittleness, fragility and pitting can be signs of nail dystrophy in AA patients. Here, we report the case of a male patient with AA refractory to various treatments, including oral, topical and intralesional corticosteroids, immunosuppressants, cyclosporin and PUVA (oxoralen plus ultraviolet light, all interrupted due to side effects. The patient’s nails had erythematous blotches (striated lunulae with regular and superficial pitting as well as fragility (trachyonychia, and he could no longer play the guitar because of these symptoms. With patient consent, we introduced tofacitinib (5 mg twice daily, which resulted in remarkable improvements not only regarding hair regrowth but also nail changes, with function recovery within 10 months.

  1. Medication Errors in Pediatric Anesthesia: A Report From the Wake Up Safe Quality Improvement Initiative.

    Science.gov (United States)

    Lobaugh, Lauren M Y; Martin, Lizabeth D; Schleelein, Laura E; Tyler, Donald C; Litman, Ronald S

    2017-09-01

    Wake Up Safe is a quality improvement initiative of the Society for Pediatric Anesthesia that contains a deidentified registry of serious adverse events occurring in pediatric anesthesia. The aim of this study was to describe and characterize reported medication errors to find common patterns amenable to preventative strategies. In September 2016, we analyzed approximately 6 years' worth of medication error events reported to Wake Up Safe. Medication errors were classified by: (1) medication category; (2) error type by phase of administration: prescribing, preparation, or administration; (3) bolus or infusion error; (4) provider type and level of training; (5) harm as defined by the National Coordinating Council for Medication Error Reporting and Prevention; and (6) perceived preventability. From 2010 to the time of our data analysis in September 2016, 32 institutions had joined and submitted data on 2087 adverse events during 2,316,635 anesthetics. These reports contained details of 276 medication errors, which comprised the third highest category of events behind cardiac and respiratory related events. Medication errors most commonly involved opioids and sedative/hypnotics. When categorized by phase of handling, 30 events occurred during preparation, 67 during prescribing, and 179 during administration. The most common error type was accidental administration of the wrong dose (N = 84), followed by syringe swap (accidental administration of the wrong syringe, N = 49). Fifty-seven (21%) reported medication errors involved medications prepared as infusions as opposed to 1 time bolus administrations. Medication errors were committed by all types of anesthesia providers, most commonly by attendings. Over 80% of reported medication errors reached the patient and more than half of these events caused patient harm. Fifteen events (5%) required a life sustaining intervention. Nearly all cases (97%) were judged to be either likely or certainly preventable. Our findings

  2. Self-reported Improvement in Side Effects and Quality of Life With Integrative Medicine in Breast Cancer Patients.

    Science.gov (United States)

    Hack, Carolin C; Hackl, Janina; Hüttner, Nina B M; Langemann, Hanna; Schwitulla, Judith; Dietzel-Drentwett, Svenja; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

    2018-05-01

    Although the demand from patients for integrative medicine is increasing, complementary medicine services are still quite heterogeneous and have not been incorporated into clinical routine. The aim of this study was to systematically evaluate improvements in side effects and quality of life associated with a hospital-based integrative medicine program in the modern breast cancer patient care setting. In a cross-sectional study, integrative health counseling and treatment were evaluated in women with breast cancer. Over a 15-month period, data for 75 patients from an integrative medicine consultancy service with standardized operating procedures were collected at the University Breast Center for Franconia. At baseline, the patients answered a questionnaire on their medical history, symptoms, and the treatment goals they were hoping to achieve with integrative medicine. In the follow-up, patient-reported outcomes related to side effects of conventional cancer treatment and patients' quality of life were analyzed. Among 60 patients with the therapy goal of reducing the side effects of conventional treatment, 46 (76.7%) were successful. Among 57 patients hoping to improve disease-related quality of life, 46 (82%) reported success. Whereas patients with metastatic disease achieved a reduction in the side effects of conventional therapy, quality-of-life improvements were predominantly achieved by patients with a good treatment prognosis. Breast cancer patients benefit from the counseling and treatment provided with integrative medicine in all phases of tumor disease. Integrative treatment services should be included as part of patient care in clinical routine work to offer patients the maximum quality of care and safety with complementary therapies.

  3. High Flow Nasal Cannula Therapy for Improving Obstructive Sleep Apnea: A Case Report

    Directory of Open Access Journals (Sweden)

    Se Joong Kim

    2015-06-01

    Full Text Available Although continuous positive airway pressure is the treatment of choice for obstructive sleep apnea, its compliance is low. Therefore, alternative therapeutic strategies are often required. High flow nasal cannula therapy uses an air compressor to deliver a constant flow of oxygen via the nasal cannula at a maximum of 60 L/m. It can produce positive end expiratory pressure and increase end expiratory pharyngeal pressure, which can help to alleviate upper airway obstruction. This is a case report of high flow nasal cannula therapy for a 71 year-old man. He had an obstructive sleep apnea and severe desaturation but failed to use continuous positive airway pressure. He underwent titration with high flow nasal cannula under polysomnography. Using high flow nasal cannula at an airflow of 45 L/m, his apnea-hypopnea, respiratory arousal and oxygen desaturation were improved. Importantly, he is very compliant with high flow nasal cannula therapy.

  4. Preliminary report of an intervention to improve mammography skills of radiologists

    International Nuclear Information System (INIS)

    D'Orsi, C.J.; Karellas, A.; Costanza, M.E.; Gaw, V.P.

    1989-01-01

    This paper presents a preliminary report of an intervention to improve mammography skills of radiologists. Although implementation of the screening guidelines has not occurred as readily as had been anticipated, use of mammograms is increasing. As the demand for this relatively new technology increases, both the availability of the test and the quality of the test done are valid concerns. Until recently, few radiology training programs provided trainees with opportunities to develop these skills. As a result, few radiologists who have been in practice more than five years have had formal training in the interpretation of mammograms. Thus providing practicing radiologists with the opportunities to develop skills in mammographic interpretation will serve to increase both availability and quality of mammographic exams

  5. Development of NMRI spectroscopy for improved petroleum recovery, Annex 6. Annual report, 1991

    Energy Technology Data Exchange (ETDEWEB)

    Barrufet, M.A.; Flumerfelt, R.W.; Jennings, J.W.; Walsh, M.P.; Watson, A.T.

    1991-12-31

    The overall objectives are to develop and apply Nuclear Magnetic Resonance Imaging (NMRI) and CT X-Ray Scanning methods for determining rock, fluid, and petrophysical properties and for fundamental studies of multiphase flow behavior in porous media. Specific objectives are to: (1) develop NMRI procedures for measuring porosity, permeability, pore size distribution, capillary pressure, and wetting characteristics, (2) apply imaging methods for improved methods of determining two- and three-phase relative permeability functions, (3) apply NMRI for development of a better understanding of dispersed phase displacement processes, and (4) apply imaging methods to develop a better understanding of saturation distribution and fingering during miscible displacements. The objectives have been organized into four subtasks. Annual progress reports for each subtask are provided.

  6. Lake Roosevelt Rainbow Trout : Habitat/Passage Improvement Project Annual Report 2000.

    Energy Technology Data Exchange (ETDEWEB)

    Sear, Sheri

    2001-02-01

    Lake Franklin D. Roosevelt was created with the completion of the Grand Coulee Dam in 1942. The lake stretches 151 miles up-stream to the International border between the United States and Canada at the 49th parallel. Increased recreational use, subsistence and sport fishing has resulted in intense interest and possible exploitation of the resources within the lake. Previous studies of the lake and its fishery have been limited. Early studies indicate that natural reproduction within the lake and tributaries are not sufficient to support a rainbow trout (Onchoryhnchus mykiss) fishery (Scholz et. al., 1988). These studies indicate that the rainbow trout population may be limited by lack of suitable habitat for spawning and rearing (Scholz et. al., 1988). The initial phase of this project (Phase I, baseline data collection- 1990-91) was directed at the assessment of limiting factors such as quality and quantity of available spawning gravel, identification of passage barriers, and assessment of other limiting factors. Population estimates were conducted using the Seber/LeCren removal/depletion method. After the initial assessment of stream parameters, several streams were selected for habitat/passage improvement projects (Phase II, implementation-1992-96). At the completion of project habitat improvements, the final phase (Phase III, monitoring) began. This phase will assess changes and gauge the success achieved through the improvements. The objective of the project is to correct passage barriers and improve habitat conditions of selected tributaries to Lake Roosevelt for adfluvial rainbow trout that utilize tributary streams for spawning and rearing. Streams with restorable habitats were selected for improvements. Completion of improvement efforts should increase the adfluvial rainbow trout contribution to the resident fishery in Lake Roosevelt. Three co-operating agencies, the Confederated Tribes of the Colville Reservation (CCT), the Spokane Tribe of Indians (STI

  7. Lake Roosevelt Rainbow Trout : Habitat/Passage Improvement Project Annual Report 1999.

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Charles D.

    2000-02-01

    Lake Franklin D. Roosevelt was created with the completion of the Grand Coulee Dam in 1942. The lake stretches 151 miles up-stream to the International border between the United States and Canada at the 49th parallel. Increased recreational use, subsistence and sport fishing has resulted in intense interest and possible exploitation of the resources within the lake. Previous studies of the lake and its fishery have been limited. Early studies indicate that natural reproduction within the lake and tributaries are not sufficient to support a rainbow trout (Onchoryhnchus mykiss) fishery (Scholz et. al., 1988). These studies indicate that the rainbow trout population may be limited by lack of suitable habitat for spawning and rearing (Scholz et. al., 1988). The initial phase of this project (Phase I, baseline data collection- 1990-91) was directed at the assessment of limiting factors such as quality and quantity of available spawning gravel, identification of passage barriers, and assessment of other limiting factors. Population estimates were conducted using the Seber/LeCren removal/depletion method. After the initial assessment of stream parameters, several streams were selected for habitat/passage improvement projects (Phase II, implementation-1992-96). At the completion of project habitat improvements, the final phase (Phase III, monitoring) began. This phase will assess changes and gauge the success achieved through the improvements. The objective of the project is to correct passage barriers and improve habitat conditions of selected tributaries to Lake Roosevelt for adfluvial rainbow trout that utilize tributary streams for spawning and rearing. Streams with restorable habitats were selected for improvements. Completion of improvement efforts should increase the adfluvial rainbow trout contribution to the resident fishery in Lake Roosevelt. Three co-operating agencies, the Confederated Tribes of the Colville Reservation (CCT), the Spokane Tribe of Indians (STI

  8. A C.L.E.A.R. Approach to Report Writing: A Framework for Improving the Efficacy of Psychoeducational Reports

    Science.gov (United States)

    Mastoras, Sarah M.; Climie, Emma A.; McCrimmon, Adam W.; Schwean, Vicki L.

    2011-01-01

    Psychoeducational reports are the primary means for a school psychologist to communicate the results of an assessment. Although reports should be written in the most efficient and reader-friendly manner, this is not always the case. Additionally, problems in report writing have remained relatively consistent for several decades, despite…

  9. Final Report SBIR Phase I, Improvement of Properties of Tubular Internal-Tin Nb3Sn

    International Nuclear Information System (INIS)

    Gregory, Eric

    2009-01-01

    Final report of SBIR to develop an economical process that can produce the best material for high field magnets to be used in the next generation of accelerators. The overall problem is to develop an economical process that can produce material with good properties for high field magnets to be used in the future for High Energy Physics (HEP) applications. The Internal-tin (IT) process, called by some the Restacked Rod process (RRP), for making Nb 3 Sn has been very successful in achieving high J c properties in the high field region. As a result it has been used effectively in several high field magnets. Originally, when this material was processed to give the highest J c it behaved unstably in the low field region and consequently did not perform as well in magnets designed for intermediate field applications. In this field range, the Powder-in-Tube (PIT) material, that has a lower d eff and a high RRR, behaved more reliably. The IT material has been improved to give better stability in the low field range and consequently the process offers a considerable challenge to the PIT process for application in both types of magnets. The PIT material has two principal drawbacks - lower J c and high cost. Work has been carried out to address these two problems and Supergenics I LLC has reported, on a low cost tubular process that is under development. It has fewer problems than the (IT) process in making low d eff materials and is of lower cost than both the IT and PIT processes. At the present stage, the J c 's that have been achieved are similar to those of the PIT material but are below those of the IT material. The purpose of the work proposed here is to improve the properties of the material made by this tubular process that has been described previously.

  10. Widely Assumed but Thinly Tested: Do Employee Volunteers’ Self-Reported Skill Improvements Reflect the Nature of their Volunteering Experience?

    Directory of Open Access Journals (Sweden)

    David Allen Jones

    2016-04-01

    Full Text Available An increasing number of companies use corporate volunteering programs (CVPs to support and coordinate their employees’ efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities they provide for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers’ self-reported skill development reflects the characteristics of the volunteers and their volunteering experience. Study participants were 74 employees who volunteered a few hours of their time once a week for ten weeks in a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit’s records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of ten work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were

  11. Feed-pump hydraulic performance and design improvement, Phase I: research program design. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brown, W.H.; Gopalakrishnan, S.; Fehlau, R.; Thompson, W.E.; Wilson, D.G.

    1982-03-01

    As a result of prior EPRI-sponsored studies, it was concluded that a research program should be designed and implemented to provide an improved basis for the design, procurement, testing, and operation of large feed pumps with increased reliability and stability over the full range of operating conditions. This two-volume report contains a research plan which is based on a review of the present state of the art and which defines the necessary R and D program and estimates the benefits and costs of the program. The recommended research program consists of 30 interrelated tasks. It is designed to perform the needed research; to verify the results; to develop improved components; and to publish computer-aided design methods, pump specification guidelines, and a troubleshooting manual. Most of the technology proposed in the research plan is applicable to nuclear power plants as well as to fossil-fired plants. This volume discusses the design, performance and failures of feed pumps, and recommendations for research on pump dynamics, design, and specifications.

  12. Benchmark Report on Key Outage Attributes: An Analysis of Outage Improvement Opportunities and Priorities

    Energy Technology Data Exchange (ETDEWEB)

    Germain, Shawn St. [Idaho National Laboratory (INL), Idaho Falls, ID (United States); Farris, Ronald [Idaho National Laboratory (INL), Idaho Falls, ID (United States)

    2014-09-01

    Advanced Outage Control Center (AOCC), is a multi-year pilot project targeted at Nuclear Power Plant (NPP) outage improvement. The purpose of this pilot project is to improve management of NPP outages through the development of an AOCC that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. This report documents the results of a benchmarking effort to evaluate the transferability of technologies demonstrated at Idaho National Laboratory and the primary pilot project partner, Palo Verde Nuclear Generating Station. The initial assumption for this pilot project was that NPPs generally do not take advantage of advanced technology to support outage management activities. Several researchers involved in this pilot project have commercial NPP experience and believed that very little technology has been applied towards outage communication and collaboration. To verify that the technology options researched and demonstrated through this pilot project would in fact have broad application for the US commercial nuclear fleet, and to look for additional outage management best practices, LWRS program researchers visited several additional nuclear facilities.

  13. Embedded Sensors and Controls to Improve Component Performance and Reliability -- Bench-scale Testbed Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Melin, Alexander M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kisner, Roger A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Drira, Anis [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Reed, Frederick K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-09-01

    Embedded instrumentation and control systems that can operate in extreme environments are challenging due to restrictions on sensors and materials. As a part of the Department of Energy's Nuclear Energy Enabling Technology cross-cutting technology development programs Advanced Sensors and Instrumentation topic, this report details the design of a bench-scale embedded instrumentation and control testbed. The design goal of the bench-scale testbed is to build a re-configurable system that can rapidly deploy and test advanced control algorithms in a hardware in the loop setup. The bench-scale testbed will be designed as a fluid pump analog that uses active magnetic bearings to support the shaft. The testbed represents an application that would improve the efficiency and performance of high temperature (700 C) pumps for liquid salt reactors that operate in an extreme environment and provide many engineering challenges that can be overcome with embedded instrumentation and control. This report will give details of the mechanical design, electromagnetic design, geometry optimization, power electronics design, and initial control system design.

  14. Are reports of randomized controlled trials improving over time? A systematic review of 284 articles published in high-impact general and specialized medical journals.

    Science.gov (United States)

    To, Matthew J; Jones, Jennifer; Emara, Mohamed; Jadad, Alejandro R

    2013-01-01

    Inadequate reporting undermines findings of randomized controlled trials (RCTs). This study assessed and compared articles published in high-impact general medical and specialized journals. Reports of RCTs published in high-impact general and specialized medical journals were identified through a search of MEDLINE from January to March of 1995, 2000, 2005, and 2010. Articles that provided original data on adult patients diagnosed with chronic conditions were included in the study. Data on trial characteristics, reporting of allocation concealment, quality score, and the presence of a trial flow diagram were extracted independently by two reviewers, and discrepancies were resolved by consensus or independent adjudication. Descriptive statistics were used for quantitative variables. Comparisons between general medical and specialized journals, and trends over time were performed using Chi-square tests. Reports of 284 trials were analyzed. There was a significantly higher proportion of RCTs published with adequate reporting of allocation concealment (p = 0.003), presentation of a trial flow diagram (pgeneral medical journals had higher quality scores than those in specialized journals (p = 0.001), reported adequate allocation concealment more often (p = 0.013), and presented a trial flow diagram more often (pjournals over the last fifteen years. These improvements are likely attributed to concerted international efforts to improve reporting quality such as CONSORT. There is still much room for improvement, especially among specialized journals.

  15. Improving Clinical Outcomes in Patients With Methicillin-Sensitive Staphylococcus aureus Bacteremia and Reported Penicillin Allergy.

    Science.gov (United States)

    Blumenthal, Kimberly G; Parker, Robert A; Shenoy, Erica S; Walensky, Rochelle P

    2015-09-01

    Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia is a morbid infection. First-line MSSA therapies (nafcillin, oxacillin, cefazolin) are generally avoided in the 10% of patients reporting penicillin (PCN) allergy, but most of these patients are not truly allergic. We used a decision tree with sensitivity analyses to determine the optimal evaluation and treatment for patients with MSSA bacteremia and reported PCN allergy. Our model simulates 3 strategies: (1) no allergy evaluation, give vancomycin (Vanc); (2) allergy history-guided treatment: if history excludes anaphylactic features, give cefazolin (Hx-Cefaz); and (3) complete allergy evaluation with history-appropriate PCN skin testing: if skin test negative, give cefazolin (ST-Cefaz). Model outcomes included 12-week MSSA cure, recurrence, and death; allergic reactions including major, minor, and potentially iatrogenic; and adverse drug reactions. Vanc results in the fewest patients achieving MSSA cure and the highest rate of recurrence (67.3%/14.8% vs 83.4%/9.3% for Hx-Cefaz and 84.5%/8.9% for ST-Cefaz) as well as the greatest frequency of allergic reactions (3.0% vs 2.4% for Hx-Cefaz and 1.7% for ST-Cefaz) and highest rates of adverse drug reactions (5.2% vs 4.6% for Hx-Cefaz and 4.7% for ST-Cefaz). Even in a "best case for Vanc" scenario, Vanc yields the poorest outcomes. ST-Cefaz is preferred to Hx-Cefaz although sensitive to input variations. Patients with MSSA bacteremia and a reported PCN allergy should have the allergy addressed for optimal treatment. Full allergy evaluation with skin testing seems to be preferred, although more data are needed. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Orthodontic clockwise rotation of maxillomandibular complex for improving facial profile in late teenagers with Class III malocclusion: A preliminary report

    OpenAIRE

    Eric JW Liou; Yu-Chi Wang

    2018-01-01

    Objective: Orthodontic camouflage treatments improve occlusion but might worsen facial profile in patients with Class III malocclusion. It has been reported that surgical clockwise rotation of maxillomandibular complex (MMc) improves facial profile by reducing chin prominence and chin throat length in patients with Class III malocclusion. The purpose of this report was to illustrate two orthodontic techniques for clockwise rotation of the MMc in late teenagers with Class III malocclusion and ...

  17. Novel Contact Materials for Improved Performance CdTe Solar Cells Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Rockett, Angus [Colorado School of Mines, Golden, CO (United States); Marsillac, Sylvain [Old Dominion Univ., Norfolk, VA (United States); Collins, Robert [Univesity of Toledo

    2018-04-15

    This program has explored a number of novel materials for contacts to CdTe solar cells in order to reduce the back contact Schottky barrier to zero and produce an ohmic contact. The project tested a wide range of potential contact materials including TiN, ZrN, CuInSe2:N, a-Si:H and alloys with C, and FeS2. Improved contacts were achieved with FeS2. As part of understanding the operation of the devices and controlling the deposition processes, a number of other important results were obtained. In the process of this project and following its conclusion it led to research that resulted in seven journal articles, nine conference publications, 13 talks presented at conferences, and training of eight graduate students. The seven journal articles were published in 2015, 2016, and 2017 and have been cited, as of March 2018, 52 times (one cited 19 times and two cited 11 times). We demonstrated high levels of doping of CIS with N but electrical activity of the resulting N was not high and the results were difficult to reproduce. Furthermore, even with high doping the contacts were not good. Annealing did not improve the contacts. A-Si:H was found to produce acceptable but unstable contacts, degrading even over a day or two, apparently due to H incorporation into the CdTe. Alloying with C did not improve the contacts or stability. The transition metal nitrides produced Schottky type contacts for all materials tested. While these contacts were found to be unsatisfactory, we investigated FeS2 and found this material to be effective and comparable to the best contacts currently available. The contacts were found to be chemically stable under heat treatment and preferable to Cu doped contacts. Thus, we demonstrated an improved contact material in the course of this project. In addition, we developed new ways of controlling the deposition of CdTe and other materials, demonstrated the nature of defects in CdTe, and studied the distribution of conductivity and carrier type in Cd

  18. Impact of a reengineered electronic error-reporting system on medication event reporting and care process improvements at an urban medical center.

    Science.gov (United States)

    McKaig, Donald; Collins, Christine; Elsaid, Khaled A

    2014-09-01

    A study was conducted to evaluate the impact of a reengineered approach to electronic error reporting at a 719-bed multidisciplinary urban medical center. The main outcome of interest was the monthly reported medication errors during the preimplementation (20 months) and postimplementation (26 months) phases. An interrupted time series analysis was used to describe baseline errors, immediate change following implementation of the current electronic error-reporting system (e-ERS), and trend of error reporting during postimplementation. Errors were categorized according to severity using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Medication Error Index classifications. Reported errors were further analyzed by reporter and error site. During preimplementation, the monthly reported errors mean was 40.0 (95% confidence interval [CI]: 36.3-43.7). Immediately following e-ERS implementation, monthly reported errors significantly increased by 19.4 errors (95% CI: 8.4-30.5). The change in slope of reported errors trend was estimated at 0.76 (95% CI: 0.07-1.22). Near misses and no-patient-harm errors accounted for 90% of all errors, while errors that caused increased patient monitoring or temporary harm accounted for 9% and 1%, respectively. Nurses were the most frequent reporters, while physicians were more likely to report high-severity errors. Medical care units accounted for approximately half of all reported errors. Following the intervention, there was a significant increase in reporting of prevented errors and errors that reached the patient with no resultant harm. This improvement in reporting was sustained for 26 months and has contributed to designing and implementing quality improvement initiatives to enhance the safety of the medication use process.

  19. Application of modern diagnostic methods to environmental improvement. Annual progress report, October 1994--September 1995

    International Nuclear Information System (INIS)

    Shepard, W.S.

    1995-12-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL), an interdisciplinary research department in the College of Engineering at Mississippi State University (MSU), is under contract with the US Department of Energy (DOE) to develop and apply advanced diagnostic instrumentation and analysis techniques to aid in solving DOE's nuclear waste problem. The program is a comprehensive effort which includes five focus areas: advanced diagnostic systems; development/application; torch operation and test facilities; process development; on-site field measurement and analysis; technology transfer/commercialization. As part of this program, diagnostic methods will be developed and evaluated for characterization, monitoring and process control. Also, the measured parameters, will be employed to improve, optimize and control the operation of the plasma torch and the overall plasma treatment process. Moreover, on-site field measurements at various DOE facilities are carried out to aid in the rapid demonstration and implementation of modern fieldable diagnostic methods. Such efforts also provide a basis for technology transfer

  20. Improved gas installations and services. Phase 1: Analysis project. Part report

    International Nuclear Information System (INIS)

    Nielsen, K.J.

    1996-05-01

    As Danish gas companies receive a large number of complaints related to the installation and operation of gas installations it was suggested that a course for personnel should be established in order to raise the standard of services and installation requirements. The first phase of the described project was to evaluate the quality of the gas installers' services so as to determine which aspects of installation and services should be emphasized during such a course. Interviews were carried out and questionnaires (illustrated within the document) sent out to installaters etc. Recommendations include that the level of information given to customers should be raised, also in relation to maintenance, and that installation should be improved. Analyses of the degree of customers' satisfaction, of the nature of the quality of services etc. expected, subjects for further training in this area and details of the training system are dealt with

  1. Improved design for large wind turbine blades of fibre composites (Phase 4) - Summary report

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, B.F.; Toftegaard, H.; Goutanos, S. (Risoe DTU, Materials Research Div., Roskilde (Denmark)); Branner, K.; Berring, P. (Risoe DTU, Wind Energy Div., Roskilde (Denmark)); Lund, E. (Aalborg Univ., Dept. of Mechanical Engineering, Aalborg (Denmark)); Wedel-Heinen, J. (Vestas Wind System, Randers (Denmark)); Garm, J.H. (LM Wind Power, Kolding (Denmark))

    2010-06-15

    Results are summarised for the project 'Improved design for large wind turbine blades (Phase 4)', partially supported by the Danish Energy Agency under the Ministry of Climate and Energy through the EUDP journal no.: 33033-0267. The aim of the project was to develop new and better design methods for wind turbine blades, so that uncertainties associated with damage and defects can be reduced. The topics that are studied include buckling-driven delamination of flat load-carrying laminates, cracking along interfaces in material joints (fracture mechanical characterisation and modelling), cyclic crack growth with large scale bridging and the use of cohesive laws in finite element programmes for simulating wind turbine blade failure. An overview is given of the methods and the major research results of the project. The implementation of the knowledge in the industry is discussed. Finally, some ideas for future research activities are considered. (author)

  2. Application of modern diagnostic methods to environmental improvement. Annual progress report, October 1994--September 1995

    Energy Technology Data Exchange (ETDEWEB)

    Shepard, W.S.

    1995-12-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL), an interdisciplinary research department in the College of Engineering at Mississippi State University (MSU), is under contract with the US Department of Energy (DOE) to develop and apply advanced diagnostic instrumentation and analysis techniques to aid in solving DOE`s nuclear waste problem. The program is a comprehensive effort which includes five focus areas: advanced diagnostic systems; development/application; torch operation and test facilities; process development; on-site field measurement and analysis; technology transfer/commercialization. As part of this program, diagnostic methods will be developed and evaluated for characterization, monitoring and process control. Also, the measured parameters, will be employed to improve, optimize and control the operation of the plasma torch and the overall plasma treatment process. Moreover, on-site field measurements at various DOE facilities are carried out to aid in the rapid demonstration and implementation of modern fieldable diagnostic methods. Such efforts also provide a basis for technology transfer.

  3. Natural Propagation and Habitat Improvement, Volume 1, Oregon, 1985 Annual and Final Reports.

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Ken

    1986-10-01

    The Hot Springs Fork of the Collawash River is a major sub-drainage in the Clackamas River drainage. Emphasis species for natural production are spring chinook, coho salmon, and winter steelhead. Increased natural production appears limited by a lack of quality rearing habitat. Habitat complexity over approximately 70% of accessible area to anadromous fish has been reduced over the last 40 years by numerous factors. Natural passage barriers limit anadromous fish access to over 7 miles of high quality habitat. In the first year of a multi-year effort to improve fish habitat in the Hot Springs Fork drainage, passage enhancement on two tributaries and channel rehabilitation on one of those tributaries was completed. Three waterfalls on Nohorn Creek were evaluated and passage improved on the uppermost waterfall to provide steelhead full access to 2.4 miles of good quality habitat. The work was completed in October 1985 and involved blasting three jump pools and two holding pools into the waterfall. On Pansy Creek, four potential passage barriers were evaluated and passage improvement work conducted on two logjams and one waterfall. Minor modifications were made to a waterfall to increase flow into a side channel which allows passage around the waterfall. Channel rehabilitation efforts on Pansy Creek (RM 0.0 to 0.3) to increase low flow pool rearing habitat and spawning habitat including blasting five pools into areas of bedrock substrate and using a track-mounted backhoe to construct instream structures. On site materials were used to construct three log sills, three boulder berms, a boulder flow deflector, and five log and boulder structures. Also, an alcove was excavated to provide overwinter rearing habitat. Pre-project monitoring consisting of physical and biological data collection was completed in the project area.

  4. Improving the quality of care for women with cardiovascular disease: report of a DCRI Think Tank, March 8 to 9, 2007.

    Science.gov (United States)

    Berger, Jeffrey S; Bairey-Merz, C Noel; Redberg, Rita F; Douglas, Pamela S

    2008-11-01

    Differences in pathophysiology, diagnosis, and treatment of women with cardiovascular disease compared with men has become a major focus during the past decade. Nevertheless, little attention has focused on improving the quality of healthcare in women compared with other areas of cardiovascular medicine. To address this deficit, Duke University Medical Center convened a national Duke Clinical Research Institute (DCRI) Think Tank meeting, including basic science and clinical researchers, payers, legislators, clinical experts, government regulators, and members of the pharmaceutical and device industries. This report provides an overview of the discussions and proposed solutions. Discussion concentrated on the development of strategies to improve the quality of health care for women with heart disease. Key components to improve quality care include: (1) enhance the quantity and quality of evidence-based medicine to guide care in women through improvements in trial design, enrollment and retention of women subjects, results analysis and reporting, and better incentives to perform research in women; (2) provide incentives to develop better data in women through mandating changes in the drug and device development and approval processes; (3) incorporate specific recommendations for women into guidelines when data are sufficient; and (4) apply proven sex-based differences in risk stratification, diagnostic testing, and drug usage and dosing in clinical care. Examples of possible strategies are included. The above approach represents a necessary, but not sufficient, platform to improve the overall quality of healthcare in women with cardiovascular disease.

  5. To report or not to report: a psychosocial investigation aimed at improving early detection of Avian Influenza outbreaks

    NARCIS (Netherlands)

    A.R.W. Elbers; M.J. Gorgievski-Duijvesteijn (Marjan); K. Zarafshani (Kiumars); G. Koch (Guus)

    2010-01-01

    textabstractSummary: The aim of this study was to identify difficulties and barriers to reporting clinically suspect situations, possibly caused by avian influenza (AI), and to explore possible incentives to reporting such situations, with the ultimate aim of facilitating early detection of AI

  6. A call for action: Improve reporting of research studies to increase the scientific basis for regulatory decision-making

    DEFF Research Database (Denmark)

    Ågerstrand, Marlene; Christiansen, Sofie; Hanberg, Annika

    2018-01-01

    This is a call for action to scientific journals to introduce reporting requirements for toxicity and ecotoxicity studies. Such reporting requirements will support the use of peer-reviewed research studies in regulatory decision-making. Moreover, this could improve the reliability...... and reproducibility of published studies in general and make better use of the resources spent in research....

  7. A call for action: Improve reporting of research studies to increase the scientific basis for regulatory decision-making

    DEFF Research Database (Denmark)

    Ågerstrand, Marlene; Christiansen, Sofie; Hanberg, Annika

    2018-01-01

    This is a call for action to scientific journals to introduce reporting requirements for toxicity and ecotoxicity studies. Such reporting requirements will support the use of peer-reviewed research studies in regulatory decision-making. Moreover, this could improve the reliability and reproducibi...

  8. Federally Sponsored Research at Educational Institutions: A Need for Improved Accountability. Report by the U.S. General Accounting Office.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report discusses federally sponsored research at educational institutions and suggests ways to improve accountability for these funds. The following suggestions are made for minimizing problems presented in this report: (1) development of more definitive cost principles for both the institutions and the Federal auditors to follow; (2) more…

  9. College Affordability for Low-Income Adults: Improving Returns on Investment for Families and Society. Report #C412

    Science.gov (United States)

    Gault, Barbara; Reichlin, Lindsey; Román, Stephanie

    2014-01-01

    This report examines how efforts to understand and improve college affordability can be informed by the experiences and circumstances of low-income adults, students of color, and students with dependent children. The report discusses how the time and financial demands associated with financial independence, parenthood, and work affect a student's…

  10. Guide to improving the performance of a manipulator system for nuclear fuel handling through computer controls. Final report

    International Nuclear Information System (INIS)

    Evans, J.M. Jr.; Albus, J.S.; Barbera, A.J.; Rosenthal, R.; Truitt, W.B.

    1975-11-01

    The Office of Developmental Automation and Control Technology of the Institute for Computer Sciences and Technology of the National Bureau of Standards provides advising services, standards and guidelines on interface and computer control systems, and performance specifications for the procurement and use of computer controlled manipulators and other computer based automation systems. These outputs help other agencies and industry apply this technology to increase productivity and improve work quality by removing men from hazardous environments. In FY 74 personnel from the Oak Ridge National Laboratory visited NBS to discuss the feasibility of using computer control techniques to improve the operation of remote control manipulators in nuclear fuel reprocessing. Subsequent discussions led to an agreement for NBS to develop a conceptual design for such a computer control system for the PaR Model 3000 manipulator in the Thorium Uranium Recycle Facility (TURF) at ORNL. This report provides the required analysis and conceptual design. Complete computer programs are included for testing of computer interfaces and for actual robot control in both point-to-point and continuous path modes

  11. Extension and improvement of the FENDL library for fusion applications (FENDL-2). Report of an IAEA advisory group meeting

    International Nuclear Information System (INIS)

    Herman, M.; Pashchenko, A.B.

    1997-09-01

    The present report contains the summary of the IAEA Advisory Meeting on Extension and Improvement of the Fusion Evaluated Nuclear Data Library (FENDL), organized by IAEA Nuclear Data Section and held in IAEA headquarters in Vienna from 3 to 7 March 1997. The FENDL library is a comprehensive collection of high-quality nuclear data, selected from the various existing national data libraries, covering the necessary input for physics and engineering studies of the material development, design, operation and safety of ITER and other fusion devices. The library has undergone an intensive testing and validation against integral benchmarks. The main scope of the Meeting was to discuss recent developments within FENDL project, review new evaluations to be included in the library, and decide on the release of the second version of the library (FENDL-2.0). During the meeting it was demonstrated that the FENDL-2.0 library shows a net improvement over the preceding FENDL-1. The release of the Library was authorized with the exception of the general purpose field FENDL/E-2.0 and its processed form, which is scheduled at the end of 1997. (author)

  12. Final Report: Utilizing Alternative Fuel Ignition Properties to Improve SI and CI Engine Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Wooldridge, Margaret; Boehman, Andre; Lavoie, George; Fatouraie, Mohammad

    2017-11-30

    Experimental and modeling studies were completed to explore leveraging physical and chemical fuel properties for improved thermal efficiency of internal combustion engines. Fundamental studies of the ignition chemistry of ethanol and iso-octane blends and constant volume spray chamber studies of gasoline and diesel sprays supported the core research effort which used several reciprocating engine platforms. Single cylinder spark ignition (SI) engine studies were carried out to characterize the impact of ethanol/gasoline, syngas (H2 and CO)/gasoline and other oxygenate/gasoline blends on engine performance. The results of the single-cylinder engine experiments and other data from the literature were used to train a GT Power model and to develop a knock criteria based on reaction chemistry. The models were used to interpret the experimental results and project future performance. Studies were also carried out using a state of the art, direct injection (DI) turbocharged multi- cylinder engine with piezo-actuated fuel injectors to demonstrate the promising spray and spark timing strategies from single-cylinder engine studies on the multi-cylinder engine. Key outcomes and conclusions of the studies were: 1. Efficiency benefits of ethanol and gasoline fuel blends were consistent and substantial (e.g. 5-8% absolute improvement in gross indicated thermal efficiency (GITE)). 2. The best ethanol/gasoline blend (based on maximum thermal efficiency) was determined by the engine hardware and limits based on component protection (e.g. peak in-cylinder pressure or maximum turbocharger inlet temperature) – and not by knock limits. Blends with <50% ethanol delivered significant thermal efficiency gains with conventional SI hardware while maintain good safety integrity to the engine hardware. 3. Other compositions of fuel blends including syngas (H2 and CO) and other dilution strategies provided significant efficiency gains as well (e.g. 5% absolute improvement in ITE). 4. When the

  13. Active music therapy improves cognition and behaviour in chronic vascular encephalopathy: a case report.

    Science.gov (United States)

    Giovagnoli, Anna Rita; Oliveri, Serena; Schifano, Letizia; Raglio, Alfredo

    2014-02-01

    This study describes the effects of active music therapy (AMT) on cognition and behaviour in chronic vascular encephalopathy. A single case study investigated different cognitive and psycho-behavioural changes after AMT. An adult patient with memory, attention, and verbal fluency deficits associated with Vascular Cognitive Impairment-No Dementia (VCI-ND) was treated. A four-months AMT course was based on creative and interactive music playing. Sixteen sessions were conducted simultaneously to the pharmacological therapy. Cognitive performances, mood, interpersonal interactions, and perceived abilities were assessed using standardized neuropsychological and psycho-behavioural measurements. At baseline, the patient reported a tendency to feel tense, nervous, and angry and difficulties in memory and visuospatial performances, frequently accompanied by attention drops. The social network was a habitual component of the patient's life, but not a source of sharing of personal experiences, safety or comfort. Neuropsychological tests showed deficits in object and figure naming, verbal fluency, short and long-term verbal memory, short-term spatial memory, selective attention, and visuomotor coordination. After AMT, the cognitive profile significantly improved in attention, visuomotor coordination, and verbal and spatial memory. Such positive changes were confirmed at the three-months follow-up. An increase of the interpersonal interactions and consistent reduction of anxiety were also observed. In selected patients with VCI-ND, a well-structured AMT intervention added to standard therapy may contribute in determining a stable improvement of cognitive and psycho-behavioural aspects. Controlled studies are needed to confirm these promising results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Comprehensive approach to improving maternal health and achieving MDG 5: report from the mountains of Lesotho.

    Directory of Open Access Journals (Sweden)

    Hind Satti

    Full Text Available BACKGROUND: Although it is now widely recognized that reductions in maternal mortality and improvements in women's health cannot be achieved through simple, vertical strategies, few programs have provided successful models for how to integrate services into a comprehensive program for maternal health. We report our experience in rural Lesotho, where Partners In Health (PIH in partnership with the Ministry of Health and Social Welfare implemented a program that provides comprehensive care of pregnant women from the community to the clinic level. METHODS: Between May and July 2009, PIH trained 100 women, many of whom were former traditional birth attendants, to serve as clinic-affiliated maternal health workers. They received performance-based incentives for accompanying pregnant women during antenatal care (ANC visits and facility-based delivery. A nurse-midwife provided ANC and delivery care and supervised the maternal health workers. To overcome geographic barriers to delivering at the clinic, women who lived far from the clinic stayed at a maternal lying-in house prior to their expected delivery dates. We analyzed data routinely collected from delivery and ANC registers to compare service utilization before and after implementation of the program. RESULTS: After the establishment of the program, the average number first ANC visits increased from 20 to 31 per month. The clinic recorded 178 deliveries in the first year of the program and 216 in the second year, compared to 46 in the year preceding the program. During the first two years of the program, 49 women with complications were successfully transported to the district hospital, and no maternal deaths occurred among the women served by the program. CONCLUSIONS: Our results demonstrate that it is possible to achieve dramatic improvements in the utilization of maternal health services and facility-based delivery by strengthening human resource capacity, implementing active follow-up in the

  15. Orthodontic clockwise rotation of maxillomandibular complex for improving facial profile in late teenagers with Class III malocclusion: A preliminary report

    Directory of Open Access Journals (Sweden)

    Eric JW Liou

    2018-01-01

    Full Text Available Objective: Orthodontic camouflage treatments improve occlusion but might worsen facial profile in patients with Class III malocclusion. It has been reported that surgical clockwise rotation of maxillomandibular complex (MMc improves facial profile by reducing chin prominence and chin throat length in patients with Class III malocclusion. The purpose of this report was to illustrate two orthodontic techniques for clockwise rotation of the MMc in late teenagers with Class III malocclusion and preliminarily evaluate their clinical effects. Patients and Methods: Six patients in late teenage with Class III malocclusion were included in this preliminary report. Bite raisers were first placed on the upper molars to open the bite and clockwise rotate the mandible. Intermaxillary elastics were then applied vertically between the upper and lower dentitions in 3 patients for bimaxillary extrusion (Technique-1 or between the upper dentition and the lower temporary anchorage devices (TADs in another 3 patients (Technique-2 for upper dentition extrusion and closure of the anterior open bite. The three-dimensional cone-beam computed tomography images taken before and after orthodontic treatment were superimposed to evaluate the treatment effects of MMc clockwise rotation for both techniques. Results: The Technique-1 extruded the upper and lower dentitions, rotated the mandible clockwise 2.01°, moved chin down 2.98 mm, and back −1.64 mm, although the mandible grew 2.47 mm during the treatment period. The Technique-2 extruded the upper dentition, rotated the mandible clockwise 0.90°, moved chin down 1.78 mm, but slightly forward 0.47 mm due to the mandible grew 2.50 mm and lower dentition was not extruded. Conclusions: The orthodontic clockwise rotation of MMc is an effective technique for orthognathic camouflage. The applications of bite raisers and bimaxillary dentition extrusion could be more effective than single dentition extrusion with TADs in the

  16. The a3 problem solving report: a 10-step scientific method to execute performance improvements in an academic research vivarium.

    Science.gov (United States)

    Bassuk, James A; Washington, Ida M

    2013-01-01

    The purpose of this study was to illustrate the application of A3 Problem Solving Reports of the Toyota Production System to our research vivarium through the methodology of Continuous Performance Improvement, a lean approach to healthcare management at Seattle Children's (Hospital, Research Institute, Foundation). The Report format is described within the perspective of a 10-step scientific method designed to realize measurable improvements of Issues identified by the Report's Author, Sponsor and Coach. The 10-step method (Issue, Background, Current Condition, Goal, Root Cause, Target Condition, Countermeasures, Implementation Plan, Test, and Follow-up) was shown to align with Shewhart's Plan-Do-Check-Act process improvement cycle in a manner that allowed for quantitative analysis of the Countermeasure's outcomes and of Testing results. During fiscal year 2012, 9 A3 Problem Solving Reports were completed in the vivarium under the teaching and coaching system implemented by the Research Institute. Two of the 9 reports are described herein. Report #1 addressed the issue of the vivarium's veterinarian not being able to provide input into sick animal cases during the work day, while report #7 tackled the lack of a standard in keeping track of weekend/holiday animal health inspections. In each Report, a measurable Goal that established the basis for improvement recognition was present. A Five Whys analysis identified the Root Cause for Report #1 as historical work patterns that existed before the veterinarian was hired on and that modern electronic communication tools had not been implemented. The same analysis identified the Root Cause for Report #7 as the vivarium had never standardized the process for weekend/holiday checks. Successful outcomes for both Reports were obtained and validated by robust audit plans. The collective data indicate that vivarium staff acquired a disciplined way of reporting on, as well as solving, problems in a manner consistent with high

  17. The a3 problem solving report: a 10-step scientific method to execute performance improvements in an academic research vivarium.

    Directory of Open Access Journals (Sweden)

    James A Bassuk

    Full Text Available The purpose of this study was to illustrate the application of A3 Problem Solving Reports of the Toyota Production System to our research vivarium through the methodology of Continuous Performance Improvement, a lean approach to healthcare management at Seattle Children's (Hospital, Research Institute, Foundation. The Report format is described within the perspective of a 10-step scientific method designed to realize measurable improvements of Issues identified by the Report's Author, Sponsor and Coach. The 10-step method (Issue, Background, Current Condition, Goal, Root Cause, Target Condition, Countermeasures, Implementation Plan, Test, and Follow-up was shown to align with Shewhart's Plan-Do-Check-Act process improvement cycle in a manner that allowed for quantitative analysis of the Countermeasure's outcomes and of Testing results. During fiscal year 2012, 9 A3 Problem Solving Reports were completed in the vivarium under the teaching and coaching system implemented by the Research Institute. Two of the 9 reports are described herein. Report #1 addressed the issue of the vivarium's veterinarian not being able to provide input into sick animal cases during the work day, while report #7 tackled the lack of a standard in keeping track of weekend/holiday animal health inspections. In each Report, a measurable Goal that established the basis for improvement recognition was present. A Five Whys analysis identified the Root Cause for Report #1 as historical work patterns that existed before the veterinarian was hired on and that modern electronic communication tools had not been implemented. The same analysis identified the Root Cause for Report #7 as the vivarium had never standardized the process for weekend/holiday checks. Successful outcomes for both Reports were obtained and validated by robust audit plans. The collective data indicate that vivarium staff acquired a disciplined way of reporting on, as well as solving, problems in a manner

  18. Improved solid oxide fuel cell stacks: Power density, durability and modularity. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Lund Frandsen, H.; Kiebach, W.R.; Hoeegh, J. (Technical Univ. of Denmark. Risoe National Lab. for Sustainable Energy, Roskilde (Denmark)) (and others)

    2010-10-15

    This report presents the work performed within the project PSO2009-1-10207 during the period from 01-04-2009 - 31-06-2010. The report is divided into three parts covering the three work packages: Stack components; Stacks and durability; and Large SOFC systems: modularity and scalability. The project contains 38 milestones and all milestones in the project have been either fully or partly fulfilled. Two major achievements within this project concern the robustness towards dynamic operations and implementation of cells with more active cathodes: Within this project tools to evaluate and test SOFC stacks with respect to robustness during dynamic operations has been developed. From stack tests performed under dynamic conditions it was observed that the effect on degradation and failure seemed to be very little. The thermo-mechanical models developed in this project in combination with the dynamic stack model was used in combination to understand why. The results clearly showed that the hardest stress field applied to the cells arises from the steady state operating point rather than from the dynamic conditions. This is a very promising result concerning the fact that especially small CHP units in a commercial system will experience dynamic conditions from load cycling and thermal cycling. A new type of cell with a more active cathode has been formulated and introduced into the TOFC stacks in this project. The aim was to improve the effect of the stack by 25 %. However, compared to a standard stack with the ''old'' cells, the stack effect was increased by 44% - from a cross flow stack with standard 2G cells to a cross flow stack with 2.5G cells. The new type of cells also show an excellent stability towards moisture in the cathode feed, and a stack with 2.5G cells has been tested for 12.000 hrs with a degradation rate of 30 mOMEGAcm2/1000 hr. (Author)

  19. Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; electronic reporting pilot; Inpatient Rehabilitation Facilities Quality Reporting Program; revision to Quality Improvement Organization regulations. Final rule with comment period.

    Science.gov (United States)

    2012-11-15

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011).

  20. Report: EPA Should Improve Controls for Managing Contractor-Held Property

    Science.gov (United States)

    Report #12-P-0388, April 3, 2012. EPA does not have effective oversight of CHP, did not accurately report CHP in its FY 2010 financial statements, and did not fully implement corrective actions from an OIG 2006 audit report.

  1. On-demand Modafinil Improves Ejaculation Time and Patient-reported Outcomes in Men With Lifelong Premature Ejaculation.

    Science.gov (United States)

    Tuken, Murat; Kiremit, Murat Can; Serefoglu, Ege Can

    2016-08-01

    To evaluate the effects of modafinil on the intravaginal ejaculatory latency time (IELT) and patient-reported outcomes in patients with lifelong premature ejaculation (PE). Treatment-naïve lifelong PE patients were included in this proof-of-concept study. Self-estimated IELTs of the patients were recorded and the Premature Ejaculation Profile (PEP) questionnaire was administered before the initiation of on-demand modafinil 100 mg treatment. At the end of 1 month of treatment, self-estimated IELTs were recorded again, along with posttreatment PEP outcomes. Overall, 55 lifelong PE patients with a mean age of 35.07 ± 7.80 (range: 22-58) years were enrolled. Modafinil treatment modestly increased the mean IELT at the end of 1 month (24.82 ± 16.10 seconds vs 49.82 ± 31.46 seconds, P = .0001). Moreover, at the end of 1 month, patients reported in the PEP questionnaire better control over ejaculation (0.75 ± 0.67 vs 1.35 ± 0.91, P = .0001), improved satisfaction with sexual intercourse (0.98 ± 0.78 vs 1.40 ± 0.85, P = .0001), lesser personal distress (0.42 ± 0.69 vs 0.89 ± 1.01, P = .0001), and reduced interpersonal difficulty (1.69 ± 1.48 vs 1.95 ± 1.47, P = .0001). In an uncontrolled proof-of-concept study of men with treatment-naïve lifelong PE where IELT was self-reported without a stopwatch, modest improvements of both IELT and patient-reported outcome measures were observed. Future controlled clinical trials are necessary to confirm these findings. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report

    Directory of Open Access Journals (Sweden)

    Mann Christian

    2011-09-01

    Full Text Available Abstract Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100% oxygen with a flow of 2.0 L/minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O, with pressure support of 4 cmH2O, trigger at 1.4 mL/second, and a maximum inspiratory time of 0.7 seconds. Over the course of seven weeks, the patient's maximum daytime fraction of inspired oxygen via nasal cannula decreased from 1.0 to 0.75, his respiratory rate from 64 breaths/minute to 50 breaths/minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented, noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy.

  3. Embedded Sensors and Controls to Improve Component Performance and Reliability: Conceptual Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Kisner, Roger A [ORNL; Melin, Alexander M [ORNL; Burress, Timothy A [ORNL; Fugate, David L [ORNL; Holcomb, David Eugene [ORNL; Wilgen, John B [ORNL; Miller, John M [ORNL; Wilson, Dane F [ORNL; Silva, Pamela C [ORNL; Whitlow, Lynsie J [ORNL; Peretz, Fred J [ORNL

    2012-10-01

    The overall project objective is to demonstrate improved reliability and increased performance made possible by deeply embedding instrumentation and controls (I&C) in nuclear power plant components. The project is employing a highly instrumented canned rotor, magnetic bearing, fluoride salt pump as its I&C technology demonstration vehicle. The project s focus is not primarily on pump design, but instead is on methods to deeply embed I&C within a pump system. However, because the I&C is intimately part of the basic millisecond-by-millisecond functioning of the pump, the I&C design cannot proceed in isolation from the other aspects of the pump. The pump will not function if the characteristics of the I&C are not embedded within the design because the I&C enables performance of the basic function rather than merely monitoring quasi-stable performance. Traditionally, I&C has been incorporated in nuclear power plant (NPP) components after their design is nearly complete; adequate performance was obtained through over-design. This report describes the progress and status of the project and provides a conceptual design overview for the embedded I&C pump.

  4. Combined diversity and improved energy detection in cooperative spectrum sensing with faded reporting channels

    Directory of Open Access Journals (Sweden)

    Srinivas Nallagonda

    2016-04-01

    Full Text Available In this paper we evaluate the performance of cooperative spectrum sensing (CSS where each cognitive radio (CR employs an improved energy detector (IED with multiple antennas and uses selection combining (SC for detecting the primary user (PU in noisy and faded sensing (S channels. We derive an expression for the probability of false alarm and expressions for probability of missed detection in non-faded (AWGN and Rayleigh faded sensing environments in terms of cumulative distribution function (CDF. Each CR transmits its decision about PU via noisy and faded reporting (R channel to fusion center (FC. In this paper we assume that S-channels are noisy and Rayleigh faded while several cases of fading are considered for R-channels such as: (i Hoyt (or Nakagami-q, (ii Rayleigh, (iii Rician (or Nakagami-n, and (iv Weibull. A Binary Symmetric channel (BSC with a fixed error probability (r in the R-channel is also considered. The impact of fading in R-channel, S-channel and several network parameters such as IED parameter, normalized detection threshold, number of CRs, and number of antennas on missed detection and total error probability is assessed. The effects of Hoyt, Rician, and Weibull fading parameters on overall performance of IED-CSS are also highlighted.

  5. A CHANGE DETECTION AND RESOURCE-AWARE DATA SENSING APPROACHES FOR IMPROVING THE REPORTING PROTOCOL MECHANISM FOR MOBILE USER

    Directory of Open Access Journals (Sweden)

    annisaa sri indrawanti

    2015-08-01

    Full Text Available Update mechanism is an important process that relays information to the end-user by sending the data from the client to the server. There are several kinds of update mechanism that are used, one of them is reporting protocol. Reporting protocol sends the data from the client to the server continuously in a certain time interval. Reporting protocol occasionally sends the same information repeatedly to the end-user and sometimes the data aren’t needed by the end-user. This is an issue, because it can cause a large amount of bandwidth usage. In this research, we have developed an improvement of the reporting protocol mechanism for mobile user using change detection and resource-aware data sensing to minimize the bandwidth and resource usage. The improvement of reporting protocol that is implemented reduces frequency of data transfer with the prediction of the changes in user activity and position. The prediction is used as a trigger when the data is about to be sent. The results have shown that the adaptive reporting protocol could improve the performance of the overall reporting protocol. This is shown by the improvement of the bandwidth efficiency up to 36-97%, memory efficiency at 1.5-6% and battery efficiency at 7-13%.

  6. Long-lasting complete response status of advanced stage IV gall bladder cancer and colon cancer after combined treatment including autologous formalin-fixed tumor vaccine: two case reports.

    Science.gov (United States)

    Imaoka, Yuki; Kuranishi, Fumito; Miyazaki, Tsubasa; Yasuda, Hiroko; Ohno, Tadao

    2017-09-11

    The prognosis of advanced (stage IV) cancer of the digestive organs is very poor. We have previously reported a case of advanced breast cancer with bone metastasis that was successfully treated with combined treatments including autologous formalin-fixed tumor vaccine (AFTV). Herein, we report the success of this approach in advanced stage IV (heavily metastasized) cases of gall bladder cancer and colon cancer. Case 1: A 61-year-old woman with stage IV gall bladder cancer (liver metastasis and lymph node metastasis) underwent surgery in May 2011, including partial resection of the liver. She was treated with AFTV as the first-line adjuvant therapy, followed by conventional chemotherapy. This patient is still alive without any recurrence, as confirmed with computed tomography, for more than 5 years. Case 2: A 64-year-old man with stage IV colon cancer (multiple para-aortic lymph node metastases and direct abdominal wall invasion) underwent non-curative surgery in May 2006. Following conventional chemotherapy, two courses of AFTV and radiation therapy were administered sequentially. This patient has had no recurrence for more than 5 years. We report the success of combination therapy including AFTV in cases of liver-metastasized gall bladder cancer and abdominal wall-metastasized colon cancer. Both patients experienced long-lasting, complete remission. Therefore, combination therapies including AFTV should be considered in patients with advanced cancer of the digestive organs.

  7. Improved electrical efficiency and bottom ash quality on waste combustion plants. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Peter A.; Nesterov, I.; Boejer, M.; Hyks, J.; Astrup, T.; Kloeft, H.; Dam-Johansen, K.; Lundtorp, K.; Hedegaard Madsen, O.; Frandsen, F. (Technical Univ. of Denmark, Kgs. Lyngby (Denmark)); Mogensen, Erhardt (Babcock and Wilcox Voelund A/S, Glostrup (Denmark))

    2010-07-01

    Investigations making it possible to evaluate and further develop concepts to improve electrical efficiency in a waste combustion plant were performed. Furthermore, one objective of the study was to investigate the possibilities of improving waste bottom ash leaching properties by use of a rotary kiln treatment. The project work included construction of a bench-scale rotary kiln, performing ash rotary kiln treatment experiments, conducting gas suction probe measurements on a waste incineration plant and making some concept evaluations. The influence of the rotary kiln thermal treatment on the leaching of Ca, Al, Si, Mg, Ba, Sr, Cl, Cu, Pb, Zn, Cr, Mo, sulfate, DOC and carbonate was determined. As a result of these tests, the rotary kiln thermal treatment of bottom ashes can be recommended for reducing the leaching of Cu, Pb, Cl, Zn and DOC; however, an increased leaching of Cr and Mo should be expected. The combustion conditions above the grate of a waste incineration plant were investigated and the release and concentration of volatile ash species in the flue gas such as Cl, Na, K, Ca, Pb, Zn and S were measured. The conducted measurements show that flue gas from grate sections 3 and 4 can produce a sufficiently hot flue gas that contains only low concentrations of corrosive species, and therefore can be used to increase superheater temperatures. Implementation of the so-called flue gas split concept together with other steam circle modifications on a waste combustion plant, and using a reasonable increase in final steam temperature from 400 to 500 deg. C, have the potential to increase electrical efficiency from 24 to 30% (with respect to lower fuel heating value) in a waste combustion plant. (Author)

  8. New Zealand's Fourth National Communication under the United Nations Framework Convention on Climate Change. Including the Report on the Global Climate Observing System and the Report on Demonstrable Progress under the Kyoto Protocol

    International Nuclear Information System (INIS)

    2006-03-01

    The New Zealand Government is committed to playing its part in the global response to climate change. This Fourth National Communication provides a snapshot of New Zealand's progress with implementing the United Nations Framework Convention on Climate Change (UNFCCC). This document covers the period from the submission of the Third National Communication in January 2002 through to the end of December 2005. This document also contains New Zealand's Report on the Global Climate Observing System and the Report on Demonstrable Progress under the Kyoto Protocol. New Zealand's response to climate change has evolved substantially since the Third National Communication was submitted. On 19 December 2002, New Zealand became the 101st nation to ratify the Kyoto Protocol. In 2002, the New Zealand Parliament passed the Climate Change Response Act. This Act established a New Zealand climate change registry and corresponding institutional arrangements in accordance with Kyoto Protocol requirements. Other achievements are detailed throughout this Fourth National Communication. When the Government introduced its climate change policy package in 2002, it anticipated there would be three reviews of the package not later than 2005, 2007 and 2010. The reviews would be necessary to monitor progress with emissions reductions, assess the effectiveness of policies, and confirm that New Zealand was positioned to meet its commitments. The first of these reviews was commissioned by the Government in mid-2005 and completed by November 2005. The review concluded that some elements of the Government's 2002 climate change policy package should be modified to better position New Zealand to respond to the longer-term challenges of climate change. A key outcome of the policy review was the announcement by the newly elected Government in December 2005 that the previously announced carbon tax would not proceed. In addition, a suite of future work programmes would be required to inform Government

  9. Self-reported needs for improving the supervision competence of PhD supervisors from the medical sciences in Denmark

    Directory of Open Access Journals (Sweden)

    Rie Raffing

    2017-10-01

    Full Text Available Abstract Background Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insufficient supervision. This led the Research Education Committee at the University of Copenhagen to recommend that supervisors further develop their supervision competence. The aim of this study was to explore PhD supervisors’ self-reported needs and wishes regarding the content of a new program in supervision, with a special focus on the supervision of PhD students in medical fields. Methods A semi-structured interview guide was developed, and 20 PhD supervisors from the Graduate School of Health and Medical Sciences at the Faculty of Health and Medical Sciences at the University of Copenhagen were interviewed. Empirical data were analysed using qualitative methods of analysis. Results Overall, the results indicated a general interest in improved competence and development of a new supervision programme. Those who were not interested argued that, due to their extensive experience with supervision, they had no need to participate in such a programme. The analysis revealed seven overall themes to be included in the course. The clinical context offers PhD supervisors additional challenges that include the following sub-themes: patient recruitment, writing the first article, agreements and scheduled appointments and two main groups of students, in addition to the main themes. Conclusions The PhD supervisors reported the clear need and desire for a competence enhancement programme targeting the supervision of PhD students at the Faculty of Health and Medical Sciences. Supervision in the clinical context appeared to require additional competence. Trial registration The Scientific Ethical Committee

  10. Self-reported needs for improving the supervision competence of PhD supervisors from the medical sciences in Denmark.

    Science.gov (United States)

    Raffing, Rie; Jensen, Thor Bern; Tønnesen, Hanne

    2017-10-23

    Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insufficient supervision. This led the Research Education Committee at the University of Copenhagen to recommend that supervisors further develop their supervision competence. The aim of this study was to explore PhD supervisors' self-reported needs and wishes regarding the content of a new program in supervision, with a special focus on the supervision of PhD students in medical fields. A semi-structured interview guide was developed, and 20 PhD supervisors from the Graduate School of Health and Medical Sciences at the Faculty of Health and Medical Sciences at the University of Copenhagen were interviewed. Empirical data were analysed using qualitative methods of analysis. Overall, the results indicated a general interest in improved competence and development of a new supervision programme. Those who were not interested argued that, due to their extensive experience with supervision, they had no need to participate in such a programme. The analysis revealed seven overall themes to be included in the course. The clinical context offers PhD supervisors additional challenges that include the following sub-themes: patient recruitment, writing the first article, agreements and scheduled appointments and two main groups of students, in addition to the main themes. The PhD supervisors reported the clear need and desire for a competence enhancement programme targeting the supervision of PhD students at the Faculty of Health and Medical Sciences. Supervision in the clinical context appeared to require additional competence. The Scientific Ethical Committee for the Capital Region of Denmark. Number: H-3-2010-101, date: 2010.09.29.

  11. New seismograph includes filters

    Energy Technology Data Exchange (ETDEWEB)

    1979-11-02

    The new Nimbus ES-1210 multichannel signal enhancement seismograph from EG and G geometrics has recently been redesigned to include multimode signal fillers on each amplifier. The ES-1210F is a shallow exploration seismograph for near subsurface exploration such as in depth-to-bedrock, geological hazard location, mineral exploration, and landslide investigations.

  12. Evaluation and capacity building to improve precollege science and mathematics achievement in the US: 10 CFR, Part 605. Technical progress report, June--December 1992

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-31

    The National Center for Improving Science Education has undertaken activities to achieve evaluation goals for DOE`s Precollege programs: develop means to determine program quality; develop means for determining the contribution of DOE precollege programs to both teacher enhancement and student achievement; provide evaluation designs and instruments and reports of program quality and impact; and strengthen both DOE`s and the Labs` capacity to do both short- and long-term planning as well as deliver effective programs and evaluation. Appendices include evaluation/technical assistance report, profiling teacher research participation and teacher development programs, teacher surveys, impact assessment design, and teacher research participation programs anecdotes for 8 labs.

  13. Analytic device including nanostructures

    KAUST Repository

    Di Fabrizio, Enzo M.; Fratalocchi, Andrea; Totero Gongora, Juan Sebastian; Coluccio, Maria Laura; Candeloro, Patrizio; Cuda, Gianni

    2015-01-01

    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  14. Saskatchewan resources. [including uranium

    Energy Technology Data Exchange (ETDEWEB)

    1979-09-01

    The production of chemicals and minerals for the chemical industry in Saskatchewan are featured, with some discussion of resource taxation. The commodities mentioned include potash, fatty amines, uranium, heavy oil, sodium sulfate, chlorine, sodium hydroxide, sodium chlorate and bentonite. Following the successful outcome of the Cluff Lake inquiry, the uranium industry is booming. Some developments and production figures for Gulf Minerals, Amok, Cenex and Eldorado are mentioned.

  15. Uganda; Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on the following topics: Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, and Payment Systems

    OpenAIRE

    International Monetary Fund

    2003-01-01

    This paper presents findings of Uganda’s Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, Insurance Regulation, Corporate Governance, and Payment Systems. The banking system in Uganda, which dominates the financial system, is fundamentally sound, more resilient than in the past, and currently poses no threat to macroeconomic stability. A major disruption ...

  16. Improving cancer treatment with cyclotron produced radionuclides. Comprehensive progress report, February 1, 1992--July 15, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.; Finn, R.D.

    1995-07-17

    This research continues the long term goals of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis, treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. This program fits into the nuclear medicine component of DOE`s mission, which is aimed at enhancing the beneficial applications of radiation, radionuclides, and stable isotopes in the diagnosis, study and treatment of human diseases. The grant includes 3 interactive components: Radiochemistry/Cyclotron; Pharmacology/Immunology; and Imaging Physics. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Section under the DOE grant during the 1992--1995 will be employed in the Pharmacology/Immunology component in the period 1996--1999. Imaging Physics resolves relevant imaging related physics issues that arise during the experimentation that results. In addition to the basic research mission, this project also provides a basis for training of research scientists in radiochemistry, immunology, bioengineering and imaging physics.

  17. Improving cancer treatment with cyclotron produced radionuclides. Comprehensive progress report, February 1, 1992--July 15, 1995

    International Nuclear Information System (INIS)

    Larson, S.M.; Finn, R.D.

    1995-01-01

    This research continues the long term goals of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis, treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. This program fits into the nuclear medicine component of DOE's mission, which is aimed at enhancing the beneficial applications of radiation, radionuclides, and stable isotopes in the diagnosis, study and treatment of human diseases. The grant includes 3 interactive components: Radiochemistry/Cyclotron; Pharmacology/Immunology; and Imaging Physics. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Section under the DOE grant during the 1992--1995 will be employed in the Pharmacology/Immunology component in the period 1996--1999. Imaging Physics resolves relevant imaging related physics issues that arise during the experimentation that results. In addition to the basic research mission, this project also provides a basis for training of research scientists in radiochemistry, immunology, bioengineering and imaging physics

  18. An improvement of the Earthworm Based Earthquake Alarm Reporting system in Taiwan

    Science.gov (United States)

    Chen, D. Y.; Hsiao, N. C.; Yih-Min, W.

    2017-12-01

    The Central Weather Bureau of Taiwan (CWB) has operated the Earthworm Based Earthquake Alarm Reporting (eBEAR) system for the purpose of earthquake early warning (EEW). The system has been used to report EEW messages to the general public since 2016 through text message from the mobile phones and the television programs. The system for inland earthquakes is able to provide accurate and fast warnings. The average epicenter error is about 5 km and the processing time is about 15 seconds. The epicenter error is defined as the distance between the epicenter estimated by the EEW system and the epicenter estimated by man. The processing time is defined as the time difference between the time earthquakes occurred and the time the system issued warning. The CWB seismic network consist about 200 seismic stations. In some area of Taiwan the distance between each seismic station is about 10 km. It means that when an earthquake occurred the seismic P wave is able to propagate through 6 stations, which is the minimum number of required stations in the EEW system, within 20 km. If the latency of data transmitting is about 1 sec, the P-wave velocity is about 6 km per sec and we take 3-sec length time window to estimate earthquake magnitude, then the processing should be around 8 sec. In fact, however, the average processing time is larger than this figure. Because some outliers of P-wave onset picks may exist in the beginning of the earthquake occurrence, the Geiger's method we used in the EEW system for earthquake location is not stable. It usually takes more time to wait for enough number of good picks. In this study we used grid search method to improve the estimations of earthquake location. The MAXEL algorithm (Sheen et al., 2015, 2016) was tested in the EEW system by simulating historical earthquakes occurred in Taiwan. The results show the processing time can be reduced and the location accuracy is acceptable for EEW purpose.

  19. Terminator Operon Reporter: combining a transcription termination switch with reporter technology for improved gene synthesis and synthetic biology applications.

    Science.gov (United States)

    Zampini, Massimiliano; Mur, Luis A J; Rees Stevens, Pauline; Pachebat, Justin A; Newbold, C James; Hayes, Finbarr; Kingston-Smith, Alison

    2016-05-25

    Synthetic biology is characterized by the development of novel and powerful DNA fabrication methods and by the application of engineering principles to biology. The current study describes Terminator Operon Reporter (TOR), a new gene assembly technology based on the conditional activation of a reporter gene in response to sequence errors occurring at the assembly stage of the synthetic element. These errors are monitored by a transcription terminator that is placed between the synthetic gene and reporter gene. Switching of this terminator between active and inactive states dictates the transcription status of the downstream reporter gene to provide a rapid and facile readout of the accuracy of synthetic assembly. Designed specifically and uniquely for the synthesis of protein coding genes in bacteria, TOR allows the rapid and cost-effective fabrication of synthetic constructs by employing oligonucleotides at the most basic purification level (desalted) and without the need for costly and time-consuming post-synthesis correction methods. Thus, TOR streamlines gene assembly approaches, which are central to the future development of synthetic biology.

  20. To report or not to report: a psychosocial investigation aimed at improving early detection of avian influenza outbreaks

    NARCIS (Netherlands)

    Elbers, A.R.W.; Gorgievski, M.J.; Zarafshani, K.; Koch, G.

    2010-01-01

    The aim of this study was to identify limitations - and solutions for those limitations – with respect to reporting clinically suspect situations on poultry farms, possibly caused by Avian Influenza (AI) with the ultimate aim to facilitate early detection of AI-outbreaks. Focus group sessions were

  1. Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort: a quality improvement report.

    Science.gov (United States)

    Patel, Priti R; Yi, Sarah H; Booth, Stephanie; Bren, Virginia; Downham, Gemma; Hess, Sally; Kelley, Karen; Lincoln, Mary; Morrissette, Kathy; Lindberg, Curt; Jernigan, John A; Kallen, Alexander J

    2013-08-01

    Bloodstream infections (BSIs) cause substantial morbidity in hemodialysis patients. In 2009, the US Centers for Disease Control and Prevention (CDC) sponsored a collaborative project to prevent BSIs in outpatient hemodialysis facilities. We sought to assess the impact of a set of interventions on BSI and access-related BSI rates in participating facilities using data reported to the CDC's National Healthcare Safety Network (NHSN). Quality improvement project. Patients in 17 outpatient hemodialysis facilities that volunteered to participate. Facilities reported monthly event and denominator data to NHSN, received guidance from the CDC, and implemented an evidence-based intervention package that included chlorhexidine use for catheter exit-site care, staff training and competency assessments focused on catheter care and aseptic technique, hand hygiene and vascular access care audits, and feedback of infection and adherence rates to staff. Crude and modeled BSI and access-related BSI rates. Up to 12 months of preintervention (January 2009 through December 2009) and 15 months of intervention period (January 2010 through March 2011) data from participating centers were analyzed. Segmented regression analysis was used to assess changes in BSI and access-related BSI rates during the preintervention and intervention periods. Most (65%) participating facilities were hospital based. Pooled mean BSI and access-related BSI rates were 1.09 and 0.73 events per 100 patient-months during the preintervention period and 0.89 and 0.42 events per 100 patient-months during the intervention period, respectively. Modeled rates decreased 32% (P = 0.01) for BSIs and 54% (P facilities were not representative of all outpatient hemodialysis centers nationally. There was no control arm to this quality improvement project. Facilities participating in a collaborative successfully decreased their BSI and access-related BSI rates. The decreased rates appeared to be maintained in the intervention

  2. Improving integration and coordination of funding, technical assistance, and reporting/data collection: recommendations from CDC and USAPI stakeholders.

    Science.gov (United States)

    Ka'opua, Lana Sue I; White, Susan F; Rochester, Phyllis F; Holden, Debra J

    2011-03-01

    Current US Federal funding mechanisms may foster program silos that disable sharing of resources and information across programs within a larger system of public health services. Such silos present challenges to USAPI communities where human resources, health infrastructure, and health financing are limited. Integrative and coordinated approaches have been recommended. The CDC Pacific Islands Integration and Coordination project was initiated by the CDC Division of Cancer Prevention and Control (DCPC). The project aim was to identify ways for the CDC to collaborate with the USAPI in improving CDC activities and processes related to chronic disease. This article focuses on recommendations for improving coordination and integration in three core areas of health services programming: funding, program reporting/data collection and analysis, and technical assistance. Preliminary information on challenges and issues relevant to the core areas was gathered through site visits, focus groups, key informant interviews, and other sources. This information was used by stakeholder groups from the CDC and the USAPI to develop recommendations in the core programming areas. Recommendations generated at the CDC and USAPI stakeholder meetings were prepared into a single set of recommendations and stakeholders reviewed the document for accuracy prior to its dissemination to CDC's National Center for Chronic Disease Prevention and Health Promotion programs management and staff. Key recommendations, include: (1) consideration of resources and other challenges unique to the USAPI when reviewing funding applications, (2) consideration of ways to increase flexibility in USAPI use of program funds, (3) dedication of funding and human resources for technical assistance, (4) provision of opportunities for capacity-building across programs and jurisdictions, (5) consideration of ways to more directly link program reporting with technical assistance. This project provided a unique opportunity

  3. Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

    Science.gov (United States)

    Fogarty, Colleen T; Winters, Paul; Farah, Subrina

    2016-05-01

    Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered. We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices." One hundred thirty-nine resident physicians and faculty supervisors in five residency training programs at the University of Rochester Medical Center participated in the workshops. Participants were asked to complete an 11-item survey of behaviors related to their use of the electronic health record prior to training and after attending training. We used paired t-tests to assess changes in self-reported behavior from pre-intervention to post-intervention. We trained 139 clinicians in the workshops; 110 participants completed the baseline assessment and 39 completed both the baseline and post-intervention assessment. Data from post-curriculum respondents found a statistically significant increase in "I told the patient when turning my attention from the patient to the computer," from 60% of the time prior to the training to 70% of the time after. Data from our program evaluation demonstrated improvement in one communication behavior. Sample size limited the detection of other changes; further research should investigate effective training techniques for patient-centered communication while using the electronic health record. © The Author(s) 2016.

  4. Improving linear accelerator service response with a real- time electronic event reporting system.

    Science.gov (United States)

    Hoisak, Jeremy D P; Pawlicki, Todd; Kim, Gwe-Ya; Fletcher, Richard; Moore, Kevin L

    2014-09-08

    To track linear accelerator performance issues, an online event recording system was developed in-house for use by therapists and physicists to log the details of technical problems arising on our institution's four linear accelerators. In use since October 2010, the system was designed so that all clinical physicists would receive email notification when an event was logged. Starting in October 2012, we initiated a pilot project in collaboration with our linear accelerator vendor to explore a new model of service and support, in which event notifications were also sent electronically directly to dedicated engineers at the vendor's technical help desk, who then initiated a response to technical issues. Previously, technical issues were reported by telephone to the vendor's call center, which then disseminated information and coordinated a response with the Technical Support help desk and local service engineers. The purpose of this work was to investigate the improvements to clinical operations resulting from this new service model. The new and old service models were quantitatively compared by reviewing event logs and the oncology information system database in the nine months prior to and after initiation of the project. Here, we focus on events that resulted in an inoperative linear accelerator ("down" machine). Machine downtime, vendor response time, treatment cancellations, and event resolution were evaluated and compared over two equivalent time periods. In 389 clinical days, there were 119 machine-down events: 59 events before and 60 after introduction of the new model. In the new model, median time to service response decreased from 45 to 8 min, service engineer dispatch time decreased 44%, downtime per event decreased from 45 to 20 min, and treatment cancellations decreased 68%. The decreased vendor response time and reduced number of on-site visits by a service engineer resulted in decreased downtime and decreased patient treatment cancellations.

  5. Costs associated with data collection and reporting for diabetes quality improvement in primary care practices: a report from SNOCAP-USA.

    Science.gov (United States)

    West, David R; Radcliff, Tiffany A; Brown, Tiffany; Cote, Murray J; Smith, Peter C; Dickinson, W Perry

    2012-01-01

    Information about the costs and experiences of collecting and reporting quality measure data are vital for practices deciding whether to adopt new quality improvement initiatives or monitor existing initiatives. Six primary care practices from Colorado's Improving Performance in Practice program participated. We conducted structured key informant interviews with Improving Performance in Practice coaches and practice managers, clinicians, and staff and directly observed practices. Practices had 3 to 7 clinicians and 75 to 300 patients with diabetes, half had electronic health records, and half were members of an independent practice association. The estimated per-practice cost of implementation for the data collection and reporting for the diabetes quality improvement program was approximately $15,552 per practice (about $6.23 per diabetic patient per month). The first-year maintenance cost for this effort was approximately $9,553 per practice ($3.83 per diabetic patient per month). The cost of implementing and maintaining a diabetes quality improvement effort that incorporates formal data collection, data management, and reporting is significant and quantifiable. Policymakers must become aware of the financial and cultural impact on primary care practices when considering value-based purchasing initiatives.

  6. Have CONSORT guidelines improved the quality of reporting of randomised controlled trials published in public health dentistry journals?

    Science.gov (United States)

    Savithra, Prakash; Nagesh, Lakshminarayan Shetty

    2013-01-01

    To assess a) whether the quality of reporting of randomised controlled trials (RCTs) has improved since the formulation of the Consolidated Standards of Reporting Trials (CONSORT) statement and b) whether there is any difference in reporting of RCTs between the selected public health dentistry journals. A hand search of the journals of public health dentistry was performed and four journals were identified for the study. They were Community Dentistry and Oral Epidemiology (CDOE), Community Dental Health (CDH), Journal of Public Health Dentistry (JPHD) and Oral Health and Preventive Dentistry (OHPD). A total of 114 RCTs published between 1990 and 2009 were selected. CONSORT guidelines were applied to each selected article in order to assess and determine any improvement since the publication of CONSORT guidelines. The chi-square test was employed to determine any statistical significant difference in quality of reporting of RCTs before and after the publication of the CONSORT guidelines. A comparison was also done to determine any statistically significant difference in quality of reporting of RCTs between the selected journals. Title, abstract, discussion and conclusion sections of the selected articles showed adherence to the CONSORT guidelines, whereas the compliance was poor with respect to the methodology section. The quality of reporting of RCTs is generally poor in public health dentistry journals. Overall, the quality of reporting has not substantially improved since the publication of CONSORT guidelines.

  7. Picture archiving and communication systems lead to sustained improvements in reporting times and productivity: results of a 5-year audit

    Energy Technology Data Exchange (ETDEWEB)

    Mackinnon, A.D.; Billington, R.A.; Adam, E.J.; Dundas, D.D. [Department of Radiology, St Georges Hospital NHS Trust, London (United Kingdom); Patel, U. [Department of Radiology, St Georges Hospital NHS Trust, London (United Kingdom)], E-mail: Uday.Patel@stgeorges.nhs.uk

    2008-07-15

    Aim: To evaluate the impact of picture archiving and communications systems (PACS) on reporting times and productivity in a large teaching hospital. Materials and methods: Reporting time, defined as the time taken from patient registration to report availability, and productivity, defined as the number of reports issued per whole time equivalent (WTE) radiologist per month, were studied for 2 years pre- and 3 years post-PACS installation. Mean reporting time was calculated for plain radiographs and specialist radiology techniques [computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine]. Productivity, total department workload, and unreported film rates were also assessed. Pre- and post-PACS findings were compared. Results: Between 2002-2006 the number of radiological patient episodes increased by 30% from 11,531/month to 15,057/month. This was accompanied by a smaller increase in WTE reporting radiologists, from 32 to 37 (15%). Mean reporting times have improved substantially post-PACS, plain radiograph reporting time decreased by 26% (from 6.8 to 5 days; p = 0.002) and specialty modalities by 24% (4.1 to 3.1 days; p < 0.001). Radiologist productivity has increased by 18% (337 films to 407 films/WTE radiologist/month). Unreported films have decreased from 5 to 4% for plain radiographs and are steady for specialty modalities (< 1%). In most areas improvements have been sustained over a 3-year period. Conclusion: Since the introduction of PACS, reporting times have decreased by 25% and the productivity improved by 18%. Sustained improvements are felt to reflect the efficiencies and cultural change that accompanied the introduction of PACS and digital dictation.

  8. Solutions Network Formulation Report: Improving NOAA's PORTS(R) Through Enhanced Data Inputs from NASA's Ocean Surface Topography Mission

    Science.gov (United States)

    Guest, DeNeice

    2007-01-01

    The Nation uses water-level data for a variety of practical purposes, including nautical charting, maritime navigation, hydrography, coastal engineering, and tsunami and storm surge warnings. Long-term applications include marine boundary determinations, tidal predictions, sea-level trend monitoring, oceanographic research, and climate research. Accurate and timely information concerning sea-level height, tide, and ocean current is needed to understand their impact on coastal management, disaster management, and public health. Satellite altimeter data products are currently used by hundreds of researchers and operational users to monitor ocean circulation and to improve scientists understanding of the role of the oceans in climate and weather. The NOAA (National Oceanic and Atmospheric Administration) National Ocean Service has been monitoring sea-level variations for many years. NOAA s PORTS (Physical Oceanographic Real-Time System) DST (decision support tool), managed by the Center for Operational Oceanographic Products and Services, supports safe and cost-efficient navigation by providing ship masters and pilots with accurate real-time information required to avoid groundings and collisions. This report assesses the capacity of NASA s satellite altimeter data to meet societal decision support needs through incorporation into NOAA s PORTS. NASA has a long heritage of collecting data for ocean research, including its current Terra and Aqua missions. Numerous other missions provide additional important information for coastal management issues, and data collection will continue in the coming decade with such missions as the OSTM (Ocean Surface Topography Mission). OSTM will provide data on sea-surface heights for determining ocean circulation, climate change, and sea-level rise. We suggest that NASA incorporate OSTM altimeter data (C- and Ku-band) into NOAA s PORTS DST in support of NASA s Coastal Management National Application with secondary support to the

  9. Improved recovery from Gulf of Mexico reservoirs. Quarterly status report, January 1--March 31, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Kimbrell, W.C.; Bassiouni, Z.A.; Bourgoyne, A.T.

    1996-04-30

    On February 18, 1992, Louisiana State University with two technical subcontractors, BDM, Inc. and ICF, Inc., began a research program to estimate the potential oil and gas reserve additions that could result from the application of advanced secondary and enhanced oil recovery technologies and the exploitation of undeveloped and attic oil zones in the Gulf of Mexico oil fields that are related to piercement salt domes. This project is a one year continuation of this research and will continue work in reservoir description, extraction processes, and technology transfer. Detailed data will be collected for two previously studies reservoirs: a South Marsh Island reservoir operated by Taylor Energy and one additional Gulf of Mexico reservoir operated by Mobil. Additional reservoirs identified during the project will also be studied if possible. Data collected will include reprocessed 2-D seismic data, newly acquired 3-D data, fluid data, fluid samples, pressure data, well test data, well logs, and core data/samples. The new data will be used to refine reservoir and geologic characterization of these reservoirs. Further laboratory investigation will provide additional simulation input data in the form of PVT properties, relative permeabilities, capillary pressure, and water compatibility. Geological investigations will be conducted to refine the models of mud-rich submarine fan architectures used by seismic analysts and reservoir engineers. Research on advanced reservoir simulation will also be conducted. This report describes a review of fine-grained submarine fans and turbidite systems.

  10. Natural Propagation and Habitat Improvement, Volume 2, Idaho, 1985 Annual and Final Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Hair, Don

    1986-09-01

    The individual reports in this volume have been separately abstracted for inclusion in the data base. The reports describe fish habitat enhancement projects on the Lochsa River, Eldorado and Camas Creeks, and the Clearwater River. (ACR)

  11. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1999-2003 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.

    2003-02-25

    The National Marine Fisheries Service (NMFS) has been conducting Natural Rearing Enhancement System (NATURES) research since the early 1990s. NATURES studies have looked at a variety of mechanisms to enhance production of wild-like salmonids from hatcheries. The goal of NATURES research is to develop fish culture techniques that enable hatcheries to produce salmon with more wild-like characteristics and increased postrelease survival. The development of such techniques is called for in the Columbia Basin Fish and Wildlife Program. This document is the draft report for the Supplemental Fish Quality Contract DE-AI79-91BP20651 Over the history of the project, the effects of seminatural raceway habitats, automated underwater feeders, exercise current velocities, live food diets, and predator avoidance training have been investigated. The findings of these studies are reported in an earlier contract report (Maynard et al. 1996a). The current report focuses on research that has been conducted between 1999 and 2002. This includes studies on the effect of exercise on salmon and steelhead trout, effects of predator avoid training, integration of NATUES protocols into production hatcheries, and the study of social behavior of steelhead grown in enriched and conventional environments. Traditionally, salmon (Oncorhynchus spp.) are reared in barren concrete raceways that lack natural substrate, in-stream structure, or overhead cover. The fish are fed in an unnatural manner with artificial feeds mechanically or hand broadcast across the water surface. This traditional approach has increased the egg-to-smolt survival of hatchery-reared fish by an order of magnitude over that experienced by wild-reared salmon. However, once hatchery-reared fish are released into the wild their smolt-to-adult survival is usually much lower than wild-reared salmon. The reduced postrelease survival of hatchery-reared fish may stem from differences in their behavior and morphology compared to wild

  12. Extension and improvement of the FENDL library for fusion applications. Summary report of an IAEA consultants' meeting

    International Nuclear Information System (INIS)

    Herman, M.

    1999-11-01

    The discussions and conclusions of the meeting on 'Extension and Improvement of the FENDL Library' are summarized in this report. It is shown that the FENDL-2.0 activation sublibrary was validated successfully. However, a number of deficiencies was identified. Possible improvements are proposed which should lead to the release of the FENDL-2.1 version of the library early in 2001. A separate abstract and indexing was provided for five contributions of participants to the meeting

  13. Flue gas conditioning for improved particle collection in electrostatic precipitators. First topical report, Results of laboratory screening of additives

    Energy Technology Data Exchange (ETDEWEB)

    Durham, M.D.

    1993-04-16

    Several tasks have been completed in a program to evaluate additives to improve fine particle collection in electrostatic precipitators. Screening tests and laboratory evaluations of additives are summarized in this report. Over 20 additives were evaluated; four were found to improve flyash precipitation rates. The Insitec particle analyzer was also evaluated; test results show that the analyzer will provide accurate sizing and counting information for particles in the size range of {le} 10 {mu}m dia.

  14. Critical Evaluation as an Aid to Improved Report Writing: A Case Study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-01-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents. They…

  15. Being Included and Excluded

    DEFF Research Database (Denmark)

    Korzenevica, Marina

    2016-01-01

    Following the civil war of 1996–2006, there was a dramatic increase in the labor mobility of young men and the inclusion of young women in formal education, which led to the transformation of the political landscape of rural Nepal. Mobility and schooling represent a level of prestige that rural...... politics. It analyzes how formal education and mobility either challenge or reinforce traditional gendered norms which dictate a lowly position for young married women in the household and their absence from community politics. The article concludes that women are simultaneously excluded and included from...... community politics. On the one hand, their mobility and decision-making powers decrease with the increase in the labor mobility of men and their newly gained education is politically devalued when compared to the informal education that men gain through mobility, but on the other hand, schooling strengthens...

  16. Project CHECO Southeast Asia Report. VNAF Improvement and Modernization Program, July 1971 - December 1973

    Science.gov (United States)

    1975-01-01

    Thus it’s not too difficult to understand that Vietnamese who follow Confucius, Mencius and Mo Tzu or who subscribe to Taoism , Buddhism or other...Bombing System, improving the Air Liaison Officer (ALO)/FAC system, improving the airlift control system, improving the food distribution system, and...to have to sustain many, many places that are surrounded and cannot get food and supplies other than by airlift, then they don’t have the capability

  17. Training on Movement Figure-Ground Discrimination Remediates Low-Level Visual Timing Deficits in the Dorsal Stream, Improving High-Level Cognitive Functioning, Including Attention, Reading Fluency, and Working Memory

    OpenAIRE

    Lawton, Teri; Shelley-Tremblay, John

    2017-01-01

    The purpose of this study was to determine whether neurotraining to discriminate a moving test pattern relative to a stationary background, figure-ground discrimination, improves vision and cognitive functioning in dyslexics, as well as typically-developing normal students. We predict that improving the speed and sensitivity of figure-ground movement discrimination (PATH to Reading neurotraining) acts to remediate visual timing deficits in the dorsal stream, thereby improving processing speed...

  18. RARE DECAYS INCLUDING PENGUINS

    Energy Technology Data Exchange (ETDEWEB)

    Eigen, G

    2003-12-04

    The authors present a preliminary measurement of the exclusive charmless semileptonic B decays, B {yields} {rho}{ell}{nu}, and the extraction of the CKM parameters V{sub ub}. IN a data sample of 55 x 10{sup 6} B{bar B} events they measure a branching fraction of {Beta}(B {yields} {rho}{ell}{nu}) = (3.39 {+-} 0.44{sub stat} {+-} 0.52{sub sys} {+-} 0.60{sub th}) x 10{sup -4} yielding |V{sub ub}| = (3.69 {+-} 0.23{sub stat} {+-} 0.27{sub sys -0.59th}{sup +0.40}) x 10{sup -3}. Next, they report on a preliminary study of the radiative penguin modes B {yields} K{ell}{sup +}{ell}{sup -} and B {yields} K*{ell}{sup +}{ell}{sup -}. In a data sample of 84 x 10{sup 6} B{bar B} events they observe a significant signal (4.4{sigma}) in B {yields} K{ell}{sup +}{ell}{sup -}, yielding a branching fraction of {Beta}(B {yields} K{ell}{sup +}{ell}{sup -}) = (0.78{sub -0.20-0.18}{sup +0.24+0.11}) x 10{sup -6}. In B {yields} K*{ell}{sup +}{ell}{sup -} the observed yield is not yet significant (2.8{sigma}), yielding an upper limit of the branching fraction of {Beta}(B {yields} K*{ell}{sup +}{ell}{sup -}) 3.0 x 10{sup -6} {at} 90% confidence level. Finally, they summarize preliminary results of searches for B {yields} {rho}({omega}){gamma}, B{sup +} {yields} K{sup +} {nu}{bar {nu}} and B{sup 0} {yields} {ell}{sup +}{ell}{sup -}.

  19. DOD Major Automated Information Systems: Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility

    Science.gov (United States)

    2016-03-01

    Leadership Responsibility Report to Congressional Committees March 2016 GAO-16-336 United States Government Accountability Office United...INFORMATION SYSTEMS Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility Why GAO Did This Study The National...milestone decisions for MAIS programs. AT&L can delegate decision authority for MAIS programs to a component head who may further delegate the authority

  20. Short report: Improving record-review surveillance of young children with an autism spectrum disorder.

    Science.gov (United States)

    Wiggins, Lisa D; Robins, Diana L; Yeargin-Allsopp, Marshalyn

    2013-09-01

    Records-based autism spectrum disorder surveillance developed at the Centers for Disease Control and Prevention has been extended to younger cohorts, although the utility of additional record sources has not been examined. We therefore conducted a pilot project to describe whether Centers for Disease Control and Prevention surveillance could identify younger children with an autism spectrum disorder evaluated as part of an ongoing screening study at Georgia State University. In all, 31 families of children who screened positive for autism spectrum disorder and received a clinical evaluation at Georgia State University agreed to participate in the project. Of these, 10 children lived inside the surveillance area and had records abstracted and reviewed for this project. Centers for Disease Control and Prevention surveillance results (i.e. autism spectrum disorder or non-autism spectrum disorder) were compared with Georgia State University evaluation results (i.e. autism spectrum disorder or non-autism spectrum disorder). In all, 4 of the 10 children were diagnosed with an autism spectrum disorder after the Georgia State University evaluation. None of the 4 children with an autism spectrum disorder were identified by current Centers for Disease Control and Prevention surveillance methods but all 4 children were identified by Centers for Disease Control and Prevention surveillance methods when additional record sources were included (i.e. records from the statewide early intervention program and Georgia State University evaluation). These findings suggest that partnering with early intervention programs and encouraging early autism spectrum disorder screening might improve autism spectrum disorder surveillance among young children.

  1. Improved detection of genetic markers of antimicrobial resistance by hybridization probe-based melting curve analysis using primers to mask proximal mutations: examples include the influenza H275Y substitution.

    Science.gov (United States)

    Whiley, David M; Jacob, Kevin; Nakos, Jennifer; Bletchly, Cheryl; Nimmo, Graeme R; Nissen, Michael D; Sloots, Theo P

    2012-06-01

    Numerous real-time PCR assays have been described for detection of the influenza A H275Y alteration. However, the performance of these methods can be undermined by sequence variation in the regions flanking the codon of interest. This is a problem encountered more broadly in microbial diagnostics. In this study, we developed a modification of hybridization probe-based melting curve analysis, whereby primers are used to mask proximal mutations in the sequence targets of hybridization probes, so as to limit the potential for sequence variation to interfere with typing. The approach was applied to the H275Y alteration of the influenza A (H1N1) 2009 strain, as well as a Neisseria gonorrhoeae mutation associated with antimicrobial resistance. Assay performances were assessed using influenza A and N. gonorrhoeae strains characterized by DNA sequencing. The modified hybridization probe-based approach proved successful in limiting the effects of proximal mutations, with the results of melting curve analyses being 100% consistent with the results of DNA sequencing for all influenza A and N. gonorrhoeae strains tested. Notably, these included influenza A and N. gonorrhoeae strains exhibiting additional mutations in hybridization probe targets. Of particular interest was that the H275Y assay correctly typed influenza A strains harbouring a T822C nucleotide substitution, previously shown to interfere with H275Y typing methods. Overall our modified hybridization probe-based approach provides a simple means of circumventing problems caused by sequence variation, and offers improved detection of the influenza A H275Y alteration and potentially other resistance mechanisms.

  2. IAEA meeting report of the consultants' meeting on safety improvements of WWER-440 model 230 nuclear power plants

    International Nuclear Information System (INIS)

    1998-05-01

    In 1992 the identification and ranking of safety issues for WWER-440/230 NPPs were completed. Some 100 safety issues have been identified and ranked according to their safety impact on the plant's defence in depth. The IAEA work was based on a conceptual design review and a series of safety review missions to each one of the four sites (Bohunice, Kozloduy, Novovoronezh and Kola) where WWER-440/230 NPPs were in operation. Results were published by the IAEA in February and May 1992. Since the initial publications the IAEA has continued its activities and conducted a number of follow-up missions and technical visits to the NPP sites to review the status of implementation of safety upgradings. In September of 1994 a Consultants Meeting (CM) was held in Vienna to consolidate all the information available to the AEA. The results of that meeting were included in the report WWER-SC-107. During 1995-1997 further information became available from technical visits conducted by the IAEA at the four sites. Therefore, in February 1998 the IAEA convened a CM in Vienna to prepare an up-to-date report on the status of safety improvements at WWER-440/230 NPPs. This report contains the results of that meeting. It reviews the status of remedial actions implemented at each plant in response to the safety issues originally identified in the IAEA reports and the remaining safety concerns. For convenience the issues are presented under broad titles related to: integrity of barriers (Section 2); performance of basic functions (Section 3); performance of supporting functions (Section 4); internal hazards (Section 5); external hazards (Section 6); accident analysis (Section 7); operational functions (Section 8); Section 9 provides an overview of the results of PSA studies performed and under way. Section 10 provides specific information on the status of Armenia NPP. It is presented separately because the IAEA assistance to this plant was provided in the framework of the national technical co

  3. Swedish children with celiac disease comply well with a gluten-free diet, and most include oats without reporting any adverse effects: a long-term follow-up study.

    Science.gov (United States)

    Tapsas, Dimitrios; Fälth-Magnusson, Karin; Högberg, Lotta; Hammersjö, Jan-Åke; Hollén, Elisabet

    2014-05-01

    The only known treatment for celiac disease is a gluten-free diet (GFD), which initially meant abstention from wheat, rye, barley, and oats. Recently, oats free from contamination with wheat have been accepted in the GFD. Yet, reports indicate that all celiac disease patients may not tolerate oats. We hypothesized that celiac children comply well with a GFD and that most have included oats in their diet. A food questionnaire was used to check our patients; 316 questionnaires were returned. Mean time on the GFD was 6.9 years, and 96.8% of the children reported that they were trying to keep a strict GFD. However, accidental transgressions occurred in 263 children (83.2%). In 2 of 3 cases, mistakes took place when the patients were not at home. Symptoms after incidental gluten intake were experienced by 162 (61.6%) patients, mostly (87.5%) from the gastrointestinal tract. Small amounts of gluten (gluten consumption. Oats were included in the diet of 89.4% of the children for a mean of 3.4 years. Most (81.9%) ate purified oats, and 45.3% consumed oats less than once a week. Among those who did not consume oats, only 5.9% refrained because of symptoms. General compliance with the GFD was good. Only the duration of the GFD appeared to influence adherence to the diet. Most patients did not report adverse effects after long-term consumption of oats. Copyright © 2014 Elsevier Inc. All rights reserved.