Factors shaping effective utilization of health information technology in urban safety-net clinics.

Science.gov (United States)

George, Sheba; Garth, Belinda; Fish, Allison; Baker, Richard

2013-09-01

Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.

Assessing Patient Activation among High-Need, High-Cost Patients in Urban Safety Net Care Settings.

Science.gov (United States)

Napoles, Tessa M; Burke, Nancy J; Shim, Janet K; Davis, Elizabeth; Moskowitz, David; Yen, Irene H

2017-12-01

We sought to examine the literature using the Patient Activation Measure (PAM) or the Patient Enablement Instrument (PEI) with high-need, high-cost (HNHC) patients receiving care in urban safety net settings. Urban safety net care management programs serve low-income, racially/ethnically diverse patients living with multiple chronic conditions. Although many care management programs track patient progress with the PAM or the PEI, it is not clear whether the PAM or the PEI is an effective and appropriate tool for HNHC patients receiving care in urban safety net settings in the United States. We searched PubMed, EMBASE, Web of Science, and PsycINFO for articles published between 2004 and 2015 that used the PAM and between 1998 and 2015 that used the PEI. The search was limited to English-language articles conducted in the United States and published in peer-reviewed journals. To assess the utility of the PAM and the PEI in urban safety net care settings, we defined a HNHC patient sample as racially/ethnically diverse, low socioeconomic status (SES), and multimorbid. One hundred fourteen articles used the PAM. All articles using the PEI were conducted outside the U.S. and therefore were excluded. Nine PAM studies (8%) included participants similar to those receiving care in urban safety net settings, three of which were longitudinal. Two of the three longitudinal studies reported positive changes following interventions. Our results indicate that research on patient activation is not commonly conducted on racially and ethnically diverse, low SES, and multimorbid patients; therefore, there are few opportunities to assess the appropriateness of the PAM in such populations. Investigators expressed concerns with the potential unreliability and inappropriate nature of the PAM on multimorbid, older, and low-literacy patients. Thus, the PAM may not be able to accurately assess patient progress among HNHC patients receiving care in urban safety net settings. Assessing

Health safety nets can break cycles of poverty and disease: a stochastic ecological model.

Science.gov (United States)

Plucinski, Mateusz M; Ngonghala, Calistus N; Bonds, Matthew H

2011-12-07

The persistence of extreme poverty is increasingly attributed to dynamic interactions between biophysical processes and economics, though there remains a dearth of integrated theoretical frameworks that can inform policy. Here, we present a stochastic model of disease-driven poverty traps. Whereas deterministic models can result in poverty traps that can only be broken by substantial external changes to the initial conditions, in the stochastic model there is always some probability that a population will leave or enter a poverty trap. We show that a 'safety net', defined as an externally enforced minimum level of health or economic conditions, can guarantee ultimate escape from a poverty trap, even if the safety net is set within the basin of attraction of the poverty trap, and even if the safety net is only in the form of a public health measure. Whereas the deterministic model implies that small improvements in initial conditions near the poverty-trap equilibrium are futile, the stochastic model suggests that the impact of changes in the location of the safety net on the rate of development may be strongest near the poverty-trap equilibrium.

Estimating the Size and Cost of the STD Prevention Services Safety Net.

Science.gov (United States)

Gift, Thomas L; Haderxhanaj, Laura T; Torrone, Elizabeth A; Behl, Ajay S; Romaguera, Raul A; Leichliter, Jami S

2015-01-01

The Patient Protection and Affordable Care Act is expected to reduce the number of uninsured people in the United States during the next eight years, but more than 10% are expected to remain uninsured. Uninsured people are one of the main populations using publicly funded safety net sexually transmitted disease (STD) prevention services. Estimating the proportion of the uninsured population expected to need STD services could help identify the potential demand for safety net STD services and improve program planning. In 2013, an estimated 8.27 million people met the criteria for being in need of STD services. In 2023, 4.70 million uninsured people are expected to meet the criteria for being in need of STD services. As an example, the cost in 2014 U.S. dollars of providing chlamydia screening to these people was an estimated $271.1 million in 2013 and is estimated to be $153.8 million in 2023. A substantial need will continue to exist for safety net STD prevention services in coming years.

Mobilizing local safety nets for enhanced adaptive capacity to ...

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

22 avr. 2016 ... In Zimbabwe, the increased frequency of drought, flash floods, and unpredictable rainfall has added to recurrent food deficits for poor households who depend on rainfed farming on nutrient poor soils. This brief explores how the erosion of Zunde raMambo — a traditional community safety net mechanism ...

Child Poverty, the Great Recession, and the Social Safety Net in the United States.

Science.gov (United States)

Bitler, Marianne; Hoynes, Hiliary; Kuku, Elira

In this paper, we comprehensively examine the effects of the Great Recession on child poverty, with particular attention to the role of the social safety net in mitigating the adverse effects of shocks to earnings and income. Using a state panel data model and data for 2000 to 2014, we estimate the relationship between the business cycle and child poverty, and we examine how and to what extent the safety net is providing protection to at-risk children. We find compelling evidence that the safety net provides protection; that is, the cyclicality of after-tax-and-transfer child poverty is significantly attenuated relative to the cyclicality of private income poverty. We also find that the protective effect of the safety net is not similar across demographic groups, and that children from more disadvantaged backgrounds, such as those living with Hispanic or single heads, or particularly those living with immigrant household heads—or immigrant spouses—experience larger poverty cyclicality than those living with non- Hispanic white or married heads, or those living with native household heads with native spouses. Our findings hold across a host of choices for how to define poverty. These include measures based on absolute thresholds or more relative thresholds. They also hold for measures of resources that include not only cash and near-cash transfers net of taxes but also several measures of the value of public medical benefits.

Caught in the competitive crossfire: safety-net providers balance margin and mission in a profit-driven health care market.

Science.gov (United States)

Cunningham, Peter J; Bazzoli, Gloria J; Katz, Aaron

2008-01-01

This paper describes how intensifying competitive pressures in the health system are simultaneously driving increased demand for safety-net care and taxing safety-net providers' ability to maintain the mission of serving all, regardless of ability to pay. Although safety-net providers adapted to previous challenges arising from managed care, health system pressures have been more intense and more generalized across different sectors in recent years than in the past. Providers are adopting some of the same strategies being used in the private sector to attract higher-paying patients and changing their "image" as a safety-net provider.

Emergency Preparedness and Response: A Safety Net

Energy Technology Data Exchange (ETDEWEB)

Aaltonen, H., E-mail: hannele.aaltonen@stuk.fi [Radiation and Nuclear Safety Authority (STUK), Helsinki (Finland)

2014-10-15

Full text: The objective of nuclear regulatory work is to prevent accidents. Nevertheless, possibility of a severe accident cannot be totally excluded, which makes a safety net, efficient emergency preparedness and response, necessary. Should the possibility of accidents be rejected, the result would be in the worst case inadequate protection of population, functions of society, and environment from harmful effects of radiation. Adequate resources for maintenance and development of emergency arrangement are crucial. However, they need to be balanced taking into account risks assessments, justified expectations of society, and international requirements. To successfully respond to an emergency, effective emergency preparedness, such as up-to-date plans and procedures, robust arrangements and knowledgeable and regularly trained staff are required. These, however, are not enough without willingness and proactive attitude to • communicate in a timely manner; • co-operate and coordinate actions; • provide and receive assistance; and • evaluate and improve emergency arrangements. In the establishment and development of emergency arrangements, redundant and diverse means or tools used are needed in, for example, communication and assessment of hazard. Any severe nuclear emergency would affect all countries either directly or indirectly. Thus, national emergency arrangements have to be compatible to the extent practicable with international emergency arrangements. It is important to all countries that the safety nets of emergency arrangements are reliable - and operate efficiently in a coordinated manner when needed - on national, regional and international level. (author)

Opportunities for improved diabetes care among patients of safety net practices: a safety net providers' strategic alliance study.

Science.gov (United States)

Reichsman, Ann; Werner, James; Cella, Peggi; Bobiak, Sarah; Stange, Kurt C

2009-01-01

To identify barriers and opportunities for quality diabetes care in safety net practices. In 3 federally qualified health centers and 1 free clinic, 19 primary care clinicians profiled patient and visit characteristics and quality of care measures for 181 consecutive visits by adult type 2 diabetic patients. Open-ended questions assessed patient and clinician perception of barriers to diabetes care and patient report of enabling factors. A multidisciplinary team identified themes from open-ended responses. Logistic regression analyses assessed the association of the identified barriers/enablers with 2 measures of quality care: glycosylated hemoglobin and prophylactic aspirin use. Ranked barriers noted by patients included adherence (40%), financial/insurance (23%), and psychosocial (13%) factors. Clinicians ranked systemic factors, including financial/ insurance (32%) and cultural/psychosocial (29%) factors, as important to adherence (29%) in determining quality diabetes care. Patients reported dietary and medical adherence (37%) and family/health care worker support (17%) as helpful factors. Among 175 patients with available data, glycosylated hemoglobin levels were associated with patient report of financial/insurance factors both as a barrier when visits and medications were unaffordable and as an opportunity when free or low-cost medications and services were provided. Patients' adherence with aspirin prophylaxis was strongly associated with African American race, prior prescription of aspirin and distribution of aspirin at the practice site (p<.001). Patients were less likely than clinicians to identify systemic and contextual factors contributing to poor diabetes care. From the front line's perspective, enabling patient self-management and systemic support is a target for improving diabetes care in safety net practices.

Development and Validation of a Short-Form Safety Net Medical Home Scale.

Science.gov (United States)

Nocon, Robert S; Gunter, Kathryn E; Gao, Yue; Lee, Sang Mee; Chin, Marshall H

2017-12-01

To develop a short-form Safety Net Medical Home Scale (SNMHS) for assessing patient-centered medical home (PCMH) capability in safety net clinics. National surveys of federally qualified health centers (FQHCs). Interviews with FQHC directors. We constructed three short-form SNMHS versions and examined correlations with full SNMHS and related primary care assessments. We tested usability with FQHC directors and reviewed scale development with an advisory group. Federally qualified health center surveys were administered in 2009 and 2013, by mail and online. Usability testing was conducted through telephone interviews with FQHC directors in 2013. Six-, 12-, and 18-question short-form SNMHS versions had Pearson correlations with full scale of 0.84, 0.92, and 0.96, respectively. All versions showed a level of convergent validity with other primary care assessment scales comparable to the full SNMHS. User testers found short forms to be low-burden, though missing some PCMH concepts. Advisory group members expressed caution over missing concepts and appropriate use of short-form self-assessments. Short-form versions of SNMHS showed strong correlations with full scale and may be useful for brief assessment of safety net PCMH capability. Each short-form SNMHS version may be appropriate for different research, quality improvement, and assessment purposes. © Health Research and Educational Trust.

Medicare Payment Penalties and Safety Net Hospital Profitability: Minimal Impact on These Vulnerable Hospitals.

Science.gov (United States)

Bazzoli, Gloria J; Thompson, Michael P; Waters, Teresa M

2018-02-08

To examine relationships between penalties assessed by Medicare's Hospital Readmission Reduction Program and Value-Based Purchasing Program and hospital financial condition. Centers for Medicare and Medicaid Services, American Hospital Association, and Area Health Resource File data for 4,824 hospital-year observations. Bivariate and multivariate analysis of pooled cross-sectional data. Safety net hospitals have significantly higher HRRP/VBP penalties, but, unlike nonsafety net hospitals, increases in their penalty rate did not significantly affect their total margins. Safety net hospitals appear to rely on nonpatient care revenues to offset higher penalties for the years studied. While reassuring, these funding streams are volatile and may not be able to compensate for cumulative losses over time. © Health Research and Educational Trust.

Comparing the Affordable Care Act's Financial Impact on Safety-Net Hospitals in States That Expanded Medicaid and Those That Did Not.

Science.gov (United States)

Dobson, Allen; DaVanzo, Joan E; Haught, Randy; Phap-Hoa, Luu

2017-11-01

Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals’ significant uncompensated care costs and shore up their financial stability. To examine how the ACA’s Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not. Using Medicare hospital cost reports for federal fiscal years 2012 and 2015, the authors compared changes in Medicaid inpatient days as a percentage of total inpatient days, Medicaid revenues as a percentage of total net patient revenues, uncompensated care costs as a percentage of total operating costs, and hospital operating margins. Medicaid expansion had a significant, favorable financial impact on safety-net hospitals. From 2012 to 2015, safety-net hospitals in expansion states, compared to those in nonexpansion states, experienced larger increases in Medicaid inpatient days and Medicaid revenues as well as reduced uncompensated care costs. These changes improved operating margins for safety-net hospitals in expansion states. Margins for safety-net hospitals in nonexpansion states, meanwhile, declined.

Internet Safety and Malaysian Students: A Study of Female Undergraduates and Their Net Pals

Directory of Open Access Journals (Sweden)

Cheong Lee Mei, Dianne

2007-12-01

Full Text Available Malaysian female undergraduates are perceived as able to rationally evaluate and estimate risks towards Net pals. Friendship is secured online while deception and fraud are revealed offline. Based on what they have been informed, the female undergraduates may know their Net pals’ likes and dislikes but the invisible cyber veil does not allow them to penetrate the illusion and accurately evaluate a person’s character and personality. This study examined how Malaysian female undergraduates use the Internet, perceive risks in meeting Net pals and the safety awareness surrounding cyber friendship. Responses of 118 female undergraduates (43% from UiTM, 30% from UM, 27% from MMU to a survey indicated that Net pals were befriended through chat rooms and websites. More than half of the female undergraduates would have a face-to-face meeting with their Net pals without the knowledge of relevant parties and have done at least one potentially unsafe behaviour. If the extent and level of Internet safety awareness is known, the problem of Internet deception that might lead to potential social problems such as rape and sexual abuse can be effectively addressed.

The safety net medical home initiative: transforming care for vulnerable populations.

Science.gov (United States)

Sugarman, Jonathan R; Phillips, Kathryn E; Wagner, Edward H; Coleman, Katie; Abrams, Melinda K

2014-11-01

Despite findings that medical homes may reduce or eliminate health care disparities among underserved and minority populations, most previous medical home pilot and demonstration projects have focused on health care delivery systems serving commercially insured patients and Medicare beneficiaries. To develop a replicable approach to support medical home transformation among diverse practices serving vulnerable and underserved populations. Facilitated by a national program team, convening organizations in 5 states provided coaching and learning community support to safety net practices over a 4-year period. To guide transformation, we developed a framework of change concepts aligned with supporting tools including implementation guides, activity checklists, and measurement instruments. Sixty-five health centers, homeless clinics, private practices, residency training centers, and other safety net practices in Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania. We evaluated implementation of the change concepts using the Patient-Centered Medical Home-Assessment, and conducted a survey of participating practices to assess perceptions of the impact of the technical assistance. All practices implemented key features of the medical home model, and nearly half (47.6%) implemented the 33 identified key changes to a substantial degree as evidenced by level A Patient-Centered Medical Home-Assessment scores. Two thirds of practices that achieved substantial implementation did so only after participating in the initiative for >2 years. By the end of the initiative, 83.1% of sites achieved external recognition as medical homes. Despite resource constraints and high-need populations, safety net clinics made considerable progress toward medical home implementation when provided robust, multimodal support over a 4-year period.

Burnout, Perceived Stress, and Job Satisfaction Among Trauma Nurses at a Level I Safety-Net Trauma Center.

Science.gov (United States)

Munnangi, Swapna; Dupiton, Lynore; Boutin, Anthony; Angus, L D George

Nurses are at the forefront of our health care delivery system and have been reported to exhibit a high level of burnout. Burnout and stress in trauma nurses at a safety-net hospital can negatively impact patient care. Safety-net hospitals are confronted with unique social, financial, as well as resource problems that can potentially make the work environment frustrating. The purpose of this study was to explore the levels of burnout, stress, and job satisfaction in nurses providing care to trauma patients at a Level I safety-net trauma center. A cross-sectional survey design was used to investigate principal factors including personal and professional demographics, burnout, perceived stress, and job satisfaction. Trauma nurses working at a Level I safety-net trauma center are stressed and exhibited moderate degree of burnout. The extent of emotional exhaustion experienced by the nurses varied with work location and was highest in surgical intensive care unit nurses. The level of job satisfaction in terms of opportunities for promotion differed significantly by race and the health status of the nurses. Satisfaction with coworkers was lowest in those nurses between the ages of 60-69 years. Female nurses were more satisfied with their coworkers than male nurses. In addition, the study revealed that significant relationships exist among perceived stress, burnout, and job satisfaction. Work environment significantly impacts burnout, job satisfaction, and perceived stress experienced by trauma nurses in a safety-net hospital. Nursing administration can make an effort to understand the levels of burnout and strategically improve work environment for trauma nurses in order to minimize stressors leading to attrition and enhance job satisfaction.

Reliability evaluation of the power supply of an electrical power net for safety-relevant applications

International Nuclear Information System (INIS)

Dominguez-Garcia, Alejandro D.; Kassakian, John G.; Schindall, Joel E.

2006-01-01

In this paper, we introduce a methodology for the dependability analysis of new automotive safety-relevant systems. With the introduction of safety-relevant electronic systems in cars, it is necessary to carry out a thorough dependability analysis of those systems to fully understand and quantify the failure mechanisms in order to improve the design. Several system level FMEAs are used to identify the different failure modes of the system and, a Markov model is constructed to quantify their probability of occurrence. A new power net architecture with application to new safety-relevant automotive systems, such as Steer-by-Wire or Brake-by-Wire, is used as a case study. For these safety-relevant loads, loss of electric power supply means loss of control of the vehicle. It is, therefore, necessary and critical to develop a highly dependable power net to ensure power to these loads under all circumstances

Patient portal readiness among postpartum patients in a safety net setting.

Science.gov (United States)

Wieland, Daryl; Gibeau, Anne; Dewey, Caitlin; Roshto, Melanie; Frankel, Hilary

2017-07-05

Maternity patients interact with the healthcare system over an approximately ten-month interval, requiring multiple visits, acquiring pregnancy-specific education, and sharing health information among providers. Many features of a web-based patient portal could help pregnant women manage their interactions with the healthcare system; however, it is unclear whether pregnant women in safety-net settings have the resources, skills or interest required for portal adoption. In this study of postpartum patients in a safety net hospital, we aimed to: (1) determine if patients have the technical resources and skills to access a portal, (2) gain insight into their interest in health information, and (3) identify the perceived utility of portal features and potential barriers to adoption. We developed a structured questionnaire to collect demographics from postpartum patients and measure use of technology and the internet, self-reported literacy, interest in health information, awareness of portal functions, and perceived barriers to use. The questionnaire was administered in person to women in an inpatient setting. Of the 100 participants surveyed, 95% reported routine internet use and 56% used it to search for health information. Most participants had never heard of a patient portal, yet 92% believed that the portal functions were important. The two most appealing functions were to check results and manage appointments. Most participants in this study have the required resources such as a device and familiarity with the internet to access a patient portal including an interest in interacting with a healthcare institution via electronic means. Pregnancy is a critical episode of care where active engagement with the healthcare system can influence outcomes. Healthcare systems and portal developers should consider ways to tailor a portal to address the specific health needs of a maternity population including those in a safety net setting.

Towards a Usability and Error "Safety Net": A Multi-Phased Multi-Method Approach to Ensuring System Usability and Safety.

Science.gov (United States)

Kushniruk, Andre; Senathirajah, Yalini; Borycki, Elizabeth

2017-01-01

The usability and safety of health information systems have become major issues in the design and implementation of useful healthcare IT. In this paper we describe a multi-phased multi-method approach to integrating usability engineering methods into system testing to ensure both usability and safety of healthcare IT upon widespread deployment. The approach involves usability testing followed by clinical simulation (conducted in-situ) and "near-live" recording of user interactions with systems. At key stages in this process, usability problems are identified and rectified forming a usability and technology-induced error "safety net" that catches different types of usability and safety problems prior to releasing systems widely in healthcare settings.

QuarkNet: Teaching and learning 21st century physics

Energy Technology Data Exchange (ETDEWEB)

Jordan, Thomas [University of Florida, Fermilab (United States)

2011-07-01

QuarkNet is an extension of the US particle physics community. Started in 1998, the project has invited well over 1000 US teachers to attend workshops, perform research, assemble hardware and explore ways to teach modern physics topics to high school students. Teachers have built and tested components for Tevatron and LHC experiments, analyzed data from the sloan digital sky survey. They build and use classroom cosmic ray muon detectors, and have explored ways to introduce their students to topics such as the production of the Top Quark. Teachers can use their web-browser to access data from the LIGO observatory and share their findings with other student users across the globe. I will discuss the practices, tools and findings of this successful collaboration.

Comparative Studies of Collaborative Team Depression Care Adoption in Safety Net Clinics

Science.gov (United States)

Ell, Kathleen; Wu, Shinyi; Guterman, Jeffrey; Schulman, Sandra-Gross; Sklaroff, Laura; Lee, Pey-Jiuan

2018-01-01

Purpose: To evaluate three approaches adopting collaborative depression care model in Los Angeles County safety net clinics with predominantly Latino type 2 diabetes patients. Methods: Pre-post differences in treatment rates and symptom reductions were compared between baseline, 6-month, and 12-month follow-ups for each approach: (a) Multifaceted…

EDUCATION IN TIMES NET GENERATION: HOW DIGITAL IMMIGRANTS CAN TEACH DIGITAL NATIVES

Directory of Open Access Journals (Sweden)

Hamilton Viana Chaves

2016-04-01

Full Text Available Members of the knowledge society, of the network society or of the informatics society are some names that seem to define the current generation. Net generation is a generic nomenclature which covers all the previous terms. Digital immigrants are the subjects whom were born before the advent of digital technologies and who joined to them. Digital natives are the subjects whom were born in the current generation and that would have special qualities, especially regarding the learning process. Considering all this context, a question arises: how the digital immigrants teach the digital natives? This item justifies itself because there is a meeting of generations, in theory, significantly differentiated. Due to this, it would be necessary to identify the appropriate educational forms according to the presented situation. Our teaching experience convinces us that, yes, we should valorize the information’s technologies and communication, understanding that these are means, not ends. It is important to highlight that any tool causes advances and regressions, a fact that serves to guide our teaching practice.

Who Lacks Support and Why? An Examination of Mothers' Personal Safety Nets

Science.gov (United States)

Harknett, Kristen S.; Hartnett, Caroline Sten

2011-01-01

We use data from the Fragile Families and Child Wellbeing Study (N = 12,140 person-waves) to identify characteristics associated with mothers' having or lacking "personal safety net" support from family and friends. We focus on characteristics that are likely to increase the importance of having support available but may also interfere with the…

Using Modeling and Rehearsal to Teach Fire Safety to Children with Autism

Science.gov (United States)

Garcia, David; Dukes, Charles; Brady, Michael P.; Scott, Jack; Wilson, Cynthia L.

2016-01-01

We evaluated the efficacy of an instructional procedure to teach young children with autism to evacuate settings and notify an adult during a fire alarm. A multiple baseline design across children showed that an intervention that included modeling, rehearsal, and praise was effective in teaching fire safety skills. Safety skills generalized to…

The Influence of Teaching Methods on Learners' Perception of E-Safety

Science.gov (United States)

Šimandl, Václav; Dobiáš, Václav; Šerý, Michal

2017-01-01

Aim/Purpose: The traditional method of teaching e-safety by lecturing is not very effective. Despite learners often being equipped with the right knowledge, they reject the need to act accordingly. There is a need to improve the way digital e-safety is taught. Background: The study compares four different teaching styles, examining how each…

Using a safety net and following the safety instructions could prevent half the paediatric trampoline injuries.

Science.gov (United States)

Rättyä, J; Serlo, W

2008-08-01

The number of recreational trampolines in Finnish households has increased. There also appears to be a drastic increase in trampoline-related injuries among paediatric patients. The aim of this study was to quantify and describe trampoline-related injuries in North Finnish paediatric patients. A retrospective analysis of medical data was used in the study, covering children 16 years and younger treated for trampoline-related injuries at Oulu University Hospital over a five-month period of time from May 1 to September 30, 2005. Medical records were reviewed and additional details regarding the injuries were obtained by questionnaire. Altogether 76 patients were treated for trampoline-related injuries, which represented 13.4 % of all paediatric accidental trauma patients. In 57 accidents (86 %), there had been multiple jumpers on the trampoline. Twenty-five of the injuries (38 %) had occurred on the trampoline, in 25 cases (38 %) a child had fallen off, in 8 cases (12 %) there had been a collision with another jumper and the person had jumped onto a trampoline from a high platform in 5 incidents (8 %). Only 3 children (5 %) hurt themselves on the trampoline when jumping alone. Orthopaedic procedures requiring general anaesthesia were necessary in a total of 31 cases (41 %). The study shows that 50 % of traumas (falling off and collisions) could have been avoided by using a safety net and by jumping one at a time. The importance of following safety instructions and the need for a safety net should be emphasised to both the supervising adults and the children.

Tools for 'safety netting' in common paediatric illnesses: A systematic review in emergency care

NARCIS (Netherlands)

E. De Vos-Kerkhof (Evelien); D.H.F. Geurts (Dorien); M. Wiggers (Mariska); H.A. Moll (Henriëtte); R. Oostenbrink (Rianne)

2016-01-01

textabstractContext Follow-up strategies after emergency department (ED) discharge, alias safety netting, is often based on the gut feeling of the attending physician. Objective To systematically identify evaluated safetynetting strategies after ED discharge and to describe determinants of

In a safety net population HPV4 vaccine adherence worsens as BMI increases.

Directory of Open Access Journals (Sweden)

Diane M Harper

Full Text Available Obesity adversely inhibits antibody response to vaccination. Three doses of HPV4 may or may not provide adequate long term protection against HPV 16/18 in obese females. The aim of this study was to determine whether adherence to HPV4 vaccination in a safety net population was reduced with increasing body mass index (BMI.We designed a historical prospective study evaluating the number and dates of HPV4 dosing that occurred from July 1, 2006 through October 1, 2009 by the demographic characteristics of the 10-26 year old recipient females. The defined dosing intervals were adapted from the literature and obesity categories were defined by the WHO.1240 females with BMI measurements received at least one dose of HPV4; 38% were obese (class I, II and III and 25% were overweight. Females with normal BMI received on-time triplet dosing significantly more often than did the obese class II and III females (30% vs. 18%, p<0.001. Obese class II/III females have a significant 45% less chance of completing the on-time triplet HPV4 series than normal women (OR = 0.55, 95% CI: 0.37, 0.83. Pregnancy history has a significant influence on BMI and HPV4 dosing compliance in this safety net population where 71% had been gravid. Hispanic females were less likely to complete HPV4 dosing regardless of BMI (aOR = 0.39, 95% CI: 0.16, 0.95.Obesity, as well as gravidity and Hispanic race, are risk factors for lack of HPV4 vaccine adherence among young females in a safety net population.

Understanding the Knowledge Gap Experienced by U.S. Safety Net Patients in Teleretinal Screening.

Science.gov (United States)

George, Sheba M; Hayes, Erin Moran; Fish, Allison; Daskivich, Lauren Patty; Ogunyemi, Omolola I

2016-01-01

Safety-net patients' socioeconomic barriers interact with limited digital and health literacies to produce a "knowledge gap" that impacts the delivery of healthcare via telehealth technologies. Six focus groups (2 African- American and 4 Latino) were conducted with patients who received teleretinal screening in a U.S. urban safety-net setting. Focus groups were analyzed using a modified grounded theory methodology. Findings indicate that patients' knowledge gap is primarily produced at three points during the delivery of care: (1) exacerbation of patients' pre-existing personal barriers in the clinical setting; (2) encounters with technology during screening; and (3) lack of follow up after the visit. This knowledge gap produces confusion, potentially limiting patients' perceptions of care and their ability to manage their own care. It may be ameliorated through delivery of patient education focused on both disease pathology and specific role of telehealth technologies in disease management.

Remote Laboratory NetLab for Effective Teaching of 1st Year Engineering Students

Directory of Open Access Journals (Sweden)

Z. Nedic

2007-08-01

Full Text Available Practical skills are important attributes of every engineering graduate. The Internet has provided tertiary education with the opportunity to develop innovative learning environments. The teaching and learning of practical skills has gained a new dimension with the emergence of remote laboratories. The rapidly growing number of remote laboratories (RL worldwide is the evidence that the educational community has recognized their potential to develop into a creative, flexible, engaging, and student-cantered learning environment. Even a brief review of the existing RLs shows a large diversity in their structure, design and implementation. However, not many researchers disclose how their RLs are integrated within their curricula. Therefore, an important question still remains to be answered: how to optimize the design of RLs and their integration in a course curriculum for the best learning outcomes? This problem is particularly important when RLs are used in teaching 1st year students who have limited technical knowledge and practical experience in using real equipment. In this paper we would like to share our experiences with NetLab, an RL developed at the University of South Australia (UniSA for teaching 1st year engineering students and make recommendations for improvements in teaching practices based on it.

Neural Net Safety Monitor Design

Science.gov (United States)

Larson, Richard R.

2007-01-01

The National Aeronautics and Space Administration (NASA) at the Dryden Flight Research Center (DFRC) has been conducting flight-test research using an F-15 aircraft (figure 1). This aircraft has been specially modified to interface a neural net (NN) controller as part of a single-string Airborne Research Test System (ARTS) computer with the existing quad-redundant flight control system (FCC) shown in figure 2. The NN commands are passed to FCC channels 2 and 4 and are cross channel data linked (CCDL) to the other computers as shown. Numerous types of fault-detection monitors exist in the FCC when the NN mode is engaged; these monitors would cause an automatic disengagement of the NN in the event of a triggering fault. Unfortunately, these monitors still may not prevent a possible NN hard-over command from coming through to the control laws. Therefore, an additional and unique safety monitor was designed for a single-string source that allows authority at maximum actuator rates but protects the pilot and structural loads against excessive g-limits in the case of a NN hard-over command input. This additional monitor resides in the FCCs and is executed before the control laws are computed. This presentation describes a floating limiter (FL) concept1 that was developed and successfully test-flown for this program (figure 3). The FL computes the rate of change of the NN commands that are input to the FCC from the ARTS. A window is created with upper and lower boundaries, which is constantly floating and trying to stay centered as the NN command rates are changing. The limiter works by only allowing the window to move at a much slower rate than those of the NN commands. Anywhere within the window, however, full rates are allowed. If a rate persists in one direction, it will eventually hit the boundary and be rate-limited to the floating limiter rate. When this happens, a persistent counter begins and after a limit is reached, a NN disengage command is generated. The

Incentivizing primary care providers to innovate: building medical homes in the post-Katrina New Orleans safety net.

Science.gov (United States)

Rittenhouse, Diane R; Schmidt, Laura A; Wu, Kevin J; Wiley, James

2014-02-01

To evaluate safety-net clinics' responses to a novel community-wide Patient-Centered Medical Home (PCMH) financial incentive program in post-Katrina New Orleans. Between June 2008 and June 2010, we studied 50 primary care clinics in New Orleans receiving federal funds to expand services and improve care delivery. Multiwave, longitudinal, observational study of a local safety-net primary care system. Clinic-level data from a semiannual survey of clinic leaders (89.3 percent response rate), augmented by administrative records. Overall, 62 percent of the clinics responded to financial incentives by achieving PCMH recognition from the National Committee on Quality Assurance (NCQA). Higher patient volume, higher baseline PCMH scores, and type of ownership were significant predictors of achieving NCQA recognition. The steepest increase in adoption of PCMH processes occurred among clinics achieving the highest, Level 3, NCQA recognition. Following NCQA recognition, 88.9 percent stabilized or increased their use of PCMH processes, although several specific PCMH processes had very low rates of adoption overall. Findings demonstrate that widespread PCMH implementation is possible in a safety-net environment when external financial incentives are aligned with the goal of practice innovation. © Health Research and Educational Trust.

The evolving role and care management approaches of safety-net medicaid managed care plans

OpenAIRE

Gusmano, Michael K.; Sparer, Michael S.; Brown, Lawrence D.; Rowe, Catherine; Gray, Bradford

2002-01-01

This article provides new empirical data about the viability and the care management activities of Medicaid managed-care plans sponsored by provider organizations that serve Medicaid and other low-income populations. Using survey and case study methods we studied these “safety-net” health plans in 1998 and 2000. Although the number of safety-net plans declined over this period, the surviving plans were larger and enjoying greater financial success than the plans we surveyed in 1998. We also f...

Creative payment strategy helps ensure a future for teaching hospitals.

Science.gov (United States)

Vancil, D R; Shroyer, A L

1998-11-01

The Colorado Medicaid Program in years past relied on disproportionate share hospital (DSH) payment programs to increase access to hospital care for Colorado citizens, ensure the future financial viability of key safety-net hospitals, and partially offset the state's cost of funding the Medicaid program. The options to finance Medicaid care using DSH payments, however, recently have been severely limited by legislative and regulatory changes. Between 1991 and 1997, a creative Medicaid refinancing strategy called the major teaching hospital (MTH) payment program enabled $131 million in net payments to be distributed to the two major teaching hospitals in Colorado to provide enhanced funding related to their teaching programs and to address the ever-expanding healthcare needs of their low-income patients. This new Medicaid payment mechanism brought the state $69.5 million in Federal funding that otherwise would not have been received.

Translating self-persuasion into an adolescent HPV vaccine promotion intervention for parents attending safety-net clinics.

Science.gov (United States)

Baldwin, Austin S; Denman, Deanna C; Sala, Margarita; Marks, Emily G; Shay, L Aubree; Fuller, Sobha; Persaud, Donna; Lee, Simon Craddock; Skinner, Celette Sugg; Wiebe, Deborah J; Tiro, Jasmin A

2017-04-01

Self-persuasion is an effective behavior change strategy, but has not been translated for low-income, less educated, uninsured populations attending safety-net clinics or to promote human papillomavirus (HPV) vaccination. We developed a tablet-based application (in English and Spanish) to elicit parental self-persuasion for adolescent HPV vaccination and evaluated its feasibility in a safety-net population. Parents (N=45) of age-eligible adolescents used the self-persuasion application. Then, during cognitive interviews, staff gathered quantitative and qualitative feedback on the self-persuasion tasks including parental decision stage. The self-persuasion tasks were rated as easy to complete and helpful. We identified six question prompts rated as uniformly helpful, not difficult to answer, and generated non-redundant responses from participants. Among the 33 parents with unvaccinated adolescents, 27 (81.8%) reported deciding to get their adolescent vaccinated after completing the self-persuasion tasks. The self-persuasion application was feasible and resulted in a change in parents' decision stage. Future studies can now test the efficacy of the tablet-based application on HPV vaccination. The self-persuasion application facilitates verbalization of reasons for HPV vaccination in low literacy, safety-net settings. This self-administered application has the potential to be more easily incorporated into clinical practice than other patient education approaches. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Improving timeliness and efficiency in the referral process for safety net providers: application of the Lean Six Sigma methodology.

Science.gov (United States)

Deckard, Gloria J; Borkowski, Nancy; Diaz, Deisell; Sanchez, Carlos; Boisette, Serge A

2010-01-01

Designated primary care clinics largely serve low-income and uninsured patients who present a disproportionate number of chronic illnesses and face great difficulty in obtaining the medical care they need, particularly the access to specialty physicians. With limited capacity for providing specialty care, these primary care clinics generally refer patients to safety net hospitals' specialty ambulatory care clinics. A large public safety net health system successfully improved the effectiveness and efficiency of the specialty clinic referral process through application of Lean Six Sigma, an advanced process-improvement methodology and set of tools driven by statistics and engineering concepts.

A Pilot Quality Improvement Collaborative to Improve Safety Net Dental Access for Pregnant Women and Young Children.

Science.gov (United States)

Vander Schaaf, Emily B; Quinonez, Rocio B; Cornett, Amanda C; Randolph, Greg D; Boggess, Kim; Flower, Kori B

2018-02-01

Objectives To determine acceptability and feasibility of a quality improvement (QI) collaborative in safety net dental practices, and evaluate its effects on financial stability, access, efficiency, and care for pregnant women and young children. Methods Five safety net dental practices participated in a 15-month learning collaborative utilizing business assessments, QI training, early childhood oral health training, and prenatal oral health training. Practices collected monthly data on: net revenue, no-show rates, total encounters, and number of encounters for young children and pregnant women. We analyzed quantitative data using paired t-tests before and after the collaborative and collected supplemental qualitative feedback from clinic staff through focus groups and directed email. Results All mean measures improved, including: higher monthly revenue ($28,380-$33,102, p = 0.37), decreased no-show rate (17.7-14.3%, p = 0.11), higher monthly dental health encounters (283-328, p = 0.08), and higher monthly encounters for young children (8.8-10.5, p = 0.65), and pregnant women (2.8-9.7, p = 0.29). Results varied by practice, with some demonstrating largest increases in encounters for young children and others pregnant women. Focus group participants reported that the collaborative improved access for pregnant women and young children, and that QI methods were often new and difficult. Conclusion for practice Participation by safety net dental practices in a QI collaborative is feasible and acceptable. Individual sites saw greater improvements in different outcomes areas, based on their own structures and needs. Future efforts should focus on specific needs of each dental practice and should offer additional QI training.

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.

Science.gov (United States)

Liang, Shuting; Kegler, Michelle C; Cotter, Megan; Emily, Phillips; Beasley, Derrick; Hermstad, April; Morton, Rentonia; Martinez, Jeremy; Riehman, Kara

2016-08-02

Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies. Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation. Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation. Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover

Population characteristics of markets of safety-net and non-safety-net hospitals.

Science.gov (United States)

Gaskin, D J; Hadley, J

1999-09-01

To compare and contrast the markets of urban safety-net (USN) hospitals with the markets of other urban hospitals. To develop profiles of the actual inpatient markets of hospitals, we linked 1994 patient-level information from hospital discharge abstracts from nine states with 1990 data at the ZIP code level from the US Census Bureau. Each hospital's market was characterized by its racial and ethnic composition, median household income, poverty rate, and educational attainment. Measures of hospital competition were also calculated for each hospital. The analysis compared the market profiles of USN hospitals to those of other urban hospitals. We also compared the level of hospital competition and financial status of USN and other urban hospitals. The markets of USN hospitals had higher proportions of racial and ethnic minorities and non-English-speaking residents. Adults residing in markets of USN hospitals were less educated. Families living in markets of USN hospitals had lower incomes and were more likely to be living at or below the federal poverty level. USN hospitals and other urban hospitals faced similar levels of competition and had similar margins. However, USN hospitals were more dependent on Medicare disproportionate share payments and on state and local government subsidies to remain solvent. USN hospitals disproportionately serve vulnerable minority and low-income communities that otherwise face financial and cultural barriers to health care. USN hospitals are dependent on the public subsidies they receive from federal, state, and local governments. Public policies and market pressures that affect the viability of USN hospitals place the access to care by vulnerable populations at risk. Public policy that jeopardizes public subsidies places in peril the financial health of these institutions. As Medicare and Medicaid managed care grow, USN hospitals may lose these patient revenues and public subsidies based on their Medicaid and Medicare patient

Teaching the science of safety in US colleges and schools of pharmacy.

Science.gov (United States)

Holdford, David A; Warholak, Terri L; West-Strum, Donna; Bentley, John P; Malone, Daniel C; Murphy, John E

2011-05-10

This paper provides baseline information on integrating the science of safety into the professional degree curriculum at colleges and schools of pharmacy. A multi-method examination was conducted that included a literature review, key informant interviews of 30 individuals, and in-depth case studies of 5 colleges and schools of pharmacy. Educators believe that they are devoting adequate time to science of safety topics and doing a good job teaching students to identify, understand, report, manage, and communicate medication risk. Areas perceived to be in need of improvement include educating pharmacy students about the Food and Drug Administration's (FDA's) role in product safety, how to work with the FDA in post-marketing surveillance and other FDA safety initiatives, teaching students methods to improve safety, and educating students to practice in interprofessional teams. The report makes 10 recommendations to help pharmacy school graduates be more effective in protecting patients from preventable drug-related problems.

Teaching Safety and Health in the Workplace. An Instructor's Guide.

Science.gov (United States)

Occupational Safety and Health Administration, Washington, DC.

The primary concern of the Occupational Safety and Health Act (OSHA) is to provide a safe and healthful workplace for every working man and woman in the nation. One way to help reduce the number of injuries and illnesses in the workplace is by training workers to be more aware of the job safety and health hazards and to teach them the methods of…

Culture of Safety among Nurses in a Tertiary Teaching Hospital in ...

African Journals Online (AJOL)

Purpose: To assess the culture of safety among nurses in a tertiary teaching hospital in Saudi Arabia. Methods: A cross-sectional survey was conducted in King Khaled University Hospital in Riyadh, Saudi Arabia. A random sample of 492 nurses was included in the survey using a pre-validated instrument, Safety Attitudes ...

The Great Recession and the Social Safety Net

Science.gov (United States)

Moffitt, Robert A.

2016-01-01

The social safety net responded in significant and favorable ways during the Great Recession. Aggregate per capita expenditures grew significantly, with particularly strong growth in the SNAP, EITC, UI, and Medicaid programs. Distributionally, the increase in transfers was widely shared across demographic groups, including families with and without children, single-parent and two-parent families. Transfers grew as well among families with more employed members and with fewer employed members. However, the increase in transfer amounts was not strongly progressive across income classes within the low-income population, increasingly slightly more for those just below the poverty line and those just above it, compared to those at the bottom of the income distribution. This is mainly the result of the EITC program, which provides greater benefits to those with higher family earnings. The expansions of SNAP and UI benefitted those at the bottom of the income distribution to a greater extent. PMID:27065356

RESTful NET

CERN Document Server

Flanders, Jon

2008-01-01

RESTful .NET is the first book that teaches Windows developers to build RESTful web services using the latest Microsoft tools. Written by Windows Communication Foundation (WFC) expert Jon Flanders, this hands-on tutorial demonstrates how you can use WCF and other components of the .NET 3.5 Framework to build, deploy and use REST-based web services in a variety of application scenarios. RESTful architecture offers a simpler approach to building web services than SOAP, SOA, and the cumbersome WS- stack. And WCF has proven to be a flexible technology for building distributed systems not necessa

Verification of the safety communication protocol in train control system using colored Petri net

International Nuclear Information System (INIS)

Chen Lijie; Tang Tao; Zhao Xianqiong; Schnieder, Eckehard

2012-01-01

This paper deals with formal and simulation-based verification of the safety communication protocol in ETCS (European Train Control System). The safety communication protocol controls the establishment of safety connection between train and trackside. Because of its graphical user interface and modeling flexibility upon the changes in the system conditions, this paper proposes a composition Colored Petri Net (CPN) representation for both the logic and the timed model. The logic of the protocol is proved to be safe by means of state space analysis: the dead markings are correct; there are no dead transitions; being fair. Further analysis results have been obtained using formal and simulation-based verification approach. The timed models for the open transmit system and the application process are created for the purpose of performance analysis of the safety communication protocol. The models describe the procedure of data transmission and processing, and also provide relevant timed and stochastic factors, as well as time delay and lost packet, which may influence the time for establishment of safety connection of the protocol. Time for establishment of safety connection of the protocol in normal state is verified by formal verification, and then time for establishment of safety connection with different probability of lost packet is simulated. After verification it is found that the time for establishment of safety connection of the safety communication protocol satisfies the safety requirements.

Survivorship Care Plan Information Needs: Perspectives of Safety-Net Breast Cancer Patients.

Science.gov (United States)

Burke, Nancy J; Napoles, Tessa M; Banks, Priscilla J; Orenstein, Fern S; Luce, Judith A; Joseph, Galen

2016-01-01

Despite the Institute of Medicine's (IOM) 2005 recommendation, few care organizations have instituted standard survivorship care plans (SCPs). Low health literacy and low English proficiency are important factors to consider in SCP development. Our study aimed to identify information needs and survivorship care plan preferences of low literacy, multi-lingual patients to support the transition from oncology to primary care and ongoing learning in survivorship. We conducted focus groups in five languages with African American, Latina, Russian, Filipina, White, and Chinese medically underserved breast cancer patients. Topics explored included the transition to primary care, access to information, knowledge of treatment history, and perspectives on SCPs. Analysis of focus group data identified three themes: 1) the need for information and education on the transition between "active treatment" and "survivorship"; 2) information needed (and often not obtained) from providers; and 3) perspectives on SCP content and delivery. Our data point to the need to develop a process as well as written information for medically underserved breast cancer patients. An SCP document will not replace direct communication with providers about treatment, symptom management and transition, a communication that is missing in participating safety-net patients' experiences of cancer care. Women turned to peer support and community-based organizations in the absence of information from providers. "Clear and effective" communication of survivorship care for safety-net patients requires dedicated staff trained to address wide-ranging information needs and uncertainties.

Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

Science.gov (United States)

Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

2008-09-01

Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

Games that "work": using computer games to teach alcohol-affected children about fire and street safety.

Science.gov (United States)

Coles, Claire D; Strickland, Dorothy C; Padgett, Lynne; Bellmoff, Lynnae

2007-01-01

Unintentional injuries are a leading cause of death and disability for children. Those with developmental disabilities, including children affected by prenatal alcohol exposure, are at highest risk for injuries. Although teaching safety skills is recommended to prevent injury, cognitive limitations and behavioral problems characteristic of children with fetal alcohol spectrum disorder make teaching these skills challenging for parents and teachers. In the current study, 32 children, ages 4-10, diagnosed with fetal alcohol syndrome (FAS) and partial FAS, learned fire and street safety through computer games that employed "virtual worlds" to teach recommended safety skills. Children were pretested on verbal knowledge of four safety elements for both fire and street safety conditions and then randomly assigned to one condition. After playing the game until mastery, children were retested verbally and asked to "generalize" their newly acquired skills in a behavioral context. They were retested after 1 week follow-up. Children showed significantly better knowledge of the game to which they were exposed, immediately and at follow-up, and the majority (72%) was able to generalize all four steps within a behavioral setting. Results suggested that this is a highly effective method for teaching safety skills to high-risk children who have learning difficulties.

Closing the Health Care Gap in Communities: A Safety Net System Approach.

Science.gov (United States)

Gabow, Patricia A

2016-10-01

The goal of U.S. health care should be good health for every American. This daunting goal will require closing the health care gap in communities with a particular focus on the most vulnerable populations and the safety net institutions that disproportionately serve these communities. This Commentary describes Denver Health's (DH's) two-pronged approach to achieving this goal: (1) creating an integrated system that focuses on the needs of vulnerable populations, and (2) creating an approach for financial viability, quality of care, and employee engagement. The implementation and outcomes of this approach at DH are described to provide a replicable model. An integrated delivery system serving vulnerable populations should go beyond the traditional components found in most integrated health systems and include components such as mental health services, school-based clinics, and correctional health care, which address the unique and important needs of, and points of access for, vulnerable populations. In addition, the demands that a safety net system experiences from an open-door policy on access and revenue require a disciplined approach to cost, quality of care, and employee engagement. For this, DH chose Lean, which focuses on reducing waste to respect the patients and employees within its health system, as well as all citizens. DH's Lean effort produced almost $195 million of financial benefit, impressive clinical outcomes, and high employee engagement. If this two-pronged approach were widely adopted, health systems across the United States would improve their chances of giving better care at costs they can afford for every person in society.

Meaningful use in the safety net: a rapid ethnography of patient portal implementation at five community health centers in California.

Science.gov (United States)

Ackerman, Sara L; Sarkar, Urmimala; Tieu, Lina; Handley, Margaret A; Schillinger, Dean; Hahn, Kenneth; Hoskote, Mekhala; Gourley, Gato; Lyles, Courtney

2017-09-01

US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45). Our findings demonstrate that the health systems devoted considerable effort to enlisting staff support for portal adoption and integrating portal-related work into clinic routines. Although all health systems had achieved, or were close to achieving, MU benchmarks, patients faced numerous barriers to portal use and our participants were uncertain how to achieve and sustain "meaningful use" as defined by and for their patients. Health systems' efforts to achieve MU certification united clinic staff under a shared ethos of improved quality of care. However, MU's assumptions about patients' demand for electronic access to health information and ability to make use of it directed clinics' attention to enrollment and message routing rather than to the relevance and usability of a tool that is minimally adaptable to the safety net context. We found a mismatch between MU-based metrics of patient engagement and the priorities and needs of safety net patient populations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Safety leadership in the teaching laboratories of electrical and electronic engineering departments at Taiwanese Universities.

Science.gov (United States)

Wu, Tsung-Chih

2008-01-01

Safety has always been one of the principal goals in teaching laboratories. Laboratories cannot serve their educational purpose when accidents occur. The leadership of department heads has a major impact on laboratory safety, so this study discusses the factors affecting safety leadership in teaching laboratories. This study uses a mail survey to explore the perceived safety leadership in electrical and electronic engineering departments at Taiwanese universities. An exploratory factor analysis shows that there are three main components of safety leadership, as measured on a safety leadership scale: safety controlling, safety coaching, and safety caring. The descriptive statistics also reveals that among faculty, the perception of department heads' safety leadership is in general positive. A two-way MANOVA shows that there are interaction effects on safety leadership between university size and instructor age; there are also interaction effects between presence of a safety committee and faculty gender and faculty age. It is therefore necessary to assess organizational factors when determining whether individual factors are the cause of differing perceptions among faculty members. The author also presents advice on improving safety leadership for department heads at small universities and at universities without safety committees.

Establishment of the National Nuclear Regulatory Portal (NNRP) as the key element of the Global Nuclear Safety and Security Network and Regulatory Network (GNSSN/RegNet) for sharing of nuclear safety information and knowledge among the Global Expert Community

International Nuclear Information System (INIS)

Kuvshinnikov, A.V.

2011-01-01

The Global Nuclear Safety and Security Network (GNSSN) implements the concept of the Global Nuclear Safety and Security Framework (GNSSF) as outlined in INSAG 21. This is the framework of instruments and resources for achieving and maintaining worldwide a high level of safety and security at nuclear facilities and activities as stated in SF-1 and supporting safety standards or recommendations such as INSAG-12. National efforts are and should be augmented by the activities of a variety of international enterprises that facilitate safety and security. The IAEA standard GS-R-3 requires that information and knowledge is managed as a resource. Further strengthening of GNSSN in particular regulatory networking as intended by GNSSN/RegNet has to be based on current national priorities, on existing regional and thematic networks and on the established mechanisms of international co-operation as presented for example on the websites of the IAEA or the OECD-NEA. Current design and operation of RegNet are flexible enough to accommodate differences in national and international approaches and practices and to facilitate exchange and cooperation on regulatory matters. The main role of GNSSN/RegNet is sharing knowledge and bringing people together to enhance and promote nuclear safety and security. The objectives of GNSSN/RegNet: enhancing safety and security by international cooperation, sharing information and best practices, enabling adequate access to relevant safety and security information and promoting the dissemination of this information, implementing active collaboration in the relevant areas related to safety and security, such as joint projects, peer reviews, enabling synergies among existing networks and initiatives, informing the public on the relevant safety and security areas and the related international collaboration. In the RegNet part of the GNSSN exist the National Nuclear Regulatory Portal (NNRP) which is on one hand a part of the global RegNet and on the

DEPOSIT GUARANTEE SCHEMES JOIN FINANCIAL SAFETY-NET

Directory of Open Access Journals (Sweden)

Eugen Dijmarescu

2011-03-01

Full Text Available Deposit Guarantee Schemes (DGS become more visible under the current conditions of the world financial markets. If those have played in the past a rather discreet role for social stability through the function of pay box following a bank failure, the recent crisis put them in a new light, once the guarantee ceiling for eligible deposits grew in order to make for the accumulation of wealth worldwide and the increased risk incurred by the leverage of banking operations. Consequently, the resources accumulated by the DGS from the member banks and their proper management make possible their involvement in pre-emptive actions aimed to avoid bankruptcies via special administration and purchase of assets and assumption of liabilities. These new attributes give DGS a role in the mechanism of financial safety-net, along the supervisors of the market. Hence, an increased preoccupation for applied corporate governance has developed and Core Principles for Effective Deposit Insurance Systems have been adopted by the Basel Committee on Banking Supervision together with International Association of Deposit Insurers. Concurrently, the EU Commission has put forward a process for reviewing the Directives 94/39 and 09/14 EC, in order to make the European DGS more prepared to deal with above mentioned issues and bestow increased confidence upon depositors.

Strategies for Aligning Physicians to System Redesign Goals at Eight Safety-Net Systems.

Science.gov (United States)

Zallman, Leah; Bearse, Adriana; Neal, Natasha; VanDeusen Lukas, Carol; Hacker, Karen

2014-12-01

Facing recent economic and regulatory pressures, safety-net systems (SNSs) are redesigning their organizations to improve care delivery, remain financially viable, and maintain competitive positions. Aligning physicians with redesign goals is a priority, particularly as many SNSs shift toward patient-centered, population health-focused models. No previous work has examined efforts to align physicians to safety net redesign efforts. This qualitative study, conducted at eight SNSs, examined challenges faced in a changing health care environment, as well as strategies and resources to address them. Strategies clustered in two categories: physician role definition and organizational infrastructure. Physician role definition strategies were (1) changing payment and employment arrangements, (2) changing clinical roles, (3) increasing physician involvement in quality improvement, and (4) strengthening physician leadership in clinical and quality roles. Organizational infrastructure strategies were (1) ensuring medical center leadership support and integration, (2) utilizing data to drive physician behavior, and (3) addressing competing allegiances with academia. All sites reported multifaceted approaches but differed in specific strategies employed, facilitators noted, and challenges encountered. The findings highlight the need to implement multiple strategies to align physicians in redesign efforts. They suggest that all health systems, whether SNSs or not, can capitalize on qualities of physicians and existing infrastructural and leadership elements to achieve physician alignment. However, they must contend with and address challenges of competing allegiance (for example, academic, physician organization, hospital), as well as resistance to changing clinical roles and payment structures.

Pro asynchronous programming with .NET

CERN Document Server

Blewett, Richard; Ltd, Rock Solid Knowledge

2014-01-01

Pro Asynchronous Programming with .NET teaches the essential skill of asynchronous programming in .NET. It answers critical questions in .NET application development, such as: how do I keep my program responding at all times to keep my users happy how do I make the most of the available hardware how can I improve performanceIn the modern world, users expect more and more from their applications and devices, and multi-core hardware has the potential to provide it. But it takes carefully crafted code to turn that potential into responsive, scalable applications.With Pro Asynchronous Programming

Video Modeling to Teach Social Safety Skills to Young Adults with Intellectual Disability

Science.gov (United States)

Spivey, Corrine E.; Mechling, Linda C.

2016-01-01

This study evaluated the effectiveness of video modeling with a constant time delay procedure to teach social safety skills to three young women with intellectual disability. A multiple probe design across three social safety skills (responding to strangers who: requested personal information; requested money; and entered the participant's…

Survey of bayesian belif nets for quantitative reliability assessment of safety critical software used in nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Eom, H.S.; Sung, T.Y.; Jeong, H.S.; Park, J.H.; Kang, H.G.; Lee, K

2001-03-01

As part of the Probabilistic Safety Assessment of safety grade digital systems used in Nuclear Power plants research, measures and methodologies applicable to quantitative reliability assessment of safety critical software were surveyed. Among the techniques proposed in the literature we selected those which are in use widely and investigated their limitations in quantitative software reliability assessment. One promising methodology from the survey is Bayesian Belief Nets (BBN) which has a formalism and can combine various disparate evidences relevant to reliability into final decision under uncertainty. Thus we analyzed BBN and its application cases in digital systems assessment area and finally studied the possibility of its application to the quantitative reliability assessment of safety critical software.

Survey of bayesian belif nets for quantitative reliability assessment of safety critical software used in nuclear power plants

International Nuclear Information System (INIS)

Eom, H. S.; Sung, T. Y.; Jeong, H. S.; Park, J. H.; Kang, H. G.; Lee, K.

2001-03-01

As part of the Probabilistic Safety Assessment of safety grade digital systems used in Nuclear Power plants research, measures and methodologies applicable to quantitative reliability assessment of safety critical software were surveyed. Among the techniques proposed in the literature we selected those which are in use widely and investigated their limitations in quantitative software reliability assessment. One promising methodology from the survey is Bayesian Belief Nets (BBN) which has a formalism and can combine various disparate evidences relevant to reliability into final decision under uncertainty. Thus we analyzed BBN and its application cases in digital systems assessment area and finally studied the possibility of its application to the quantitative reliability assessment of safety critical software

Game Theory .net.

Science.gov (United States)

Shor, Mikhael

2003-01-01

States making game theory relevant and accessible to students is challenging. Describes the primary goal of GameTheory.net is to provide interactive teaching tools. Indicates the site strives to unite educators from economics, political and computer science, and ecology by providing a repository of lecture notes and tests for courses using…

WE-NET substask 3. Conceptual design of total system (Safety measures and evaluation techniques); 1998 nendo suiso riyo kokusai clean energy system gijutsu (WE-NET). 3. Zentai system gainen sekkei anzen taisaku hyoka gijutsu

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-01

Under the hydrogen-utilizing international clean energy system technology project WE-NET (World Energy NET Work) in fiscal 1998, researches and studies were conducted to clearly define safety designs and to improve on accident-and-safety analyses. In relation with system safety design, investigations continued into Japanese and foreign manuals and regulations about the handling of hydrogen and its peripherals, and safe design guidelines (draft) were compiled. Anomalies and accidents supposed to be typical of each of the systems concerned were investigated. As for accident-and-safety analyses, incorporation of a turbulence model was studied in relation to models representing the leak, evaporation, and diffusion of liquid hydrogen, and improvement was achieved when the scope of evaluation was enlarged concerning the hydrogen detonation model. The integration of the two models was discussed for the due evaluation of a series of processes of liquid hydrogen leak, evaporation, diffusion, and detonation. Calculation was performed for two assumed accidents, and the results were found to justify the integration of the two models. (NEDO)

Access, interest, and attitudes toward electronic communication for health care among patients in the medical safety net.

Science.gov (United States)

Schickedanz, Adam; Huang, David; Lopez, Andrea; Cheung, Edna; Lyles, C R; Bodenheimer, Tom; Sarkar, Urmimala

2013-07-01

Electronic and internet-based tools for patient-provider communication are becoming the standard of care, but disparities exist in their adoption among patients. The reasons for these disparities are unclear, and few studies have looked at the potential communication technologies have to benefit vulnerable patient populations. To characterize access to, interest in, and attitudes toward internet-based communication in an ethnically, economically, and linguistically diverse group of patients from a large urban safety net clinic network. Observational, cross-sectional study Adult patients (≥ 18 years) in six resource-limited community clinics in the San Francisco Department of Public Health (SFDPH) MAIN MEASURES: Current email use, interest in communicating electronically with health care professionals, barriers to and facilitators of electronic health-related communication, and demographic data-all self-reported via survey. Sixty percent of patients used email, 71 % were interested in using electronic communication with health care providers, and 19 % reported currently using email informally with these providers for health care. Those already using any email were more likely to express interest in using it for health matters. Most patients agreed electronic communication would improve clinic efficiency and overall communication with clinicians. A significant majority of safety net patients currently use email, text messaging, and the internet, and they expressed an interest in using these tools for electronic communication with their medical providers. This interest is currently unmet within safety net clinics that do not offer a patient portal or secure messaging. Tools such as email encounters and electronic patient portals should be implemented and supported to a greater extent in resource-poor settings, but this will require tailoring these tools to patients' language, literacy level, and experience with communication technology.

Shaping forest safety nets with markets: Adaptation to climate change under changing roles of tropical forests in Congo Basin

NARCIS (Netherlands)

Nkem, J.; Kalame, F.B.; Idinoba, M.; Somorin, O.A.; Ndoye, O.; Awono, A.

2010-01-01

Tropical forests hold several goods and services used by forest-dependent people as safety nets to traverse difficult periods of resource supply. These same goods and services are constantly surrounded by emerging markets linking remote communities with major urban centers nationally and

Teaching Petri Nets Using P3

Science.gov (United States)

Gasevic, Dragan; Devedzic, Vladan

2004-01-01

This paper presents Petri net software tool P3 that is developed for training purposes of the Architecture and organization of computers (AOC) course. The P3 has the following features: graphical modeling interface, interactive simulation by single and parallel (with previous conflict resolution) transition firing, two well-known Petri net…

Internet access and online cancer information seeking among Latino immigrants from safety net clinics.

Science.gov (United States)

Selsky, Claire; Luta, George; Noone, Anne-Michelle; Huerta, Elmer E; Mandelblatt, Jeanne S

2013-01-01

Internet use is widespread, but little is known about Internet use for cancer information among Latinos, especially those who rely on safety net clinics. The authors investigated access to and intended use of the Internet for cancer information among low income, immigrant Latinos predominately from Central and South America. A cross-sectional study of 1,273 Latinos 21 years and older attending safety net clinics or health fairs was conducted from June 2007 to November 2008. The authors used logistic regression models to evaluate associations of age, acculturation, psychosocial factors and other covariates with Internet access and intended use of the Internet for cancer information among those with access. Of the sample, 44% reported Internet access. Higher information self-efficacy and greater trust in the Internet were independently associated with Internet access (p = .05 and p Internet use for cancer information, considering covariates. In addition, those with high (vs. low) perceived risk of cancer (OR = 1.76; 95% CI [1.14, 2.73]; p = .01) and higher levels of trust in online health information (OR = 1.47 per one-point increase; 95% [CI 1.19, 1.82]; p = .0004) were more likely to intend to seek cancer information online. These findings that Internet access is fairly high in the immigrant Latino population and that the Internet is a trusted source of cancer information suggest that the Internet may be a channel for cancer control interventions.

Are HPV vaccination services accessible to high-risk communities? A spatial analysis of HPV-associated cancer and Chlamydia rates and safety-net clinics.

Science.gov (United States)

Tsui, Jennifer; Rodriguez, Hector P; Gee, Gilbert C; Escobedo, Loraine A; Kominski, Gerald F; Bastani, Roshan

2013-12-01

While HPV vaccines can greatly benefit adolescents and young women from high-risk areas, little is known about whether safety-net immunization services are geographically accessible to communities at greatest risk for HPV-associated diseases. We explore the spatial relationship between areas with high HPV risk and proximity to safety-net clinics from an ecologic perspective. We used cancer registry data and Chlamydia surveillance data to identify neighborhoods within Los Angeles County with high risk for HPV-associated cancers. We examined proximity to safety-net clinics among neighborhoods with the highest risk. Proximity was measured as the shortest distance between each neighborhood center and the nearest clinic and having a clinic within 3 miles of each neighborhood center. The average 5-year non-age-adjusted rates were 1,940 cases per 100,000 for Chlamydia and 60 per 100,000 for HPV-associated cancers. A large majority, 349 of 386 neighborhoods with high HPV-associated cancer rates and 532 of 537 neighborhoods with high Chlamydia rates, had a clinic within 3 miles of the neighborhood center. Clinics were more likely to be located within close proximity to high-risk neighborhoods in the inner city. High-risk neighborhoods outside of this urban core area were less likely to be near accessible clinics. The majority of high-risk neighborhoods were geographically near safety-net clinics with HPV vaccination services. Due to low rates of vaccination, these findings suggest that while services are geographically accessible, additional efforts are needed to improve uptake. Programs aimed to increase awareness about the vaccine and to link underserved groups to vaccination services are warranted.

Shared decision-making during surgical consultation for gallstones at a safety-net hospital.

Science.gov (United States)

Mueck, Krislynn M; Leal, Isabel M; Wan, Charlie C; Goldberg, Braden F; Saunders, Tamara E; Millas, Stefanos G; Liang, Mike K; Ko, Tien C; Kao, Lillian S

2018-04-01

Understanding patient perspectives regarding shared decision-making is crucial to providing informed, patient-centered care. Little is known about perceptions of vulnerable patients regarding shared decision-making during surgical consultation. The purpose of this study was to evaluate whether a validated tool reflects perceptions of shared decision-making accurately among patients seeking surgical consultation for gallstones at a safety-net hospital. A mixed methods study was conducted in a sample of adult patients with gallstones evaluated at a safety-net surgery clinic between May to July 2016. Semi-structured interviews were conducted after their initial surgical consultation and analyzed for emerging themes. Patients were administered the Shared Decision-Making Questionnaire and Autonomy Preference Scale. Univariate analyses were performed to identify factors associated with shared decision-making and to compare the results of the surveys to those of the interviews. The majority of patients (N = 30) were female (90%), Hispanic (80%), Spanish-speaking (70%), and middle-aged (45.7 ± 16 years). The proportion of patients who perceived shared decision-making was greater in the Shared Decision-Making Questionnaire versus the interviews (83% vs 27%, P decision for operation was not associated with shared decision-making. Contributory factors to this discordance include patient unfamiliarity with shared decision-making, deference to surgeon authority, lack of discussion about different treatments, and confusion between aligned versus shared decisions. Available questionnaires may overestimate shared decision-making in vulnerable patients suggesting the need for alternative or modifications to existing methods. Furthermore, such metrics should be assessed for correlation with patient-reported outcomes, such as satisfaction with decisions and health status. Copyright © 2017 Elsevier Inc. All rights reserved.

Rethinking the therapeutic misconception: social justice, patient advocacy, and cancer clinical trial recruitment in the US safety net.

Science.gov (United States)

Burke, Nancy J

2014-09-20

Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. In the course of two years of ethnographic fieldwork in a safety net hospital, I conducted clinic observations (n=150 clinic days) and in-depth in-person qualitative interviews with patients (n=37) and providers (n=15). I used standard qualitative methods to organize and code resulting fieldnote and interview data. Findings suggest that TM is limited in relevance for the interdisciplinary context of cancer clinical trial recruitment in the safety net setting. Ethnographic data show the value of the discussions that happen prior to the informed consent, those that introduce the idea of participation in research. These preliminary discussions are elemental especially when recruiting underserved and vulnerable patients for clinical trial participation who are often unfamiliar with medical research and how it relates to medical care. Data also highlight the multiple actors involved in research discussions and the ethics of social justice and patient advocacy they mobilize, suggesting that class, inequality, and dependency influence the forms of ethical engagements in public hospital settings. On the ground ethics of social justice and patient advocacy are more relevant than TM as guiding ethical principles in the context of

The Expected Net Present Value of Developing Weight Management Drugs in the Context of Drug Safety Litigation.

Science.gov (United States)

Chawla, Anita; Carls, Ginger; Deng, Edmund; Tuttle, Edward

2015-07-01

Following withdrawals, failures, and significant litigation settlements, drug product launches in the anti-obesity category slowed despite a large and growing unmet need. Litigation concerns, a more risk-averse regulatory policy, and the difficulty of developing a product with a compelling risk-benefit profile in this category may have limited innovators' expected return on investment and restricted investment in this therapeutic area. The objective of the study was to estimate perceived manufacturer risk associated with product safety litigation and increased development costs vs. revenue expectations on anticipated return on investment and to determine which scenarios might change a manufacturer's investment decision. Expected net present value of a weight-management drug entering pre-clinical trials was calculated for a range of scenarios representing evolving expectations of development costs, revenue, and litigation risk over the past 25 years. These three factors were based on published estimates, historical data, and analogs from other therapeutic areas. The main driver in expected net present value calculations is expected revenue, particularly if one assumes that litigation risk and demand are positively correlated. Changes in development costs associated with increased regulatory concern with potential safety issues for the past 25 years likely did not impact investment decisions. Regulatory policy and litigation risk both played a role in anti-obesity drug development; however, product revenue-reflecting efficacy at acceptable levels of safety-was by far the most important factor. To date, relatively modest sales associated with recent product introductions suggest that developing a product that is sufficiently efficacious with an acceptable level of safety continues to be the primary challenge in this market.

Teaching medical students consultation skills using e-learning

DEFF Research Database (Denmark)

Jørgensen, Merete; Witt, Klaus; Fridorff-Jens, Peter Kindt

2015-01-01

of a student includes a test-video of a consultation with the student in the doctor role, seeing a real patient, and the student´s skills in the subsequent analysis of the communication process according to its patientcentredness. The aim of the study is to measure the effect of adding access to 16 video cases......Teaching consultation skills to medical students using e-learning. Introduction: We have been teaching Family Medicine at the University of Copenhagen for more than twenty years. We wish to develop a method to evaluate the current teaching of consultation skills and the effect of new interventions...... of the ten items. The students were able to identify more elements in the test-video, related to patient function, to inform the patient properly, the use of summarizing and safety-netting Conclusion On-line video cases used interactively in the classroom sessions increase the students’ skills in analysing...

Targeting International Food Aid Programmes: The Case of Productive Safety Net Programme in Tigray, Ethiopia

Directory of Open Access Journals (Sweden)

Hossein Azadi

2017-09-01

Full Text Available Ethiopia has experienced more than five major droughts in the past three decades, leading to high dependency on international food aids. Nevertheless, studies indicate that asset depletion has not been prevented; neither did food insecurity diminish. Since 2004/5, the Productive Safety Net Programme (PSNP has been implemented to improve food security in Tigray, Northern Ethiopia. Critics point out that the implementation of food aid programmes can have negative impacts as well as positive outcomes for local communities. Accordingly, this survey study aimed to analyse the distribution and allocation of food aids in the Productive Safety Net Programme (PSNP in Tigray. Results of 479 interviews revealed that targeting different households in the PSNP has been considerably linked to socio-demographic attributes among which age and size of family were decisive factors to receive food aids. Furthermore, older households with smaller family size received more direct support. Inequality between genders was another major finding of this study. When combined with the marital status, there was also a big difference in the percentage of married or unmarried women receiving food aids. These findings could provide fundamental information for policy intervention to correct food security programmes at household level and reduce hunger. Given that, socio-demographic factors can help to identify particular and usually different requirements, vulnerabilities and coping strategies of the members of the food aid programme, so that they can be much more addressed when an emergency happens.

Assessment of Safety Condition in One of the Teaching Hospitals in Kermanshah (2015: A Case Study

Directory of Open Access Journals (Sweden)

Masod Ghanbari Kakavand

2016-09-01

Full Text Available Background & Aims of the Study: Many working conditions-related stress factors that can produce injuries and illnesses are important in hospital environments. So, the health and safety of nurses and patients from workplace-induced injuries and illnesses is important. In this study, we have assessed the safety condition of one of the teaching hospitals in Kermanshah (2015. Materials and Methods: This descriptive and cross-sectional study was conducted in one of the teaching hospital of Kermanshah University of medical sciences. For this aim a checklist was prepared based on the Occupational Safety and Health Administration's standards and Part 3 of the manual of National Building Regulations. These checklists comprised (The final checklist had 239 questions of 9 dimensions various sections of safety including; fire safety, building safety, electrical safety, emergency exit routes safety, heating and cooling equipment safety, operating room and laundry room and salty home safety. Eventually, using SPSS 16 and descriptive statistics, data were analyzed. Results: According to the results of this study, 66.6% of the units had poor safety and 33.4% of them were moderately safe. As well as, only ICU and CCU unit, heating and cooling equipment and operational room showed moderate compliance with safety requirements and other sections were poorly complied. Conclusion: The results of this study showed that safety conditions of hospital were not at favorable level. These poor safety statues can jeopardize patients and hospital personnel. Thus some interventions such as improvement of working conditions, compliance with safety acts and implementation of health, safety and environmental management system would be necessary.

Fusion through the NET

International Nuclear Information System (INIS)

Spears, B.

1987-01-01

The paper concerns the next generation of fusion machines which are intended to demonstrate the technical viability of fusion. In Europe, the device that will follow on from JET is known as NET - the Next European Torus. If the design programme for NET proceeds, Europe could start to build the machine in 1994. The present JET programme hopes to achieve breakeven in the early 1990's. NET hopes to reach ignition in the next century, and so lay the foundation for a demonstration reactor. A description is given of the technical specifications of the components of NET, including: the first wall, the divertors to protect the wall, the array of magnets that provide the fields containing the plasma, the superconducting magnets, and the shield of the machine. NET's research programme is briefly outlined, including the testing programme to optimise conditions in the machine to achieve ignition, and its safety work. (U.K.)

Shaping forest safety nets with markets: Adaptation to climate change under changing roles of tropical forests in Congo Basin

International Nuclear Information System (INIS)

Nkem, Johnson; Kalame, Fobissie B.; Idinoba, Monica; Somorin, Olufunso A.; Ndoye, Ousseynou; Awono, Abdon

2010-01-01

Tropical forests hold several goods and services used by forest-dependent people as safety nets to traverse difficult periods of resource supply. These same goods and services are constantly surrounded by emerging markets linking remote communities with major urban centers nationally and internationally. How these markets affect adaptation remains unclear. This paper examines the roles of markets in non-timber forest products that normally serve as safety nets for forest communities, and the implications for climate change adaptation in the Congo Basin. Following the identification and prioritization of forest-based development sectors for adaptation by stakeholders, the types of markets and trades surrounding the identified sectors were examined in two provinces in the Democratic Republic of Congo as a case study in order to evaluate revenue flows and their potential contribution to adaptation by local communities. The distribution of the market revenue leaves local people with returns much lower than the worth of the commodity, while wholesalers and retailers reap most of the benefits and profit from the high variability in volume and market earnings for the same commodity across provinces. Markets may increase the value of a commodity as observed in this study, but their contributions to adaptation appear highly limited for local communities following their distribution among the stakeholders in the market chain. This is likely to be worse in free market settings, especially when it diminishes the safety net roles of forest goods and services. Markets should therefore complement rather than substitute forests roles for adaptation to climate change in tropical forest countries. Capturing the benefits of trade for adaptation is crucial but will require policy reforms and further research that addresses the complexity in benefit sharing.

Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

Directory of Open Access Journals (Sweden)

Ken Russell Coelho

2011-01-01

Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

Performance Measurement and Target-Setting in California's Safety Net Health Systems.

Science.gov (United States)

Hemmat, Shirin; Schillinger, Dean; Lyles, Courtney; Ackerman, Sara; Gourley, Gato; Vittinghoff, Eric; Handley, Margaret; Sarkar, Urmimala

Health policies encourage implementing quality measurement with performance targets. The 2010-2015 California Medicaid waiver mandated quality measurement and reporting. In 2013, California safety net hospitals participating in the waiver set a voluntary performance target (the 90th percentile for Medicare preferred provider organization plans) for mammography screening and cholesterol control in diabetes. They did not reach the target, and the difference-in-differences analysis suggested that there was no difference for mammography ( P = .39) and low-density lipoprotein control ( P = .11) performance compared to measures for which no statewide quality improvement initiative existed. California's Medicaid waiver was associated with improved performance on a number of metrics, but this performance was not attributable to target setting on specific health conditions. Performance may have improved because of secular trends or systems improvements related to waiver funding. Relying on condition-specific targets to measure performance may underestimate improvements and disadvantage certain health systems. Achieving ambitious targets likely requires sustained fiscal, management, and workforce investments.

The state of quality improvement and patient safety teaching in health professional education in New Zealand.

Science.gov (United States)

Robb, Gillian; Stolarek, Iwona; Wells, Susan; Bohm, Gillian

2017-10-27

To investigate how quality and patient safety domains are being taught in the pre-registration curricula of health profession education programmes in New Zealand. All tertiary institutions providing training for medicine, nursing, midwifery, dentistry, pharmacy, physiotherapy, dietetics and 11 other allied health professions in New Zealand were contacted and a person with relevant curriculum knowledge was invited to participate. Interviews were conducted using a semi-structured interview guide to explore nine quality and safety domains; improvement science, patient safety, quality and safety culture, evidence-based practice, patient-centred care, teamwork and communication, leadership for change, systems thinking and use of information technology (IT). Transcribed data were extracted and categorised by discipline and domain. Two researchers independently identified and categorised themes within each domain, using a general inductive approach. Forty-nine institutions were contacted and 43 (88%) people were interviewed. The inclusion and extent of quality and safety teaching was variable. Evidence-based practice, patient-centred care and teamwork and communication were the strongest domains and well embedded in programmes, while leadership, systems thinking and the role of IT were less explicitly included. Except for two institutions, improvement science was absent from pre-registration curricula. Patient safety teaching was focused mainly around incident reporting, and to a lesser extent learning from adverse events. Although a 'no blame' culture was articulated as important, the theme of individual accountability was still apparent. While participants agreed that all domains were important, the main barriers to incorporating improvement science and patient safety concepts into existing programmes included an 'already stretched curriculum' and having faculty with limited expertise in these areas. Although the building blocks for improving the quality and safety of

Evaluating a Website to Teach Children Safety with Dogs: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

David C. Schwebel

2016-12-01

Full Text Available Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A randomized controlled trial was conducted with 69 children aged 4–5 randomly assigned to use the dog safety website or a control transportation safety website for ~3 weeks. Assessment of dog safety knowledge and behavior plus skill in three relevant cognitive constructs (impulse control, noticing details, and perspective-taking was conducted both at baseline and following website use. The dog safety website incorporated interactive games, instructional videos including testimonials, a motivational rewards system, and messaging to parents concerning child lessons. Our results showed that about two-thirds of the intervention sample was not adherent to website use at home, so both intent-to-treat and per-protocol analyses were conducted. Intent-to-treat analyses yielded mostly null results. Per-protocol analyses suggested children compliant to the intervention protocol scored higher on knowledge and recognition of safe behavior with dogs following the intervention compared to the control group. Adherent children also had improved scores post-intervention on the cognitive skill of noticing details compared to the control group. We concluded that young children’s immature cognition can lead to dog bites. Interactive eHealth training on websites shows potential to teach children relevant cognitive and safety skills to reduce risk. Compliance to website use is a challenge, and some relevant cognitive skills (e.g., noticing details may be more amenable to computer-based training than others (e.g., impulse control.

Understanding the digital divide in the clinical setting: the technology knowledge gap experienced by US safety net patients during teleretinal screening.

Science.gov (United States)

George, Sheba; Moran, Erin; Fish, Allison; Ogunyemi, Lola

2013-01-01

Differential access to everyday technology and healthcare amongst safety net patients is associated with low technological and health literacies, respectively. These low rates of literacy produce a complex patient "knowledge gap" that influences the effectiveness of telehealth technologies. To understand this "knowledge gap", six focus groups (2 African-American and 4 Latino) were conducted with patients who received teleretinal screenings in U.S. urban safety-net settings. Findings indicate that patients' "knowledge gap" is primarily produced at three points: (1) when patients' preexisting personal barriers to care became exacerbated in the clinical setting; (2) through encounters with technology during screening; and (3) in doctor-patient follow-up. This "knowledge gap" can produce confusion and fear, potentially affecting patients' confidence in quality of care and limiting their disease management ability. In rethinking the digital divide to include the consequences of this knowledge gap faced by patients in the clinical setting, we suggest that patient education focus on both their disease and specific telehealth technologies deployed in care delivery.

Facilitators and barriers of implementing enhanced recovery in colorectal surgery at a safety net hospital: A provider and patient perspective.

Science.gov (United States)

Alawadi, Zeinab M; Leal, Isabel; Phatak, Uma R; Flores-Gonzalez, Juan R; Holihan, Julie L; Karanjawala, Burzeen E; Millas, Stefanos G; Kao, Lillian S

2016-03-01

Enhanced Recovery After Surgery (ERAS) pathways are known to decrease complications and duration of stay in colorectal surgery patients. However, it is unclear whether an ERAS pathway would be feasible and effective at a safety-net hospital. The aim of this study was to identify local barriers and facilitators before the adoption of an ERAS pathway for patients undergoing colorectal operations at a safety-net hospital. Semistructured interviews were conducted to assess the perceived barriers and facilitators before ERAS adoption. Stratified purposive sampling was used. Interviews were audiotaped, transcribed verbatim, and analyzed using content analysis. Analytic and investigator triangulation were used to establish credibility. Interviewees included 8 anesthesiologists, 5 surgeons, 6 nurses, and 18 patients. Facilitators identified across the different medical professions were (1) feasibility and alignment with current practice, (2) standardization of care, (3) smallness of community, (4) good teamwork and communication, and (5) caring for patients. The barriers were (1) difficulty in adapting to change, (2) lack of coordination between different departments, (3) special needs of a highly comorbid and socioeconomically disadvantaged patient population, (4) limited resources, and (5) rotating residents. Facilitators identified by the patients were (1) welcoming a speedy recovery, (2) being well-cared for and satisfied with treatment, (3) adequate social support, (4) welcoming early mobilization, and (5) effective pain management. The barriers were (1) lack of quiet and private space, (2) need for more patient education and counseling, and (3) unforeseen complications. Although limited hospital resources are perceived as a barrier to ERAS implementation at a safety-net hospital, there is strong support for such pathways and multiple factors were identified that may facilitate change. Inclusion of patient perspectives is critical to identifying challenges and

Feasibility of a Video-Based Advance Care Planning Website to Facilitate Group Visits among Diverse Adults from a Safety-Net Health System.

Science.gov (United States)

Zapata, Carly; Lum, Hillary D; Wistar, Emily; Horton, Claire; Sudore, Rebecca L

2018-02-20

Primary care providers in safety-net settings often do not have time to discuss advance care planning (ACP). Group visits (GV) may be an efficient means to provide ACP education. To assess the feasibility and impact of a video-based website to facilitate GVs to engage diverse adults in ACP. Feasibility pilot among patients who were ≥55 years of age from two primary care clinics in a Northern California safety-net setting. Participants attended two 90-minute GVs and viewed the five steps of the movie version of the PREPARE website ( www.prepareforyourcare.org ) concerning surrogates, values, and discussing wishes in video format. Two clinician facilitators were available to encourage participation. We assessed pre-to-post ACP knowledge, whether participants designated a surrogate or completed an advance directive (AD), and acceptability of GVs and PREPARE materials. We conducted two GVs with 22 participants. Mean age was 64 years (±7), 55% were women, 73% nonwhite, and 55% had limited literacy. Knowledge improved about surrogate designation (46% correct pre vs. 85% post, p = 0.01) and discussing decisions with others (59% vs. 90%, p = 0.01). Surrogate designation increased (48% vs. 85%, p = 0.01) and there was a trend toward AD completion (9% vs. 24%, p = 0.21). Participants rated the GVs and PREPARE materials a mean of 8 (±3.1) on a 10-point acceptability scale. Using the PREPARE movie to facilitate ACP GVs for diverse adults in safety net, primary care settings is feasible and shows potential for increasing ACP engagement.

A study on the quantitative evaluation of the reliability for safety critical software using Bayesian belief nets

International Nuclear Information System (INIS)

Eom, H. S.; Jang, S. C.; Ha, J. J.

2003-01-01

Despite the efforts to avoid undesirable risks, or at least to bring them under control in the world, new risks that are highly difficult to manage continue to emerge from the use of new technologies, such as the use of digital instrumentation and control (I and C) components in nuclear power plant. Whenever new risk issues came out by now, we have endeavored to find the most effective ways to reduce risks, or to allocate limited resources to do this. One of the major challenges is the reliability analysis of safety-critical software associated with digital safety systems. Though many activities such as testing, verification and validation (V and V) techniques have been carried out in the design stage of software, however, the process of quantitatively evaluating the reliability of safety-critical software has not yet been developed because of the irrelevance of the conventional software reliability techniques to apply for the digital safety systems. This paper focuses on the applicability of Bayesian Belief Net (BBN) techniques to quantitatively estimate the reliability of safety-critical software adopted in digital safety system. In this paper, a typical BBN model was constructed using the dedication process of the Commercial-Off-The-Shelf (COTS) installed by KAERI. In conclusion, the adoption of BBN technique can facilitate the process of evaluating the safety-critical software reliability in nuclear power plant, as well as provide very useful information (e.g., 'what if' analysis) associated with software reliability in the viewpoint of practicality

Bridging the Gap: A Framework and Strategies for Integrating the Quality and Safety Mission of Teaching Hospitals and Graduate Medical Education.

Science.gov (United States)

Tess, Anjala; Vidyarthi, Arpana; Yang, Julius; Myers, Jennifer S

2015-09-01

Integrating the quality and safety mission of teaching hospitals and graduate medical education (GME) is a necessary step to provide the next generation of physicians with the knowledge, skills, and attitudes they need to participate in health system improvement. Although many teaching hospital and health system leaders have made substantial efforts to improve the quality of patient care, few have fully included residents and fellows, who deliver a large portion of that care, in their efforts. Despite expectations related to the engagement of these trainees in health care quality improvement and patient safety outlined by the Accreditation Council for Graduate Medical Education in the Clinical Learning Environment Review program, a structure for approaching this integration has not been described.In this article, the authors present a framework that they hope will assist teaching hospitals in integrating residents and fellows into their quality and safety efforts and in fostering a positive clinical learning environment for education and patient care. The authors define the six essential elements of this framework-organizational culture, teaching hospital-GME alignment, infrastructure, curricular resources, faculty development, and interprofessional collaboration. They then describe the organizational characteristics required for each element and offer concrete strategies to achieve integration. This framework is meant to be a starting point for the development of robust national models of infrastructure, alignment, and collaboration between GME and health care quality and safety leaders at teaching hospitals.

Effectiveness of video-assisted teaching program on safety measures followed by the employees working in the silica-based industry in Puducherry, India.

Science.gov (United States)

Nanthini, Thiruvengadam; Karunagari, Karaline

2016-01-01

Employees constitute a large and important sector of the world's population. The global labor force is about 2,600 million and 75% of this force is working in developing countries. Occupational health and safety (OHS) must be managed in every aspect of their work. Occupational safety and health (OSH), also commonly referred to as OHS or workplace health and safety (WHS) is an area concerned with the safety, health, and welfare of people engaged in any employment. The goal of OSH is to foster a safe and healthy work environment. The aim of this study is to evaluate the effectiveness of video-assisted teaching program on safety measures. A total of 105 employees were selected from M/s ACE Glass Containers Ltd. at Puducherry, India using the convenience sampling technique. Pretest was conducted using a self-administered questionnaire. Subsequent video-assisted teaching was conducted by the investigator after which posttest was conducted. Video-assisted teaching program was found to be effective in improving the knowledge, attitude, and practice of the subjects. Periodical reorientation on safety measures are needed for all the employees as it is essential for promoting the well-being of employees working in any industry.

End-Stage Renal Disease Outcomes among the Kaiser Permanente Southern California Creatinine Safety Program (Creatinine SureNet): Opportunities to Reflect and Improve.

Science.gov (United States)

Sim, John J; Batech, Michael; Danforth, Kim N; Rutkowski, Mark P; Jacobsen, Steven J; Kanter, Michael H

2017-01-01

The Kaiser Permanente Southern California (KPSC) creatinine safety program (Creatinine SureNet) identifies and outreaches to thousands of people annually who may have had a missed diagnosis for chronic kidney disease (CKD). We sought to determine the value of this outpatient program and evaluate opportunities for improvement. Longitudinal cohort study (February 2010 through December 2015) of KPSC members captured into the creatinine safety program who were characterized using demographics, laboratory results, and different estimations of glomerular filtration rate. Age- and sex-adjusted rates of end-stage renal disease (ESRD) were compared with those in the overall KPSC population. Among 12,394 individuals, 83 (0.7%) reached ESRD. The age- and sex-adjusted relative risk of ESRD was 2.7 times higher compared with the KPSC general population during the same period (94.7 vs 35.4 per 100,000 person-years; p creatinine measurements, only 13% had a urine study performed (32% among patients with confirmed CKD). Our study found a higher incidence of ESRD among individuals captured into the KPSC creatinine safety program. If the Chronic Kidney Disease Epidemiology Collaboration equation were used, fewer people would have been captured while improving the accuracy for diagnosing CKD. Urine testing was low even among patients with confirmed CKD. Our findings demonstrate the importance of a creatinine safety net program in an integrated health system but also suggest opportunities to improve CKD care and screening.

How Well Does the “Safety Net” Work for Family Safety Nets? Economic Survival Strategies Among Grandmother Caregivers in Severe Deprivation

Directory of Open Access Journals (Sweden)

LaShawnDa Pittman

2015-11-01

Full Text Available Using qualitative data collected from fifty-eight African American grandmothers raising grandchildren in skipped-generation households (SGHs, I reveal how and why women in non-normative families, lacking legal protections and publicly recognized authority as parents, must negotiate risk in pursuit of resources. I demonstrate that these grandmothers struggle for economic survival while seeking simultaneously to minimize the risk of losing their grandchildren and maximize their chances of receiving public assistance. I argue that grandmothers in SGHs face significant challenges obtaining government benefits owing to policy eligibility guidelines, street-level implementation, and family dynamics. Ultimately, I illustrate how the severe deprivation experienced by these grandmothers is exacerbated by their exclusion from safety net programs that could help them support the children in their care.

MMPM - Mars MetNet Precursor Mission

Science.gov (United States)

Harri, A.-M.; Schmidt, W.; Pichkhadze, K.; Linkin, V.; Vazquez, L.; Uspensky, M.; Polkko, J.; Genzer, M.; Lipatov, A.; Guerrero, H.; Alexashkin, S.; Haukka, H.; Savijarvi, H.; Kauhanen, J.

2008-09-01

MetNet Mars Mission will provide a crucial support for the safety of large landing missions in general and manned Mars missions in particular. Accurate knowledge of atmospheric conditions and weather data is essential to guarantee safe landings of the forthcoming Mars mission elements. The MetNet Mars Mission is exactly this type of tool that is needed both for the Martian atmospheric science as well as for the mission safety issues.

Verification of a primary-to-secondary leaking safety procedure in a nuclear power plant using coloured Petri nets

International Nuclear Information System (INIS)

Nemeth, E.; Bartha, T.; Fazekas, Cs.; Hangos, K.M.

2009-01-01

This paper deals with formal and simulation-based verification methods of a PRImary-to-SEcondary leaking (abbreviated as PRISE) safety procedure. The PRISE safety procedure controls the draining of the contaminated water in a faulty steam generator when a non-compensable leaking from the primary to the secondary circuit occurs. Because of the discrete nature of the verification, a Coloured Petri Net (CPN) representation is proposed for both the procedure and the plant model. We have proved by using a non-model-based strategy that the PRISE safety procedure is safe, there are no dead markings in the state space, and all transitions are live; being either impartial or fair. Further analysis results have been obtained using a model-based verification approach. We created a simple, low dimensional, nonlinear dynamic model of the primary circuit in a VVER-type pressurized water nuclear power plant for the purpose of the model-based verification. This is in contrast to the widely used safety analysis that requires an accurate detailed model. Our model also describes the relevant safety procedures, as well as all of the major leaking-type faults. We propose a novel method to transform this model to a CPN form by discretization. The composed plant and PRISE safety procedure system has also been analysed by simulation using CPN analysis tools. We found by the model-based analysis-using both single and multiple faults-that the PRISE safety procedure initiates the draining when the PRISE event occurs, and no false alarm will be initiated

The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations

Directory of Open Access Journals (Sweden)

Neda Ratanawongsa

2017-01-01

Full Text Available Widespread electronic health record (EHR implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1 the adoption of RxNorm; (2 standardized naming and picklist options for high alert medications such as insulin; (3 the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4 enhanced bidirectional communication with pharmacy partners; and (5 informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations.

Is There a Net Gener in the House? - Dispelling a Mystification

Directory of Open Access Journals (Sweden)

Rolf Schulmeister

2009-07-01

Full Text Available The subject of this essay is the so-called ‘net generation’, the ‘generation @’, or the ‘millennials’ and the speculations about the importance of this generation for teaching. This essay represents both a critical analysis of such allegations and assumptions and a discourse, from the perspective of socialization, on the use of media in teaching.

Diabetes Health Information Technology Innovation to Improve Quality of Life for Health Plan Members in Urban Safety Net

Science.gov (United States)

Ratanawongsa, Neda; Handley, Margaret A.; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

2014-01-01

Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support (ATSM) / health coaching intervention for English, Spanish-, and Cantonese-speaking members from four publicly-funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] 0.29, pimproving patient-reported self-management and may also improve some outcomes. PMID:24594561

Establishing benchmarks for the management of elevated liver enzymes and/or dilated biliary trees in an urban safety net hospital: analysis of 915 subjects.

Science.gov (United States)

Liu, Laindy; Cripps, Michael W; Riggle, Andrew J; Wolf, Steven E; Nakonezny, Paul A; Phelan, Herb A

2015-12-01

The push for public reporting of outcomes necessitates relevant benchmarks for disease states across different settings. This study establishes benchmarks for choledocholithiasis management in a safety net hospital setting. We reviewed all patients admitted to our acute care surgery service with biochemical evidence of choledocholithiasis who underwent same-admission cholecystectomy (CCY) between July 2012 and December 2013. During this 18-month period, 915 patients were admitted with biochemical evidence of choledocholithiasis. Descriptive statistics for the cohort are provided, which include a 51% rate of obesity and 95% rate of pathologic cholecystitis. Conversion rates of 4% and complication rates of 6% were found. The majority had a CCY without biliary imaging (n = 630, 68.9%). Relevant benchmarks are characterized, and results of a practice pattern of omitting pre- or intraoperative biliary tree imaging are described. These findings serve as a first benchmark of choledocholithiasis management for urban safety net hospitals. Copyright © 2015 Elsevier Inc. All rights reserved.

Teaching patient safety in the medical undergraduate program at the Universidade Federal de São Paulo.

Science.gov (United States)

Bohomol, Elena; Cunha, Isabel Cristina Kowal Olm

2015-01-01

To analyze the Educational Project of the undergraduate medical course to verify what is taught regarding Patient Safety and to enable reflections on the educational practice. A descriptive study, using document research as strategy. The document of investigation was the Educational Project of the medical course, in 2006, at the Escola Paulista de Medicina of the Universidade Federal de São Paulo. The theoretical framework adopted was the Multi-Professional Patient Safety Curriculum Guide of the World Health Organization, which led to the preparation of a list with 153 tracking terms. We identified 65 syllabus units in the Educational Project of the course, in which 40 (61.5%) addressed topics related to Patient Safety. Themes on the topic "Infection prevention and control" were found in 19 (47.5%) units and teaching of "Interaction with patients and caregivers" in 12 (32.5%); however content related to "Learning from errors to prevent harm" were not found. None of the framework topics had their proposed themes entirely taught during the period of education of the future physicians. Patient safety is taught in a fragmented manner, which values clinical skills such as the diagnosis and treatment of diseases, post-treatment, surgical procedures, and follow-up. Since it is a recent movement, the teaching of patient safety confronts informative proposals based on traditional structures centered on subjects and on specific education, and it is still poorly valued.

Piloting and Evaluating a Workshop to Teach Georgia Teachers about Weather Science and Safety

Science.gov (United States)

Stewart, Alan E.; Knox, John A.; Schneider, Pat

2015-01-01

A survey of 691 Georgia teachers suggested that their students generally were not prepared for severe weather. Teachers also were somewhat dissatisfied with the quality of the teaching resources on weather and weather safety. Only 46 (7%) of the teachers were aware of the American Red Cross Masters of Disaster (MoD) weather science and safety…

An Analysis of the Role of Social Safety Net Scholarships in Reducing School Drop-Out during the Indonesian Economic Crisis. Innocenti Working Papers.

Science.gov (United States)

Cameron, Lisa A.

This paper uses regression and matching techniques to evaluate Indonesia's Social Safety Net Scholarships Programme. The scholarships program was developed to try to prevent large numbers of children from dropping out of school as a result of the Asian financial crisis. The expectation was that many families would find it difficult to keep their…

A Pilot Program Integrating Hepatitis B Virus (HBV) Screening into an Outpatient Endoscopy Unit Improves HBV Screening Among an Ethnically Diverse Safety-Net Hospital.

Science.gov (United States)

Campbell, Brendan; Lopez, Aristeo; Liu, Benny; Bhuket, Taft; Wong, Robert J

2018-01-01

Safety-net hospitals are enriched in ethnic minorities and provide opportunities for high-impact hepatitis B virus (HBV) screening. We aim to evaluate the impact of a pilot program integrating HBV screening into outpatient endoscopy among urban safety-net populations. From July 2015 to May 2017, consecutive adults undergoing outpatient endoscopy were prospectively assessed for HBV screening eligibility using US Preventative Services Task Force guidelines. Rates of prior HBV screening were assessed, and those eligible but not screened were offered HBV testing. Multivariate logistic regression models evaluated predictors of test acceptance among eligible patients. Among 1557 patients (47.1% male, 69.4% foreign born), 65.1% were eligible for HBV screening, among which 24.5% received prior screening. In our pilot screening program in the endoscopy unit, 91.4% (n = 855) of eligible patients accepted HBV testing. However, only 55.3% (n = 415) of those that accepted actually completed HBV testing. While there was a trend toward higher rates of test acceptance among African-Americans compared to non-Hispanic whites (OR 3.31, 95% CI 0.96-11.38, p = 0.06), no other sex-specific or race/ethnicity-specific disparities in HBV test acceptance were observed. Among those who completed HBV testing, we identified 10 new patients with chronic HBV (2.4% prevalence). Only 24.5% of eligible patients received prior HBV screening among our cohort. Our pilot program integrating HBV screening into outpatient endoscopy successfully tested an additional 415 patients, improving overall HBV screening from 24.5 to 75.6%. Integrating HBV testing into non-traditional settings has potential to bridge the gap in HBV screening among safety-net systems.

FiberNet--a new embolic protection device for carotid artery stenting.

Science.gov (United States)

Bauer, C; Franke, J; Bertog, S C; Woerner, V; Ghasemzadeh-Asl, S; Sievert, H

2014-05-01

Though distal filter protection during carotid stenting reduces the risk of cerebrovascular events, periprocedural stroke remains a risk despite their broad usage. This observation may be related to the pore size of common filters. The FiberNet distal filter system is unique by its very small pore size (40 µm) as well as its low profile and flexibility. Little data is available regarding the clinical performance and safety of this device. The aim was the evaluation of the safety of the FiberNet embolic protection system during carotid artery stenting. All consecutive patients treated with carotid stenting at our institution using the FiberNet device were systematically followed. Primary endpoint was the rate of all death and stroke within 30 days of the procedure. Carotid artery stenting using the FiberNet embolic protection system was performed in 54 patients. The procedure was technical successful in all patients. Three patients (5.5%) had a TIA. Amauosis fugax occurred in two patients (3.7%). One patient (1.9%) had a minor stroke with hemiparesis of the left arm and face which resolved completely within 48 hr after the procedure. No patient died or suffered a major stroke. The safety and feasibility of the FiberNet distal protection system appears to be at least equivalent to that reported in studies using conventional distal filter protection. Copyright © 2013 Wiley Periodicals, Inc.

Modelling human factor with Petri nets

International Nuclear Information System (INIS)

Bedreaga, Luminita; Constantinescu, Cristina; Guzun, Basarab

2007-01-01

The human contribution to risk and safety of nuclear power plant operation can be best understood, assessed and quantified using tools to evaluate human reliability. Human reliability analysis becomes an important part of every probabilistic safety assessment and it is used to demonstrate that nuclear power plants designed with different safety levels are prepared to cope with severe accidents. Human reliability analysis in context of probabilistic safety assessment consists in: identifying human-system interactions important to safety; quantifying probabilities appropriate with these interactions. Nowadays, the complex system functions can be modelled using special techniques centred either on states space adequate to system or on events appropriate to the system. Knowing that complex system model consists in evaluating the likelihood of success, in other words, in evaluating the possible value for that system being in some state, the inductive methods which are based on the system states can be applied also for human reliability modelling. Thus, switching to the system states taking into account the human interactions, the underlying basis of the Petri nets can be successfully applied and the likelihoods appropriate to these states can also derived. The paper presents the manner to assess the human reliability quantification using Petri nets approach. The example processed in the paper is from human reliability documentation without a detailed human factor analysis (qualitative). The obtained results by these two kinds of methods are in good agreement. (authors)

Internet safety education for youth: stakeholder perspectives.

Science.gov (United States)

Moreno, Megan A; Egan, Katie G; Bare, Kaitlyn; Young, Henry N; Cox, Elizabeth D

2013-06-05

Internet use is nearly ubiquitous among US youth; risks to internet use include cyberbullying, privacy violations and unwanted solicitation. Internet safety education may prevent these negative consequences; however, it is unclear at what age this education should begin and what group is responsible for teaching this topic. Surveys were distributed to key stakeholders in youth safety education including public school teachers, clinicians, parents and adolescents. Surveys assessed age at which internet safety education should begin, as well as experiences teaching and learning internet safety. Surveys of adults assessed willingness to teach internet safety. Finally, participants were asked to identify a group whose primary responsibility it should be to teach internet safety. A total of 356 participants completed the survey (93.4% response rate), including 77 teachers, 111 clinicians, 72 parents and 96 adolescents. Stakeholders felt the optimal mean age to begin teaching internet safety was 7.2 years (SD = 2.5), range 2-15. Internet safety was regularly taught by some teachers (20.8%), few clinicians (2.6%) and many parents (40.3%). The majority of teachers, clinicians and parents were willing to teach internet safety, but all groups surveyed identified parents as having primary responsibility for teaching this topic. Findings suggest agreement among key stakeholders for teaching internet safety at a young age, and for identifying parents as primary teachers of this topic. Clinicians have a unique opportunity to support parents by providing resources, guidance and support.

Holes in the US nuclear safety net

International Nuclear Information System (INIS)

Utroska, D.

1987-01-01

Contrary to popular perception, the NRC has neither the authority nor the resources to comprehensively regulate the authority nor the resources to comprehensively regulate the nuclear power industry: it cannot check and monitor every nuclear plant in detail to assure reasonable reactor safety. This is widely understood within the power industry. After the Three Mile Island accident, the nuclear industry formed a group called the Institute of Nuclear Power Operations (INPO), based in Atlanta, Georgia. Its self-proclaimed mandate is to pick up the safety initiative where NRC regulations and reviews leave off; to make sure that each nuclear plant in the United States goes beyond compliance with minimum regulations and achieves excellence in safe and efficient performance. INPO's 1986 budget was $44 million, paid to the institute by electricity ratepayers via the nuclear utilities. Among other things, the money funds INPO's development of nuclear plant operating criteria and pays for plant inspections to determine if the standards are being met. INPO has deliberately maintained a low profile. INPO does not become involved in public or media activities on behalf of the industry or in the role of promoting the nuclear power option, the organization's formal institutional plan declares. A key aspect of INPO's public noninvolvement is keeping to itself and its members the results of its nuclear plant safety evaluations. Although consumers fund INPO activities and have a stake in nuclear plant safety, the press and the public are denied access to INPO safety investigation reports. 8 references

A business planning model to identify new safety net clinic locations.

Science.gov (United States)

Langabeer, James; Helton, Jeffrey; DelliFraine, Jami; Dotson, Ebbin; Watts, Carolyn; Love, Karen

2014-01-01

Community health clinics serving the poor and underserved are geographically expanding due to changes in U.S. health care policy. This paper describes the experience of a collaborative alliance of health care providers in a large metropolitan area who develop a conceptual and mathematical decision model to guide decisions on expanding its network of community health clinics. Community stakeholders participated in a collaborative process that defined constructs they deemed important in guiding decisions on the location of community health clinics. This collaboration also defined key variables within each construct. Scores for variables within each construct were then totaled and weighted into a community-specific optimal space planning equation. This analysis relied entirely on secondary data available from published sources. The model built from this collaboration revolved around the constructs of demand, sustainability, and competition. It used publicly available data defining variables within each construct to arrive at an optimal location that maximized demand and sustainability and minimized competition. This is a model that safety net clinic planners and community stakeholders can use to analyze demographic and utilization data to optimize capacity expansion to serve uninsured and Medicaid populations. Communities can use this innovative model to develop a locally relevant clinic location-planning framework.

Auto Safety

Science.gov (United States)

... Safe Videos for Educators Search English Español Auto Safety KidsHealth / For Parents / Auto Safety What's in this ... by teaching some basic rules. Importance of Child Safety Seats Using a child safety seat (car seat) ...

Coloured Petri Nets: Basic Concepts, Analysis Methods and Practical Use. Vol. 1, Basic Concepts

DEFF Research Database (Denmark)

Jensen, Kurt

This three-volume work presents a coherent description of the theoretical and practical aspects of coloured Petri nets. These CP-nets are shown to be a full-fledged language for the design, specification, simulation, validation and implementation of large software systems. The introductory first...... volume contains the formal definition of CP-nets and the mathematical theory behind their analysis methods. It gives a detailed presentation of many small examples and a brief overview of some industrial applications. The purpose of the book is to teach the reader how to construct CP-net models...

Net Operating Working Capital, Capital Budgeting, and Cash Budgets: A Teaching Example

Science.gov (United States)

Tuner, James A.

2016-01-01

Many introductory finance texts present information on the capital budgeting process, including estimation of project cash flows. Typically, estimation of project cash flows begins with a calculation of net income. Getting from net income to cash flows requires accounting for non-cash items such as depreciation. Also important is the effect of…

Games that ''Work'': Using Computer Games to Teach Alcohol-Affected Children about Fire and Street Safety

Science.gov (United States)

Coles, Claire D.; Strickland, Dorothy C.; Padgett, Lynne; Bellmoff, Lynnae

2007-01-01

Unintentional injuries are a leading cause of death and disability for children. Those with developmental disabilities, including children affected by prenatal alcohol exposure, are at highest risk for injuries. Although teaching safety skills is recommended to prevent injury, cognitive limitations and behavioral problems characteristic of…

Innovative Strategies Designed to Improve Adult Pneumococcal Immunizations in Safety Net Patient-Centered Medical Homes.

Science.gov (United States)

Park, Nina J; Sklaroff, Laura Myerchin; Gross-Schulman, Sandra; Hoang, Khathy; Tran, Helen; Campa, David; Scheib, Geoffrey; Guterman, Jeffrey J

2016-08-01

Streptococcus pneumoniae is a principal cause of serious illness, including bacteremia, meningitis, and pneumonia, worldwide. Pneumococcal immunization is proven to reduce morbidity and mortality in high-risk adult and elderly populations. Current pneumococcal vaccination practices are suboptimal in part because of recommendation complexity, the high cost of provider-driven immunization interventions, and outreach methods that are not patient-centric. These barriers are amplified within the safety net. This paper identifies efforts by the Los Angeles County Department of Health Services to increase pneumococcal immunization rates for adult indigent patient populations. A 4-part approach will be used to increase vaccination rates: (1) protocol driven care, (2) staff education, (3) electronic identification of eligible patients, and (4) automated patient outreach and scheduling. The proposed analytics plan and potential for scalability are described. (Population Health Management 2016;19:240-247).

Teaching Russian Via Distance Learning, the EdNet Experience.

Science.gov (United States)

Zsiray, Stephen W., Jr.; And Others

In Utah, the statewide distance education network (EdNet) enables students from five rural and suburban high schools to learn Russian and earn college credits. Courses in Russian are offered through a partnership involving the Cache County School District, Utah State University, and the Utah State Office of Education. Classes are taught on one…

A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida

OpenAIRE

Tookes, Hansel; Diaz, Chanelle; Li, Hua; Khalid, Rafi; Doblecki-Lewis, Susanne

2015-01-01

Background Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence...

Sub-optimal Testing and Awareness of HCV and HBV Among High Risk Individuals at an Underserved Safety-Net Hospital.

Science.gov (United States)

Wong, Robert J; Campbell, Brendan; Liu, Benny; Baden, Rachel; Bhuket, Taft

2018-02-01

Sub-optimal screening for chronic hepatitis C virus (HCV) and chronic hepatitis B virus (HBV) among high risk groups delays diagnosis and treatment. We aimed to evaluate overall rates of HCV and HBV screening and patient knowledge of their testing result. Adults age ≥18 years undergoing elective outpatient endoscopy at a large, urban safety-net hospital from July 2015 to July 2016 were prospectively evaluated to determine rates of HCV and HBV testing, the results of those completed tests, and patient knowledge of test results among high risk individuals (as determined by U.S. Preventative Services Task Force). Among 1125 patients (52.3% male, 70.4% foreign-born), 66.5% were high risk for chronic HCV; only 30.9% received prior testing. 14.7% had positive chronic HCV infection. Patients born in the 1945-1965 cohort were more likely to have received prior HCV testing compared to those born outside of this cohort (32.7 vs. 16.9%, p = 0.01). Among patients who received HCV screening, 29.3% were aware of test results. Overall, 61.6% were high risk for chronic HBV; only 25.1% received prior testing. 4.1% were positive for chronic HBV. Compared to Caucasians, Asians (19.0 vs. 44.4%, p HBV testing. Among patients who received prior HBV screening, 18.4% were aware of test results. Less than one-third of high risk patients received HCV and HBV screening among an ethnically diverse safety-net population. Equally low rates of patient knowledge of testing results were observed.

An interprofessional course using human patient simulation to teach patient safety and teamwork skills.

Science.gov (United States)

Vyas, Deepti; McCulloh, Russell; Dyer, Carla; Gregory, Gretchen; Higbee, Dena

2012-05-10

To assess the effectiveness of human patient simulation to teach patient safety, team-building skills, and the value of interprofessional collaboration to pharmacy students. Five scenarios simulating semi-urgent situations that required interprofessional collaboration were developed. Groups of 10 to 12 health professions students that included 1 to 2 pharmacy students evaluated patients while addressing patient safety hazards. Pharmacy students' scores on 8 of 30 items on a post-simulation survey of knowledge, skills, and attitudes improved over pre-simulation scores. Students' scores on 3 of 10 items on a team building and interprofessional communications survey also improved after participating in the simulation exercise. Over 90% of students reported that simulation increased their understanding of professional roles and the importance of interprofessional communication. Simulation training provided an opportunity to improve pharmacy students' ability to recognize and react to patient safety concerns and enhanced their interprofessional collaboration and communication skills.

Gaming, texting, learning? Teaching engineering ethics through students' lived experiences with technology.

Science.gov (United States)

Voss, Georgina

2013-09-01

This paper examines how young peoples' lived experiences with personal technologies can be used to teach engineering ethics in a way which facilitates greater engagement with the subject. Engineering ethics can be challenging to teach: as a form of practical ethics, it is framed around future workplace experience in a professional setting which students are assumed to have no prior experience of. Yet the current generations of engineering students, who have been described as 'digital natives', do however have immersive personal experience with digital technologies; and experiential learning theory describes how students learn ethics more successfully when they can draw on personal experience which give context and meaning to abstract theories. This paper reviews current teaching practices in engineering ethics; and examines young people's engagement with technologies including cell phones, social networking sites, digital music and computer games to identify social and ethical elements of these practices which have relevance for the engineering ethics curricula. From this analysis three case studies are developed to illustrate how facets of the use of these technologies can be drawn on to teach topics including group work and communication; risk and safety; and engineering as social experimentation. Means for bridging personal experience and professional ethics when teaching these cases are discussed. The paper contributes to research and curriculum development in engineering ethics education, and to wider education research about methods of teaching 'the net generation'.

Software hazard analysis for nuclear digital protection system by Colored Petri Net

International Nuclear Information System (INIS)

Bai, Tao; Chen, Wei-Hua; Liu, Zhen; Gao, Feng

2017-01-01

Highlights: •A dynamic hazard analysis method is proposed for the safety-critical software. •The mechanism relies on Colored Petri Net. •Complex interactions between software and hardware are captured properly. •Common failure mode in software are identified effectively. -- Abstract: The software safety of a nuclear digital protection system is critical for the safety of nuclear power plants as any software defect may result in severe damage. In order to ensure the safety and reliability of safety-critical digital system products and their applications, software hazard analysis is required to be performed during the lifecycle of software development. The dynamic software hazard modeling and analysis method based on Colored Petri Net is proposed and applied to the safety-critical control software of the nuclear digital protection system in this paper. The analysis results show that the proposed method can explain the complex interactions between software and hardware and identify the potential common cause failure in software properly and effectively. Moreover, the method can find the dominant software induced hazard to safety control actions, which aids in increasing software quality.

Educating future leaders in patient safety

Science.gov (United States)

Leotsakos, Agnès; Ardolino, Antonella; Cheung, Ronny; Zheng, Hao; Barraclough, Bruce; Walton, Merrilyn

2014-01-01

Education of health care professionals has given little attention to patient safety, resulting in limited understanding of the nature of risk in health care and the importance of strengthening systems. The World Health Organization developed the Patient Safety Curriculum Guide: Multiprofessional Edition to accelerate the incorporation of patient safety teaching into higher educational curricula. The World Health Organization Curriculum Guide uses a health system-focused, team-dependent approach, which impacts all health care professionals and students learning in an integrated way about how to operate within a culture of safety. The guide is pertinent in the context of global educational reforms and growing recognition of the need to introduce patient safety into health care professionals’ curricula. The guide helps to advance patient safety education worldwide in five ways. First, it addresses the variety of opportunities and contexts in which health care educators teach, and provides practical recommendations to learning. Second, it recommends shared learning by students of different professions, thus enhancing student capacity to work together effectively in multidisciplinary teams. Third, it provides guidance on a range of teaching methods and pedagogical activities to ensure that students understand that patient safety is a practical science teaching them to act in evidence-based ways to reduce patient risk. Fourth, it encourages supportive teaching and learning, emphasizing the need to establishing teaching environments in which students feel comfortable to learn and practice patient safety. Finally, it helps educators incorporate patient safety topics across all areas of clinical practice. PMID:25285012

A Patient Navigator Intervention to Reduce Hospital Readmissions among High-Risk Safety-Net Patients: A Randomized Controlled Trial.

Science.gov (United States)

Balaban, Richard B; Galbraith, Alison A; Burns, Marguerite E; Vialle-Valentin, Catherine E; Larochelle, Marc R; Ross-Degnan, Dennis

2015-07-01

Evidence-based interventions to reduce hospital readmissions may not generalize to resource-constrained safety-net hospitals. To determine if an intervention by patient navigators (PNs), hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients. Randomized controlled trial. General medicine inpatients having at least one of the following readmission risk factors: (1) age ≥60 years, (2) any in-network inpatient admission within the past 6 months, (3) length of stay ≥3 days, (4) admission diagnosis of heart failure, or (5) chronic obstructive pulmonary disease. The analytic sample included 585 intervention patients and 925 controls. PNs provided coaching and assistance in navigating the transition from hospital to home through hospital visits and weekly telephone outreach, supporting patients for 30 days post-discharge with discharge preparation, medication management, scheduling of follow-up appointments, communication with primary care, and symptom management. The primary outcome was in-network 30-day hospital readmissions. Secondary outcomes included rates of outpatient follow-up. We evaluated outcomes for the entire cohort and stratified by patient age >60 years (425 intervention/584 controls) and ≤60 years (160 intervention/341 controls). Overall, 30-day readmission rates did not differ between intervention and control patients. However, the two age groups demonstrated marked differences. Intervention patients >60 years showed a statistically significant adjusted absolute 4.1% decrease [95% CI: -8.0%, -0.2%] in readmission with an increase in 30-day outpatient follow-up. Intervention patients ≤60 years showed a statistically significant adjusted absolute 11.8% increase [95% CI: 4.4%, 19.0%] in readmission with no change in 30-day outpatient follow-up. A patient navigator intervention among high risk, safety-net patients decreased readmission among older patients while increasing readmissions

State Space Methods for Timed Petri Nets

DEFF Research Database (Denmark)

Christensen, Søren; Jensen, Kurt; Mailund, Thomas

2001-01-01

it possible to condense the usually infinite state space of a timed Petri net into a finite condensed state space without loosing analysis power. The second method supports on-the-fly verification of certain safety properties of timed systems. We discuss the application of the two methods in a number......We present two recently developed state space methods for timed Petri nets. The two methods reconciles state space methods and time concepts based on the introduction of a global clock and associating time stamps to tokens. The first method is based on an equivalence relation on states which makes...

Impact of a Patient Navigator Program on Hospital-Based and Outpatient Utilization Over 180 Days in a Safety-Net Health System.

Science.gov (United States)

Balaban, Richard B; Zhang, Fang; Vialle-Valentin, Catherine E; Galbraith, Alison A; Burns, Marguerite E; Larochelle, Marc R; Ross-Degnan, Dennis

2017-09-01

With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. Randomized controlled trial conducted October 2011 through April 2013. Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease. The analytic sample included 739 intervention patients, 1182 controls. Through hospital visits and 30 days of post-discharge telephone outreach, PNs provided coaching and assistance with medications, appointments, transportation, communication with primary care, and self-care. Primary outcomes: (1) hospital-based utilization, a composite of ED visits and hospital admissions; (2) hospital admissions; (3) ED visits; and (4) outpatient visits. We evaluated outcomes following an index discharge, stratified by patient age (≥ 60 and safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. Our findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time periods.

Health Services Utilization Among Fee-for-Service Medicare and Medicaid Patients Under Age 65 with Behavioral Health Illness at an Urban Safety Net Hospital.

Science.gov (United States)

Cancino, Ramon S; Jack, Brian W; Jarvis, John; Cummings, Alice Kate; Cooper, Ellie; Cremieux, Pierre-Yves; Burgess, James F

2017-07-01

In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011. We compared patients with and without behavioral health illness. The main outcome measures were hospital admission and ED use. Chi-square and Wilcoxon rank-sum tests were used for descriptive statistics on categorical and continuous variables, respectively. Greedy propensity score matching was used to control for confounding factors. Rate ratios (RR) and 95% confidence intervals (CI) were determined after matching and after adjusting for those variables that remained significantly different after matching. In 2011, 10% of all fee-for-service dual eligible patients aged less than 65 years in Massachusetts were seen at Boston Medical Center. Data before propensity score matching showed significant differences in age, sex, race/ethnicity, marital status, education, employment, physical comorbidities, and Charlson Comorbidity Index score between patients with and without behavioral health illness. Analysis after propensity score matching found significant differences in sex, Hispanic race, and other education and employment status. Compared with patients without behavioral health illness, patients with behavioral health illness had a higher RR for hospital admissions (RR = 2.07; 95% CI = 1.81-2.38; P fee-for-service plan had significantly higher rates of hospital admission and ED use compared with dual eligible patients without behavioral health illness at the largest urban safety net medical center in New England. Safety net hospitals care for a large proportion of dual

Coloured Petri Nets: Basic Concepts, Analysis Methods and Practical Use. Vol. 2, Analysis Methods

DEFF Research Database (Denmark)

Jensen, Kurt

ideas behind the analysis methods are described as well as the mathematics on which they are based and also how the methods are supported by computer tools. Some parts of the volume are theoretical while others are application oriented. The purpose of the volume is to teach the reader how to use......This three-volume work presents a coherent description of the theoretical and practical aspects of coloured Petri nets (CP-nets). The second volume contains a detailed presentation of the analysis methods for CP-nets. They allow the modeller to investigate dynamic properties of CP-nets. The main...... the formal analysis methods, which does not require a deep understanding of the underlying mathematical theory....

The NordiNet® International Outcome Study and NovoNet® ANSWER Program®: rationale, design, and methodology of two international pharmacoepidemiological registry-based studies monitoring long-term clinical and safety outcomes of growth hormone therapy (Norditropin®).

Science.gov (United States)

Höybye, Charlotte; Sävendahl, Lars; Christesen, Henrik Thybo; Lee, Peter; Pedersen, Birgitte Tønnes; Schlumpf, Michael; Germak, John; Ross, Judith

2013-01-01

Randomized controlled trials have shown that growth hormone (GH) therapy has effects on growth, metabolism, and body composition. GH therapy is prescribed for children with growth failure and adults with GH deficiency. Carefully conducted observational study of GH treatment affords the opportunity to assess long-term treatment outcomes and the clinical factors and variables affecting those outcomes, in patients receiving GH therapy in routine clinical practice. The NordiNet® International Outcome Study (IOS) and the American Norditropin® Web Enabled Research (ANSWER Program®) are two complementary, non-interventional, observational studies that adhere to current guidelines for pharmacoepidemiological data. The studies include pediatric and adult patients receiving Norditropin®, as prescribed by their physicians. The studies gather long-term data on the safety and effectiveness of reallife treatment with the recombinant human GH, Norditropin®. We describe the origins, aims, objectives, and design methodology of the studies, as well as their governance and validity, strengths, and limitations. The NordiNet® IOS and ANSWER Program® studies will provide valid insights into the effectiveness and safety of GH treatment across a diverse and large patient population treated in accordance with real-world clinical practice and following the Good Pharmacoepidemiological Practice and STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines.

Child access to the nutritional safety net during and after the Great Recession: The case of WIC.

Science.gov (United States)

Jackson, Margot I; Mayne, Patrick

2016-12-01

Because children disproportionately live in poverty, they are especially vulnerable during economic crises, making the social safety net a key buffer against the effects of economic disadvantage on their development. The Great Recession of 2007-2009 had strong and lasting effects on American children and families, including striking negative effects on their health environments. Understanding access to the health safety net during this time of increased economic need, as well as the extent to which all children-regardless of age, income or race/ethnicity-share in the increased use of transfer programs, is therefore important in identifying the availability and accessibility of government assistance for those in need. Focusing on the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program because of its strong effects on child development, we use longitudinal data from the Survey of Income and Program Participation (SIPP) to examine change and stability in children's WIC enrollment before, during and after the recession. Specifically, we examine: 1) whether children's WIC enrollment increased alongside changing family income, and 2) the extent to which changes in participation were shared by all subpopulations, regardless of age, income, and race/ethnicity. Analyses reveal that WIC participation among eligible children increased leading up to, during, and after the Great Recession, suggesting that the program was responsive to increasing economic need. Examining the distribution of WIC enrollment across demographic groups largely reveals a pattern of stable inequality in access and "take up." Children born to poorer and less-educated mothers were more likely to be enrolled prior to the recession, and these differences remain mostly constant during and after the recession. Eligible Hispanic children had consistently higher enrollment, particularly among those in families with foreign-born mothers. The findings suggest that not all

Professional Parallel Programming with C# Master Parallel Extensions with NET 4

CERN Document Server

Hillar, Gastón

2010-01-01

Expert guidance for those programming today's dual-core processors PCs As PC processors explode from one or two to now eight processors, there is an urgent need for programmers to master concurrent programming. This book dives deep into the latest technologies available to programmers for creating professional parallel applications using C#, .NET 4, and Visual Studio 2010. The book covers task-based programming, coordination data structures, PLINQ, thread pools, asynchronous programming model, and more. It also teaches other parallel programming techniques, such as SIMD and vectorization.Teach

Using CSCW for developing problem-oriented teaching and learning in a net environment

DEFF Research Database (Denmark)

Cheesman, Robin; Heilesen, Simon

Roskilde University’s master’s programme in computer-mediated communication combines face-to-face seminars with net seminars focusing on collaborative project work. Net-based learning based on CSCW offers both advantages and pitfalls: (i) it helps to activate all students, (ii) it fosters...... complexity in organising tasks, (iii) asynchronous environment generates a need for synchronous communication, and (iv) exaggerated structuring limits self-organising and motivation....

Study protocol for "Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET)": a pragmatic trial comparing implementation strategies.

Science.gov (United States)

Gold, Rachel; Hollombe, Celine; Bunce, Arwen; Nelson, Christine; Davis, James V; Cowburn, Stuart; Perrin, Nancy; DeVoe, Jennifer; Mossman, Ned; Boles, Bruce; Horberg, Michael; Dearing, James W; Jaworski, Victoria; Cohen, Deborah; Smith, David

2015-10-16

Little research has directly compared the effectiveness of implementation strategies in any setting, and we know of no prior trials directly comparing how effectively different combinations of strategies support implementation in community health centers. This paper outlines the protocol of the Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET), a trial designed to compare the effectiveness of several common strategies for supporting implementation of an intervention and explore contextual factors that impact the strategies' effectiveness in the community health center setting. This cluster-randomized trial compares how three increasingly hands-on implementation strategies support adoption of an evidence-based diabetes quality improvement intervention in 29 community health centers, managed by 12 healthcare organizations. The strategies are as follows: (arm 1) a toolkit, presented in paper and electronic form, which includes a training webinar; (arm 2) toolkit plus in-person training with a focus on practice change and change management strategies; and (arm 3) toolkit, in-person training, plus practice facilitation with on-site visits. We use a mixed methods approach to data collection and analysis: (i) baseline surveys on study clinic characteristics, to explore how these characteristics impact the clinics' ability to implement the tools and the effectiveness of each implementation strategy; (ii) quantitative data on change in rates of guideline-concordant prescribing; and (iii) qualitative data on the "how" and "why" underlying the quantitative results. The outcomes of interest are clinic-level results, categorized using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, within an interrupted time-series design with segmented regression models. This pragmatic trial will compare how well each implementation strategy works in "real-world" practices. Having a better understanding of how different

Survey of Employees' Safety Attitude in a Teaching Hospital Tehran 2010

Directory of Open Access Journals (Sweden)

M. Mahmmoudi

2011-01-01

Full Text Available Background and aimsThe Medical Errors and the potential unsafe actions are always regarded as a serious trouble by the managers and health care providers. Using the employees' attitude data as a measurement criterion in the evaluation of the hospitals performance in the field of the “Safety” can improve the safety level among the personnel and patients . Survey of employees' attitude about safety and its comparison with different groups of offering health services in a teaching Hospital was the main objective of present study.   MethodsIn order to specify patient safety culture in Moddares hospital, all employees including physicians, nurses, managers and employees of Para-clinic, a volume sample consisting of 212 persons were selected. Then it was used from questionnaire of safety attitude within 6 dimensions including Teamwork climate, Safety climate, perceptions of Management , Job Satisfaction, Working Conditions and Stress Recognition. At first this questionnaire was gone under assessing validity and trust. The scale of measuring, Likert was 5 grades. In order to specify difference between groups under study it was used from ANOVA test.   Results Positive safety culture within 6 dimensions including Teamwork Climate, Safety climate, Job Satisfaction, Stress Recognition, Perception of Management , Working Conditions for doctors were 3, 4.13, 17.4, 0, 4.3, and 8.7 respectively; the aforesaid Dimensions for nurses were 19, 2.6, 10.3, 7.8, 2.6 and 15.5 respectively, the aforesaid Dimensions for managers were 30.3, 6.1, 33.3, 0, 18.2 and 21.2 respectively and the aforesaid Dimensions for employees of Para-clinic Were 50, 12.5, 25, 12.5, 10 and 37.5 respectively. There was Significant difference from View Point of statistics (p<0.5 from Dimensions of Job satisfaction among managers and nurses, employees of Para-clinic and nurses this difference Were zero and 0.001. From View Point of Stress recognition among managers and employees of Para

Evaluating Behavioral Skills Training with and without Simulated in Situ Training for Teaching Safety Skills to Children

Science.gov (United States)

Miltenberger, Raymond; Gross, Amy; Knudson, Peter; Bosch, Amanda; Jostad, Candice; Breitwieser, Carrie Brower

2009-01-01

This study compared the effectiveness of behavioral skills training (BST) to BST plus simulated in situ training (SIT) for teaching safety skills to children to prevent gun play. The results were evaluated in a posttest only control group design. Following the first assessment, participants in both training groups and the control group who did not…

Water Safety

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Water Safety KidsHealth / For Parents / Water Safety What's in ... remains your best measure of protection. Making Kids Water Wise It's important to teach your kids proper ...

Introducing standardized “readbacks” to improve patient safety in surgery: a prospective survey in 92 providers at a public safety-net hospital

Directory of Open Access Journals (Sweden)

Prabhakar Hari

2012-06-01

Full Text Available Abstract Background Communication breakdowns represent the main root cause of preventable complications which lead to harm to surgical patients. Standardized readbacks have been successfully implemented as a main pillar of professional aviation safety for decades, to ensure a safe closed-loop communication between air traffic control and individual pilots. The present study was designed to determine the perception of staff in perioperative services regarding the role of standardized readbacks for improving patient safety in surgery at a single public safety-net hospital and level 1 trauma center. Methods A 12-item questionnaire was sent to 180 providers in perioperative services at Denver Health Medical Center. The survey was designed to determine the individual participants’ perception of (1 appropriateness of current readback processes; (2 willingness to attend a future training module on this topic; (3 specific scenarios in which readbacks may be effective; and (4 perceived major barriers to the implementation of standardized readbacks. Survey results were compared between departments (surgery versus anesthesia and between specific staff roles (attending or midlevel provider, resident physician, nursing staff, using non-parametric tests. Results The response rate to the survey was 50.1 % (n = 92. Respondents overwhelmingly recognized the role of readbacks in reducing communication errors and improving patient safety. There was a strong agreement among respondents to support participation in a readbacks training program. There was no difference in the responses between the surgery and anesthesia departments. There was a statistically significant difference in the healthcare providers willingness to attend a short training module on readbacks (p  The main challenge for respondents, which emanated from their responses, appeared to relate to determining the ideal scenarios in which readbacks may be most appropriately used. Overall

Home closure as a weapon in the Dutch war on drugs: Does judicial review function as a safety net?

Science.gov (United States)

Bruijn, L Michelle; Vols, Michel; Brouwer, Jan G

2018-01-01

A widespread sense of a failing criminal justice system and increased feelings of insecurity changed the response to crime into a culture of control, which is characterized by policies that punish and exclude. In the Netherlands, these influences can be witnessed in the war on drugs where local authorities use their administrative power to close homes involved in drug-related crime. Citizens can invoke judicial review over these administrative interferences by claiming that such closure results in an unfair balance between purposes, means and consequences. This paper assesses whether judicial review functions as a safety net against losing one's home due to drug-related crime. We used doctrinal legal research methods to examine the "law in the books" and empirical legal research methods to analyse the "law in action". We used a survey to investigate how often the drug-related closure power was used in 2015, and we statistically analysed all published case law of Dutch lower courts between 2007 and 2016. The scope of the closure power broadened over the years and our data show that local authorities fiercely make use of this instrument. In 41.4% of the cases, citizens are successful in fighting the closure. While scholarly literature indicates that judicial courts function as safeguards by questioning the proportionality of administrative action, raising a proportionality defence does not necessarily result in a more favourable outcome for citizens. In fact, raising a proportionality defence makes it more likely to result in dismissal of the appeal. The stretched scope of the drug-related closure power together with the relatively low success rate of citizens who fight the loss of their home and a seemingly meaningless proportionality check show no sign of a safety net against the loss of one's home at the suit of a local authority. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

An exploratory qualitative study on perceptions about mosquito bed nets in the Niger Delta: what are the barriers to sustained use?

Directory of Open Access Journals (Sweden)

Galvin KT

2011-04-01

Full Text Available Kathleen T Galvin1, Nick Petford2, Frances Ajose3, Dai Davies41Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset, UK; 2University of Northampton, Northampton, UK; 3Department of Medicine, Lagos State University and The Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; 4Niger Delta Development Initiative, Poole, Dorset, UKBackground: The effectiveness of malaria control programs is determined by an array of complex factors, including the acceptability and sustained use of preventative measures such as the bed net. A small-scale exploratory study was conducted in several locations in the Niger Delta region, Nigeria, to discover barriers against the use of bed nets, in the context of a current drive to scale up net use in Nigeria.Methods: A qualitative approach with a convenience sample was used. One to one interviews with mostly male adult volunteers were undertaken which explored typical living and sleeping arrangements, and perceptions about and barriers against the use of the mosquito prevention bed net.Results: Several key issues emerged from the qualitative data. Bed nets were not reported as widely used in this small sample. The reasons reported for lack of use included issues of convenience, especially net set up and dismantling; potential hazard and safety concerns; issues related to typical family composition and nature of accommodation; humid weather conditions; and perceptions of cost and effectiveness. Most barriers to net use concerned issues about everyday practical living and sleeping arrangements and perceptions about comfort. Interviewees identified were aware of malaria infection risks, but several also indicated certain beliefs that were barriers to net use.Conclusions: Successful control of malaria and scale up of insecticide-treated net coverage relies on community perceptions and practice. This small study has illuminated a number of important everyday life issues, which remain barriers to

Keys to Successful Diabetes Self-Management for Uninsured Patients: Social Support, Observational Learning, and Turning Points A Safety Net Providers’ Strategic Alliance Study

Science.gov (United States)

Hanahan, Melissa A.; Werner, James J.; Tomsik, Phillip; Weirich, Stephen A.; Reichsman, Ann; Navracruz, Lisa; Clemons-Clark, Terri; Cella, Peggi; Terchek, Joshua; Munson, Michelle R.

2015-01-01

Objective To determine how medically uninsured patients with limited material resources successfully manage diabetes. Methods Clinicians at 5 safety net practices enrolled uninsured adult patients (N=26) with prior diagnosis of diabetes for 6 months or longer. Patients were interviewed about enabling factors, motivations, resources, and barriers. Chart reviews and clinician surveys supplemented interview data. Interview, survey, and chart review data were analyzed and findings were summarized. Results Two distinct groups of patients were investigated: 1) “successful,” defined as those with an HbA1c of ≤7% or a recent improvement of at least 2% (n=17); and 2) “unsuccessful,” defined as patients with HbA1c of ≥9% (n=9) without recent improvement. In comparison to unsuccessful patients, successful patients more often reported having friends or family with diabetes, sought information about the disease, used evidence-based self-management strategies, held an accurate perception of their own disease control, and experienced “turning point” events that motivated increased efforts in disease management. Conclusions Uninsured safety net patients who successfully managed diabetes learned from friends and family with diabetes and leveraged disease-related events into motivational turning points. It may be beneficial for clinicians to incorporate social learning and motivational enhancement into diabetes interventions to increase patients’ motivation for improved levels of self-management. PMID:21671529

Criticality Safety Information Resource Center Web portal: www.csirc.net

International Nuclear Information System (INIS)

Harmon, C.D. II; Jones, T.

2000-01-01

The Nuclear Criticality Safety Group (ESH-6) at Los Alamos National Laboratory (LANL) is in the process of collecting and archiving historical and technical information related to nuclear criticality safety from LANL and other facilities. In an ongoing effort, this information is being made available via the Criticality Safety Information Resource Center (CSIRC) web site, which is hosted and maintained by ESH-6 staff. Recently, the CSIRC Web site was recreated as a Web portal that provides the criticality safety community with much more than just archived data

The NordiNet® International Outcome Study and NovoNet® ANSWER Program®

DEFF Research Database (Denmark)

Höybye, Charlotte; Sävendahl, Lars; Christesen, Henrik Thybo

2013-01-01

on the safety and effectiveness of reallife treatment with the recombinant human GH, Norditropin®. We describe the origins, aims, objectives, and design methodology of the studies, as well as their governance and validity, strengths, and limitations. CONCLUSION: The NordiNet® IOS and ANSWER Program® studies...... will provide valid insights into the effectiveness and safety of GH treatment across a diverse and large patient population treated in accordance with real-world clinical practice and following the Good Pharmacoepidemiological Practice and STrengthening the Reporting of OBservational studies in Epidemiology......OBJECTIVE: Randomized controlled trials have shown that growth hormone (GH) therapy has effects on growth, metabolism, and body composition. GH therapy is prescribed for children with growth failure and adults with GH deficiency. Carefully conducted observational study of GH treatment affords...

Barriers and Facilitators to Online Portal Use Among Patients and Caregivers in a Safety Net Health Care System: A Qualitative Study.

Science.gov (United States)

Tieu, Lina; Sarkar, Urmimala; Schillinger, Dean; Ralston, James D; Ratanawongsa, Neda; Pasick, Rena; Lyles, Courtney R

2015-12-03

Patient portals have the potential to support self-management for chronic diseases and improve health outcomes. With the rapid rise in adoption of patient portals spurred by meaningful use incentives among safety net health systems (a health system or hospital providing a significant level of care to low-income, uninsured, and vulnerable populations), it is important to understand the readiness and willingness of patients and caregivers in safety net settings to access their personal health records online. To explore patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital, a safety net hospital. We conducted 16 in-depth interviews with chronic disease patients and caregivers who expressed interest in using the Internet to manage their health. Discussions focused on health care experiences, technology use, and interest in using an online portal to manage health tasks. We used open coding to categorize all the barriers and facilitators to portal use, followed by a second round of coding that compared the categories to previously published findings. In secondary analyses, we also examined specific barriers among 2 subgroups: those with limited health literacy and caregivers. We interviewed 11 patients and 5 caregivers. Patients were predominantly male (82%, 9/11) and African American (45%, 5/11). All patients had been diagnosed with diabetes and the majority had limited health literacy (73%, 8/11). The majority of caregivers were female (80%, 4/5), African American (60%, 3/5), caregivers of individuals with diabetes (60%, 3/5), and had adequate health literacy (60%, 3/5). A total of 88% (14/16) of participants reported interest in using the portal after viewing a prototype. Major perceived barriers included security concerns, lack of technical skills/interest, and preference for in-person communication. Facilitators to portal use included convenience, health monitoring, and improvements in patient

Evaluating the Effectiveness of Two Teaching Strategies to Improve Nursing Students' Knowledge, Skills, and Attitudes About Quality Improvement and Patient Safety.

Science.gov (United States)

Maxwell, Karen L; Wright, Vivian H

The purpose of this study was to evaluate two teaching strategies with regard to quality and safety education for nurses content on quality improvement and safety. Two groups (total of 64 students) participated in online learning or online learning in conjunction with a flipped classroom. A pretest/posttest control group design was used. The use of online modules in conjunction with the flipped classroom had a greater effect on increasing nursing students' knowledge of quality improvement than the use of online modules only. There was no statistically significant difference between the groups for safety.

The relative effectiveness of managed care penetration and the healthcare safety net in reducing avoidable hospitalizations.

Science.gov (United States)

Pracht, Etienne E; Orban, Barbara L; Comins, Meg M; Large, John T; Asin-Oostburg, Virginia

2011-01-01

Avoidable hospitalizations represent a key indicator for access to, and the quality of, primary care. Therefore, understanding their behavior is essential in terms of management of healthcare resources and costs. This analysis examines the affect of 2 healthcare strategies on the rate of avoidable hospitalization, managed care and the healthcare safety net. The avoidable hospitalizations definition developed by Weissman et al. (1992) was used to identify relevant inpatient episodes. A 2-stage simultaneous equations multivariate regression model with instrumental variables was used to estimate the relative influence of HMO penetration and the composition of local hospital markets on the rate of avoidable hospitalizations. Control variables in the model include healthcare supply and demand, demographic, socioeconomic, and health status characteristics. Increased market presence of public hospitals significantly reduced avoidable hospitalizations. HMO penetration did not influence the rate of avoidable hospitalizations. The results suggest that public investments in healthcare facilities and infrastructure are more effective in reducing avoidable hospitalizations. © 2011 National Association for Healthcare Quality.

International Clean Energy System Using Hydrogen Conversion (WE-NET). subtask 3. Conceptual design of the total system (safety measures and evaluation technology); Suiso riyo kokusai clean energy system gijutsu (WE-NET). subtask 3. Zentai system gainen sekkei (anzen taisaku hyoka gijutsu)

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-03-01

Safety measures and assessment technology were studied for the WE-NET project. As the study result in fiscal 1996, the information on safety design, anomaly and accident was collected and arranged. The information on safety measures, ideology and criterion was also collected by visiting some domestic and overseas organizations experienced about handling of liquid hydrogen (LH). The initial survey was made for the safety design ideology, analytical technique and disaster preventive measures of LNG systems as the similar cold liquid system. Accidents and explosion accident of a hydrogen production plant (water electrolysis) in Germany were analyzed. Events on storage tanks and leakage around the tanks were studied as typical risk of LH considering temporary and LNG system design information. The model based on the LH spillage test result and 3-D dispersion of vapor cloud were prepared by modifying a simulation code. The model allowed evaluation of the effect of explosion and fire accidents of compressed hydrogen gas and flying fragments on structures and people, and visual display of distances from a tank and damage conditions. 19 refs., 29 figs., 18 tabs.

The impact of public hospital closure on medical and residency education: implications and recommendations.

Science.gov (United States)

Walker, Kara Odom; Calmes, Daphne; Hanna, Nancy; Baker, Richard

2008-12-01

Challenges around safety-net hospital closure have impacted medical student and resident exposure to urban public healthcare sites that may influence their future practice choices. To assess the impact of the closure of a public safety-net teaching hospital for the clinical medical education of Charles Drew University medical students and residents. Retrospective cohort study of medical students' and residents' and clinical placement into safety-net experiences after the closure of the primary teaching hospital. The hospital closure impacted both medical student and residency training experiences. Only 71% (17/24) of medical student rotations and 13% (23/180) of residents were maintained at public safety-net clinical sittings. The closure of the public safety-net hospital resulted in the loss of 36% of residency training spots sponsored by historically black medical schools in the United States and an even larger negative impact on the number of physicians training in underserved urban areas of Los Angeles County. While the medical educational program changes undertaken in the wake of hospital closure have negatively affected the immediate clinical educational experiences of medical students and residents, it remains to be seen whether the training site location changes will alter their long-term preferences in specialty choice and practice location.

Safety performance indicators for the road network.

NARCIS (Netherlands)

Weijermars, W. Gitelman, V. Papadimitriou, E. Lima De & Azevedo, C.

2010-01-01

Within the 6th FP European project SafetyNet, a team has worked on the development of Safety Performance Indicators (SPIs) on seven road safety related areas. These SPIs reflect the operational conditions of the road traffic system that influence the system's safety performance. SPIs were developed

Exploring Facilitators and Barriers to Initiation and Completion of the Human Papillomavirus (HPV) Vaccine Series among Parents of Girls in a Safety Net System.

Science.gov (United States)

O'Leary, Sean T; Lockhart, Steven; Barnard, Juliana; Furniss, Anna; Dickinson, Miriam; Dempsey, Amanda F; Stokley, Shannon; Federico, Steven; Bronsert, Michael; Kempe, Allison

2018-01-23

Objective: To assess, among parents of predominantly minority, low-income adolescent girls who had either not initiated (NI) or not completed (NC) the HPV vaccine series, attitudes and other factors important in promoting the series, and whether attitudes differed by language preference. Design/Methods: From August 2013-October 2013, we conducted a mail survey among parents of girls aged 12-15 years randomly selected from administrative data in a Denver safety net system; 400 parents from each group (NI and NC) were targeted. Surveys were in English or Spanish. The response rate was 37% (244/660; 140 moved or gone elsewhere; 66% English-speaking, 34% Spanish-speaking). Safety attitudes of NIs and NCs differed, with 40% NIs vs. 14% NC's reporting they thought HPV vaccine was unsafe ( p HPV vaccine before, but now I am" (English-speaking, 23%, Spanish-speaking, 50%). Items rated as very important among NIs in the decision regarding vaccination included: more information about safety (74%), more information saying it prevents cancer (70%), and if they knew HPV was spread mainly by sexual contact (61%). Conclusions : Safety concerns, being unaware of the need for multiple doses, and low perceived risk of infection remain significant barriers to HPV vaccination for at-risk adolescents. Some parents' safety concerns do not appear until initial vaccination.

Technology-facilitated depression care management among predominantly Latino diabetes patients within a public safety net care system: comparative effectiveness trial design.

Science.gov (United States)

Wu, Shinyi; Ell, Kathleen; Gross-Schulman, Sandra G; Sklaroff, Laura Myerchin; Katon, Wayne J; Nezu, Art M; Lee, Pey-Jiuan; Vidyanti, Irene; Chou, Chih-Ping; Guterman, Jeffrey J

2014-03-01

Health disparities in minority populations are well recognized. Hispanics and Latinos constitute the largest ethnic minority group in the United States; a significant proportion receives their care via a safety net. The prevalence of diabetes mellitus and comorbid depression is high among this group, but the uptake of evidence-based collaborative depression care management has been suboptimal. The study design and baseline characteristics of the enrolled sample in the Diabetes-Depression Care-management Adoption Trial (DCAT) establishes a quasi-experimental comparative effectiveness research clinical trial aimed at accelerating the adoption of collaborative depression care in safety net clinics. The study was conducted in collaboration with the Los Angeles County Department of Health Services at eight county-operated clinics. DCAT has enrolled 1406 low-income, predominantly Hispanic/Latino patients with diabetes to test a translational model of depression care management. This three-group study compares usual care with a collaborative care team support model and a technology-facilitated depression care model that provides automated telephonic depression screening and monitoring tailored to patient conditions and preferences. Call results are integrated into a diabetes disease management registry that delivers provider notifications, generates tasks, and issues critical alerts. All subjects receive comprehensive assessments at baseline, 6, 12, and 18 months by independent English-Spanish bilingual interviewers. Study outcomes include depression outcomes, treatment adherence, satisfaction, acceptance of assessment and monitoring technology, social and economic stress reduction, diabetes self-care management, health care utilization, and care management model cost and cost-effectiveness comparisons. DCAT's goal is to optimize depression screening, treatment, follow-up, outcomes, and cost savings to reduce health disparities. Copyright © 2013 Elsevier Inc. All rights

Appropriate Determination of Net Working Capital in Corporate Financial Management

Directory of Open Access Journals (Sweden)

Zdeněk Motlíček

2015-01-01

Full Text Available Liquidity and working capital management belongs to one of the fundamental tasks of short-term financial management. However, in the context of net working capital, the issue of management of current assets and liabilities significantly overlaps with long-term financial management, in which the effects of various decisions have long-term consequences, with considerable inertia and possibility of high losses. The present study is therefore focused on the determination of appropriate amount of working capital, as an important part of financial decision making process in the company. The paper presents an empirical research aiming to identify the appropriate approach to accurate calculations of net working capital and determining its needs. The main contribution of the study can be found in the verification of calculation method of net working capital needs, which, according to the authors, may be beneficial both for business practice and teaching of financial management at universities.

Mobile phone use patterns and preferences in safety net office-based buprenorphine patients.

Science.gov (United States)

Tofighi, Babak; Grossman, Ellie; Buirkle, Emily; McNeely, Jennifer; Gourevitch, Marc; Lee, Joshua D

2015-01-01

Integrating mobile phone technologies in addiction treatment is of increasing importance and may optimize patient engagement with their care and enhance the delivery of existing treatment strategies. Few studies have evaluated mobile phone and text message (TM) use patterns in persons enrolled in addiction treatment, and none have assessed the use in safety net, office-based buprenorphine practices. A 28-item, quantitative and qualitative semistructured survey was administered to opiate-dependent adults in an urban, publicly funded, office-based buprenorphine program. Survey domains included demographic characteristics, mobile phone and TM use patterns, and preferences pertaining to their recovery. Surveyors approached 73 of the 155 eligible subjects (47%); 71 respondents completed the survey. Nearly all participants reported mobile phone ownership (93%) and TM use (93%), and most reported "very much" or "somewhat" comfort sending TM (79%). Text message contact with 12-step group sponsors, friends, family members, and counselors was also described (32%). Nearly all preferred having their providers' mobile phone number (94%), and alerting the clinic via TM in the event of a potential relapse to receive both supportive TM and a phone call from their buprenorphine provider was also well received (62%). Mobile phone and TM use patterns and preferences among this sample of office-based buprenorphine participants highlight the potential of adopting patient-centered mobile phone-based interventions in this treatment setting.

Petri nets - part 1: concepts and application areas

International Nuclear Information System (INIS)

Sivertsen, Terje

2004-03-01

There exist a number of models, languages, methods, and tools that support the specification and analysis of system requirements. One important class comprises graphical methods based on the concept of Petri nets. Due to the wide variety of applications, these methods are relevant also in research and applications outside the digital systems safety domain. The present report constitutes the first of three parts of a unified exposition of graphical methods based on the concept of Petri nets. The report provides an introduction to basic concepts of Petri nets and an overview of a wide variety of application areas. The second part of the trilogy will present a number of techniques and tools. The third part will focus on analysis. Petri nets have been proposed for a wide variety of applications, and new areas are considered as new challenges emerge from scientific, technological, and social developments. The wide variety of application areas reflects a broad interest in Petri nets, coming from diverse directions. Empirically, as well as theoretically, there are good reasons to claim that Petri nets are applicable for many different kinds of problems. What is common to the different applications and problems addressed is the need for a formalism that allows adequate representation of important system characteristics like concurrency, asyncronicity, distribution, parallelism, and non-determinism. Several of the references in the report discuss NPP-related applications, or applications with great potentials for technology transfer from other areas to the nuclear domain. (Author)

Development of a Reality-Based Multimedia Case Study Teaching Method and Its Effect on Students' Planned Food Safety Behaviors

Science.gov (United States)

Alberts, Caitlin M.; Stevenson, Clinton D.

2017-01-01

There is opportunity to decrease the frequency of foodborne illnesses by improving food safety competencies and planned behaviors of college students before they begin careers in the food industry. The objectives of this study were to (1) develop a multimedia case study teaching method that provides real world context for food science education;…

Artisanal fishing net float loss and a proposal for a float design solution

Directory of Open Access Journals (Sweden)

Paulo de Tarso Chaves

2016-03-01

Full Text Available Abstract Plastic floats from fishing nets are commonly found washed up on beaches in southern Brazil. They are usually broken and show signs of having been repaired. Characteristics of floats and interviews with fishermen suggest two main causes of float loss. First, collisions between active gear, bottom trawl nets for shrimp, and passive gear, drift nets for fish, destroy nets and release fragments of them, including floats. Second, the difficulty with which floats are inserted on the float rope of the nets when they are used near the surface. Floats are inserted to replace damaged or lost floats, or they may be removed if it is desired that the nets be used in deeper waters. Floats may thus be poorly fixed to the cables and lost. Here a new float design that offers greater safety in use and for the replacement of floats is described and tested.

SU-D-BRD-06: Creating a Safety Net for a Fully Automated, Script Driven Electronic Medical Record

Energy Technology Data Exchange (ETDEWEB)

Sheu, R; Ghafar, R; Powers, A; Green, S; Lo, Y [Mount Sinai Medical Center, New York, NY (United States)

2015-06-15

Purpose: Demonstrate the effectiveness of in-house software in ensuring EMR workflow efficiency and safety. Methods: A web-based dashboard system (WBDS) was developed to monitor clinical workflow in real time using web technology (WAMP) through ODBC (Open Database Connectivity). Within Mosaiq (Elekta Inc), operational workflow is driven and indicated by Quality Check Lists (QCLs), which is triggered by automation software IQ Scripts (Elekta Inc); QCLs rely on user completion to propagate. The WBDS retrieves data directly from the Mosaig SQL database and tracks clinical events in real time. For example, the necessity of a physics initial chart check can be determined by screening all patients on treatment who have received their first fraction and who have not yet had their first chart check. Monitoring similar “real” events with our in-house software creates a safety net as its propagation does not rely on individual users input. Results: The WBDS monitors the following: patient care workflow (initial consult to end of treatment), daily treatment consistency (scheduling, technique, charges), physics chart checks (initial, EOT, weekly), new starts, missing treatments (>3 warning/>5 fractions, action required), and machine overrides. The WBDS can be launched from any web browser which allows the end user complete transparency and timely information. Since the creation of the dashboards, workflow interruptions due to accidental deletion or completion of QCLs were eliminated. Additionally, all physics chart checks were completed timely. Prompt notifications of treatment record inconsistency and machine overrides have decreased the amount of time between occurrence and execution of corrective action. Conclusion: Our clinical workflow relies primarily on QCLs and IQ Scripts; however, this functionality is not the panacea of safety and efficiency. The WBDS creates a more thorough system of checks to provide a safer and near error-less working environment.

SU-D-BRD-06: Creating a Safety Net for a Fully Automated, Script Driven Electronic Medical Record

International Nuclear Information System (INIS)

Sheu, R; Ghafar, R; Powers, A; Green, S; Lo, Y

2015-01-01

Purpose: Demonstrate the effectiveness of in-house software in ensuring EMR workflow efficiency and safety. Methods: A web-based dashboard system (WBDS) was developed to monitor clinical workflow in real time using web technology (WAMP) through ODBC (Open Database Connectivity). Within Mosaiq (Elekta Inc), operational workflow is driven and indicated by Quality Check Lists (QCLs), which is triggered by automation software IQ Scripts (Elekta Inc); QCLs rely on user completion to propagate. The WBDS retrieves data directly from the Mosaig SQL database and tracks clinical events in real time. For example, the necessity of a physics initial chart check can be determined by screening all patients on treatment who have received their first fraction and who have not yet had their first chart check. Monitoring similar “real” events with our in-house software creates a safety net as its propagation does not rely on individual users input. Results: The WBDS monitors the following: patient care workflow (initial consult to end of treatment), daily treatment consistency (scheduling, technique, charges), physics chart checks (initial, EOT, weekly), new starts, missing treatments (>3 warning/>5 fractions, action required), and machine overrides. The WBDS can be launched from any web browser which allows the end user complete transparency and timely information. Since the creation of the dashboards, workflow interruptions due to accidental deletion or completion of QCLs were eliminated. Additionally, all physics chart checks were completed timely. Prompt notifications of treatment record inconsistency and machine overrides have decreased the amount of time between occurrence and execution of corrective action. Conclusion: Our clinical workflow relies primarily on QCLs and IQ Scripts; however, this functionality is not the panacea of safety and efficiency. The WBDS creates a more thorough system of checks to provide a safer and near error-less working environment

Horizontal ichthyoplankton tow-net system with unobstructed net opening

Science.gov (United States)

Nester, Robert T.

1987-01-01

The larval fish sampler described here consists of a modified bridle, frame, and net system with an obstruction-free net opening and is small enough for use on boats 10 m or less in length. The tow net features a square net frame attached to a 0.5-m-diameter cylinder-on-cone plankton net with a bridle designed to eliminate all obstructions forward of the net opening, significantly reducing currents and vibrations in the water directly preceding the net. This system was effective in collecting larvae representing more than 25 species of fish at sampling depths ranging from surface to 10 m and could easily be used at greater depths.

Higher-moment measurements of net-kaon, net-charge and net-proton multiplicity distributions at STAR

International Nuclear Information System (INIS)

Sarkar, Amal

2014-01-01

In this paper, we report the measurements of the various moments, such as mean, standard deviation (σ), skewness (S) and kurtosis (κ) of the net-kaon, net-charge and net-proton multiplicity distributions at mid-rapidity in Au + Au collisions from √(s NN )=7.7 to 200 GeV with the STAR experiment at RHIC. This work has been done with the aim to locate the critical point on the QCD phase diagram. These moments and their products are related to the thermodynamic susceptibilities of conserved quantities such as net baryon number, net charge, and net strangeness as well as to the correlation length of the system which diverges in an ideal infinite thermodynamic system at the critical point. For a finite system, existing for a finite time, a non-monotonic behavior of these variables would indicate the presence of the critical point. Furthermore, we also present the moment products Sσ, κσ 2 of net-kaon, net-charge and net-proton multiplicity distributions as a function of collision centrality and energy. The energy and the centrality dependence of higher moments and their products have been compared with different models

URBAN-NET: A Network-based Infrastructure Monitoring and Analysis System for Emergency Management and Public Safety

Energy Technology Data Exchange (ETDEWEB)

Lee, Sangkeun (Matt) [ORNL; Chen, Liangzhe [ORNL; Duan, Sisi [ORNL; Chinthavali, Supriya [ORNL; Shankar, Mallikarjun (Arjun) [ORNL; Prakash, B. Aditya [Virginia Tech, Blacksburg, VA

2016-01-01

Abstract Critical Infrastructures (CIs) such as energy, water, and transportation are complex networks that are crucial for sustaining day-to-day commodity flows vital to national security, economic stability, and public safety. The nature of these CIs is such that failures caused by an extreme weather event or a man-made incident can trigger widespread cascading failures, sending ripple effects at regional or even national scales. To minimize such effects, it is critical for emergency responders to identify existing or potential vulnerabilities within CIs during such stressor events in a systematic and quantifiable manner and take appropriate mitigating actions. We present here a novel critical infrastructure monitoring and analysis system named URBAN-NET. The system includes a software stack and tools for monitoring CIs, pre-processing data, interconnecting multiple CI datasets as a heterogeneous network, identifying vulnerabilities through graph-based topological analysis, and predicting consequences based on what-if simulations along with visualization. As a proof-of-concept, we present several case studies to show the capabilities of our system. We also discuss remaining challenges and future work.

Simulation as a surgical teaching model.

Science.gov (United States)

Ruiz-Gómez, José Luis; Martín-Parra, José Ignacio; González-Noriega, Mónica; Redondo-Figuero, Carlos Godofredo; Manuel-Palazuelos, José Carlos

2018-01-01

Teaching of surgery has been affected by many factors over the last years, such as the reduction of working hours, the optimization of the use of the operating room or patient safety. Traditional teaching methodology fails to reduce the impact of these factors on surgeońs training. Simulation as a teaching model minimizes such impact, and is more effective than traditional teaching methods for integrating knowledge and clinical-surgical skills. Simulation complements clinical assistance with training, creating a safe learning environment where patient safety is not affected, and ethical or legal conflicts are avoided. Simulation uses learning methodologies that allow teaching individualization, adapting it to the learning needs of each student. It also allows training of all kinds of technical, cognitive or behavioural skills. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Fiscal 1997 survey report. Subtask 3 (hydrogen utilization worldwide clean system technology) (WE-NET) (total system conceptual design/safety measures/evaluation technology); 1997 nendo seika hokokusho. Suiso riyo kokusai clean energy system gijutsu (WE-NET) subtask 3 zentai system gainen sekkei - anzen taisaku hyoka gijutsu

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-03-01

Concerning the study of safety measures in WE-NET, the paper described the fiscal 1997 results. For drawing up a policy for safety design, technology of preserving hydrogen at high temperature/pressure, continuing collecting information on existing plants (liquid hydrogen, LNG). Investigating manuals of NASA and NASDA and also referring to people`s opinions at chemical plants, etc., the study entered into the setting-up of the safety policy and design standards. Examples of anomalies/accidents were extracted, and classification/arrangement were commenced of the measures for anomalies of detection/prevention/protection. Toward the diffusion of hydrogen and the enhancement and unification of explosion/fire simulation models, the extraction of problems has been almost finished. The second mini work shop on safety was held in the U.S., and exchanges of information were made among researchers of each country. All agreed on the importance of collecting data as the base of safety standards. As to safety measures in various tests using combustor evaluation experimental facilities, experimental equipment for materials under liquid hydrogen and experimental equipment of thermal insulation under liquid hydrogen, problems were extracted between researchers and people concerned with safety measures, and the measures to solve them were studied. 18 refs., 31 figs., 10 tabs.

The use of open source electronic health records within the federal safety net.

Science.gov (United States)

Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri

2014-01-01

To conduct a federally funded study that examines the acquisition, implementation and operation of open source electronic health records (EHR) within safety net medical settings, such as federally qualified health centers (FQHC). The study was conducted by the National Opinion Research Center (NORC) at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to West Virginia, California and Arizona FQHC that were currently using an open source EHR. Five of the six sites that were chosen as part of the study found a number of advantages in the use of their open source EHR system, such as utilizing a large community of users and developers to modify their EHR to fit the needs of their provider and patient communities, and lower acquisition and implementation costs as compared to a commercial system. Despite these advantages, many of the informants and site visit participants felt that widespread dissemination and use of open source was restrained due to a negative connotation regarding this type of software. In addition, a number of participants stated that there is a necessary level of technical acumen needed within the FQHC to make an open source EHR effective. An open source EHR provides advantages for FQHC that have limited resources to acquire and implement an EHR, but additional study is needed to evaluate its overall effectiveness.

Fiscal 1999 phase 2 R and D report of WE-NET (International Clean Energy Network Using Hydrogen Conversion). Task 2. Research on safety measures; 1999 nendo suiso riyo kokusai clean energy system gijutsu (WE-NET) dainiki kenkyu kaihatsu seika hokokusho. Task 2. Anzen taisaku ni kansuru chosa kenkyu

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-03-01

This report summarizes the fiscal 1999 WE-NET phase 2, task 2 research result on safety measures. In the study on preparation of the safety design standard, based on the concept design of the hydrogen supply station under investigation in task 7, latent anomalies and accidents, safety measures against them, and precautions for the safety design were arranged. Survey was made on databases available to collect failure rates necessary for quantitative risk assessment. In the study on establishment of a safety evaluation method, an evaporation apparatus for liquid hydrogen was prepared for comparative experiment with liquid nitrogen. Various information on flow and evaporation properties of liquid hydrogen were obtained. Survey was made on previously reported documents for hydrogen explosion experiment and preparation of an experiment plan. The simulation model for spillage, evaporation and diffusion of liquid hydrogen was verified and improved on the basis of the experiment results. A commercially available computation program for hydrogen deflagration was introduced, and its implementation was studied. (NEDO)

The present condition and projection of construction of railway net of the Danube-Morava corridor

Directory of Open Access Journals (Sweden)

Vemić Mirčeta

2005-01-01

Full Text Available The railway net of the Danube-Morava corridor, together with the road net represent the central section of the Pan-European transport corridor X. According to the traffic and economic standards, the railway net represents the second main traffic direction of this corridor as the area-functioning system of the territory of Serbia. Main railway lines have favourable positions as they are located along prominent geographical features, namely river valleys thus enabling considerable flow of goods, passengers and information. The paper presents some characteristics of the present condition of the railway net, its functioning and safety, with certain ideas of its future construction and expected exploitation till 2015. Traffic infrastructure represents the initial factor of overall development of a state and its connection with the surrounding countries. It is considered to be of strategic importance for a country to built railway net. Improvement and additional construction of railway lines is of the greatest priority for the purpose of enlargement of overall mobility and quality of life of population, to make urban areas closer, to improve connections, functions efficiency and level of services of railway system, reduction of negative influence on other economic systems and human environment, better safety etc.

A dynamic simulation to study NET in-vessel handling operations

International Nuclear Information System (INIS)

Fung, P.T.F.

1989-01-01

The inspection, maintenance and repair of the Next European Torus (NET) fusion machine will require the extensive use of remote handling equipment to minimise the human exposure to the high radiation environment. The use of efficient manipulators will reduce the NET downtime by reducing the preparation time for entry into the controlled area and by performing the task with reasonable area and by performing the task with reasonable dexterity and speed, consistent with safety. A high fidelity simulation is a valuable tool to assist in the manipulator design, operations, trajectory planning, parameter optimisation and system verification. A manipulator simulation package called ASAD was originally developed by Spar for space manipulator applications. It is now being adapted to simulate the in-Vessel HandlingUnit for the NET program. This terestrial version of ASAD has been name ASAD - T. Spar, through the services of the Canadian Fusion Fuels Technology Project, is under contract to the NET program for the performance of this activity. This paper describes the capabillities and underlying assumptions of ASAD - T, aling with description of the simulation development of the NET in-vessel manipulator. (author). 4 refs.; 7 figs

SupportNet for Frontline Behavioral Health Providers

Science.gov (United States)

2014-06-30

to help women and their children achieve safety and wellbeing while challenging communities to end sexual and family violence. In the process, TESSA...did not engage with the SupportNet intervention as a function of their level of burnout. Lack of military support was cited by staff as being a barrier...October 2013, which resulted in government employees being furloughed. Since the project itself was funded by the Department of Defense, the project was

Net-baryon-, net-proton-, and net-charge kurtosis in heavy-ion collisions within a relativistic transport approach

International Nuclear Information System (INIS)

Nahrgang, Marlene; Schuster, Tim; Stock, Reinhard; Mitrovski, Michael; Bleicher, Marcus

2012-01-01

We explore the potential of net-baryon, net-proton and net-charge kurtosis measurements to investigate the properties of hot and dense matter created in relativistic heavy-ion collisions. Contrary to calculations in a grand-canonical ensemble we explicitly take into account exact electric and baryon charge conservation on an event-by-event basis. This drastically limits the width of baryon fluctuations. A simple model to account for this is to assume a grand-canonical distribution with a sharp cut-off at the tails. We present baseline predictions of the energy dependence of the net-baryon, net-proton and net-charge kurtosis for central (b≤2.75 fm) Pb+Pb/Au+Au collisions from E lab =2A GeV to √(s NN )=200 GeV from the UrQMD model. While the net-charge kurtosis is compatible with values around zero, the net-baryon number decreases to large negative values with decreasing beam energy. The net-proton kurtosis becomes only slightly negative for low √(s NN ). (orig.)

The Economic Impact of Productive Safety Net Program on Poverty: Microeconometrics Analysis, Tigrai National Regional State, Ethiopia

Directory of Open Access Journals (Sweden)

Yibrah Hagos Gebresilassie

2014-08-01

Full Text Available This paper aims at evaluating the impact of productive safety net program on poverty using primary data from randomly selected 600 households in central zone of Tigrai National Regional State, Ethiopia. Propensity Score Matching and Foster-Greer-Thorbecke were used to evaluate impact of the program and poverty, respectively. The paper revealed that the program has positive and significant effect on consumption, livestock holdings, and productive assets. Moreover, impact of the program on total consumption expenditure per adult equivalent was found to be positive and significant. Using total poverty line, poverty rate was lowest among program participants (30.33% than non-participants (31.1%. Highest poverty rate was found among households headed by women (38.42% while households headed by men (23.1%. The study also revealed that the program has positive and significant effect on poverty reduction and protecting productive assets. Finally, it was recommended that female headed program participants based programs should be provided to help boost their agricultural output and reduce endemic poverty.

Work Disability Among Native-born and Foreign-born Americans: On Origins, Health, and Social Safety Nets.

Science.gov (United States)

Engelman, Michal; Kestenbaum, Bert M; Zuelsdorff, Megan L; Mehta, Neil K; Lauderdale, Diane S

2017-12-01

Public debates about both immigration policy and social safety net programs are increasingly contentious. However, little research has explored differences in health within America's diverse population of foreign-born workers, and the effect of these workers on public benefit programs is not well understood. We investigate differences in work disability by nativity and origins and describe the mix of health problems associated with receiving Social Security Disability Insurance benefits. Our analysis draws on two large national data sources-the American Community Survey and comprehensive administrative records from the Social Security Administration-to determine the prevalence and incidence of work disability between 2001 and 2010. In sharp contrast to prior research, we find that foreign-born adults are substantially less likely than native-born Americans to report work disability, to be insured for work disability benefits, and to apply for those benefits. Overall and across origins, the foreign-born also have a lower incidence of disability benefit award. Persons from Africa, Northern Europe, Canada, and parts of Asia have the lowest work disability benefit prevalence rates among the foreign-born; persons from Southern Europe, Western Europe, the former Soviet Union, and the Caribbean have the highest rates.

Petri Nets

Indian Academy of Sciences (India)

In a computer system, for example, typical discrete events ... This project brought out a series of influential reports on Petri net theory in the mid and late ... Technology became a leading centre for Petri net research and from then on, Petri nets ...

A multi-tiered approach to safety education.

Science.gov (United States)

Oates, Kim; Sammut, John; Kennedy, Peter

2013-08-01

The World Health Organization has recognised that patient safety education should begin at the undergraduate level. This should not just be for medical students, but for all students in the health professions. Although all students in the health professions should receive a basic grounding in patient safety, there is also a need to develop future leaders in this field. As a result of widespread early student exposure, some students may become interested in learning more. It follows that a postgraduate approach is also needed. The New South Wales Clinical Excellence Commission (CEC) has initiated a tiered approach to patient safety education by providing patient safety teaching in medical, nursing and allied health schools. Teaching is provided in cooperation with the host university, and is interactive, using a mixture of interactive lectures, video clips, films and break-out groups to discuss scenarios and feedback from students to their peers about the concepts they have discussed. For medical graduates, the CEC has initiated patient safety teaching in the early postgraduate years, and provides an elective in patient safety for trainee doctor specialists as part of their accredited training. This process helps to identify and mentor future medical leaders in this field. In addition to teaching the core principles of patient safety to a wide range of students in the health professions, an approach for developing future leaders will provide additional opportunities for motivated students and create opportunities for continuing development in the early postgraduate years and beyond. © 2013 John Wiley & Sons Ltd.

Preparing Net Gen pre-service teachers for digital native classrooms

Directory of Open Access Journals (Sweden)

Valentin Ekiaka Nzai

2014-09-01

Full Text Available This paper explored Net Gen Bilingual pre-service teachers’ perspectives future digital native classrooms based on the National Education Technology Plan (2010 postulates. Participants were Seven Net Gen bilingual future teachers enrolled at a semester – long laboratory of practices project for Literacy Development for English Language Learners. Data were collected using Ginsburg’s (1989 narrative strategy, which consisted of analyzing information from participants’ life stories produced during two audiotaped focus group conversations. Findings showed that pre-service teachers had positive perceptions and beliefs toward the laboratory of practices built upon the experimental cyberlearning workstation frame designed by the authors. The hands-on experiences helped them enhance their digital native-like citizenship in order to meet future students’ individual abilities and learning styles, and stimulate teaching with digital technologies. Some recommendations and limitations are also addressed.

Exploring Facilitators and Barriers to Initiation and Completion of the Human Papillomavirus (HPV Vaccine Series among Parents of Girls in a Safety Net System

Directory of Open Access Journals (Sweden)

Sean T. O’Leary

2018-01-01

Full Text Available Objective: To assess, among parents of predominantly minority, low-income adolescent girls who had either not initiated (NI or not completed (NC the HPV vaccine series, attitudes and other factors important in promoting the series, and whether attitudes differed by language preference. Design/Methods: From August 2013–October 2013, we conducted a mail survey among parents of girls aged 12–15 years randomly selected from administrative data in a Denver safety net system; 400 parents from each group (NI and NC were targeted. Surveys were in English or Spanish. Results: The response rate was 37% (244/660; 140 moved or gone elsewhere; 66% English-speaking, 34% Spanish-speaking. Safety attitudes of NIs and NCs differed, with 40% NIs vs. 14% NC’s reporting they thought HPV vaccine was unsafe (p < 0.0001 and 43% NIs vs. 21% NCs that it may cause long-term health problems (p < 0.001. Among NCs, 42% reported they did not know their daughter needed more shots (English-speaking, 20%, Spanish-speaking 52% and 39% reported that “I wasn’t worried about the safety of the HPV vaccine before, but now I am” (English-speaking, 23%, Spanish-speaking, 50%. Items rated as very important among NIs in the decision regarding vaccination included: more information about safety (74%, more information saying it prevents cancer (70%, and if they knew HPV was spread mainly by sexual contact (61%. Conclusions: Safety concerns, being unaware of the need for multiple doses, and low perceived risk of infection remain significant barriers to HPV vaccination for at-risk adolescents. Some parents’ safety concerns do not appear until initial vaccination.

The Design of NetSecLab: A Small Competition-Based Network Security Lab

Science.gov (United States)

Lee, C. P.; Uluagac, A. S.; Fairbanks, K. D.; Copeland, J. A.

2011-01-01

This paper describes a competition-style of exercise to teach system and network security and to reinforce themes taught in class. The exercise, called NetSecLab, is conducted on a closed network with student-formed teams, each with their own Linux system to defend and from which to launch attacks. Students are expected to learn how to: 1) install…

The equivalency between logic Petri workflow nets and workflow nets.

Science.gov (United States)

Wang, Jing; Yu, ShuXia; Du, YuYue

2015-01-01

Logic Petri nets (LPNs) can describe and analyze batch processing functions and passing value indeterminacy in cooperative systems. Logic Petri workflow nets (LPWNs) are proposed based on LPNs in this paper. Process mining is regarded as an important bridge between modeling and analysis of data mining and business process. Workflow nets (WF-nets) are the extension to Petri nets (PNs), and have successfully been used to process mining. Some shortcomings cannot be avoided in process mining, such as duplicate tasks, invisible tasks, and the noise of logs. The online shop in electronic commerce in this paper is modeled to prove the equivalence between LPWNs and WF-nets, and advantages of LPWNs are presented.

The Equivalency between Logic Petri Workflow Nets and Workflow Nets

Science.gov (United States)

Wang, Jing; Yu, ShuXia; Du, YuYue

2015-01-01

Logic Petri nets (LPNs) can describe and analyze batch processing functions and passing value indeterminacy in cooperative systems. Logic Petri workflow nets (LPWNs) are proposed based on LPNs in this paper. Process mining is regarded as an important bridge between modeling and analysis of data mining and business process. Workflow nets (WF-nets) are the extension to Petri nets (PNs), and have successfully been used to process mining. Some shortcomings cannot be avoided in process mining, such as duplicate tasks, invisible tasks, and the noise of logs. The online shop in electronic commerce in this paper is modeled to prove the equivalence between LPWNs and WF-nets, and advantages of LPWNs are presented. PMID:25821845

Knowledge, attitude and practice of aspects of laboratory safety in Pathology Laboratories at the University of Port Harcourt Teaching Hospital, Nigeria.

Science.gov (United States)

Ejilemele, A A; Ojule, A C

2005-12-01

To assess current knowledge, attitudes and practice of aspects of laboratory safety in pathology laboratories at the University of Port Harcourt Teaching Hospital in view of perceived inadequacies in safety practices in clinical laboratories in developing countries. Sixty (60) self- administered questionnaires were distributed to all cadres of staff in four (4) different laboratories (Chemical Pathology, Haematology, Blood bank and Medical Microbiology) at the Hospital. Gross deficiencies were found in the knowledge, attitudes and practice of laboratory safety by laboratory staff in areas of use of personal protective equipment, specimen collection and processing, centrifuge--related hazards, infective hazards waste disposal and provision and use of First Aid Kits. Issues pertaining to laboratory safety are not yet given adequate attention by both employers and employees in developing countries in this ear of resurgence of diseases such as HIV/AIDS and Hepatitis Band C, is emphasized.

Subject related teaching in udeskole (outdoor school)

DEFF Research Database (Denmark)

Barfod, Karen Seierøe

Subject related teaching in udeskole In this symposium, subject related teaching on a regular basis in the outdoors, known as udeskole will be described and discussed. Based on recent and ongoing research and development, the education taking the place of teaching into account of the learning...... will identify the necessity of doing research into the field, as 18,4% of all Danish schools is shown to have one or more classes working with udeskole (Barfod et al, 2016). Secondly, the subject related teaching in the outdoors will be exemplified by four research projects. First, the subject ‘Danish...... teaching in the outdoors will be supplemented with recent research upon barriers for using external learning environments ‘the open school’ in Skive Muncipiality. Closing the seminar will be a presentation of the national Danish Network UdeskoleNet and its application. Sources: Barfod, K., Ejbye-Ernst, N...

Patient safety in undergraduate radiography curricula: A European perspective

International Nuclear Information System (INIS)

England, A.; Azevedo, K.B.; Bezzina, P.; Henner, A.; McNulty, J.P.

2016-01-01

Purpose: To establish an understanding of patient safety within radiography education across Europe by surveying higher education institutions registered as affiliate members of the European Federation of Radiographer Societies (EFRS). Method: An online survey was developed to ascertain data on: programme type, patient safety definitions, relevant safety topics, specific areas taught, teaching and assessment methods, levels of teaching and curriculum drivers. Responses were identifiable in terms of educational institution and country. All 54 affiliated educational institutions were invited to participate. Descriptive and thematic analyses are reported. Results: A response rate of 61.1% (n = 33) was achieved from educational institutions representing 19 countries. Patient safety topics appear to be extremely well covered across curricula, however, topics including radiation protection and optimisation were not reported as being taught at an ‘advanced level’ by five and twelve respondents, respectively. Respondents identified the clinical department as the location of most patient safety-related teaching. Conclusions: Patient safety topics are deeply embedded within radiography curricula across Europe. Variations exist in terms of individual safety topics including, teaching and assessment methods, and the depth in which subjects are taught. Results from this study provide a baseline for assessing developments in curricula and can also serve as a benchmark for comparisons. - Highlights: • First European report on patient safety (PS). • PS deeply embedded within training curricula. • Terms and definitions largely consistent. • Some variety in the delivery and assessment methods. • Report provides baseline and opportunities for comparisons.

The OA System of College - - Design of the Teaching Quality Monitoring Subsystem

Science.gov (United States)

Wu, Hongjuan; Ying, Hong; Jiang, Youyi; Yan, Pei

According to the drawbacks of traditional teaching quality monitoring subsystems and based on the achievements of practical research in the teaching quality monitoring administration in College, this paper provides a design of overall structure of teaching quality monitoring subsystem, that is more suitable for colleges' management. This new system is endowed with the same features as .NET application programes: easy to extend, easy to maintain, flexible, convenient, and it let enterprises, students' parents and excellent graduates participate in teaching quality monitoring administration, have significant effect to ensure the quality of talent training in colleges.

Coloured Petri Nets

DEFF Research Database (Denmark)

Jensen, Kurt

1987-01-01

The author describes a Petri net model, called coloured Petri nets (CP-nets), by means of which it is possible to describe large systems without having to cope with unnecessary details. The author introduces CP-nets and provide a first impression of their modeling power and the suitability...

Net one, net two: the primary care network income statement.

Science.gov (United States)

Halley, M D; Little, A W

1999-10-01

Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses.

Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).

Science.gov (United States)

Patel, Puja; Hemmeger, Heather; Kozak, Mary Ann; Gernant, Stephanie A; Snyder, Margie E

2015-01-01

To describe the experiences and opinions of pharmacists serving as site coordinators for the Medication Safety Research Network of Indiana (Rx-SafeNet). Retail chain, independent, and hospital/health system outpatient community pharmacies throughout Indiana, with a total of 127 pharmacy members represented by 26 site coordinators. Rx-SafeNet, a statewide practice-based research network (PBRN) formed in 2010 and administered by the Purdue University College of Pharmacy. Barriers and facilitators to participation in available research studies, confidence participating in research, and satisfaction with overall network communication. 22 of 26 site coordinators participated, resulting in an 85% response rate. Most (72.2%) of the respondents had received a doctor of pharmacy degree, and 13.6% had postgraduate year (PGY)1 residency training. The highest reported benefits of PBRN membership were an enhanced relationship with the Purdue University College of Pharmacy (81% agreed or strongly agreed) and enhanced professional development (80% agreed or strongly agreed). Time constraints were identified as the greatest potential barrier to network participation, reported by 62% of respondents. In addition, the majority (59%) of survey respondents identified no prior research experience. Last, respondents' confidence in performing research appeared to increase substantially after becoming network members, with 43% reporting a lack of confidence in engaging in research before joining the network compared with 90% reporting confidence after joining the network. In general, Rx-SafeNet site coordinators appeared to experience increased confidence in research engagement after joining the network. While respondents identified a number of benefits associated with network participation, concerns about potential time constraints remained a key barrier to participation. These findings will assist network leadership in identifying opportunities to positively increase member participation

Can We Do That Here? Establishing the Scope of Surgical Practice at a New Safety-Net Community Hospital Through a Transparent, Collaborative Review of Physician Privileges.

Science.gov (United States)

O'Neill, Sean M; Seresinghe, Sarah; Sharma, Arun; Russell, Tara A; Crawford, L'Orangerie; Frencher, Stanley K

2018-01-01

Stewarding of physician privileges wisely is imperative, but no guidelines exist for how to incorporate system-level factors in privileging decisions. A newly opened, safety-net community hospital tailored the scope of surgical practice through review of physician privileges. Martin Luther King, Jr. Community Hospital is a public-private partnership, safety-net institution in South Los Angeles that opened in July 2015. It has 131 beds, including a 28-bed emergency department, a 20-bed ICU, and 5 operating rooms. Staff privileging decisions were initially based only on physicians' training and experience, but this resulted in several cases that tested the boundaries of what a small community hospital was prepared to handle. A collaborative, transparent process to review physician privileges was developed. This began with physician-only review of procedure lists, followed by a larger, multidisciplinary group to assess system-level factors. Specific questions were used to guide discussion, and unanimous approval from all stakeholders was required to include a procedure. An initial list of 558 procedures across 11 specialties was reduced to 321 (57.5%). No new cases that fall outside these new boundaries have arisen. An inclusive process was crucial for obtaining buy-in and establishing cultural norms. Arranging transfer agreements remains a significant challenge. Accumulation of institutional experience continues through regular performance reviews. As this hospital's capabilities mature, a blueprint has been established for expanding surgical scope of practice based explicitly on system-level factors. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

From learning from accidents to teaching about accident causation and prevention: Multidisciplinary education and safety literacy for all engineering students

International Nuclear Information System (INIS)

Saleh, Joseph H.; Pendley, Cynthia C.

2012-01-01

In this work, we argue that system accident literacy and safety competence should be an essential part of the intellectual toolkit of all engineering students. We discuss why such competence should be taught and nurtured in engineering students, and provide one example for how this can be done. We first define the class of adverse events of interest as system accidents, distinct from occupational accidents, through their (1) temporal depth of causality and (2) diversity of agency or groups and individuals who influence or contribute to the accident occurrence/prevention. We then address the question of why the interest in this class of events and their prevention, and we expand on the importance of system safety literacy and the contributions that engineering students can make in the long-term towards accident prevention. Finally, we offer one model for an introductory course on accident causation and system safety, discuss the course logistics, material and delivery, and our experience teaching this subject. The course starts with the anatomy of accidents and is grounded in various case studies; these help illustrate the multidisciplinary nature of the subject, and provide the students with the important concepts to describe the phenomenology of accidents (e.g., initiating events, accident precursor or lead indicator, and accident pathogen). More importantly, the case studies invite a deep reflection on the underlying failure mechanisms, their generalizability, and the various safety levers for accident prevention. The course then proceeds to an exposition of defense-in-depth, safety barriers and principles, essential elements for an education in accident prevention, and it concludes with a presentation of basic concepts and tools for uncertainty and risk analysis. Educators will recognize the difficulties in designing a new course on such a broad subject. It is hoped that this work will invite comments and contributions from the readers, and that the journal will

Critical safety issues in the design of fusion machines

International Nuclear Information System (INIS)

Kramer, W.

1991-01-01

In the course of developing fusion machines both general safety considerations and safety assessments for the various components and systems of actual machines increase in number and become more and more coherent. This is particularly true for the NET/ITER projects where safety analysis plays an increasing role for the design of the machine. Since in a D/T tokamak the radiological hazards will be dominant basic radiological safety objectives are discussed. Critical safety issues as identified in particular by the NET/ITER community are reviewed. Subsequently, issues of major concern are considered both for normal operation and for conceivable accidents. The following accidents are considered to be crucial: Loss of cooling in plasma facing components, loss of vacuum, tritium system failure, and magnet system failure. To mitigate accident consequences a confinement concept based on passive features and multiple barriers including detritiation and filtering has to be applied. The reactor building as final barrier needs special attention to cope with both internal and external hazards. (orig.)

A MODERNIDADE, O ENSINO DE CIÊNCIAS E A GERAÇÃO NET. A EXPERIMENTAÇÃO COMO ESTRATÉGIA MOTIVACIONAL

Directory of Open Access Journals (Sweden)

Adriano Vieira de Carvalho

2013-08-01

Full Text Available Este trabalho busca apresentar uma proposta para o ensino de disciplinas da área de Ciências da Natureza que se mostre adequada às necessidades da atual clientela estudantil (a geração net, baseando suas estratégias de ensino na utilização de atividades práticas e no uso de ambientes não formais, como fator capaz de obter a motivação dos estudantes e melhorar sua aprendizagem. São descritas algumas das causas geradoras das transformações importantes pelas quais passou a escola nas últimas décadas, a qual acabou por tornar-se incapaz de atender às atuais necessidades dos estudantes, os quais provém de origens bastante diferenciadas e cresceram influenciados pela moderna tecnologia (em especial, pela internet. As características da geração net são discutidas e demonstram ser de difícil harmonização com a forma do ensino tradicional, clamando pela utilização de novos métodos e estratégias.ABSTRACTThis study aims to present a proposal for teaching disciplines of natural sciences show that fits the needs of the current student clientele (net generation, basing their teaching strategies in the use of practical activities and the use of non-formal environments as a factor able to get the motivation of students and improve their learning. Describe some of the causes that generate the major transformations undergone by the school in recent decades, which eventually become unable to meet the current needs of the students, who come from very different backgrounds and grew up influenced by modern technology (especially, the Internet. The characteristics of the net generation are discussed and shown to be difficult to harmonize with the traditional way of teaching, calling for new methods and strategies.Keywords: Teaching of Science with CTSA approach. Preservice Teacher.

Bicycle Safety in Action.

Science.gov (United States)

National Commission on Safety Education, Washington, DC.

This material was designed to assist schools in teaching bicycle safety. As the population grows and competition for road space increases, it is more imperative than ever that we concentrate attention on the need for caution among pupil cyclists. The pamphlet: (1) discusses the role of bicycle safety in classroom instruction and in student…

Effectiveness of direct-acting antiviral therapy for hepatitis C in difficult-to-treat patients in a safety-net health system: a retrospective cohort study.

Science.gov (United States)

Yek, Christina; de la Flor, Carolina; Marshall, John; Zoellner, Cindy; Thompson, Grace; Quirk, Lisa; Mayorga, Christian; Turner, Barbara J; Singal, Amit G; Jain, Mamta K

2017-11-20

Direct-acting antivirals (DAAs) have revolutionized chronic hepatitis C (HCV) treatment, but real-world effectiveness among vulnerable populations, including uninsured patients, is lacking. This study was conducted to characterize the effectiveness of DAAs in a socioeconomically disadvantaged and underinsured patient cohort. This retrospective observational study included all patients undergoing HCV treatment with DAA-based therapy between April 2014 and June 2016 at a large urban safety-net health system (Parkland Health and Hospital System, Dallas, TX, USA). The primary outcome was sustained virologic response (SVR), with secondary outcomes including treatment discontinuation, treatment relapse, and loss to follow-up. DAA-based therapy was initiated in 512 patients. The cohort was socioeconomically disadvantaged (56% uninsured and 13% Medicaid), with high historic rates of alcohol (41%) and substance (50%) use, and mental health disorders (38%). SVR was achieved in 90% of patients (n = 459); 26 patients (5%) were lost to follow-up. SVR was significantly lower in patients with decompensated cirrhosis (82% SVR; OR 0.37, 95% CI 0.16-0.85) but did not differ by insurance status (P = 0.98) or alcohol/substance use (P = 0.34). Reasons for treatment failure included loss to follow-up (n = 26, 5%), viral relapse (n = 16, 3%), non-treatment-related death (n = 7, 1%), and treatment discontinuation (n = 4, 1%). Of patients with viral relapse, 6 reported non-compliance and have not been retreated, 5 have been retreated and achieved SVR, 4 have undergone resistance testing but not yet initiated retreatment, and 1 was lost to follow-up. Effective outcomes with DAA-based therapy can be achieved in difficult-to-treat underinsured populations followed in resource-constrained safety-net health systems.

Patient safety and infection control: bases for curricular integration.

Science.gov (United States)

Silva, Andréa Mara Bernardes da; Bim, Lucas Lazarini; Bim, Felipe Lazarini; Sousa, Alvaro Francisco Lopes; Domingues, Pedro Castania Amadio; Nicolussi, Adriana Cristina; Andrade, Denise de

2018-05-01

To analyze curricular integration between teaching of patient safety and good infection prevention and control practices. Integrative review, designed to answer the question: "How does curricular integration of content about 'patient safety teaching' and content about 'infection prevention and control practices' occur in undergraduate courses in the health field?". The following databases were searched for primary studies: CINAHL, LILACS, ScienceDirect, Web of Science, Scopus, Europe PMC and MEDLINE. The final sample consisted of 13 studies. After content analysis, primary studies were grouped into two subject categories: "Innovative teaching practices" and "Curricular evaluation. Patient safety related to infection prevention and control practices is present in the curriculum of health undergraduate courses, but is not coordinated with other themes, is taught sporadically, and focuses mainly on hand hygiene.

www.HistoNet2000.de – didaktisches Konzept und Nutzerakzeptanz eines e-learning-Programms / www.HistoNet2000.de – didactic concept and user-acceptance of an e-learning program

Directory of Open Access Journals (Sweden)

Abele, Harald

2007-12-01

Full Text Available HistoNet2000 is an Internet learning and training program for Microscopic Anatomy. This online-platform was programmed as a prototype also to be used for other medical topics where visual learning plays an important role. The 2006 remodelled second version of HistoNet2000 is databased and has a tool for editors. In times of high student numbers but tight resources such as staff, classrooms and learning material HistoNet2000 supports the quality of and has a lasting effect on traditional teachings like lectures, classes etc. Furthermore it meets the growing wish of the students of information society for using multi-media systems by offering a blended-learning supply. The modular based program enables a linked and interactive as well as self-scrutinizing learning of Histology. The crucial visual training is supported by providing a wide range of pictures that cannot be offered in a book due to the high costs. As a tutor function is included the student has the possibility to communicate with the lecturer any time via e-mail, an offer widely used. Development and user-acceptance were scientifically analysed. A survey in 1998 and 1999 about e-learning asked 505 students in their preliminary clinical studies about hardware equipment, their attitude and desires in using the New Media. Though the hardware equipment was rather moderate at these times compared to nowadays, a majority showed quite an interest in the use of e-learning programs as a supplement to the traditional teaching methods and support for private study. The evaluation of the user-acceptance by logfiles 2006 and 2007 showed that HistoNet2000 is a very widely used learning program: the average of the more than 20,000 visitors every six months looked at about 100 pages and called up a data of more than 1 MB. In 2007 the user-acceptance even climbed over 40% in some months.

THE CONCEPT OF “SAFETY NET” AND ITS APPLICATION IN AMERICAN AND CANADIAN AGRICULTURE

Directory of Open Access Journals (Sweden)

Michał Soliwoda

2016-06-01

Full Text Available This aim of the article was  to provide a multi-faceted presentation of the possibilities of aplication the concept of "safety net" in agriculture in the United States and Canada. Literature review, elements of heuristic methods, and the documentaty method- in comparative terms - were used.  . The theoretical basis of the concept of safety nets in agriculture refer to the achievements earned by many schools and streams  in economics and finance. An in-depth analysis is based on an "eclectic" and interdisciplinary approach. In practice, the "architecture" of safety nets in agriculture in the U.S.  and Canada is quite complex and is based on relationships between the individual components. The role of risk management systems for agriculture will be strengthened.

The Affordability of Providing Sexually Transmitted Disease Services at a Safety-net Clinic.

Science.gov (United States)

Dean, Lorraine T; Montgomery, Madeline C; Raifman, Julia; Nunn, Amy; Bertrand, Thomas; Almonte, Alexi; Chan, Philip A

2018-04-01

Sexually transmitted diseases continue to increase in the U.S. There is a growing need for financially viable models to ensure the longevity of safety-net sexually transmitted disease clinics, which provide testing and treatment to high-risk populations. This micro-costing analysis estimated the number of visits required to balance cost and revenue of a sexually transmitted disease clinic in a Medicaid expansion state. In 2017, actual and projected cost and revenues were estimated from the Rhode Island sexually transmitted disease clinic in 2015. Projected revenues for a hypothetical clinic offering a standard set of sexually transmitted disease services were based on Medicaid; private ("commercial") insurance; and institutional ("list price") reimbursement rates. The number of visits needed to cover clinic costs at each rate was assessed. Total operating cost for 2,153 clinic visits was estimated at $255,769, or $119 per visit. Laboratory testing and salaries each accounted for 44% of operating costs, medications for treatment 7%, supplies 5%, and 28% of visits used insurance. For a standard clinic offering a basic set of sexually transmitted disease services to break even, a projected 73% of visits need to be covered at the Medicaid rate, 38% at private rate, or 11% at institutional rate. Sexually transmitted disease clinics may be financially viable when a majority of visits are billed at a Medicaid rate; however, mixed private/public models may be needed if not all visits are billed. In this manner, sexually transmitted disease clinics can be solvent even if not all visits are billed to insurance, thus ensuring access to uninsured or underinsured patients. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

WE-G-BRA-02: SafetyNet: Automating Radiotherapy QA with An Event Driven Framework

International Nuclear Information System (INIS)

Hadley, S; Kessler, M; Litzenberg, D; Lee, C; Irrer, J; Chen, X; Acosta, E; Weyburne, G; Lam, K; Younge, K; Matuszak, M; Keranen, W; Covington, E; Moran, J

2015-01-01

Purpose: Quality assurance is an essential task in radiotherapy that often requires many manual tasks. We investigate the use of an event driven framework in conjunction with software agents to automate QA and eliminate wait times. Methods: An in house developed subscription-publication service, EventNet, was added to the Aria OIS to be a message broker for critical events occurring in the OIS and software agents. Software agents operate without user intervention and perform critical QA steps. The results of the QA are documented and the resulting event is generated and passed back to EventNet. Users can subscribe to those events and receive messages based on custom filters designed to send passing or failing results to physicists or dosimetrists. Agents were developed to expedite the following QA tasks: Plan Revision, Plan 2nd Check, SRS Winston-Lutz isocenter, Treatment History Audit, Treatment Machine Configuration. Results: Plan approval in the Aria OIS was used as the event trigger for plan revision QA and Plan 2nd check agents. The agents pulled the plan data, executed the prescribed QA, stored the results and updated EventNet for publication. The Winston Lutz agent reduced QA time from 20 minutes to 4 minutes and provided a more accurate quantitative estimate of radiation isocenter. The Treatment Machine Configuration agent automatically reports any changes to the Treatment machine or HDR unit configuration. The agents are reliable, act immediately, and execute each task identically every time. Conclusion: An event driven framework has inverted the data chase in our radiotherapy QA process. Rather than have dosimetrists and physicists push data to QA software and pull results back into the OIS, the software agents perform these steps immediately upon receiving the sentinel events from EventNet. Mr Keranen is an employee of Varian Medical Systems. Dr. Moran’s institution receives research support for her effort for a linear accelerator QA project from

WE-G-BRA-02: SafetyNet: Automating Radiotherapy QA with An Event Driven Framework

Energy Technology Data Exchange (ETDEWEB)

Hadley, S; Kessler, M [The University of Michigan, Ann Arbor, MI (United States); Litzenberg, D [Univ Michigan, Ann Arbor, MI (United States); Lee, C; Irrer, J; Chen, X; Acosta, E; Weyburne, G; Lam, K; Younge, K; Matuszak, M [University of Michigan, Ann Arbor, MI (United States); Keranen, W [Varian Medical Systems, Palo Alto, CA (United States); Covington, E [University of Michigan Hospital and Health System, Ann Arbor, MI (United States); Moran, J [Univ Michigan Medical Center, Ann Arbor, MI (United States)

2015-06-15

Purpose: Quality assurance is an essential task in radiotherapy that often requires many manual tasks. We investigate the use of an event driven framework in conjunction with software agents to automate QA and eliminate wait times. Methods: An in house developed subscription-publication service, EventNet, was added to the Aria OIS to be a message broker for critical events occurring in the OIS and software agents. Software agents operate without user intervention and perform critical QA steps. The results of the QA are documented and the resulting event is generated and passed back to EventNet. Users can subscribe to those events and receive messages based on custom filters designed to send passing or failing results to physicists or dosimetrists. Agents were developed to expedite the following QA tasks: Plan Revision, Plan 2nd Check, SRS Winston-Lutz isocenter, Treatment History Audit, Treatment Machine Configuration. Results: Plan approval in the Aria OIS was used as the event trigger for plan revision QA and Plan 2nd check agents. The agents pulled the plan data, executed the prescribed QA, stored the results and updated EventNet for publication. The Winston Lutz agent reduced QA time from 20 minutes to 4 minutes and provided a more accurate quantitative estimate of radiation isocenter. The Treatment Machine Configuration agent automatically reports any changes to the Treatment machine or HDR unit configuration. The agents are reliable, act immediately, and execute each task identically every time. Conclusion: An event driven framework has inverted the data chase in our radiotherapy QA process. Rather than have dosimetrists and physicists push data to QA software and pull results back into the OIS, the software agents perform these steps immediately upon receiving the sentinel events from EventNet. Mr Keranen is an employee of Varian Medical Systems. Dr. Moran’s institution receives research support for her effort for a linear accelerator QA project from

Application of deconvolution interferometry with both Hi-net and KiK-net data

Science.gov (United States)

Nakata, N.

2013-12-01

Application of deconvolution interferometry to wavefields observed by KiK-net, a strong-motion recording network in Japan, is useful for estimating wave velocities and S-wave splitting in the near surface. Using this technique, for example, Nakata and Snieder (2011, 2012) found changed in velocities caused by Tohoku-Oki earthquake in Japan. At the location of the borehole accelerometer of each KiK-net station, a velocity sensor is also installed as a part of a high-sensitivity seismograph network (Hi-net). I present a technique that uses both Hi-net and KiK-net records for computing deconvolution interferometry. The deconvolved waveform obtained from the combination of Hi-net and KiK-net data is similar to the waveform computed from KiK-net data only, which indicates that one can use Hi-net wavefields for deconvolution interferometry. Because Hi-net records have a high signal-to-noise ratio (S/N) and high dynamic resolution, the S/N and the quality of amplitude and phase of deconvolved waveforms can be improved with Hi-net data. These advantages are especially important for short-time moving-window seismic interferometry and deconvolution interferometry using later coda waves.

Role of computer techniques for knowledge propagation about nuclear energetics safety

International Nuclear Information System (INIS)

Osachkin, V.S.

1996-01-01

The development of nuclear power engineering depends on the levels of nuclear, radiological and ecological safety. To ensure the approval of such levels by the community to spread the knowledge on Safety of Nuclear Engineering in understandable forms. New computer technologies may play an important role in the safety education of the public and upgrading of qualification of personnel. The progress in computer nets development makes it possible to use besides e-mail qualification of personnel. The progress in computer in nets development makes it possible to use besides e-mail and BBS the Internet system for remote education. As an example a computer course on Atomic Energy and its safety presented. This course now written in Russian consists of 6 parts, namely: physical basis of utilization of Nuclear energy; technical bases of uses of Nuclear energy; nuclear Reactors and their Systems; safety Principles, Goals, Nuclear Safety Regulation; the Environmental Impact of the us of Nuclear Power, severe accident consequences and scenarios

Applying Petri nets in modelling the human factor

International Nuclear Information System (INIS)

Bedreaga, Luminita; Constntinescu, Cristina; Guzun, Basarab

2007-01-01

Usually, in the reliability analysis performed for complex systems, we determine the success probability to work with other performance indices, i.e. the likelihood associated with a given state. The possible values assigned to system states can be derived using inductive methods. If one wants to calculate the probability to occur a particular event in the system, then deductive methods should be applied. In the particular case of the human reliability analysis, as part of probabilistic safety analysis, the international regulatory commission have developed specific guides and procedures to perform such assessments. The paper presents the modality to obtain the human reliability quantification using the Petri nets approach. This is an efficient means to assess reliability systems because of their specific features. The examples showed in the paper are from human reliability documentation without a detailed human factor analysis (qualitative). We present human action modelling using event trees and Petri nets approach. The obtained results by these two kinds of methods are in good concordance. (authors)

Innovative Patient Safety Curriculum Using iPAD Game (PASSED) Improved Patient Safety Concepts in Undergraduate Medical Students.

Science.gov (United States)

Kow, A W C; Ang, B L S; Chong, C S; Tan, W B; Menon, K R

2016-11-01

While healthcare outcomes have improved significantly, the complex management of diseases in the hospitals has also escalated the risks in patient safety. Therefore, in the process of training medical students to be proficient in medical knowledge and skills, the importance of patient safety cannot be neglected. A new innovation using mobile apps gaming system (PAtient Safety in Surgical EDucation-PASSED) to teach medical students on patient safety was created. Students were taught concepts of patient safety followed by a gaming session using iPad games created by us. This study aims to evaluate the outcome of patient safety perception using the PASSED games created. An interactive iPad game focusing on patient safety issues was created by the undergraduate education team in the Department of Surgery, Yong Loo Lin School of Medicine at the National University of Singapore. The game employed the unique touched-screen feature with clinical scenarios extracted from the hospital sentinel events. Some of the questions were time sensitive, with extra bonus marks awarded if the student provided the correct answer within 10 s. Students could reattempt the questions if the initial answer was wrong. However, this entailed demerit points. Third-year medical students posted to the Department of Surgery experienced this gaming system in a cohort of 55-60 students. Baseline understanding of the students on patient safety was evaluated using Attitudes to Patient Safety Questionnaire III (APSQ-III) prior to the game. A 20 min talk on concept of patient safety using the WHO Patient Safety Guidelines was conducted. Following this, students downloaded the apps from ITune store and played with the game for 20-30 min. The session ended with the students completing the postintervention questionnaire. A total of 221 3rd year medical students responded to the survey during the PASSED session. Majority of the students felt that the PASSED game had trained them to understand the

Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial.

Science.gov (United States)

Wu, Shinyi; Ell, Kathleen; Jin, Haomiao; Vidyanti, Irene; Chou, Chih-Ping; Lee, Pey-Jiuan; Gross-Schulman, Sandra; Sklaroff, Laura Myerchin; Belson, David; Nezu, Arthur M; Hay, Joel; Wang, Chien-Ju; Scheib, Geoffrey; Di Capua, Paul; Hawkins, Caitlin; Liu, Pai; Ramirez, Magaly; Wu, Brian W; Richman, Mark; Myers, Caitlin; Agustines, Davin; Dasher, Robert; Kopelowicz, Alex; Allevato, Joseph; Roybal, Mike; Ipp, Eli; Haider, Uzma; Graham, Sharon; Mahabadi, Vahid; Guterman, Jeffrey

2018-04-23

Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers. The aim of this study was to compare 6-month outcomes of a technology-facilitated care model with a usual care model and a supported care model that involved team-based collaborative depression care for safety-net primary care adult patients with type 2 diabetes. DCAT is a translational study in collaboration with Los Angeles County Department of Health Services, the second largest safety-net care system in the United States. A comparative effectiveness study with quasi-experimental design was conducted in three groups of adult patients with type 2 diabetes to compare three delivery models: usual care, supported care, and technology-facilitated care. Six-month outcomes included depression and diabetes care measures and patient-reported outcomes. Comparative treatment effects were estimated by linear or logistic regression models that used generalized propensity scores to adjust for sampling bias inherent in the nonrandomized design. DCAT enrolled 1406 patients (484 in usual care, 480 in supported care, and 442 in technology-facilitated care), most of whom were Hispanic or Latino and female. Compared with usual care, both the supported care and technology-facilitated care groups were associated with significant reduction in depressive symptoms measured by scores on the 9-item Patient Health Questionnaire (least squares estimate, LSE: usual care=6.35, supported care=5.05, technology-facilitated care=5

Safety net : train safely, profitably, and stay out of jail

Energy Technology Data Exchange (ETDEWEB)

Byfield, M.

2005-08-01

This article discussed the benefits of new Web-based training and development services provided by AMEC Training and Development Services. Various Alberta safety regulations were also reviewed, and it was noted that the upstream oil and gas sector have already begun building up strong safety programs. Companies are now increasingly using computer-based training for employees to improve workplace safety. Web-based courses ensure that the subject material is understood by students. In addition, Web-based materials can be economically delivered to field personnel. The learning process can be tracked and recorded in the event that misfortune should occur in the future. Various e-learning packages were evaluated, including Gemini's SWIFT e-learning package. However, the degree to which the Web can replace classroom instruction remains controversial. Typically, modules of a course focus initially on a foundation description of the plant or process, then progress to operating procedures and troubleshooting lessons. Moving diagrams can be programmed using Macro-media Flash, and can be used to portray moving mechanical parts and chemical changes that would normally not be visible to an operator even when standing beside the equipment. It was concluded that with hundreds of workers to train, often on a just-in-time basis, training services that include Web-based instruction are often the most cost-effective and efficient means of training staff. 5 figs.

Net Neutrality

DEFF Research Database (Denmark)

Savin, Andrej

2017-01-01

Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else.......Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else....

Annotating Coloured Petri Nets

DEFF Research Database (Denmark)

Lindstrøm, Bo; Wells, Lisa Marie

2002-01-01

Coloured Petri nets (CP-nets) can be used for several fundamentally different purposes like functional analysis, performance analysis, and visualisation. To be able to use the corresponding tool extensions and libraries it is sometimes necessary to include extra auxiliary information in the CP......-net. An example of such auxiliary information is a counter which is associated with a token to be able to do performance analysis. Modifying colour sets and arc inscriptions in a CP-net to support a specific use may lead to creation of several slightly different CP-nets – only to support the different uses...... of the same basic CP-net. One solution to this problem is that the auxiliary information is not integrated into colour sets and arc inscriptions of a CP-net, but is kept separately. This makes it easy to disable this auxiliary information if a CP-net is to be used for another purpose. This paper proposes...

NetSig

DEFF Research Database (Denmark)

Horn, Heiko; Lawrence, Michael S; Chouinard, Candace R

2018-01-01

Methods that integrate molecular network information and tumor genome data could complement gene-based statistical tests to identify likely new cancer genes; but such approaches are challenging to validate at scale, and their predictive value remains unclear. We developed a robust statistic (Net......Sig) that integrates protein interaction networks with data from 4,742 tumor exomes. NetSig can accurately classify known driver genes in 60% of tested tumor types and predicts 62 new driver candidates. Using a quantitative experimental framework to determine in vivo tumorigenic potential in mice, we found that Net......Sig candidates induce tumors at rates that are comparable to those of known oncogenes and are ten-fold higher than those of random genes. By reanalyzing nine tumor-inducing NetSig candidates in 242 patients with oncogene-negative lung adenocarcinomas, we find that two (AKT2 and TFDP2) are significantly amplified...

Estimating dependability of programmable systems using bayesian belief nets

International Nuclear Information System (INIS)

Gran, Bjoern Axel; Dahll, Gustav

2000-05-01

The research programme at the Halden Project on software safety assessment is augmented through a joint project with Kongsberg Defence and Aerospace AS and Det Norske Veritas. The objective of this project is to investigate the possibility to combine the Bayesian Belief Net (BBN) methodology with a software safety standard. The report discusses software safety standards in general, with respect to how they can be used to measure software safety. The possibility to transfer the requirements of a software safety standard into a BBN is also investigated. The aim is to utilise the BBN methodology and associated tools, by transferring the software safety measurement into a probabilistic quantity. In this way software can be included in a total probabilistic safety analysis. This project was performed by applying the method for an evaluation of a real, safety related programmable system which was developed according to the avionic standard DO-178B. The test case, the standard, and the BBN methodology are shortly described. This is followed by a description of the construction of the BBN used in this project. This includes the topology of the BBN, the elicitation of probabilities and the making of observations. Based on this a variety of computations are made using the SERENE methodology and the HUGIN tool. Observations and conclusions are made on the basis of the findings from this process. This report should be considered as a progress report in a more long-term activity on the use of BBNs as support for safety assessment of programmable systems. (Author). 23 refs., 9 figs., tabs

Learning Visual Basic NET

CERN Document Server

Liberty, Jesse

2009-01-01

Learning Visual Basic .NET is a complete introduction to VB.NET and object-oriented programming. By using hundreds of examples, this book demonstrates how to develop various kinds of applications--including those that work with databases--and web services. Learning Visual Basic .NET will help you build a solid foundation in .NET.

Safety and efficacy of Bolus administration of magnesium sulphate ...

African Journals Online (AJOL)

Safety and efficacy of Bolus administration of magnesium sulphate for preeclampsia. ... On-going research is addressing its administration in terms of dosage, duration and safety. Objective: We evaluated a ... Keywords: safety, efficacy, bolus magnesium sulphate, preeclampsia, University of Benin Teaching Hospital

[Patient safety culture in Family practice residents of Galicia].

Science.gov (United States)

Portela Romero, Manuel; Bugarín González, Rosendo; Rodríguez Calvo, María Sol

To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. A cross-sectional study. Seven FP of Galicia teaching units. 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care. The results were grouped into 12 composites assessed by the mentioned questionnaire. The study variables were the socio-demographic dimensions of the questionnaire, as well as occupational/professional variables: age, gender, year of residence, and teaching unit of FP of Galicia. The "Organisational learning" and "Teamwork" items were considered strong areas. However, the "Patient safety and quality issues", "Information exchange with other settings", and "Work pressure and pace" items were considered areas with significant potential for improvement. First-year residents obtained the best results and the fourth-year ones the worst. The results may indicate the need to include basic knowledge on patient safety in the teaching process of FP residents in order to increase and consolidate the fragile patient safety culture described in this study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Does Employee Safety Matter for Patients Too? Employee Safety Climate and Patient Safety Culture in Health Care.

Science.gov (United States)

Mohr, David C; Eaton, Jennifer Lipkowitz; McPhaul, Kathleen M; Hodgson, Michael J

2015-04-22

We examined relationships between employee safety climate and patient safety culture. Because employee safety may be a precondition for the development of patient safety, we hypothesized that employee safety culture would be strongly and positively related to patient safety culture. An employee safety climate survey was administered in 2010 and assessed employees' views and experiences of safety for employees. The patient safety survey administered in 2011 assessed the safety culture for patients. We performed Pearson correlations and multiple regression analysis to examine the relationships between a composite measure of employee safety with subdimensions of patient safety culture. The regression models controlled for size, geographic characteristics, and teaching affiliation. Analyses were conducted at the group level using data from 132 medical centers. Higher employee safety climate composite scores were positively associated with all 9 patient safety culture measures examined. Standardized multivariate regression coefficients ranged from 0.44 to 0.64. Medical facilities where staff have more positive perceptions of health care workplace safety climate tended to have more positive assessments of patient safety culture. This suggests that patient safety culture and employee safety climate could be mutually reinforcing, such that investments and improvements in one domain positively impacts the other. Further research is needed to better understand the nexus between health care employee and patient safety to generalize and act upon findings.

Summary of the nuclear safety in operation

International Nuclear Information System (INIS)

2004-01-01

This summary is a collection of general information about nuclear safety of PWR type reactors exploited by EDF. Teaching aid, this work has been conceived by operators for operators, it must not be considered nor used as a doctrine document with a regulatory or prescriptive characteristic. it summarizes the great principles of nuclear safety, places them in a global approach and shows their coherence. It consists in 6 chapters and 6 annexes. The news of this edition are the chapter 2 devoted to the safety management and the annexe 6 devoted to the principal teaching coming from the feedback. At the end a glossary explains the signs and abbreviations and an index allows to find themes in the memento text from keywords. (N.C.)

Pro-Nets versus No-Nets: Differences in Urban Older Adults' Predilections for Internet Use

Science.gov (United States)

Cresci, M. Kay; Yarandi, Hossein N.; Morrell, Roger W.

2010-01-01

Enthusiasm for information technology (IT) is growing among older adults. Many older adults enjoy IT and the Internet (Pro-Nets), but others have no desire to use it (No-Nets). This study found that Pro-Nets and No-Nets were different on a number of variables that might predict IT use. No-Nets were older, had less education and income, were…

A Comprehensive Approach to Managing School Safety: Case Studies in Catalonia, Spain

Science.gov (United States)

Díaz-Vicario, Anna; Gairín Sallán, Joaquín

2017-01-01

Background: Schools should be safe spaces for students, teaching staff and non-teaching staff. For the concept of "safety" to be meaningful, it must be interpreted broadly to encompass well-being in its widest sense. A common challenge for schools and educational authorities is, therefore, to manage school safety appropriately not only…

To make or buy patient safety solutions: a resource dependence and transaction cost economics perspective.

Science.gov (United States)

Fareed, Naleef; Mick, Stephen S

2011-01-01

For almost a decade, public and private organizations have pressured hospitals to improve their patient safety records. Since 2008, the Centers for Medicare & Medicaid Services has no longer been reimbursing hospitals for secondary diagnoses not reported during the point of admission. This ruling has motivated some hospitals to engage in safety-oriented programs to decrease adverse events. This study examined which hospitals may engage in patient safety solutions and whether they create these patient safety solutions within their structures or use suppliers in the market. We used a theoretical model that incorporates the key constructs of resource dependence theory and transaction cost economics theory to predict a hospital's reaction to Centers for Medicare & Medicaid Services "never event" regulations. We present propositions that speculate on how forces conceptualized from the resource dependence theory may affect adoption of patient safety innovations and, when they do, whether the adopting hospitals will do so internally or externally according to the transaction cost economics theory. On the basis of forces identified by the resource dependence theory, we predict that larger, teaching, safety net, horizontally integrated, highly interdependent, and public hospitals in concentrated, high public payer presence, competitive, and resource-rich environments will be more likely to engage in patient safety innovations. Following the logic of the transaction cost economics theory, we predict that of the hospitals that react positively to the never event regulation, most will internalize their innovations in patient safety solutions rather than approach the market, a choice that helps hospitals economize on transaction costs. This study helps hospital managers in their strategic thinking and planning in relation to current and future regulations related to patient safety. For researchers and policy analysts, our propositions provide the basis for empirical testing.

Experiments and simulation of a net closing mechanism for tether-net capture of space debris

Science.gov (United States)

Sharf, Inna; Thomsen, Benjamin; Botta, Eleonora M.; Misra, Arun K.

2017-10-01

This research addresses the design and testing of a debris containment system for use in a tether-net approach to space debris removal. The tether-net active debris removal involves the ejection of a net from a spacecraft by applying impulses to masses on the net, subsequent expansion of the net, the envelopment and capture of the debris target, and the de-orbiting of the debris via a tether to the chaser spacecraft. To ensure a debris removal mission's success, it is important that the debris be successfully captured and then, secured within the net. To this end, we present a concept for a net closing mechanism, which we believe will permit consistently successful debris capture via a simple and unobtrusive design. This net closing system functions by extending the main tether connecting the chaser spacecraft and the net vertex to the perimeter and around the perimeter of the net, allowing the tether to actuate closure of the net in a manner similar to a cinch cord. A particular embodiment of the design in a laboratory test-bed is described: the test-bed itself is comprised of a scaled-down tether-net, a supporting frame and a mock-up debris. Experiments conducted with the facility demonstrate the practicality of the net closing system. A model of the net closure concept has been integrated into the previously developed dynamics simulator of the chaser/tether-net/debris system. Simulations under tether tensioning conditions demonstrate the effectiveness of the closure concept for debris containment, in the gravity-free environment of space, for a realistic debris target. The on-ground experimental test-bed is also used to showcase its utility for validating the dynamics simulation of the net deployment, and a full-scale automated setup would make possible a range of validation studies of other aspects of a tether-net debris capture mission.

Recommendations for the development and application of Evaluation Tools for road infrastructure safety management in the EU. Road Infrastructure Safety Management Evaluation Tools (RISMET), Deliverable No. 7.

NARCIS (Netherlands)

Schermers, G. Cardoso, J. Elvik, R. Weller, G. Dietze, M. Reurings, M. Azeredo, S. & Charman, S.

2014-01-01

“ERA-NET ROAD — Coordination and Implementation of Road Research in Europe” was a Coordination Action funded by the 6th Framework Programme of the EC. The partners in the 2009 ERA-NET ROAD (ENR) Safety at the heart of road design initiative were the United Kingdom, Finland, Netherlands, Sweden,

Resident training in a teaching hospital: How do attendings teach in the real operative environment?

Science.gov (United States)

Glarner, Carly E; Law, Katherine E; Zelenski, Amy B; McDonald, Robert J; Greenberg, Jacob A; Foley, Eugene F; Wiegmann, Douglas A; Greenberg, Caprice C

2017-07-01

The study aim was to explore the nature of intraoperative education and its interaction with the environment where surgical education occurs. Video and audio recording captured teaching interactions between colorectal surgeons and general surgery residents during laparoscopic segmental colectomies. Cases and collected data were analyzed for teaching behaviors and workflow disruptions. Flow disruptions (FDs) are considered deviations from natural case progression. Across 10 cases (20.4 operative hours), attendings spent 11.2 hours (54.7%) teaching, using directing (M = 250.1), and confirming (M = 236.1) most. FDs occurred 410 times, accounting for 4.4 hours of case time (21.57%). Teaching occurred with FD events for 2.4 hours (22.2%), whereas 77.8% of teaching happened outside FD occurrence. Teaching methods shifted from active to passive during FD events to compensate for patient safety. Understanding how FDs impact operative learning will inform faculty development in managing interruptions and improve its integration into resident education. Copyright © 2016. Published by Elsevier Inc.

Pragmatic trial of an intervention to increase human papillomavirus vaccination in safety-net clinics

Directory of Open Access Journals (Sweden)

Maureen Sanderson

2017-02-01

Full Text Available Abstract Background Human papillomavirus (HPV infection has been causally linked to six cancers, and many disproportionately affect minorties. This study reports on the development and effectiveness of an intervention aimed at increasing HPV vaccine uptake among African American and Hispanic pediatric patients in safety-net clinics. Methods Formative research, community engagement, and theory guided development of the intervention. A clustered, non-randomized controlled pragmatic trial was conducted in four clinics providing healthcare for the underserved in Tennessee, U.S., with two intervention sites and two usual care sites. Patients aged 9-18 years (N = 408 and their mothers (N = 305 enrolled, with children clustered within families. The intervention consisted of two provider/staff training sessions and provision of patient education materials, consisting of a video/flyer promoting HPV vaccine. Medical records were reviewed before/after the initial visit and after 12 months. Results At the initial visit, provision of patient education materials and provider recommendation were higher at intervention sites versus usual care sites, and receipt of HPV vaccine was higher at intervention sites (45.4% versus 32.9% but not significantly after adjusting for patient’s age and mother’s education. Provider recommendation, but not education materials, increased the likelihood of vaccine receipt at the initial visit, although over one-third of intervention mothers cited the flyer/video as motivating vaccination. Completion of the 3-dose series at follow-up was lower in the intervention arm. Conclusions Future interventions should combine patient education, intensive provider/staff education, and patient reminders. Research should compare patient education focusing on HPV vaccine only versus all adolescent vaccines. Trial registration Retrospectively registered with ClinicalTrials.gov NCT02808832 , 9/12/16

ROOT.NET: Using ROOT from .NET languages like C# and F#

Science.gov (United States)

Watts, G.

2012-12-01

ROOT.NET provides an interface between Microsoft's Common Language Runtime (CLR) and .NET technology and the ubiquitous particle physics analysis tool, ROOT. ROOT.NET automatically generates a series of efficient wrappers around the ROOT API. Unlike pyROOT, these wrappers are statically typed and so are highly efficient as compared to the Python wrappers. The connection to .NET means that one gains access to the full series of languages developed for the CLR including functional languages like F# (based on OCaml). Many features that make ROOT objects work well in the .NET world are added (properties, IEnumerable interface, LINQ compatibility, etc.). Dynamic languages based on the CLR can be used as well, of course (Python, for example). Additionally it is now possible to access ROOT objects that are unknown to the translation tool. This poster will describe the techniques used to effect this translation, along with performance comparisons, and examples. All described source code is posted on the open source site CodePlex.

ROOT.NET: Using ROOT from .NET languages like C and F

International Nuclear Information System (INIS)

Watts, G

2012-01-01

ROOT.NET provides an interface between Microsoft's Common Language Runtime (CLR) and .NET technology and the ubiquitous particle physics analysis tool, ROOT. ROOT.NET automatically generates a series of efficient wrappers around the ROOT API. Unlike pyROOT, these wrappers are statically typed and so are highly efficient as compared to the Python wrappers. The connection to .NET means that one gains access to the full series of languages developed for the CLR including functional languages like F (based on OCaml). Many features that make ROOT objects work well in the .NET world are added (properties, IEnumerable interface, LINQ compatibility, etc.). Dynamic languages based on the CLR can be used as well, of course (Python, for example). Additionally it is now possible to access ROOT objects that are unknown to the translation tool. This poster will describe the techniques used to effect this translation, along with performance comparisons, and examples. All described source code is posted on the open source site CodePlex.

Teaching Bank Runs through Films

Science.gov (United States)

Flynn, David T.

2009-01-01

The author advocates the use of films to supplement textbook treatments of bank runs and panics in money and banking or general banking classes. Modern students, particularly those in developed countries, tend to be unfamiliar with potential fragilities of financial systems such as a lack of deposit insurance or other safety net mechanisms. Films…

SafeNet: a methodology for integrating general-purpose unsafe devices in safe-robot rehabilitation systems.

Science.gov (United States)

Vicentini, Federico; Pedrocchi, Nicola; Malosio, Matteo; Molinari Tosatti, Lorenzo

2014-09-01

Robot-assisted neurorehabilitation often involves networked systems of sensors ("sensory rooms") and powerful devices in physical interaction with weak users. Safety is unquestionably a primary concern. Some lightweight robot platforms and devices designed on purpose include safety properties using redundant sensors or intrinsic safety design (e.g. compliance and backdrivability, limited exchange of energy). Nonetheless, the entire "sensory room" shall be required to be fail-safe and safely monitored as a system at large. Yet, sensor capabilities and control algorithms used in functional therapies require, in general, frequent updates or re-configurations, making a safety-grade release of such devices hardly sustainable in cost-effectiveness and development time. As such, promising integrated platforms for human-in-the-loop therapies could not find clinical application and manufacturing support because of lacking in the maintenance of global fail-safe properties. Under the general context of cross-machinery safety standards, the paper presents a methodology called SafeNet for helping in extending the safety rate of Human Robot Interaction (HRI) systems using unsafe components, including sensors and controllers. SafeNet considers, in fact, the robotic system as a device at large and applies the principles of functional safety (as in ISO 13489-1) through a set of architectural procedures and implementation rules. The enabled capability of monitoring a network of unsafe devices through redundant computational nodes, allows the usage of any custom sensors and algorithms, usually planned and assembled at therapy planning-time rather than at platform design-time. A case study is presented with an actual implementation of the proposed methodology. A specific architectural solution is applied to an example of robot-assisted upper-limb rehabilitation with online motion tracking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Data communication between Panasonic PLC and PC using SerialPort control in C#.NET environment

Science.gov (United States)

Gao, Ting; Gan, Xiaochuan; Ma, Liqun

2015-02-01

With the gradual promotion of Microsoft.NET platform, C# as an object-oriented programming language based on the platform has been widely used. Therefore, more attention is concentrated on how to achieve the communication between Panasonic PLC and PC efficiently and fast in C#.NET environment. In this paper, a method of using SerialPort control which could be used for achieving communication between PLC and PC is introduced. Meanwhile, the reason of abnormal thread when displayed the receiving data in form is analyzed and the programming method to solve the problem of thread safety is designed. Achieving the communication of Panasonic PLC and PC in C#.NET environment can give full play to the advantages of the .NET framework. It is practical, easy communication, high reliability and can combine with other measurement and calibration procedures effectively and conveniently. Configuration software is expensive and can only communicate with PLC separately, but these shortcomings can be solved in C#.NET environment. A well-designed user interface realized real-time monitoring of PLC parameters and achieved management and control integration. The experiment show that this method of data transfer is accurate and the program' running is stable.

Money for nothing? The net costs of medical training.

Science.gov (United States)

Barros, Pedro P; Machado, Sara R

2010-09-01

One of the stages of medical training is the residency programme. Hosting institutions often claim compensation for the training provided. How much should this compensation be? According to our results, given the benefits arising from having residents among the house staff, no transfer (either tuition fee or subsidy) should be set to compensate the hosting institution for providing medical training. This paper quantifies the net costs of medical training, defined as the training costs over and above the wage paid. We jointly consider two effects. On the one hand, residents take extra time and resources from both the hosting institution and the supervisor. On the other hand, residents can be regarded as a less expensive substitute to nurses and/or graduate physicians, in the production of health care, both in primary care centres and hospitals. The net effect can be either positive or negative. We use the fact that residents, in Portugal, are centrally allocated to National Health Service hospitals to treat them as a fixed exogenous production factor. The data used comes from Portuguese hospitals and primary care centres. Cost function estimates point to a small negative marginal impact of residents on hospitals' (-0.02%) and primary care centres' (-0.9%) costs. Nonetheless, there is a positive relation between size and cost to the very large hospitals and primary care centres. Our approach to estimation of residents' costs controls for other teaching activities hospitals might have (namely undergraduate Medical Schools). Overall, the net costs of medical training appear to be quite small.

Quantum net dynamics

International Nuclear Information System (INIS)

Finkelstein, D.

1989-01-01

The quantum net unifies the basic principles of quantum theory and relativity in a quantum spacetime having no ultraviolet infinities, supporting the Dirac equation, and having the usual vacuum as a quantum condensation. A correspondence principle connects nets to Schwinger sources and further unifies the vertical structure of the theory, so that the functions of the many hierarchic levels of quantum field theory (predicate algebra, set theory, topology,hor-ellipsis, quantum dynamics) are served by one in quantum net dynamics

High-level Petri Nets

DEFF Research Database (Denmark)

various journals and collections. As a result, much of this knowledge is not readily available to people who may be interested in using high-level nets. Within the Petri net community this problem has been discussed many times, and as an outcome this book has been compiled. The book contains reprints...... of some of the most important papers on the application and theory of high-level Petri nets. In this way it makes the relevant literature more available. It is our hope that the book will be a useful source of information and that, e.g., it can be used in the organization of Petri net courses. To make......High-level Petri nets are now widely used in both theoretical analysis and practical modelling of concurrent systems. The main reason for the success of this class of net models is that they make it possible to obtain much more succinct and manageable descriptions than can be obtained by means...

MetNet - In situ observational Network and Orbital platform to investigate the Martian environment

Science.gov (United States)

Harri, Ari-Matti; Leinonen, Jussi; Merikallio, Sini; Paton, Mark; Haukka, Harri; Polkko, Jouni

2007-09-01

MetNet Mars Mission is an in situ observational network and orbital platform mission to investigate the Martian environment and it has been proposed to European Space Agency in response to Call for proposals for the first planning cycle of Cosmic Vision 2015-2025 D/SCI/DJS/SV/val/21851. The MetNet Mars Mission is to be implemented in collaboration with ESA, FMI, LA, IKI and the payload providing science teams. The scope of the MetNet Mission is to deploy 16 MetNet Landers (MNLs) on the Martian surface by using inflatable descent system structures accompanied by an atmospheric sounder and data relay onboard the MetNet Orbiter (MNO), which is based on ESA Mars Express satellite platform. The MNLs are attached on the three sides of the satellite and most of the MNLs are deployed to Mars separately a few weeks prior to the arrival to Mars. The MetNet Orbiter will perform continuous atmospheric soundings thus complementing the accurate in situ observations at the Martian ground produced by the MetNet observation network, as well as the orbiter will serve as the primary data relay between the MetNet Landers and the Earth. The MNLs are equipped with a versatile science payload focused on the atmospheric science of Mars. Detailed characterisation of the Martian atmospheric circulation patterns, boundary layer phenomena, and climatological cycles, as well as interior investigations, require simultaneous in situ meteorological, seismic and magnetic measurements from networks of stations on the Martian surface. MetNet Mars Mission will also provide a crucial support for the safety of large landing missions in general and manned Mars missions in particular. Accurate knowledge of atmospheric conditions and weather data is essential to guarantee safe landings of the forthcoming Mars mission elements.

The potential of centrifugal casting for the production of near net shape uranium parts

International Nuclear Information System (INIS)

Robertson, E.

1993-09-01

This report was written to provide a detailed summary of a literature survey on the near net shape casting process of centrifugal casting. Centrifugal casting is one potential casting method which could satisfy the requirements of the LANL program titled Near Net Shape Casting of Uranium for Reduced Environmental, Safety and Health Impact. In this report, centrifugal casting techniques are reviewed and an assessment of the ability to achieve the near net shape and waste minimization goals of the LANL program by using these techniques is made. Based upon the literature reviewed, it is concluded that if properly modified for operation within a vacuum, vertical or horizontal centrifugation could be used to safely cast uranium for the production of hollow, cylindrical parts. However, for the production of components of geometries other than hollow tubes, vertical centrifugation could be combined with other casting methods such as semi-permanent mold or investment casting

Planning of nets

International Nuclear Information System (INIS)

Carberry, M

1996-01-01

The paper is about the planning of nets in areas of low density like it is the case of the rural areas. The author includes economic and technological aspects, planning of nets, demands and management among others

Programming NET Web Services

CERN Document Server

Ferrara, Alex

2007-01-01

Web services are poised to become a key technology for a wide range of Internet-enabled applications, spanning everything from straight B2B systems to mobile devices and proprietary in-house software. While there are several tools and platforms that can be used for building web services, developers are finding a powerful tool in Microsoft's .NET Framework and Visual Studio .NET. Designed from scratch to support the development of web services, the .NET Framework simplifies the process--programmers find that tasks that took an hour using the SOAP Toolkit take just minutes. Programming .NET

Transformational leadership in nursing and medication safety education: a discussion paper.

Science.gov (United States)

Vaismoradi, Mojtaba; Griffiths, Pauline; Turunen, Hannele; Jordan, Sue

2016-10-01

This paper discusses the application of transformational leadership to the teaching and learning of safe medication management. The prevalence of adverse drug events (ADEs) and medication-related hospitalisations (one hundred thousand each year in the USA) are of concern. This discussion is based on a narrative literature review and scrutiny of international nursing research to synthesise pedagogical strategies for the application of transformational leadership to teaching medication safety. The four elements relating transformational leadership to medication safety education are: 'Idealised influence' or role modelling, both actual and exemplary, 'Inspirational motivation' providing students with commitment to medication safety, 'Intellectual stimulation' encouraging students to value improvement and change, and 'Individualised consideration' of individual students' educational goals, practice development and patient outcomes. The model lends itself to experiential learning and a case-study approach to teaching, offering an opportunity to reduce nursing's theory-practice gap. Transformational leadership for medication safety education is characterised by a focus on the role of nurse educators and mentors in the development of students' abilities, creation of a supportive culture, and enhancement of students' creativity, motivation and ethical behaviour. This will prepare nursing graduates with the competencies necessary to be diligent about medication safety and the prevention of errors. Teaching medication safety through transformational leadership requires the close collaboration of educators, managers and policy makers. Investigation of strategies to reduced medication errors and consequent patient harm should include exploration of the application of transformational leadership to education and its impact on the number and severity of medication errors. © 2016 John Wiley & Sons Ltd.

Field Test of the World Health Organization Multi-Professional Patient Safety Curriculum Guide

Science.gov (United States)

Farley, Donna; Zheng, Hao; Rousi, Eirini; Leotsakos, Agnès

2015-01-01

Introduction Although the importance of training in patient safety has been acknowledged for over a decade, it remains under-utilized and under-valued in most countries. WHO developed the Multi-professional Patient Safety Curriculum Guide to provide schools with the requirements and tools for incorporating patient safety in education. It was field tested with 12 participating schools across the six WHO regions, to assess its effectiveness for teaching patient safety to undergraduate and graduate students in a global variety of settings. Methods The evaluation used a combined prospective/retrospective design to generate formative information on the experiences of working with the Guide and summative information on the impacts of the Guide. Using stakeholder interviews and student surveys, data were gathered from each participating school at three times: the start of the field test (baseline), soon after each school started teaching, and soon after each school finished teaching. Results Stakeholders interviewed were strongly positive about the Guide, noting that it emphasized universally important patient safety topics, was culturally appropriate for their countries, and gave credibility and created a focus on patient safety at their schools. Student perceptions and attitudes regarding patient safety improved substantially during the field test, and their knowledge of the topics they were taught doubled, from 10.7% to 20.8% of correct answers on the student survey. Discussion This evaluation documented the effectiveness of the Curriculum Guide, for both ease of use by schools and its impacts on improving the patient safety knowledge of healthcare students. WHO should be well positioned to refine the contents of the Guide and move forward in encouraging broader use of the Guide globally for teaching patient safety. PMID:26406893

Field Test of the World Health Organization Multi-Professional Patient Safety Curriculum Guide.

Science.gov (United States)

Farley, Donna; Zheng, Hao; Rousi, Eirini; Leotsakos, Agnès

2015-01-01

Although the importance of training in patient safety has been acknowledged for over a decade, it remains under-utilized and under-valued in most countries. WHO developed the Multi-professional Patient Safety Curriculum Guide to provide schools with the requirements and tools for incorporating patient safety in education. It was field tested with 12 participating schools across the six WHO regions, to assess its effectiveness for teaching patient safety to undergraduate and graduate students in a global variety of settings. The evaluation used a combined prospective/retrospective design to generate formative information on the experiences of working with the Guide and summative information on the impacts of the Guide. Using stakeholder interviews and student surveys, data were gathered from each participating school at three times: the start of the field test (baseline), soon after each school started teaching, and soon after each school finished teaching. Stakeholders interviewed were strongly positive about the Guide, noting that it emphasized universally important patient safety topics, was culturally appropriate for their countries, and gave credibility and created a focus on patient safety at their schools. Student perceptions and attitudes regarding patient safety improved substantially during the field test, and their knowledge of the topics they were taught doubled, from 10.7% to 20.8% of correct answers on the student survey. This evaluation documented the effectiveness of the Curriculum Guide, for both ease of use by schools and its impacts on improving the patient safety knowledge of healthcare students. WHO should be well positioned to refine the contents of the Guide and move forward in encouraging broader use of the Guide globally for teaching patient safety.

Game Coloured Petri Nets

DEFF Research Database (Denmark)

Westergaard, Michael

2006-01-01

This paper introduces the notion of game coloured Petri nets. This allows the modeler to explicitly model what parts of the model comprise the modeled system and what parts are the environment of the modeled system. We give the formal definition of game coloured Petri nets, a means of reachability...... analysis of this net class, and an application of game coloured Petri nets to automatically generate easy-to-understand visualizations of the model by exploiting the knowledge that some parts of the model are not interesting from a visualization perspective (i.e. they are part of the environment...

Safety implications of standardized continuous quality improvement programs in community pharmacy.

Science.gov (United States)

Boyle, Todd A; Ho, Certina; Mackinnon, Neil J; Mahaffey, Thomas; Taylor, Jeffrey M

2013-06-01

Standardized continuous quality improvement (CQI) programs combine Web-based technologies and standardized improvement processes, tools, and expectations to enable quality-related events (QREs) occurring in individual pharmacies to be shared with pharmacies in other jurisdictions. Because standardized CQI programs are still new to community pharmacy, little is known about how they impact medication safety. This research identifies key aspects of medication safety that change as a result of implementing a standardized CQI program. Fifty-three community pharmacies in Nova Scotia, Canada, adopted the SafetyNET-Rx standardized CQI program in April 2010. The Institute for Safe Medication Practices (ISMP) Canada's Medication Safety Self-Assessment (MSSA) survey was administered to these pharmacies before and 1 year into their use of the SafetyNET-Rx program. The nonparametric Wilcoxon signed-rank test was used to explore where changes in patient safety occurred as a result of SafetyNETRx use. Significant improvements occurred with quality processes and risk management, staff competence, and education, and communication of drug orders and other information. Patient education, environmental factors, and the use of devices did not show statistically significant changes. As CQI programs are designed to share learning from QREs, it is reassuring to see that the largest improvements are related to quality processes, risk management, staff competence, and education.

Coloured Petri Nets

DEFF Research Database (Denmark)

Jensen, Kurt

1991-01-01

This paper describes how Coloured Petri Nets (CP-nets) have been developed — from being a promising theoretical model to being a full-fledged language for the design, specification, simulation, validation and implementation of large software systems (and other systems in which human beings and...

Net zero water

CSIR Research Space (South Africa)

Lindeque, M

2013-01-01

Full Text Available the national grid. The unfortunate situation with water is that there is no replacement technology for water. Water can be supplied from many different sources. A net zero energy development will move closer to a net zero water development by reducing...

Decreasing Turnaround Time and Increasing Patient Satisfaction in a Safety Net Hospital-Based Pediatrics Clinic Using Lean Six Sigma Methodologies.

Science.gov (United States)

Jayasinha, Yasangi

2016-01-01

Increasingly, health care quality indicators are focusing on patient-centeredness as an indicator of performance. The National Quality Forum lists assessment of patient experience, often conducted using patient surveys, as a top priority. We developed a patient-reported time stamp data collection tool that was used to collect cycle times in a safety net hospital-based outpatient pediatrics clinic. Data were collected using patient-reported survey to obtain cycle times in Pediatric clinic, as well as qualitative and quantitative patient satisfaction data. Several rapid-cycle improvements were performed using Lean Six Sigma methodologies to reduce cycle time by eliminating waste and revise unnecessary processes to improve operational effectiveness and patient and staff satisfaction. A total of 94 surveys were collected and revealed average cycle time of 113 minutes. Our measured patient satisfaction rating was 87%. Discharge and check-in processes were identified as the least efficient and were targeted for intervention. Following implementation, the overall cycle time was decreased from 113 to 90 minutes. Patient satisfaction ratings increased from 87% to 95%. We demonstrate that using Lean Six Sigma tools can be invaluable to clinical restructuring and redesign and results in measurable, improved outcomes in care delivery.

Applying the Trigger Review Method after a brief educational intervention: potential for teaching and improving safety in GP specialty training?

Science.gov (United States)

McKay, John; de Wet, Carl; Kelly, Moya; Bowie, Paul

2013-08-30

The Trigger Review Method (TRM) is a structured approach to screening clinical records for undetected patient safety incidents (PSIs) and identifying learning and improvement opportunities. In Scotland, TRM participation can inform GP appraisal and has been included as a core component of the national primary care patient safety programme that was launched in March 2013. However, the clinical workforce needs up-skilled and the potential of TRM in GP training has yet to be tested. Current TRM training utilizes a workplace face-to-face session by a GP expert, which is not feasible. A less costly, more sustainable educational intervention is necessary to build capability at scale. We aimed to determine the feasibility and impact of TRM and a related training intervention in GP training. We recruited 25 west of Scotland GP trainees to attend a 2-hour TRM workshop. Trainees then applied TRM to 25 clinical records and returned findings within 4-weeks. A follow-up feedback workshop was held. 21/25 trainees (84%) completed the task. 520 records yielded 80 undetected PSIs (15.4%). 36/80 were judged potentially preventable (45%) with 35/80 classified as causing moderate to severe harm (44%). Trainees described a range of potential learning and improvement plans. Training was positively received and appeared to be successful given these findings. TRM was valued as a safety improvement tool by most participants. This small study provides further evidence of TRM utility and how to teach it pragmatically. TRM is of potential value in GP patient safety curriculum delivery and preparing trainees for future safety improvement expectations.

Towards new information resources for public health--from WordNet to MedicalWordNet.

Science.gov (United States)

Fellbaum, Christiane; Hahn, Udo; Smith, Barry

2006-06-01

In the last two decades, WordNet has evolved as the most comprehensive computational lexicon of general English. In this article, we discuss its potential for supporting the creation of an entirely new kind of information resource for public health, viz. MedicalWordNet. This resource is not to be conceived merely as a lexical extension of the original WordNet to medical terminology; indeed, there is already a considerable degree of overlap between WordNet and the vocabulary of medicine. Instead, we propose a new type of repository, consisting of three large collections of (1) medically relevant word forms, structured along the lines of the existing Princeton WordNet; (2) medically validated propositions, referred to here as medical facts, which will constitute what we shall call MedicalFactNet; and (3) propositions reflecting laypersons' medical beliefs, which will constitute what we shall call the MedicalBeliefNet. We introduce a methodology for setting up the MedicalWordNet. We then turn to the discussion of research challenges that have to be met to build this new type of information resource. We build a database of sentences relevant to the medical domain. The sentences are generated from WordNet via its relations as well as from medical statements broken down into elementary propositions. Two subcorpora of sentences are distinguished, MedicalBeliefNet and MedicalFactNet. The former is rated for assent by laypersons; the latter for correctness by medical experts. The sentence corpora will be valuable for a variety of applications in information retrieval as well as in research in linguistics and psychology with respect to the study of expert and non-expert beliefs and their linguistic expressions. Our work has to meet several considerable challenges. These include accounting for the distinction between medical experts and laypersons, the social issues of expert-layperson communication in different media, the linguistic aspects of encoding medical knowledge, and

Multiflavor string-net models

Science.gov (United States)

Lin, Chien-Hung

2017-05-01

We generalize the string-net construction to multiple flavors of strings, each of which is labeled by the elements of an Abelian group Gi. The same flavor of strings can branch, while different flavors of strings can cross one another and thus they form intersecting string nets. We systematically construct the exactly soluble lattice Hamiltonians and the ground-state wave functions for the intersecting string-net condensed phases. We analyze the braiding statistics of the low-energy quasiparticle excitations and find that our model can realize all the topological phases as the string-net model with group G =∏iGi . In this respect, our construction provides various ways of building lattice models which realize topological order G , corresponding to different partitions of G and thus different flavors of string nets. In fact, our construction concretely demonstrates the Künneth formula by constructing various lattice models with the same topological order. As an example, we construct the G =Z2×Z2×Z2 string-net model which realizes a non-Abelian topological phase by properly intersecting three copies of toric codes.

Rare, but challenging tumors: NET

International Nuclear Information System (INIS)

Ivanova, D.; Balev, B.

2013-01-01

Full text: Introduction: Gastroenteropancreatic Neuroendocrine Tumors (GEP - NET) are a heterogeneous group of tumors with different locations and many different clinical, histological, and imaging performance. In a part of them a secretion of various organic substances is present. The morbidity of GEP - NET in the EU is growing, and this leads to increase the attention to them. What you will learn: Imaging methods used for localization and staging of GEP - NET, characteristics of the study’s protocols; Classification of GEP - NET; Demonstration of typical and atypical imaging features of GEP - NET in patients registered at the NET Center at University Hospital ‘St. Marina’, Varna; Features of metastatic NET, The role of imaging in the evaluation of treatment response and follow-up of the patients. Discussion: The image semiotics analysis is based on 19 cases of GEP - NET registered NET Center at University Hospital ‘St. Marina’. The main imaging method is multidetector CT (MDCT), and magnetic resonance imaging (MRI ) has advantages in the evaluation of liver lesions and the local prevalence of anorectal tumors. In patients with advanced disease and liver lesions the assessment of skeletal involvement (MRI/ nuclear medical method) is mandatory. The majority of GEP - NET have not any specific imaging findings. Therefore it is extremely important proper planning and conducting of the study (MDCT and MR enterography; accurate assessment phase of scanning, positive and negative contrast). Conclusion: GEP - NET is a major diagnostic challenge due to the absence of typical imaging characteristics and often an overlap with those of the tumors of different origin can be observed. Therefore, a good knowledge of clinical and imaging changes occurring at different locations is needed. MDCT is the basis for the diagnosis, staging and follow-up of these neoplasms

Seafood Safety and Quality: The Consumer’s Role

Directory of Open Access Journals (Sweden)

Doris T. Hicks

2016-10-01

Full Text Available All the good news about seafood—the health and nutritional benefits, the wide varieties and flavors—has had a positive effect on consumption: people are eating more seafood (http://www.seagrant.sunysb.edu/seafood/pdfs/SeafoodSavvy.pdf. Yet consumers want to be assured that seafood is as safe as, or safer to eat than, other foods. When you hear “seafood safety”, think of a safety net designed to protect you, the consumer, from food-borne illness. Every facet of the seafood industry, from harvester to consumer, plays a role in holding up the safety net. The role of state and federal agencies, fishermen, aquaculturists, retailers, processors, restaurants, and scientists is to provide, update, and carry out the necessary handling, processing, and inspection procedures to give consumers the safest seafood possible. The consumer’s responsibility is to follow through with proper handling techniques, from purchase to preparation. It doesn’t matter how many regulations and inspection procedures are set up; the final edge of the safety net is held by the consumer. This article will give you the information you need to educate yourself and be assured that the fish and shellfish you consume are safe. The most common food-borne illnesses are caused by a combination of bacteria naturally present in our environment and food handling errors made in commercial settings, food service institutions, or at home.

Food insecurity among students living with HIV: Strengthening safety ...

African Journals Online (AJOL)

Food insecurity among students living with HIV: Strengthening safety nets at the Nelson Mandela Metropolitan University, South Africa. ... of age and managed as part of the Campus Health Service antiretroviral therapy (ART) programme.

Limitations of shallow nets approximation.

Science.gov (United States)

Lin, Shao-Bo

2017-10-01

In this paper, we aim at analyzing the approximation abilities of shallow networks in reproducing kernel Hilbert spaces (RKHSs). We prove that there is a probability measure such that the achievable lower bound for approximating by shallow nets can be realized for all functions in balls of reproducing kernel Hilbert space with high probability, which is different with the classical minimax approximation error estimates. This result together with the existing approximation results for deep nets shows the limitations for shallow nets and provides a theoretical explanation on why deep nets perform better than shallow nets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Encouraging student-driven clinical research in Germany: the CHIR-Net SIGMA network

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Frey Pia-Elena

2017-11-01

Full Text Available Evidence should define and guide modern clinical care, yet many relevant questions in surgical practice remain unconfirmed by substantial data. Evidence-based medicine requires both the implementation of its principles in day-to-day work and the acquisition of new evidence preferably by randomized controlled trials and systematic reviews. Meaningful clinical research, however, is challenging to conduct, and its overall infrastructure in Germany was, until recently, considered poor compared to other leading countries. Although this has been significantly improved after the establishment of the Study Center of the German Surgical Society (SDGC and the surgical clinical trial network CHIR-Net, limited focus has been put on the training, teaching, and recruitment of medical students to become competent clinical researchers and clinician scientists. To ensure continuing comprehensive clinical research in surgery, CHIR-Net aims to establish a student-driven multicenter research network in Germany, which is embedded in both the national CHIR-Net and the pan-European and international frameworks. Student-Initiated German Medical Audits (SIGMA is a product of the strong collaboration between clinical scientists and medical trainees, enabling students to contribute to high-quality clinical trials. Additionally, participants are offered extensive training to support the next generation of research-active clinicians. Starting on 2018, SIGMA will perform its first multicenter observational study in Germany.

Development and practice for a PACS-based interactive teaching model for CT image

International Nuclear Information System (INIS)

Tian Junzhang; Jiang Guihua; Zheng Liyin; Wang Ling; Wenhua; Liang Lianbao

2002-01-01

Objective: To explore the interactive teaching model for CT imaging based on PACS, and provide the clinician and young radiologist with continued medical education. Methods: 100 M trunk net was adopted in PACS and 10 M was exchanged on desktop. Teaching model was installed in browse and diagnosis workstation. Teaching contents were classified according to region and managed according to branch model. Text data derived from authoritative textbooks, monograph, and periodicals. Imaging data derived from cases proved by pathology and clinic. The data were obtained through digital camera and scanner or from PACS. After edited and transformed into standard digital image through DICOM server, they were saved in HD of PACS image server with file form. Results: Teaching model for CT imaging provided kinds of cases of CT sign, clinic characteristics, pathology and distinguishing diagnosis. Normal section anatomy, typical image, and its notation could be browsed real time. Teaching model for CT imaging could provide reference to teaching, diagnosis and report. Conclusion: PACS-based teaching model for CT imaging could provide interactive teaching and scientific research tool and improve work quality and efficiency

ANALYSIS OF SUBJECT DISCRETE MATHEMATICS PARTS AND PROPOSAL OF E-COURSE MODEL FOLLOWING PETRI NETS FOR INFORMATICS EDUCATION

Directory of Open Access Journals (Sweden)

TURČÁNI, Milan

2013-03-01

Full Text Available Nowadays, quality Mathematical basis - Informatics is an inherent part of study. Mathematical basis is provided by Discrete Mathematics that is taught as a compulsory subject in stated study program in the Department of Mathematics. Authors clarify significance and importance of simple thematic units of subject Discrete Mathematics in teaching technical-system subjects in study programme Applied Informatics. Mentioned subject is being taught in first year of University study and knowledge that students acquire during the study of this course are the "cornerstone" for their further development in technical-system study. Justness and importance of individual topics were analysed based on the evaluation of questionnaires, in which pedagogues teaching professional IT subjects alloted weighted coefficients to individual thematic units. Weighted coefficients were alloted based on the significance of the given topic of the subject Discrete Math, with regard to the IT subject they are teaching. Upon designing the e-course, experience with the creation of linear and branch teaching software were used. For the simulation of the transition of students through individual lessons as well as the whole course, authors employed the method of the teaching process simulation using Petri nets.

The effect of netting solidity ratio and inclined angle on the hydrodynamic characteristics of knotless polyethylene netting

Science.gov (United States)

Tang, Hao; Hu, Fuxiang; Xu, Liuxiong; Dong, Shuchuang; Zhou, Cheng; Wang, Xuefang

2017-10-01

Knotless polyethylene (PE) netting has been widely used in aquaculture cages and fishing gears, especially in Japan. In this study, the hydrodynamic coefficient of six knotless PE netting panels with different solidity ratios were assessed in a flume tank under various attack angles of netting from 0° (parallel to flow) to 90° (perpendicular to flow) and current speeds from 40 cm s-1 to 130 cm s-1. It was found that the drag coefficient was related to Reynolds number, solidity ratio and attack angle of netting. The solidity ratio was positively related with drag coefficient for netting panel perpendicular to flow, whereas when setting the netting panel parallel to the flow the opposite result was obtained. For netting panels placed at an angle to the flow, the lift coefficient reached the maximum at an attack angle of 50° and then decreased as the attack angle further increased. The solidity ratio had a dual influence on drag coefficient of inclined netting panels. Compared to result in the literature, the normal drag coefficient of knotless PE netting measured in this study is larger than that of nylon netting or Dyneema netting.

Use of bed nets and factors that influence bed net use among Jinuo Ethnic Minority in southern China.

Science.gov (United States)

Xu, Jian-wei; Liao, Yuan-mei; Liu, Hui; Nie, Ren-hua; Havumaki, Joshua

2014-01-01

Insecticide-treated nets (ITNs) are an integral part of vector control recommendations for malaria elimination in China. This study investigated the extent to which bed nets were used and which factors influence bed net use among Jinuo Ethnic Minority in China-Myanmar-Laos border areas. This study combined a quantitative household questionnaire survey and qualitative semi-structured in-depth interviews (SDI). Questionnaires were administered to 352 heads of households. SDIs were given to 20 key informants. The bed net to person ratio was 1∶2.1 (i.e., nearly one net for every two people), however only 169 (48.0%) households owned at least one net and 623 (47.2%) residents slept under bed nets the prior night. The percentages of residents who regularly slept under nets (RSUN) and slept under nets the prior night (SUNPN) were similar (48.0% vs. 47.2%, P>0.05), however the percentage correct use of nets (CUN) was significantly lower (34.5%, Pcash income per person (ACIP) was an independent factor that influenced bed net use (PHigh bed net availability does not necessarily mean higher coverage or bed net use. Household income, house type and knowledge of the ability of bed nets to prevent malaria are all independent factors that influence bed net use among Jinuo Ethnic Minority.

Ageing management of AG3NET beam tubes in ORPHEE Research

International Nuclear Information System (INIS)

Florence, Gupta; Maud, Corbel

2013-01-01

The materials used in research reactors come from the best compromise between research needs and safety issues such as integrity of equipment during their whole life. For example, aluminium alloys such as AG3NET are interesting for research reactors dedicated to the production of neutron flux since they are transparent to neutrons but they become fragile under irradiation. Therefore the evolution of material's mechanical properties under irradiation is a topic of interest for research reactors safety and operators must implement an ageing management program of equipment subject to irradiation. This kind of aluminium alloys compound is used in many French research reactors like the Jules Horowitz reactor (JHR) and ORPHEE reactor operated by the Atomic Energy and Alternative Energies Commission (CEA) or the high flux reactor (HFR) operated by the Laue-Langevin Institute (ILL). Particularly, in the ORPHEE reactor, AG3NET is used for beam tubes, located in the heavy water tank surrounding the core, which guide neutrons towards experimental stations. The failure of a beam tube in ORPHEE reactor can lead to a reactivity insertion in the core, whose effects can be managed by the control rods system. Nevertheless, to control the effects of ageing on such equipment, the operator plans to replace the beam tubes on the basis of a criterion he defined. For the ORPHEE's second periodic safety review, the operator has re-evaluated the situation of the beam tubes with regard of this criterion and has established a beam tube replacement schedule. The 'Institut de Radioprotection et de Surete Nucleaire' (IRSN), as a technical support of the French nuclear safety authority, assessed the elements presented by the CEA for this periodic safety review and concluded that the replacement criterion used for these equipment lead to reach a fragile behaviour of the materials. Thus, the breaking of several beam tubes can't be excluded but this situation can leads to severe consequences on the

NetView technical research

Science.gov (United States)

1993-01-01

This is the Final Technical Report for the NetView Technical Research task. This report is prepared in accordance with Contract Data Requirements List (CDRL) item A002. NetView assistance was provided and details are presented under the following headings: NetView Management Systems (NMS) project tasks; WBAFB IBM 3090; WPAFB AMDAHL; WPAFB IBM 3084; Hill AFB; McClellan AFB AMDAHL; McClellan AFB IBM 3090; and Warner-Robins AFB.

Efficacy of PermaNet® 3.0 and PermaNet® 2.0 nets against laboratory-reared and wild Anopheles gambiae sensu lato populations in northern Tanzania.

Science.gov (United States)

Kweka, Eliningaya J; Lyaruu, Lucile J; Mahande, Aneth M

2017-01-18

Mosquitoes have developed resistance against pyrethroids, the only class of insecticides approved for use on long-lasting insecticidal nets (LLINs). The present study sought to evaluate the efficacy of the pyrethroid synergist PermaNet® 3.0 LLIN versus the pyrethroid-only PermaNet® 2.0 LLIN, in an East African hut design in Lower Moshi, northern Tanzania. In this setting, resistance to pyrethroid insecticides has been identified in Anopheles gambiae mosquitoes. Standard World Health Organization bioefficacy evaluations were conducted in both laboratory and experimental huts. Experimental hut evaluations were conducted in an area where there was presence of a population of highly pyrethroid-resistant An. arabiensis mosquitoes. All nets used were subjected to cone bioassays and then to experimental hut trials. Mosquito mortality, blood-feeding inhibition and personal protection rate were compared between untreated nets, unwashed LLINs and LLINs that were washed 20 times. Both washed and unwashed PermaNet® 2.0 and PermaNet® 3.0 LLINs had knockdown and mortality rates of 100% against a susceptible strain of An. gambiae sensu stricto. The adjusted mortality rate of the wild mosquito population after use of the unwashed PermaNet® 3.0 and PermaNet® 2.0 nets was found to be higher than after use of the washed PermaNet® 2.0 and PermaNet® 3.0 nets. Given the increasing incidence of pyrethroid resistance in An. gambiae mosquitoes in Tanzania, we recommend that consideration is given to its distribution in areas with pyrethroid-resistant malaria vectors within the framework of a national insecticide-resistance management plan.

Design of the Lifestyle Improvement through Food and Exercise (LIFE) study: a randomized controlled trial of self-management of type 2 diabetes among African American patients from safety net health centers.

Science.gov (United States)

Lynch, Elizabeth B; Liebman, Rebecca; Ventrelle, Jennifer; Keim, Kathryn; Appelhans, Bradley M; Avery, Elizabeth F; Tahsin, Bettina; Li, Hong; Shapera, Merle; Fogelfeld, Leon

2014-11-01

The Lifestyle Improvement through Food and Exercise (LIFE) study is a community-based randomized-controlled trial to measure the effectiveness of a lifestyle intervention to improve glycemic control among African Americans with type 2 diabetes attending safety net clinics. The study enrolled African American adults with a diagnosis of type 2 diabetes and HbA1c ≥ 7.0 who had attended specific safety net community clinics in the prior year. 210 patients will be enrolled and randomized to either the LIFE intervention or a standard of care control group, which consists of two dietitian-led diabetes self-management classes. The LIFE intervention was delivered in 28 group sessions over 12 months and focused on improving diet through dietitian-led culturally-tailored nutrition education, increasing physical activity through self-monitoring using an accelerometer, increasing ability to manage blood sugar through modifications to lifestyle, and providing social support for behavior change. In addition to the group sessions, peer supporters made regular telephone calls to participants to monitor progress toward behavioral goals and provide social support. The 12-month intervention phase was followed by a six-month maintenance phase consisting of two group sessions. The primary outcome of the study is change in A1C from baseline to 12 months, and an additional follow-up will occur at 18 months. The hypothesis of the study is that the participants in the LIFE intervention will show a greater improvement in glycemic control over 12 months than participants in the control group. Copyright © 2014 Elsevier Inc. All rights reserved.

The risk management of perishable supply chain based on coloured Petri Net modeling

Directory of Open Access Journals (Sweden)

Lu Liu

2018-03-01

Full Text Available The supply chain of perishable products is a combination of information organization, sharing and integration. The information modeling of supply chain is constructed to abstract key quality information including environment information, processing procedures and product quality assessments based on principle of quality safety factors and property of decay rate. The coloured Petri Net is applied for integrated description of independent information classification, aiming at risk identification and risk management framework. Well, according to the quality deterioration tendency, risk grades management and decision-making system are established. Practically, the circulation system of aquatic products is studied in this paper for full processing description. The simulation experiments are manipulated on environmental information, processing information and product quality information by the coloured Petri Net. Eventually, the conclusion turns out precisely as such that the coloured Petri Net conclusive for information classification and information transmission while integrated information management is available of efficient risk identification and decision-making system in supply chain of perishable products. Meanwhile, the validity of evaluating management and shelf-life estimation of perishable products are technically feasible.

PODATKOVNE STORITVE ADO.NET IN ADO.NET ENTITY FRAMEWORK

OpenAIRE

Volavc, Franc

2012-01-01

V diplomskem delu smo predstavili Microsoftovi ogrodji ADO.NET in ADO.NET Entity Framework. Preučili in analizirali smo metode za dostop do podatkovnih virov, ki jih ponujata ogrodji, ter nato te ugotovitve preslikati v odločitveno drevo, katero bo programerjem in razvijalcem informacijskih sistemov pomagalo pri odločanju glede pristopa za dostop do podatkovnih virov. Ker bomo v diplomskem delu predstavili Microsoftovi ogrodji, bomo posledično omejeni zgolj na Microsoftovo tehnologijo, se pra...

Blanket testing in NET

International Nuclear Information System (INIS)

Chazalon, M.; Daenner, W.; Libin, B.

1989-01-01

The testing stages in NET for the performance assessment of the various breeding blanket concepts developed at the present time in Europe for DEMO (LiPb and ceramic blankets) and the requirements upon NET to perform these tests are reviewed. Typical locations available in NET for blanket testing are the central outboard segments and the horizontal ports of in-vessel sectors. These test positions will be connectable with external test loops. The number of test loops (helium, water, liquid metal) will be such that each major class of blankets can be tested in NET. The test positions, the boundary conditions and the external test loops are identified and the requirements for test blankets are summarized (author). 6

Living probabilistic safety assessment of French 1300 MWe PWR nuclear power plant unit: methodology, results and teaching

International Nuclear Information System (INIS)

Dubreuil Chambardel, A.; Villemeur, A.; Berger, J.P.; Moroni, J.M.

1991-02-01

Launched in 1986 by Electricite de France, the Probabilistic Safety Assessment of a French 1300 MWe Pressurized Water Reactor (called PSA 1300) was completed in 1989. The first objective was to assess the annual core damage frequency by identifying all the accident scenarii likely to contribute significantly to this frequency. The second objective of the study was to provide an automated computerized tool (software) for updating the assessment - in order to take new data and knowledge into account - and for performing numerous sensitivity studies easily. Its scope and characteristics render this study unique. Indeed, it required an effort amounting to 50 engineer-years. The results and the first lessons are presented in this paper. The PSA 1300 teachings will be extensively used for the design and operation of existing or future French nuclear power reactors

Incidence of iatrogenic pneumothorax in the United States in teaching vs. non-teaching hospitals from 2000 to 2012.

Science.gov (United States)

John, Jason; Seifi, Ali

2016-08-01

Iatrogenic pneumothorax is a patient safety indicator (PSI) representing a complication of procedures such as transthoracic needle aspiration, subclavicular needle stick, thoracentesis, transbronchial biopsy, pleural biopsy, and positive pressure ventilation. This study examined whether there was a significant difference in rate of iatrogenic pneumothorax in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. We performed a retrospective cohort study on iatrogenic pneumothorax incidence from 2000 to 2012 using the Healthcare Cost and Utilization Project (HCUP) database. Pairwise t tests were performed. Odds ratios and P values were calculated, using a Bonferroni-adjusted α threshold, to examine differences in iatrogenic pneumothorax incidence in teaching vs. non-teaching hospitals. Our study revealed that after the year 2000, teaching hospitals had significantly greater iatrogenic pneumothorax incidence compared to non-teaching hospitals in every year of the study period (Ppneumothorax occurred with significantly greater incidence in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. This trend may have been enhanced by the residency duty-hour regulations implemented in 2003 in teaching institutions, or due to higher rates of procedures in teaching institutions due to the nature of a tertiary center. Iatrogenic pneumothorax was more prevalent in teaching hospitals compared to non-teaching hospitals after the year 2000. Further randomized control studies are warranted to evaluate the etiology of this finding. Published by Elsevier Inc.

Current Status and Future Prospect of K-NET and KiK-net

Science.gov (United States)

Aoi, S.; Kunugi, T.; Suzuki, W.; Nakamura, H.; Fujiwara, H.

2014-12-01

During 18 years since the deployment of K-NET following the Kobe earthquake, our attention has mainly focused on rapidity of the data collection and an unfailing and reliable observation. In this presentation, we review three generations of the instruments employed by K-NET and KiK-net from these two points of view.At beginning of the 2000's, we newly developed the second generation instruments (K-NET02, K-NET02A, KiK-net06) to replace the first generation instruments (K-NET95, SMAC-MDK) employed when the networks were constructed in the 1990's. These instruments have an automatic dial-out function. It takes typically 2-5 s to establish communication and a few seconds to send the pre-trigger data. After that, data is available typically within a 1.5 s delay. Not only waveform data but also strong motion indexes such as real-time intensity, PGA, PGV, PGD, and response spectra are continuously sent once a second.After the 2011 Tohoku earthquake, we have developed the third generation instruments (K-NET11, KiK-net11) and have replaced almost half of the all stations country wide. Main improvement of this instrument is more unfailing and reliable observation. Because we have often experienced very large ground motions (e.g. 45 records exceeding gravity), the maximum measureable range was expanded from 2000 gal to 4000 gal for the second generation instrument, and to 8000 gal for the third. For the third generation instrument, in case of power failure, observation (including transmission of data) works for seven days thanks to the backup battery, while for the second generation instruments it works only for one day. By adding an oblique component to the three-component accelerometers, we could automatically distinguish shaking data from noise such as electric pulses which may cause a false alarm in EEW. Implementation to guarantee the continuity of observation under severe conditions such as during the Tohoku earthquake is very important, as well as a highly efficient

Near-peers improve patient safety training in the preclinical curriculum.

Science.gov (United States)

Raty, Sally R; Teal, Cayla R; Nelson, Elizabeth A; Gill, Anne C

2017-01-01

Accrediting bodies require medical schools to teach patient safety and residents to develop teaching skills in patient safety. We created a patient safety course in the preclinical curriculum and used continuous quality improvement to make changes over time. To assess the impact of resident teaching on student perceptions of a Patient Safety course. Using the Institute for Healthcare Improvement patient safety curriculum as a frame, the course included the seven IHI modules, large group lectures and small group facilitated discussions. Applying a social action methodology, we evaluated the course for four years (Y1-Y4). In Y1, Y2, Y3 and Y4, we distributed a course evaluation to each student (n = 184, 189, 191, and 184, respectively) and the response rate was 96, 97, 95 and 100%, respectively. Overall course quality, clarity of course goals and value of small group discussions increased in Y2 after the introduction of residents as small group facilitators. The value of residents and the overall value of the course increased in Y3 after we provided residents with small group facilitation training. Preclinical students value the interaction with residents and may perceive the overall value of a course to be improved based on near-peer involvement. Residents gain valuable experience in small group facilitation and leadership.

Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania

Directory of Open Access Journals (Sweden)

Gerrets Rene PM

2008-06-01

Full Text Available Abstract Background Tanzania has a well-developed network of commercial ITN retailers. In 2004, the government introduced a voucher subsidy for pregnant women and, in mid 2005, helped distribute free nets to under-fives in small number of districts, including Rufiji on the southern coast, during a child health campaign. Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed. Methods Cross-sectional household survey in 6,331 members of randomly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district, Southern Tanzania was conducted in 2006. A questionnaire was administered to every consenting respondent about net use, treatment status and delivery mechanism. Findings Net use was 62.7% overall, 87.2% amongst infants (0 to1 year, 81.8% amongst young children (>1 to 5 years, 54.5% amongst older children (6 to 15 years and 59.6% amongst adults (>15 years. 30.2% of all nets had been treated six months prior to interview. The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy (41.8%. Half of nets used by young children (50.0% and over a third of those used by older children (37.2% were obtained free of charge through the vaccination campaign. The largest source of nets amongst the population overall was commercial purchase (45.1% use and was the primary means for protecting adults (60.2% use. All delivery mechanisms, especially sale of nets at full market price, under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets. Conclusion All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population. Each of them reached their relevant target group and free nets only temporarily

Patient safety culture among medical students in Singapore and Hong Kong.

Science.gov (United States)

Leung, Gilberto Ka Kit; Ang, Sophia Bee Leng; Lau, Tang Ching; Neo, Hong Jye; Patil, Nivritti Gajanan; Ti, Lian Kah

2013-09-01

Undergraduate education in medical schools plays an important role in promoting patient safety. Medical students from different backgrounds may have different perceptions and attitudes toward issues concerning safety. This study aimed to investigate whether patient safety cultures differed between students from two Asian countries, and if they did, to find out how they differed. This study also aimed to identify the educational needs of these students. A voluntary, cross-sectional and self-administered questionnaire survey was conducted on 259 students from two medical schools - one in Hong Kong and the other in Singapore. None of the students had received any formal teaching on patient safety. We used a validated survey instrument, the Attitudes to Patient Safety Questionnaire III (APSQ-III), which was designed specifically for students and covered nine key factors of patient safety culture. Of the 259 students, 81 (31.3%) were from Hong Kong and 178 (68.7%) were from Singapore. The overall response rate was 66.4%. Significant differences between the two groups of students were found for two key factors - 'patient safety training', with Hong Kong students being more likely to report having received more of such training (p = 0.007); and 'error reporting confidence', which Singapore students reported having less of (p working hours and professional incompetence were important causes of medical errors. The importance of patient involvement and team functioning were ranked relatively lower by the students. Students from different countries with no prior teaching on patient safety may differ in their baseline patient safety cultures and educational needs. Our findings serve as a reference for future longitudinal studies on the effects of different teaching and healthcare development programmes.

Initial CAD investigations for NET

International Nuclear Information System (INIS)

Katz, F.; Leinemann, K.; Ludwig, A.; Marek, U.; Olbrich, W.; Schlechtendahl, E.G.

1985-11-01

This report summarizes the work done under contract no. 164/84-7/FU-D-/NET between the Commission of the European Communities and KfK during the period from June 1, 1984, through May 31, 1985. The following topics are covered in this report: Initial modelling of NET version NET2A, CAD system extension for remote handling studies, analysis of the CAD information structure, work related to the transfer of CAD information between KfK and the NET team. (orig.) [de

NetBeans IDE 8 cookbook

CERN Document Server

Salter, David

2014-01-01

If you're a Java developer of any level using NetBeans and want to learn how to get the most out of NetBeans, then this book is for you. Learning how to utilize NetBeans will provide a firm foundation for your Java application development.

The Net Advance of Physics

Science.gov (United States)

THE NET ADVANCE OF PHYSICS Review Articles and Tutorials in an Encyclopædic Format Established 1995 [Link to MIT] Computer support for The Net Advance of Physics is furnished by The Massachusetts Newest Additions SPECIAL FEATURES: Net Advance RETRO: Nineteenth Century Physics History of Science

Improved netting

International Nuclear Information System (INIS)

Bramley, A.; Clabburn, R.J.T.

1976-01-01

A method is described for producing netting composed of longitudinal and transverse threads of irradiation cross linked thermoplastic material, the threads being joined together at their crossings by moulded masses of cross linked thermoplastic material. The thread may be formed of polyethylene filaments, subjected to a radiation dose of 15 to 25 MR. The moulding can be conducted at 245 0 to 260 0 C or higher. The product is claimed to be an improved quality of netting, with bonds of increased strength between crossing threads. (U.K.)

Would Socrates Have Actually Used the "Socratic Method" for Clinical Teaching?

Science.gov (United States)

Stoddard, Hugh A; O'Dell, David V

2016-09-01

Medical students and residents are familiar with clinical teaching methods in which a faculty member poses a series of questions to them. This technique is often called the "Socratic method," but it is frequently perceived by learners as an attempt to demean them, a practice that is colloquially known as "pimping." The distinction between Socratic teaching and pimping lies in the perception of "psychological safety." Psychological safety allows learners to answer questions or ask for help without threats to their dignity or worthiness. In a psychologically safe clinical teaching context, learners recognize that questions posed by attending physicians probe their current understanding and guide them to expand their knowledge. In pimping, questions are posed to embarrass the learner and to reinforce the teacher's position of power over them. Absent a threat of disparagement or condemnation, learners are able to focus on building schema for knowledge, skills, and attitudes, rather than worrying about shielding their self-worth. This article presents the proper Socratic method, as intended by Socrates, and contrasts it with pimping. This perspective defines psychological safety as the pivotal factor distinguishing Socratic teaching from pimping, and establishes the foundation for empirical studies of these common practices in medical education.

Modelling and Simulating Complex Systems in Biology: introducing NetBioDyn : A Pedagogical and Intuitive Agent-Based Software

OpenAIRE

Ballet, Pascal; Rivière, Jérémy; Pothet, Alain; Théron, Michaël; Pichavant, Karine; Abautret, Frank; Fronville, Alexandra; Rodin, Vincent

2017-01-01

International audience; Modelling and teaching complex biological systems is a difficult process. Multi-Agent Based Simulations (MABS) have proved to be an appropriate approach both in research and education when dealing with such systems including emergent, self-organizing phenomena. This chapter presents NetBioDyn, an original software aimed at biologists (students, teachers, researchers) to easily build and simulate complex biological mechanisms observed in multicellular and molecular syst...

Net alkalinity and net acidity 1: Theoretical considerations

International Nuclear Information System (INIS)

Kirby, Carl S.; Cravotta, Charles A.

2005-01-01

Net acidity and net alkalinity are widely used, poorly defined, and commonly misunderstood parameters for the characterization of mine drainage. The authors explain theoretical expressions of 3 types of alkalinity (caustic, phenolphthalein, and total) and acidity (mineral, CO 2 , and total). Except for rarely-invoked negative alkalinity, theoretically defined total alkalinity is closely analogous to measured alkalinity and presents few practical interpretation problems. Theoretically defined 'CO 2 -acidity' is closely related to most standard titration methods with an endpoint pH of 8.3 used for determining acidity in mine drainage, but it is unfortunately named because CO 2 is intentionally driven off during titration of mine-drainage samples. Using the proton condition/mass-action approach and employing graphs to illustrate speciation with changes in pH, the authors explore the concept of principal components and how to assign acidity contributions to aqueous species commonly present in mine drainage. Acidity is defined in mine drainage based on aqueous speciation at the sample pH and on the capacity of these species to undergo hydrolysis to pH 8.3. Application of this definition shows that the computed acidity in mgL -1 as CaCO 3 (based on pH and analytical concentrations of dissolved Fe II , Fe III , Mn, and Al in mgL -1 ):acidity calculated =50{1000(10 -pH )+[2(Fe II )+3(Fe III )]/56+2(Mn) /55+3(Al)/27}underestimates contributions from HSO 4 - and H + , but overestimates the acidity due to Fe 3+ and Al 3+ . However, these errors tend to approximately cancel each other. It is demonstrated that 'net alkalinity' is a valid mathematical construction based on theoretical definitions of alkalinity and acidity. Further, it is shown that, for most mine-drainage solutions, a useful net alkalinity value can be derived from: (1) alkalinity and acidity values based on aqueous speciation (2) measured alkalinity minus calculated acidity, or (3) taking the negative of the

Net alkalinity and net acidity 1: Theoretical considerations

Science.gov (United States)

Kirby, C.S.; Cravotta, C.A.

2005-01-01

Net acidity and net alkalinity are widely used, poorly defined, and commonly misunderstood parameters for the characterization of mine drainage. The authors explain theoretical expressions of 3 types of alkalinity (caustic, phenolphthalein, and total) and acidity (mineral, CO2, and total). Except for rarely-invoked negative alkalinity, theoretically defined total alkalinity is closely analogous to measured alkalinity and presents few practical interpretation problems. Theoretically defined "CO 2-acidity" is closely related to most standard titration methods with an endpoint pH of 8.3 used for determining acidity in mine drainage, but it is unfortunately named because CO2 is intentionally driven off during titration of mine-drainage samples. Using the proton condition/mass- action approach and employing graphs to illustrate speciation with changes in pH, the authors explore the concept of principal components and how to assign acidity contributions to aqueous species commonly present in mine drainage. Acidity is defined in mine drainage based on aqueous speciation at the sample pH and on the capacity of these species to undergo hydrolysis to pH 8.3. Application of this definition shows that the computed acidity in mg L -1 as CaCO3 (based on pH and analytical concentrations of dissolved FeII, FeIII, Mn, and Al in mg L -1):aciditycalculated=50{1000(10-pH)+[2(FeII)+3(FeIII)]/56+2(Mn)/ 55+3(Al)/27}underestimates contributions from HSO4- and H+, but overestimates the acidity due to Fe3+ and Al3+. However, these errors tend to approximately cancel each other. It is demonstrated that "net alkalinity" is a valid mathematical construction based on theoretical definitions of alkalinity and acidity. Further, it is shown that, for most mine-drainage solutions, a useful net alkalinity value can be derived from: (1) alkalinity and acidity values based on aqueous speciation, (2) measured alkalinity minus calculated acidity, or (3) taking the negative of the value obtained in a

Proof Nets for Lambek Calculus

NARCIS (Netherlands)

Roorda, Dirk

1992-01-01

The proof nets of linear logic are adapted to the non-commutative Lambek calculus. A different criterion for soundness of proof nets is given, which gives rise to new algorithms for proof search. The order sensitiveness of the Lambek calculus is reflected by the planarity condition on proof nets;

Properties of porous netted materials

International Nuclear Information System (INIS)

Daragan, V.D.; Drozdov, B.G.; Kotov, A.Yu.; Mel'nikov, G.N.; Pustogarov, A.V.

1987-01-01

Hydraulic and strength characteristics, efficient heat conduction and inner heat exchange coefficient are experimentally studied for porous netted materials on the base of the brass nets as dependent on porosity, cell size and method of net laying. Results of the studies are presented. It is shown that due to anisotropy of the material properties the hydraulic resistance in the direction parallel to the nets plane is 1.3-1.6 times higher than in the perpendicular one. Values of the effective heat conduction in the direction perpendicular to the nets plane at Π>0.45 agree with the data from literature, at Π<0.45 a deviation from the calculated values is marked in the direction of the heat conduction decrease

Sweden's Cooperation with Eastern Europe in Radiation Safety 2010

International Nuclear Information System (INIS)

Van Dassen, Lars; Andersson, Sarmite; Bejarano, Gabriela

2011-09-01

The Swedish Radiation Safety Authority implemented in 2010 cooperation projects in Russia, Ukraine, Georgia, Armenia, Lithuania and Moldova based on instructions from the Swedish Government and agreements with the European Union and the Swedish International Development Cooperation Agency, SIDA. The projects aim at achieving a net contribution to radiation safety (including nuclear safety, nuclear security and non-proliferation as well as radiation protection and emergency preparedness) for the benefit of the host country as well as Sweden. This report gives an overview of all the projects implemented in 2010

A Bayesian belief nets based quantitative software reliability assessment for PSA: COTS case study

International Nuclear Information System (INIS)

Eom, H. S.; Sung, T. Y.; Jeong, H. S.; Park, J. H.; Kang, H. G.; Lee, K. Y.; Park, J. K

2002-03-01

Current reliability assessments of safety critical software embedded in the digital systems in nuclear power plants are based on the rule-based qualitative assessment methods. Then recently practical needs require the quantitative features of software reliability for Probabilistic Safety Assessment (PSA) that is one of important methods being used in assessing the whole safety of nuclear power plant. But conventional quantitative software reliability assessment methods are not enough to get the necessary results in assessing the safety critical software used in nuclear power plants. Thus, current reliability assessment methods for these digital systems exclude the software part or use arbitrary values for the software reliability in the assessment. This reports discusses a Bayesian Belief Nets (BBN) based quantification method that models current qualitative software assessment in formal way and produces quantitative results required for PSA. Commercial Off-The-Shelf (COTS) software dedication process that KAERI developed was applied to the discussed BBN based method for evaluating the plausibility of the proposed method in PSA

Lyme Disease: A Sourcebook for Teaching about a Major Environmental Problem.

Science.gov (United States)

Anderson, Norman D.; Stubbs, Harriett S.

This book and others in the Changes in the Environment Series were produced as part of the GLOBE-NET Project, a partnership of science teachers and research scientists working on various aspects of global change. This book contains up-to-date information about Lyme disease, activities for the classroom, and other resources useful in teaching about…

Usage of Mobile Phone Applications and Its Impact on Teaching and Learning

Science.gov (United States)

Davidovitch, Nitza; Yavich, Roman

2018-01-01

This study continues studies on the concept of leisure as culture dependent -- between tradition and modernity, while focusing on the usage of mobile phone applications and its impact on teaching and learning within a unique population. The study examined the association between having NetSpark on one's Smartphone and utilization of spare time…

Understanding Net Zero Energy Buildings

DEFF Research Database (Denmark)

Salom, Jaume; Widén, Joakim; Candanedo, José

2011-01-01

Although several alternative definitions exist, a Net-Zero Energy Building (Net ZEB) can be succinctly described as a grid-connected building that generates as much energy as it uses over a year. The “net-zero” balance is attained by applying energy conservation and efficiency measures...... and by incorporating renewable energy systems. While based on annual balances, a complete description of a Net ZEB requires examining the system at smaller time-scales. This assessment should address: (a) the relationship between power generation and building loads and (b) the resulting interaction with the power grid...

History-dependent stochastic Petri nets

NARCIS (Netherlands)

Schonenberg, H.; Sidorova, N.; Aalst, van der W.M.P.; Hee, van K.M.; Pnueli, A.; Virbitskaite, I.; Voronkov, A.

2010-01-01

Stochastic Petri Nets are a useful and well-known tool for performance analysis. However, an implicit assumption in the different types of Stochastic Petri Nets is the Markov property. It is assumed that a choice in the Petri net only depends on the current state and not on earlier choices. For many

Pro ASP.NET 4 in VB 2010

CERN Document Server

MacDonald, Matthew; Freeman, Adam; Szpuszta, Mario; Agarwal, Vidya Vrat

2010-01-01

ASP.NET 4 is the latest version of Microsoft's revolutionary ASP.NET technology. It is the principal standard for creating dynamic web pages on the Windows platform. Pro ASP.NET 4 in VB 2010 raises the bar for high-quality, practical advice on learning and deploying Microsoft's dynamic web solution. This new edition is updated with everything you need to come to grips with the latest version of ASP.NET, including coverage of ASP.NET MVC, ASP.NET AJAX 4, ASP.NET Dynamic Data, and Silverlight 3. Seasoned .NET professionals Matthew MacDonald and Mario Szpuszta explain how you can get the most fro

Safety and Security at School: A Pedagogical Perspective

Science.gov (United States)

de Waal, Elda; Grosser, M. M.

2009-01-01

Education law and policy currently focus on broader physical aspects of safety and security at schools, as well as, for example, on pedagogical insecurity such as is caused by discriminatory teaching, but law and policy have yet to pay attention to the overall and far-reaching pedagogical safety and security of learners. By means of a descriptive…

NASA Net Zero Energy Buildings Roadmap

Energy Technology Data Exchange (ETDEWEB)

Pless, S.; Scheib, J.; Torcellini, P.; Hendron, B.; Slovensky, M.

2014-10-01

In preparation for the time-phased net zero energy requirement for new federal buildings starting in 2020, set forth in Executive Order 13514, NASA requested that the National Renewable Energy Laboratory (NREL) to develop a roadmap for NASA's compliance. NASA detailed a Statement of Work that requested information on strategic, organizational, and tactical aspects of net zero energy buildings. In response, this document presents a high-level approach to net zero energy planning, design, construction, and operations, based on NREL's first-hand experience procuring net zero energy construction, and based on NREL and other industry research on net zero energy feasibility. The strategic approach to net zero energy starts with an interpretation of the executive order language relating to net zero energy. Specifically, this roadmap defines a net zero energy acquisition process as one that sets an aggressive energy use intensity goal for the building in project planning, meets the reduced demand goal through energy efficiency strategies and technologies, then adds renewable energy in a prioritized manner, using building-associated, emission- free sources first, to offset the annual energy use required at the building; the net zero energy process extends through the life of the building, requiring a balance of energy use and production in each calendar year.

Can the Aviation Industry be Useful in Teaching Oncology about Safety?

Science.gov (United States)

Davies, J M; Delaney, G

2017-10-01

Healthcare practitioners have long considered aviation as a domain from which much can be learned about safety. Over the past 30 years, attempts have been made to apply aviation safety-related concepts to healthcare. Although some applications have been successful, a few decades later, many healthcare safety experts have learned that the appeal of the aviation-healthcare analogy is an illusion. Both domains are so basically dissimilar that simple adoption of aviation concepts will not be successful. However, what has succeeded is healthcare's adaptation of specific aviation safety concepts. Three concepts, investment in safety, human factors and safety management systems, are described and examples are given of adapted applications to healthcare/clinical oncology. Finally, there is a need to ensure that these concepts are applied systematically throughout healthcare rather than sporadically and without a centralised mandate, to help ensure success and improved patient and provider safety. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Getting to Net Zero

Energy Technology Data Exchange (ETDEWEB)

2016-09-01

The technology necessary to build net zero energy buildings (NZEBs) is ready and available today, however, building to net zero energy performance levels can be challenging. Energy efficiency measures, onsite energy generation resources, load matching and grid interaction, climatic factors, and local policies vary from location to location and require unique methods of constructing NZEBs. It is recommended that Components start looking into how to construct and operate NZEBs now as there is a learning curve to net zero construction and FY 2020 is just around the corner.

Net Zero Energy Buildings

DEFF Research Database (Denmark)

Marszal, Anna Joanna; Bourrelle, Julien S.; Gustavsen, Arild

2010-01-01

and identify possible renewable energy supply options which may be considered in calculations. Finally, the gap between the methodology proposed by each organisation and their respective national building code is assessed; providing an overview of the possible changes building codes will need to undergo......The international cooperation project IEA SHC Task 40 / ECBCS Annex 52 “Towards Net Zero Energy Solar Buildings”, attempts to develop a common understanding and to set up the basis for an international definition framework of Net Zero Energy Buildings (Net ZEBs). The understanding of such buildings...

Pro NET Best Practices

CERN Document Server

Ritchie, Stephen D

2011-01-01

Pro .NET Best Practices is a practical reference to the best practices that you can apply to your .NET projects today. You will learn standards, techniques, and conventions that are sharply focused, realistic and helpful for achieving results, steering clear of unproven, idealistic, and impractical recommendations. Pro .NET Best Practices covers a broad range of practices and principles that development experts agree are the right ways to develop software, which includes continuous integration, automated testing, automated deployment, and code analysis. Whether the solution is from a free and

The National School Safety Framework: A framework for preventing ...

African Journals Online (AJOL)

The National School Safety Framework (NSSF) – approved by the Minister of Education in April 2015 - is located within a range of international and national laws and policies that recognise the safety of learners and educators as a prerequisite for quality learning and teaching at school. The framework affirms the ...

ASP.NET web API build RESTful web applications and services on the .NET framework

CERN Document Server

Kanjilal, Joydip

2013-01-01

This book is a step-by-step, practical tutorial with a simple approach to help you build RESTful web applications and services on the .NET framework quickly and efficiently.This book is for ASP.NET web developers who want to explore REST-based services with C# 5. This book contains many real-world code examples with explanations whenever necessary. Some experience with C# and ASP.NET 4 is expected.

Household bed net ownership and use among under-5 children in Nigeria

Directory of Open Access Journals (Sweden)

Osuorah DC

2013-07-01

Full Text Available D Chidiebere Osuorah,1,2 Chijioke Elias Ezeudu,2 Stanley Kenechi Onah,2 Obinna Tochukwu Anyabolu31Child Survival Unit, Medical Research Council UK, The Gambia Unit, Banjul, The Gambia; 2Department of Pediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra, Nigeria; 3School of Health and Social Care, Oxford Brookes University, Oxford, UKBackground: Malaria remains the leading cause of morbidity and mortality in sub-Saharan Africa, with children under 5 years accounting for 86% of all malaria deaths. For effective control of malaria, WHO recommends rapid diagnosis and effective treatment, insecticide-treated bed nets, and indoor residual spraying. The use of insecticide-treated bed nets has been shown to be the most cost-effective strategy in preventing this infection. However, despite the Roll Back Malaria subsidized and free bed net distribution initiatives in some Africa countries, bed net uptake and usage still remains low in many households.Aim: This study aimed to investigate household characteristics and child factors that determine bed net ownership and use amongst under-5 children and the effect of its usage on malaria parasitemia in under-5 children in Nigeria.Methods: Data from a nationally representative sample of 5895 households was obtained from the 36 states and the Federal Capital Territory in the 2010 Nigeria demographic and health survey, with a minimum of 67 households enrolled per state. Appropriate statistical tools were used to identify the characteristics of households that owned a bed net and to examine the association between the households and child-level factors that predict the use of bed net and malaria prevalence among under-5 children within these households.Results: The rate of households bed net ownership in Nigeria is about 45.5%. About 48.5% of under-5 children in 33.9% of households surveyed, use a bed net during sleep. There was a strong correlation between households ownership and child

Usefulness of an Internet-based thematic learning network: comparison of effectiveness with traditional teaching.

Science.gov (United States)

Coma Del Corral, María Jesús; Guevara, José Cordero; Luquin, Pedro Abáigar; Peña, Horacio J; Mateos Otero, Juan José

2006-03-01

UniNet is an Internet-based thematic network for a virtual community of users (VCU). It supports one multidisciplinary community of doctoral students, who receive most of the courses on the network. The evident advantages of distance learning by Internet, in terms of costs, comfort, etc., require a previous evaluation of the system, focusing on the learning outcomes of the student. The aim was to evaluate the real learning of the students of doctorate courses, by comparing the effectiveness of distance learning in UniNet with traditional classroom-based teaching. Five doctorate courses were taught simultaneously to two independent groups of students in two ways: one, through the UniNet Network, and the other in a traditional classroom. The academic knowledge of students was evaluated at the beginning and end of each course. The difference in score was considered as a knowledge increase. The comparison was made using Student's t-test for independent groups. There were no significant statistical differences in the outcomes of the two groups of students. This suggests that both teaching systems were equivalent in increasing the knowledge of the students. Both educational methods, the traditional system and the online system in a thematic network, are effective and similar for increasing knowledge.

Translating Colored Control Flow Nets into Readable Java via Annotated Java Workflow Nets

DEFF Research Database (Denmark)

Lassen, Kristian Bisgaard; Tjell, Simon

2007-01-01

In this paper, we present a method for developing Java applications from Colored Control Flow Nets (CCFNs), which is a special kind of Colored Petri Nets (CPNs) that we introduce. CCFN makes an explicit distinction between the representation of: The system, the environment of the system, and the ......In this paper, we present a method for developing Java applications from Colored Control Flow Nets (CCFNs), which is a special kind of Colored Petri Nets (CPNs) that we introduce. CCFN makes an explicit distinction between the representation of: The system, the environment of the system......, and the interface between the system and the environment. Our translation maps CCFNs into Anno- tated Java Workflow Nets (AJWNs) as an intermediate step, and these AJWNs are finally mapped to Java. CCFN is intended to enforce the modeler to describe the system in an imperative manner which makes the subsequent...... translation to Java easier to define. The translation to Java preserves data dependencies and control-flow aspects of the source CCFN. This paper contributes to the model-driven software development paradigm, by showing how to model a system, environment, and their interface, as a CCFN and presenting a fully...

The Microscale Inorganic Laboratory: Safety, Economy and Versatility.

Science.gov (United States)

Szafran, Zvi; And Others

1989-01-01

Discussed are four major advantages to the use of microscale laboratories for teaching chemistry. Included are effects on waste generation, laboratory safety, reagent variety, and laboratory efficiency. (CW)

Programming NET 35

CERN Document Server

Liberty, Jesse

2009-01-01

Bestselling author Jesse Liberty and industry expert Alex Horovitz uncover the common threads that unite the .NET 3.5 technologies, so you can benefit from the best practices and architectural patterns baked into the new Microsoft frameworks. The book offers a Grand Tour" of .NET 3.5 that describes how the principal technologies can be used together, with Ajax, to build modern n-tier and service-oriented applications. "

Net metering: zero electricity bill

International Nuclear Information System (INIS)

Mangi, A.; Khan, Z.

2011-01-01

Worldwide move towards renewable energy sources, environmental concerns and decentralization of the power sector have made net metering an attractive option for power generation at small scale. This paper discusses the net metering, economical issues of renewable sources in Pakistan, technical aspects, installation suitability according to varying terrain, existing utility rules and formulation of legislation for net metering making it economically attractive. (author)

Seminar series on Safety matters

CERN Multimedia

HSE

2010-01-01

The HSE - Occupational Health & Safety and Environmental Protection - Unit is starting a seminar series on Safety matters. The aim is to invite colleagues from Universities, Industries or Government Agencies to share their experience. The seminars will take place in intervals of several months. Part of the Seminars will be held in the form of a Forum where participants can discuss and share views with persons who manage, teach or research Safety matters elsewhere. You are invited to the first Safety Seminar on 22nd September 2010 at 10h00 in building 40 S2 A1 "Salle Andersson" L’Ecole Polytechnique Fédérale de Lausanne (EPFL) will present the way safety is managed in their research institution. Some aspects of research in physics and chemical laboratories will also be presented. The seminar will be given by Dr Thierry Meyer, Head of OHS at FSB-EPFL and Dr Amela Groso, responsible for the safety of the physics institutes

Net Locality

DEFF Research Database (Denmark)

de Souza e Silva, Adriana Araujo; Gordon, Eric

Provides an introduction to the new theory of Net Locality and the profound effect on individuals and societies when everything is located or locatable. Describes net locality as an emerging form of location awareness central to all aspects of digital media, from mobile phones, to Google Maps......, to location-based social networks and games, such as Foursquare and facebook. Warns of the threats these technologies, such as data surveillance, present to our sense of privacy, while also outlining the opportunities for pro-social developments. Provides a theory of the web in the context of the history...... of emerging technologies, from GeoCities to GPS, Wi-Fi, Wiki Me, and Google Android....

Construction of monophase nets

International Nuclear Information System (INIS)

Suarez A, Jose Antonio

1996-01-01

The paper refers to the use of monophase loads in commercial residential urbanizations and in small industries, for this reason it is considered unnecessary the construction of three-phase nets. The author makes a historical recount of these nets in Bogota, his capacities, uses and energy savings

Cultivating engaged leadership through a learning collaborative: lessons from primary care renewal in Oregon safety net clinics.

Science.gov (United States)

McMullen, Carmit K; Schneider, Jennifer; Firemark, Alison; Davis, James; Spofford, Mark

2013-01-01

The aim of this study was to explore how learning collaboratives cultivate leadership skills that are essential for implementing patient-centered medical homes (PCMHs). We conducted an ethnographic evaluation of a payor-incentivized PCMH implementation in Oregon safety net clinics, known as Primary Care Renewal. Analyses primarily drew on in-depth interviews with organizational leaders who were involved in the initiative. We solicited perspectives on the history, barriers, facilitators, and other noteworthy factors related to the implementation of PCMH. We reviewed and summarized transcripts and created and applied a coding dictionary to identify emergent leadership themes. We reviewed field notes from clinic site visits and observations of learning collaborative activities for additional information on the role of engaged leadership. Interview data suggested that organizations followed a similar, sequential process of Primary Care Renewal implementation having 2 phases-inspiration and implementation-and that leaders needed and learned different leadership skills in each phase. Leaders reported that collaborative learning opportunities were critical for developing engaged leadership skills during the inspiration phase of transformation. Facilitative and modeling aspects of engaged leadership were most important for codesigning a vision and plan for change. Adaptive leadership skills became more important during the implementation phase, when specific operational and management skills were needed to foster standardization and spread of the Primary Care Renewal initiative throughout participating clinics. The PCMH has received much attention as a way to reorganize and potentially improve primary care. Documenting steps and stages for cultivating leaders with the vision and skills to transform their organizations into PCMHs may offer a useful roadmap to other organizations considering a similar transformation.

Caught in the Net: Perineuronal Nets and Addiction

Directory of Open Access Journals (Sweden)

Megan Slaker

2016-01-01

Full Text Available Exposure to drugs of abuse induces plasticity in the brain and creates persistent drug-related memories. These changes in plasticity and persistent drug memories are believed to produce aberrant motivation and reinforcement contributing to addiction. Most studies have explored the effect drugs of abuse have on pre- and postsynaptic cells and astrocytes; however, more recently, attention has shifted to explore the effect these drugs have on the extracellular matrix (ECM. Within the ECM are unique structures arranged in a net-like manner, surrounding a subset of neurons called perineuronal nets (PNNs. This review focuses on drug-induced changes in PNNs, the molecules that regulate PNNs, and the expression of PNNs within brain circuitry mediating motivation, reward, and reinforcement as it pertains to addiction.

Occupational Safety. Hand Tools. Pre-Apprenticeship Phase 1 Training.

Science.gov (United States)

Lane Community Coll., Eugene, OR.

This self-paced student training module on safety when using hand tools is one of a number of modules developed for Pre-apprenticeship Phase 1 Training. Purpose of the module is to teach students the correct safety techniques for operating common hand- and arm-powered tools, including selection, maintenance, technique, and uses. The module may…

Leading Edge. Volume 7, Number 3. Systems Safety Engineering

Science.gov (United States)

2010-01-01

foods were not always safe to eat given the sanitary conditions of the day. In 1943, the psychologist Abraham Maslow proposed a five-level... hierarchy of basic human needs, and safety was number two on this list. System safety is a specialized and formalized extension of our in- herent drive for...factors, hazards, mishaps, and ef- fects. The following is an example of each element within the hierarchy : An exposed sharp edge in a relay cabi- net

Development of a British Road Safety Education Support Materials Curriculum.

Science.gov (United States)

Bouck, Linda H.

Road safety education needs to be a vital component in the school curriculum. This paper describes a planned road safety education support materials curriculum developed to aid educators in the Wiltshire County (England) primary schools. Teaching strategies include topic webs, lecture, class discussion, group activities, and investigative learning…

The K-NET - A year after

International Nuclear Information System (INIS)

Kinoshita, S.; Ohtani, K.; Katayama, T.

2001-01-01

We started to release the K-NET strong-motion data from June 1996 and about one year passed. In this article, we report the development of K-NET and some applications using the K-NET information released on the Internet. (author)

Mars MetNet Mission Status

Science.gov (United States)

Harri, A.-M.; Aleksashkin, S.; Arruego, I.; Schmidt, W.; Genzer, M.; Vazquez, L.; Haukka, H.; Palin, M.; Nikkanen, T.

2015-10-01

New kind of planetary exploration mission for Mars is under development in collaboration between the Finnish Meteorological Institute (FMI), Lavochkin Association (LA), Space Research Institute (IKI) and Institutio Nacional de Tecnica Aerospacial (INTA). The Mars MetNet mission is based on a new semihard landing vehicle called MetNet Lander (MNL). The scientific payload of the Mars MetNet Precursor [1] mission is divided into three categories: Atmospheric instruments, Optical devices and Composition and structure devices. Each of the payload instruments will provide significant insights in to the Martian atmospheric behavior. The key technologies of the MetNet Lander have been qualified and the electrical qualification model (EQM) of the payload bay has been built and successfully tested.

NET SALARY ADJUSTMENT

CERN Multimedia

Finance Division

2001-01-01

On 15 June 2001 the Council approved the correction of the discrepancy identified in the net salary adjustment implemented on 1st January 2001 by retroactively increasing the scale of basic salaries to achieve the 2.8% average net salary adjustment approved in December 2000. We should like to inform you that the corresponding adjustment will be made to your July salary. Full details of the retroactive adjustments will consequently be shown on your pay slip.

Net energy gain from DT fusion

International Nuclear Information System (INIS)

Buende, R.

1985-01-01

The net energy which can be gained from an energy raw material by means of a certain conversion system is deduced as the figure-of-merit which adequately characterizes the net energy balance of utilizing an energy source. This potential net energy gain is determined for DT fusion power plants. It is represented as a function of the degree of exploitation of the energy raw material lithium ore and is compared with the net energy which can be gained with LW and FBR power plants by exploiting uranium ore. The comparison clearly demonstrates the net energetic advantage of DT fusion. A sensitivity study shows that this holds even if the energy expenditure for constructing and operating is drastically increased

Net alkalinity and net acidity 2: Practical considerations

Science.gov (United States)

Kirby, C.S.; Cravotta, C.A.

2005-01-01

The pH, alkalinity, and acidity of mine drainage and associated waters can be misinterpreted because of the chemical instability of samples and possible misunderstandings of standard analytical method results. Synthetic and field samples of mine drainage having various initial pH values and concentrations of dissolved metals and alkalinity were titrated by several methods, and the results were compared to alkalinity and acidity calculated based on dissolved solutes. The pH, alkalinity, and acidity were compared between fresh, unoxidized and aged, oxidized samples. Data for Pennsylvania coal mine drainage indicates that the pH of fresh samples was predominantly acidic (pH 2.5-4) or near neutral (pH 6-7); ??? 25% of the samples had pH values between 5 and 6. Following oxidation, no samples had pH values between 5 and 6. The Standard Method Alkalinity titration is constrained to yield values >0. Most calculated and measured alkalinities for samples with positive alkalinities were in close agreement. However, for low-pH samples, the calculated alkalinity can be negative due to negative contributions by dissolved metals that may oxidize and hydrolyze. The Standard Method hot peroxide treatment titration for acidity determination (Hot Acidity) accurately indicates the potential for pH to decrease to acidic values after complete degassing of CO2 and oxidation of Fe and Mn, and it indicates either the excess alkalinity or that required for neutralization of the sample. The Hot Acidity directly measures net acidity (= -net alkalinity). Samples that had near-neutral pH after oxidation had negative Hot Acidity; samples that had pH mine drainage treatment can lead to systems with insufficient Alkalinity to neutralize metal and H+ acidity and is not recommended. The use of net alkalinity = -Hot Acidity titration is recommended for the planning of mine drainage treatment. The use of net alkalinity = (Alkalinitymeasured - Aciditycalculated) is recommended with some cautions

Utility of routine postoperative visit after appendectomy and cholecystectomy with evaluation of mobile technology access in an urban safety net population.

Science.gov (United States)

Chen, Diane W; Davis, Rachel W; Balentine, Courtney J; Scott, Aaron R; Gao, Yue; Tapia, Nicole M; Berger, David H; Suliburk, James W

2014-08-01

The value of routine postoperative visits after general surgery remains unclear. The objective of this study was to evaluate the utility of routine postoperative visits after appendectomy and cholecystectomy and to determine access to mobile technology as an alternative platform for follow-up. Retrospective review of 219 appendectomies and 200 cholecystectomies performed at a safety net hospital. One patient underwent both surgeries. Patient demographics, duration of clinic visit, and need for additional imaging, tests or readmissions were recorded. Access to mobile technology was surveyed by a validated questionnaire. Of 418 patients, 84% percent completed a postoperative visit. At follow-up, 58 patients (14%) required 70 interventions, including staple removal (16, 23%), suture removal (4, 6%), drain removal (8, 11%), additional follow-up (20, 28%), medication action (16, 21%), additional imaging (3, 4%), and readmission (1, 1%). Occupational paperwork (62) and nonsurgical clinic referrals (28) were also performed. Average check-in to check-out time was 100 ± 54 min per patient. One intervention was performed for every 7.8 h of time in the clinic. Additionally, 88% of the surveyed population reported access to cell phone technology, and 69% of patients mobile technology, which is pervasive in our population. Copyright © 2014 Elsevier Inc. All rights reserved.

Bed net ownership in Kenya: the impact of 3.4 million free bed nets

Directory of Open Access Journals (Sweden)

Vulule John

2010-06-01

Full Text Available Abstract Background In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs were distributed free in a campaign targeting children 0-59 months old (CU5s in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated. Methods A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs with attached global positioning systems (GPS were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data. Results In targeted areas, 67.5% (95% CI: 64.6, 70.3% of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0% of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7% slept under an ITN during the previous evening. Nearly forty percent (39.1% of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%. Conclusions The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels.

Home Kitchen Safety Lessons for Children and Adults

OpenAIRE

Wingfield, Amanda

2014-01-01

The purpose of this project was to design a series of lessons introducing food safety concepts and hand washing to children ages three to five, which is a group that is considered an ‘at risk’ population with food safety regards. There are other curriculum that reach this audience, but the intent of this one is to target stay-at-home mothers, whose children are not in preschool. The project goal is to teach the mother and child food safety concepts while simultaneously using hands on cooking ...

47 CFR 65.450 - Net income.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Net income. 65.450 Section 65.450... OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Exchange Carriers § 65.450 Net income. (a) Net income shall consist of all revenues derived from the provision of interstate telecommunications services...

Improving patient safety: patient-focused, high-reliability team training.

Science.gov (United States)

McKeon, Leslie M; Cunningham, Patricia D; Oswaks, Jill S Detty

2009-01-01

Healthcare systems are recognizing "human factor" flaws that result in adverse outcomes. Nurses work around system failures, although increasing healthcare complexity makes this harder to do without risk of error. Aviation and military organizations achieve ultrasafe outcomes through high-reliability practice. We describe how reliability principles were used to teach nurses to improve patient safety at the front line of care. Outcomes include safety-oriented, teamwork communication competency; reflections on safety culture and clinical leadership are discussed.

Retrospect and prospect of “Traffic Safety Education” in Kagawa Prefecture

Directory of Open Access Journals (Sweden)

Takeo Ihara

2011-03-01

Full Text Available The aim of this paper is to explain why we have conducted “Traffic Safety Education” in the Kagawa Prefecture during the past ten years so as to clarify the important factors for preventing painful traffic accidents in advance. To meet this aim, we firstly clarify the reason why we eventually decided to conduct “Traffic Safety Education” in the Kagawa Prefecture. In other words, the organization of powerful actors and/or leaders to cope with traffic accidents plays a very important role in “Traffic Safety Education.” Then, we specifically describe the essential parts of our “Traffic Safety Education”. In this respect, we have decided to select the following two aims: to reduce the number of traffic accidents, and to improve traffic manners, respectively. Thirdly, we evaluate various measures, such as teaching materials, teaching methods, and other activities of our “Traffic Safety Education” in detail. Lastly, we summarize the remaining tasks, which have been revealed so far, together with some concluding remarks.

Business Profile of Boat Lift Net and Stationary Lift Net Fishing Gear in Morodemak Waters Central Java

Science.gov (United States)

Hapsari, Trisnani D.; Jayanto, Bogi B.; Fitri, Aristi D. P.; Triarso, I.

2018-02-01

Lift net is one of the fishing gears that is used widely in the Morodemak coastal fishing port (PPP) for catching pelagic fish. The yield of fish captured by these fishing gear has high economic value, such as fish belt (Trichiurus sp), squids (Loligo sp) and anchovies (Stelophorus sp). The aims of this research were to determine the technical aspects of boat lift net and stationary lift net fishing gear in Morodemak Waters Demak Regency; to find out the financial aspect of those fishing gears and to analyze the financial feasibility by counting PP, NPV, IRR, and B/C ratio criteria. This research used case study method with descriptive analysis. The sampling method was purposive sampling with 22 fishermen as respondents. The result of the research showed that the average of boat lift net acceptance was Rp 388,580,000. The financial analysis of fisheries boat lift net with the result of NPV Rp 836,149,272, PP 2.44 years, IRR value 54%, and B/C ratio 1.73. The average of stationary lift net acceptance was Rp 27,750,000. The financial analysis lift net with the result of NPV Rp 37,937,601; PP 1.96 years, IRR value 86%, and B/C ratio 1.32. This research had a positive NPV value, B/C ratio >1, and IRR > discount rate (12 %). This study concluded that the fishery business of boat lift net and stationary lift net in Morodemak coastal fishing port (PPP) was worth running.

Net neutrality and audiovisual services

OpenAIRE

van Eijk, N.; Nikoltchev, S.

2011-01-01

Net neutrality is high on the European agenda. New regulations for the communication sector provide a legal framework for net neutrality and need to be implemented on both a European and a national level. The key element is not just about blocking or slowing down traffic across communication networks: the control over the distribution of audiovisual services constitutes a vital part of the problem. In this contribution, the phenomenon of net neutrality is described first. Next, the European a...

Medical Education: Entrusting Faith in Bedside Teaching

Directory of Open Access Journals (Sweden)

Saurabh RamBihariLal Shrivastava

2014-05-01

Full Text Available Globally, patient safety and quality of health care services are the predominant challenges faced by the health care industry. To produce competent doctors it is essential to inculcate skills such as clinical reasoning, critical thinking, and self-directed learning among the medical students. Bedside teaching is a common teaching format in medical education where students are taught in an interactive manner with real patients in hospital wards which help them in acquiring the medical skills and interpersonal behavior necessary for their daily practice as doctors.

Reliability Analysis of Core Protection Calculator System by Combining Petri Net and Fault Tree

International Nuclear Information System (INIS)

Kim, Hyejin; Kim, Jonghyun

2013-01-01

This paper proposes an approach to analyzing the reliability of digital systems by combining Petri net (PN) and Fault tree. The Petri net allows modeling event dependencies and interaction, to represent the time sequence, and to model assumptions for dynamic events. The Petri net model can be straightforwardly transformed to fault tree using the gate. Then, the FT can be integrated into the existing PSA. This paper applies the approach to the reliability analysis of Core Protection Calculator System (CPCS). Digital technology is replacing the analog instrumentation and control (I and C) systems in both new and upgraded nuclear power plants. As digital systems are introduced to nuclear power plants, issues related with reliability analyses of these digital systems are being raised. One of these issues is that static fault tree (FT) and event tree (ET) approach cannot properly account for dynamic interactions in the digital systems, such as multiple top events, logic loops and time delay. Many methods have been proposed to solve the problems, but there is no single method that is universally accepted for the application to the current generation probabilistic safety analysis (PSA)

Reliability Analysis of Core Protection Calculator System by Combining Petri Net and Fault Tree

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyejin; Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2013-10-15

This paper proposes an approach to analyzing the reliability of digital systems by combining Petri net (PN) and Fault tree. The Petri net allows modeling event dependencies and interaction, to represent the time sequence, and to model assumptions for dynamic events. The Petri net model can be straightforwardly transformed to fault tree using the gate. Then, the FT can be integrated into the existing PSA. This paper applies the approach to the reliability analysis of Core Protection Calculator System (CPCS). Digital technology is replacing the analog instrumentation and control (I and C) systems in both new and upgraded nuclear power plants. As digital systems are introduced to nuclear power plants, issues related with reliability analyses of these digital systems are being raised. One of these issues is that static fault tree (FT) and event tree (ET) approach cannot properly account for dynamic interactions in the digital systems, such as multiple top events, logic loops and time delay. Many methods have been proposed to solve the problems, but there is no single method that is universally accepted for the application to the current generation probabilistic safety analysis (PSA)

47 CFR 65.500 - Net income.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Net income. 65.500 Section 65.500... OF RETURN PRESCRIPTION PROCEDURES AND METHODOLOGIES Interexchange Carriers § 65.500 Net income. The net income methodology specified in § 65.450 shall be utilized by all interexchange carriers that are...

Aplicació Microsoft .Net : Hotel Spa

OpenAIRE

Marquès Palmer, Jordi

2010-01-01

Desenvolupament d'una aplicació amb Microsoft .NET, WCF, WPF, Linq2SQL, d'un Hotel Spa. Desarrollo de una aplicación con Microsoft .NET, WCF, WPF, Linq2SQL, de un Hotel Spa. Application development using Microsoft .NET, WCF, WPF, Linq2SQL, for a Spa Hotel.

Occupational Safety and Health Practices: An Alarming Call to Action

Science.gov (United States)

Threeton, Mark D.; Evanoski, Danielle C.

2014-01-01

In an effort to provide additional insight on providing a secure teaching and learning environment within schools, this study sought to: (1) explore the safety and health practices within Career and Technical Education (CTE); and (2) identify the perceived obstacles which appear to hinder implementation of health and safety programs. While it…

The Status of Road Safety in Iran during 2001 – 2006

Directory of Open Access Journals (Sweden)

M. J. Jafari

2013-08-01

.Result: The results revealed that during the period of 6 years, death toll has been increased by 9 deaths per 100000 person of the population. Moreover, application of seat belt and safety helmet has been increased by 20% and 18%, respectively. It also indicated that the number of motorists and the length of paved roads have been increased by 20%, and 10%, respectively. The net income per capita has also grown from 5884 US$ to 7968 US$ and the life expectancy has gone up from 68.9 years to 70.9 years, the percentage of the literate population has grown by 2% (from 76% to 78% and the human development index has increased from 0.721 to 0.759. The results of the present study showed that the increased level of death toll per 10000 vehicles and the increased level (% of seat belt as well as helmet application, paved roads, urbanization, the net income per capita, life expectancy, literacy and human development index were statistically significant and R2 coefficient for this factors was 0.84, 0.9, 0.994, 0.9, 0.97, 0.82, 0.69 and 0.84 respectively. .Conclusion: According to result of the present study, roads safety were not in an appropriate level. The roads safety status can be determined using road safety indicators to be applied for road safety promotion.

Evaluating peer teaching about chronic disease.

Science.gov (United States)

Guenther, Sylvia; Shadbolt, Narelle; Roberts, Chris; Clark, Tyler

2014-12-01

The primary care areas of priority (PCAP) activity was developed to engage medical students in learning about chronic disease management in a clinical context from their peers. It is one of several summative assessment tasks that occur during a primary care community term rotation in a graduate-entry medical programme. We evaluated the acceptability and effectiveness of the PCAP activity as a combined teaching, learning and assessment innovation. Evaluation and assessment data from students who rotated through the four community term blocks during the 2011-2012 academic year was analysed using both qualitative and quantitative methods. PCAP peer teaching activity is an effective format for teaching about the management of chronic conditions in the community Analysis indicated that 89 per cent (n = 148/166) of responding students rated the PCAP as satisfactory, good or excellent. The marking rubric contained 11 assessable components, including teaching skills, mastery of clinical knowledge, developing a management plan, disease prevention and health promotion opportunities, identifying patient safety issues, the impact of the clinical presentation on the patient and family, and consideration of health equity factors. Analysis of the assessment scores indicated that the majority of students achieved the specified learning outcomes. The PCAP peer teaching activity was an acceptable and effective format for teaching about the management of chronic conditions in the community, and is adaptable to other teaching contexts. Students enjoyed teaching and being taught by their peers, and assessment results indicated that they developed their clinical knowledge as well as their teaching ability regarding chronic disease management. © 2014 John Wiley & Sons Ltd.

Automatic Prompt System in the Process of Mapping plWordNet on Princeton WordNet

Directory of Open Access Journals (Sweden)

Paweł Kędzia

2015-06-01

Full Text Available Automatic Prompt System in the Process of Mapping plWordNet on Princeton WordNet The paper offers a critical evaluation of the power and usefulness of an automatic prompt system based on the extended Relaxation Labelling algorithm in the process of (manual mapping plWordNet on Princeton WordNet. To this end the results of manual mapping – that is inter-lingual relations between plWN and PWN synsets – are juxtaposed with the automatic prompts that were generated for the source language synsets to be mapped. We check the number and type of inter-lingual relations introduced on the basis of automatic prompts and the distance of the respective prompt synsets from the actual target language synsets.

Safety and immunogenicity of a combined Tetanus, Diphtheria, recombinant acellular Pertussis vaccine (TdaP) in healthy Thai adults.

Science.gov (United States)

Sirivichayakul, Chukiat; Chanthavanich, Pornthep; Limkittikul, Kriengsak; Siegrist, Claire-Anne; Wijagkanalan, Wassana; Chinwangso, Pailinrut; Petre, Jean; Hong Thai, Pham; Chauhan, Mukesh; Viviani, Simonetta

2017-01-02

An acellular Pertussis (aP) vaccine containing recombinant genetically detoxified Pertussis Toxin (PTgen), Filamentous Hemagglutinin (FHA) and Pertactin (PRN) has been developed by BioNet-Asia (BioNet). We present here the results of the first clinical study of this recombinant aP vaccine formulated alone or in combination with tetanus and diphtheria toxoids (TdaP). A phase I/II, observer-blind, randomized controlled trial was conducted at Mahidol University in Bangkok, Thailand in healthy adult volunteers aged 18-35 y. The eligible volunteers were randomized to receive one dose of either BioNet's aP or Tetanus toxoid-reduced Diphtheria toxoid-acellular Pertussis (TdaP) vaccine, or the Tdap Adacel® vaccine in a 1:1:1 ratio. Safety follow-up was performed for one month. Immunogenicity was assessed at baseline, at 7 and 28 d after vaccination. Anti-PT, anti-FHA, anti-PRN, anti-tetanus and anti-diphtheria IgG antibodies were assessed by ELISA. Anti-PT neutralizing antibodies were assessed also by CHO cell assay. A total of 60 subjects (20 per each vaccine group) were enrolled and included in the safety analysis. Safety laboratory parameters, incidence of local and systemic post-immunization reactions during 7 d after vaccination and incidence of adverse events during one month after vaccination were similar in the 3 vaccine groups. One month after vaccination, seroresponse rates of anti-PT, anti-FHA and anti-PRN IgG antibodies exceeded 78% in all vaccine groups. The anti-PT IgG, anti-FHA IgG, and anti-PT neutralizing antibody geometric mean titers (GMTs) were significantly higher following immunization with BioNet's aP and BioNet's TdaP than Adacel® (Pdiphtheria GMTs at one month after immunization were comparable in all vaccine groups. All subjects had seroprotective titers of anti-tetanus and anti-diphtheria antibodies at baseline. In this first clinical study, PTgen-based BioNet's aP and TdaP vaccines showed a similar tolerability and safety profile to Adacel

The study of three-dimensional net method of deformation observation

International Nuclear Information System (INIS)

Jia Jinyun

1996-12-01

Due to the influence of all kinds of factors, when buildings and equipment of nuclear power stations, water power stations and so on are in their service, deformations always happen to them. Especially, the breakage, the slide of edge danger rocks and basic displacement in the area of nuclear power station site can all interfere its regular operation, even endanger safety. But the traditional trigonometric net control can not obtain high precise deformation observation. So, topographic balanced vertical deviations are applied. The slope distance is divided rationally into horizontal and vertical components, then the precise vertical component is used to participate in restricting the deflection in order to enhance the observation post's precision. Meanwhile, the element model is selected, high precise monitoring net of three-dimensional deformation is set up, using astro-geodetic deflection of the vertical to correct the observation values. In this way, the earth error of height is given, the plane coordinate is defined by paralleling some plane of reference ellipsoid. This method may satisfy the deformation observation in the projects such as nuclear power stations or so. (8 figs., 5 tabs.)

Improving the Accuracy of Outdoor Educators' Teaching Self-Efficacy Beliefs through Metacognitive Monitoring

Science.gov (United States)

Schumann, Scott; Sibthorp, Jim

2016-01-01

Accuracy in emerging outdoor educators' teaching self-efficacy beliefs is critical to student safety and learning. Overinflated self-efficacy beliefs can result in delayed skilled development or inappropriate acceptance of risk. In an outdoor education context, neglecting the accuracy of teaching self-efficacy beliefs early in an educator's…

Loss of protection with insecticide-treated nets against pyrethroid-resistant Culex quinquefasciatus mosquitoes once nets become holed: an experimental hut study

Directory of Open Access Journals (Sweden)

Irish SR

2008-06-01

Full Text Available Abstract Background An important advantage of pyrethroid-treated nets over untreated nets is that once nets become worn or holed a pyrethroid treatment will normally restore protection. The capacity of pyrethroids to kill or irritate any mosquito that comes into contact with the net and prevent penetration of holes or feeding through the sides are the main reasons why treated nets continue to provide protection despite their condition deteriorating over time. Pyrethroid resistance is a growing problem among Anopheline and Culicine mosquitoes in many parts of Africa. When mosquitoes become resistant the capacity of treated nets to provide protection might be diminished, particularly when holed. An experimental hut trial against pyrethroid-resistant Culex quinquefasciatus was therefore undertaken in southern Benin using a series of intact and holed nets, both untreated and treated, to assess any loss of protection as nets deteriorate with use and time. Results There was loss of protection when untreated nets became holed; the proportion of mosquitoes blood feeding increased from 36.2% when nets were intact to between 59.7% and 68.5% when nets were holed to differing extents. The proportion of mosquitoes blood feeding when treated nets were intact was 29.4% which increased to 43.6–57.4% when nets were holed. The greater the number of holes the greater the loss of protection regardless of whether nets were untreated or treated. Mosquito mortality in huts with untreated nets was 12.9–13.6%; treatment induced mortality was less than 12%. The exiting rate of mosquitoes into the verandas was higher in huts with intact nets. Conclusion As nets deteriorate with use and become increasingly holed the capacity of pyrethroid treatments to restore protection is greatly diminished against resistant Culex quinquefasciatus mosquitoes.

Traditional nets interfere with the uptake of long-lasting insecticidal nets in the Peruvian Amazon: the relevance of net preference for achieving high coverage and use.

Directory of Open Access Journals (Sweden)

Koen Peeters Grietens

Full Text Available While coverage of long-lasting insecticide-treated nets (LLIN has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru.The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses.A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2% than in those with walls (73.8% (OR = 5.2, 95CI [2.2; 12.3], p<0.001.Net preference can interfere with optimal LLIN use. In order to improve the number of effective days of LLIN protection per dollar spent, appropriate quantitative and qualitative

HANPP Collection: Human Appropriation of Net Primary Productivity as a Percentage of Net Primary Productivity

Data.gov (United States)

National Aeronautics and Space Administration — The Human Appropriation of Net Primary Productivity (HANPP) as a Percentage of Net Primary Product (NPP) portion of the HANPP Collection represents a map identifying...

Delta Semantics Defined By Petri Nets

DEFF Research Database (Denmark)

Jensen, Kurt; Kyng, Morten; Madsen, Ole Lehrmann

and the possibility of using predicates to specify state changes. In this paper a formal semantics for Delta is defined and analysed using Petri nets. Petri nets was chosen because the ideas behind Petri nets and Delta concide on several points. A number of proposals for changes in Delta, which resulted from...

Coloured Petri Nets and the Invariant Method

DEFF Research Database (Denmark)

Jensen, Kurt

1981-01-01

processes to be described by a common subnet, without losing the ability to distinguish between them. Our generalization, called coloured Petri nets, is heavily influenced by predicate transition-nets introduced by H.J. Genrich and K. Lautenbach. Moreover our paper shows how the invariant-method, introduced...... for Petri nets by K. Lautenbach, can be generalized to coloured Petri nets....

Net metering in British Columbia : white paper

International Nuclear Information System (INIS)

Berry, T.

2003-01-01

Net metering was described as being the reverse registration of an electricity customer's revenue meter when interconnected with a utility's grid. It is a provincial policy designed to encourage small-distributed renewable power generation such as micro-hydro, solar energy, fuel cells, and larger-scale wind energy. It was noted that interconnection standards for small generation is an important issue that must be addressed. The British Columbia Utilities Commission has asked BC Hydro to prepare a report on the merits of net metering in order to support consultations on a potential net metering tariff application by the utility. This report provides information on net metering with reference to experience in other jurisdictions with net metering, and the possible costs and benefits associated with net metering from both a utility and consumer perspective. Some of the barriers and policy considerations for successful implementation of net metering were also discussed. refs., tabs., figs

Educational Technology-Related Performance of Teaching Faculty in Higher Education: Implications for eLearning Management

Science.gov (United States)

Larbi-Apau, Josephine A.; Guerra-Lopez, Ingrid; Moseley, James L.; Spannaus, Timothy; Yaprak, Attila

2017-01-01

The study examined teaching faculty's educational technology-related performances (ETRP) as a measure for predicting eLearning management in Ghana. A total of valid data (n = 164) were collected and analyzed on applied ISTE-NETS-T Performance Standards using descriptive and ANOVA statistics. Results showed an overall moderate performance with the…

Hospital Accreditation: What is its Effect on Quality and Safety Indicators? Experience of an Iranian teaching hospital

Directory of Open Access Journals (Sweden)

Ali Janati

2016-07-01

Full Text Available Background: program evaluation is an integral and expected component in the development of any healthcare program. It helps decision-makers to base their decisions on facts. Objective: This paper analyzes the effect of accreditation on three indicators related to patient safety and hospital care quality in ICU wards of an Iranian teaching hospital. Methods: This interventional study was accomplished based on executive management and scientific methods such as plan-do-check-act (PDCA cycle and audit to improve quality and safety. We used data reported from ICU wards of the hospital to analyze the effect of accreditation on the three selected indicators. (SPSS version 22.00 was used for the statistical analysis. Results: In total, 6997 patients were analyzed. The accreditation interventions appeared to be effective at reducing pressure ulcer incidence average (from an average of 6.8 percent to 4.1 percent (p=0.045. The accreditation also. The average stay of the patients during the study also positively changed from an average of 1.58 days to 10.13 days (1.45 improvements(p=0.0303. In relation to hospital acquired infection but, unexpectedly, its effect on hospital was negative, then it considerably increased and rose from 1.5 percent to 8.1 percent (p=0.001. However this increasing was due to enhanced infection incident report system. Conclusion: hospital accreditation has presented ample opportunity a significant positive effect on hospitals. 

Biological Petri Nets

CERN Document Server

Wingender, E

2011-01-01

It was suggested some years ago that Petri nets might be well suited to modeling metabolic networks, overcoming some of the limitations encountered by the use of systems employing ODEs (ordinary differential equations). Much work has been done since then which confirms this and demonstrates the usefulness of this concept for systems biology. Petri net technology is not only intuitively understood by scientists trained in the life sciences, it also has a robust mathematical foundation and provides the required degree of flexibility. As a result it appears to be a very promising approach to mode

[Implementation of a safety and health planning system in a teaching hospital].

Science.gov (United States)

Mariani, F; Bravi, C; Dolcetti, L; Moretto, A; Palermo, A; Ronchin, M; Tonelli, F; Carrer, P

2007-01-01

University Hospital "L. Sacco" had started in 2006 a two-year project in order to set up a "Health and Safety Management System (HSMS)" referring to the technical guideline OHSAS 18001:1999 and the UNI and INAIL "Guidelines for a health and safety management system at workplace". So far, the following operations had been implemented: Setting up of a specific Commission within the Risk Management Committee; Identification and appointment of Departmental Representatives of HSMS; Carrying out of a training course addressed to Workers Representatives for Safety and Departmental Representatives of HSMS; Development of an Integrated Informative System for Prevention and Safety; Auditors qualification; Inspection of the Occupational Health Unit and the Prevention and Safety Service: reporting of critical situations and monitoring solutions adopted. Short term objectives are: Self-evaluation through check-lists of each department; Sharing of the Improvement Plan among the departments of the hospital; Planning of Health and Safety training activities in the framework of the Hospital Training Plan; Safety audit.

Patient safety education at Japanese medical schools: results of a nationwide survey.

Science.gov (United States)

Maeda, Shoichi; Kamishiraki, Etsuko; Starkey, Jay

2012-05-10

Patient safety education, including error prevention strategies and management of adverse events, has become a topic of worldwide concern. The importance of the patient safety is also recognized in Japan following two serious medical accidents in 1999. Furthermore, educational curriculum guideline revisions in 2008 by relevant the Ministry of Education includes patient safety as part of the core medical curriculum. However, little is known about the patient safety education in Japanese medical schools partly because a comprehensive study has not yet been conducted in this field. Therefore, we have conducted a nationwide survey in order to clarify the current status of patient safety education at medical schools in Japan. Response rate was 60.0% (n = 48/80). Ninety-eight-percent of respondents (n = 47/48) reported integration of patient safety education into their curricula. Thirty-nine percent reported devoting less than five hours to the topic. All schools that teach patient safety reported use of lecture based teaching methods while few used alternative methods, such as role-playing or in-hospital training. Topics related to medical error theory and legal ramifications of error are widely taught while practical topics related to error analysis such as root cause analysis are less often covered. Based on responses to our survey, most Japanese medical schools have incorporated the topic of patient safety into their curricula. However, the number of hours devoted to the patient safety education is far from the sufficient level with forty percent of medical schools that devote five hours or less to it. In addition, most medical schools employ only the lecture based learning, lacking diversity in teaching methods. Although most medical schools cover basic error theory, error analysis is taught at fewer schools. We still need to make improvements to our medical safety curricula. We believe that this study has the implications for the rest of the world as a

Patient safety education at Japanese medical schools: results of a nationwide survey

Directory of Open Access Journals (Sweden)

Maeda Shoichi

2012-05-01

Full Text Available Abstract Background Patient safety education, including error prevention strategies and management of adverse events, has become a topic of worldwide concern. The importance of the patient safety is also recognized in Japan following two serious medical accidents in 1999. Furthermore, educational curriculum guideline revisions in 2008 by relevant the Ministry of Education includes patient safety as part of the core medical curriculum. However, little is known about the patient safety education in Japanese medical schools partly because a comprehensive study has not yet been conducted in this field. Therefore, we have conducted a nationwide survey in order to clarify the current status of patient safety education at medical schools in Japan. Results Response rate was 60.0% (n = 48/80. Ninety-eight-percent of respondents (n = 47/48 reported integration of patient safety education into their curricula. Thirty-nine percent reported devoting less than five hours to the topic. All schools that teach patient safety reported use of lecture based teaching methods while few used alternative methods, such as role-playing or in-hospital training. Topics related to medical error theory and legal ramifications of error are widely taught while practical topics related to error analysis such as root cause analysis are less often covered. Conclusions Based on responses to our survey, most Japanese medical schools have incorporated the topic of patient safety into their curricula. However, the number of hours devoted to the patient safety education is far from the sufficient level with forty percent of medical schools that devote five hours or less to it. In addition, most medical schools employ only the lecture based learning, lacking diversity in teaching methods. Although most medical schools cover basic error theory, error analysis is taught at fewer schools. We still need to make improvements to our medical safety curricula. We believe that this

Modelling of current loads on aquaculture net cages

Science.gov (United States)

Kristiansen, Trygve; Faltinsen, Odd M.

2012-10-01

In this paper we propose and discuss a screen type of force model for the viscous hydrodynamic load on nets. The screen model assumes that the net is divided into a number of flat net panels, or screens. It may thus be applied to any kind of net geometry. In this paper we focus on circular net cages for fish farms. The net structure itself is modelled by an existing truss model. The net shape is solved for in a time-stepping procedure that involves solving a linear system of equations for the unknown tensions at each time step. We present comparisons to experiments with circular net cages in steady current, and discuss the sensitivity of the numerical results to a set of chosen parameters. Satisfactory agreement between experimental and numerical prediction of drag and lift as function of the solidity ratio of the net and the current velocity is documented.

FY 2000 Project of international clean energy network using hydrogen conversion (WE-NET)

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

Described herein are the FY 2000 results of the research and development project aimed at construction of the international clean energy network using hydrogen conversion (WE-NET). The projects include 12 tasks; system evaluation for, e.g., optimum scenario for introduction of hydrogen energy; experiments for hydrogen safety; study on the international cooperation for WE-NET; development of power generation technology using a 100kW cogeneration system including hydrogen-firing diesel engine; developmental research on vehicles driven by a hydrogen fuel cell system; developmental research on the basic technologies for PEFC utilizing pure hydrogen; developmental research on a 30Nm{sup 3}/hour hydrogen refueling station for vehicles; developmental research on hydrogen production technology; developmental research on hydrogen transportation and storage technology, e.g., liquid hydrogen pump; research and development of the databases of and processing technology for cryogenic materials exposed to liquid hydrogen; developmental research on hydrogen absorbing alloys for small-scale hydrogen transportation and storage systems; and study on innovative and leading technologies. (NEDO)

PhysioNet

Data.gov (United States)

U.S. Department of Health & Human Services — The PhysioNet Resource is intended to stimulate current research and new investigations in the study of complex biomedical and physiologic signals. It offers free...

Pro Agile NET Development with Scrum

CERN Document Server

Blankenship, Jerrel; Millett, Scott

2011-01-01

Pro Agile .NET Development with SCRUM guides you through a real-world ASP.NET project and shows how agile methodology is put into practice. There is plenty of literature on the theory behind agile methodologies, but no book on the market takes the concepts of agile practices and applies these in a practical manner to an end-to-end ASP.NET project, especially the estimating, requirements and management aspects of a project. Pro Agile .NET Development with SCRUM takes you through the initial stages of a project - gathering requirements and setting up an environment - through to the development a

Interprofessional Peer Teaching of Pharmacy and Physical Therapy Students.

Science.gov (United States)

Sadowski, Cheryl A; Li, Johnson Ching-hong; Pasay, Darren; Jones, C Allyson

2015-12-25

To evaluate an interprofessional peer-teaching activity during which physical therapy students instructed undergraduate pharmacy students on 3 ambulatory devices (canes, crutches, walkers). The pre/post evaluation of 2 pharmacy undergraduate classes included 220 students, 110 per year. After pharmacy students completed a 10-point, knowledge-based pretest, they participated in a hands-on activity with physical therapy students teaching them about sizing, use, and safety of canes, crutches, and walkers. A 10-point posttest was completed immediately afterward. The mean difference of pre/post scores was 3.5 (SD 1.9) for the peer-led teaching, and 3.8 (SD 2.2) for the peer learning group. Students had positive responses regarding the learning exercise and recommended further peer teaching. The peer-learning activity involving physical therapy students teaching pharmacy students was an effective method of improving knowledge and skills regarding basic ambulatory devices.

KONVERGENSI DALAM PROGRAM NET CITIZEN JOURNALISM

Directory of Open Access Journals (Sweden)

Rhafidilla Vebrynda

2017-06-01

Full Text Available Di dalam artikel ini, peneliti ingin melihat perkembangan teknologi di Indonesia sebagai sebuah peluang untuk menjalankan sebuah program berita berbasis video kiriman masyarakat. Perkembangan teknologi tersebut adalah teknologi penyiaran, teknologi sosial media dan teknologi dalam proses produksi sebuah video. Di Indonesia, jumlah televisi semakin banyak. Setiap stasiun televisi harus bersaing untuk dapat bertahan hidup. Net TV merupakan sebuah stasiun televisi baru di Indonesia yang harus memiliki berbagai program unggulan baru agar dapat bersaing dengan televisi lainnya yang sudah ada. Net TV menggunakan berbagai platform media untuk menjalankan program Net Citizen Journalism (Net CJ. Penggunaan berbagai platform media dikenal dengan istilah multiplatform dan secara teoritis dikenal dengan istilah konvergensi. Konvergensi yaitu saat meleburnya domain-domain dalam berbagai media komunikasi. Artikel ini menggunakan metode studi kasus untuk melihat bagaimana konvergensi terjadi dalam proses pengelolaan program Net CJ. Teknik pengumpulan data adalah dengan wawancara mendalam, observasi dan studi dokumen. Wawancara mendalam dilakukan dari tiga sudut pandang yaitu dari pengelola program, pengguna/audience dan pengamat media. Penelitian ini menemukan bahwa dengan menggunakan berbagai platform media yang fungsinya berbeda, memiliki satu tujuan yang sama yaitu untuk menjalankan program Net CJ. Adapun berbagai platform dalam proses produksi program yaitu tayangan TV konvensional, streaming TV, website, aplikasi Net CJ, facebook, twitter, instagram dan path. Konvergensi media dijalankan dalam dua proses, yaitu proses produksi dan proses promosi program berita.

Which family members use the best nets? An analysis of the condition of mosquito nets and their distribution within households in Tanzania

Directory of Open Access Journals (Sweden)

Lines Jo

2010-07-01

Full Text Available Abstract Background Household ownership of insecticide-treated mosquito nets (ITNs is increasing, and coverage targets have been revised to address universal coverage with ITNs. However, many households do not have enough nets to cover everyone, and the nets available vary in physical condition and insecticide treatment status. Since 2004, the Government of Tanzania has been implementing the Tanzania National Voucher Scheme (TNVS, which distributes vouchers for ITNs through antenatal clinics to target pregnant women and their infants. This analysis aimed to determine the following: (1 coverage patterns of bed nets within households according to physical condition and treatment status; (2 who might be at risk if mosquitoes were diverted from occupants of untreated nets to those not using nets? (3 the degree to which those at highest risk of malaria use the most protective nets. Methods Data from the 2006 TNVS household survey were analysed to assess within-household distribution of net use. The associations between net characteristics and net user were also evaluated. Multivariate analysis was applied to the relationship between the number of holes per net and user characteristics while adjusting for confounders. Results In households with a net:person ratio better than 1:4 (one net for every four household members, more than 80% of the people in such households reported using a net the previous night. ITNs were most likely to be used by infants, young children (1-4 y, and women of childbearing age; they were least likely to be used by older women (≥50 y, older children (5-14 y, and adult men. The nets used by infants and women of childbearing age were in better-than-average physical condition; the nets used by older women and older children were in worse-than-average condition; while young children and adult men used nets in intermediate (average condition. When adjusted for confounders, the nets used by young and older children had more holes

The Definitive Guide to NetBeans Platform

CERN Document Server

Bock, Heiko

2009-01-01

The Definitive Guide to NetBeans(t) Platform is a thorough and definitive introduction to the NetBeans Platform, covering all its major APIs in detail, with relevant code examples used throughout. The original German book on which this title is based was well received. The NetBeans Platform Community has put together this English translation, which author Heiko Bock updated to cover the latest NetBeans Platform 6.5 APIs. With an introduction by known NetBeans Platform experts Jaroslav Tulach, Tim Boudreau, and Geertjan Wielenga, this is the most up-to-date book on this topic at the moment. All

Visual Studio 2010 and NET 4 Six-in-One

CERN Document Server

Novak, Istvan; Granicz, Adam

2010-01-01

Complete coverage of all key .NET 4 and Visual Studio 2010 languages and technologies. .NET 4 is Microsoft's latest version of their core programming platform, and Visual Studio 2010 is the toolset that helps write .NET 4 applications. This comprehensive resource offers one-stop shopping for all you need to know to get productive with .NET 4. Experienced author and .NET guru Mitchel Sellers reviews all the important new features of .NET 4, including .NET charting and ASP.NET charting, ASP.NET dynamic data and jQuery, and the addition of F# as a supported package language. The expansive coverag

Which nets are being used: factors associated with mosquito net use in Amhara, Oromia and Southern Nations, Nationalities and Peoples' Regions of Ethiopia.

Science.gov (United States)

Ngondi, Jeremiah M; Graves, Patricia M; Gebre, Teshome; Mosher, Aryc W; Shargie, Estifanos B; Emerson, Paul M; Richards, Frank O

2011-04-17

There has been recent large scale-up of malaria control interventions in Ethiopia where transmission is unstable. While household ownership of long-lasting insecticidal nets (LLIN) has increased greatly, there are concerns about inadequate net use. This study aimed to investigate factors associated with net use at two time points, before and after mass distribution of nets. Two cross sectional surveys were carried out in 2006 and 2007 in Amhara, Oromia and SNNP regions. The latter was a sub-sample of the national Malaria Indicator Survey (MIS 3R). Each survey wave used multi-stage cluster random sampling with 25 households per cluster (224 clusters with 5,730 households in Baseline 2006 and 245 clusters with 5,910 households in MIS 3R 2007). Net ownership was assessed by visual inspection while net utilization was reported as use of the net the previous night. This net level analysis was restricted to households owning at least one net of any type. Logistic regression models of association between net use and explanatory variables including net type, age, condition, cost and other household characteristics were undertaken using generalized linear latent and mixed models (GLLAMM). A total of 3,784 nets in 2,430 households were included in the baseline 2006 analysis while the MIS 3R 2007 analysis comprised 5,413 nets in 3,328 households. The proportion of nets used the previous night decreased from 85.1% to 56.0% between baseline 2006 and MIS 3R 2007, respectively. Factors independently associated with increased proportion of nets used were: LLIN net type (at baseline 2006); indoor residual spraying (at MIS 3R 2007); and increasing wealth index at both surveys. At both baseline 2006 and MIS 3R 2007, reduced proportion of nets used was independently associated with increasing net age, increasing damage of nets, increasing household net density, and increasing altitude (>2,000 m). This study identified modifiable factors affecting use of nets that were consistent

Which nets are being used: factors associated with mosquito net use in Amhara, Oromia and Southern Nations, Nationalities and Peoples' Regions of Ethiopia

Directory of Open Access Journals (Sweden)

Mosher Aryc W

2011-04-01

Full Text Available Abstract Background There has been recent large scale-up of malaria control interventions in Ethiopia where transmission is unstable. While household ownership of long-lasting insecticidal nets (LLIN has increased greatly, there are concerns about inadequate net use. This study aimed to investigate factors associated with net use at two time points, before and after mass distribution of nets. Methods Two cross sectional surveys were carried out in 2006 and 2007 in Amhara, Oromia and SNNP regions. The latter was a sub-sample of the national Malaria Indicator Survey (MIS 3R. Each survey wave used multi-stage cluster random sampling with 25 households per cluster (224 clusters with 5,730 households in Baseline 2006 and 245 clusters with 5,910 households in MIS 3R 2007. Net ownership was assessed by visual inspection while net utilization was reported as use of the net the previous night. This net level analysis was restricted to households owning at least one net of any type. Logistic regression models of association between net use and explanatory variables including net type, age, condition, cost and other household characteristics were undertaken using generalized linear latent and mixed models (GLLAMM. Results A total of 3,784 nets in 2,430 households were included in the baseline 2006 analysis while the MIS 3R 2007 analysis comprised 5,413 nets in 3,328 households. The proportion of nets used the previous night decreased from 85.1% to 56.0% between baseline 2006 and MIS 3R 2007, respectively. Factors independently associated with increased proportion of nets used were: LLIN net type (at baseline 2006; indoor residual spraying (at MIS 3R 2007; and increasing wealth index at both surveys. At both baseline 2006 and MIS 3R 2007, reduced proportion of nets used was independently associated with increasing net age, increasing damage of nets, increasing household net density, and increasing altitude (>2,000 m. Conclusion This study identified

Expected Net Present Value, Expected Net Future Value, and the Ramsey Rule

OpenAIRE

Gollier, Christian

2010-01-01

Weitzman (1998) showed that when future interest rates are uncertain, using the expected net present value implies a term structure of discount rates that is decreasing to the smallest possible interest rate. On the contrary, using the expected net future value criteria implies an increasing term structure of discount rates up to the largest possible interest rate. We reconcile the two approaches by introducing risk aversion and utility maximization. We show that if the aggregate consumption ...

Discrete, continuous, and hybrid petri nets

CERN Document Server

David, René

2004-01-01

Petri nets do not designate a single modeling formalism. In fact, newcomers to the field confess sometimes to be a little puzzled by the diversity of formalisms that are recognized under this "umbrella". Disregarding some extensions to the theoretical modeling capabilities, and looking at the level of abstraction of the formalisms, Condition/Event, Elementary, Place/Transition, Predicate/Transition, Colored, Object Oriented... net systems are frequently encountered in the literature. On the other side, provided with appropriate interpretative extensions, Controled Net Systems, Marking Diagrams (the Petri net generalization of State Diagrams), or the many-many variants in which time can be explicitly incorporated -Time(d), Deterministic, (Generalized) Stochastic, Fuzzy...- are defined. This represents another way to define practical formalisms that can be obtained by the "cro- product" of the two mentioned dimensions. Thus Petri nets constitute a modeling paradigm, understandable in a broad sense as "the total...

The teaching/research trade-off in law: data from the right tail.

Science.gov (United States)

Ginsburg, Tom; Miles, Thomas J

2015-02-01

There is a long scholarly debate on the trade-off between research and teaching in various fields, but relatively little study of the phenomenon in law. This analysis examines the relationship between the two core academic activities at one particular school, the University of Chicago Law School, which is considered one of the most productive in legal academia. We measure of scholarly productivity with the total number of publications by each professor for each year, and we approximate performance in teaching with course loads and average scores in student evaluations for each course. In OLS regressions, we estimate scholarly output as a function of teaching loads, faculty characteristics, and other controls. We also estimate teaching evaluation scores as a function of scholarly productivity, fixed effects for years and course subject, and faculty characteristics. Net of other factors, we find that, under some specifications, research and teaching are positively correlated. In particular, we find that students' perceptions of teaching quality rises, but at a decreasing rate, with the total amount of scholarship. We also find that certain personal characteristics correlate with productivity. The recent debate on the mission of American law schools has hinged on the assumption that a trade-off exists between teaching and research, and this article's analysis, although limited in various ways, casts some doubt on that assumption. © The Author(s) 2014.

NetProt: Complex-based Feature Selection.

Science.gov (United States)

Goh, Wilson Wen Bin; Wong, Limsoon

2017-08-04

Protein complex-based feature selection (PCBFS) provides unparalleled reproducibility with high phenotypic relevance on proteomics data. Currently, there are five PCBFS paradigms, but not all representative methods have been implemented or made readily available. To allow general users to take advantage of these methods, we developed the R-package NetProt, which provides implementations of representative feature-selection methods. NetProt also provides methods for generating simulated differential data and generating pseudocomplexes for complex-based performance benchmarking. The NetProt open source R package is available for download from https://github.com/gohwils/NetProt/releases/ , and online documentation is available at http://rpubs.com/gohwils/204259 .

Net energy benefits of carbon nanotube applications

International Nuclear Information System (INIS)

Zhai, Pei; Isaacs, Jacqueline A.; Eckelman, Matthew J.

2016-01-01

Highlights: • Life cycle net energy benefits are examined. • CNT-enabled and the conventional technologies are compared. • Flash memory with CNT switches show significant positive net energy benefit. • Lithium-ion batteries with MWCNT cathodes show positive net energy benefit. • Lithium-ion batteries with SWCNT anodes tend to exhibit negative net energy benefit. - Abstract: Implementation of carbon nanotubes (CNTs) in various applications can reduce material and energy requirements of products, resulting in energy savings. However, processes for the production of carbon nanotubes (CNTs) are energy-intensive and can require extensive purification. In this study, we investigate the net energy benefits of three CNT-enabled technologies: multi-walled CNT (MWCNT) reinforced cement used as highway construction material, single-walled CNT (SWCNT) flash memory switches used in cell phones and CNT anodes and cathodes used in lithium-ion batteries used in electric vehicles. We explore the avoided or additional energy requirement in the manufacturing and use phases and estimate the life cycle net energy benefits for each application. Additional scenario analysis and Monte Carlo simulation of parameter uncertainties resulted in probability distributions of net energy benefits, indicating that net energy benefits are dependent on the application with confidence intervals straddling the breakeven line in some cases. Analysis of simulation results reveals that SWCNT switch flash memory and MWCNT Li-ion battery cathodes have statistically significant positive net energy benefits (α = 0.05) and SWCNT Li-ion battery anodes tend to have negative net energy benefits, while positive results for MWCNT-reinforced cement were significant only under an efficient CNT production scenario and a lower confidence level (α = 0.1).

Towards a Standard for Modular Petri Nets

DEFF Research Database (Denmark)

Kindler, Ekkart; Petrucci, Laure

2009-01-01

concepts could or should be subject to import and export in high-level Petri nets. In this paper, we formalise a minimal version of modular high-level Petri nets, which is based on the concepts of modular PNML. This shows that modular PNML can be formalised once a specific version of Petri net is fixed....... Moreover, we present and discuss some more advanced features of modular Petri nets that could be included in the standard. This way, we provide a formal foundation and a basis for a discussion of features to be included in the upcoming standard of a module concept for Petri nets in general and for high-level...

Petri Nets

Indian Academy of Sciences (India)

GENERAL I ARTICLE ... In Part 1 of this two-part article, we have seen im- ..... mable logic controller and VLSI arrays, office automation systems, workflow management systems, ... complex discrete event and real-time systems; and Petri nets.

Achievement report for fiscal 2000 on the phase II research and development for hydrogen utilizing international clean energy system technology (WE-NET). Task 2. Investigations and researched on safety measures; 2000 nendo suiso riyo kokusai clean energy system gijutsu (WE-NET) dai 2 ki kenkyu kaihatsu. Task 2. Anzen taisaku ni kansuru chosa kenkyu

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

This paper describes the achievements in fiscal 2000 from the WE-NET Phase II for Task-2, the safety measures. In order to structure safety design criteria, potential anomalies, accident phenomena, and safety measures that can be applied were put into order based on the conceptual designs on hydrogen supply stations. Items of information were collected and put into order on failure rates and other factors to estimate accident occurrence frequency required for quantitative risk assessment. Representative event scenarios were selected by estimating the event evolving processes. In order to obtain knowledge about the steady state of run-off and evaporation of liquefied hydrogen, experiments were performed by using a small-size experimenting device, whereas new findings were discovered. To identify the fundamental knowledge related to explosion of hydrogen, and to verify a program simulating the explosion, explosion experiments were inaugurated to have established the stable experiment performing method. A calculation program simulating leakage and evaporation of liquefied hydrogen was verified and analyzed from the experimental results, and the program improvements were discussed. Pre-estimation and verification were carried out on the explosion experiments by using the hydrogen explosion and combustion simulating calculation program, and discussions were given on program improvement. (NEDO)

Measuring and benchmarking safety culture: application of the safety attitudes questionnaire to an acute medical admissions unit.

Science.gov (United States)

Relihan, E; Glynn, S; Daly, D; Silke, B; Ryder, S

2009-12-01

To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results against international data and guide a unit-based, integrated, risk management strategy. The safety attitudes questionnaire (SAQ), a validated instrument for the measurement of safety culture was applied to an AMAU. All AMAU healthcare staff (n = 92) were surveyed: doctors, nurses, healthcare assistants (HCAs) and allied healthcare professionals (AHPs). Safety attitude scores for the overall unit and individual caregiver types were assessed across six domains of safety culture. When compared against an international benchmark, the AMAU scored significantly higher for four of the six safety domains: p < 0.01 for 'teamwork climate', 'safety climate' and 'stress recognition' and p < 0.05 for 'job satisfaction'. The difference between nurse manager scores and the overall mean for the study group was statistically significant for the domains of 'teamwork climate' (p < 0.05) and 'safety climate' (p < 0.01). HCAs scored significantly lower relative to staff overall with regard to 'working conditions' (p < 0.05) and 'perceptions of management' (p < 0.01). The SAQ was successfully applied to an AMAU setting giving a valuable insight into staff issues of concern across the safety spectrum: employee and environmental safety, clinical risk management and medication safety.

Information Portals: A New Tool for Teaching Information Literacy Skills

OpenAIRE

Kolah, Debra; Fosmire, Michael

2010-01-01

Librarians at Rice and Purdue Universities created novel assignments to teach students important information literacy skills. The assignments required the students to use a third-party web site, PageFlakes and NetVibes, respectively, to create a dynamically updated portal to information they needed for their research and class projects. The use of off-the-shelf web 2.0 technology to enable students to discover the latest information in their subject areas of interest provides an engaging, han...

Linear Logic on Petri Nets

DEFF Research Database (Denmark)

Engberg, Uffe Henrik; Winskel, Glynn

This article shows how individual Petri nets form models of Girard's intuitionistic linear logic. It explores questions of expressiveness and completeness of linear logic with respect to this interpretation. An aim is to use Petri nets to give an understanding of linear logic and give some apprai...

First study of the negative binomial distribution applied to higher moments of net-charge and net-proton multiplicity distributions

International Nuclear Information System (INIS)

Tarnowsky, Terence J.; Westfall, Gary D.

2013-01-01

A study of the first four moments (mean, variance, skewness, and kurtosis) and their products (κσ 2 and Sσ) of the net-charge and net-proton distributions in Au + Au collisions at √(s NN )=7.7–200 GeV from HIJING simulations has been carried out. The skewness and kurtosis and the collision volume independent products κσ 2 and Sσ have been proposed as sensitive probes for identifying the presence of a QCD critical point. A discrete probability distribution that effectively describes the separate positively and negatively charged particle (or proton and anti-proton) multiplicity distributions is the negative binomial (or binomial) distribution (NBD/BD). The NBD/BD has been used to characterize particle production in high-energy particle and nuclear physics. Their application to the higher moments of the net-charge and net-proton distributions is examined. Differences between κσ 2 and a statistical Poisson assumption of a factor of four (for net-charge) and 40% (for net-protons) can be accounted for by the NBD/BD. This is the first application of the properties of the NBD/BD to describe the behavior of the higher moments of net-charge and net-proton distributions in nucleus–nucleus collisions

TwiddleNet: Smartphones as Personal Servers

OpenAIRE

Gurminder, Singh; Center for the Study of Mobile Devices and Communications

2012-01-01

TwiddleNet uses smartphones as personal servers to enable instant content capture and dissemination for firstresponders. It supports the information sharing needs of first responders in the early stages of an emergency response operation. In TwiddleNet, content, once captured, is automatically tagged and disseminated using one of the several networking channels available in smartphones. TwiddleNet pays special attention to minimizing the equipment, network set-up time, and content...

Safety and economic impacts of photo radar program.

Science.gov (United States)

Chen, Greg

2005-12-01

Unsafe speed is one of the major traffic safety challenges facing motorized nations. In 2003, unsafe speed contributed to 31 percent of all fatal collisions, causing a loss of 13,380 lives in the United States alone. The economic impact of speeding is tremendous. According to NHTSA, the cost of unsafe speed related collisions to the American society exceeds 40 billion US dollars per year. In response, automated photo radar speed enforcement programs have been implemented in many countries. This study assesses the economic impacts of a large-scale photo radar program in British Columbia. The knowledge generated from this study could inform policy makers and project managers in making informed decisions with regard to this highly effective and efficient, yet very controversial program. This study establishes speed and safety effects of photo radar programs by summarizing two physical impact investigations in British Columbia. It then conducts a cost-benefit analysis to assess the program's economic impacts. The cost-benefit analysis takes into account both societal and funding agency's perspectives. It includes a comprehensive account of major impacts. It uses willingness to pay principle to value human lives saved and injuries avoided. It incorporates an extended sensitivity analysis to quantify the robustness of base case conclusions. The study reveals an annual net benefit of approximately 114 million in year 2001 Canadian dollars to British Columbians. The study also finds a net annual saving of over 38 million Canadian dollars for the Insurance Corporation of British Columbia (ICBC) that funded the program. These results are robust under almost all alternative scenarios tested. The only circumstance under which the net benefit of the program turns negative is when the real safety effects were one standard deviation below the estimated values, which is possible but highly unlikely. Automated photo radar traffic safety enforcement can be an effective and efficient

Using a Three-Dimensional Interactive Model To Teach Environmental Concepts to Visually Impaired Children.

Science.gov (United States)

Budd, Julia M.; LaGrow, Steven J.

2000-01-01

A study investigated the efficacy of using the Buddy Road Kit, an interactive, wooden model, to teach environmental concepts to 4 children with visual impairments ages 7 to 11 years old. Results indicate the model was effective in teaching environmental concepts and traffic safety to the children involved. (Contains references.) (CR)

Pro visual C++/CLI and the net 35 platform

CERN Document Server

Fraser, Stephen

2008-01-01

Pro Visual C++/CLI and the .NET 3.5 Platform is about writing .NET applications using C++/CLI. While readers are learning the ins and outs of .NET application development, they will also be learning the syntax of C++, both old and new to .NET. Readers will also gain a good understanding of the .NET architecture. This is truly a .NET book applying C++ as its development language not another C++ syntax book that happens to cover .NET.

SkyNet: Modular nuclear reaction network library

Science.gov (United States)

Lippuner, Jonas; Roberts, Luke F.

2017-10-01

The general-purpose nuclear reaction network SkyNet evolves the abundances of nuclear species under the influence of nuclear reactions. SkyNet can be used to compute the nucleosynthesis evolution in all astrophysical scenarios where nucleosynthesis occurs. Any list of isotopes can be evolved and SkyNet supports various different types of nuclear reactions. SkyNet is modular, permitting new or existing physics, such as nuclear reactions or equations of state, to be easily added or modified.

Elliptic net and its cryptographic application

Science.gov (United States)

Muslim, Norliana; Said, Mohamad Rushdan Md

2017-11-01

Elliptic net is a generalization of elliptic divisibility sequence and in cryptography field, most cryptographic pairings that are based on elliptic curve such as Tate pairing can be improved by applying elliptic nets algorithm. The elliptic net is constructed by using n dimensional array of values in rational number satisfying nonlinear recurrence relations that arise from elliptic divisibility sequences. The two main properties hold in the recurrence relations are for all positive integers m>n, hm +nhm -n=hm +1hm -1hn2-hn +1hn -1hm2 and hn divides hm whenever n divides m. In this research, we discuss elliptic divisibility sequence associated with elliptic nets based on cryptographic perspective and its possible research direction.

Net neutrality and audiovisual services

NARCIS (Netherlands)

van Eijk, N.; Nikoltchev, S.

2011-01-01

Net neutrality is high on the European agenda. New regulations for the communication sector provide a legal framework for net neutrality and need to be implemented on both a European and a national level. The key element is not just about blocking or slowing down traffic across communication

Inferring Phylogenetic Networks Using PhyloNet.

Science.gov (United States)

Wen, Dingqiao; Yu, Yun; Zhu, Jiafan; Nakhleh, Luay

2018-07-01

PhyloNet was released in 2008 as a software package for representing and analyzing phylogenetic networks. At the time of its release, the main functionalities in PhyloNet consisted of measures for comparing network topologies and a single heuristic for reconciling gene trees with a species tree. Since then, PhyloNet has grown significantly. The software package now includes a wide array of methods for inferring phylogenetic networks from data sets of unlinked loci while accounting for both reticulation (e.g., hybridization) and incomplete lineage sorting. In particular, PhyloNet now allows for maximum parsimony, maximum likelihood, and Bayesian inference of phylogenetic networks from gene tree estimates. Furthermore, Bayesian inference directly from sequence data (sequence alignments or biallelic markers) is implemented. Maximum parsimony is based on an extension of the "minimizing deep coalescences" criterion to phylogenetic networks, whereas maximum likelihood and Bayesian inference are based on the multispecies network coalescent. All methods allow for multiple individuals per species. As computing the likelihood of a phylogenetic network is computationally hard, PhyloNet allows for evaluation and inference of networks using a pseudolikelihood measure. PhyloNet summarizes the results of the various analyzes and generates phylogenetic networks in the extended Newick format that is readily viewable by existing visualization software.

Construction of the radiation oncology teaching files system for charged particle radiotherapy.

Science.gov (United States)

Masami, Mukai; Yutaka, Ando; Yasuo, Okuda; Naoto, Takahashi; Yoshihisa, Yoda; Hiroshi, Tsuji; Tadashi, Kamada

2013-01-01

Our hospital started the charged particle therapy since 1996. New institutions for charged particle therapy are planned in the world. Our hospital are accepting many visitors from those newly planned medical institutions and having many opportunities to provide with the training to them. Based upon our experiences, we have developed the radiation oncology teaching files system for charged particle therapy. We adopted the PowerPoint of Microsoft as a basic framework of our teaching files system. By using our export function of the viewer any physician can create teaching files easily and effectively. Now our teaching file system has 33 cases for clinical and physics contents. We expect that we can improve the safety and accuracy of charged particle therapy by using our teaching files system substantially.

Net Neutrality: Media Discourses and Public Perception

Directory of Open Access Journals (Sweden)

Christine Quail

2010-01-01

Full Text Available This paper analyzes media and public discourses surrounding net neutrality, with particular attention to public utility philosophy, from a critical perspective. The article suggests that further public education about net neutrality would be beneficial. The first portion of this paper provides a survey of the existing literature surrounding net neutrality, highlighting the contentious debate between market-based and public interest perspectives. In order to contextualize the debate, an overview of public utility philosophy is provided, shedding light on how the Internet can be conceptualized as a public good. Following this discussion, an analysis of mainstream media is presented, exploring how the media represents the issue of net neutrality and whether or not the Internet is discussed through the lens of public utility. To further examine how the net neutrality debate is being addressed, and to see the potential impacts of media discourses on the general public, the results of a focus group are reported and analyzed. Finally, a discussion assesses the implications of the net neutrality debate as presented through media discourses, highlighting the future of net neutrality as an important policy issue.

NET system integration

International Nuclear Information System (INIS)

Farfaletti-Casali, F.; Mitchell, N.; Salpietro, E.; Buzzi, U.; Gritzmann, P.

1985-01-01

The NET system integration procedure is the process by which the requirements of the various Tokamak machine design areas are brought together to form a compatible machine layout. Each design area produces requirements which generally allow components to be built at minimum cost and operate with minimum technical risk, and the final machine assembly should be achieved with minimum departure from these optimum designs. This is carried out in NET by allowing flexibility in the maintenance and access methods to the machine internal components which must be regularly replaced by remote handling, in segmentation of these internal components and in the number of toroidal field coils

Conformal Nets II: Conformal Blocks

Science.gov (United States)

Bartels, Arthur; Douglas, Christopher L.; Henriques, André

2017-08-01

Conformal nets provide a mathematical formalism for conformal field theory. Associated to a conformal net with finite index, we give a construction of the `bundle of conformal blocks', a representation of the mapping class groupoid of closed topological surfaces into the category of finite-dimensional projective Hilbert spaces. We also construct infinite-dimensional spaces of conformal blocks for topological surfaces with smooth boundary. We prove that the conformal blocks satisfy a factorization formula for gluing surfaces along circles, and an analogous formula for gluing surfaces along intervals. We use this interval factorization property to give a new proof of the modularity of the category of representations of a conformal net.

Putting Petri nets to work in Industry

NARCIS (Netherlands)

Aalst, van der W.M.P.

1994-01-01

Petri nets exist for over 30 years. Especially in the last decade Petri nets have been put into practive extensively. Thanks to several useful extensions and the availability of computer tools, Petri nets have become a mature tool for modelling and analysing industrial systems. This paper describes

Servant teaching: the power and promise for nursing education.

Science.gov (United States)

Robinson, F Patrick

2009-01-01

The best theoretical or practical approaches to achieving learning outcomes in nursing likely depend on multiple variables, including instructor-related variables. This paper explores one such variable and its potential impact on learning. Application of the principles inherent in servant leadership to teaching/learning in nursing education is suggested as a way to produce professional nurses who are willing and able to transform the health care environment to achieve higher levels of quality and safety. Thus, the concept of servant teaching is introduced with discussion of the following principles and their application to teaching in nursing: judicious use of power, listening and empathy, willingness to change, reflection and contemplation, collaboration and consensus, service learning, healing, conceptualization, stewardship, building community, and commitment to the growth of people. Faculty colleagues are invited to explore the use of servant teaching and its potential for nursing education.

Motorcycle Safety Education. Bulletin No. 21.

Science.gov (United States)

Alabama State Dept. of Education, Montgomery. Div. of Instructional Services.

This guide for motorcycle safety instructors is intended to provide essential information in a usable format for teaching the basic knowledge and skills to (1) maintain the motorcycle in a safe riding condition; (2) develop an ability to handle the motorcycle in a safe and sane manner; (3) develop defensive driving techniques; and (4) understand…

Fiscal 1996 achievement report. International Clean Energy Network Using Hydrogen Conversion (WE-NET) technology

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-03-01

Research and development was performed for the WE-NET (World Energy Network) project which aims to carry out hydrogen production, transportation, and supply to consumers, by the use of renewable energy. Under subtask 1, the whole WE-NET project was subjected to evaluation, which included coordination between the respective tasks. Under subtask 2, information exchange and research cooperation were carried out with research institutes overseas. Under subtask 3, a conceptual design was prepared of a total system using ammonia as the medium for hydrogen transportation, accident data were collected and screened, and safety measures and evaluation techniques were developed and improved. Under subtask 4, the hot press method and the electroless plating method were selected as better electrode bonding methods. Under subtask 5, hydrogen liquefaction cycle processes, liquid hydrogen tankers, storage facilities, etc., were studied. Under subtasks 6-9, furthermore, investigations were conducted about low-temperature substance technology, hydrogen energy, hydrogen combustion turbine, etc. (NEDO)

Net Gain

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

Describing the effect of tax incentives for import, production, and sale of nets and insecticides; and ..... So far, China is the only country where a system for the routine treatment of ...... 1993), and the trials in Ecuador and Peru (Kroeger et al.

Mars MetNet Precursor Mission Status

Science.gov (United States)

Harri, A.-M.; Aleksashkin, S.; Guerrero, H.; Schmidt, W.; Genzer, M.; Vazquez, L.; Haukka, H.

2013-09-01

We are developing a new kind of planetary exploration mission for Mars in collaboration between the Finnish Meteorological Institute (FMI), Lavochkin Association (LA), Space Research Institute (IKI) and Institutio Nacional de Tecnica Aerospacial (INTA). The Mars MetNet mission is based on a new semi-hard landing vehicle called MetNet Lander (MNL). The scientific payload of the Mars MetNet Precursor [1] mission is divided into three categories: Atmospheric instruments, Optical devices and Composition and structure devices. Each of the payload instruments will provide significant insights in to the Martian atmospheric behavior. The key technologies of the MetNet Lander have been qualified and the electrical qualification model (EQM) of the payload bay has been built and successfully tested.

SolNet

DEFF Research Database (Denmark)

Jordan, Ulrike; Vajen, Klaus; Bales, Chris

2014-01-01

-accompanying Master courses, placements of internships, and PhD scholarship projects. A new scholarship project, “SHINE”, was launched in autumn 2013 in the frame work of the Marie Curie program of the European Union (Initial Training Network, ITN). 13 PhD-scholarships on solar district heating, solar heat......SolNet, founded in 2006, is the first coordinated International PhD education program on Solar Thermal Engineering. The SolNet network is coordinated by the Institute of Thermal Engineering at Kassel University, Germany. The network offers PhD courses on solar heating and cooling, conference...... for industrial processes, as well as sorption stores and materials started in December 2013. Additionally, the project comprises a training program with five PhD courses and several workshops on solar thermal engineering that will be open also for other PhD students working in the field. The research projects...

Symmetric Cryptosystem Based on Petri Net

Directory of Open Access Journals (Sweden)

Hussein ‎ A. Lafta

2017-12-01

Full Text Available In this wok, a novel approach based on ordinary Petri net is used to generate private key . The reachability marking  of petri net is used as encryption/decryption key to provide more complex key . The same ordinary Petri Nets models  are used for the sender(encryption and  the receiver(decryption.The plaintext has been permutated  using  look-up table ,and XOR-ed with key to generate cipher text

[Costs of serious adverse events in a community teaching hospital, in Mexico].

Science.gov (United States)

Gutiérrez-Mendoza, Luis Meave; Torres-Montes, Abraham; Soria-Orozco, Manuel; Padrón-Salas, Aldanely; Ramírez-Hernández, María Elizabeth

2015-01-01

Serious adverse events during hospital care are a worldwide reality and threaten the safety of the hospitalised patient. To identify serious adverse events related to healthcare and direct hospital costs in a Teaching Hospital in México. A study was conducted in a 250-bed Teaching Hospital in San Luis Potosi, Mexico. Data were obtained from the Quality and Patient Safety Department based on 2012 incidents report. Every event was reviewed and analysed by an expert team using the "fish bone" tool. The costs were calculated since the event took place until discharge or death of the patient. A total of 34 serious adverse events were identified. The average cost was $117,440.89 Mexican pesos (approx. €7,000). The great majority (82.35%) were largely preventable and related to the process of care. Undergraduate medical staff were involved in 58.82%, and 14.7% of patients had suffered adverse events in other hospitals. Serious adverse events in a Teaching Hospital setting need to be analysed to learn and deploy interventions to prevent and improve patient safety. The direct costs of these events are similar to those reported in developed countries. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Net Pay Estimator | Alaska Division of Retirement and Benefits

Science.gov (United States)

Benefits > Net Pay Estimator Online Counselor Scheduler Empower Retirement Account Info Online myRnB Accessibility Net Pay Estimator Click here for the Retiree Net Pay Estimator? The net pay estimator is a useful tool to estimate your net pay under different salaries, federal withholding tax exemptions, and

CPN Tools-Assisted Simulation and Verification of Nested Petri Nets

Directory of Open Access Journals (Sweden)

L. W. Dworza´nski

2012-01-01

Full Text Available Nested Petri nets (NP-nets are an extension of Petri net formalism within the “netswithin-nets” approach, when tokens in a marking are Petri nets, which have an autonomous behavior and are synchronized with the system net. The formalism of NP-nets allows modeling multi-level multi-agent systems with dynamic structure in a natural way. Currently, there is no tool for supporting NP-nets simulation and analysis. The paper proposes the translation of NP-nets into Colored Petri nets and the use of CPN Tools as a virtual machine for NP-nets modeling, simulation and automatic verification.

Indian social safety net programs as platforms for introducing wheat flour fortification: a case study of Gujarat, India.

Science.gov (United States)

Fiedler, John L; Babu, Sunil; Smitz, Marc-Francois; Lividini, Keith; Bermudez, Odilia

2012-03-01

Micronutrient deficiencies exact an enormous health burden on India. The release of the National Family Health Survey results--showing the relatively wealthy state of Gujarat having deficiency levels exceeding national averages--prompted Gujarat officials to introduce fortified wheat flour in their social safety net programs (SSNPs). To provide a case study of the introduction of fortified wheat flour in Gujarat's Public Distribution System (PDS), Integrated Child Development Scheme (ICDS), and Mid-Day Meal (MDM) Programme to assess the coverage, costs, impact, and cost-effectiveness of the initiative. India's 2004/05 National Sample Survey data were used to identify beneficiaries of each of Gujarat's three SSNPs and to estimate usual intake levels of vitamin A, iron, and zinc. Comparing age- and sex-specific usual intakes to Estimated Average Requirements, the proportion of the population with inadequate intakes was estimated. Postfortification intake levels and reductions in inadequate intake were estimated. The incremental cost of fortifying wheat flour and the cost-effectiveness of each program were estimated. When each program was assessed independently, the proportion of the population with inadequate vitamin A intakes was reduced by 34% and 74% among MDM and ICDS beneficiaries, respectively. Both programs effectively eliminated inadequate intakes of both iron and zinc. Among PDS beneficiaries, the proportion with inadequate iron intakes was reduced by 94%. CONCLUSIONS. Gujarat's substitution of fortified wheat flour for wheat grain is dramatically increasing the intake of micronutrients among its SSNP beneficiaries. The incremental cost of introducing fortification in each of the programs is low, and, according to World Health Organization criteria, each program is "highly cost-effective." The introduction of similar reforms throughout India would largely eliminate the inadequate iron intake among persons participating in any of the three SSNPs and would

Special Section on Coloured Petri Nets

DEFF Research Database (Denmark)

1998-01-01

Special section on coloured Petri nets, their basic concepts, analysis methods, tool support and industrial applications.......Special section on coloured Petri nets, their basic concepts, analysis methods, tool support and industrial applications....

The Petri Net Markup Language : concepts, technology, and tools

NARCIS (Netherlands)

Billington, J.; Christensen, S.; Hee, van K.M.; Kindler, E.; Kummer, O.; Petrucci, L.; Post, R.D.J.; Stehno, C.; Weber, M.; Aalst, van der W.M.P.; Best, E.

2003-01-01

The Petri Net Markup Language (PNML) is an XML-based interchange format for Petri nets. In order to support different versions of Petri nets and, in particular, future versions of Petri nets, PNML allows the definition of Petri net types.Due to this flexibility, PNML is a starting point for a

Using an online quiz-based reinforcement system to teach healthcare quality and patient safety and care transitions at the University of California.

Science.gov (United States)

Shaikh, Ulfat; Afsar-Manesh, Nasim; Amin, Alpesh N; Clay, Brian; Ranji, Sumant R

2017-10-01

Implementing quality improvement (QI) education during clinical training is challenging due to time constraints and inadequate faculty development in these areas. Quiz-based reinforcement systems show promise in fostering active engagement, collaboration, healthy competition and real-time formative feedback, although further research on their effectiveness is required. An online quiz-based reinforcement system to increase resident and faculty knowledge in QI, patient safety and care transitions. Experts in QI and educational assessment at the 5 University of California medical campuses developed a course comprised of 3 quizzes on Introduction to QI, Patient Safety and Care Transitions. Each quiz contained 20 questions and utilized an online educational quiz-based reinforcement system that leveraged spaced learning. Approximately 500 learners completed the course (completion rate 66-86%). Knowledge acquisition scores for all quizzes increased after completion: Introduction to QI (35-73%), Patient Safety (58-95%), and Care Transitions (66-90%). Learners reported that the quiz-based system was an effective teaching modality and preferred this type of education to classroom-based lectures. Suggestions for improvement included reducing frequency of presentation of questions and utilizing more questions that test learners on application of knowledge instead of knowledge acquisition. A multi-campus online quiz-based reinforcement system to train residents in QI, patient safety and care transitions was feasible, acceptable, and increased knowledge. The course may be best utilized to supplement classroom-based and experiential curricula, along with increased attention to optimizing frequency of presentation of questions and enhancing application skills. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

BioNet Digital Communications Framework

Science.gov (United States)

Gifford, Kevin; Kuzminsky, Sebastian; Williams, Shea

2010-01-01

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

7 CFR 1221.17 - Net market value.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Net market value. 1221.17 Section 1221.17 Agriculture... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Definitions § 1221.17 Net market value. Net market value means: (a) Except as provided in paragraph (b)and (c) of this section, the value...

Feasibility and Design of an Electronic Surgical Safety Checklist in a Teaching Hospital: A User-Based Approach.

Science.gov (United States)

Kiefel, Karin; Donsa, Klaus; Tiefenbacher, Peter; Mischak, Robert; Brunner, Gernot; Sendlhofer, Gerald; Pieber, Thomas

2018-01-01

The Surgical Safety Checklist (SSC) is routinely used in operating rooms (OR) but its acceptance is low. One promising way to improve acceptance of the SSC and thus quality of patient care is digitalization. To investigate how a digitalization of the SSC could be implemented in a teaching hospital. Based on the identified user requirements we designed a first user interface (UI). We performed a literature review, identified user perceptions and requirements during 12 interviews including a standardized questionnaire in surgical departments at the University Hospital Graz (Austria). Subsequently a first prototype of a UI was designed. Seven different approaches for digital SSC were identified in literature. Our interviews showed that 90% of the participants had a positive attitude towards a digitalization of SSC. The most favoured version of a digitalized SSC was a tablet-based client-server system with integration in the EHR and projection on an OR monitor. Digitalization of the SSC is requested by medical and nursing personnel. Based on the identified user requirements we designed a process oriented UI of a digital SSC.

NetBeans GUI Builder

OpenAIRE

Pusiankova, Tatsiana

2009-01-01

This work aims at making readers familiar with the powerful tool NetBeans IDE GUI Builder and helping them make their first steps to creation of their own graphical user interface in the Java programming language. The work includes theoretical description of NetBeans IDE GUI Builder, its most important characteristics and peculiarities and also a set of practical instructions that will help readers in creation of their first GUI. The readers will be introduced to the environment of this tool ...

Application and Theory of Petri Nets

DEFF Research Database (Denmark)

This volume contains the proceedings of the 13th International Conference onApplication and Theory of Petri Nets, held in Sheffield, England, in June 1992. The aim of the Petri net conferences is to create a forum for discussing progress in the application and theory of Petri nets. Typically....... Balbo and W. Reisig, 18 submitted papers, and seven project papers. The submitted papers and project presentations were selectedby the programme committee and a panel of referees from a large number of submissions....

Rotational KMS States and Type I Conformal Nets

Science.gov (United States)

Longo, Roberto; Tanimoto, Yoh

2018-01-01

We consider KMS states on a local conformal net on S 1 with respect to rotations. We prove that, if the conformal net is of type I, namely if it admits only type I DHR representations, then the extremal KMS states are the Gibbs states in an irreducible representation. Completely rational nets, the U(1)-current net, the Virasoro nets and their finite tensor products are shown to be of type I. In the completely rational case, we also give a direct proof that all factorial KMS states are Gibbs states.

Improving patient safety: lessons from rock climbing.

Science.gov (United States)

Robertson, Nic

2012-02-01

How to improve patient safety remains an intractable problem, despite large investment and some successes. Academics have argued that the root of the problem is a lack of a comprehensive 'safety culture' in hospitals. Other safety-critical industries such as commercial aviation invest heavily in staff training to develop such a culture, but comparable programmes are almost entirely absent from the health care sector. In rock climbing and many other dangerous activities, the 'buddy system' is used to ensure that safety systems are adhered to despite adverse circumstances. This system involves two or more people using simple checks and clear communication to prevent problems causing harm. Using this system as an example could provide a simple, original and entertaining way of introducing medical students to the idea that human factors are central to ensuring patient safety. Teaching the buddy system may improve understanding and acceptance of other patient safety initiatives, and could also be used by junior doctors as a tool to improve the safety of their practice. © Blackwell Publishing Ltd 2012.

Assessment of Native Languages for Food Safety Training Programs for Meat Industry Employees

Science.gov (United States)

Olsen, Sherrlyn S.; Cordray, Joseph C.; Sapp, Stephen; Sebranek, Joseph G.; Anderson, Barbara; Wenger, Matt

2012-01-01

Challenges arise when teaching food safety to culturally diverse employees working in meatpacking and food manufacturing industries. A food safety training program was developed in English, translated into Spanish, and administered to 1,265 adult learners. Assessments were conducted by comparing scores before and immediately following training.…

Net charge fluctuations and local charge compensation

International Nuclear Information System (INIS)

Fu Jinghua

2006-01-01

We propose net charge fluctuation as a measure of local charge correlation length. It is demonstrated that, in terms of a schematic multiperipheral model, net charge fluctuation satisfies the same Quigg-Thomas relation as satisfied by charge transfer fluctuation. Net charge fluctuations measured in finite rapidity windows depend on both the local charge correlation length and the size of the observation window. When the observation window is larger than the local charge correlation length, the net charge fluctuation only depends on the local charge correlation length, while forward-backward charge fluctuations always have strong dependence on the observation window size. Net charge fluctuations and forward-backward charge fluctuations measured in the present heavy ion experiments show characteristic features similar to those from multiperipheral models. But the data cannot all be understood within this simple model

Long Term RadNet Quality Data

Data.gov (United States)

U.S. Environmental Protection Agency — This RadNet Quality Data Asset includes all data since initiation and when ERAMS was expanded to become RadNet, name changed to reflect new mission. This includes...

Editorial Seminar.net Issue 3 Vol. 6

Directory of Open Access Journals (Sweden)

Yngve Nordkvelle

2010-11-01

reflected in the questions of each test they have developed and suggest functionalities for a future test tool to support an improved design process.Hugo Nordseth, Sonja Ekker and Robin Munkvold of Nord-Trøndelag University College present their joint article: “Tools for peer assessment in an e-learning environment”. They explore the functionalities of tools for peer assessment within the LMS used for two different topics taught at their college, in combination with a set of rubrics and a tool called “Six Thinking Hats”. They report that using these in combination stimulate students to write better assignments and provide a deeper understanding of the subjects taught.Arvid Staupe of The Norwegian University of Science and Technology, argues in his article “Experiences from Blended Learning, Net-based Learning and Mind Tools” that in spite of a strong increase in the number of students attending classes, it is possible to improve the quality of the course when blended teaching approaches are employed, using net-based learning material and mind tools, and founded firmly on an educational philosophy.The last article, by Ana Laws, of the University of Bergen, is about “Digital Storytelling as an emerging documentary form”. She claims that digital storytelling can be fruitfully studied using concepts and perspectives from documentary theory. She offers two definitions of digital storytelling and compares to how documentary filmmaking has been characterized. She further argues that contemporary discussions in the field of documentary theory are applicable to the ongoing theorising of “Digital storytelling” and therefore might benefit from the reflections on authorial responsibility and claims of realism and truthfulness in this area.[1] http://www.insidehighered.com/news/focus/technology/recent/pearson (accessed Nov.16.2010

Petri Nets

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 4; Issue 9. Petri Nets - Applications. Y Narahari. General Article Volume 4 Issue 9 September 1999 pp 44-52 ... Author Affiliations. Y Narahari1. Department of Computer Science and Automation, Indian Institute of Science, Bangalore 560 012, India.

Ontological Annotation with WordNet

Energy Technology Data Exchange (ETDEWEB)

Sanfilippo, Antonio P.; Tratz, Stephen C.; Gregory, Michelle L.; Chappell, Alan R.; Whitney, Paul D.; Posse, Christian; Paulson, Patrick R.; Baddeley, Bob; Hohimer, Ryan E.; White, Amanda M.

2006-06-06

Semantic Web applications require robust and accurate annotation tools that are capable of automating the assignment of ontological classes to words in naturally occurring text (ontological annotation). Most current ontologies do not include rich lexical databases and are therefore not easily integrated with word sense disambiguation algorithms that are needed to automate ontological annotation. WordNet provides a potentially ideal solution to this problem as it offers a highly structured lexical conceptual representation that has been extensively used to develop word sense disambiguation algorithms. However, WordNet has not been designed as an ontology, and while it can be easily turned into one, the result of doing this would present users with serious practical limitations due to the great number of concepts (synonym sets) it contains. Moreover, mapping WordNet to an existing ontology may be difficult and requires substantial labor. We propose to overcome these limitations by developing an analytical platform that (1) provides a WordNet-based ontology offering a manageable and yet comprehensive set of concept classes, (2) leverages the lexical richness of WordNet to give an extensive characterization of concept class in terms of lexical instances, and (3) integrates a class recognition algorithm that automates the assignment of concept classes to words in naturally occurring text. The ensuing framework makes available an ontological annotation platform that can be effectively integrated with intelligence analysis systems to facilitate evidence marshaling and sustain the creation and validation of inference models.

Characterizing behavioural congruences for Petri nets

DEFF Research Database (Denmark)

Nielsen, Mogens; Priese, Lutz; Sassone, Vladimiro

1995-01-01

We exploit a notion of interface for Petri nets in order to design a set of net combinators. For such a calculus of nets, we focus on the behavioural congruences arising from four simple notions of behaviour, viz., traces, maximal traces, step, and maximal step traces, and from the corresponding...... four notions of bisimulation, viz., weak and weak step bisimulation and their maximal versions. We characterize such congruences via universal contexts and via games, providing in such a way an understanding of their discerning powers....

Model and calculations for net infiltration

International Nuclear Information System (INIS)

Childs, S.W.; Long, A.

1992-01-01

In this paper a conceptual model for calculating net infiltration is developed and implemented. It incorporates the following important factors: viability of climate for the next 10,000 years, areal viability of net infiltration, and important soil/plant factors that affect the soil water budget of desert soils. Model results are expressed in terms of occurrence probabilities for time periods. In addition the variability of net infiltration is demonstrated both for change with time and differences among three soil/hydrologic units present at the site modeled

Implementing NetScaler VPX

CERN Document Server

Sandbu, Marius

2014-01-01

An easy-to-follow guide with detailed step-by step-instructions on how to implement the different key components in NetScaler, with real-world examples and sample scenarios.If you are a Citrix or network administrator who needs to implement NetScaler in your virtual environment to gain an insight on its functionality, this book is ideal for you. A basic understanding of networking and familiarity with some of the different Citrix products such as XenApp or XenDesktop is a prerequisite.

Professional Visual Basic 2010 and .NET 4

CERN Document Server

Sheldon, Bill; Sharkey, Kent

2010-01-01

Intermediate and advanced coverage of Visual Basic 2010 and .NET 4 for professional developers. If you've already covered the basics and want to dive deep into VB and .NET topics that professional programmers use most, this is your book. You'll find a quick review of introductory topics-always helpful-before the author team of experts moves you quickly into such topics as data access with ADO.NET, Language Integrated Query (LINQ), security, ASP.NET web programming with Visual Basic, Windows workflow, threading, and more. You'll explore all the new features of Visual Basic 2010 as well as all t

Evaluation of an active learning module to teach hazard and risk in Hazard Analysis and Critical Control Points (HACCP) classes.

Science.gov (United States)

Oyarzabal, Omar A; Rowe, Ellen

2017-04-01

The terms hazard and risk are significant building blocks for the organization of risk-based food safety plans. Unfortunately, these terms are not clear for some personnel working in food manufacturing facilities. In addition, there are few examples of active learning modules for teaching adult participants the principles of hazard analysis and critical control points (HACCP). In this study, we evaluated the effectiveness of an active learning module to teach hazard and risk to participants of HACCP classes provided by the University of Vermont Extension in 2015 and 2016. This interactive module is comprised of a questionnaire; group playing of a dice game that we have previously introduced in the teaching of HACCP; the discussion of the terms hazard and risk; and a self-assessment questionnaire to evaluate the teaching of hazard and risk. From 71 adult participants that completed this module, 40 participants (56%) provided the most appropriate definition of hazard, 19 participants (27%) provided the most appropriate definition of risk, 14 participants (20%) provided the most appropriate definitions of both hazard and risk, and 23 participants (32%) did not provide an appropriate definition for hazard or risk. Self-assessment data showed an improvement in the understanding of these terms (P active learning modules to teach food safety classes. This study suggests that active learning helps food personnel better understand important food safety terms that serve as building blocks for the understanding of more complex food safety topics.

Image processing for safety assessment in civil engineering.

Science.gov (United States)

Ferrer, Belen; Pomares, Juan C; Irles, Ramon; Espinosa, Julian; Mas, David

2013-06-20

Behavior analysis of construction safety systems is of fundamental importance to avoid accidental injuries. Traditionally, measurements of dynamic actions in civil engineering have been done through accelerometers, but high-speed cameras and image processing techniques can play an important role in this area. Here, we propose using morphological image filtering and Hough transform on high-speed video sequence as tools for dynamic measurements on that field. The presented method is applied to obtain the trajectory and acceleration of a cylindrical ballast falling from a building and trapped by a thread net. Results show that safety recommendations given in construction codes can be potentially dangerous for workers.

Perbandingan Hasil Belajar Teknik Dasar Pukulan Pada Permainan Tenis Meja Antara Yang Langsung Mengunakan Net Dengan Tanpa Menggunakan Net Terlebih Dahulu

Directory of Open Access Journals (Sweden)

Indra Safari

2016-07-01

Full Text Available Abstrak   Tujuan penelitian ini adalah untuk mengkaji antara hasil belajar langsung menggunakan net dengan yang tanpa menggunakan net terlebih dahulu terhadap peningkatan penguasaan teknik dasar pukulan pada permainan tenis meja bagi pemula.Untuk memecahkan permasalahan tersebut penulis menggunakan metode eksperimen, sedangkan data yang diperoleh adalah melalui eksperimen lapangan. Populasi yang digunakan dalam penelitian ini adalah siswa SDN Muhammadiyah III Bandung, sedangkan untuk sampelnya yaitu siswa kelas 4 s/d 6 (putera dan yang termasuk dalam kategori umur pemula. Hasil penelitian ini menunjukkan bahwa walaupun secara perhitungan statistic kedua cara pembelajaran tersebut tidak ada perbedaan yang berarti (signifikan, tetapi secara fakta di lapangan dengan frekuensi tiga kali dalam seminggu dengan cara pembelajaran tanpa menggunakan net terlebih dahulu memberikan perbedaan dalam perbedaan mean, yaitu yang langsung menggunakan net (0 – 89,0 sedangkan yang tanpa menggunakan net terlebih dahulu (0 – 93,0 dengan taraf nyata 0,05. Kata Kunci: teknik dasar, menggunakan net dan tanpa menggunakan net

A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.

Directory of Open Access Journals (Sweden)

Hansel Tookes

Full Text Available Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs. Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated.IDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs. 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9% died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million.Injection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.

Mars MetNet Mission Status

Science.gov (United States)

Harri, Ari-Matti; Aleksashkin, Sergei; Arruego, Ignacio; Schmidt, Walter; Genzer, Maria; Vazquez, Luis; Haukka, Harri

2015-04-01

New kind of planetary exploration mission for Mars is under development in collaboration between the Finnish Meteorological Institute (FMI), Lavochkin Association (LA), Space Research Institute (IKI) and Institutio Nacional de Tecnica Aerospacial (INTA). The Mars MetNet mission is based on a new semi-hard landing vehicle called MetNet Lander (MNL). The scientific payload of the Mars MetNet Precursor [1] mission is divided into three categories: Atmospheric instruments, Optical devices and Composition and structure devices. Each of the payload instruments will provide significant insights in to the Martian atmospheric behavior. The key technologies of the MetNet Lander have been qualified and the electrical qualification model (EQM) of the payload bay has been built and successfully tested. 1. MetNet Lander The MetNet landing vehicles are using an inflatable entry and descent system instead of rigid heat shields and parachutes as earlier semi-hard landing devices have used. This way the ratio of the payload mass to the overall mass is optimized. The landing impact will burrow the payload container into the Martian soil providing a more favorable thermal environment for the electronics and a suitable orientation of the telescopic boom with external sensors and the radio link antenna. It is planned to deploy several tens of MNLs on the Martian surface operating at least partly at the same time to allow meteorological network science. 2. Scientific Payload The payload of the two MNL precursor models includes the following instruments: Atmospheric instruments: 1. MetBaro Pressure device 2. MetHumi Humidity device 3. MetTemp Temperature sensors Optical devices: 1. PanCam Panoramic 2. MetSIS Solar irradiance sensor with OWLS optical wireless system for data transfer 3. DS Dust sensor The descent processes dynamic properties are monitored by a special 3-axis accelerometer combined with a 3-axis gyrometer. The data will be sent via auxiliary beacon antenna throughout the

An evaluation of The Great Escape: can an interactive computer game improve young children's fire safety knowledge and behaviors?

Science.gov (United States)

Morrongiello, Barbara A; Schwebel, David C; Bell, Melissa; Stewart, Julia; Davis, Aaron L

2012-07-01

Fire is a leading cause of unintentional injury and, although young children are at particularly increased risk, there are very few evidence-based resources available to teach them fire safety knowledge and behaviors. Using a pre-post randomized design, the current study evaluated the effectiveness of a computer game (The Great Escape) for teaching fire safety information to young children (3.5-6 years). Using behavioral enactment procedures, children's knowledge and behaviors related to fire safety were compared to a control group of children before and after receiving the intervention. The results indicated significant improvements in knowledge and fire safety behaviors in the intervention group but not the control. Using computer games can be an effective way to promote young children's understanding of safety and how to react in different hazardous situations.

Mars MetNet Mission Payload Overview

Science.gov (United States)

Harri, A.-M.; Haukka, H.; Alexashkin, S.; Guerrero, H.; Schmidt, W.; Genzer, M.; Vazquez, L.

2012-09-01

A new kind of planetary exploration mission for Mars is being developed in collaboration between the Finnish Meteorological Institute (FMI), Lavochkin Association (LA), Space Research Institute (IKI) and Institutio Nacional de Tecnica Aerospacial (INTA). The Mars MetNet mission [1] is based on a new semi-hard landing vehicle called MetNet Lander (MNL). The scientific payload of the Mars MetNet Precursor mission is divided into three categories: Atmospheric instruments, Optical devices and Composition and structure devices. Each of the payload instruments will provide crucial scientific data about the Martian atmospheric phenomena.

The net neutrality debate on Twitter

Directory of Open Access Journals (Sweden)

Wolf J. Schünemann

2015-12-01

Full Text Available The internet has been seen as a medium that empowers individual political actors in relation to established political elites and media gatekeepers. The present article discusses this “net empowerment hypothesis” and tests it empirically by analysing Twitter communication on the regulation of net neutrality. We extracted 503.839 tweets containing #NetNeutrality posted between January and March 2015 and analysed central developments and the network structure of the debate. The empirical results show that traditional actors from media and politics still maintain a central role.

Mass distribution of free insecticide-treated nets do not interfere with continuous net distribution in Tanzania.

Science.gov (United States)

Eze, Ikenna C; Kramer, Karen; Msengwa, Amina; Mandike, Renata; Lengeler, Christian

2014-05-27

To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007-2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by other countries with endemic malaria.

Knowledge, perception and practice of injection safety and ...

African Journals Online (AJOL)

Knowledge, perception and practice of injection safety and healthcare waste management among teaching hospital staff in south east Nigeria: an intervention study. ... Following the intervention, a significantly high number became aware of post-exposure prophylaxis and color coded bins and liners. Conclusion: There is a ...

Reconfiguration of distribution nets

International Nuclear Information System (INIS)

Latorre Bayona, Gerardo; Angarita Marquez, Jorge Luis

2000-01-01

Starting of the location of the reconfiguration problem inside the context of the operation of distribution nets, of the quality indicators definition and of the presentation of the alternatives more used for reduction of technical losses, they are related diverse reconfiguration methodologies proposed in the technical literature, pointing out their three principals limitations; also are presents the results of lost obtained starting from simulation works carried out in distribution circuits of the ESSA ESP, which permitting to postulate the reconfiguration of nets like an excellent alternative to reduce technical losses

National Chemistry Teacher Safety Survey

Science.gov (United States)

Plohocki, Barbra A.

This study evaluated the status of secondary school instructional chemistry laboratory safety using a survey instrument which focused on Teacher background Information, Laboratory Safety Equipment, Facility Safety, General Safety, and a Safety Content Knowledge Survey. A fifty question survey instrument based on recent research and questions developed by the researcher was mailed to 500 secondary school chemistry teachers who participated in the 1993 one-week Woodrow Wilson National Fellowship Foundation Chemistry Institute conducted at Princeton University, New Jersey. The data received from 303 respondents was analyzed by t tests and Analysis of Variance (ANOVA). The level of significance for the study was set at ~\\ performance on the Safety Content Knowledge Survey and secondary school chemistry teachers who have had undergraduate and/or graduate safety training and those who have not had undergraduate and/or graduate safety training. Secondary school chemistry teachers who attended school district sponsored safety inservices did not score higher on the Safety Content Knowledge Survey than teachers who did not attend school district sponsored safety inservice sessions. The type of school district (urban, suburban, or rural) had no significant correlation to the type of laboratory safety equipment found in the instructional chemistry laboratory. The certification area (chemistry or other type of certificate which may or may not include chemistry) of the secondary school teacher had no significant correlation to the type of laboratory equipment found in the instructional chemistry laboratory. Overall, this study indicated a majority of secondary school chemistry teachers were interested in attending safety workshops applicable to chemistry safety. Throughout this research project, many teachers indicated they were not adequately instructed on the collegiate level in science safety and had to rely on common sense and self-study in their future teaching careers.

Teaching microbiological food safety through case studies

Directory of Open Access Journals (Sweden)

Florence Dubois-Brissonnet

2015-10-01

Full Text Available Higher education students usually ask for more training based on case studies. This was addressed by designing a specific food safety module (24 hours in which students were shown how to predict microbiological risks in food products i.e. they were asked to determine product shelf-life according to product formulation, preservation methods and consumption habits using predictive microbiology tools. Working groups of four students first identified the main microbiological hazards associated with a specific product. To perform this task, they were given several documents including guides for good hygiene practices, reviews on microbiological hazards in the food sector, flow sheets, etc…  After three-hours of work, the working groups prepared and gave an oral presentation in front of their classmates and professors. This raised comments and discussion that allowed students to adjust their conclusions before beginning the next step of their work. This second step consisted in the evaluation of the safety risk associated with the two major microbiological hazards of the product studied, using predictive microbiology. Students then attended a general lecture on the different tools of predictive microbiology and tutorials (6 hours that made them familiar with the modelling of bacterial growth or inactivation. They applied these tools (9 hours to predict the shelf-life of the studied product according to various scenarios of preservation (refrigeration, water activity, concentration of salt or acid, modified atmosphere, etc… and/or consumption procedures (cooking. The module was concluded by oral presentations of each working group and included student evaluation (3 hours.

Criteria for Definition of Net Zero Energy Buildings

DEFF Research Database (Denmark)

Sartori, Igor; Marszal, Anna Joanna; Napolitano, Assunta

2010-01-01

The idea of a Net Zero Energy Building (Net ZEB) is understood conceptually, as it is understood that the way a Net ZEB is defined affects significantly the way it is designed in order to achieve the goal. However, little agreement exists on a common definition; the term is used commercially...... without a clear understanding and countries are enacting policies and national targets based on the concept without a clear definition in place. This paper presents a harmonised framework for describing the relevant characteristics of Net ZEBs in a series of criteria. Evaluation of the criteria...... and selection of the related options becomes a methodology for elaborating sound Net ZEB definitions in a formal, systematic and comprehensive way, creating the basis for legislations and action plans to effectively achieve the political targets. The common denominator for the different possible Net ZEB...

Professional ASP.NET 4 in C# and VB

CERN Document Server

Evjen, Bill; Rader, Devin

2010-01-01

This book was written to introduce you to the features and capabilities that ASP.NET 4 offers, as well as to give you an explanation of the foundation that ASP.NET provides. We assume you have a general understanding of Web technologies, such as previous versions of ASP.NET, Active Server Pages 2.0/3.0, or JavaServer Pages. If you understand the basics of Web programming, you should not have much trouble following along with this book's content. If you are brand new to ASP.NET, be sure to check out Beginning ASP.NET 4: In C# and VB by Imar Spaanjaars (Wiley Publishing, Inc., 2010) to help you

Beginning DotNetNuke Skinning and Design

CERN Document Server

Hay, Andrew

2011-01-01

DotNetNuke is an open source framework built on top of the ASP.Net platform. While this system offers an impressive set of out-of-the-box features for public and private sites, it also includes a compelling story for folks who want to present a unique look and feel to visitors. The skinning engine inside of DotNetNuke has strengthened over the course of several years and hundreds of thousands of registered users. The success of its skin and module developer community is another key indicator of the depth and breadth of this technology. The Core Team responsible for the DotNetNuke brand has gon

Maintaining Health and Safety at Workplace: Employee and Employer's Role in Ensuring a Safe Working Environment

Science.gov (United States)

Jonathan, Grace Katunge; Mbogo, Rosemary Wahu

2016-01-01

The concern for health and safety is legitimate in every context of human enterprise. In schools, for teaching staff's safety to be guaranteed, the equipment available should be properly maintained and installation for nonexistent ones done according to the health and safety policies. With a focus on Mbooni West district, this paper reports the…

ASP.NET MVC 4 mobile app development

CERN Document Server

Meadows, Andy

2013-01-01

A step-by-step tutorial to get acquainted with the ASP.NET MVC4 Framework and its features in order to discover how to develop web applications using them.This book is targeted at people who are familiar with C# development on the .NET platform and are interested in web development with the ASP.NET development framework. No prior web or mobile development experience is required

Asynchronous stream processing with S-Net

NARCIS (Netherlands)

Grelck, C.; Scholz, S.-B.; Shafarenko, A.

2010-01-01

We present the rationale and design of S-Net, a coordination language for asynchronous stream processing. The language achieves a near-complete separation between the application code, written in any conventional programming language, and the coordination/communication code written in S-Net. Our

Undergraduate Organic Chemistry Laboratory Safety

Science.gov (United States)

Luckenbaugh, Raymond W.

1996-11-01

Each organic chemistry student should become familiar with the educational and governmental laboratory safety requirements. One method for teaching laboratory safety is to assign each student to locate safety resources for a specific class laboratory experiment. The student should obtain toxicity and hazardous information for all chemicals used or produced during the assigned experiment. For example, what is the LD50 or LC50 for each chemical? Are there any specific hazards for these chemicals, carcinogen, mutagen, teratogen, neurotixin, chronic toxin, corrosive, flammable, or explosive agent? The school's "Chemical Hygiene Plan", "Prudent Practices for Handling Hazardous Chemicals in the Laboratory" (National Academy Press), and "Laboratory Standards, Part 1910 - Occupational Safety and Health Standards" (Fed. Register 1/31/90, 55, 3227-3335) should be reviewed for laboratory safety requirements for the assigned experiment. For example, what are the procedures for safe handling of vacuum systems, if a vacuum distillation is used in the assigned experiment? The literature survey must be submitted to the laboratory instructor one week prior to the laboratory session for review and approval. The student should then give a short presentation to the class on the chemicals' toxicity and hazards and describe the safety precautions that must be followed. This procedure gives the student first-hand knowledge on how to find and evaluate information to meet laboartory safety requirements.

NetMOD Version 2.0 Parameters

Energy Technology Data Exchange (ETDEWEB)

Merchant, Bion J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-08-01

NetMOD ( Net work M onitoring for O ptimal D etection) is a Java-based software package for conducting simulation of seismic, hydroacoustic and infrasonic networks. Network simulations have long been used to study network resilience to station outages and to determine where additional stations are needed to reduce monitoring thresholds. NetMOD makes use of geophysical models to determine the source characteristics, signal attenuation along the path between the source and station, and the performance and noise properties of the station. These geophysical models are combined to simulate the relative amplitudes of signal and noise that are observed at each of the stations. From these signal-to-noise ratios (SNR), the probability of detection can be computed given a detection threshold. This document describes the parameters that are used to configure the NetMOD tool and the input and output parameters that make up the simulation definitions.

NET IBK Computer code package for the needs of planning, construction and operation of nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Matausek, M V; Kocic, A; Marinkovic, N; Milosevic, M; Stancic, V [Boris Kidric Institute of nuclear sciences Vinca, Belgrade (Yugoslavia)

1978-07-01

Within the Nuclear Engineering Laboratory of the Boris Kidric Institute of Nuclear Sciences (NET IBK) a systematic work has been performed on collecting nuclear data for reactor calculation needs, on developing own methods and computing programs for reactor calculations, as well as on adapting and applying the foreign methods and codes. In this way a complete library of computer programs was formed for precise prediction of nuclear fuel burnup and depletion, for evaluation of the Power distribution variations with irradiation, for computing the amount of produced plutonium and its number densities etc. Programs for evaluation of location of different types of safety and economic analysis have been developed as well. The aim of this paper is to present our abilities to perform complex computations needed for planning, constructing and operating the nuclear power plants, by describing the NET IBK computer programs package. (author)

The effectiveness of a bicycle safety program for improving safety-related knowledge and behavior in young elementary students.

Science.gov (United States)

McLaughlin, Karen A; Glang, Ann

2010-05-01

The purpose of this study was to evaluate the "Bike Smart" program, an eHealth software program that teaches bicycle safety behaviors to young children. Participants were 206 elementary students in grades kindergarten to 3. A random control design was employed to evaluate the program, with students assigned to either the treatment condition (Bike Smart) or the control condition (a video on childhood safety). Outcome measures included computer-based knowledge items (safety rules, helmet placement, hazard discrimination) and a behavioral measure of helmet placement. Results demonstrated that regardless of gender, cohort, and grade the participants in the treatment group showed greater gains than control participants in both the computer-presented knowledge items (p > .01) and the observational helmet measure (p > .05). Findings suggest that the Bike Smart program can be a low cost, effective component of safety training packages that include both skills-based and experiential training.

Collaborative learning in nursing simulation: near-peer teaching using standardized patients.

Science.gov (United States)

Owen, Amy M; Ward-Smith, Peggy

2014-03-01

Simulation in nursing education uses specific patient scenarios to provide students with hands-on learning experiences. A near-peer teaching experience, using upper-level nursing students as standardized patients, was created as an educational intervention. The premises of social cognitive theory, which include cognitive, behavioral, and environmental factors, were incorporated into this teaching activity. The upper-level students played the role of a patient, while they also practiced leadership, teaching, and mentoring of first-semester nursing students. In the scenario, the first-semester students provided care to the patient, while focusing on safety, identifying the problem, and practicing clinical decision making. Faculty were present to provide guidance and promote communication in debriefing. Near-peer teaching provided a learning opportunity for all students, facilitated teamwork, and encouraged knowledge and skills attainment. Copyright 2014, SLACK Incorporated.

Community Net Energy Metering: How Novel Policies Expand Benefits of Net Metering to Non-Generators

Energy Technology Data Exchange (ETDEWEB)

Rose, James; Varnado, Laurel

2009-04-01

As interest in community solutions to renewable energy grows, more states are beginning to develop policies that encourage properties with more than one meter to install shared renewable energy systems. State net metering policies are evolving to allow the aggregation of multiple meters on a customer’s property and to dissolve conventional geographical boundaries. This trend means net metering is expanding out of its traditional function as an enabling incentive to offset onsite customer load at a single facility. This paper analyzes community net energy metering (CNEM) as an emerging vehicle by which farmers, neighborhoods, and municipalities may more easily finance and reap the benefits of renewable energy. Specifically, it aims to compare and contrast the definition of geographical boundaries among different CNEM models and examine the benefits and limitations of each approach. As state policies begin to stretch the geographic boundaries of net metering, they allow inventive solutions to encourage renewable energy investment. This paper attempts to initiate the conversation on this emerging policy mechanism and offers recommendations for further development of these policies.

Teaching quality improvement.

Science.gov (United States)

Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula

2010-08-01

Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.

Unlearning in feed-forward multi-nets

NARCIS (Netherlands)

Spaanenburg, L; Kurkova,; Steele, NC; Neruda, R; Karny, M

2001-01-01

Multi-nets promise an improved performance over monolithic neural networks by virtue of their distributed implementation. Modular neural networks are multi-nets based on an judicious assembly of functionally different parts. This can be viewed as again a monolithic network, but with more complex

Enabling the paperless world with RosettaNet

Energy Technology Data Exchange (ETDEWEB)

Robson, C.

2004-07-01

RosettaNet implementation has grown phenomenally since 2001 when it was first used in earnest. This paper will discuss the depth and breadth of RosettaNet today as the B2B (business to business) standard of choice of the global high-technology industry. This year individual companies will be transacting billions of dollars of ''paperless'' trade using RosettaNet. As well as the basic ordering processes, the standard now supports business processes as diverse as Collaborative Forecasting, Design Win, Material Composition and Logistics. In addition, RosettaNet's formal implementation initiatives, or Milestone Programs, are in progress to develop improved capabilities in areas such as eCustoms and semi-conductor test data exchange. This paper provides a view into this paperless world from a RosettaNet vantage point. The presentation at the Electronics Goes Green Conference will include additional information from published ''benefits cases.'' (orig.)

Near-Net Forging Technology Demonstration Program

Science.gov (United States)

Hall, I. Keith

1996-01-01

Significant advantages in specific mechanical properties, when compared to conventional aluminum (Al) alloys, make aluminum-lithium (Al-Li) alloys attractive candidate materials for use in cryogenic propellant tanks and dry bay structures. However, the cost of Al-Li alloys is typically five times that of 2219 aluminum. If conventional fabrication processes are employed to fabricate launch vehicle structure, the material costs will restrict their utilization. In order to fully exploit the potential cost and performance benefits of Al-Li alloys, it is necessary that near-net manufacturing methods be developed to off-set or reduce raw material costs. Near-net forging is an advanced manufacturing method that uses elevated temperature metal movement (forging) to fabricate a single piece, near-net shape, structure. This process is termed 'near-net' because only a minimal amount of post-forge machining is required. The near-net forging process was developed to reduce the material scrap rate (buy-to-fly ratio) and fabrication costs associated with conventional manufacturing methods. The goal for the near-net forging process, when mature, is to achieve an overall cost reduction of approximately 50 percent compared with conventional manufacturing options for producing structures fabricated from Al-Li alloys. This NASA Marshall Space Flight Center (MSFC) sponsored program has been a part of a unique government / industry partnership, coordinated to develop and demonstrate near-net forging technology. The objective of this program was to demonstrate scale-up of the near-net forging process. This objective was successfully achieved by fabricating four integrally stiffened, 170- inch diameter by 20-inch tall, Al-Li alloy 2195, Y-ring adapters. Initially, two 2195 Al-Li ingots were converted and back extruded to produce four cylindrical blockers. Conventional ring rolling of the blockers was performed to produce ring preforms, which were then contour ring rolled to produce

Patient safety competency and educational needs of nursing educators in South Korea

Science.gov (United States)

2017-01-01

Background Nursing educators must be qualified to teach patient safety to nursing students to ensure patient safety in the clinical field. The purpose of this study was to assess nursing educators’ competencies and educational needs for patient safety in hospitals and nursing schools. Method A mixed-methods sequential explanatory design employed a survey and focus group interview with nursing educators (school clinical instructors and hospital nurse preceptors). Thirty-eight questionnaires filled out by clinical instructors from six four-year nursing universities and 106 questionnaires from nurse preceptors from three high-level general hospitals in the Seoul metropolitan area were analyzed to obtain quantitative data. Focus group interviews were conducted among six clinical instructors from one nursing school and four nurse preceptors from one high-level general hospital in Seoul. Results Nursing educators had higher levels of attitude compared with relatively lower levels of skill and knowledge regarding patient safety. They reported educational needs of “medication” and “infection prevention” as being higher and “human factors” and “complexity of systems” as being lower. Nursing educators desired different types of education for patient safety. Conclusion It is necessary to enhance nursing educators’ patient safety skills and knowledge by developing and providing an integrated program of patient safety, with various teaching methods to meet their educational needs. The findings of this study provide the basic information needed to reform patient safety education programs appropriately to fit nursing educators' needs and their patient safety competencies in both clinical practice and academia. Furthermore, the findings have revealed the importance of effective communication between clinical and academic settings in making patient safety education seamless. PMID:28873099

Patient safety competency and educational needs of nursing educators in South Korea.

Directory of Open Access Journals (Sweden)

Haena Jang

Full Text Available Nursing educators must be qualified to teach patient safety to nursing students to ensure patient safety in the clinical field. The purpose of this study was to assess nursing educators' competencies and educational needs for patient safety in hospitals and nursing schools.A mixed-methods sequential explanatory design employed a survey and focus group interview with nursing educators (school clinical instructors and hospital nurse preceptors. Thirty-eight questionnaires filled out by clinical instructors from six four-year nursing universities and 106 questionnaires from nurse preceptors from three high-level general hospitals in the Seoul metropolitan area were analyzed to obtain quantitative data. Focus group interviews were conducted among six clinical instructors from one nursing school and four nurse preceptors from one high-level general hospital in Seoul.Nursing educators had higher levels of attitude compared with relatively lower levels of skill and knowledge regarding patient safety. They reported educational needs of "medication" and "infection prevention" as being higher and "human factors" and "complexity of systems" as being lower. Nursing educators desired different types of education for patient safety.It is necessary to enhance nursing educators' patient safety skills and knowledge by developing and providing an integrated program of patient safety, with various teaching methods to meet their educational needs. The findings of this study provide the basic information needed to reform patient safety education programs appropriately to fit nursing educators' needs and their patient safety competencies in both clinical practice and academia. Furthermore, the findings have revealed the importance of effective communication between clinical and academic settings in making patient safety education seamless.

Safety in laboratories: Indian scenario.

Science.gov (United States)

Mustafa, Ajaz; Farooq, A Jan; Qadri, Gj; S A, Tabish

2008-07-01

Health and safety in clinical laboratories is becoming an increasingly important subject as a result of emergence of highly infectious diseases such as Hepatitis and HIV. A cross sectional study was carried out to study the safety measures being adopted in clinical laboratories of India. Heads of laboratories of teaching hospitals of India were subjected to a standardized, pretested questionnaire. Response rate was 44.8%. only 60% of laboratories had person in-charge of safety in laboratory. Seventy three percent of laboratories had safety education program regarding hazards. In 91% of laboratories staff is using protective clothing while working in laboratories. Hazardous material regulations are followed in 78% of laboratories. Regular health check ups are carried among laboratory staff in 43.4% of laboratories.Safety manual is available in 56.5% of laboratories. 73.9% of laboratories are equipped with fire extinguishers. Fume cupboards are provided in 34.7% of laboratories and they are regularly checked in 87.5% of these laboratories. In 78.26% of laboratories suitable measures are taken to minimize formation of aerosols.In 95.6% of laboratories waste is disposed off as per bio-medical waste management handling rules. Laboratory of one private medical college was accredited with NABL and safety parameters were better in that laboratory. Installing safety engineered devices apparently contributes to significant decrease in injuries in laboratories; laboratory safety has to be a part of overall quality assurance programme in hospitals. Accreditation has to be made necessary for all laboratories.

Net-Zero Building Technologies Create Substantial Energy Savings -

Science.gov (United States)

only an estimated 1% of commercial buildings are built to net-zero energy criteria. One reason for this Continuum Magazine | NREL Net-Zero Building Technologies Create Substantial Energy Savings Net -Zero Building Technologies Create Substantial Energy Savings Researchers work to package and share step

Facilitating the Practical Use of Coloured Petri Nets

DEFF Research Database (Denmark)

Lindstrøm, Bo

This dissertation is to investigate and advance tools for practical use of CP-nets. This includes development of facilities for creating domain-specific graphical user interfaces, a proposal for facilities for including auxiliary information in a CP-net without modifying the CP-net itself...

Using Banks: Teaching Banking Skills to Low-Income Consumers.

Science.gov (United States)

Shurtz, Mary Ann; LeFlore, Ann Becker

This module, one of six on teaching consumer matters to low-income adults, discusses banking skills. Topics include banking services (savings accounts, safety deposit boxes, Christmas clubs, loans, etc.), checking accounts (deposits, checkwriting, check registers, opening an account), how to use the check register (cancelled checks, deposits),…

47 CFR 69.302 - Net investment.

Science.gov (United States)

2010-10-01

...) Investment in Accounts 2002, 2003 and to the extent such inclusions are allowed by this Commission, Account... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Net Investment § 69.302 Net investment. (a) Investment in Accounts 2001, 1220 and Class B Rural...

Net Neutrality and Inflation of Traffic

NARCIS (Netherlands)

Peitz, M.; Schütt, F.

2015-01-01

Under strict net neutrality Internet service providers (ISPs) are required to carry data without any differentiation and at no cost to the content provider. We provide a simple framework with a monopoly ISP to evaluate different net neutrality rules. Content differs in its sensitivity to delay.

NetMOD Version 2.0 Mathematical Framework

Energy Technology Data Exchange (ETDEWEB)