WorldWideScience

Sample records for schultz manager utilization

  1. A Conversation with Howard Schultz CEO of Starbucks

    OpenAIRE

    Christopher Muller

    2014-01-01

    At the 12th annual European Food Service Summit in Zurich, Switzerland in September 2011, Professor Christopher Muller sat down with Howard Schultz, the CEO of Starbucks to discuss a wide range of topics. Their discussion touched on best management and business practices and the techniques that Schultz used to bring Starbucks back from the brink of bankruptcy to the international coffee corporation it is today.

  2. A Conversation with Howard Schultz CEO of Starbucks

    Directory of Open Access Journals (Sweden)

    Christopher Muller

    2014-04-01

    Full Text Available At the 12th annual European Food Service Summit in Zurich, Switzerland in September 2011, Professor Christopher Muller sat down with Howard Schultz, the CEO of Starbucks to discuss a wide range of topics. Their discussion touched on best management and business practices and the techniques that Schultz used to bring Starbucks back from the brink of bankruptcy to the international coffee corporation it is today.

  3. Johannes Heinrich Schultz and National Socialism.

    Science.gov (United States)

    Brunner, Jürgen; Schrempf, Matthias; Steger, Florian

    2008-01-01

    Johannes Heinrich Schultz (1884-1970) established the set of techniques known as "autogenic training." From 1936 until 1945 he worked as assistant director of the Göring Institute. His role during National Socialism has been underestimated in our opinion. We considered Schultz's academic publications and his "autobiography" from 1964. Schultz publicly advocated compulsory sterilization as well as the "annihilation of life unworthy of life" and developed a diagnostic scheme which distinguished between the neurotic/curable and the hereditary/ incurable. In fact, this classification was then employed to decide between life and death. In order to justify the "New German Psychotherapy" alongside eugenic psychiatry, Schultz carried out degrading and inhuman "treatments" of homosexual prisoners of concentration camps who were in mortal danger. This study was based on written documents. We were not able to interview contemporary witnesses. By advocating compulsory sterilization and the "annihilation of life unworthy of life" and by the abuse of homosexuals as research objects Schultz violated fundamental ethical principles of psychiatry.

  4. Managing the nuclear utility

    International Nuclear Information System (INIS)

    Williams, J.W. Jr.

    1985-01-01

    The Florida Power and Light Company (FP and L) is the fifth largest investor-owned utility in the country. The success of nuclear power generation at the St. Lucie Units 1 and 2 and Turkey Point Units 3 and 4 has resulted from a continuing management commitment to the nuclear program. The management of the power plants rely strongly on teamwork for most large projects and activities whether they entail plant operation, construction, or maintenance. Various examples of how teamwork has been used to realize the successful completion of projects or solutions to problems are given

  5. Utilization management in anatomic pathology.

    Science.gov (United States)

    Lewandrowski, Kent; Black-Schaffer, Steven

    2014-01-01

    There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management. © 2013.

  6. Sexual reproduction in Odontella regia (Schultze) Simonsen 1974 (Bacillariophyta)

    Digital Repository Service at National Institute of Oceanography (India)

    Hegde, S.; Narale, D.D.; Anil, A.C.

    The sequence of spermatogenesis and sperm cell count of Odontella regia (Schultze) Simonsen from Indian waters is reported. The sequence of events in the spermatogenesis producing 16 spermatogonia following four differentiating (depauperating...

  7. Utilization and management of alder.

    Science.gov (United States)

    David G. Briggs; Dean S. DeBell; William A. Atkinson

    1978-01-01

    In the Pacific Northwest and British Columbia, red alder often grows on forest lands following natural or man-caused disturbances. Frequently ignored as a pest or weed, many alder stands have developed to the point where important utilization and management questions are being asked. It is recognized that alder is a fast growing species, and that its rapid early growth...

  8. Managing change in nuclear utilities

    International Nuclear Information System (INIS)

    2001-07-01

    The nuclear power industry has undergone change since inception, but never so much as now. The rewards for proactively changing in anticipation of emerging demands are great, but the cost of failure is also great. Today nuclear plants are being shut down by socio-political and economic processes. The survival of the technology as a clean energy source for the future depends on the demonstration of long term safety to the public, protection of the environment, and economic superiority to competing energy sources. The overriding influence on these factors is strong management of the business with effective regulation. In particular it is necessary for both utility and regulator to believe that enhancing safety is part of being successful. This publication has been developed for all levels of management who are developing and implementing changes within their areas of responsibility. The safety conscious, continuous improvement, management culture, which has proven successful in today's nuclear business, has taken time to develop. Many utilities have difficulty sustaining this culture during the transitions that are intrinsic to change. Properly managed however, changes can enhance nuclear safety, plant reliability and cost competitiveness, from the design stage to decommissioning. Change has no respect for timing and regardless of the level of experience managers may have in its management, large scale change is confronting every nuclear utility world wide. These take the form of government policy changes, open market demands, privatization with the demand for increased shareholder returns, regulatory and social pressures, and economic and political transition. The danger from such issues for the nuclear company executive and the regulator is that they are powerful distractions, particularly for those executives who are not experienced in the unique managerial requirements of the nuclear business. This report gathers the experience of Member States into an array of

  9. Managing change in nuclear utilities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    The nuclear power industry has undergone change since inception, but never so much as now. The rewards for proactively changing in anticipation of emerging demands are great, but the cost of failure is also great. Today nuclear plants are being shut down by socio-political and economic processes. The survival of the technology as a clean energy source for the future depends on the demonstration of long term safety to the public, protection of the environment, and economic superiority to competing energy sources. The overriding influence on these factors is strong management of the business with effective regulation. In particular it is necessary for both utility and regulator to believe that enhancing safety is part of being successful. This publication has been developed for all levels of management who are developing and implementing changes within their areas of responsibility. The safety conscious, continuous improvement, management culture, which has proven successful in today's nuclear business, has taken time to develop. Many utilities have difficulty sustaining this culture during the transitions that are intrinsic to change. Properly managed however, changes can enhance nuclear safety, plant reliability and cost competitiveness, from the design stage to decommissioning. Change has no respect for timing and regardless of the level of experience managers may have in its management, large scale change is confronting every nuclear utility world wide. These take the form of government policy changes, open market demands, privatization with the demand for increased shareholder returns, regulatory and social pressures, and economic and political transition. The danger from such issues for the nuclear company executive and the regulator is that they are powerful distractions, particularly for those executives who are not experienced in the unique managerial requirements of the nuclear business. This report gathers the experience of Member States into an array of

  10. Drug utilization research and risk management

    NARCIS (Netherlands)

    Mazzaglia, Giampiero; Mol, Peter G. M.; Elseviers, Monique; Wettermark, Björn; Almarsdóttir, Anna Birna; Andersen, Morten; Benko, Ria; Bennie, Marion; Eriksson, Irene; Godman, Brian; Krska, Janet; Poluzzi, Elisabetta; Taxis, Katja; Vlahovic-Palcevski, Vera; Stichele, Robert Vander

    2016-01-01

    Good risk management requires continuous evaluation and improvement of planned activities. The evaluation impact of risk management activities requires robust study designs and carefully selected outcome measures. Key learnings and caveats from drug utilization research should be applied to the

  11. Utilization Management in the Blood Transfusion Service

    Science.gov (United States)

    Peña, Jeremy Ryan Andrew; Dzik, Walter “Sunny”

    2015-01-01

    The scope of activity of the Blood Transfusion Service (BTS) makes it unique among the clinical laboratories. The combination of therapeutic and diagnostic roles necessitates a multi-faceted approach to utilization management in the BTS. We present our experience in utilization management in large academic medical center. PMID:24080431

  12. The laboratory test utilization management toolbox.

    Science.gov (United States)

    Baird, Geoffrey

    2014-01-01

    Efficiently managing laboratory test utilization requires both ensuring adequate utilization of needed tests in some patients and discouraging superfluous tests in other patients. After the difficult clinical decision is made to define the patients that do and do not need a test, a wealth of interventions are available to the clinician and laboratorian to help guide appropriate utilization. These interventions are collectively referred to here as the utilization management toolbox. Experience has shown that some tools in the toolbox are weak and other are strong, and that tools are most effective when many are used simultaneously. While the outcomes of utilization management studies are not always as concrete as may be desired, what data is available in the literature indicate that strong utilization management interventions are safe and effective measures to improve patient health and reduce waste in an era of increasing financial pressure.

  13. Time management problems and discounted utility.

    Science.gov (United States)

    König, Cornelius J; Kleinmann, Martin

    2007-05-01

    The lens of behavioral decision theory offers a new perspective for research on time management. The basic idea of this approach is that people discount future consequences of their time management decisions, meaning that they work on tasks with smaller but sooner outcomes rather than on tasks with larger but later outcomes. The authors performed 2 experimental studies to test whether people are sensitive to differences in the discounted utility of time management decisions. In Experiment 1, they used vignettes of typical time management situations; Experiment 2 was a laboratory simulation (an in-basket task that was part of a training assessment). Participants in both studies were German students. As expected, manipulating the discounted utility of options resulted in different time management decisions. In Experiment 1, reactions to time management situations were judged as less likely if the reactions had lower discounted utilities. In Experiment 2, people spent less time on an interruption.

  14. Utilizing Interns in Facilities Management

    Science.gov (United States)

    Judkins, Clarissa; Morris, John P.; Molocznik, Chuck

    2011-01-01

    Facilities management is rapidly changing and developing from a position an individual stumbles into--or work one's way up through--to a discipline and vocation all of its own. There is a need for a collaborative strategy among leaders in practice, education, and research to share knowledge and experience and to establish professional and ethical…

  15. Asset Management for Water and Wastewater Utilities

    Science.gov (United States)

    Renewing and replacing the nation's public water infrastructure is an ongoing task. Asset management can help a utility maximize the value of its capital as well as its operations and maintenance dollars.

  16. Development of a utility conflict management system.

    Science.gov (United States)

    2009-02-01

    A critical process for the timely development and delivery of highway construction projects is the early : identification and depiction of utility interests that may interfere with proposed highway facilities. The : effective management of such utili...

  17. Decision support for utility environmental risk management

    International Nuclear Information System (INIS)

    Balson, W.E.; Wilson, D.S.

    1991-01-01

    This paper reviews a number of decision support methods developed and applied by Decision Focus Incorporated to help utility personnel manage current environmental problems. This work has been performed for the Environmental Risk Analysis Program of EPRI's Environment Division, and also for a number of electric utilities across the country. These are two distinct types of decision support software tools that have been created: economic risk management and environmental risk analysis. These types differ primarily in the identification of who will make a decision. Economic risk management tools are directed primarily at decisions made by electric utilities. Environmental risk analysis tools are directed primarily at decisions made by legislative or regulatory agencies, about which a utility may wish to comment

  18. Establishing benchmarks and metrics for utilization management.

    Science.gov (United States)

    Melanson, Stacy E F

    2014-01-01

    The changing environment of healthcare reimbursement is rapidly leading to a renewed appreciation of the importance of utilization management in the clinical laboratory. The process of benchmarking of laboratory operations is well established for comparing organizational performance to other hospitals (peers) and for trending data over time through internal benchmarks. However, there are relatively few resources available to assist organizations in benchmarking for laboratory utilization management. This article will review the topic of laboratory benchmarking with a focus on the available literature and services to assist in managing physician requests for laboratory testing. © 2013.

  19. A bayesian approach to laboratory utilization management

    Directory of Open Access Journals (Sweden)

    Ronald G Hauser

    2015-01-01

    Full Text Available Background: Laboratory utilization management describes a process designed to increase healthcare value by altering requests for laboratory services. A typical approach to monitor and prioritize interventions involves audits of laboratory orders against specific criteria, defined as rule-based laboratory utilization management. This approach has inherent limitations. First, rules are inflexible. They adapt poorly to the ambiguity of medical decision-making. Second, rules judge the context of a decision instead of the patient outcome allowing an order to simultaneously save a life and break a rule. Third, rules can threaten physician autonomy when used in a performance evaluation. Methods: We developed an alternative to rule-based laboratory utilization. The core idea comes from a formula used in epidemiology to estimate disease prevalence. The equation relates four terms: the prevalence of disease, the proportion of positive tests, test sensitivity and test specificity. When applied to a laboratory utilization audit, the formula estimates the prevalence of disease (pretest probability [PTP] in the patients tested. The comparison of PTPs among different providers, provider groups, or patient cohorts produces an objective evaluation of laboratory requests. We demonstrate the model in a review of tests for enterovirus (EV meningitis. Results: The model identified subpopulations within the cohort with a low prevalence of disease. These low prevalence groups shared demographic and seasonal factors known to protect against EV meningitis. This suggests too many orders occurred from patients at low risk for EV. Conclusion: We introduce a new method for laboratory utilization management programs to audit laboratory services.

  20. Improving Knowledge Management and Utilization of Research ...

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

    Improving Knowledge Management and Utilization of Research Results in Ecohealth Projects. This study brings together lead investigators from 11 past and ongoing Ecohealth projects across Latin America who are interested in achieving better development outcomes guided by research results. Their collective ...

  1. Fleet management tools for the utility industry

    Energy Technology Data Exchange (ETDEWEB)

    Caywood, J. [Terex Telelect, Watertown, SD (United States)

    2002-08-01

    In order to enable fleet managers to make the appropriate decisions concerning buying, selling, renting, leasing or repairing vehicles, information about ownership and operating cost and utilization are important. Fleet management tools are now available in the heavy construction industry. The author describes one such fleet management services customized for the utility industry: FleetEdge. This system utilizes current and future technologies to enable the managers to take proactive or predictive approaches to fleet management. An example of a company that has opted for this system was reviewed: Reliant Energy-Houston Metro. The data collection process was explained. A mini-computer processor is fitted on the equipment, and the requested monitoring parameters in turn determine the variety of sensors and alarms to be selected. Location can also be monitored through the use of Global Positioning System (GPS) equipment. The parameters normally include low engine oil pressure, high engine operating temperature, high transmission operating temperature, high hydraulic oil temperature, engine hours. Wireless data transfer is effected via cellular or satellite networks. The data is then collected and checked for errors and format at a hub before going to the computer server through the Internet. Information is transmitted from the accounting system to fleet management service through a secure interface. The data is then configured to meet the client's needs. It results in up to date, understandable information to the client. Equipment utilization, downtime and cost by machine or category is easily accessible and printed if required. Fleet equipment status is provided, as well as hourly cost analysis. Other reports are also available. 2 tabs., 2 figs.

  2. Effective utilization and management of research reactors

    Energy Technology Data Exchange (ETDEWEB)

    Muranaka, R [International Atomic Energy Agency, Vienna (Austria). Div. of Research and Isotopes

    1984-06-01

    The problem of utilizing a research reactor effectively is closely related to its management and therefore should not be considered separately. Too often, attention has been focused on specific techniques and methods rather than on the overall programme of utilization, with the result that skills and equipment have been acquired without any active continuing programme of applications and services. The seminar reported here provided a forum for reactor managers, users, and operators to discuss their experience. At the invitation of the Government of Malaysia, it was held at the Asia Pacific Development Centre, Kuala Lumpur, from 7 to 11 November 1983. It was attended by about 50 participants from 19 Member States; it is hoped that a report on the seminar, including papers presented, can be published and thus reach a wider audience. Thirty-one lectures and contributions were presented at a total of seven sessions: Research reactor management; Radiation exposure and safety; Research reactor utilization (two sessions); PUSPATI Research Reactor Project Development; Core conversion to low-enriched uranium, and safeguards; Research reactor technology. In addition, a panel discussed the causes and resolutions of the under-utilization of research reactors.

  3. Effective utilization and management of research reactors

    International Nuclear Information System (INIS)

    Muranaka, R.

    1984-01-01

    The problem of utilizing a research reactor effectively is closely related to its management and therefore should not be considered separately. Too often, attention has been focused on specific techniques and methods rather than on the overall programme of utilization, with the result that skills and equipment have been acquired without any active continuing programme of applications and services. The seminar reported here provided a forum for reactor managers, users, and operators to discuss their experience. At the invitation of the Government of Malaysia, it was held at the Asia Pacific Development Centre, Kuala Lumpur, from 7 to 11 November 1983. It was attended by about 50 participants from 19 Member States; it is hoped that a report on the seminar, including papers presented, can be published and thus reach a wider audience. Thirty-one lectures and contributions were presented at a total of seven sessions: Research reactor management; Radiation exposure and safety; Research reactor utilization (two sessions); PUSPATI Research Reactor Project Development; Core conversion to low-enriched uranium, and safeguards; Research reactor technology. In addition, a panel discussed the causes and resolutions of the under-utilization of research reactors

  4. Calculating cost savings in utilization management.

    Science.gov (United States)

    MacMillan, Donna

    2014-01-01

    A major motivation for managing the utilization of laboratory testing is to reduce the cost of medical care. For this reason it is important to understand the basic principles of cost accounting in the clinical laboratory. The process of laboratory testing includes three distinct components termed the pre-analytic, analytic and post-analytic phases. Utilization management efforts may impact the cost structure of these three phases in different ways depending on the specific details of the initiative. Estimates of cost savings resulting from utilization management programs reported in the literature have often been fundamentally flawed due to a failure to understand basic concepts such as the difference between laboratory costs versus charges and the impact of reducing laboratory test volumes on the average versus marginal cost structure in the laboratory. This article will provide an overview of basic cost accounting principles in the clinical laboratory including both job order and process cost accounting. Specific examples will be presented to illustrate these concepts in various different scenarios. © 2013.

  5. Strategic management and utilization of patents

    International Nuclear Information System (INIS)

    Kim, Gyeong Go; Yun, Gwon Jun

    1993-11-01

    This book deals with why does management of patents need?, system of management of patents with function and site of management of patents and system and composition, what does management of patents department do?, task like technical development, management regulation, patent information, management of patents in small business with technical development of small business, how does business manage the patents in real, introduction of management of patents in the U.S, Europe, Japan, and Korea, and management of patents as strategic management.

  6. Geomorphic aspects of post-fire soil erosion - Schultz Fire 2010

    Science.gov (United States)

    Ann Youberg; Karen A. Koestner; Daniel G. Neary; Peter E. Koestner

    2011-01-01

    The summer of 2010 brought wildfires and near record monsoon rains to northern Arizona, USA, which generated debris flows and floods that caused extensive damage. The human-caused Schultz Fire on the Coconino National Forest northeast of Flagstaff was the largest wildfire in Arizona during 2010, burning 6,100 ha between June 20th and 30th. Ignited by an abandoned...

  7. Knowledge management implementation and the tools utilized in ...

    African Journals Online (AJOL)

    Knowledge management implementation and the tools utilized in healthcare for ... a knowledge driven process and thus knowledge management and the tools to ... health record systems, communities of practice and advanced care planning.

  8. Practical constraints on fuel management a utility perspective

    International Nuclear Information System (INIS)

    Grier, C.A.

    1986-01-01

    The practical and potential constraints of performing fuel management at a large utility are reviewed. Based on approximately six years of experience in performing fuel management the constraints due to commercial, technical, utility system, design methods, and personnel and computer resources are discussed in detail

  9. Depositional characteristics of post-fire flooding following the Schultz Fire, San Francisco Peaks, Arizona

    Science.gov (United States)

    Karen A. Koestner; Mike D. Carroll; Daniel G. Neary; Peter E. Koestner; Ann Youberg

    2011-01-01

    During the summer of 2010 the northern Arizona mountain town of Flagstaff experienced three fires all blazing the same week in late-June, the height of the fire season for this region. By July 1st, all three were extinguished, but that was only the first phase of disturbance. The largest and most detrimental of these fires was the Schultz Fire. From June 20th to July...

  10. Post-fire rill and gully formation, Schultz Fire 2010, Arizona, USA

    Science.gov (United States)

    Daniel G. Neary; Karen A. Koestner; Ann Youberg; Peter E. Koestner

    2011-01-01

    The Schultz Fire burned 6,100 ha on the eastern slopes of the San Francisco Peaks, a dormant Middle Pliocene to Holocene aged stratovolcano in northern Arizona (Figure 1). The fire burned in the Coconino National Forest between June 20th and 30th, 2010, across moderate to very steep ponderosa pine and mixed conifer watersheds. About 40% of the fire area was classified...

  11. Viewpoint of utilities regarding fuel management of nuclear power plants

    International Nuclear Information System (INIS)

    Held, C.; Moraw, G.; Schneeberger, M.; Szeless, A.

    1977-01-01

    The engagement of utilities in nuclear power requires them to engage in an increasing amount of fuel management activities in order to carry out all the tasks involved. Essentially, these activities involve two main areas: The procurement of all steps of the fuel cycle from the head to the back end; and in-core fuel management. A general survey of the different steps of the nuclear fuel cycle is presented together with the related activities and responsibilities which have to be borne by the utilities. Today's increasing utility involvement in the nuclear fuel management is shown, as well as future fuel management trends. The fuel management activities of the utilities are analysed with respect to organizational, technical, safeguarding, and financial aspects. The active participation of the utilities in fuel management helps to achieve high availability and flexibility of the nuclear power plant during its whole life as well as safe waste isolation. This can be ensured by continuous optimization of all fuel management aspects of the power plant or, on a larger scale, of a power plant system, i.e. activities by utilities to minimize fuel-cycle effects on the environment, which include optimization of fuel behaviour, and radiation exposure to the public and personnel; and technical and economic evaluations by utilities of out- and in-core fuel management. (author)

  12. Radioactive waste management: a utility view

    International Nuclear Information System (INIS)

    Draper, E.L.

    1982-01-01

    The management of radioactive waste continues to be a matter of public concern and discussion. There is broad agreement among members of the technical community that the various types of waste radioactive species can be managed without jeopardizing public health and safety. Despite this consensus, one of the major reasons cited by opponents of commercial nuclear power for their opposition is the lack of a fully deployed waste management program. Such a program has been suggested but implementation is not yet complete. It is essential that a program be undertaken so as to dispel the impression that past inaction on waste disposal represents an inability to deal safely with wastes

  13. Agricultural waste concept, generation, utilization and management ...

    African Journals Online (AJOL)

    Agricultural wastes are non-product outputs of production and processing of ... less than the cost of collection, transportation, and processing for beneficial use. ... Agricultural waste management system (AWMS) was discussed and a typical ...

  14. Maintenance Management in Network Utilities Framework and Practical Implementation

    CERN Document Server

    Gómez Fernández, Juan F

    2012-01-01

    In order to satisfy the needs of their customers, network utilities require specially developed maintenance management capabilities. Maintenance Management information systems are essential to ensure control, gain knowledge and improve-decision making in companies dealing with network infrastructure, such as distribution of gas, water, electricity and telecommunications. Maintenance Management in Network Utilities studies specified characteristics of maintenance management in this sector to offer a practical approach to defining and implementing  the best management practices and suitable frameworks.   Divided into three major sections, Maintenance Management in Network Utilities defines a series of stages which can be followed to manage maintenance frameworks properly. Different case studies provide detailed descriptions which illustrate the experience in real company situations. An introduction to the concepts is followed by main sections including: • A Literature Review: covering the basic concepts an...

  15. Utilities' view on the fuel management of nuclear power plants

    International Nuclear Information System (INIS)

    Held, C.; Moraw, G.; Schneeberger, M.; Szeless, A.

    1977-01-01

    Utilities engagement in nuclear power requires an increasing amount of fuel management activities by the utilities in order to meet all tasks involved. These activities comprise essentially two main areas: - activities to secure the procurement of all steps of the fuel cycle from the head to the back end; - activities related to the incore fuel managment. A general survey of the different steps of the nuclear fuel cycle is presented together with the related activities and responsibilities which have to be realized by the utilities. Starting in the past, today's increasing utility involvement in the nuclear fuel management is shown, as well as future fuel management trends. The scope of utilities' fuel management activities is analyzed with respect to organizational aspects, technical aspects, safeguarding aspects, and financial aspects. Utilities taking active part in the fuel management serves to achieve high availability and flexibility of the nuclear power plant during the whole plant life as well as safe waste isolation. This can be assured by continuous optimization of all fuel management aspects of the power plant or on a larger scale of a power plant system, i.e., utility activities to minimize the effects of fuel cycle on the environment, which includes optimization of fuel behaviour, radiation exposure to public and personnel, and utility technical and economic evaluations of out- and incore fuel management. These activities of nuclear power producing utilities in the field of nuclear fuel cycle are together with a close cooperation with fuel industry as well as national and international authorities a necessary basis for the further utilization of nuclear power

  16. Improving Knowledge Management and Utilization of Research ...

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

    They are extremely vulnerable, and they have to cope with few resources, poor health, ... and improve research implementation approaches and instruments through ... The project's long-term aim is to contribute to integrated policies that link health, ... IWRA/IDRC webinar on climate change and adaptive water management.

  17. Resource management in utility and cloud computing

    CERN Document Server

    Zhao, Han

    2013-01-01

    This SpringerBrief reviews the existing market-oriented strategies for economically managing resource allocation in distributed systems. It describes three new schemes that address cost-efficiency, user incentives, and allocation fairness with regard to different scheduling contexts. The first scheme, taking the Amazon EC2? market as a case of study, investigates the optimal resource rental planning models based on linear integer programming and stochastic optimization techniques. This model is useful to explore the interaction between the cloud infrastructure provider and the cloud resource c

  18. Leveraging network utility management practices for regulatory purposes

    International Nuclear Information System (INIS)

    2009-11-01

    Electric utilities around the globe are entering a phase where they must modernize and implement smart grid technologies. In order to optimize system architecture, asset replacement, and future operating costs, it the utilities must implement robust and flexible asset management structures. This report discussed the ways in which regulators assess investment plans. It focused on the implicit or explicit use of an asset management approach, including principles; processes; input and outputs; decision-making criteria and prioritization methods. The Ontario Energy Board staff were familiarized with the principles and objectives of established and emerging asset management processes and underlying analytic processes, systems and tools in order to ensure that investment information provided by network utilities regarding rates and other applications could be evaluated effectively. Specifically, the report discussed the need for and importance of asset management and provided further details of international markets and their regulatory approaches to asset management. The report also discussed regulatory approaches for review of asset management underlying investment plans as well as an overview of international regulatory practice for review of network utility asset management. It was concluded that options for strengthening regulatory guidance and assessment included utilizing appropriate and effective benchmarking to assess, promote and provide incentives for best practices and steer clear of the potential perverse incentives. 21 tabs., 17 figs., 1 appendix.

  19. Prudent management of utility assets -- Problem or promise?

    International Nuclear Information System (INIS)

    Hatch, D.; Serwinowski, M.

    1998-01-01

    As utilities move into a deregulated market, the extent and nature of their asset base, as well as, the manner in which they have managed it, may play a key factor in the form of regulatory recovery. Utilities must face the issue of stranded assets. One form of addressing this issue is using ''EVA'', Economic Value Added as a mechanism to form financial models for prudent asset management. The authors present an approach to this challenging aspect of deregulation. They focus on the following utility assets: buildings/facilities, and excess real physical assets. Primarily focusing on Niagara Mohawk, two or three case studies are used to demonstrate how proactive management and EVA analysis transforms underperforming utility assets. These will be presented in a way that can show benefits for all utility stakeholders such as cost avoidance, load growth, real estate tax savings, stranded asset reductions, environmental gains, corporate image enhancement, and regulatory/governmental gains; over and above possible economic gains. Examples will be given that include the transformation of utility assets into award winning commercial, residential, and industrial developments as well as recreational/park lands and greenways. Similarly, other examples will show the many tangible and intangible benefits of an effective investment recovery and waste stream management program. Various strategies will also be presented that detail how utilities can begin to develop a total comprehensive plan for their asset portfolio. The first step in realizing and maximizing EVA towards a portfolio of assets is a change in corporate policy--one from passive ownership to active prudent management. Service and cost will drive competition resulting from full deregulation. To drive down costs, utilities will need to become more efficient in dealing with their asset base. By embracing an EVA model on an entire asset portfolio, utilities can prepare and excel in the newly shaped marketplace

  20. Implementing Integrated Multicultural Instructional Design in Management Education

    Science.gov (United States)

    Schultz, Jennifer L.; Higbee, Jeanne L.

    2011-01-01

    This purpose of this paper is to summarize the principles of integrated multicultural instructional design (IMID; Higbee, Goff, & Schultz, in press; Higbee, Schultz, & Goff, 2010) and present specific strategies for incorporating IMID in management education. The primary goal of IMID is to promote the integration of multicultural content…

  1. Trade-off decisions in distribution utility management

    Science.gov (United States)

    Slavickas, Rimas Anthony

    As a result of the "unbundling" of traditional monopolistic electricity generation and transmission enterprises into a free-market economy, power distribution utilities are faced with very difficult decisions pertaining to electricity supply options and quality of service to the customers. The management of distribution utilities has become increasingly complex, versatile, and dynamic to the extent that conventional, non-automated management tools are almost useless and obsolete. This thesis presents a novel and unified approach to managing electricity supply options and quality of service to customers. The technique formulates the problem in terms of variables, parameters, and constraints. An advanced Mixed Integer Programming (MIP) optimization formulation is developed together with novel, logical, decision-making algorithms. These tools enable the utility management to optimize various cost components and assess their time-trend impacts, taking into account the intangible issues such as customer perception, customer expectation, social pressures, and public response to service deterioration. The above concepts are further generalized and a Logical Proportion Analysis (LPA) methodology and associated software have been developed. Solutions using numbers are replaced with solutions using words (character strings) which more closely emulate the human decision-making process and advance the art of decision-making in the power utility environment. Using practical distribution utility operation data and customer surveys, the developments outlined in this thesis are successfully applied to several important utility management problems. These involve the evaluation of alternative electricity supply options, the impact of rate structures on utility business, and the decision of whether to continue to purchase from a main grid or generate locally (partially or totally) by building Non-Utility Generation (NUG).

  2. Impact of HMO ownership on management processes and utilization outcomes.

    Science.gov (United States)

    Ahern, M; Molinari, C

    2001-05-01

    To examine the effects of health maintenance organization (HMO) ownership characteristics on selected utilization outcomes and management processes affecting utilization. We used 1995 HMO data from the American Association of Health Plans. Using regression analysis, we examined the relation between HMO utilization (hospital discharges, days, and average length of stay; cardiac catheterization procedures; and average cost of outpatient prescriptions) and the structural characteristics of HMOs: ownership type (insurance company, hospital, physician, independent, and national managed care company), HMO size, for-profit status, model type, geographic region, and payer mix. HMO ownership type is significantly associated with medical management processes, including risk sharing by providers, risk sharing by consumers, and other management strategies. Relative to hospital-owned HMOs, insurance company-owned HMOs have fewer hospital discharges, fewer hospital days, and longer lengths of stay. National managed care organization-owned HMOs have fewer cardiac catheterizations and lower average outpatient prescription costs. Independently owned HMOs have more cardiac catheterizations. For-profit HMOs have lower prescription costs. Relative to hospital-owned HMOs, insurance company-owned HMOs are more likely to use hospital risk sharing and provider capitation and less likely to use out-of-pocket payments for hospital use and a closed formulary. National managed care organization-owned HMOs are less likely to use provider capitation, out-of-pocket payments for hospital use, catastrophic case management, and hospital risk sharing. Physician-hospital-owned HMOs are less likely to use catastrophic case management. For-profit HMOs are more likely to use hospital risk sharing and catastrophic case management. HMO ownership type affects utilization outcomes and management strategies.

  3. Utilization management in radiology, part 2: perspectives and future directions.

    Science.gov (United States)

    Duszak, Richard; Berlin, Jonathan W

    2012-10-01

    Increased utilization of medical imaging in the early part of the last decade has resulted in numerous efforts to reduce associated spending. Recent initiatives have focused on managing utilization with radiology benefits managers and real-time order entry decision support systems. Although these approaches might seem mutually exclusive and their application to radiology appears unique, the historical convergence and broad acceptance of both programs within the pharmacy sector may offer parallels for their potential future in medical imaging. In this second installment of a two-part series, anticipated trends in radiology utilization management are reviewed. Perspectives on current and future potential roles of radiologists in such initiatives are discussed, particularly in light of emerging physician payment models. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Information management applications for the compliance function: a utility perspective

    International Nuclear Information System (INIS)

    Savoie, R.A.

    1986-01-01

    Today's complex and changing regulatory environment presents many challenges to those involved in the nuclear power industry. This is particularly true of technical personnel and managers involved in serving the compliance function for nuclear utilities. Adequately supporting the construction, startup, and operations of a nuclear power plant while simultaneously satisfying each regulatory requirement requires the meshing of thousands of individual regulatory tasks with each possible implementation option. The compliance function acts as a screen or filter between the regulatory bodies and the utility nuclear staff. Many varied approaches are taken by utilities in performing this compliance function, both from an organizational and information management perspective. The purpose of this paper is to describe the experiences of Louisiana Power and Light (LP and L) in developing its compliance function and to describe the innovative information management techniques LP and L has developed to serve this function

  5. U.S. electric utility demand-side management 1995

    International Nuclear Information System (INIS)

    1997-01-01

    The US Electric Utility Demand-Side Management report is prepared by the Coal and Electric Data and Renewables Division; Office of Coal, Nuclear, Electric and Alternative Fuels; Energy Information Administration (EIA); US Department of Energy. The report presents comprehensive information on electric power industry demand-side management (DSM) activities in the US at the national, regional, and utility levels. The objective of the publication is to provide industry decision makers, government policy makers, analysts, and the general public with historical data that may be used in understanding DSM as it relates to the US electric power industry. The first chapter, ''Profile: US Electric Utility Demand-Side Management'', presents a general discussion of DSM, its history, current issues, and a review of key statistics for the year. Subsequent chapters present discussions and more detailed data on energy savings, peak load reductions and costs attributable to DSM. 9 figs., 24 tabs

  6. Analysis of community response to transportation noise a quarter century after Schultz (1978)

    Science.gov (United States)

    Fidell, Sanford

    2003-10-01

    Transportation noise is a vexing and intrinsically controversial problem that has plagued societies since the beginnings of urban civilization. A function relating cumulative noise exposure to the prevalence of noise-induced annoyance [T. J. Schultz, ``Synthesis of social surveys on noise annoyance,'' J. Acoust. Soc. Am. 64, 377-405 (1978)] is the foundation for contemporary analyses of transportation noise effects on communities. The expenditures of billions of dollars in airplane ticket and fuel taxes for the construction of an airport infrastructure and for the mitigation of noise impacts in the United States are governed by policies ostensibly supported by a successor to Schultz's original ``synthesis'' curve. Many have grown so comfortable with the last quarter century's paradigm for transportation noise assessment and regulation, however, that they have lost sight of its underpinnings and limitations. A review of the historical and modern states of the art identifies persistent unresolved problems in the prediction and explanation of community response to transportation noise that are not fully addressed by descriptive dosage-effect analysis.

  7. Estudio de la propagación sexual del arboloco Montanoa quadrangularis Schultz Bipontianus Asteraceae

    Directory of Open Access Journals (Sweden)

    William Escobar-Torres

    2010-04-01

    Full Text Available Sexual propagation of arboloco Montanoa quadrangularis Schultz Bipontianus (Asteraceae. Objective. To develop sexual propagationmethodologies for Montanoa quadrangularis Schultz Bipontianus (arboloco. Materials and methods. Seeds were harvested from treesgrown at the Chilaca environmental station (Geoambiente Ltda. located in Pacho, Cundinamarca, Colombia. The study was carried out intwo phases: firstly, substrate effect on germination responses was evaluated in seedbed conditions. Substrates evaluated were: local soil,local soil mixed with worm humus, and peat. Additionally, two spatial arrangements were assessed: seeds sown at random and at 0.5 cmin depth. Secondly, in nursery conditions the effect of the substrates local soil, local soil mixed with worm humus and peat, as well as theeffect of developmental stages of the plants (with 2, 4, and 6 leaves on their further growth and development were evaluated. Results. Inseedbed conditions, the germination capacity was highly influenced by peat substrate (83.67% whereas in local soil the germinationcapacity was 40.83%. In nursery conditions, 6-leaf plants grown in local soil mixed with worm humus showed the best responses onparameters such as plant total length (9.51 cm, leaf area (36.69 cm2, and total dry weight (0.10 g. Conclusions. The type of substrateused in seedbed conditions influenced the germination capacity of M. quadrangularis seeds. The substrate and the developmental stage ofthe plant had a significant influence on the growth and development of arboloco plants.

  8. Light Duty Utility Arm computer software configuration management plan

    International Nuclear Information System (INIS)

    Philipp, B.L.

    1998-01-01

    This plan describes the configuration management for the Light Duty Utility Arm robotic manipulation arm control software. It identifies the requirement, associated documents, and the software control methodology. The Light Duty Utility Ann (LDUA) System is a multi-axis robotic manipulator arm and deployment vehicle, used to perform surveillance and characterization operations in support of remediation of defense nuclear wastes currently stored in the Hanford Underground Storage Tanks (USTs) through the available 30.5 cm (12 in.) risers. This plan describes the configuration management of the LDUA software

  9. Successful process management for public utilities; Erfolgreiches Prozessmanagement fuer Stadtwerke

    Energy Technology Data Exchange (ETDEWEB)

    Knipprath, Daniel [projekt:unternehmensberatungsgesellschaft mbH, Muenchen (Germany); Schaefer, Anke [Dr. Schaefer PR- und Strategieberatung, Rostock (Germany)

    2011-06-15

    As a result of regulatory cuts in their revenue structure, public utilities are increasingly compelled to improve their cost efficiency. Furthermore, they have to deal with altered framework conditions of energy procurement as well as the necessity of sustainable customer loyalty management. The example of a regional supplier is used here to show how goal-oriented process management can contribute to securing a sustainable, promising position in the market.

  10. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Science.gov (United States)

    2010-10-01

    ... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

  11. Risk management strategies utilized by small scale poultry farmers ...

    African Journals Online (AJOL)

    Birds can only tolerate narrow temperature changes; therefore, poultry flocks are vulnerable to climate induced risk. This study investigated risk management strategies utilized by small scale poultry farmers in Oyo state. A total of 118 respondents were sampled using multi stage sampling procedure. Interview schedule was ...

  12. LiDAR utility for natural resource managers

    Science.gov (United States)

    Andrew Thomas Hudak; Jeffrey Scott Evans; Alistair Mattthew Stuart. Smith

    2009-01-01

    Applications of LiDAR remote sensing are exploding, while moving from the research to the operational realm. Increasingly, natural resource managers are recognizing the tremendous utility of LiDAR-derived information to make improved decisions. This review provides a cross-section of studies, many recent, that demonstrate the relevance of LiDAR across a suite of...

  13. Building Maintenance and Utilities Management. Florida Vocational Program Guide.

    Science.gov (United States)

    University of South Florida, Tampa. Dept. of Adult and Vocational Education.

    This program guide identifies primary concerns in the organization, operation, and evaluation of a building maintenance and utilities management program. It is designed for local school district and community college administrators, instructors, program advisory committees, and regional coordinating councils. The guide begins with the Dictionary…

  14. assessing the utilization of personnel in the management of ...

    African Journals Online (AJOL)

    LUCY

    MANAGEMENT OF TECHNICAL EDUCATION IN AKWA IBOM. STATE, NIGERIA. ALOYSIUS O. UMOSEN. (Received 19, April 2011; Revision Accepted 16, June 2011). ABSTRACT. The study assesses the utilization of technical teachers in Akwa Ibom State technical colleges. The study design was ex-post facto.

  15. Comparison of Dorris-Gray and Schultz methods for the calculation of surface dispersive free energy by inverse gas chromatography.

    Science.gov (United States)

    Shi, Baoli; Wang, Yue; Jia, Lina

    2011-02-11

    Inverse gas chromatography (IGC) is an important technique for the characterization of surface properties of solid materials. A standard method of surface characterization is that the surface dispersive free energy of the solid stationary phase is firstly determined by using a series of linear alkane liquids as molecular probes, and then the acid-base parameters are calculated from the dispersive parameters. However, for the calculation of surface dispersive free energy, generally, two different methods are used, which are Dorris-Gray method and Schultz method. In this paper, the results calculated from Dorris-Gray method and Schultz method are compared through calculating their ratio with their basic equations and parameters. It can be concluded that the dispersive parameters calculated with Dorris-Gray method will always be larger than the data calculated with Schultz method. When the measuring temperature increases, the ratio increases large. Compared with the parameters in solvents handbook, it seems that the traditional surface free energy parameters of n-alkanes listed in the papers using Schultz method are not enough accurate, which can be proved with a published IGC experimental result. © 2010 Elsevier B.V. All rights reserved.

  16. Rock gabion, rip-rap, and culvert treatments: Successes and failures in post-fire erosion mitigation, Schultz Fire 2010

    Science.gov (United States)

    Daniel G. Neary; Karen A. Koestner

    2011-01-01

    Following the Schultz Fire in June of 2010, several erosion mitigation efforts were undertaken to reduce the impacts of post-fire flooding expected during the 2010 monsoon. One treatment consisted of the placement of large rock rip-rap on targeted fill slopes of a high elevation forest road that contains a buried pipeline supplying water to the city of Flagstaff....

  17. EPRI Guide to Managing Nuclear Utility Protective Clothing Programs

    International Nuclear Information System (INIS)

    Kelly, J.J.; Kelly, D.M.

    1993-10-01

    The Electric Power Research Institute (EPRI) commissioned a radioactive waste related project (RP2414-34) in 1989 to produce a guide for developing and managing nuclear plant protective clothing programs. Every nuclear facility must coordinate some type of protective clothing program for its radiation workers to ensure proper and safe protection for the wearer and to maintain control over the spread of contamination. Yet, every nuclear facility has developed its own unique program for managing such clothing. Accordingly, a need existed for a reference guide to assist with standardizing protective clothing programs and in controlling the potentially escalating economics of such programs. The initial Guide to Managing Nuclear Utility Protective Clothing Programs, NP-7309, was published in May 1991. Since that time, a number of utilities have reviewed and/or used the report to enhance their protective clothing programs. Some of these utilities requested that a computer program be developed to assist utilities in evaluating the economics of protective clothing programs consistent with the guidance in NP-7309. The PCEVAL computer code responds to that industry need. This report, the PCEVAL User's Manual, provides detailed instruction on use of the software

  18. Toward a New, Musical Paradigm of Place: The Port River Symphonic of Chester Schultz

    Directory of Open Access Journals (Sweden)

    Robin, Ryan

    2014-05-01

    Full Text Available In privileging music as a focus for applied ecology, the goal of this essay is to deepen perspectives on the musical representation of land in an age of complex environmental challenge. As the metaphor driving public narration of environmental crises, the notion of Earth as our home—signified by the prefix “eco”—brings with it a critical expectation for the musical academy to retreat from bland talk about a “sense of place.” Based on the premise that damaged ecologies are a matter of concern to many people, Indigenous and Settler; and building on the late Val Plumwood’s theory of “shadow” or “denied” places (Australian Humanities Review 44, 2008, the author introduces Within Our Reach: A Symphony of the Port River Soundscapes by anti-elitist South Australian composer Chester Schultz (b. 1945. Inspired by the tradition of R. Murray Schafer’s performances for outdoor sites, Schultz predicated this niche symphony on the noise-polluting defoliation of Adelaide’s “wetland wonder,” the Old Port Reach. Presented as a series of narrative soundscapes, the symphony harnesses the power of music, including popular genres, to engender a sense of local “belonging” to the Port. In an ecological subtext an Indigenous Elder sings in the re-awakening language of the Kaurna people who, in 1890, were evicted from their “nourishing terrain” (terminology after Rose, 1996 by the CSR Sugar Refinery. Schultz’s ethical musical representation of local oral, natural and industrial history generates a benchmark opus for what shadow place composition might sound like in the modern global city.

  19. Is strategic asset management applicable to small and medium utilities?

    Science.gov (United States)

    Alegre, Helena

    2010-01-01

    Urban water infrastructures provide essential services to modern societies and represent a major portion of the value of municipal physical assets. Managing these assets rationally is therefore fundamental for the sustainability of the services and to the economy of societies. "Asset Management" (AM) is a modern term for an old practice--assets have always been managed. In recent years, significant evolution occurred in terms of the AM formal approaches, of the monitoring and decision support tools and of the implementation success cases. However, most tools developed are too sophisticated and data seek for small utilities. The European R&D network COST Action C18 ( E-mail: www.costc18.org) identified key research problems related to the management of urban water infrastructures, currently not covered by on-going projects of the European Framework Program. The top 1 topic is "Efficient management of small community". This paper addresses challenges and opportunities for small and medium utilities with regard to infrastructure AM (IAM). To put this into context, the first sections discuss the need for IAM, highlight key recent developments, and present IAM drivers, as well as research and development gaps, priorities and products needed.

  20. Improve data integration performance by employing metadata management utility

    Energy Technology Data Exchange (ETDEWEB)

    Wei, M.; Sung, A.H. [New Mexico Petroleum Recovery Research Center, Socorro, NM (United States)

    2005-07-01

    This conference paper explored ways of integrating petroleum and exploration data obtained from different sources in order to provide more comprehensive data for various analysis purposes and to improve the integrity and consistency of integrated data. This paper proposes a methodology to enhance oil and gas industry data integration performance by cooperating data management utilities in Microsoft SQL Server database management system (DBMS) for small scale data integration without support of commercial software. By semi-automatically capturing metadata, data sources are investigated in detail, data quality problems are partially cleansed, and the performance of data integration is improved. 20 refs., 7 tabs., 1 fig.

  1. Reconciling privacy and efficient utility management in smart cities

    OpenAIRE

    Rebollo Monedero, David; Bartoli, Andrea; Hernández Serrano, Juan; Forné Muñoz, Jorge; Soriano Ibáñez, Miguel

    2014-01-01

    A key aspect in the design of smart cities is, undoubtedly, a plan for the efficient management of utilities, enabled by technologies such as those entailing smart metering of the residential consumption of electricity, water or gas. While one cannot object to the appealing advantages of smart metering, the privacy risks posed by the submission of frequent, data-rich measurements cannot simply remain overlooked. The objective of this paper is to provide a general perspective on the contrastin...

  2. Utilities pull together to design latest storm management software

    Energy Technology Data Exchange (ETDEWEB)

    Wildman, T.; Ritchie, I.

    2003-04-01

    Development of Outage Mitigation and Recovery software by the Electric Power Research Institute with the support of cooperating electric utilities is discussed. The software is designed to aid utilities in their resource allocation and mutual assistance activities during recovery from major outages cause by natural or man-made disasters. The software is designed to operate in conjunction with major commercial outage systems, to add significant new functionality not available in existing systems. The new software module, called emPower, was actually developed by LeT Systems, a world leader in the design, development and deployment of mission critical e-business-based, real-time outage, network and workforce management solutions for the utility sector. The software is a real-time, stand-alone, web-based program built around advanced intelligence and robust algorithms, designed to interface easily and cleanly with embedded outage mitigation and recovery systems. emPower provides extensive procedural and logistical support to successfully integrate crews and equipment, and automatically assigns tasks and schedules them in accordance with defined restoration goals and priorities. emPower also tracks all activities and generates proper reports for internal and external agencies, among them utility management, police, government departments, media, medical facilities, and customers.

  3. Demand-side management pricing options in electric utilities

    International Nuclear Information System (INIS)

    Sardana, P.; Herman, P.

    1990-01-01

    In 1989 Ontario Hydro implemented optional time-of-use (TOU) rates at the wholesale level for all municipal utilities in the province. At the same time, mandatory TOU rates were implemented for large users (customers with loads in excess of 5 MW) served by municipal utilities and Ontario Hydro's direct customers. To fully explore the potential of rate structures as demand-side management (DSM) tools, Ontario Hydro retained a consulting firm to carry out a survey of innovative rate structures in other jurisdications. The survey was intended to identify: the status quo of rate structures in other jurisdictions that were designed specifically to encourage DSM; a profile of the cost basis of the rate structures, for example whether traditional embedded cost of service analyses or contentious methods such as marginal cost pricing were used; whether innovative rates have been successful, and customer reactions and attitudes; and how innovative rates fit into the overall strategy of the utilities. It was found that TOU, interruptible and end-use targeted rates are the rate structures of choice for many utilities. Most are concerned with deferring capacity, reducing peak demand, and shifting load out of peak periods. Most utilities report success with their programs and satisfaction with the present form of the programs. 5 tabs

  4. Utility Potential of Parthenium hysterophorus for Its Strategic Management

    Directory of Open Access Journals (Sweden)

    Anita Saini

    2014-01-01

    Full Text Available Parthenium hysterophorus, one of the world’s most dangerous weeds, is responsible for huge losses to the biodiversity, agriculture, economy, and health of livestock and human beings. High competitive success rate and adaptability of the species enable it to dominate diverse types of habitats. Various weed control strategies are being used globally to reduce its population to manageable levels. But owing to many limitations associated with the conventional methods, management of Parthenium still remains a challenge. Recently large scale utilization has been taken up as a holistic approach for the control of weeds. Parthenium hysterophorus can be managed by exploiting this weed in diverse fields. In agriculture, it can be used either as green manure or after composting. Industrially it can be used for producing various value added products. The weed also exhibits many environmental applications. Chemical constituents of Parthenium show extensive range of pharmacological activities suggesting its role as a chemotherapeutic agent. This review briefly discusses the problem of Parthenium and enlists its possible utilities which can open new avenues for effective management of this violent weed.

  5. Contemporary management of carotid blowout syndrome utilizing endovascular techniques.

    Science.gov (United States)

    Manzoor, Nauman F; Rezaee, Rod P; Ray, Abhishek; Wick, Cameron C; Blackham, Kristine; Stepnick, David; Lavertu, Pierre; Zender, Chad A

    2017-02-01

    To illustrate complex interdisciplinary decision making and the utility of modern endovascular techniques in the management of patients with carotid blowout syndrome (CBS). Retrospective chart review. Patients treated with endovascular strategies and/or surgical modalities were included. Control of hemorrhage, neurological, and survival outcomes were studied. Between 2004 and 2014, 33 patients had 38 hemorrhagic events related to head and neck cancer that were managed with endovascular means. Of these, 23 were localized to the external carotid artery (ECA) branches and five localized to the ECA main trunk; nine were related to the common carotid artery (CCA) or internal carotid artery (ICA), and one event was related to the innominate artery. Seven events related to the CCA/ICA or innominate artery were managed with endovascular sacrifice, whereas three cases were managed with a flow-preserving approach (covered stent). Only one patient developed permanent hemiparesis. In two of the three cases where the flow-preserving approach was used, the covered stent eventually became exposed via the overlying soft tissue defect, and definitive management using carotid revascularization or resection was employed to prevent further hemorrhage. In cases of soft tissue necrosis, vascularized tissues were used to cover the great vessels as applicable. The use of modern endovascular approaches for management of acute CBS yields optimal results and should be employed in a coordinated manner by the head and neck surgeon and the neurointerventionalist. 4. Laryngoscope, 2016 127:383-390, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Utility leaders must manage change in the workplace

    International Nuclear Information System (INIS)

    Wolf, R.; Gering, D.

    1997-01-01

    Like most other industries in the United States, the utility industry is undergoing profound changes. Furthermore, the industry is in a far more precarious position than almost all other businesses. Deregulation, a changing labor pool, competition and years of unbridled growth are some of the extraordinary factors impacting the industry. Perhaps the greatest challenge of all rests with the utility industry's top management. To lead their organizations from government anointed monopolies to rightful market leaders demands major intellectual and physical adjustments. Given this most difficult position, executives must learn to embrace change as a constant business opportunity and develop skills to constructively channel and manage change. The challenge to utilities is deceptively clear - to be competitive in a consumer and service driven environment. Unfortunately, the actions necessary to accomplish this daunting task are not that clear. The authors offer that this transition does not have to be as ominous as it may seem, provided one develops and employs a good plan and the open minds necessary to navigate these tricky waters

  7. Managing the GPS/GIS function in an electric utility

    International Nuclear Information System (INIS)

    Michelsen, M.W. Jr.

    1999-01-01

    A new period of higher significance has arrived for the GPS/GIS function at electric utilities such that to a degree never seen before, utility managers are looking to their GIS programs, filled with increasingly accurate data collected by GPS technology, before making many decisions. With this capability comes an expectation for GPS/GIS professionals to provide higher levels of planning and management of their data collection process. At Duke Power in Charlotte, North Carolina, managers rely on GPS mapping to fill their data collection equipment needs. When the city of Charlotte requested a more detailed billing system, Duke Power co-sponsored the street lighting inventory project, a comprehensive program implemented to fully account for street lighting facilities within the billing area. One of the key projects to be kept in mind was the creation of a common data base viewable by GIS from which a bill could be created and as well reveal data. A billing calculation routine can be run against the data base to generate a bill or use MapInfo to see a graphical picture. Prior to the creation of this data base capability, the difference between the data base as a display tool and billing system was a potential source of discrepancy, which is eliminated now. Creating the data base allows more than just creating a bill for the city, it allows Duke Power to work better with the city by improving its billing accountability and provides better service as well

  8. Generic steam generator life cycle management from a utility perspective

    International Nuclear Information System (INIS)

    Baker, R.L.

    1993-01-01

    Steam generator repairs and replacements, which have occurred over the last 10 years, have lead many utilities to evaluate the economics of continued maintenance on existing steam generators against the economics of steam generator replacement. Such an endeavor requires an assessment of the expected rate and types of degradation. In addition, an identification of possible preventative or remedial measures and their potential effectiveness must be made. To arrive at an assessment of the economic impact of various combinations of potential courses of action many utilities have employed in-house developed or customized commercial programs to convert technical assessments into economic impact evaluations. This paper intends to give the reader an introduction to the technical issues and insight into a method of addressing the economic impact of possible management strategies. 52 refs., 17 figs., 2 tabs

  9. Utilization of lean management principles in the ambulatory clinic setting.

    Science.gov (United States)

    Casey, Jessica T; Brinton, Thomas S; Gonzalez, Chris M

    2009-03-01

    The principles of 'lean management' have permeated many sectors of today's business world, secondary to the success of the Toyota Production System. This management method enables workers to eliminate mistakes, reduce delays, lower costs, and improve the overall quality of the product or service they deliver. These lean management principles can be applied to health care. Their implementation within the ambulatory care setting is predicated on the continuous identification and elimination of waste within the process. The key concepts of flow time, inventory and throughput are utilized to improve the flow of patients through the clinic, and to identify points that slow this process -- so-called bottlenecks. Nonessential activities are shifted away from bottlenecks (i.e. the physician), and extra work capacity is generated from existing resources, rather than being added. The additional work capacity facilitates a more efficient response to variability, which in turn results in cost savings, more time for the physician to interact with patients, and faster completion of patient visits. Finally, application of the lean management principle of 'just-in-time' management can eliminate excess clinic inventory, better synchronize office supply with patient demand, and reduce costs.

  10. Effects of utility demand-side management programs on uncertainty

    International Nuclear Information System (INIS)

    Hirst, E.

    1994-01-01

    Electric utilities face a variety of uncertainties that complicate their long-term resource planning. These uncertainties include future economic and load growths, fuel prices, environmental and economic regulations, performance of existing power plants, cost and availability of purchased power, and the costs and performance of new demand and supply resources. As utilities increasingly turn to demand-side management (DSM) programs to provide resources, it becomes more important to analyze the interactions between these programs and the uncertainties facing utilities. This paper uses a dynamic planning model to quantify the uncertainty effects of supply-only vs DSM + supply resource portfolios. The analysis considers four sets of uncertainties: economic growth, fuel prices, the costs to build new power plants, and the costs to operate DSM programs. The two types of portfolios are tested against these four sets of uncertainties for the period 1990 to 2010. Sensitivity, scenario, and worst-case analysis methods are used. The sensitivity analyses show that the DSM + supply resource portfolio is less sensitive to unanticipated changes in economic growth, fuel prices, and power-plant construction costs than is the supply-only portfolio. The supply-only resource mix is better only with respect to uncertainties about the costs of DSM programs. The base-case analysis shows that including DSM programs in the utility's resource portfolio reduces the net present value of revenue requirements (NPV-RR) by 490 million dollars. The scenario-analysis results show an additional 30 million dollars (6%) in benefits associated with reduction in these uncertainties. In the worst-case analysis, the DSM + supply portfolio again reduces the cost penalty associated with guessing wrong for both cases, when the utility plans for high needs and learns it has low needs and vice versa. 20 refs

  11. Rock gabion, rock armoring, and culvert treatments contributing to and reducing erosion during post-wildfire flooding - Schultz Fire 2010

    Science.gov (United States)

    Daniel G. Neary; Karen A. Koestner; Ann Youberg

    2011-01-01

    The Schultz Fire burned 6,100 ha on the eastern slopes of the San Francisco Peaks of the Coconino National Forest in north-central Arizona. The fire burned between June 20th and 30th, 2010, across moderate to very steep ponderosa pine and mixed conifer watersheds. One of the Burned Area Emergency Response treatments on Coconino National Forest lands consisted of the...

  12. Federated and Cloud Enabled Resources for Data Management and Utilization

    Science.gov (United States)

    Rankin, R.; Gordon, M.; Potter, R. G.; Satchwill, B.

    2011-12-01

    The emergence of cloud computing over the past three years has led to a paradigm shift in how data can be managed, processed and made accessible. Building on the federated data management system offered through the Canadian Space Science Data Portal (www.cssdp.ca), we demonstrate how heterogeneous and geographically distributed data sets and modeling tools have been integrated to form a virtual data center and computational modeling platform that has services for data processing and visualization embedded within it. We also discuss positive and negative experiences in utilizing Eucalyptus and OpenStack cloud applications, and job scheduling facilitated by Condor and Star Cluster. We summarize our findings by demonstrating use of these technologies in the Cloud Enabled Space Weather Data Assimilation and Modeling Platform CESWP (www.ceswp.ca), which is funded through Canarie's (canarie.ca) Network Enabled Platforms program in Canada.

  13. Anomaly manifestation of Lieb-Schultz-Mattis theorem and topological phases

    Science.gov (United States)

    Cho, Gil Young; Hsieh, Chang-Tse; Ryu, Shinsei

    2017-11-01

    The Lieb-Schultz-Mattis (LSM) theorem dictates that emergent low-energy states from a lattice model cannot be a trivial symmetric insulator if the filling per unit cell is not integral and if the lattice translation symmetry and particle number conservation are strictly imposed. In this paper, we compare the one-dimensional gapless states enforced by the LSM theorem and the boundaries of one-higher dimensional strong symmetry-protected topological (SPT) phases from the perspective of quantum anomalies. We first note that they can both be described by the same low-energy effective field theory with the same effective symmetry realizations on low-energy modes, wherein non-on-site lattice translation symmetry is encoded as if it were an internal symmetry. In spite of the identical form of the low-energy effective field theories, we show that the quantum anomalies of the theories play different roles in the two systems. In particular, we find that the chiral anomaly is equivalent to the LSM theorem, whereas there is another anomaly that is not related to the LSM theorem but is intrinsic to the SPT states. As an application, we extend the conventional LSM theorem to multiple-charge multiple-species problems and construct several exotic symmetric insulators. We also find that the (3+1)d chiral anomaly provides only the perturbative stability of the gaplessness local in the parameter space.

  14. Pro-ACT II: integrating utilization management, discharge planning, and nursing case management into the outcomes manager role.

    Science.gov (United States)

    Brett, J L; Bueno, M; Royal, N; Kendall-Sengin, K

    1997-02-01

    Building on redesign efforts that created case management, clinical care technicians, support service hosts, and pharmacy technician roles, this redesign focused on integrating case management, utilization management, and discharge planning functions into a new outcomes manager role. The authors describe the process of developing and implementing the new role and outline specific actions that eliminated redundancy and inefficiency. Results of the evaluation of the project are reviewed, including full-time equivalent and salary savings and employee and physician satisfaction improvements.

  15. Availability and utilization of opioids for pain management: global issues.

    Science.gov (United States)

    Manjiani, Deepak; Paul, D Baby; Kunnumpurath, Sreekumar; Kaye, Alan David; Vadivelu, Nalini

    2014-01-01

    Pain can significantly influence an individual's health status and can have serious negative consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and impairment of daily living activities. Pain can cause psychological impairment and decrease healing and recovery from injuries and illness. A hallmark of many chronic conditions, pain affects more patients' lives than diabetes mellitus, heart disease, and cancer combined. However, many chronic sufferers do not have access to effective pain management for a variety of reasons, including limited access, restrictions, and personal and cultural biases. This review summarizes issues of access, distribution, and cultural bias with regard to opioid agents and seeks to clarify the challenges related to opioid delivery. The considerable negative physical and mental consequences of chronic pain are discussed for the general and palliative care population. Opioids are an effective treatment for various intractable painful conditions, but problems in global opioid access for safe and rational use in pain management contribute to unnecessary suffering. These problems persist despite increased understanding in recent years of the pathophysiology of pain. Comprehensive guidelines for goal-directed and patient-friendly chronic opiate therapy will potentially enhance the outlook for future chronic pain management. The improvement of pain education in undergraduate and postgraduate training will benefit patients and clinicians. The promise of new medications, along with the utilization of multimodal approaches, has the potential to provide effective pain relief to future generations of sufferers.

  16. Utility analysis and calibration of QOL assessment in disease management.

    Science.gov (United States)

    Liu, Mo

    2018-05-02

    In clinical trials, the assessment of health-related quality of life (QOL) (or patient-reported outcome [PRO] measure) has become very popular especially for clinical studies conducted for evaluating clinical benefits of patients with chronic, severe, and/or life threatening diseases. Health-related QOL information and PRO measures are useful for disease management for achieving best clinical practice. In this article, we will focus on health-related QOL assessment. The concept, design, and analysis of health-related QOL in clinical trials are reviewed. Validation of the use of health-related QOL instrument in terms of some key performance characteristics such as accuracy, reliability, sensitivity, and responsibility for assuring quality, integrity, and validity of collected QOL data are discussed. The concept of utility analysis and calibration (e.g., with respect to life events) for achieving the optimization of disease management are proposed. The change of the QOL could be translated into different life events for effective disease management. These translations could evaluate the treatment effect by more directly displaying the change of the QOL.

  17. The utility of neuroimaging in the management of dementia

    Directory of Open Access Journals (Sweden)

    Uduak E Williams

    2015-01-01

    Full Text Available Dementia is a syndrome of progressive dysfunction of two or more cognitive domains associated with impairment of activities of daily living. An understanding of the pathophysiology of dementia and its early diagnosis is important in the pursuit of possible disease modifying therapy for dementia. Neuroimaging has greatly transformed this field of research as its function has changed from a mere tool for diagnosing treatable causes of dementia to an instrument for pre-symptomatic diagnosis of dementia. This review focuses on the diagnostic utility of neuroimaging in the management of progressive dementias. Structural imaging techniques like computerized tomography scan and magnetic resonance imaging highlights the anatomical, structural and volumetric details of the brain; while functional imaging techniques such as positron emission tomography, arterial spin labeling, single photon emission computerized tomography and blood oxygen level-dependent functional magnetic resonance imaging focuses on chemistry, circulatory status and physiology of the different brain structures and regions.

  18. Plant life management optimized utilization of existing nuclear power plants

    International Nuclear Information System (INIS)

    Watzinger, H.; Erve, M.

    1999-01-01

    For safe, reliable and economical nuclear power generation it is of central importance to understand, analyze and manage aging-related phenomena and to apply this information in the systematic utilization and as-necessary extension of the service life of components and systems. An operator's overall approach to aging and plant life management which also improves performance characteristics can help to optimize plant operating economy. In view of the deregulation of the power generation industry with its increased competition, nuclear power plants must today also increasingly provide for or maintain a high level of plant availability and low power generating costs. This is a difficult challenge even for the newest, most modern plants, and as plants age they can only remain competitive if a plant operator adopts a strategic approach which takes into account the various aging-related effects on a plant-wide basis. The significance of aging and plant life management for nuclear power plants becomes apparent when looking at their age: By the year 2000 roughly fifty of the world's 434 commercial nuclear power plants will have been in operation for thirty years or more. According to the International Atomic Energy Agency, as many as 110 plants will have reached the thirty-year service mark by the year 2005. In many countries human society does not push the construction of new nuclear power plants and presumably will not change mind within the next ten years. New construction licenses cannot be expected so that for economical and ecological reasons existing plants have to be operated unchallengeably. On the other hand the deregulation of the power production market is asking just now for analysis of plant life time to operate the plants at a high technical and economical level until new nuclear power plants can be licensed and constructed. (author)

  19. Strategic Risk Management Behavior: What Can Utility Functions Tell Us

    NARCIS (Netherlands)

    Pennings, J.M.E.; Garcia, P.

    2004-01-01

    Abstract The validity of the utility concept, particularly in an expected utility framework, has been questioned because of its inability to predict revealed behavior. In this paper we focus on the global shape of the utility function instead of the local shape of the utility function. We examine

  20. Federal Energy Efficiency through Utility Partnerships: Federal Energy Management Program (FEMP) Program Overview Fact Sheet

    International Nuclear Information System (INIS)

    Beattie, D.; Wolfson, M.

    2001-01-01

    This Utility Program Overview describes how the Federal Energy Management Program (FEMP) utility program assists Federal energy managers. The document identifies both a utility financing mechanism and FEMP technical assistance available to support agencies' implementation of energy and water efficiency methods and renewable energy projects

  1. Demand-side management: The perspective of a combination utility

    International Nuclear Information System (INIS)

    Packard, C.P.

    1993-01-01

    During the 1980's, Baltimore Gas ampersand Electric (BG ampersand E) met part of the rapid growth in demand for electricity in its service territory by implementing cost-effective demand-side management (DSM) programs--specifically, peak shaving and load shifting strategies. BG ampersand E's focus in the 1990's has been expanded to include all DSM options with an increasing emphasis on those which promote overall 1 energy efficiency or strategic conservation. This change in focus is being driven by Federal legislation, state regulatory requirements and the perceived potential benefits for both the customer and the Company. Current activities related to DSM include involvement in a Collaborative Process to design cost-effective electric and gas conservation programs for all customer classes--low-income, residential, commercial and industrial. Program design consists of four steps: (1) data gathering and technology assessment; (2) development of program concepts; (3) detailed program design and (4) monitoring and evaluation. Significant reductions in the projected peaks as well as in sales in future years are the anticipated results of our efforts. As a combination utility, unique opportunities and challenges face BG ampersand E: fuel switching, eligibility of non-full requirements customers, and energy options for customers

  2. Managing the environmental impacts of utility lighting retrofits programs

    International Nuclear Information System (INIS)

    Cress, K.

    1993-01-01

    One of the most popular demand-side management (DSM) programs currently being sponsored by electric utilities is the removal of old fluorescent light ballasts and replacing them with more efficient models. This type of program, however, can produce a substantial waste stream of the old ballasts, many of which contain Polychlorinated Biphenyl(s) (PCBs), a regulated hazardous substance. The proper disposal of spent light ballasts should be an integral component of DSM programs. This paper will discuss the experience that New England Electric System (NEES) 1 has had with disposing of spent light ballasts resulting from the implementation of our Small Commercial ampersand Industrial Program (a direct install lighting program which provides for the installation of energy efficient lighting measures which include fluorescent fixtures, ballasts and lamps, specular reflectors, compact fluorescent systems, high intensity discharge fixtures, and occupancy sensors. This innovative program is one of the largest in the country and has achieved over 6,000 installations). In this paper, we will review why PCBs are classified as hazardous substances and what effect State and Federal regulations have on the transportation and disposal of ballasts that contain PCBs. Second, we will explain our ballast disposal process which includes collecting, processing, storing, shipping and ultimate disposal. Third, we will discuss our experiences with two different methods of disposal - incineration and recycling. And last we will report on program results

  3. Tank Operations Contract Construction Management Methodology. Utilizing The Agency Method Of Construction Management

    International Nuclear Information System (INIS)

    Lesko, K.F.; Berriochoa, M.V.

    2010-01-01

    Washington River Protection Solutions, LLC (WRPS) has faced significant project management challenges in managing Davis-Bacon construction work that meets contractually required small business goals. The unique challenge is to provide contracting opportunities to multiple small business constructioin subcontractors while performing high hazard work in a safe and productive manner. Previous to the WRPS contract, construction work at the Hanford Tank Farms was contracted to large companies, while current Department of Energy (DOE) Contracts typically emphasize small business awards. As an integral part of Nuclear Project Management at Hanford Tank Farms, construction involves removal of old equipment and structures and installation of new infrastructure to support waste retrieval and waste feed delivery to the Waste Treatment Plant. Utilizing the optimum construction approach ensures that the contractors responsible for this work are successful in meeting safety, quality, cost and schedule objectives while working in a very hazardous environment. This paper descirbes the successful transition from a traditional project delivery method that utilized a large business general contractor and subcontractors to a new project construction management model that is more oriented to small businesses. Construction has selected the Agency Construction Management Method (John E Schaufelberger, Len Holm, 'Management of Construction Projects, A Constructor's Perspective', University of Washington, Prentice Hall 2002). This method was implemented in the first quarter of Fiscal Year 2009 (FY2009), where Construction Management is performed by substantially home office resources from the URS Northwest Office in Richland, Washington. The Agency Method has allowed WRPS to provide proven Construction Managers and Field Leads to mentor and direct small business contractors, thus providing expertise and assurance of a successful project. Construction execution contracts are subcontracted

  4. TANK OPERATIONS CONTRACT CONSTRUCTION MANAGEMENT METHODOLOGY UTILIZING THE AGENCY METHOD OF CONSTRUCTION MANAGEMENT

    Energy Technology Data Exchange (ETDEWEB)

    LESKO KF; BERRIOCHOA MV

    2010-02-26

    Washington River Protection Solutions, LLC (WRPS) has faced significant project management challenges in managing Davis-Bacon construction work that meets contractually required small business goals. The unique challenge is to provide contracting opportunities to multiple small business constructioin subcontractors while performing high hazard work in a safe and productive manner. Previous to the WRPS contract, construction work at the Hanford Tank Farms was contracted to large companies, while current Department of Energy (DOE) Contracts typically emphasize small business awards. As an integral part of Nuclear Project Management at Hanford Tank Farms, construction involves removal of old equipment and structures and installation of new infrastructure to support waste retrieval and waste feed delivery to the Waste Treatment Plant. Utilizing the optimum construction approach ensures that the contractors responsible for this work are successful in meeting safety, quality, cost and schedule objectives while working in a very hazardous environment. This paper descirbes the successful transition from a traditional project delivery method that utilized a large business general contractor and subcontractors to a new project construction management model that is more oriented to small businesses. Construction has selected the Agency Construction Management Method (John E Schaufelberger, Len Holm, "Management of Construction Projects, A Constructor's Perspective", University of Washington, Prentice Hall 2002). This method was implemented in the first quarter of Fiscal Year 2009 (FY2009), where Construction Management is performed by substantially home office resources from the URS Northwest Office in Richland, Washington. The Agency Method has allowed WRPS to provide proven Construction Managers and Field Leads to mentor and direct small business contractors, thus providing expertise and assurance of a successful project. Construction execution contracts are

  5. Palm utilization and management in Asia: examples for the neotropics

    Directory of Open Access Journals (Sweden)

    1992-01-01

    productos comestibles de 61 especies de palmas asiáticas. A partir de estos ejemplos, se hacen sugerencias para el manejo y la valorización de las palmas neotropicales, a fin de incrementar el suministro de alimentos y de otros productos útiles. Asia is endowed with the world’s greatest palm biodiversity, and also possesses the highest diversity of palm utilization. Palms have a long history of management for both subsistence and commercial products, many of which are deeply embedded in local cultures. In Asia, traditional technologies of exploiting wild and semi-wild palm populations, as well as processing techniques associated with many of the palm products, are generally more advanced than in the Neotropics. Native Asian palms currently provide significant quantities of food, beverage, fiber, rattan, construction material and other products. This article surveys edible products from 61 Asian palm species. Using these examples from Asia, suggestions are made as to how Neotropical palms could be managed and valorized for food and other useful products.

  6. Urban management: Addressing the housing and utility challenge

    Directory of Open Access Journals (Sweden)

    Nikitina Oksana

    2016-01-01

    Full Text Available The authors have studied the three aspects of urban management: apartment buildings, major repair management, requirements for facility management companies to be licensed and waste management. The paper presents all the mentioned above aspects and possible negative circumstances and proposes solutions to the problems.

  7. A perspective on laboratory utilization management from Canada.

    Science.gov (United States)

    Naugler, Christopher

    2014-01-01

    Utilization, particularly in chemistry and molecular testing, is growing rapidly in Canada at a time when laboratory budgets are shrinking. Canadian laboratories face particular challenges as the prevailing funding model limits the scope for new revenue generation. Aggressive and coordinated interventions to reduce over-utilization will be necessary to ensure the long-term viability of the current system. © 2013.

  8. 1980 survey and evaluation of utility conservation, load management, and solar end-use projects. Volume 3: utility load management projects. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    The results of the 1980 survey of electric utility-sponsored energy conservation, load management, and end-use solar energy conversion projects are described. The work is an expansion of a previous survey and evaluation and has been jointly sponsored by EPRI and DOE through the Oak Ridge National Laboratory. There are three volumes and a summary document. Each volume presents the results of an extensive survey to determine electric utility involvement in customer-side projects related to the particular technology (i.e., conservation, solar, or load management), selected descriptions of utility projects and results, and first-level technical and economic evaluations.

  9. Hans-Peter Schultze, a great paleoichthyologist for whom work is synonymous with enjoyment

    Directory of Open Access Journals (Sweden)

    R. Cloutier

    2002-01-01

    Full Text Available In the summer of 1982, Hans-Peter Schultze and Gloria Arratia were invited to a small museum located on a fossiliferous site of the Devonian Escuminac Formation in Miguasha, Quebec, eastern Canada, Hans-Peter was to work with Marius Arsenault, the director of the Miguasha Museum, on the skull of the elpistostegalid Elpistostege watsoni, a species closely related to basal tetrapod. In addition, he went through the collections to describe and measure numerous juvenile specimens of the osteolepiform. Eusthenopteran foordi. As expected, there two projects turned out to be important contributions in lower vertebrate paleontology and systematics: one on the origin of tetrapods (1985, and the second one on growth patterns of a Late Devonian fish (1984. During his visit to Miguasha, Hans-Peter also spent time digging for fossils and drawing numerous specimens in the collection. In addition, in order to help the personnel of the museum to identify some of the Escuminac fished, he created an identification key based on the gross morphology of the scales. For a small group of undergraduate students, hired at the museum during the summer as naturalists, it was a unique opportunity to discuss paleontology with a leading researcher. We were amazed by his willingness to talk to us, even if then most of us only spoke French! For the first time, we were exposed to Hennigian methodology and its usage in vertebrate paleontology during and evening lecture that Hans-Peter prepared for us. His lecture was delightful; it was an intensive course in lower vertebrate anatomy, and an intellectual journey among the philosophers Karl Marx and Karl Popper, the entomologists Willy Hennig and Lars Brundin, and "The Band of Four" (Rosen et al., 1981. It was for most of us our first exposure to science, as it should be done. We were all impressed by his knowledge and above all by his simplicity and friendliness. Two years later I started my Ph.D. at The University of Kansas

  10. The Implications of Healthcare Utilization of Diabetes Disease Management

    National Research Council Canada - National Science Library

    Webb, Jonathan R

    2008-01-01

    ..., and $31 billion in excess general medical costs. The purpose of this study is to determine whether sustained hemoglobin HbA1c testing among patients is followed by reductions in healthcare utilization...

  11. Resource Guide to Effective Utility Management and Lean

    Science.gov (United States)

    Water and wastewater utilities are critical to the environmental, economic, and social well being of our nation’s communities, as they work to ensure that the public continues to enjoy the benefits of clean and safe water.

  12. Accelerating experience : utility sector case studies in training and knowledge management

    Energy Technology Data Exchange (ETDEWEB)

    Trudel-Ferrari, C.C. [Kinectrics Inc., Toronto, ON (Canada)

    2010-07-01

    This paper discussed the development of effective training and knowledge management systems for recently hired personnel in electric utilities. Case studies of best practices from electric utilities in Ontario, consultants, and universities were used to develop an overview of current training practices. Methods of identifying, attracting, and recruiting personnel were presented and knowledge management and mentoring programs were discussed. The use of training programs in developing knowledge databases was also evaluated. Knowledge management formats included qualification training; simulation training; knowledge transfer; and curriculum development. Human resources, revenue, and management issues currently challenging electric utilities were discussed along with various new training practices. 2 refs., 3 tabs., 2 figs.

  13. Outcomes management of mechanically ventilated patients: utilizing informatics technology.

    Science.gov (United States)

    Smith, K R

    1998-11-01

    This article examines an informatics system developed for outcomes management of the mechanically ventilated adult population, focusing on weaning the patient from mechanical ventilation. The link between medical informatics and outcomes management is discussed, along with the development of methods, tools, and data sets for outcomes management of the mechanically ventilated adult population at an acute care academic institution. Pros and cons of this system are identified, and specific areas for improvement of future health care outcomes medical informatics systems are discussed.

  14. Carbon emissions and management scenarios for consumer-owned utilities

    International Nuclear Information System (INIS)

    Fischlein, Miriam; Smith, Timothy M.; Wilson, Elizabeth J.

    2009-01-01

    An important subset of the utility sector has been scarcely explored for its ability to reduce carbon dioxide emissions: consumer-owned electric utilities significantly contribute to U.S. greenhouse gas emissions, but are often excluded from energy efficiency and renewable energy policies. They sell a quarter of the nation's electricity, yet the carbon impact of these sales is not well understood, due to their small size, unique ownership models, and high percentage of purchased power for distribution. This paper situates consumer-owned utilities in the context of emerging U.S. climate policy, quantifying for the first time the state-by-state carbon impact of electricity sales by consumer-owned utilities. We estimate that total retail sales by consumer-owned utilities account for roughly 568 million metric tons of CO 2 annually, making this sector the 7th largest CO 2 emitter globally, and examine state-level carbon intensities of the sector in light of the current policy environment and the share of COU distribution in the states. Based on efficiency and fuel mix pathways under conceivable regulations, carbon scenarios for 2030 are developed.

  15. UTILITY OF ANNUAL FINANCIAL STATEMENTS IN THE MANAGEMENT PROCESS

    Directory of Open Access Journals (Sweden)

    PUICAN LILIANA

    2015-07-01

    Full Text Available Process knowledge of the financial situation of the economic entity presupposes the use of analysis and synthesis, as indispensable tools of investigation. Financial management of the economic entity have to belong to the basic role in strategic financial decisions that would solve the problem of effective management of the process optimal growth, balanced and proportionate entity. That is why it becomes necessary and imperative objective analysis of the implications of the current financial management in economic entities familiarize managers with the basic tools with which they operate, acquiring knowledge about planning and financial control, evaluation techniques of investment projects, about how to conduct financial and economic diagnosis and management control of the entity, the key issues in its orientation towards performance.

  16. Assessing the utilization of personnel in the management of ...

    African Journals Online (AJOL)

    The study assesses the utilization of technical teachers in Akwa Ibom State technical colleges. The study design was ex-post facto. Three research questions were formulated to guide the study. The population of the study consisted of all the technical colleges in Akwa Ibom State. Inventory method titled: ”Teaching ...

  17. assessing the utilization of personnel in the management of ...

    African Journals Online (AJOL)

    LUCY

    Technical Education (NBTE). The study revealed that teaching personnel in technical colleges in Akwa. Ibom State possess the required qualifications and experience as stipulated by National Board for. Technical Education (NBTE).The teacher/ student ratios in the colleges are high and the teachers are fully utilized.

  18. Utilization of Near Field Communication Technology for Loyalty Management

    Directory of Open Access Journals (Sweden)

    Ferina Ferdianti

    2013-09-01

    Full Text Available Near Field Communication (NFC is one of wireless technology developed at this time. We can use a mobile phone to do many transactions with NFC. Mobile developments have created to provide convenience for users in all aspects. However, at this time the function of NFC just limited for payment and micropayment. Beside it, there are assets that support to increase sales with attention of loyality management system. In this system, discounts or prizes are given based on data mining for every transaction costumers. Loyalty management has three concept, those are Frequency, Recency and Quantity. The goals are minimizing the cost, making purchase process faster, and managing data obtained through the NFC technology more simple. The result of this paper is the procedure to use data mining of NFC for loyalty management and system design using Unified Modeling Language approach.

  19. Utilizing Contingent Claims to Improve the Management of CAFOs

    OpenAIRE

    Gramig, Benjamin M.; Skees, Jerry R.; Black, J. Roy

    2004-01-01

    We propose a market-based approach to reducing the environmental risk posed by concentrated animal feeding operations (CAFOs). The dual problems of hidden information and hidden action faced by policymakers are considered alongside the competing incentives faced by the CAFO manager in a multiple principal-agent setting. A new approach that uses insurance-like contracts is introduced by use of the specific example of a swine operation with a lagoon-based manure management system. Index-based c...

  20. Managing an evolution: Deregulation of the electric utility industry

    Energy Technology Data Exchange (ETDEWEB)

    Skinner, S.K.

    1994-12-31

    The author discusses the emerging competitive situation in the electric power industry as deregulation of electric utilities looms on the horizon. The paper supports this change, and the competition it will bring, but urges caution as changes are instituted, and the regulatory bodies decide how and how much to free, and at what rates. The reason for his urge for caution comes from historical experience of other industries, which were smaller and had less direct impact on every American.

  1. SIMULTANEOUS VISUALIZATION OF DIFFERENT UTILITY NETWORKS FOR DISASTER MANAGEMENT

    Directory of Open Access Journals (Sweden)

    S. Semm

    2012-07-01

    Full Text Available Cartographic visualizations of crises are used to create a Common Operational Picture (COP and enforce Situational Awareness by presenting and representing relevant information. As nearly all crises affect geospatial entities, geo-data representations have to support location-specific decision-making throughout the crises. Since, Operator's attention span and their working memory are limiting factors for the process of getting and interpreting information; the cartographic presentation has to support individuals in coordinating their activities and with handling highly dynamic situations. The Situational Awareness of operators in conjunction with a COP are key aspects of the decision making process and essential for coming to appropriate decisions. Utility networks are one of the most complex and most needed systems within a city. The visualization of utility infrastructure in crisis situations is addressed in this paper. The paper will provide a conceptual approach on how to simplify, aggregate, and visualize multiple utility networks and their components to meet the requirements of the decision-making process and to support Situational Awareness.

  2. Simultaneous Visualization of Different Utility Networks for Disaster Management

    Science.gov (United States)

    Semm, S.; Becker, T.; Kolbe, T. H.

    2012-07-01

    Cartographic visualizations of crises are used to create a Common Operational Picture (COP) and enforce Situational Awareness by presenting and representing relevant information. As nearly all crises affect geospatial entities, geo-data representations have to support location-specific decision-making throughout the crises. Since, Operator's attention span and their working memory are limiting factors for the process of getting and interpreting information; the cartographic presentation has to support individuals in coordinating their activities and with handling highly dynamic situations. The Situational Awareness of operators in conjunction with a COP are key aspects of the decision making process and essential for coming to appropriate decisions. Utility networks are one of the most complex and most needed systems within a city. The visualization of utility infrastructure in crisis situations is addressed in this paper. The paper will provide a conceptual approach on how to simplify, aggregate, and visualize multiple utility networks and their components to meet the requirements of the decision-making process and to support Situational Awareness.

  3. Utilizing a disease management approach to improve ESRD patient outcomes.

    Science.gov (United States)

    Anand, Shaan; Nissenson, Allen R

    2002-01-01

    In this era of processes and systems to improve quality, disease management is one methodology to improve care delivery and outcomes for patients with chronic kidney disease (CKD). In most disease management systems a senior renal nurse coordinates all aspects of the patient's care and ensures that the prescribed and necessary care is delivered for both CKD-related and comorbid conditions. The nurse also continually monitors outcomes on quality indicators and key performance measures. These outcome data are then aggregated and analyzed, are compared with local and national benchmarks, and drive the continuous quality improvement (CQI) process. Such a system attempts to centralize the currently fragmented care delivery system, continually improve patient outcomes, and conserve scarce economic resources. Early data suggest a disease management approach may improve both the morbidity and mortality of CKD patients.

  4. Mobile healthcare information management utilizing Cloud Computing and Android OS.

    Science.gov (United States)

    Doukas, Charalampos; Pliakas, Thomas; Maglogiannis, Ilias

    2010-01-01

    Cloud Computing provides functionality for managing information data in a distributed, ubiquitous and pervasive manner supporting several platforms, systems and applications. This work presents the implementation of a mobile system that enables electronic healthcare data storage, update and retrieval using Cloud Computing. The mobile application is developed using Google's Android operating system and provides management of patient health records and medical images (supporting DICOM format and JPEG2000 coding). The developed system has been evaluated using the Amazon's S3 cloud service. This article summarizes the implementation details and presents initial results of the system in practice.

  5. Communications technologies for demand side management, DSM, and European utility communications architecture, EurUCA

    Energy Technology Data Exchange (ETDEWEB)

    Uuspaeae, P. [VTT Energy, Espoo (Finland)

    1996-12-31

    The scope of this research is data communications for electric utilities. Demand Side Management (DSM) calls for communication between the Electric Utility and the Customer. The communication capacity needed will depend on the functions that are chosen for DSM, and on the number of customers. Some functions may be handled with one-way communications, some functions require two-way communication. Utility Communication Architecture looks for an overall view of the communications needs and communication systems in an electric utility. The objective is to define and specify suitable and compatible communications procedures within the Utility and also to outside parties. (27 refs.)

  6. Communications technologies for demand side management, DSM, and European utility communications architecture, EurUCA

    Energy Technology Data Exchange (ETDEWEB)

    Uuspaeae, P [VTT Energy, Espoo (Finland)

    1997-12-31

    The scope of this research is data communications for electric utilities. Demand Side Management (DSM) calls for communication between the Electric Utility and the Customer. The communication capacity needed will depend on the functions that are chosen for DSM, and on the number of customers. Some functions may be handled with one-way communications, some functions require two-way communication. Utility Communication Architecture looks for an overall view of the communications needs and communication systems in an electric utility. The objective is to define and specify suitable and compatible communications procedures within the Utility and also to outside parties. (27 refs.)

  7. Utilizing a Simulation Exercise to Illustrate Critical Inventory Management Concepts

    Science.gov (United States)

    Umble, Elisabeth; Umble, Michael

    2013-01-01

    Most undergraduate business students simply do not appreciate the elegant mathematical beauty of inventory models. So how does an instructor capture students' interest and keep them engaged in the learning process when teaching inventory management concepts? This paper describes a competitive and energizing in-class simulation game that introduces…

  8. Evolution of an outage management organization in a small utility

    International Nuclear Information System (INIS)

    Oubre, R.P.; Shetler, J.

    1985-01-01

    Six refueling outages with a number of major equipment failure outages have taught Rancho Seco management three main items. One is that a dedicated management organization must be formed for the purpose of controlling work functions at Rancho Seco. This dedicated organization must have the experience of the plant and not have the responsibility for the actual maintenance. Second, upper management within a power plant must get directly involved in the outage. Upper management must show their presence, give input, and be available when needed. The third item learned is that the scheduling organization must be adequately staffed. Although Rancho Seco completed a refueling outage in 1978 within only 36 days, additional inspection requirements due to regulatory changes and/or previous equipment failures requiring follow-up actions would place the shortest possible outage today at approx.70 days. The only way an organization can keep this outage time down is with the proper scheduling of the resources and the timely coordination of activities to reduce conflicts

  9. Sentinel Asia step 2 utilization for disaster management in Malaysia

    International Nuclear Information System (INIS)

    Moslin, S I; Wahap, N A; Han, O W

    2014-01-01

    With the installation of Wideband InterNetworking engineering test and Demonstration Satellite (WINDS) communication system in the National Space Centre, Banting; officially Malaysia is one of the twelve Sentinel Asia Step2 System Regional Servers in the Asia Pacific region. The system will be dedicated to receive and deliver images of disaster struck areas observed by Asia Pacific earth observation satellites by request of the Sentinel Asia members via WINDS satellite or 'Kizuna'. Sentinel Asia is an initiative of collaboration between space agencies and disaster management agencies, applying remote sensing and web-GIS technologies to assist disaster management in Asia Pacific. When a disaster occurred, participating members will make an Emergency Observation Request (EOR) to the Asian Disaster Reduction Centre (ADRC). Subsequently, the Data Provider Node (DPN) will execute the emergency observation using the participating earth observation satellites. The requested images then will be processed and analysed and later it will be uploaded on the Sentinel Asia website to be utilised for disaster management and mitigation by the requestor and any other international agencies related to the disaster. Although the occurrences of large scale natural disasters are statistically seldom in Malaysia, but we can never be sure with the unpredictable earth climate nowadays. This paper will demonstrate the advantage of using Sentinel Asia Step2 for local disaster management. Case study will be from the recent local disaster occurrences. In addition, this paper also will recommend a local disaster management support system by using the Sentinel Asia Step2 facilities in ANGKASA

  10. Regulation and competition in public utilities: Electric utility management in Italy and other industrialized countries

    International Nuclear Information System (INIS)

    Fraquelli, G.

    1992-01-01

    In industrialized countries, electric power has become a vital energy resource requiring significant efforts on the part of national institutions to establish and maintain sound management and energy supply strategies. The situation in Italy reflects world trends in that electric power in this country now accounts for over one-third of total energy consumption and this percentage is expected to increase steadily through to the year 2000. This endorsement of electric power is having a strong impact on quality of life and on international relations as Italy, in order to ensure security of energy supplies, is actively pursuing of strategy of energy source and supplier diversification. With reference to recent proposals, in line with European Communities free market strategies, to deregulate the Italian electric power industry, this paper briefly analyzes the current institutional nature of ENEL (the Italian National Electricity Board) and compares the Italian electric power industry and market situation with that of Japan and the USA. The various aspects taken into consideration include investment, rate structure, quality of service, management methods and competition. An analysis is made of the most pressing difficulties currently troubling ENEL and suggestions are made as to the best courses of action to be taken

  11. Approach to improve construction management utilizing information technology

    International Nuclear Information System (INIS)

    Lee, Woo Bang; Moon, Jin Yeong

    2003-01-01

    Korea Hydro and Nuclear Power (KHNP) has been managed Nuclear Power Plant (NPP) construction projects including basic project planning, design, procurement, construction and start-up for nearly 30 years, and taken the leading role in the self-reliance program for constructing NPP. To maintain its leading position of construction technology and export it to other countries, it is more likely required to build the strong and competitive business management system to improve internal business efficiency and transparency, and also to respond to the change of external business circumstances such as electricity market opening. KHNP is implementing Enterprise Resource Planning (ERP) System as a business innovation tool to improve business efficiency, which changes the way of performing work from organizational system to process-oriented system in order to optimize the company resources to achieve above goals. This change should be made based on the results of performing Business Process Re-engineering (BPR) to maximize overall business efficiency. For the construction project management area, the establishment of Integrated Construction Information Sharing System based on Information Technology (IT) is the most important part. It makes possible to build collaboration system with 'Win-Win strategy' between the project owner and all related entities and to contribute to secure transparency and cut the project cost down. We would like to introduce our NPP Construction Project Management System, Infrastructure for Information System, Information Sharing System among construction related entities and Implementation Practices in this paper and also include the suggestions on our customary practice and subject that should be improved

  12. PACS project management utilizing web-based tools

    Science.gov (United States)

    Patel, Sunil; Levin, Brad; Gac, Robert J., Jr.; Harding, Douglas, Jr.; Chacko, Anna K.; Radvany, Martin; Romlein, John R.

    2000-05-01

    As Picture Archiving and Communications Systems (PACS) implementations become more widespread, the management of deploying large, multi-facility PACS will become a more frequent occurrence. The tools and usability of the World Wide Web to disseminate project management information obviates time, distance, participant availability, and data format constraints, allowing for the effective collection and dissemination of PACS planning, implementation information, for a potentially limitless number of concurrent PACS sites. This paper will speak to tools, such as (1) a topic specific discussion board, (2) a 'restricted' Intranet, within a 'project' Intranet. We will also discuss project specific methods currently in use in a leading edge, regional PACS implementation concerning the sharing of project schedules, physical drawings, images of implementations, site-specific data, point of contacts lists, project milestones, and a general project overview. The individual benefits realized for the end user from each tool will also be covered. These details will be presented, balanced with a spotlight on communication as a critical component of any project management undertaking. Using today's technology, the web arguably provides the most cost and resource effective vehicle to facilitate the broad based, interactive sharing of project information.

  13. A Systems Approach to Information Technology (IT) Infrastructure Design for Utility Management Automation Systems

    OpenAIRE

    A. Fereidunian; H. Lesani; C. Lucas; M. Lehtonen; M. M. Nordman

    2006-01-01

    Almost all of electric utility companies are planning to improve their management automation system, in order to meet the changing requirements of new liberalized energy market and to benefit from the innovations in information and communication technology (ICT or IT). Architectural design of the utility management automation (UMA) systems for their IT-enabling requires proper selection of IT choices for UMA system, which leads to multi-criteria decision-makings (MCDM). In resp...

  14. Security Vulnerability and Patch Management in Electric Utilities: A Data-Driven Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Li, Qinghua [Univ. of Arkansas, Fayetteville, AR (United States); Zhang, Fengli [Univ. of Arkansas, Fayetteville, AR (United States)

    2018-01-18

    This paper explores a real security vulnerability and patch management dataset from an electric utility in order to shed light on characteristics of the vulnerabilities that electric utility assets have and how they are remediated in practice. Specifically, it first analyzes the distribution of vulnerabilities over software, assets, and other metric. Then it analyzes how vulnerability features affect remediate actions.

  15. Electric utility load management: rational use of energy program pilot study

    Energy Technology Data Exchange (ETDEWEB)

    1977-08-01

    In recognition of the role that load management can play in ensuring that the growing demand for electricity is met in a cost- and energy-efficient manner, in mid-1974, the NATO Committee on the Challenges of Modern Society sponsored all three meetings to provide a forum for representatives of U.S. and European utilities to exchange views and experiences on the various aspects of load management. It was the consensus of representatives at the meetings that three overall approaches offer significant opportunities for achieving improved load management: development of marginal-cost rate structures; power pooling and energy storage by utilities; and efforts by consumers. Industrial consumers can assist electric utilities in their efforts to level system loads through three important methods: interruptible power and deferred load control; peak self-generation; and shifts in operating schedules. Residential/commercial consumers also have an important role to play by managing both their electric heating load (through the interruption of direct-resistance heating and the storage of heat) and their air conditioning load. In response to the interest expressed by the participants in the CCMS conferences, the U.S. and several European governments, national electric utility industry organizations, state public utility commissions, and many individual utilities have undertaken R and D projects to investigate and test various aspects of these three approaches to load management. This report describes the projects that were presented by the utility representatives.

  16. Utility asset management : where you are, where you are going, knowing when you get there

    International Nuclear Information System (INIS)

    Johanson, R.G.

    2002-01-01

    Water and wastewater systems are one of the largest infrastructure assets a city can own. Cities are faced with a deteriorating infrastructure with a decreasing budget. A plan is needed to effectively manage this deterioration. New regulations and accounting requirements (CMOM - Capacity Management Operations and Management and GASB-34) are pushing utilities into asset management planning to manage their systems. An asset management plan provides a comprehensive assessment of the current condition of the utility and a projection of the cost required to meet standards of service. The capital asset management system provides a means to protect, maintain or improve the asset value of the water or sewer system (or any infrastructure) with planned maintenance and repair. (author)

  17. Utility asset management : where you are, where you are going, knowing when you get there

    Energy Technology Data Exchange (ETDEWEB)

    Johanson, R.G. [GRW Engineers, Inc., Louisville, Kentucky (United States)]. E-mail: rjohanson@grwinc.com

    2002-06-15

    Water and wastewater systems are one of the largest infrastructure assets a city can own. Cities are faced with a deteriorating infrastructure with a decreasing budget. A plan is needed to effectively manage this deterioration. New regulations and accounting requirements (CMOM - Capacity Management Operations and Management and GASB-34) are pushing utilities into asset management planning to manage their systems. An asset management plan provides a comprehensive assessment of the current condition of the utility and a projection of the cost required to meet standards of service. The capital asset management system provides a means to protect, maintain or improve the asset value of the water or sewer system (or any infrastructure) with planned maintenance and repair. (author)

  18. Clinical utility of foam dressings in wound management: a review

    Directory of Open Access Journals (Sweden)

    Nielsen J

    2015-02-01

    Full Text Available Jakob Nielsen, Karsten Fogh Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark Background: The management of chronic wounds is a significant medical burden associated with large health care expenditures. Since the establishment of moist wound healing in the 1960s, several types of wound dressings have been developed. However, the evidence for effectiveness when comparing various types of wound dressings is limited. Objectives: The purpose of this review is 1 to provide a general description of the role of foam in wound therapy and 2 to evaluate the evidence for effectiveness of foam dressings compared to other frequently used products. Summary and conclusion: Foam has a significant role in the clinical management of chronic wounds and in moist wound healing. There are only a few randomized controlled trials, which in general, show no significant difference in the healing effect of different dressing types. The choice of wound dressing should therefore be based on clinical evaluation of the wound and the periwound skin. Keywords: foam dressing, chronic wounds, comparative effectiveness, healing, periwound skin, ulcers 

  19. Water Utility Management Strategies in Turkey: The current situation and the challenges

    Science.gov (United States)

    Alp, E.; Aksoy, M. N.; Koçer, B.

    2013-12-01

    As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement

  20. Biogas plants: Utilization of microorganisms for waste management

    Energy Technology Data Exchange (ETDEWEB)

    Stadlbauer, E A; Trieu, C

    1984-05-01

    The continuous realisation of the basic principles of environmental conservation and compatability demands concern about the problems of eliminating wastes in an industrialised society. Biogas- and therefore technical plants for methane generation by anaerobic fermentation have promoted to effective means of environmental protection and sources of alternate energy from organic wastes. Methane fermentation has been employed for the stabilisation of sludges at municipal waste treatment plants for decades. However, the anaerobic digestion process shows promising applications both for industrial effluents and agricultural wastes as well as municipal solid wastes and covered waste deposits. In view of the advances achieved interdisciplinary cooperation the actual potential and perspective of methane fermentation technology with respect to the solution of the increasing problems of waste management and energy supply is discussed.

  1. Utilization of market research in managing hospital pharmacy resources.

    Science.gov (United States)

    Hernandez, L; McNamara, E J

    1984-10-01

    A market research survey of staff physicians and nurses was completed to obtain information on customer preference to be used in making planning and development decisions about the allocation of the pharmacy department's resources. Survey questionnaires were mailed to representative samples of each professional group and included the optimum mix of open-ended and closed-ended questions that would result in the highest response rate. The survey responses identified differences in wants and needs between the nurses and physicians that demonstrate the value of market research. Data obtained from the survey are being used by a staff advisory committee and management to develop departmental goals and objectives that will reduce costs and increase profit margins under the ever-increasing restrictions of prospective reimbursement.

  2. Optimal Energy Management for a Smart Grid using Resource-Aware Utility Maximization

    Science.gov (United States)

    Abegaz, Brook W.; Mahajan, Satish M.; Negeri, Ebisa O.

    2016-06-01

    Heterogeneous energy prosumers are aggregated to form a smart grid based energy community managed by a central controller which could maximize their collective energy resource utilization. Using the central controller and distributed energy management systems, various mechanisms that harness the power profile of the energy community are developed for optimal, multi-objective energy management. The proposed mechanisms include resource-aware, multi-variable energy utility maximization objectives, namely: (1) maximizing the net green energy utilization, (2) maximizing the prosumers' level of comfortable, high quality power usage, and (3) maximizing the economic dispatch of energy storage units that minimize the net energy cost of the energy community. Moreover, an optimal energy management solution that combines the three objectives has been implemented by developing novel techniques of optimally flexible (un)certainty projection and appliance based pricing decomposition in an IBM ILOG CPLEX studio. A real-world, per-minute data from an energy community consisting of forty prosumers in Amsterdam, Netherlands is used. Results show that each of the proposed mechanisms yields significant increases in the aggregate energy resource utilization and welfare of prosumers as compared to traditional peak-power reduction methods. Furthermore, the multi-objective, resource-aware utility maximization approach leads to an optimal energy equilibrium and provides a sustainable energy management solution as verified by the Lagrangian method. The proposed resource-aware mechanisms could directly benefit emerging energy communities in the world to attain their energy resource utilization targets.

  3. Managed Care for Children: Effect on Access to Care and Utilization of Health Services.

    Science.gov (United States)

    Szilagyi, Peter G.

    1998-01-01

    Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)

  4. Software for security event management: Development and utilization

    Directory of Open Access Journals (Sweden)

    Aleksandr V. Kuznetcov

    2017-11-01

    Full Text Available We address the challenge to the information security coming from the lack of algorithmic machinery for managing the security events. We start with a mathematical formulation of the problem for a tabular processor by introducing an appropriate target function. Details of corresponding algorithm can be found by following the provided links. We describe our original software module that implements the algorithm for determining the registered security events. The module is based on the tabular processor certified by the Russian Federal Service for Technical and Export Control. We present a control sample for testing the developed module. The sample has the dimension 30x20 and contains 14 choices for threshold values of security events number. The results of the tests comply with the specified boundary conditions and demonstrate a nonlinear dependence of the objective function on the number of registered security events, as well as a nonlinear dependence of the percentage of the detected security event on the total initial number of security events to be registered at the event source. The performance of the module specifically, the central processing unit usage is found acceptable (not exceeding 33%, which allows one to use the software for typical automated workplaces equipped with appropriate tabular processors. Our approach is universal with respect to the application areas.

  5. Certified meter data managers provide potent tool : Utilities, customers benefit from accurate energy data

    Energy Technology Data Exchange (ETDEWEB)

    Hall, V.

    2004-02-01

    The use of customer energy information and its importance in building business-to-business and business-to-consumer demographic profiles, and the role of certified meter data management agents, i.e. companies that have created infrastructures to manage large volumes of energy data that can be used to drive marketing to energy customers, is discussed. Short and long-term load management planning, distribution planning, outage management and demand response programs, efforts to streamline billing and create revenue-generating value-added services, are just some of the areas that can benefit from comprehensively collected and accurate consumer data. The article emphasizes the process of certification, the benefits certified meter data management companies can provide to utilities as well as to consumers, their role in disaster recovery management, and characteristics of the way such companies bring the benefits of their operations to their client utilities and consumers. 1 tab.

  6. Integrated Assessment of the Policy of Working Capital Management in Housing and Utilities Enterprises

    Directory of Open Access Journals (Sweden)

    Vladimir Petrovich Poluyanov

    2017-06-01

    Full Text Available The article describes the approaches to the management of current assets in the enterprises of various industries in economic literature. We discuss theoretical, methodological and applied issues concerning the formation and improvement of the working capital management policy in utility companies, which require further study. The authors propose to assess the policy of working capital management in these enterprises by means of the integrated approach based on the system of reasoned indicators defining the type of working capital management policy. It includes indicators characterizing the policy of working capital management, management of the liquidity of working capital and the policy of financing sources management. The indicators which define the type of the policy of working capital management have been chosen as the most influential for each vector of the improvement of management policy. The range of values is set taking into account the current market conditions for the housing and utilities companies based on theoretical standard values adapted to modern situation. The paper proposes to use an integrated indicator for the evaluation of the policy of working capital management in housing and utilities enterprises. We have substantiated the technique of the integrated assessment of the policy of working capital management in housing and utilities companies. As an example of the application of this indicator, we defined the type of the policy of working capital management in Rostovvodokanal Company. The initial data for the calculation of integrated indicators are the official data on the structure of the balance and financial results of Rostovvodokanal Company during the period from 2012 to 2016. At the Rostovvodokanal Company, it is necessary to bring the type of the policy of working capital management and sources of its financing closer to moderate or conservative type. The authors have substantiated the optimal type of policy of

  7. Depositional characteristics and sediment availability resulting from the post-Schultz Fire floods of 2010

    Science.gov (United States)

    Karen A. Koestner; Mike D. Carroll; Daniel G. Neary; Peter E. Koestner; Ann Youberg

    2011-01-01

    Wildfire is a major land management concern due to direct impacts of fire on forest resources, and potentially negative effects on landscape processes by increasing rates of runoff, erosion, downstream sedimentation, and overall site degradation (DeBano et al. 1998, Neary et al. 2005, Robichaud et al. 2010). In the United States the number of fires has been increasing...

  8. Building utility executive strength. [Job rotation as part of management training

    Energy Technology Data Exchange (ETDEWEB)

    Esser, N.J.

    1977-02-17

    The selection and development of strong executive talent to manage the utility industry is essential if some of the controversy and confusion over the role and policies of utilities is to be resolved. The industry has traditionally trained and elevated executives within the organization, but new technical developments have changed the managerial skills required of executives. Today's manager needs an understanding of the total industry regardless of his initial training, the politics involved in advocating issues, and the need to keep costs down. To develop managerial continuity, utilities can institute job rotation as part of their management training program. The option to bring in executives from outside the company allows more stringent standards and introduces new ideas. Competitive salaries increase the opportunity to attract and retain talent. The Board of Directors can actively develop a flexible organizational structure that allows the executive group to adjust to changing demand. (DCK)

  9. Human resources management in the water utilities of Hermosillo and Mexicali

    OpenAIRE

    Edmundo Loera Burnes; Alejandro Salazar Adams

    2017-01-01

    This paper studies how the Human Resources Management Systems (HRMS) influence the performance of water utilities in Mexico. The differentiated performance of the water utilities of the cities of Hermosillo and Mexicali were compared to their HRMS characteristics through the analysis of four categories: 1) Hiring policies, 2) Development and training, 3) Salaries, benefits and incentives, and 4) Sanct...

  10. Outline of a multiattribute utility approach to development of a waste management strategy at Sillamaee

    International Nuclear Information System (INIS)

    Anselmo, P.C.

    2000-01-01

    The article briefly discusses a framework for analysis of the waste disposition and management problem at Sillamaee. It is a response to the need to develop a strategic waste management plan for the Sillamaee site. A hypothetical objectives hierarchy is presented, along with two possible methods for aggregating scores for designated alternatives. Waste management and disposal problems, particularly nuclear waste disposal problems, have been addressed by many decision analysts. The latter citations are examples of Multiattribute Utility (MAU) Analysis, a decision analysis technique that is most appropriate for evaluation of waste management strategies at Sillamaee

  11. When the 'soft-path' gets hard: demand management and financial instability for water utilities

    Science.gov (United States)

    Zeff, H. B.; Characklis, G. W.

    2014-12-01

    In the past, cost benefit analysis (CBA) has been viewed as an effective means of evaluating water utility strategies, particularly those that were dependent on the construction of new supply infrastructure. As water utilities have begun to embrace 'soft-path' approaches as a way to reduce the need for supply-centric development, CBA fails to recognize some important financial incentives affected by reduced water consumption. Demand management, both as a short-term response to drought and in longer-term actions to accommodate demand growth, can introduce revenue risks that adversely affect a utility's ability to repay debt, re-invest in aging infrastructure, or maintain reserve funds for use in a short-term emergency. A utility that does not generate sufficient revenue to support these functions may be subject to credit rating downgrades, which in turn affect the interest rate it pays on its debt. Interest rates are a critical consideration for utility managers in the capital-intensive water sector, where debt payments for infrastructure often account for a large portion of a utility's overall costs. Even a small increase in interest rates can add millions of dollars to the cost of new infrastructure. Recent studies have demonstrated that demand management techniques can lead to significant revenue variability, and credit rating agencies have begun to take notice of drought response plans when evaluating water utility credit ratings, providing utilities with a disincentive to fully embrace soft-path approaches. This analysis examines the impact of demand management schemes on key credit rating metrics for a water utility in Raleigh, North Carolina. The utility's consumer base is currently experiencing rapid population growth, and demand management has the potential to reduce the dependence on costly new supply infrastructure but could lead to financial instability that will significantly increase the costs of financing future projects. This work analyzes how 'soft

  12. Human resources management in the water utilities of Hermosillo and Mexicali

    Directory of Open Access Journals (Sweden)

    Edmundo Loera Burnes

    2017-05-01

    Full Text Available

    This paper studies how the Human Resources Management Systems (HRMS influence the performance of water utilities in Mexico. The differentiated performance of the water utilities of the cities of Hermosillo and Mexicali were compared to their HRMS characteristics through the analysis of four categories: 1 Hiring policies, 2 Development and training, 3 Salaries, benefits and incentives, and 4 Sanctions systems. The main differences between these utilities are on categories 2 and 3, where Mexicali shows greater levels. The study provides a vision of water utilities from the point of view of HRMG, which has not been taken into account in previous research. Although Mexicali provides its workers with better training and incentives, it is observed that the influence of local governments and the excessive power of unions have led to weak HRMS that affect the performance of water utilities.

  13. Shortcomings in safety management: symptoms, examples and recovery processes. Omission of Operational Culture can be fatal for the power utility

    International Nuclear Information System (INIS)

    Hezoucky, F.; )

    2006-01-01

    During recent years, many utilities and their nuclear branches have undergone substantial change. The effectiveness of management in handling the change varies considerably from utility to utility. At the extreme, the way the change is managed and nuclear safety and operational performance aspects are integrated can either help lead a plant to operational excellence or destroy what was once an effective organisation. (author)

  14. Randic and Schultz molecular topological indices and their correlation with some X-ray absorption parameters

    International Nuclear Information System (INIS)

    Khatri, Sunil; Kekre, Pravin A; Mishra, Ashutosh

    2016-01-01

    The properties of a molecular system are affected by the topology of molecule. Therefore many studies have been made where the various physic-chemical properties are correlated with the topological indices. These studies have shown a very good correlation demonstrating the utility of the graph theoretical approach. It is, therefore, very natural to expect that the various physical properties obtained by the X-ray absorption spectra may also show correlation with the topological indices. Some complexes were used to establish correlation between topological indices and some X-ray absorption parameters like chemical shift. The chemical shift is on the higher energy side of the metal edge in these complexes. The result obtained in these studies shows that the topological indices of organic molecule acting as a legands can be used for estimating edge shift theoretically. (paper)

  15. Analysis on digital management of uranium geological archives and its second exploitation and utilization

    International Nuclear Information System (INIS)

    Kong Hui

    2009-01-01

    The enormous data and examples show that the second exploitation and utilization of geological archives information are important and necessary for geological prospecting. The author deeply studies and analyzes the information service system for uranium geology, it is believed that the traditional management mode of geological archives must be transformed into modernized service mode. The way of how to expand, apply and improve the 'management and analytical system for uranium resources information' is discussed for implementing geo-informational construction. (authors)

  16. Report of the Office of Chief Counsel on the role of the managing utility and its suppliers

    International Nuclear Information System (INIS)

    Gorinson, S.M.; Kane, K.P.

    1979-10-01

    Information is presented concerning the role of General Public Utilities Service Corp.; site change; role of Met Ed in design of TMI-2; control room design; containment isolation criteria selection; GPUSC startup and test group; commercial operation; management relationships within the utility; site management; review committees; procedures; attention to experience; NRC inspections; management approach to the emergency; and the TMI-2 recovery program

  17. Report of the Office of Chief Counsel on the role of the managing utility and its suppliers

    International Nuclear Information System (INIS)

    Gorinson, S.M.; Kane, K.P.

    1979-10-01

    Information is presented concerning the role of General Public Utilities Service Corp.; site change; role of Met Ed in design of TMI-2; control room design; containment isolation criteria selection; GPUSC startup and test group; commercial operation; managment relationships within the utility; site management; review committees; procedures; attention to experience; NRC inspections; management approach to the emergency; and the TMI-2 recovery program

  18. Sitophilus granarius L. (Coleoptera) Toxicity and Biological Activities of the Essential Oils of Tanacetum macrophyllum (Waldst. & Kit.) Schultz Bip.

    Science.gov (United States)

    Polatoğlu, Kaan; Karakoç, Ömer Cem; Demirci, Betül; Gören, Nezhun; Can Başer, Kemal Hüsnü

    2015-01-01

    Insecticides of the natural origin are an important alternative to the synthetic insecticides that are being employed for the preserving stored products. The volatiles obtained from T. cinerariifolium (=Pyrethrum cinerariifolium) is being used for many types of insecticidal applications; however there is a very little information on the insecticidal activity of the essential oils of other Tanacetum species. The main purpose of the present study is to determine the chemical composition of T. macrophyllum (Waldst. & Kit.) Schultz Bip. essential oils and evaluate their insecticidal activity against S. granarius as well as its other beneficial biological activities. Highest contact toxicity was observed in the leaf oil of (88.93%) against S. granarius. The flower oil showed considerable fumigant toxicity against L. minor at 10 mg/mL application concentration (61.86 %) when compared with other samples at the same concentration. The highest DPPH (2,2-Diphenyl-1-picrylhydrazyl) scavenging activity (47.7%) and phosphomolybdenum reducing activity was observed also for the flower oil of T. macrophyllum at 10 mg/mL concentration. The essential oils were analyzed by GC, GC/MS. The flower and leaf oils were characterized with γ-eudesmol 21.5%, (E)-sesquilavandulol 20.3%, copaborneol 8.5% and copaborneol 14.1%, 1,8-cineole 11%, bornyl acetate 9.6%, borneol 6.3% respectively. AHC analysis of the qualitative and quantitative data obtained from the essential oil composition of the T. macrophyllum essential oil from the present research and previous reports pointed out that two different chemotypes could be proposed with current findings which are p-methyl benzyl alcohol/ cadinene and eudesmane chemotypes.

  19. Business model innovation for Local Energy Management: a perspective from Swiss utilities

    Directory of Open Access Journals (Sweden)

    Emanuele Facchinetti

    2016-08-01

    Full Text Available The successful deployment of the energy transition relies on a deep reorganization of the energy market. Business model innovation is recognized as a key driver of this process. This work contributes to this topic by providing to potential Local Energy Management stakeholders and policy makers a conceptual framework guiding the Local Energy Management business model innovation. The main determinants characterizing Local Energy Management concepts and impacting its business model innovation are identified through literature reviews on distributed generation typologies and customer/investor preferences related to new business opportunities emerging with the energy transition. Afterwards, the relation between the identified determinants and the Local Energy Management business model solution space is analyzed based on semi-structured interviews with managers of Swiss utilities companies. The collected managers’ preferences serve as explorative indicators supporting the business model innovation process and provide insights to policy makers on challenges and opportunities related to Local Energy Management.

  20. Security Analysis of the Electronic Management System for a Total Site Utility System

    DEFF Research Database (Denmark)

    Manso Cortes, Oscar

    2016-01-01

    This paper presents the Security Analysis of the Electronic Management System (EMS) of a Total Site Utility System as proposed under the scope of the Efenis project. The Efenis project has been funded by the European Commission via the seventh framework programme (EC FP7) with the aim to improve ...

  1. Bridge management system for the Western Cape provincial government, South Africa: implementation and utilization

    CSIR Research Space (South Africa)

    Nell, AJ

    2008-10-01

    Full Text Available This paper describes the implementation and utilization of the bridge management system (BMS) of the Department of Transport and Public Works of the Western Cape Provincial Government. The implementation of the BMS as well as the visual assessment...

  2. Utility of an intraoperabive gamma probe in the surgical management of secondary or tertiary hyperparathyroidism

    NARCIS (Netherlands)

    Jorna, Francisca H.; Jager, Pieter L.; Lemstra, Clara; Wiggers, Theo; Stegeman, Coen A.; Plukker, John T. M.

    BACKGROUND: In primary hyperparathyroidism the gamma probe is effective, but its role in secondary hyperparathyroidism is unclear. We investigated the utility of the probe in the surgical management of secondary and tertiary hyperparathyroidism. METHODS: The value of the probe in guiding resection

  3. Communications technologies for demand side management, DSM, and European utility communications architecture, EurUCA

    Energy Technology Data Exchange (ETDEWEB)

    Kaerkkaeinen, S.; Kekkonen, V. [VTT Energy, Espoo (Finland); Rissanen, P. [Tietosavo Oy (Finland)

    1996-12-31

    In this project the main target is to develop and assess methods for DSM (Demand Side Management) and distribution automation planning from the utility`s point of view. The final goal is to integrate these methods for the strategic planning of electric utilities. In practice the project is divided into four main parts: The development and assessment of DSM/IRP planning methods and cost/benefit analysis as a part of international co-operation (IEA DSM Agreement: Annex IV, European Cost/Benefit analysis of DSM, EUBC, and Finnish SAVE-project started in 1995 in co-operation with SRC International and six electric utilities in Finland); Development of PC-based DSM planning and assessment tools at VTT; Development of a decision support system of distribution network planning including DSM options at Tietosavo Oy and Integration of DSM planning and network planning tools in co-operation with VTT Energy and Tietosavo Oy

  4. Transforming public utility commissions in the new regulatory environment: Some issues and ideas for managing change

    Energy Technology Data Exchange (ETDEWEB)

    Wirick, D.W.; Davis, V.W.; Burns, R.E.; Jones, D.N.

    1996-07-01

    In the face of sweeping changes in utility markets and regulatory practices, public utility commissions are being forced to change in fundamental ways--to substantially transform themselves rather than to make only incremental changes in their operations. Managing this process of radical change is complicated by the fact that for the foreseeable future some portions of utility markets (e.g., water utilities) will function much as they have before. Some envision commissions in the future that are more externally focussed, that rely more on dispute resolution than adjudicatory proceedings, that concentrate on identifying and understanding competitive markets, that are more automated, and that are more likely to question old assumptions and definitions. This report identifies the considerations commissions might apply for identifying what mix of skills or fields of experise should compromise the technical staff. Factors are also identified which point towards a sectoral arrangement of staff and those factors which point toward a functional approach.

  5. Communications technologies for demand side management, DSM, and European utility communications architecture, EurUCA

    Energy Technology Data Exchange (ETDEWEB)

    Kaerkkaeinen, S; Kekkonen, V [VTT Energy, Espoo (Finland); Rissanen, P [Tietosavo Oy (Finland)

    1997-12-31

    In this project the main target is to develop and assess methods for DSM (Demand Side Management) and distribution automation planning from the utility`s point of view. The final goal is to integrate these methods for the strategic planning of electric utilities. In practice the project is divided into four main parts: The development and assessment of DSM/IRP planning methods and cost/benefit analysis as a part of international co-operation (IEA DSM Agreement: Annex IV, European Cost/Benefit analysis of DSM, EUBC, and Finnish SAVE-project started in 1995 in co-operation with SRC International and six electric utilities in Finland); Development of PC-based DSM planning and assessment tools at VTT; Development of a decision support system of distribution network planning including DSM options at Tietosavo Oy and Integration of DSM planning and network planning tools in co-operation with VTT Energy and Tietosavo Oy

  6. A comparison of costs associated with utility management options for dry active waste

    Energy Technology Data Exchange (ETDEWEB)

    Hornibrook, C. [EPRI, Palo Alto, CA (United States)

    1995-12-31

    The economics of low level waste management is receiving more attention today than ever before. This is due to four factors: (1) the increases in the cost of processing of these wastes; (2) increases in the cost of disposal; (3) the addition of storage costs for those without access to disposal; and (4) the increasing competitive nature of the electric generation industry. These pressures are forcing the industry to update it`s evaluation of the mix of processing that will afford it the best long term economics and minimize it`s risks for unforeseen costs. Whether disposal is available or not, all utilities face the same challenge of minimizing the costs associated with the management of these wastes. There are a number of variables that will impact how a utility manages their wastes but the problem is the uncertainty of what will actually happen, i.e., will disposal be available, when and at what cost. Using the EPRI-developed WASTECOST: DAW code, this paper explores a variety of LLW management options available to utilities. Along with providing the costs and benefits, other technical considerations which play an important part in the management of these wastes are also addressed.

  7. Managing water utility financial risks through third-party index insurance contracts

    Science.gov (United States)

    Zeff, Harrison B.; Characklis, Gregory W.

    2013-08-01

    As developing new supply capacity has become increasingly expensive and difficult to permit (i.e., regulatory approval), utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on streamflow indices. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: Drought surcharges and contingency funds (i.e., self-insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multireservoir model provides information on the scale and timing of droughts, and the financial effects of these events are simulated using detailed data derived from utility billing records. Results suggest that third-party index insurance contracts, either independently or in combination with more traditional hedging tools, can provide an effective means of reducing a utility's financial vulnerability to drought.

  8. Utility evaluations for Markov states of lung cancer for PET-based disease management

    International Nuclear Information System (INIS)

    Papatheofanis, F.J.

    2000-01-01

    Utilities for the health outcomes states (Markov states) of non-small cell lung carcinoma (NSCLCL) should be measured to evaluate management options for patients because patients are key participants in the process of care, and their assessment of diagnostic and therapeutic value in the options presented to them ultimately impacts their net health outcomes. This investigation sought to measure utilities for stage-dependent outcomes states of NSCLC. Persons (n=23) with suspected NSCLC based on physical findings and computed tomography completed a short utilities survey. Utility valuations were obtained according to severity of morbidity and varied considerably. Respondents rated these health states according to accuracy measures for 18 flurodeoxyglucose ( 18 FDG) positron emission tomography (PET) imaging and mediastinoscopy. The results demonstrate that stage-dependent morbidity is an important consideration for patients with NSCLC and should be included in any decision analysis regarding the evaluation or treatment of NSCLC. Respondents valued the quality of information obtained from non-invasive mediastinoscopy comparably. The utilities obtained from this investigation are useful in clinical decision-making based on Markov processes because they provide an initial estimation of utility assessment for 18 FDG-based diagnostic evaluation of lung cancer. Consequently, these utilities will be useful in future decision analyses that require patient preference in the assignment of the evaluation of decision options (branches)

  9. Use of multiattribute utility theory for formulary management in a health system.

    Science.gov (United States)

    Chung, Seonyoung; Kim, Sooyon; Kim, Jeongmee; Sohn, Kieho

    2010-01-15

    The application, utility, and flexibility of the multiattribute utility theory (MAUT) when used as a formulary decision methodology in a Korean medical center were evaluated. A drug analysis model using MAUT consisting of 10 steps was designed for two drug classes of dihydropyridine calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs). These two drug classes contain the most diverse agents among cardiovascular drugs on Samsung Medical Center's drug formulary. The attributes identified for inclusion in the drug analysis model were effectiveness, safety, patient convenience, and cost, with relative weights of 50%, 30%, 10%, and 10%, respectively. The factors were incorporated into the model to quantify the contribution of each attribute. For each factor, a utility scale of 0-100 was established, and the total utility score for each alternative was calculated. An attempt was made to make the model adaptable to changing health care and regulatory circumstances. The analysis revealed amlodipine besylate to be an alternative agent, with the highest total utility score among the dihydropyridine CCBs, while barnidipine hydrochloride had the lowest score. For ARBs, losartan potassium had the greatest total utility score, while olmesartan medoxomil had the lowest. A drug analysis model based on the MAUT was successfully developed and used in making formulary decisions for dihydropyridine CCBs and ARBs for a Korean health system. The model incorporates sufficient utility and flexibility of a drug's attributes and can be used as an alternative decision-making tool for formulary management in health systems.

  10. Lbs Augmented Reality Assistive System for Utilities Infrastructure Management Through Galileo and Egnos

    Science.gov (United States)

    Stylianidis, E.; Valaria, E.; Smagas, K.; Pagani, A.; Henriques, J.; Garca, A.; Jimeno, E.; Carrillo, I.; Patias, P.; Georgiadis, C.; Kounoudes, A.; Michail, K.

    2016-06-01

    There is a continuous and increasing demand for solutions, both software and hardware-based, that are able to productively handle underground utilities geospatial data. Innovative approaches that are based on the use of the European GNSS, Galileo and EGNOS, sensor technologies and LBS, are able to monitor, document and manage utility infrastructures' data with an intuitive 3D augmented visualisation and navigation/positioning technology. A software and hardware-based system called LARA, currently under develop- ment through a H2020 co-funded project, aims at meeting that demand. The concept of LARA is to integrate the different innovative components of existing technologies in order to design and develop an integrated navigation/positioning and information system which coordinates GNSS, AR, 3D GIS and geodatabases on a mobile platform for monitoring, documenting and managing utility infrastruc- tures on-site. The LARA system will guide utility field workers to locate the working area by helping them see beneath the ground, rendering the complexity of the 3D models of the underground grid such as water, gas and electricity. The capacity and benefits of LARA are scheduled to be tested in two case studies located in Greece and the United Kingdom with various underground utilities. The paper aspires to present the first results from this initiative. The project leading to this application has received funding from the European GNSS Agency under the European Union's Horizon 2020 research and innovation programme under grant agreement No 641460.

  11. LBS AUGMENTED REALITY ASSISTIVE SYSTEM FOR UTILITIES INFRASTRUCTURE MANAGEMENT THROUGH GALILEO AND EGNOS

    Directory of Open Access Journals (Sweden)

    E. Stylianidis

    2016-06-01

    Full Text Available There is a continuous and increasing demand for solutions, both software and hardware-based, that are able to productively handle underground utilities geospatial data. Innovative approaches that are based on the use of the European GNSS, Galileo and EGNOS, sensor technologies and LBS, are able to monitor, document and manage utility infrastructures’ data with an intuitive 3D augmented visualisation and navigation/positioning technology. A software and hardware-based system called LARA, currently under develop- ment through a H2020 co-funded project, aims at meeting that demand. The concept of LARA is to integrate the different innovative components of existing technologies in order to design and develop an integrated navigation/positioning and information system which coordinates GNSS, AR, 3D GIS and geodatabases on a mobile platform for monitoring, documenting and managing utility infrastruc- tures on-site. The LARA system will guide utility field workers to locate the working area by helping them see beneath the ground, rendering the complexity of the 3D models of the underground grid such as water, gas and electricity. The capacity and benefits of LARA are scheduled to be tested in two case studies located in Greece and the United Kingdom with various underground utilities. The paper aspires to present the first results from this initiative. The project leading to this application has received funding from the European GNSS Agency under the European Union’s Horizon 2020 research and innovation programme under grant agreement No 641460.

  12. R and D options for demand side management in Japanese electric utilities

    International Nuclear Information System (INIS)

    Yamamoto, T.

    1995-01-01

    Japanese electric utilities are facing several problems: increasing construction cost of power facilities, siting constraints and the environmental issue of greenhouse gas emissions. To overcome these problems, electric utilities have been promoting demand-side-management (DSM) activities as well as supplier-side measures, with some presently being carried out through promoting energy conservation technologies and introducing tariff options for residential/commercial and industrial consumers. R and D works have been carried out on various fields such as energy storage and heat storage which contribute to the improvement of the load factor. 5 figs., 2 tabs

  13. Supplier-independent fuel management from the viewpoint of a large German utility - Objectives and experience

    International Nuclear Information System (INIS)

    Kallmeyer, D.H.; Petersen, K.

    1986-01-01

    Internationally, many nuclear power operating utilities tend to have alternative fuel supplies and as a consequence also have to build up a supplier-independent fuel management. The main reasons are competition within the fuel assembly market as a price-regulating mechanism; quality comparison and corresponding improvements in fuel technology, documentation system and licensing support activities; improved necessity on the part of the manufacturer to be open for innovations; improved supply reliability by redundant manufacturer qualification; and gain of know-how for the utility by collection and comparison of the state of the art of the different suppliers in the important technical and physical disciplines

  14. E-LEARNING AS A KNOWLEDGE MANAGEMENT APPROACH FOR INTELLECTUAL CAPITAL UTILIZATION

    Directory of Open Access Journals (Sweden)

    Issa SHEHABAT

    2009-01-01

    Full Text Available This paper addresses human resources utilization at the university environment. We address the design issues of e-learning courses that can capture the teacher knowledge. The underlying objective is that e-learning is a key knowledge and major resources for many universities. Therefore, the design of e-learning should be an important part of the university knowledge management process. Teachers' knowledge in any important topic or field should be managed in a way that the university can benefit from it in case of teacher leaving or retired. Hence, intellectual personal knowledge management will be explored through the development of e-learning systems. Some concepts from the Artificial Intelligence field can be used in developing such systems. The potential for utilizing human knowledge in the university environment will optimize the resources and can be of cost effective and quality assurance factors and provide the university with a sustainable competitive advantage. Assuring the proper knowledge management within the university environment is a more complex issue. This is due to the diverse of topics in one hand and the behavior of the student and the lecturers on the other hand. Effective implementation and success requires a lot of efforts that will guarantee the utilization of the intellectual capital within the university environment.

  15. E-LEARNING AS A KNOWLEDGE MANAGEMENT APPROACH FOR INTELLECTUAL CAPITAL UTILIZATION

    Directory of Open Access Journals (Sweden)

    Issa SHEHABAT

    2008-01-01

    Full Text Available This paper addresses human resources utilization at the university environment. We address the design issues of e-learning courses that can capture the teacher knowledge. The underlying objective is that e-learning is a key knowledge and major resources for many universities. Therefore, the design of e-learning should be an important part of the university knowledge management process. Teachers' knowledge in any important topic or field should be managed in a way that the university can benefit from it in case of teacher leaving or retired. Hence, intellectual personal knowledge management will be explored through the development of e-learning systems. Some concepts from the Artificial Intelligence field can be used in developing such systems.The potential for utilizing human knowledge in the university environment will optimize the resources and can be of cost effective and quality assurance factors and provide the university with a sustainable competitive advantage.Assuring the proper knowledge management within the university environment is a more complex issue. This is due to the diverse of topics in one hand and the behavior of the student and the lecturers on the other hand. Effective implementation and success requires a lot of efforts that will guarantee the utilization of the intellectual capital within the university environment.

  16. Thru-life impacts of driver aggression, climate, cabin thermal management, and battery thermal management on battery electric vehicle utility

    Science.gov (United States)

    Neubauer, Jeremy; Wood, Eric

    2014-08-01

    Battery electric vehicles (BEVs) offer the potential to reduce both oil imports and greenhouse gas emissions, but have a limited utility that is affected by driver aggression and effects of climate-both directly on battery temperature and indirectly through the loads of cabin and battery thermal management systems. Utility is further affected as the battery wears through life in response to travel patterns, climate, and other factors. In this paper we apply the National Renewable Energy Laboratory's Battery Lifetime Analysis and Simulation Tool for Vehicles (BLAST-V) to examine the sensitivity of BEV utility to driver aggression and climate effects over the life of the vehicle. We find the primary challenge to cold-climate BEV operation to be inefficient cabin heating systems, and to hot-climate BEV operation to be high peak on-road battery temperatures and excessive battery degradation. Active cooling systems appear necessary to manage peak battery temperatures of aggressive, hot-climate drivers, which can then be employed to maximize thru-life vehicle utility.

  17. Utilizing on-farm best management practices: Managing Nitrate Leaching Using Evapotranspiration Based Irrigation Methods

    Science.gov (United States)

    Zaragosa, I.; Melton, F. S.; Dexter, J.; Post, K.; Haffa, A.; Kortman, S.; Spellenberg, R.; Cahn, M.

    2017-12-01

    In efforts to provide tools to allow farmers to optimize and quantify water usage and fertilizer applications, University of California Cooperative Extension (UCCE) developed the CropManage irrigation and nitrogen scheduling tool that provides real time evapotranspiration (ETc) based irrigation recommendations and fertilizer recommendations on a per field basis. CropManage incorporates satellite based estimates of fractional cover from web data services from the Satellite Irrigation Management Information Support (SIMS) system developed by NASA Ames Research Center in collaboration with California State University Monterey Bay (CSUMB). In this study, we conducted field trials to quantify the benefits of using these tools to support best management practices (BMPs) for irrigation and nutrient management in strawberries and lettuce in the Salinas Valley, California. We applied two different irrigation treatments based on full replacement (100%) of crop evapotranspiration (ETc), and irrigation at 130% of ETc replacement to approximate irrigation under business as usual irrigation management. Both field studies used a randomized block design with four replicates each. We used CropManage to calculate the 100% and 130% ETc replacement requirements prior to each irrigation event. We collected drainage volume and samples and analyzed them for 8500 to nitrate as (NO3-) concentrations. Experimental results for both strawberries and lettuce showed a significant decrease in the percentage of applied nitrogen leached for the 100% ETc replacement treatment against the 130% ETc replacement treatment. For strawberries, we observed that 24% of applied nitrogen was leached under the 100% ETc replacement treatment, versus 51% of applied nitrogen that was leached under the 130% ETc replacement treatment. For lettuce, we observe that 2% of the applied nitrogen leached bellow the soil profile, versus 6% of the applied nitrogen for the 130%ETc replacement treatment. In both experiments

  18. Utilizing Knowledge Management in Education: The Case of "The University of Jordan"

    Directory of Open Access Journals (Sweden)

    Osama M. Rababah

    2013-03-01

    Full Text Available Knowledge as a result of processing the relevant information which is collection of raw data, facts, measurements, and statistics, requires sensitive management that leads educators and learners to increase concern for knowledge management, especially in the educational field. This paper intends to present this proposed approach directly to the one of its main sources of creation; Education. After the introductory part, the paper presents the Knowledge Management in the context of “The University of Jordan” emphasizing every components of knowledge management: people, process, and technology. Then, the researchers will show the result of the survey which had been carried out on 140 students at The University of Jordan, the survey was about their perceptions regarding the utility and quality of knowledge they gained through their studying at The University of Jordan.

  19. Assessment of utility side financial benefits of demand side management considering environmental impacts

    Science.gov (United States)

    Abeygunawardane, Saranga Kumudu

    2018-02-01

    Any electrical utility prefers to implement demand side management and change the shape of the demand curve in a beneficial manner. This paper aims to assess the financial gains (or losses) to the generating sector through the implementation of demand side management programs. An optimization algorithm is developed to find the optimal generation mix that minimizes the daily total generating cost. This daily total generating cost includes the daily generating cost as well as the environmental damage cost. The proposed optimization algorithm is used to find the daily total generating cost for the base case and for several demand side management programs using the data obtained from the Sri Lankan power system. Results obtained for DSM programs are compared with the results obtained for the base case to assess the financial benefits of demand side management to the generating sector.

  20. Herbicide-resistant crops: utilities and limitations for herbicide-resistant weed management.

    Science.gov (United States)

    Green, Jerry M; Owen, Micheal D K

    2011-06-08

    Since 1996, genetically modified herbicide-resistant (HR) crops, particularly glyphosate-resistant (GR) crops, have transformed the tactics that corn, soybean, and cotton growers use to manage weeds. The use of GR crops continues to grow, but weeds are adapting to the common practice of using only glyphosate to control weeds. Growers using only a single mode of action to manage weeds need to change to a more diverse array of herbicidal, mechanical, and cultural practices to maintain the effectiveness of glyphosate. Unfortunately, the introduction of GR crops and the high initial efficacy of glyphosate often lead to a decline in the use of other herbicide options and less investment by industry to discover new herbicide active ingredients. With some exceptions, most growers can still manage their weed problems with currently available selective and HR crop-enabled herbicides. However, current crop management systems are in jeopardy given the pace at which weed populations are evolving glyphosate resistance. New HR crop technologies will expand the utility of currently available herbicides and enable new interim solutions for growers to manage HR weeds, but will not replace the long-term need to diversify weed management tactics and discover herbicides with new modes of action. This paper reviews the strengths and weaknesses of anticipated weed management options and the best management practices that growers need to implement in HR crops to maximize the long-term benefits of current technologies and reduce weed shifts to difficult-to-control and HR weeds.

  1. R and D options for demand side management in Japanese electric utilities

    International Nuclear Information System (INIS)

    Yamamoto, Takahiko

    1996-01-01

    Japanese electric demand has been steadily increasing in accordance with the economic growth. However, Japanese electric utilities are facing several problems; increasing construction cost of power facilities, siting constraints and the environmental issue of greenhouse gas emissions. To overcome these problems, electric utilities have been promoting demand-side-management (DSM) activities as well as supplier-side measures, with some presently being carried out through promoting energy conservation technologies and introducing electric tariff options of specific contracts for residential/commercial and industrial consumers. Japanese electric utilities have been carrying out R and D for the future, in particular, energy storage and heat storage which contribute to the improvement of load factor. In this paper, I would like to outline the R and D options for DSM in Japan. (author)

  2. Integrated outage management: Leveraging utility system assets including GIS and AMR for optimum outage response

    Energy Technology Data Exchange (ETDEWEB)

    Finamore, E. P.

    2004-02-01

    The control of electrical system outages is discussed. The principal argument advanced is that traditional stand-alone methods of outage response will no longer get the job done without utility companies integrating their outage management systems with other system assets such as GIS (geographic information system) and AMR (advanced metering systems). Many meter reading systems, while primarily supporting customer billing, can also provide outage alarm and some are also capable of service restoration notification, which is an invaluable benefit to service operators since it obviates the need for verifying system restoration by labour-intensive on-site visits or customer call-backs. If successfully leveraged, optimization of all utility assets and improvements in labour productivity can results in improved outage management performance gains without affecting performance in other areas.

  3. Resource potential of bamboo, challenges and future directions towards sustainable management and utilization in Ethiopia

    Directory of Open Access Journals (Sweden)

    Getachew Desalegn

    2014-08-01

    Full Text Available Aim of study: Bamboo, the fastest growing and high yielding perennial plant of the world has more than 1500 species and 1500 versatile socio-economic uses and ecological services. Ethiopia has two indigenous bamboo species namely Yushania alpina and Oxytenantheria abyssinica, covering about one million ha with a wide distribution. The objective of this paper is to highlight the potential of bamboo resources, challenges including biodeterioration damage, opportunities and future research directions towards its sustainable management and rational utilization.Area of study: Bamboo resources of EthiopiaMaterial and Methods: Reconnaissance survey was done to some parts of the bamboo growing potential areas in Ethiopia besides the literature review. Main results: The bamboo resource, despite its socio-economic and environmental benefits, currently, in most areas has been under high pressure due to land use changes, bamboo mass- flowering, poor processing with low value addition, and damage by biodeteriorating agents (termites, beetles and fungi. The preservative tests on Ethiopian bamboos revealed low natural durability and highlighted the paramount importance of appropriate protection measures such as Tanalith and vehicles used motor oil to increase durability, service life and rational utilization of bamboo-based products and structures as potential alternative construction and furniture material.Research highlights: Therefore, integrated research and development interventions involving different propagation and managements techniques, harvesting season, processing, value addition including proper seasoning and preservation technologies and marketing are recommended to fill the information and technological gaps on sustainable management and rational utilization of this fast growing and multipurpose bamboo resources in Ethiopia.Key words: Bamboo; challenges; management; socio-economic and environmental significance; utilization.

  4. Rationale for utilizing 3PL in supply chain management: A shippers' economic perspective

    OpenAIRE

    Koichiro Tezuka

    2011-01-01

    In this paper we first propose a conceptual framework for evaluating 3PL (third-party logistics) utilization in SCM (supply chain management), in which it is assumed that shippers may enjoy advantages derived from four contributory sources of 3PL specialization: scale, know-how, searching ability, and IT skills. It is also supposed that shippers may particularly benefit from 3PL when facing uncertain business environments. We also apply principal–agent relationships to shippers and 3PL provid...

  5. Energy and water quality management systems for water utility's operations: a review.

    Science.gov (United States)

    Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

    2015-04-15

    Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Rationale for utilizing 3PL in supply chain management: A shippers' economic perspective

    Directory of Open Access Journals (Sweden)

    Koichiro Tezuka

    2011-07-01

    Full Text Available In this paper we first propose a conceptual framework for evaluating 3PL (third-party logistics utilization in SCM (supply chain management, in which it is assumed that shippers may enjoy advantages derived from four contributory sources of 3PL specialization: scale, know-how, searching ability, and IT skills. It is also supposed that shippers may particularly benefit from 3PL when facing uncertain business environments. We also apply principal–agent relationships to shippers and 3PL providers. Further, we see enhancing “agency efficiency” as important to obtaining the benefits of 3PL utilization. We also look at the role of 3PL provider selection, the “hold-up” problem under incomplete contracts, and asset ownership. After that we briefly discuss the utilization of 3PL and environmental concerns. These are the main points that we consider related to 3PL utilization. The main contribution of this study is to identify discussion points from models and theories, such as contract theory, that relate to the utilization of 3PL in SCM.

  7. The past, present, and future of U.S. utility demand-side management programs

    International Nuclear Information System (INIS)

    Eto, J.

    1996-12-01

    Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers' energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests

  8. The past, present, and future of U.S. utility demand-side management programs

    Energy Technology Data Exchange (ETDEWEB)

    Eto, J. [Lawrence Berkeley National Lab., CA (United States). Environmental Energy Technologies Div.

    1996-12-01

    Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers` energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests.

  9. An effective utilization management strategy by dual approach of influencing physician ordering and gate keeping.

    Science.gov (United States)

    Elnenaei, Manal O; Campbell, Samuel G; Thoni, Andrea J; Lou, Amy; Crocker, Bryan D; Nassar, Bassam A

    2016-02-01

    There is increasing recognition of the importance of appropriate laboratory test utilization. We investigate the effect of a multifaceted educational approach that includes physician feedback on individual test ordering, in conjunction with targeted restriction, on the utilization of selected laboratory tests. Scientific evidence was compiled on the usefulness and limitations of tests suspected of being over utilized in our laboratories. A variety of approaches were used to deliver education on each of the targeted tests, with greater focus on primary care physicians (PCPs). Feedback on requesting behavior of these tests was also communicated to the latter group which included an educational component. Laboratory based restriction of testing was also exercised, including the unbundling of our electrolyte panel. PCP requesting patterns for the selected tests were found to be markedly skewed. The interventions implemented over the study period resulted in a substantial 51% reduction in overall ordering of five of the targeted tests equating to an annual marginal cost saving of $60,124. Unbundling of the electrolyte panel resulted in marginal cost savings that equated annually to $42,500 on chloride and $48,000 on total CO2. A multifaceted educational approach combined with feedback on utilization and laboratory driven gate-keeping significantly reduced the number of laboratory tests suspected of being redundant or unjustifiably requested. Laboratory professionals are well positioned to manage demand on laboratory tests by utilizing evidence base in developing specific test ordering directives and gate-keeping rules. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  10. Management practices utilization in organizations – A comparison between catching-up and well-developed economies

    Directory of Open Access Journals (Sweden)

    Vojko Potočan

    2016-01-01

    Full Text Available The main purpose of this paper is to examine the utilization of management practices in catching-up and well-developed economies. Within that framework, the paper examines the utilization of management practices in Slovenian and Croatian organizations, as both are considered the representatives of catching-up economies from Central and East Europe (CEE, while also comparing the utilization of management practices in the two selected economies to the global use of management practices. Evidences about management practices utilization reveal that in well-developed economies in the forefront are management practices aiming to support customer relationship management, strength customer relations and customer satisfaction, while in Slovenia and Croatia prevail practices that are oriented toward optimization of the business and its processes. Based on the research results and the situation in organizations, a possible future pattern of management practice utilization in organizations operating in catching up economies is outlined, with the aim to reduce the developmental lag and increase competitiveness of those organizations. The paper also provides several practical implications for future utilization of management practices in catching-up economies. The sample of catching up-countries includes 155 responses from employees in Slovenian organizations and 185 from Croatian ones. Data for samples from well-developed economies are obtained from a global survey of management practices.

  11. Thermal management of closed computer modules utilizing high density circuitry. [in Airborne Information Management System

    Science.gov (United States)

    Hoadley, A. W.; Porter, A. J.

    1990-01-01

    This paper presents data on a preliminary analysis of the thermal dynamic characteristics of the Airborne Information Management System (AIMS), which is a continuing design project at NASA Dryden. The analysis established the methods which will be applied to the actual AIMS boards as they become available. The paper also describes the AIMS liquid cooling system design and presents a thermodynamic computer model of the AIMS cooling system, together with an experimental validation of this model.

  12. Research reactor utilization, safety, decommissioning, fuel and waste management. Posters of an international conference

    International Nuclear Information System (INIS)

    2005-01-01

    For more than 50 years research reactors have played an important role in the development of nuclear science and technology. They have made significant contributions to a large number of disciplines as well as to the educational and research programmes of about 70 countries world wide. About 675 research reactors have been built to date, of which some 278 are now operating in 59 countries (86 of them in 38 developing Member States). Altogether over 13,000 reactor-years of cumulative operational experience has been gained during this remarkable period. The objective of this conference was to foster the exchange of information on current research reactor concerns related to safety, operation, utilization, decommissioning and to provide a forum for reactor operators, designers, managers, users and regulators to share experience, exchange opinions and to discuss options and priorities. The topical areas covered were: a) Utilization, including new trends and directions for utilization of research reactors. Effective management of research reactors and associated facilities. Engineering considerations and experience related to refurbishment and modifications. Strategic planning and marketing. Classical applications (nuclear activation analysis, isotope production, neutron beam applications, industrial irradiations, medical applications). Training for operators. Educational programmes using a reactor. Current developments in design and fabrication of experimental facilities. Irradiation facilities. Projects for regional uses of facilities. Core management and calculation tools. Future trends for reactors. Use of simulators for training and educational programmes. b) Safety, including experience with the preparation and review of safety analysis reports. Human factors in safety analysis. Management of extended shutdown periods. Modifications: safety analysis, regulatory aspects, commissioning programmes. Engineering safety features. Safety culture. Safety peer reviews and

  13. Is control through utilization a cost effective Prosopis juliflora management strategy?

    Science.gov (United States)

    Wakie, Tewodros T; Hoag, Dana; Evangelista, Paul H; Luizza, Matthew; Laituri, Melinda

    2016-03-01

    The invasive tree Prosopis juliflora is known to cause negative impacts on invaded ranges. High P. juliflora eradication costs have swayed developing countries to follow a new and less expensive approach known as control through utilization. However, the net benefits of this new approach have not been thoroughly evaluated. Our objective was to assess the economic feasibility of selected P. juliflora eradication and utilization approaches that are currently practiced in one of the severely affected developing countries, Ethiopia. The selected approaches include converting P. juliflora infested lands into irrigated farms (conversion), charcoal production, and seed flour production. We estimate the costs and revenues of the selected P. juliflora eradication and utilization approaches by interviewing 19 enterprise owners. We assess the economic feasibility of the enterprises by performing enterprise, break-even, investment, sensitivity, and risk analyses. Our results show that conversion to irrigated cotton is economically profitable, with Net Present Value (NPV) of 5234 US$/ha over 10 years and an interest rate of 10% per year. Conversion greatly reduces the spread of P. juliflora on farmlands. Managing P. juliflora infested lands for charcoal production with a four-year harvest cycle is profitable, with NPV of 805 US$/ha. However, the production process needs vigilant regulation to protect native plants from exploitation and caution should be taken to prevent charcoal production sites from becoming potential seed sources. Though flour from P. juliflora pods can reduce invasions by destroying viable seeds, flour enterprises in Ethiopia are unprofitable. Conversion and charcoal production can be undertaken with small investment costs, while flour production requires high investment costs. Introducing new changes in the production and management steps of P. juliflora flour might be considered to make the enterprise profitable. Our study shows that control

  14. Can a chronic disease management pulmonary rehabilitation program for COPD reduce acute rural hospital utilization?

    Science.gov (United States)

    Rasekaba, T M; Williams, E; Hsu-Hage, B

    2009-01-01

    Chronic obstructive pulmonary disease (COPD) imposes a costly burden on healthcare. Pulmonary rehabilitation (PR) is the best practice to better manage COPD to improve patient outcomes and reduce acute hospital care utilization. To evaluate the impact of a once-weekly, eight-week multidisciplinary PR program as an integral part of the COPD chronic disease management (CDM) Program at Kyabram District Health Services. The study compared two cohorts of COPD patients: CDM-PR Cohort (4-8 weeks) and Opt-out Cohort (0-3 weeks) between February 2006 and March 2007. The CDM-PR Program involved multidisciplinary patient education and group exercise training. Nonparametric statistical tests were used to compare acute hospital care utilization 12 months before and after the introduction of CDM-PR. The number of patients involved in the CDM-PR Cohort was 29 (n = 29), and that in the Opt-out Cohort was 24 (n = 24). The CDM-PR Cohort showed significant reductions in cumulative acute hospital care utilization indicators (95% emergency department presentations, 95% inpatient admissions, 99% length of stay; effect sizes = 0.62-0.66, P 0.05). Total costs associated with the hospital care utilization decreased from $130,000 to $7,500 for the CDM-PR Cohort and increased from $77,700 to $101,200 for the Opt-out Cohort. Participation in the CDM-PR for COPD patients can significantly reduce acute hospital care utilization and associated costs in a small rural health service.

  15. Resource utilization after introduction of a standardized clinical assessment and management plan.

    Science.gov (United States)

    Friedman, Kevin G; Rathod, Rahul H; Farias, Michael; Graham, Dionne; Powell, Andrew J; Fulton, David R; Newburger, Jane W; Colan, Steven D; Jenkins, Kathy J; Lock, James E

    2010-01-01

    A Standardized Clinical Assessment and Management Plan (SCAMP) is a novel quality improvement initiative that standardizes the assessment and management of all patients who carry a predefined diagnosis. Based on periodic review of systemically collected data the SCAMP is designed to be modified to improve its own algorithm. One of the objectives of a SCAMP is to identify and reduce resource utilization and patient care costs. We retrospectively reviewed resource utilization in the first 93 arterial switch operation (ASO) SCAMP patients and 186 age-matched control ASO patients. We compared diagnostic and laboratory testing obtained at the initial SCAMP clinic visit and control patient visits. To evaluate the effect of the SCAMP over time, the number of clinic visits per patient year and echocardiograms per patient year in historical control ASO patients were compared to the projected rates for ASO SCAMP participants. Cardiac magnetic resonance imaging (MRI), stress echocardiogram, and lipid profile utilization were higher in the initial SCAMP clinic visit group than in age-matched control patients. Total echocardiogram and lung scan usage were similar. Chest X-ray and exercise stress testing were obtained less in SCAMP patients. ASO SCAMP patients are projected to have 0.5 clinic visits and 0.5 echocardiograms per year. Historical control patients had more clinic visits (1.2 vs. 0.5 visits/patient year, P<.01) and a higher echocardiogram rate (0.92 vs. 0.5 echocardiograms/patient year, P<.01) Implementation of a SCAMP may initially lead to increased resource utilization, but over time resource utilization is projected to decrease.

  16. Barriers to Innovation in Urban Wastewater Utilities: Attitudes of Managers in California.

    Science.gov (United States)

    Kiparsky, Michael; Thompson, Barton H; Binz, Christian; Sedlak, David L; Tummers, Lars; Truffer, Bernhard

    2016-06-01

    In many regions of the world, urban water systems will need to transition into fundamentally different forms to address current stressors and meet impending challenges-faster innovation will need to be part of these transitions. To assess the innovation deficit in urban water organizations and to identify means for supporting innovation, we surveyed wastewater utility managers in California. Our results reveal insights about the attitudes towards innovation among decision makers, and how perceptions at the level of individual managers might create disincentives for experimentation. Although managers reported feeling relatively unhindered organizationally, they also spend less time on innovation than they feel they should. The most frequently reported barriers to innovation included cost and financing; risk and risk aversion; and regulatory compliance. Considering these results in the context of prior research on innovation systems, we conclude that collective action may be required to address underinvestment in innovation.

  17. The comparison of alternatives for nuclear spent fuel management using multi-attribute utility function

    International Nuclear Information System (INIS)

    Yang, J. W.; Kang, C. S.

    1999-01-01

    It is necessary to find a solution immediately to nuclear spent fuel management that is temporarily stored in on-site spent fuel storage before the saturation of the storage. However the choice of alternative for nuclear spent fuel management consists of complex process that are affected by economic, technical and social factors. And it is not easy to quantify these factors; public opinion, probability of diplomatic problem and contribution to development of nuclear technology. Therefore the analysis of the affecting factors and assessment of alternatives are required. This study performed the comparison of the alternatives for nuclear spent fuel management using MAU (Multi-Attribute Utility Function) and AHP(Analytic Hierarchy Process)

  18. Integrating Systems Health Management with Adaptive Controls for a Utility-Scale Wind Turbine

    Science.gov (United States)

    Frost, Susan A.; Goebel, Kai; Trinh, Khanh V.; Balas, Mark J.; Frost, Alan M.

    2011-01-01

    Increasing turbine up-time and reducing maintenance costs are key technology drivers for wind turbine operators. Components within wind turbines are subject to considerable stresses due to unpredictable environmental conditions resulting from rapidly changing local dynamics. Systems health management has the aim to assess the state-of-health of components within a wind turbine, to estimate remaining life, and to aid in autonomous decision-making to minimize damage. Advanced adaptive controls can provide the mechanism to enable optimized operations that also provide the enabling technology for Systems Health Management goals. The work reported herein explores the integration of condition monitoring of wind turbine blades with contingency management and adaptive controls. Results are demonstrated using a high fidelity simulator of a utility-scale wind turbine.

  19. Utilizing Radiofrequency Identification Technology to Improve Safety and Management of Blood Bank Supply Chains.

    Science.gov (United States)

    Coustasse, Alberto; Meadows, Pamela; Hall, Robert S; Hibner, Travis; Deslich, Stacie

    2015-11-01

    The importance of efficiency in the supply chain of perishable products, such as the blood products used in transfusion services, cannot be overstated. Many problems can occur, such as the outdating of products, inventory management issues, patient misidentification, and mistransfusion. The purpose of this article was to identify the benefits and barriers associated with radiofrequency identification (RFID) usage in improving the blood bank supply chain. The methodology for this study was a qualitative literature review following a systematic approach. The review was limited to sources published from 2000 to 2014 in the English language. Sixty-five sources were found, and 56 were used in this research study. According to the finding of the present study, there are numerous benefits and barriers to RFID utilization in blood bank supply chains. RFID technology offers several benefits with regard to blood bank product management, including decreased transfusion errors, reduction of product loss, and more efficient inventory management. Barriers to RFID implementation include the cost associated with system implementation and patient privacy issues. Implementation of an RFID system can be a significant investment. However, when observing the positive impact that such systems may have on transfusion safety and inventory management, the cost associated with RFID systems can easily be justified. RFID in blood bank inventory management is vital to ensuring efficient product inventory management and positive patient outcomes.

  20. Opioid management strategy decreases admissions in high-utilizing adults with sickle cell disease.

    Science.gov (United States)

    Mager, Amy; Pelot, Kristin; Koch, Kathryn; Miller, Lawrence; Hubler, Collin; Ndifor, Anisah; Coan, Canice; Leonard, Cynthia; Field, Joshua J

    A subset of adults with sickle cell disease (SCD) heavily utilizes the emergency department (ED) and hospital. The objective of our study was to determine the efficacy of a multidisciplinary strategy to address unmet needs in highly utilizing adults with SCD. In a prospective study, adults with SCD with ≥10 admissions per year were assessed by a multidisciplinary team for gaps in medical, social, and psychological care. Thereafter, the team decided upon the subject's predominant domain that drove admissions and instituted an interventional plan. All plans included an opioid management strategy. Preintervention and postintervention admission rate, as well as opioid use, was compared. Twelve subjects were enrolled. Median rate of ED and hospital admissions preintervention was 25 per year. The predominant domains identified were social needs (n = 6), psychological disorder (n = 1), and substance use disorder (n = 5). Multifaceted interventional plans were developed to address a wide range of gaps in care, but an opioid management strategy was the only intervention successfully completed. Even so, when the preintervention versus postintervention admission rate was compared, regardless of the domain, there was a 40 percent decline in hospital admissions (p = 0.03). Consistent with the successful implementation of an opioid management plan, the decrease in admissions was accompanied by a 37 percent decrease in intravenous opioid use (p = 0.02) and 10 percent decrease in oral opioid use (p = 0.04). An opioid management strategy, as part of a larger effort to improve care for high-utilizing adults with SCD, decreased rate of admissions and opioid use.

  1. An analysis of the factors influencing demand-side management activity in the electric utility industry

    Science.gov (United States)

    Bock, Mark Joseph

    Demand-side management (DSM), defined as the "planning, implementation, and monitoring of utility activities designed to encourage consumers to modify their pattern of electricity usage, including the timing and level of electricity demand," is a relatively new concept in the U.S. electric power industry. Nevertheless, in twenty years since it was first introduced, utility expenditures on DSM programs, as well as the number of such programs, have grown rapidly. At first glance, it may seem peculiar that a firm would actively attempt to reduce demand for its primary product. There are two primary explanations as to why a utility might pursue DSM: regulatory mandate, and self-interest. The purpose of this dissertation is to determine the impact these influences have on the amount of DSM undertaken by utilities. This research is important for two reasons. First, it provides insight into whether DSM will continue to exist as competition becomes more prevalent in the industry. Secondly, it is important because no one has taken a comprehensive look at firm-level DSM activity on an industry-wide basis. The primary data set used in this dissertation is the U.S. Department of Energy's Annual Electric Utility Report, Form EIA-861, which represents the most comprehensive data set available for analyzing DSM activity in the U.S. There are four measures of DSM activity in this data set: (1) utility expenditures on DSM programs; (2) energy savings by DSM program participants; and (3) the actual and (4) the potential reductions in peak load resulting from utility DSM measures. Each is used as the dependent variable in an econometric analysis where independent variables include various utility characteristics, regulatory characteristics, and service territory and customer characteristics. In general, the results from the econometric analysis suggest that in 1993, DSM activity was primarily the result of regulatory pressure. All of the evidence suggests that if DSM continues to

  2. Integrated EAP/Managed Behavioral Health Plan Utilization by Persons with Substance Use Disorders

    Science.gov (United States)

    Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard

    2011-01-01

    New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioral health care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. PMID:21185684

  3. Exploration and mining - Report 800C. Predevelopment studies for mine methane management and utilization

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    Since 1999 Japan and Australia have been engaged in a 5-year predevelopment study of mine methane management and utilization. The effort aims to develop a technique to recover and utilize the greenhouse gas that escapes during coal mining for a decrease in the environmental impact of coal mining and to develop a technique to simulate the behavior of gas during coal mining. Understanding gas behavior will be useful in formulating a plan for optimum mine methane management and utilization in a newly developed mining zone. Technology transfer and interchangeability were considered and the Hunter Valley, New South Wales, was chosen as the experiment site. Tasks to discharge in fiscal 2000 were (1) collection of data on resources, technology, and the trend of Government policy and regulations, (2) measurement of stress and gas permeability and the assessment of mechanical strength of rock and coal at specified spots in the mining zone, (3) 3-dimensional gasping of the Wambo coal mine geography from the standpoints of geology and civil engineering, grasping of gas characteristics, and modelling and (4) the development of gas and rock behavior grasping technology for use during coal mining. (NEDO)

  4. Dynamic Power Management for Portable Hybrid Power-Supply Systems Utilizing Approximate Dynamic Programming

    Directory of Open Access Journals (Sweden)

    Jooyoung Park

    2015-05-01

    Full Text Available Recently, the optimization of power flows in portable hybrid power-supply systems (HPSSs has become an important issue with the advent of a variety of mobile systems and hybrid energy technologies. In this paper, a control strategy is considered for dynamically managing power flows in portable HPSSs employing batteries and supercapacitors. Our dynamic power management strategy utilizes the concept of approximate dynamic programming (ADP. ADP methods are important tools in the fields of stochastic control and machine learning, and the utilization of these tools for practical engineering problems is now an active and promising research field. We propose an ADP-based procedure based on optimization under constraints including the iterated Bellman inequalities, which can be solved by convex optimization carried out offline, to find the optimal power management rules for portable HPSSs. The effectiveness of the proposed procedure is tested through dynamic simulations for smartphone workload scenarios, and simulation results show that the proposed strategy can successfully cope with uncertain workload demands.

  5. The influence of system interactivity and technical support on learning management system utilization

    Directory of Open Access Journals (Sweden)

    Sousan Baleghi-Zadeh

    2017-03-01

    Full Text Available In recent years, there has been a growing increase in using Learning Management System (LMS by universities. However, its utilization by students is limited in Malaysia. The main purpose of the present study is to develop and test a model that predicts LMS utilization by Malaysian higher education students. Based on the Technology Acceptance Model, the study investigated the relationships among six constructs (system interactivity, technical support, perceived ease of use, perceived usefulness, behavioral intention to use and LMS use through structural equation modelling. The participants were 216 undergraduate students from a local university in Malaysia. The result of the study revealed that system interactivity had a significant effect on perceived usefulness, but not on perceived ease of use; technical support had a significant effect on perceived ease of use, but not on perceived usefulness.

  6. Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

    2017-01-01

    Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct

  7. Line Program Environmental Management Audit: Formerly Utilized Sites Remedial Action Program

    International Nuclear Information System (INIS)

    1992-05-01

    This report documents the results of the Line Program Environmental Management Audit completed for the Formerly Utilized Sites Remedial Action Program (FUSRAP). During this Audit, activities and records were reviewed and personnel interviewed at Oak Ridge, Tennessee. Additionally, since FUSRAP falls under the responsibility of the Office of the Assistant Secretary for Environmental Restoration and Waste Management, selected individuals from this office were interviewed in Washington, DC and Germantown, Maryland. The onsite portion of the FUSRAP Audit was conducted from March 16 through 27, 1992, by the US Department of Energy's Office of Environmental Audit (EH-24) located within the Office of the Assistant Secretary for Environment, Safety and Health (EH-1). The scope of the FUSRAP Line Program Environmental Management Audit was comprehensive and included all areas of environmental management with the exception of the National Environmental Policy Act (NEPA). Since the subject of compliance with and implementation of the requirements of NEPA is the responsibility of the DOE Headquarters Office of NEPA Oversight, management issues pertaining to NEPA were not investigated as part of this Audit

  8. Flash memory management system and method utilizing multiple block list windows

    Science.gov (United States)

    Chow, James (Inventor); Gender, Thomas K. (Inventor)

    2005-01-01

    The present invention provides a flash memory management system and method with increased performance. The flash memory management system provides the ability to efficiently manage and allocate flash memory use in a way that improves reliability and longevity, while maintaining good performance levels. The flash memory management system includes a free block mechanism, a disk maintenance mechanism, and a bad block detection mechanism. The free block mechanism provides efficient sorting of free blocks to facilitate selecting low use blocks for writing. The disk maintenance mechanism provides for the ability to efficiently clean flash memory blocks during processor idle times. The bad block detection mechanism provides the ability to better detect when a block of flash memory is likely to go bad. The flash status mechanism stores information in fast access memory that describes the content and status of the data in the flash disk. The new bank detection mechanism provides the ability to automatically detect when new banks of flash memory are added to the system. Together, these mechanisms provide a flash memory management system that can improve the operational efficiency of systems that utilize flash memory.

  9. Knowledge management of eco-industrial park for efficient energy utilization through ontology-based approach

    International Nuclear Information System (INIS)

    Zhang, Chuan; Romagnoli, Alessandro; Zhou, Li; Kraft, Markus

    2017-01-01

    Highlights: •An intelligent energy management system for Eco-Industrial Park (EIP) is proposed. •An explicit domain ontology for EIP energy management is designed. •Ontology-based approach can increase knowledge interoperability within EIP. •Ontology-based approach can allow self-optimization without human intervention in EIP. •The proposed system harbours huge potential in the future scenario of Internet of Things. -- Abstract: An ontology-based approach for Eco-Industrial Park (EIP) knowledge management is proposed in this paper. The designed ontology in this study is formalized conceptualization of EIP. Based on such an ontological representation, a Knowledge-Based System (KBS) for EIP energy management named J-Park Simulator (JPS) is developed. By applying JPS to the solution of EIP waste heat utilization problem, the results of this study show that ontology is a powerful tool for knowledge management of complex systems such as EIP. The ontology-based approach can increase knowledge interoperability between different companies in EIP. The ontology-based approach can also allow intelligent decision making by using disparate data from remote databases, which implies the possibility of self-optimization without human intervention scenario of Internet of Things (IoT). It is shown through this study that KBS can bridge the communication gaps between different companies in EIP, sequentially more potential Industrial Symbiosis (IS) links can be established to improve the overall energy efficiency of the whole EIP.

  10. Cost-Utility Analysis: Sartorius Flap versus Negative Pressure Therapy for Infected Vascular Groin Graft Managment.

    Science.gov (United States)

    Chatterjee, Abhishek; Macarios, David; Griffin, Leah; Kosowski, Tomasz; Pyfer, Bryan J; Offodile, Anaeze C; Driscoll, Daniel; Maddali, Sirish; Attwood, John

    2015-11-01

    Sartorius flap coverage and adjunctive negative pressure wound therapy (NPWT) have been described in managing infected vascular groin grafts with varying cost and clinical success. We performed a cost-utility analysis comparing sartorius flap with NPWT in managing an infected vascular groin graft. A literature review compiling outcomes for sartorius flap and NPWT interventions was conducted from peer-reviewed journals in MEDLINE (PubMed) and EMBASE. Utility scores were derived from expert opinion and used to estimate quality-adjusted life years (QALYs). Medicare current procedure terminology and diagnosis-related groups codes were used to assess the costs for successful graft salvage with the associated complications. Incremental cost-effectiveness was assessed at $50,000/QALY, and both univariate and probabilistic sensitivity analyses were conducted to assess robustness of the conclusions. Thirty-two studies were used pooling 384 patients (234 sartorius flaps and 150 NPWT). NPWT had better clinical outcomes (86.7% success rate, 0.9% minor complication rate, and 13.3% major complication rate) than sartorius flap (81.6% success rate, 8.0% minor complication rate, and 18.4% major complication rate). NPWT was less costly ($12,366 versus $23,516) and slightly more effective (12.06 QALY versus 12.05 QALY) compared with sartorius flap. Sensitivity analyses confirmed the robustness of the base case findings; NPWT was either cost-effective at $50,000/QALY or dominated sartorius flap in 81.6% of all probabilistic sensitivity analyses. In our cost-utility analysis, use of adjunctive NPWT, along with debridement and antibiotic treatment, for managing infected vascular groin graft wounds was found to be a more cost-effective option when compared with sartorius flaps.

  11. Removal of uranium and priority pollutant metals from Fernald Environmental Management Project wastewater utilizing potassium ferrate

    International Nuclear Information System (INIS)

    Hampshire, Lyle H.; Potts, Michael E.

    1992-01-01

    A side-by-side treatment comparison between calcium hydroxide and TRU/Clear '4', a potassium ferrate based wastewater treatment chemical, was performed in a process wastewater and stormwater treatment facility. Results from the full-scale plant testing demonstrated that potassium ferrate could achieve the same treatment levels as calcium hydroxide while generating 55% less sludge than the calcium hydroxide treatment. The testing also showed that utilization of potassium ferrate would minimize the volume of sludge generated and assist in the reduction of total waste management costs associated with storage, monitoring, transportation, and final disposition of generated sludge. (author)

  12. Principles of Selection, Implementation and Utilization of RFID in Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Juraj Vaculik

    2009-01-01

    Full Text Available The paper deals with RFID (Radio Frequency Identificationimplementation and utilization within supply chain managementand also includes the economic feasibility of rollingout RFID. The members of the supply chain networks- suppliers,manufacturers and distributors - will operate independentlyfrom one another and according to their own agendas.This type of unmanaged network, howeve1; results in inefficiencies.The manufacturer might have a goal of maximizing productionin order to minimize unit costs. Clearly, all members ofthe supply chain stand to gain by coordinating their efforts toimprove efficiency and overall supply chain performance. Thisarticle is divided into three parts: Supply chain, Economic feasibilityof rolling out RFID and Processes of Supply chain management.

  13. Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

    Science.gov (United States)

    Korbel, Lindsey; Spencer, John David

    2015-03-01

    The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Business Model Innovation for Local Energy Management: A Perspective from Swiss Utilities

    Energy Technology Data Exchange (ETDEWEB)

    Facchinetti, Emanuele, E-mail: emanuele.facchinetti@hslu.ch [Lucerne Competence Center for Energy Research, Lucerne University of Applied Science and Arts, Horw (Switzerland); Eid, Cherrelle [Faculty of Technology, Policy and Management, Delft University of Technology, Delft (Netherlands); Bollinger, Andrew [Urban Energy Systems Laboratory, EMPA, Dübendorf (Switzerland); Sulzer, Sabine [Lucerne Competence Center for Energy Research, Lucerne University of Applied Science and Arts, Horw (Switzerland)

    2016-08-04

    The successful deployment of the energy transition relies on a deep reorganization of the energy market. Business model innovation is recognized as a key driver of this process. This work contributes to this topic by providing to potential local energy management (LEM) stakeholders and policy makers a conceptual framework guiding the LEM business model innovation. The main determinants characterizing LEM concepts and impacting its business model innovation are identified through literature reviews on distributed generation typologies and customer/investor preferences related to new business opportunities emerging with the energy transition. Afterwards, the relation between the identified determinants and the LEM business model solution space is analyzed based on semi-structured interviews with managers of Swiss utilities companies. The collected managers’ preferences serve as explorative indicators supporting the business model innovation process and provide insights into policy makers on challenges and opportunities related to LEM.

  15. Business Model Innovation for Local Energy Management: A Perspective from Swiss Utilities

    International Nuclear Information System (INIS)

    Facchinetti, Emanuele; Eid, Cherrelle; Bollinger, Andrew; Sulzer, Sabine

    2016-01-01

    The successful deployment of the energy transition relies on a deep reorganization of the energy market. Business model innovation is recognized as a key driver of this process. This work contributes to this topic by providing to potential local energy management (LEM) stakeholders and policy makers a conceptual framework guiding the LEM business model innovation. The main determinants characterizing LEM concepts and impacting its business model innovation are identified through literature reviews on distributed generation typologies and customer/investor preferences related to new business opportunities emerging with the energy transition. Afterwards, the relation between the identified determinants and the LEM business model solution space is analyzed based on semi-structured interviews with managers of Swiss utilities companies. The collected managers’ preferences serve as explorative indicators supporting the business model innovation process and provide insights into policy makers on challenges and opportunities related to LEM.

  16. A Review on Landfill Management in the Utilization of Plastic Waste as an Alternative Fuel

    Directory of Open Access Journals (Sweden)

    Hidayah Nurul

    2018-01-01

    Full Text Available Wastes from landfills originate from many spheres of life. These are produces as a result of human activities either domestically or industrially. The global plastic production increased over years due to the vast applications of plastics in many sectors. The continuous demand of plastics caused the plastic wastes accumulation in the landfill consumed a lot of spaces that contributed to the environmental. In addition, economic growth and development also increased our demand and dependency on plastics which leads to its accumulation in landfills imposing risk on human health, animals and cause environmental pollution problems such as ground water contamination, sanitary related issues, etc. The management and disposal of plastic waste have become a major concern, especially in developing cities. The idea of waste to energy recovery is one of the promising techniques used for managing the waste of plastic. Hence, this paper aims review at utilizing of plastic as an alternative fuel.

  17. Environmental auditing: Capabilities and management utility of recreation impact monitoring programs

    Science.gov (United States)

    Marion, J.L.

    1995-01-01

    A recreation impact monitoring system was developed and applied in 1984?1986 and in 1991 to all backcountry river-accessed campsites within Delaware Water Gap National Recreation Area, Pennsylvania and New Jersey. Results suggest that actions implemented by park managers in response to problems identified by the initial survey were highly effective in reducing resource degradation caused by camping. In particular, the elimination of some designated campsites and installation of anchored firegrates reduced the total area of disturbance by 50%. Firegrate installation provided a focal point that increased the concentration of camping activities, allowing peripheral areas to recover. As suggested by predictive models, additional resource degradation caused by increased camping intensities is more than offset by improvements in the condition of areas where use is eliminated. The capabilities and management utility of recreation impact monitoring programs, illustrated by the Delaware Water Gap monitoring program, are also presented and discussed.

  18. Progress and problems in the Formerly Utilized Sites Remedial Action Program and Surplus Facilities Management Program

    International Nuclear Information System (INIS)

    Fiore, J.J.; Turi, G.P.

    1988-01-01

    The Formerly Utilized Sites Remedial Action Program (FUSRAP) was established in 1974 to identify, evaluate, and as appropriate, conduct remedial actions at sites used in the early years of nuclear energy development by the Manhattan Engineer District and the Atomic Energy Commission (AEC). This program currently has 29 sites and is evaluating 350 other sites for possible inclusion in the program. Another remedial action program in the Department of Energy's (DOE) Division of Facility and Site Decommissioning Projects is the Surplus Facilities Management Program (SFMP). The SFMP involves the safe management, decontamination and disposal of surplus DOE contaminated facilities which were not related to defense activities. There are currently 33 projects at 15 different sites in the program. These two programs have made steady progress over the last 10 or so years in cleaning up sites so that they can be reused or released for unrestricted use. Work has been completed at 8 of the FUSRAP sites and three of the SFMP sites

  19. Optimization of workflow scheduling in Utility Management System with hierarchical neural network

    Directory of Open Access Journals (Sweden)

    Srdjan Vukmirovic

    2011-08-01

    Full Text Available Grid computing could be the future computing paradigm for enterprise applications, one of its benefits being that it can be used for executing large scale applications. Utility Management Systems execute very large numbers of workflows with very high resource requirements. This paper proposes architecture for a new scheduling mechanism that dynamically executes a scheduling algorithm using feedback about the current status Grid nodes. Two Artificial Neural Networks were created in order to solve the scheduling problem. A case study is created for the Meter Data Management system with measurements from the Smart Metering system for the city of Novi Sad, Serbia. Performance tests show that significant improvement of overall execution time can be achieved by Hierarchical Artificial Neural Networks.

  20. A Review on Landfill Management in the Utilization of Plastic Waste as an Alternative Fuel

    Science.gov (United States)

    Hidayah, Nurul; Syafrudin

    2018-02-01

    Wastes from landfills originate from many spheres of life. These are produces as a result of human activities either domestically or industrially. The global plastic production increased over years due to the vast applications of plastics in many sectors. The continuous demand of plastics caused the plastic wastes accumulation in the landfill consumed a lot of spaces that contributed to the environmental. In addition, economic growth and development also increased our demand and dependency on plastics which leads to its accumulation in landfills imposing risk on human health, animals and cause environmental pollution problems such as ground water contamination, sanitary related issues, etc. The management and disposal of plastic waste have become a major concern, especially in developing cities. The idea of waste to energy recovery is one of the promising techniques used for managing the waste of plastic. Hence, this paper aims review at utilizing of plastic as an alternative fuel.

  1. Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

    Science.gov (United States)

    Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

    2011-04-01

    New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. What is heartburn worth? A cost-utility analysis of management strategies.

    Science.gov (United States)

    Heudebert, G R; Centor, R M; Klapow, J C; Marks, R; Johnson, L; Wilcox, C M

    2000-03-01

    To determine the best treatment strategy for the management of patients presenting with symptoms consistent with uncomplicated heartburn. We performed a cost-utility analysis of 4 alternatives: empirical proton pump inhibitor, empirical histamine2-receptor antagonist, and diagnostic strategies consisting of either esophagogastroduodenoscopy (EGD) or an upper gastrointestinal series before treatment. The time horizon of the model was 1 year. The base case analysis assumed a cohort of otherwise healthy 45-year-old individuals in a primary care practice. Empirical treatment with a proton pump inhibitor was projected to provide the greatest quality-adjusted survival for the cohort. Empirical treatment with a histamine2 receptor antagonist was projected to be the least costly of the alternatives. The marginal cost-effectiveness of using a proton pump inhibitor over a histamine2-receptor antagonist was approximately $10,400 per quality-adjusted life year (QALY) gained in the base case analysis and was less than $50,000 per QALY as long as the utility for heartburn was less than 0.95. Both diagnostic strategies were dominated by proton pump inhibitor alternative. Empirical treatment seems to be the optimal initial management strategy for patients with heartburn, but the choice between a proton pump inhibitor or histamine2-receptor antagonist depends on the impact of heartburn on quality of life.

  3. Longitudinal analysis on utilization of medical document management system in a hospital with EPR implementation.

    Science.gov (United States)

    Kuwata, Shigeki; Yamada, Hitomi; Park, Keunsik

    2011-01-01

    Document management systems (DMS) have widespread in major hospitals in Japan as a platform to digitize the paper-based records being out of coverage by EPR. This study aimed to examine longitudinal trends of actual use of DMS in a hospital in which EPR had been in operation, which would be conducive to planning the further information management system in the hospital. Degrees of utilization of electronic documents and templates with DMS were analyzed based on data extracted from a university-affiliated hospital with EPR. As a result, it was found that the number of electronic documents as well as scanned documents circulating at the hospital tended to increase. The result indicated that replacement of paper-based documents with electronic documents did not occur. Therefore it was anticipated that the need for DMS would continue to increase in the hospital. The methods used this study to analyze the trend of DMS utilization would be applicable to other hospitals with with a variety of DMS implementation, such as electronic storage by scanning documents or paper preservation that is compatible with EPR.

  4. Urban water infrastructure asset management - a structured approach in four water utilities.

    Science.gov (United States)

    Cardoso, M A; Silva, M Santos; Coelho, S T; Almeida, M C; Covas, D I C

    2012-01-01

    Water services are a strategic sector of large social and economic relevance. It is therefore essential that they are managed rationally and efficiently. Advanced water supply and wastewater infrastructure asset management (IAM) is key in achieving adequate levels of service in the future, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution. This paper presents a methodology for supporting the development of urban water IAM, developed during the AWARE-P project as well as an appraisal of its implementation in four water utilities. Both water supply and wastewater systems were considered. Due to the different contexts and features of the utilities, the main concerns vary from case to case; some problems essentially are related to performance, others to risk. Cost is a common deciding factor. The paper describes the procedure applied, focusing on the diversity of drivers, constraints, benefits and outcomes. It also points out the main challenges and the results obtained through the implementation of a structured procedure for supporting urban water IAM.

  5. Variability in blood and blood component utilization as assessed by an anesthesia information management system.

    Science.gov (United States)

    Frank, Steven M; Savage, Will J; Rothschild, Jim A; Rivers, Richard J; Ness, Paul M; Paul, Sharon L; Ulatowski, John A

    2012-07-01

    Data can be collected for various purposes with anesthesia information management systems. The authors describe methods for using data acquired from an anesthesia information management system to assess intraoperative utilization of blood and blood components. Over an 18-month period, data were collected on 48,086 surgical patients at a tertiary care academic medical center. All data were acquired with an automated anesthesia recordkeeping system. Detailed reports were generated for blood and blood component utilization according to surgical service and surgical procedure, and for individual surgeons and anesthesiologists. Transfusion hemoglobin trigger and target concentrations were compared among surgical services and procedures, and between individual medical providers. For all patients given erythrocytes, the mean transfusion hemoglobin trigger was 8.4 ± 1.5, and the target was 10.2 ± 1.5 g/dl. Variation was significant among surgical services (trigger range: 7.5 ± 1.2-9.5 ± 1.1, P = 0.0001; target range: 9.1 ± 1.2-11.3 ± 1.4 g/dl, P = 0.002), surgeons (trigger range: 7.2 ± 0.7-9.8 ± 1.0, P = 0.001; target range: 8.8 ± 0.9-11.8 ± 1.3 g/dl, P = 0.001), and anesthesiologists (trigger range: 7.2 ± 0.8-9.6 ± 1.2, P = 0.001; target range: 9.0 ± 0.9-11.7 ± 1.3 g/dl, P = 0.0004). The use of erythrocyte salvage, fresh frozen plasma, and platelets varied threefold to fourfold among individual surgeons compared with their peers performing the same surgical procedure. The use of data acquired from an anesthesia information management system allowed a detailed analysis of blood component utilization, which revealed significant variation among surgical services and surgical procedures, and among individual anesthesiologists and surgeons compared with their peers. Incorporating these methods of data acquisition and analysis into a blood management program could reduce unnecessary transfusions, an outcome that may increase patient safety and reduce costs.

  6. Utilization technique of 'radiation management manual in medical field (2012).' What should be learnt from the Fukushima nuclear accident

    International Nuclear Information System (INIS)

    Kikuchi, Toru

    2014-01-01

    From the abstract of contents of the 'Radiation management manual in medical field (2012),' the utilization technique of the manual is introduced. Introduced items are as follows: (1) Exposure management; exposure management for radiation medical workers, patients, and citizens in the medical field, and exposure management for radiation workers and citizens involved in the emergency work related to the Fukushima nuclear accident, (2) Health management; health management for radiation medical workers, (3) Radiation education: Education/training for radiation medical workers, and radiation education for health care workers, (4) Accident and emergency measures; emergency actions involved in the radiation accidents and radiation medicine at medical facilities

  7. Optimal Computing Resource Management Based on Utility Maximization in Mobile Crowdsourcing

    Directory of Open Access Journals (Sweden)

    Haoyu Meng

    2017-01-01

    Full Text Available Mobile crowdsourcing, as an emerging service paradigm, enables the computing resource requestor (CRR to outsource computation tasks to each computing resource provider (CRP. Considering the importance of pricing as an essential incentive to coordinate the real-time interaction among the CRR and CRPs, in this paper, we propose an optimal real-time pricing strategy for computing resource management in mobile crowdsourcing. Firstly, we analytically model the CRR and CRPs behaviors in form of carefully selected utility and cost functions, based on concepts from microeconomics. Secondly, we propose a distributed algorithm through the exchange of control messages, which contain the information of computing resource demand/supply and real-time prices. We show that there exist real-time prices that can align individual optimality with systematic optimality. Finally, we also take account of the interaction among CRPs and formulate the computing resource management as a game with Nash equilibrium achievable via best response. Simulation results demonstrate that the proposed distributed algorithm can potentially benefit both the CRR and CRPs. The coordinator in mobile crowdsourcing can thus use the optimal real-time pricing strategy to manage computing resources towards the benefit of the overall system.

  8. Designing management strategies for carbon dioxide storage and utilization under uncertainty using inexact modelling

    Science.gov (United States)

    Wang, Yu; Fan, Jie; Xu, Ye; Sun, Wei; Chen, Dong

    2017-06-01

    Effective application of carbon capture, utilization and storage (CCUS) systems could help to alleviate the influence of climate change by reducing carbon dioxide (CO2) emissions. The research objective of this study is to develop an equilibrium chance-constrained programming model with bi-random variables (ECCP model) for supporting the CCUS management system under random circumstances. The major advantage of the ECCP model is that it tackles random variables as bi-random variables with a normal distribution, where the mean values follow a normal distribution. This could avoid irrational assumptions and oversimplifications in the process of parameter design and enrich the theory of stochastic optimization. The ECCP model is solved by an equilibrium change-constrained programming algorithm, which provides convenience for decision makers to rank the solution set using the natural order of real numbers. The ECCP model is applied to a CCUS management problem, and the solutions could be useful in helping managers to design and generate rational CO2-allocation patterns under complexities and uncertainties.

  9. Appraising longitudinal trends in the strategic risks cited by risk managers in the international water utility sector, 2005-2015.

    Science.gov (United States)

    Chalker, Rosemary T C; Pollard, Simon J T; Leinster, Paul; Jude, Simon

    2018-03-15

    We report dynamic changes in the priorities for strategic risks faced by international water utilities over a 10year period, as cited by managers responsible for managing them. A content analysis of interviews with three cohorts of risk managers in the water sector was undertaken. Interviews probed the focus risk managers' were giving to strategic risks within utilities, as well as specific questions on risk analysis tools (2005); risk management cultures (2011) and the integration of risk management with corporate decision-making (2015). The coding frequency of strategic (business, enterprise, corporate) risk terms from 18 structured interviews (2005) and 28 semi-structured interviews (12 in 2011; 16 in 2015) was used to appraise changes in the perceived importance of strategic risks within the sector. The aggregated coding frequency across the study period, and changes in the frequency of strategic risks cited at three interview periods identified infrastructure assets as the most significant risk over the period and suggests an emergence of extrinsic risk over time. Extended interviews with three utility risk managers (2016) from the UK, Canada and the US were then used to contextualise the findings. This research supports the ongoing focus on infrastructure resilience and the increasing prevalence of extrinsic risk within the water sector, as reported by the insurance sector and by water research organisations. The extended interviews provided insight into how strategic risks are now driving the implementation agenda within utilities, and into how utilities can secure tangible business value from proactive risk governance. Strategic external risks affecting the sector are on the rise, involve more players and are less controllable from within a utility's own organisational boundaries. Proportionate risk management processes and structures provide oversight and assurance, whilst allowing a focus on the tangible business value that comes from managing strategic

  10. Management of End-Stage Ankle Arthritis: Cost-Utility Analysis Using Direct and Indirect Costs.

    Science.gov (United States)

    Nwachukwu, Benedict U; McLawhorn, Alexander S; Simon, Matthew S; Hamid, Kamran S; Demetracopoulos, Constantine A; Deland, Jonathan T; Ellis, Scott J

    2015-07-15

    Total ankle replacement and ankle fusion are costly but clinically effective treatments for ankle arthritis. Prior cost-effectiveness analyses for the management of ankle arthritis have been limited by a lack of consideration of indirect costs and nonoperative management. The purpose of this study was to compare the cost-effectiveness of operative and nonoperative treatments for ankle arthritis with inclusion of direct and indirect costs in the analysis. Markov model analysis was conducted from a health-systems perspective with use of direct costs and from a societal perspective with use of direct and indirect costs. Costs were derived from the 2012 Nationwide Inpatient Sample (NIS) and expressed in 2013 U.S. dollars; effectiveness was expressed in quality-adjusted life years (QALYs). Model transition probabilities were derived from the available literature. The principal outcome measure was the incremental cost-effectiveness ratio (ICER). In the direct-cost analysis for the base case, total ankle replacement was associated with an ICER of $14,500/QALY compared with nonoperative management. When indirect costs were included, total ankle replacement was both more effective and resulted in $5900 and $800 in lifetime cost savings compared with the lifetime costs following nonoperative management and ankle fusion, respectively. At a $100,000/QALY threshold, surgical management of ankle arthritis was preferred for patients younger than ninety-six years and total ankle replacement was increasingly more cost-effective in younger patients. Total ankle replacement, ankle fusion, and nonoperative management were the preferred strategy in 83%, 12%, and 5% of the analyses, respectively; however, our model was sensitive to patient age, the direct costs of total ankle replacement, the failure rate of total ankle replacement, and the probability of arthritis after ankle fusion. Compared with nonoperative treatment for the management of end-stage ankle arthritis, total ankle

  11. EVALUATION OF UTILIZING SERVICE ORIENTED ARCHITECTURE AS A SUITABLE SOLUTION TO ALIGN UNIVERSITY MANAGEMENT INFORMATION SYSTEMS AND LEARNING MANAGEMENT SYSTEMS

    Directory of Open Access Journals (Sweden)

    A. M. RIAD

    2009-10-01

    Full Text Available To help universities achieve their goals, it is important to align managerial functionalities side by side with educational aspects. Universities consume University Management Information Systems (UMIS to handle managerial aspects as they do with Learning Management Systems (LMS to achieve learning objectives. UMIS advances LMS by decades and has reached stable and mature consistency level. LMS is the newly acquired solution in Universities; compared to UMIS, and so adopting LMSs in universities can be achieved via three different deployment approaches. First approach believes in LMS ability to replace UMIS and performing its functionalities. Second approach presents the idea of extending UMIS to include LMS functionalities. Third approach arises from the shortages of the two proposed approaches and present integration between both as the appropriate deployment approach. Service Oriented Architecture (SOA is a design pattern that can be used as a suitable architectural solution to align UMIS and LMS. SOA can be utilized in universities to overcome some of information systems’ challenges like the integration between UMIS and LMS. This paper presents the current situation at Mansoura University; Egypt, presents integration as the most suitable solution, and evaluates three different implementation techniques: Dynamic Query, Stored Procedure, and Web services. Evaluation concludes that though SOA enhanced many different aspects of both UMIS and LMS; and consequently university overall. It is not recommended to adopt SOA via Web services as the building unit of the system, but as the interdisciplinary interface between systems.

  12. Role of transportation in the utilities' management of spent fuel storage

    International Nuclear Information System (INIS)

    Newman, D.F.

    1985-01-01

    Additional spent fuel storage can be provided by using a combination of wet and dry storage technologies, with the technology or technologies used in any specific instance being determined by the particular circumstances involved. The capability for spent fuel storage at a reactor site can be enhanced using any one or a combination of the following: expansion of existing pool storage capacity; more efficient use of available capacity; and addition of an independent spent fuel storage installation (ISFSI). Each of these methods, which are described more fully below, have characteristics that may make them more or less suitable for use, depending on the nuclear power plant where they will be deployed, the magnitude of the need for additional storage, the utility's overall spent fuel management strategy, and other factors. 15 refs., 2 figs., 2 tabs

  13. Non-utility generation and demand management reliability of customer delivery systems

    International Nuclear Information System (INIS)

    Hamoud, G.A.; Wang, L.

    1995-01-01

    A probabilistic methodology for evaluating the impact of non-utility generation (NUG) and demand management programs (DMP) on supply reliability of customer delivery systems was presented. The proposed method was based on the criteria that the supply reliability to the customers on the delivery system should not be affected by the integration of either NUG or DMPs. The method considered station load profile, load forecast, and uncertainty in size and availability of the nuio. Impacts on system reliability were expressed in terms of possible delays of the in-service date for new facilities or in terms of an increase in the system load carrying capability. Examples to illustrate the proposed methodology were provided. 10 refs., 8 tabs., 2 figs

  14. [Guidelines for the diagnosis and management of thyroid disease and their utility].

    Science.gov (United States)

    Hashimoto, Koshi; Mori, Masatomo

    2012-11-01

    Thyroid dysfunction is a common disorder in daily clinical practice, however due to unspecific and diverse symptoms of the disease, it is sometimes hard to make a definite diagnosis. Japan thyroid association (JTA) published 'Guideline for the diagnosis of thyroid disease, 2010' and it is open to the public on the JTA website(http : //www.japanthyroid.jp/doctor/ guideline/japanese.html). English version of the guideline is also available. JTA also published 'Guideline for the management of subclinical hypothyroidism 2008' and 'Guideline for the diagnosis of thyroid storm, version 2'. The latter in English version has been published in Thyroid(http : //www.ncbi.nlm.nih.gov/pubmed/22494618). The utility of these guidelines is discussed.

  15. Spent fuel storage requirements for nuclear utilities and OCRWM [Office of Civilian Radioactive Waste Management

    International Nuclear Information System (INIS)

    Wood, T.W.

    1990-03-01

    Projected spent fuel generation at US power reactors exceeds estimated aggregate pool storage capacity by approximately 30,000 metric tons of uranium (MTU). Based on the current repository schedule, little of the spent fuel inventory will be disposed of prior to shutdown of existing reactors, and a large additional capacity for surface storage of spent fuel will be required, either at reactors or at a centralized DOE storage site. Allocation of this storage requirement across the utility-DOE interface, and the resulting implications for reactor sites and the performance of the federal waste management system, were studied during the DOE MRS System Study and again subsequent to the reassessment of the repository schedule. Spent fuel logistics and cost results from these analyses will be used in definition of spent fuel storage capacity requirements for the federal system. 9 refs., 8 figs., 1 tab

  16. Turbo Charge CPU Utilization in Fork/Join Using the ManagedBlocker

    CERN Multimedia

    CERN. Geneva

    2017-01-01

    Fork/Join is a framework for parallelizing calculations using recursive decomposition, also called divide and conquer. These algorithms occasionally end up duplicating work, especially at the beginning of the run. We can reduce wasted CPU cycles by implementing a reserved caching scheme. Before a task starts its calculation, it tries to reserve an entry in the shared map. If it is successful, it immediately begins. If not, it blocks until the other thread has finished its calculation. Unfortunately this might result in a significant number of blocked threads, decreasing CPU utilization. In this talk we will demonstrate this issue and offer a solution in the form of the ManagedBlocker. Combined with the Fork/Join, it can keep parallelism at the desired level.

  17. Study of the Korean anthracite for utilization and the coal mine data management

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    This report consists of two articles. (1) Petrographic study of the Korean anthracite for utilization (5): This research was initiated for the development of filtering materials those can be used in waste water treatment sites The small scale of filtration tester was built on the waste water treatment site of Chungjoo electric Co. to use waste water processed by purifying system for the feasibility study. (2) Study of the closed coal mine data management: Underground maps about 1700 adits of 100 coal mines, and related graphic data have been collected in the database. And all those data were entered into the database in vectorial form, coordinates obtaining from the digitizing tablet. Detailed works are described in the other report, including the discussions of graphic database and data handling of graphical mine data. Comments about the GIS is also provided in the volume. (author). 25 refs., 45 figs., 50 tabs., 3 maps.

  18. Genetics and Genomics: Discovery, Validation, and Utility of Novel Tools for management of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Alan W. Shindel

    2017-01-01

    Full Text Available Genomics is the science of how genes influence human health and disease states. It differs from traditional genetic screening in that the transcriptional activity (or other markers in full panels of related genes are studied. Compared to simple genetic testing, assessment of expression levels in a panel of genes provides a more nuanced and holistic understanding of genetic modulation of human disease. Genomic testing may be used to great effect in resolving controversial questions on detection and treatment of prostate cancer. Genomic tests are currently in use for numerous facets of prostate cancer care, including screening, biopsy, and treatment planning. The clinical validity (predictive capacity of these assays has been well established; studies on clinical utility (i.e. usefulness of these tests in guiding patient/provider decisions have shown promising results. Men’s health specialists should be familiar with the role genomic testing will play in contemporary management of prostate cancer.

  19. Understanding the economic burden of heart failure in China: impact on disease management and resource utilization.

    Science.gov (United States)

    Huang, Jun; Yin, Hongjun; Zhang, Milun; Ni, Qian; Xuan, Jianwei

    2017-05-01

    This study has two objectives: (1) to examine healthcare resource utilization in heart failure (HF) patients; and (2) to examine the treatment costs associated with HF in China. The data used in this study was from the 2014 national insurance database sponsored by the China Health Insurance Research Association (CHIRA), that covers national urban employees and residents. ICD-10 codes and keywords indicating heart failure diagnoses were used to identify patients with heart failure. Drug utilization, hospital visits, re-admission, and treatment costs in different service categories were examined. A total of 7,847 patients were included in this analysis, of which 1,157 patients had a 1-year complete follow-up period. In total, 48.16% of patients received the combination treatment of angiotensin-converting-enzyme inhibitor (ACEI)/angiotensin II receptor blockers (ARB) and beta-blockers (BB); and 22.87% of patients received the combination treatment of ACEI/ARB, beta-blockers and Mineralocorticoid receptor antagonists (MRAs). The annual treatment cost per patient with HF diagnosis was RMB 28,974, of which 66% was for inpatient care. The cost on HF medications accounted for 8.2% of annual cost. Treatment cost was much higher in provincial-level municipalities than that of prefecture-level and other cities. Hospitalization is a major driver of HF treatment cost. Compared to the requirements in international treatment guidelines, HF standard of care medication treatment was under-utilized among HF patients in China. The high re-admission rate among Chinese patients indicates that the management of HF needs to be improved. The percentage of GDP spent on treating HF patients was much lower than that in the developed countries.

  20. Anti-diabetic drug utilization of pregnant diabetic women in us managed care.

    Science.gov (United States)

    Knox, Caitlin A; Delaney, Joseph A C; Winterstein, Almut G

    2014-01-17

    With the increasing prevalence of type 2 diabetes in young adulthood, treatment of diabetes in pregnancy faces new challenges. Anti-diabetic drug utilization patterns of pregnant women with pre-existing diabetes are poorly described. We aim to describe anti-diabetic (AD) agent utilization among diabetic pregnant women. We utilized IMS LifeLink, including administrative claims data of patients in US managed care plans, to establish a retrospective cohort of women, age 18-46 years (N = 96,740) with billed procedures for a live birth, and a 12 month eligibility period before and 3 month after delivery. Diabetes mellitus was identified from ≥2 in- or outpatient claims with diagnoses (ICD-9-CM 250.XX) before pregnancy. We estimated the prevalence of AD drugs before, during and after pregnancy, and secular trends across the study period (1999-2009), using linear regression. A sensitivity analysis was conducted to identify the extent of misclassification of trimesters. Almost six percent (n = 5,581) of the live birth cohort had diabetes mellitus. Throughout the study, 48% (1999) and 78% (2009) (p metformin, sulfonylureas, thiazolidinediones (TZD), and combination AD. The annual prevalence of insulin use increased by only 1% from 39% (1999) to 40% (2009) (p = 0.589) during pregnancy, while use of sulfonylureas and metformin increased from 2.5% and 4.2% (1999) to 17.3% and 15.3% (2009) (p use steadily increased in prevalence from the 1st to 3rd trimester (16.5% and 3.3% to 33.0% and 7.5%), while metformin and TZD use decreased (11.4% and 1.6% to 3.8% and 0.2%). AD use during pregnancy demonstrates the need for additional investigation regarding safety and efficacy of AD drugs on maternal outcomes.

  1. Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital.

    Science.gov (United States)

    Konger, Raymond L; Ndekwe, Paul; Jones, Genea; Schmidt, Ronald P; Trey, Marty; Baty, Eric J; Wilhite, Denise; Munshi, Imtiaz A; Sutter, Bradley M; Rao, Maddamsetti; Bashir, Chowdry M

    2016-03-01

    To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team. Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged. Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care. Published by Oxford University Press on behalf of the American Society for Clinical Pathology, 2016. This work is written by US Government employees and is in the public domain in the US.

  2. Alternatives for management of wastes generated by the formerly utilized sites remedial action program and supplement

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Peterson, J.M.; Vocke, R.W.; Alexander, J.K.

    1983-03-01

    Alternatives for disposal or stabilization of the wastes generated by the US Department of Energy's Formerly Utilized Sites Remedial Action Program (FUSRAP) are identified and compared, with emphasis on the long-term aspects. These wastes consist of soil material and rubble containing trace amounts of radionuclides. A detailed pathway analysis for the dose to the maximally exposed individual is carried out using an adaptation of the natural analogue method. Comparisons of the different alternatives, based on the results of the pathway analysis and qualitative cost considerations, indicate that, if the hazard is such that the wastes must be removed and disposed of rather than stabilized in place, disposal by immediate dispersal is preferable to containment, and containment followed by slow planned dispersal is preferable to containment without dispersal. The Supplement presents refinements of work that was reported at the 1982 International Decommissioning Symposium. The new material consists of revisions of the estimates of the predicted potential dose to the maximally exposed individual and a more detailed comparative assessment of the radiological impacts of alternatives for management of wastes generated by the US Department of Energy's Formerly Utilized Sites Remedial Action Program (FUSRAP)

  3. Effects of Home Energy Management Systems on Distribution Utilities and Feeders Under Various Market Structure; NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, M.; Pratt, A.; Lunacek, M.; Mittal, S.; Wu, H.; Jones, W.

    2015-06-15

    The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is not well understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load. used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load.

  4. A Patient-Centered Emergency Department Management Strategy for Sickle-Cell Disease Super-Utilizers.

    Science.gov (United States)

    Simpson, Grant G; Hahn, Hallie R; Powel, Alex A; Leverence, Robert R; Morris, Linda A; Thompson, Lara G; Zumberg, Marc S; Borde, Deepa J; Tyndall, Joseph A; Shuster, Jonathan J; Yealy, Donald M; Allen, Brandon R

    2017-04-01

    A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily. We evaluated the effects of a single-site interventional study targeted at a population of adult sickle-cell disease super-utilizers using a pre- and post-implementation design. The pre-intervention period was 06/01/13 to 12/31/13 (seven months) and the post-intervention period was 01/01/14 to 02/28/15 (14 months). Our approach included patient-specific best practice advisories (BPA); an ED management protocol; and formation of a "medical home" for these patients. For 10 subjects targeted initially we developed and implemented coordinated care plans; after deployment, we observed a tendency toward reduction in ED and inpatient utilization across all measured indices. Between the annualized pre- and post-implementation periods we found the following: ED visits decreased by 16.5 visits/pt-yr (95% confidence interval [CI] [-1.32-34.2]); ED length of state (LOS) decreased by 115.3 hours/pt-yr (95% CI [-82.9-313.5]); in-patient admissions decreased by 4.20 admissions/pt-yr (95% CI [-1.73-10.1]); in-patient LOS decreased by 35.8 hours/pt-yr (95% CI [-74.9-146.7]); and visits where the patient left before treatment were reduced by an annualized total of 13.7 visits. We observed no patient mortality in our 10 subjects, and no patient required admission to the intensive care unit 72 hours following discharge. This effort suggests that a targeted approach is both feasible and potentially effective, laying a foundation for broader study.

  5. Modeling strategy to identify patients with primary immunodeficiency utilizing risk management and outcome measurement.

    Science.gov (United States)

    Modell, Vicki; Quinn, Jessica; Ginsberg, Grant; Gladue, Ron; Orange, Jordan; Modell, Fred

    2017-06-01

    This study seeks to generate analytic insights into risk management and probability of an identifiable primary immunodeficiency defect. The Jeffrey Modell Centers Network database, Jeffrey Modell Foundation's 10 Warning Signs, the 4 Stages of Testing Algorithm, physician-reported clinical outcomes, programs of physician education and public awareness, the SPIRIT® Analyzer, and newborn screening, taken together, generates P values of less than 0.05%. This indicates that the data results do not occur by chance, and that there is a better than 95% probability that the data are valid. The objectives are to improve patients' quality of life, while generating significant reduction of costs. The advances of the world's experts aligned with these JMF programs can generate analytic insights as to risk management and probability of an identifiable primary immunodeficiency defect. This strategy reduces the uncertainties related to primary immunodeficiency risks, as we can screen, test, identify, and treat undiagnosed patients. We can also address regional differences and prevalence, age, gender, treatment modalities, and sites of care, as well as economic benefits. These tools support high net benefits, substantial financial savings, and significant reduction of costs. All stakeholders, including patients, clinicians, pharmaceutical companies, third party payers, and government healthcare agencies, must address the earliest possible precise diagnosis, appropriate intervention and treatment, as well as stringent control of healthcare costs through risk assessment and outcome measurement. An affected patient is entitled to nothing less, and stakeholders are responsible to utilize tools currently available. Implementation offers a significant challenge to the entire primary immunodeficiency community.

  6. Utilizing a diabetic registry to manage diabetes in a low-income Asian American population.

    Science.gov (United States)

    Seto, Winnie; Turner, Barbara S; Champagne, Mary T; Liu, Lynn

    2012-08-01

    Racial and income disparities persist in diabetes management in America. One third of African and Hispanic Americans with diabetes receive the recommended diabetes services (hemoglobin A1c [A1c] testing, retinal and foot examinations) shown to reduce diabetes complications and mortality, compared to half of whites with diabetes. National data for Asian Americans are limited, but studies suggest that those with language and cultural barriers have difficulty accessing health services. A diabetic registry has been shown to improve process and clinical outcomes in a population with diabetes. This study examined whether a community center that serves primarily low-income Asian American immigrants in Santa Clara County, California, could improve diabetes care and outcomes by implementing a diabetic registry. The registry was built using the Access 2007 software program. A total of 580 patients with diabetes were identified by reviewing charts, the appointment database, and reimbursement records from Medicaid, Medicare, and private insurance companies. Utilizing the registry, medical assistants contacted patients for follow-up appointments, and medical providers checked and tracked the patients' A1c results. Among the 431 patients who returned for treatment, the mean A1c was reduced from 7.27% to 6.97% over 8 months (P<0.001). Although 10.8% of the patients changed from controlled to uncontrolled diabetes post intervention, 32.6% of patients with uncontrolled diabetes converted to controlled diabetes (P<0.001). The diabetes control rate improved from 47% to 59% at the end of the study. This study demonstrated that a diabetic registry is an effective tool to manage an underserved population with diabetes, thereby reducing disparities in diabetes management.

  7. The utility of screening in the design of trials for symptom management in cancer.

    Science.gov (United States)

    Jeon, Sangchoon; Given, Charles W; Sikorskii, Alla; Given, Barbara

    2009-10-01

    Clinical trials that test interventions for symptom management must target patients whose symptoms are severe and can benefit from participation. Screening symptoms for their severity prior to trial entry may be an important element of trial design. This research describes the utility of screening for severity of symptoms prior to entry into clinical trials for symptom management in cancer. To accomplish this, 601 cancer patients undergoing chemotherapy were assessed at screening and at the initial intervention contact, using the 0-10 rating scale for severity of nine symptoms. Post-test probabilities and likelihood ratios (LRs) were estimated across cut-offs in screening severity scores. Areas under receiver operating characteristic curves for reaching threshold of four at the initial intervention contact were estimated by a nonparametric method. It was found that screening severity scores were good predictors for identifying patients who would not reach threshold but did not always accurately predict patients who would. The cut-offs between 2 and 4 on a 0-10 scale could be used to identify patients that might benefit from receipt of interventions. For all symptoms, the LRs were greater than one across possible screening cut-offs. The findings indicate that decision rules based on screening prior to entry into cancer symptom management trials can provide reasonable discriminative accuracy by differentiating among patients who are likely to reach higher levels of severity later in the trial from those who are not. Optimal severity cut-offs can be established based on LRs and desired sensitivity and specificity.

  8. An Acuity Tool for Heart Failure Case Management: Quantifying Workload, Service Utilization, and Disease Severity.

    Science.gov (United States)

    Kilgore, Matthew D

    and practice application of the KHFCM Acuity Tool. Quality improvement outcomes included a more valid reflection of encounter times and demonstration of the KHFCM Acuity Tool as a reliable, practical, credible, and satisfying tool for reflecting HF case manager workloads and HF disease severity. The KHFCM Acuity Tool defines workload simply as a function of the number of HFCM services performed and the duration of time spent on a client encounter. The design of the tool facilitates the measure of workload, service utilization, and HF disease characteristics, independently from the overall measure of acuity, so that differences in individual case manager practice, as well as client characteristics within sites, across sites, and potentially throughout annual seasons, can be demonstrated. Data produced from long-term applications of the KHFCM Acuity Tool, across all regions, could serve as a driver for establishing systemwide HFCM productivity benchmarks or standards of practice for HF case managers. Data produced from localized applications could serve as a reference for coordinating staffing resources or developing HFCM productivity benchmarks within individual regions or sites.

  9. Utilizing a GPS-enabled fleet management system to improve safety through real-time personnel monitoring and asset management

    Energy Technology Data Exchange (ETDEWEB)

    Mavreas, M. [Bell Canada, Montreal, PQ (Canada)

    2005-07-01

    The telepod is a real-time dispatch, tracking and vehicle management system developed by Bell, which also allows remote access to company data. Advantages of the system were discussed in this power point presentation. It was suggested that the system offers increased efficiency, asset tracking and more accurate maintenance. Productivity improvements are made possible through real-time dispatching of orders, which results in improved customer service. Additional benefits of the system include fuel savings; trip reports to track vehicle start and stop times; and improved route changes through trip analysis. The system also enables the tracking of vehicles driven after work hours and on weekends. The generator tracking capability provides information on when generators are being moved as well as uptime for improved maintenance in addition to registering fuel levels to ensure business keeps running during a blackout. The vehicle management system is also capable of identifying under-utilized vehicles and can assist in the reduction of inactive vehicles as well as in a reduction of fuel consumption and harmful emissions by controlling idling time. Other advantages include maintenance eliminated mileage errors; an improved inspection program; remote diagnosis and prognostics; a reduction in downtime and costs associated with unnecessary vehicle breakdown; and reduced vehicle wear and tear. Among the safety features is a trigger for the dispatch of emergency vehicles. It was suggested that the lone worker device provides technicians with a sense of security, as well as ensuring greater consumer safety. It was concluded that Bell supports industry cooperation for safe driving awareness through advertising campaigns, and communicates safety messages to customers, employees and the public at large. tabs, figs.

  10. Multi-utility enterprises: an outlook on the prospects in the liberalising markets. Terms and definitions, competition, management strategies, trends; Multi-Utility: Wohin entwickelt sich der Markt? Begriffe, Standort, Strategie, Tendenzen

    Energy Technology Data Exchange (ETDEWEB)

    Mattis, M. [multi-utility consulting, Stuttgart (Germany)

    2003-03-01

    In the light of a spreading confusion of concepts in the context of emerging new business structures and new supply and disposal services in the utility sector, the article explains the current concepts and terms like utility, multi-utility, single-utility, and cross selling, and the respective corporate management and trading characteristics. (orig./CB) [German] In der Ver- und Entsorgung herrscht heillose Begriffsverwirrung. Viele verstehen unter Begriffen wie Utility, Multi-Utility, Single-Utility und cross selling etwas anderes. Versuch einer Begriffsbestimmung und daran anschliessende strategische Ueberlegungen. (orig./CB)

  11. Efficient management and promotion of utilization of the video information acquired by observation

    Science.gov (United States)

    Kitayama, T.; Tanaka, K.; Shimabukuro, R.; Hase, H.; Ogido, M.; Nakamura, M.; Saito, H.; Hanafusa, Y.; Sonoda, A.

    2012-12-01

    In Japan Agency for Marine-Earth Science and Technology (JAMSTEC), the deep sea videos are made from the research by JAMSTEC submersibles in 1982, and the information on the huge deep-sea that will reach more 4,000 dives (ca. 24,700 tapes) by the present are opened to public via the Internet since 2002. The deep-sea videos is important because the time variation of deep-sea environment with difficult investigation and collection and growth of the living thing in extreme environment can be checked. Moreover, with development of video technique, the advanced analysis of an investigation image is attained. For grasp of deep sea environment, especially the utility value of the image is high. In JAMSTEC's Data Research Center for Marine-Earth Sciences (DrC), collection of the video are obtained by dive investigation of JAMSTEC, preservation, quality control, and open to public are performed. It is our big subject that the huge video information which utility value has expanded managed efficiently and promotion of use. In this announcement, the present measure is introduced about these subjects . The videos recorded on a tape or various media onboard are collected, and the backup and encoding for preventing the loss and degradation are performed. The video inside of a hard disk has the large file size. Then, we use the Linear Tape File System (LTFS) which attracts attention with image management engineering these days. Cost does not start compared with the usual disk backup, but correspondence years can also save the video data for a long time, and the operatively of a file is not different from a disk. The video that carried out the transcode to offer is archived by disk storage, and offer according to a use is possible for it. For the promotion of utilization of the video, the video public presentation system was reformed completely from November, 2011 to "JAMSTEC E-library of Deep Sea Images (http:// www.godac.jamstec.go.jp/jedi/)" This new system has preparing

  12. Developing sensor-based robots with utility to waste management applications

    International Nuclear Information System (INIS)

    Trivedi, M.M.; Abidi, M.A.; Gonzalez, R.C.

    1990-01-01

    There are several Environmental Restoration and Waste Management (ER and WM) application areas where autonomous or teleoperated robotic systems can be utilized to improve personnel safety and reduce operation costs. In this paper the authors describe continuing research undertaken by their group in intelligent robotics area which should have a direct relevance to a number of ER and WM applications. The authors' current research is sponsored by the advanced technology division of the U.S. Department of Energy. It is part of a program undertaken at four universities (Florida, Michigan, Tennessee, and Texas) and the Oak ridge National Laboratory directed towards the development of advanced robotic systems for use in nuclear environments. The primary motivation for using robotic (autonomous and/or teleoperated) technology in such hazardous environments is to reduce exposure and costs associated with performing tasks such as surveillance, maintenance and repair. The main focus of the authors' research a the University of Tennessee has been to contribute to the development of autonomous inspection and manipulation systems which utilize a wide array of sensory inputs in controlling the actions of a stationary robot. The authors' experimental research effort is directed towards design and evaluation of new methodologies using a laboratory based robotic testbed. A unique feature of this testbed is a multisensor module useful in the characterization of the robot workspace. In this paper, the authors describe the development of a robot vision system for automatic spill detection, localization and clean-up verification; and the development of efficient techniques for analyzing range images using a parallel computer. The 'simulated spill cleanup' scenario allows us to show the applicability of robotic systems to problems encountered in nuclear environments

  13. Augmented Reality Applications for Substation Management by Utilizing Standards-Compliant SCADA Communication

    Directory of Open Access Journals (Sweden)

    Miro Antonijević

    2018-03-01

    Full Text Available Most electrical substations are remotely monitored and controlled by using Supervisory Control and Data Acquisition (SCADA applications. Current SCADA systems have been significantly enhanced by utilizing standardized communication protocols and the most prominent is the IEC 61850 international standard. These enhancements enable improvements in different domains of SCADA systems such as communication engineering, data management and visualization of automation process data in SCADA applications. Process data visualization is usually achieved through Human Machine Interface (HMI screens in substation control centres. However, this visualization method sometimes makes supervision, control and maintenance procedures executed by engineers slow and error-prone because it separates equipment from its automation data. Augmented reality (AR and mixed reality (MR visualization techniques have matured enough to provide new possibilities of displaying relevant data wherever needed. This paper presents a novel methodology for visualizing process related SCADA data to enhance and facilitate human-centric activities in substations such as regular equipment maintenance. The proposed solution utilizes AR visualization techniques together with standards-based communication protocols used in substations. The developed proof-of-concept AR application that enables displaying SCADA data on the corresponding substation equipment with the help of AR markers demonstrates originality and benefits of the proposed visualization method. Additionally, the application enables displaying widgets and 3D models of substation equipment to make the visualization more user-friendly and intuitive. The visualized SCADA data needs to be refreshed considering soft real-time data delivery restrictions. Therefore, the proposed solution is thoroughly tested to demonstrate the applicability of proposed methodology in real substations.

  14. Assessment of management approaches in a public water utility: A case study of the Namibia water corporation (NAMWATER)

    Science.gov (United States)

    Ndokosho, Johnson; Hoko, Zvikomborero; Makurira, Hodson

    More than 90% of urban water supply and sanitation services in developing countries are provided by public organizations. However, public provision of services has been inherently inefficient. As a result a number of initiatives have emerged in recent years with a common goal to improve service delivery. In Namibia, the water sector reform resulted in the creation of a public utility called the Namibia Water Corporation (NAMWATER) which is responsible for bulk water supply countrywide. Since its inception in 1998, NAMWATER has been experiencing poor financial performance. This paper presents the findings of a case study that compared the management approaches of NAMWATER to the New Public Management (NPM) paradigm. The focus of the NPM approach is for the public water sector to mirror private sector methods of management so that public utilities can accrue the benefits of effectiveness, efficiency and flexibility often associated with private sector. The study tools used were a combination of literature review, interviews and questionnaires. It was found out that NAMWATER has a high degree of autonomy in its operations, albeit government approved tariffs and sourcing of external financing. The utility reports to government annually to account for results. The utility embraces a notion of good corporate culture and adheres to sound management practices. NAMWATER demonstrated a strong market-orientation indicated by the outsourcing of non-core functions but benchmarking was poorly done. NAMWATER’s customer-orientation is poor as evidenced by the lack of customer care facilities. NAMWATER’s senior management delegated operational authority to lower management to facilitate flexibility and eliminate bottlenecks. The lower management is in turn held accountable for performance by the senior management. There are no robust methods of ensuring sufficient accountability indicated by absence of performance contracts or service level agreements. It was concluded that

  15. Psychosocial and nonclinical factors predicting hospital utilization in patients of a chronic disease management program: a prospective observational study.

    Science.gov (United States)

    Tran, Mark W; Weiland, Tracey J; Phillips, Georgina A

    2015-01-01

    Psychosocial factors such as marital status (odds ratio, 3.52; 95% confidence interval, 1.43-8.69; P = .006) and nonclinical factors such as outpatient nonattendances (odds ratio, 2.52; 95% confidence interval, 1.22-5.23; P = .013) and referrals made (odds ratio, 1.20; 95% confidence interval, 1.06-1.35; P = .003) predict hospital utilization for patients in a chronic disease management program. Along with optimizing patients' clinical condition by prescribed medical guidelines and supporting patient self-management, addressing psychosocial and nonclinical issues are important in attempting to avoid hospital utilization for people with chronic illnesses.

  16. Can we delay the replacement of this component?-an asset management approach to the question [for electric utilities

    DEFF Research Database (Denmark)

    Østergaard, Jacob; Jensen, A. Norsk

    2001-01-01

    Asset management is emerging as a new approach on how to exploit an electric utility physical asset in the most profitable way. One of the major questions to answer by the asset management staff is when to do replacements? This is a difficult question, which require weighting of several parameter...... on Windows CE handheld computers which are presented in this paper. The calculations shown in the paper are based on this tool, and the software system is today available and used by Danish electric utilities....

  17. Utilization of Local Law Enforcement Aerial Resources in Consequence Management (CM) Response

    Energy Technology Data Exchange (ETDEWEB)

    Wasiolek, Piotr T.; Malchow, Russell L.

    2013-03-12

    During the past decade the U.S. Department of Homeland Security (DHS) was instrumental in enhancing the nation’s ability to detect and prevent a radiological or nuclear attack in the highest risk cities. Under the DHS Securing the Cities initiative, nearly 13,000 personnel in the New York City region have been trained in preventive radiological and nuclear detection operations, and nearly 8,500 pieces of radiological detection equipment have been funded. As part of the preventive radiological/nuclear detection (PRND) mission, several cities have received funding to purchase commercial aerial radiation detection systems. In 2008, the U.S. Department of Energy, National Nuclear Security Administration Aerial Measuring System (AMS) program started providing Mobile Aerial Radiological Surveillance (MARS) training to such assets, resulting in over 150 HAZMAT teams’ officers and pilots from 10 law enforcement organizations and fire departments being trained in the aerial radiation detection. From the beginning, the MARS training course covered both the PRND and consequence management (CM) missions. Even if the law enforcement main focus is PRND, their aerial assets can be utilized in the collection of initial radiation data for post-event radiological CM response. Based on over 50 years of AMS operational experience and information collected during MARS training, this presentation will focus on the concepts of CM response using aerial assets as well as utilizing law enforcement/fire department aerial assets in CM. Also discussed will be the need for establishing closer relationships between local jurisdictions’ aerial radiation detection capabilities and state and local radiation control program directors, radiological health department managers, etc. During radiological events these individuals may become primary experts/advisers to Incident Commanders for radiological emergency response, especially in the early stages of a response. The knowledge of the existence

  18. Collaboration Across Worldviews: Managers and Scientists on Hawai'i Island Utilize Knowledge Coproduction to Facilitate Climate Change Adaptation.

    Science.gov (United States)

    Laursen, Scott; Puniwai, Noelani; Genz, Ayesha S; Nash, Sarah A B; Canale, Lisa K; Ziegler-Chong, Sharon

    2018-05-30

    Complex socio-ecological issues, such as climate change have historically been addressed through technical problem solving methods. Yet today, climate science approaches are increasingly accounting for the roles of diverse social perceptions, experiences, cultural norms, and worldviews. In support of this shift, we developed a research program on Hawai'i Island that utilizes knowledge coproduction to integrate the diverse worldviews of natural and cultural resource managers, policy professionals, and researchers within actionable science products. Through their work, local field managers regularly experience discrete land and waterscapes. Additionally, in highly interconnected rural communities, such as Hawai'i Island, managers often participate in the social norms and values of communities that utilize these ecosystems. Such local manager networks offer powerful frameworks within which to co-develop and implement actionable science. We interviewed a diverse set of local managers with the aim of incorporating their perspectives into the development of a collaborative climate change research agenda that builds upon existing professional networks utilized by managers and scientists while developing new research products. We report our manager needs assessment, the development process of our climate change program, our interactive forums, and our ongoing research products. Our needs assessment showed that the managers' primary source of information were other professional colleagues, and our in-person forums informed us that local managers are very interested in interacting with a wider range of networks to build upon their management capacities. Our initial programmatic progress suggests that co-created research products and in-person forums strengthen the capacities of local managers to adapt to change.

  19. Update on the clinical utility of once-daily tacrolimus in the management of transplantation

    Directory of Open Access Journals (Sweden)

    Revollo J

    2015-05-01

    Full Text Available Jane Revollo Department of Pharmacy, Jackson Memorial Hospital, University of Miami Leonard M Miller School of Medicine Miami, FL, USAThe review by Posadas Salas and Srinivas of the clinical utility of once-daily tacrolimus formulations in the management of transplant patients1 was timely and relevant. It is worth noting, however, the data were presented in a way that overlooked several key differences between two distinct once-daily tacrolimus formulations. These formulations differ in bioavailability, Cmax, Tmax, dose required to achieve target trough levels, and time to reach target trough. The specific formulation and dosing information of one product was detailed in this review (described as modified release 4 [MR-4]; Astagraf®, Astellas Pharma Inc., Tokyo, Japan, but no formulation or dosing details were provided for a very different once-daily tacrolimus formulation (LCP-Tacro™; Veloxis Pharmaceuticals A/S, Hørsholm, Denmark for which a thorough review was recently published.2 The latter product is currently approved in Europe and under review by the US Food and Drug Administration in the US. In presenting data in this review, the authors did not identify which product was investigated in each of the studies discussed. This could easily lead to misinterpretation of results or erroneous conclusions, ie, that both once-daily formulations are the same. In fact, a careful parsing of the data clearly demonstrates that they are not equivalent. Misunderstanding of this point could have a potentially serious impact on appropriate dosing, safety, and patient management in the post-transplant setting. Differentiation between the two products is needed to clarify what appear to be conflicting results of the studies presented in this review.View original paper by Posadas Salas and Srinivas

  20. Bilateral vocal fold immobility: a 13 year review of etiologies, management and the utility of the empey index

    OpenAIRE

    Brake, Maria K.; Anderson, Jennifer

    2015-01-01

    Background Bilateral vocal fold immobility (BVFI) is a rare diagnosis causing dyspnea, dysphonia and dysphagia. Management depends on respiratory performance, airway patency, vocal ability, and quality-of-life priorities. The authors review the presentation, management and outcome in patients diagnosed with BVFI. The utility and efficacy of the Empey index (EI) and the Expiratory Disproportion Index (EDI) are evaluated as an objective monitoring tools for BVFI patients. Methods A 13-year retr...

  1. Utility of serum periostin in combination with exhaled nitric oxide in the management of asthma

    Directory of Open Access Journals (Sweden)

    Tadao Nagasaki

    2017-07-01

    Full Text Available Type-2/eosinophilic inflammation plays a pivotal role in asthma. The identification of severe type-2/eosinophilic asthma is important for improving the management of patients with asthma. Therefore, efforts to develop non-invasive biomarkers for type-2/eosinophilic airway inflammation have been made during this decade. Currently, fraction of exhaled nitric oxide (FeNO and serum periostin levels are considered markers of type-2/eosinophilic inflammation in asthma. However, a single-marker approach has limited the ability to diagnose severe type-2/eosinophilic asthma accurately and predict disease outcomes precisely. The present article reviews the utility of FeNO and serum periostin levels in a single-marker approach and in a multiple-marker approach in identifying patients with severe type-2/eosinophilic asthma. Furthermore, based on a sub-analysis of the Kinki Hokuriku Airway disease Conference (KiHAC, geno-endo-phenotypes of patients were stratified into four groups according to the FeNO and serum periostin levels.

  2. Nitrogen fertilization management and nitrogen (15N) utilization by corn crop in red latosol

    International Nuclear Information System (INIS)

    Duete, Robson Rui Cotrim; Ambrosano, Edmilson Jose

    2008-01-01

    Nitrogen is the nutrient that is most absorbed by corn crop, influences grain yield most, and requires the most complex management. The objective of this work was to evaluate the effect of nitrogen (urea 15 N) rate and split-applications, on grain yield, N fertilizer utilization and amount of soil native N absorbed by corn crop in a Red Latosol. The experiment was arranged in a randomized complete block design, with nine treatments and four replications, represented by five N rates: 0, 55, 95, 135 and 175 kg ha -1 N, 15 kg of N applied at sowing, and the remaining amount in different split-applications: 40 and 80 kg ha -1 applied in single rates in the 8-leaf stage or half in the 4-leaf stage + half in the 8-leaf stage; 120 kg ha -1 split in 1/2 + 1/2 or 1/3 + 1/3 + 1/3 in the 4, 8 or 12-leaf stage; 160 kg ha-1 split in 1/4 + 3/8 + 3/8 or 1/4 + 1/4 + 1/4 + 1/4 in the 4, 8, 12-leaf stages or at flowering and pollination. The N fertilizer use by corn was, on average, 39 %, and the soil was the main source of the nutrient for the crop. With three split applications of 135 kg ha-1 N, until 8 leaves, the N fertilizer use is most efficient (52 %) and the grain yield highest (author)

  3. Management of stomal varices with transvenous obliteration utilizing sodium tetradecyl sulfate foam sclerosis.

    Science.gov (United States)

    Saad, Wael E A; Schwaner, Sandra; Lippert, Allison; Sabri, Saher S; Al-Osaimi, Abdullah; Matsumoto, Alan H; Angle, John F; Caldwell, Stephen

    2014-12-01

    The management of parastomal varices is not established. Transjugular intrahepatic portosystemic shunt (TIPS) creation is the most commonly described treatment; however, the rebleed rate after TIPS is 21-37%. The purpose of the study is to determine the effectiveness of transvenous obliteration using sodium tetradecyl sulfate (STS) and to describe a new simplified technique in obliterating these varices. Four patients are presented who underwent transvenous obliteration using STS. One was obliterated using balloon occlusion from the systemic veins, the second was obliterated without balloon from a transhepatic antegrade approach, and the last two patients were obliterated using the direct antegrade technique. This simplified technique requires only a micropuncture kit (not requiring balloons or coils) and ultrasound transducer compression of the systemic draining veins, relying on high portal pressure to keep the sclerosant confined to the varices. The sclerosant is essentially trapped between the portal pressure and the ultrasound-transducer compression (10-15 min). Technical success was achieved in all four patients without procedural or postprocedural complications and no rebleeding for a mean follow-up of 17 (range 2-33) months. Transvenous obliteration of parastomal varices utilizing STS as a sclerosant is safe and effective. The newly described technique is simple, feasible, and requires minimal equipment (no balloons or coils or catheters).

  4. Assessment of Social Information Processing in early childhood: development and initial validation of the Schultz Test of Emotion Processing-Preliminary Version.

    Science.gov (United States)

    Schultz, David; Ambike, Archana; Logie, Sean Kevin; Bohner, Katherine E; Stapleton, Laura M; Vanderwalde, Holly; Min, Christopher B; Betkowski, Jennifer A

    2010-07-01

    Crick and Dodge's (Psychological Bulletin 115:74-101, 1994) social information processing model has proven very useful in guiding research focused on aggressive and peer-rejected children's social-cognitive functioning. Its application to early childhood, however, has been much more limited. The present study responds to this gap by developing and validating a video-based assessment tool appropriate for early childhood, the Schultz Test of Emotion Processing-Preliminary Version (STEP-P). One hundred twenty-five Head Start preschool children participated in the study. More socially competent children more frequently attributed sadness to the victims of provocation and labeled aggressive behaviors as both morally unacceptable and less likely to lead to positive outcomes. More socially competent girls labeled others' emotions more accurately. More disruptive children more frequently produced physically aggressive solutions to social provocations, and more disruptive boys less frequently interpreted social provocations as accidental. The STEP-P holds promise as an assessment tool that assesses knowledge structures related to the SIP model in early childhood.

  5. Participation, Retention, and Utilization of a Web-Based Chronic Disease Self-Management Intervention Among Older Adults.

    Science.gov (United States)

    Portz, Jennifer Dickman; LaMendola, Walter F

    2018-05-21

    Web-based self-management (web-based SM) interventions provide a potential resource for older adults to engage in their own chronic disease management. The purpose of this study is to investigate the effect of age on participation, retention, and utilization of a web-based SM intervention. This study reports the results of a secondary data analysis of the effects of age in a randomized trial of a web-based diabetes SM intervention. Participation, reasons for nonenrollment, retention, reasons for disenrollment, and website utilization were examined by age using discriminant function, survival analysis, and multivariate analysis of variance as appropriate. Website utilization by all participants dropped after 6 months but did not vary significantly with age. Though older adults (>60 of age) were less likely to choose to participate (F = 57.20, p Web-based SM offers a feasible approach for older adults with chronic disease to engage in their health management, but it needs to be improved. Those older adults who passed the rigorous screens for this experiment and chose to participate may have been more likely than younger participants to utilize web-based SM intervention tools. They were more persistent in their use of the web-based SM to try to improve health outcomes and formed definitive opinions about its utility before termination.

  6. Variables contributing to an excellent customer service management profile within the regulated electric utility industry: A comparison of self-concept with customer satisfaction for customer service management

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, L.E.

    1991-01-01

    This research sought to address the relationship between self-concept and customer satisfaction: can customer satisfaction with a major electric utility be explained in terms of the self-reported, self-concept of the utility's managers The population to which the results of this study were generalized consisted of customer service managers in public electric utilities across the United States. In order to represent this population, a sample was selected consisting of customer service managers at a midwestern electric utility based in a large metropolitan area. Participants in this study were managers of four direct customer contact service organizations within six geographic division organizations. The methodology included comparisons of these four customer contact service organizations on twelve independent, self-concept variables and six customer satisfaction dependent variables using Analysis of Variance (ANOVA), Scheffe' tests, Chi-Square, and Stepwise multiple regression. The groups were found not to be significantly different and knowledge of the self-concept scores for managers will not increase the ability to predict customer satisfaction over no knowledge of self-concept scores.

  7. How Managed Care Affects Medicaid Utilization : A Synthetic Difference-in-Difference Zero-Inflated Count Model

    NARCIS (Netherlands)

    Freund, D.A.; Kniesner, T.J.; LoSasso, A.T.

    1996-01-01

    We develop a synthetic difference-in-differences statistical design to apply to experimental data for adult women living in Hennepin County, Minnesota, to estimate the impact of Medicaid managed care on various modes of medical care use.Because the outcomes of interest are utilization counts with

  8. Minimal support technology and in situ resource utilization for risk management of planetary spaceflight missions

    Science.gov (United States)

    Murphy, K. L.; Rygalov, V. Ye.; Johnson, S. B.

    2009-04-01

    All artificial systems and components in space degrade at higher rates than on Earth, depending in part on environmental conditions, design approach, assembly technologies, and the materials used. This degradation involves not only the hardware and software systems but the humans that interact with those systems. All technological functions and systems can be expressed through functional dependence: [Function]˜[ERU]∗[RUIS]∗[ISR]/[DR];where [ERU]efficiency (rate) of environmental resource utilization[RUIS]resource utilization infrastructure[ISR]in situ resources[DR]degradation rateThe limited resources of spaceflight and open space for autonomous missions require a high reliability (maximum possible, approaching 100%) for system functioning and operation, and must minimize the rate of any system degradation. To date, only a continuous human presence with a system in the spaceflight environment can absolutely mitigate those degradations. This mitigation is based on environmental amelioration for both the technology systems, as repair of data and spare parts, and the humans, as exercise and psychological support. Such maintenance now requires huge infrastructures, including research and development complexes and management agencies, which currently cannot move beyond the Earth. When considering what is required to move manned spaceflight from near Earth stations to remote locations such as Mars, what are the minimal technologies and infrastructures necessary for autonomous restoration of a degrading system in space? In all of the known system factors of a mission to Mars that reduce the mass load, increase the reliability, and reduce the mission’s overall risk, the current common denominator is the use of undeveloped or untested technologies. None of the technologies required to significantly reduce the risk for critical systems are currently available at acceptable readiness levels. Long term interplanetary missions require that space programs produce a craft

  9. Lessons learned from new construction utility demand side management programs and their implications for implementing building energy codes

    Energy Technology Data Exchange (ETDEWEB)

    Wise, B.K.; Hughes, K.R.; Danko, S.L.; Gilbride, T.L.

    1994-07-01

    This report was prepared for the US Department of Energy (DOE) Office of Codes and Standards by the Pacific Northwest Laboratory (PNL) through its Building Energy Standards Program (BESP). The purpose of this task was to identify demand-side management (DSM) strategies for new construction that utilities have adopted or developed to promote energy-efficient design and construction. PNL conducted a survey of utilities and used the information gathered to extrapolate lessons learned and to identify evolving trends in utility new-construction DSM programs. The ultimate goal of the task is to identify opportunities where states might work collaboratively with utilities to promote the adoption, implementation, and enforcement of energy-efficient building energy codes.

  10. Energy management of a university campus utilizing short-term load forecasting with an artificial neural network

    Science.gov (United States)

    Palchak, David

    Electrical load forecasting is a tool that has been utilized by distribution designers and operators as a means for resource planning and generation dispatch. The techniques employed in these predictions are proving useful in the growing market of consumer, or end-user, participation in electrical energy consumption. These predictions are based on exogenous variables, such as weather, and time variables, such as day of week and time of day as well as prior energy consumption patterns. The participation of the end-user is a cornerstone of the Smart Grid initiative presented in the Energy Independence and Security Act of 2007, and is being made possible by the emergence of enabling technologies such as advanced metering infrastructure. The optimal application of the data provided by an advanced metering infrastructure is the primary motivation for the work done in this thesis. The methodology for using this data in an energy management scheme that utilizes a short-term load forecast is presented. The objective of this research is to quantify opportunities for a range of energy management and operation cost savings of a university campus through the use of a forecasted daily electrical load profile. The proposed algorithm for short-term load forecasting is optimized for Colorado State University's main campus, and utilizes an artificial neural network that accepts weather and time variables as inputs. The performance of the predicted daily electrical load is evaluated using a number of error measurements that seek to quantify the best application of the forecast. The energy management presented utilizes historical electrical load data from the local service provider to optimize the time of day that electrical loads are being managed. Finally, the utilization of forecasts in the presented energy management scenario is evaluated based on cost and energy savings.

  11. Utilizing Clinical Pharmacy Specialists to Address Access to Care Barriers in the Veteran Population for the Management of Diabetes.

    Science.gov (United States)

    Edwards, Krystal L; Hadley, Ryan L; Baby, Nidhu; Yeary, Julianne C; Chastain, Lisa M; Brown, Crystal D

    2017-08-01

    To show that clinical pharmacy specialists (CPSs) can be utilized in remote facilities to provide appropriate diabetes outcomes along with potential cost savings. A retrospective cohort chart review conducted at the Veterans Affairs North Texas Healthcare System (VANTHCS) evaluated outcomes in patients with type 2 diabetes mellitus referred to CPSs at Fort Worth Outpatient Clinic (FWOPC) or the endocrinologist-managed specialty clinic at the Dallas VA Medical Center (DVAMC). The primary outcome was percentage of patients reaching hemoglobin A1c (HbA1c) goal of facility if patients continued to be referred to CPS. CPSs can be utilized in diabetes management to provide similar health outcomes as the endocrinologist-managed clinic and to potentially allow for facility cost savings.

  12. Utility of Objective Chest Tube Management After Pulmonary Resection Using a Digital Drainage System.

    Science.gov (United States)

    Takamochi, Kazuya; Imashimizu, Kota; Fukui, Mariko; Maeyashiki, Tatsuo; Suzuki, Mikiko; Ueda, Takuya; Matsuzawa, Hironori; Hirayama, Shunki; Matsunaga, Takeshi; Oh, Shiaki; Suzuki, Kenji

    2017-07-01

    We sought to evaluate the clinical utility of chest tube management after pulmonary resection based on objective digital monitoring of pleural pressure and digital surveillance for air leaks. We prospectively recorded the perioperative data of 308 patients who underwent pulmonary resection between December 2013 and January 2016. We used information from a digital monitoring thoracic drainage system to measure peak air leakage during the first 24 hours after the operation, patterns of air leakage over the first 72 hours, and patterns of pleural pressure changes until the chest tubes were removed. There were 240 patients with lung cancer and 68 patients with other diseases. The operations included 49 wedge resections, 58 segmentectomies, and 201 lobectomies. A postoperative air leak was observed in 61 patients (20%). A prolonged air leak exceeding 20 mL/min lasting 5 days or more was observed in 18 patients (5.8%). Multivariate analysis of various perioperative factors showed forced expiratory volume in 1 second below 70%, patterns of air leakage, defined as exacerbating and remitting or without a trend toward improvement, and peak air leakage of 100 mL/min or more were significant positive predictors of prolonged air leak. Fluctuations in pleural pressure occurred just after the air leakage rate decreased to less than 20 mL/min. Digital monitoring of peak air leakage and patterns of air leakage were useful for predicting prolonged air leak after pulmonary resection. Information on the disappearance of air leak could be derived from the change in the rate of air leakage and from the increase in fluctuation of pleural pressure. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review.

    Science.gov (United States)

    Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

    2017-09-01

    Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.

  14. Site remediation technologies and environmental management practices in the utility industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    Sessions covered: chemical oxidation; DNAPL and source management; regulatory perspectives and state programs; manufactured gas plant site management; sediments, cyanides, and other issues at MGP sites; biotechnology applications; agricultural waste issues; risk communication and bioremediation; air emissions and air toxics management; project management and redevelopment; environmentally acceptable endpoint and risk-based site management; site assessment, background concentration and closure; risk communication and beneficial use by recycling; PCB and RCRA issues; and phytoremediation and bioremediation of wastes.

  15. 8th World Congress on Engineering Asset Management & the 3rd International Conference on Utility Management & Safety

    CERN Document Server

    Mathew, Joseph; Wong, King; Lam, Rocky; Ko, CN; WCEAM 2013; ICUMAS; Engineering asset management : systems, professional practices and certification

    2015-01-01

    This proceedings represents state-of-the-art trends and developments in the emerging field of engineering asset management as presented at the Eight World Congress on Engineering Asset Management (WCEAM). The Proceedings of the WCEAM 2013 is an excellent reference for practitioners, researchers and students in the multidisciplinary field of asset management, covering topics such as: Asset condition monitoring and intelligent maintenance, 2.  Asset data warehousing, data mining and fusion, 3. Asset performance and level-of-service models, 4. Design and life-cycle integrity of physical assets, 5. Deterioration and preservation models for assets, 6. Education and training in asset management, 7. Engineering standards in asset management, 8. Fault diagnosis and prognostics, 9. Financial analysis methods for physical assets, 10. Human dimensions in integrated asset management, 11. Information quality management, 12. Information systems and knowledge management, 13. Intelligent sensors and devices, 14. Maintenance...

  16. A Midwest utility's perspective of DSM [demand-side management]: Balancing the needs of customers, shareholders and the environment

    International Nuclear Information System (INIS)

    Collins, G.F.

    1990-01-01

    PSI Energy, a predominately coal-burning Indiana electric utility, is very concerned about the environment and is using demand-side management (DSM) as part of a strategy to balance the sometimes conflicting interests of the environment, the economy, customers and shareholders. Faced with slow growth within its service territory, an abundance of low-cost, high sulfur coal burning baseload capacity, massive future expenditures for acid rain mitigation and a weakened financial state due to a cancelled nuclear project, PSI Energy has taken a novel approach to preserving value for customers, shareholders, the economy and environment. To accomodate Indiana's goal of least cost utility planning, PSI initiated an all-source bidding program in which it solicited bids for peaking capacity or the equivalent. Four parallel but separate solicitations were pursued: combustion turbine manufacturers for PSI owned and operated capacity, other utilities and non-utility generators for purchased power and third parties for demand-side management. PSI's philosophy with respect to bidding can be expressed as: simplicity, flexibility, creativity, partnerships, expeditious and fairness. There is a minimum bid of 5 MW of summer peak demand reduction, and the minimum contract length is 10 years. The entire 550 MW capacity block available to be filled in the program is open to demand-side resources. The ten major evaluation criteria involved in the program are: price, sponsor qualifications, operational impact, marketing plan, technology, financing plan, verification and measurement, form of security, project management plan, and project cost estimates

  17. Managing carbon regulatory risk in utility resource planning: Current practices in the Western United States

    International Nuclear Information System (INIS)

    Barbose, Galen; Wiser, Ryan; Phadke, Amol; Goldman, Charles

    2008-01-01

    Concerns about global climate change have substantially increased the likelihood that future policy will seek to minimize carbon dioxide emissions. As such, even today, electric utilities are making resource planning and investment decisions that consider the possible implications of these future carbon regulations. In this article, we examine the manner in which utilities assess the financial risks associated with future carbon regulations within their long-term resource plans. We base our analysis on a review of the most recent resource plans filed by 15 electric utilities in the Western United States. Virtually all of these utilities made some effort to quantitatively evaluate the potential cost of future carbon regulations when analyzing alternate supply- and demand-side resource options for meeting customer load. Even without federal climate regulation in the US, the prospect of that regulation is already having an impact on utility decision-making and resource choices. That said, the methods and assumptions used by utilities to analyze carbon regulatory risk, and the impact of that analysis on their choice of a particular resource strategy, vary considerably, revealing a number of opportunities for analytic improvement. Though our review focuses on a subset of US electric utilities, this work holds implications for all electric utilities and energy policymakers who are seeking to minimize the compliance costs associated with future carbon regulations

  18. Fusion Teaching: Utilizing Course Management Technology to Deliver an Effective Multimodal Pedagogy

    Science.gov (United States)

    Childs, Bradley D.; Cochran, Howard H.; Velikova, Marieta

    2013-01-01

    Fusion teaching merges several pedagogies into a coherent whole. Course management technology allows for the digitization and delivery of pedagogies in an effective and exciting manner. Online course management options more easily enable outcome assessment and monitoring for continuous improvement.

  19. Physician resource utilization in radiation oncology: a model based on management of carcinoma of the prostate

    International Nuclear Information System (INIS)

    Kobeissi, Beverly J.; Gupta, Mahendra; Perez, Carlos A.; Dopuch, Nicholas; Michalski, Jeff M.; Antwerp, George van; Gerber, Russell; Wasserman, Todd H.

    1998-01-01

    Purpose: To develop a methodology to estimate the comparative cost of physician time in treating patients with localized prostate cancer, using as an example two-dimensional (2D) vs. three-dimensional (3D) conformal irradiation techniques, and to illustrate how current cost-accounting techniques can be used to quantify the cost of physician time and effort of any treatment. Methods and Materials: Activity-based costing, a recent innovation in accounting, widely recommended for estimating and managing the costs of specific activities, was used to derive physician resource utilization costs (actual cost of the physician services and related support services consumed). Results: Patients treated with 3D conformal irradiation consume about 50% more physician time than patients receiving 2D conventional radiation therapy. The average professional reimbursement for the 3D conformal irradiation is only about 26% more than for the 2D treatment. Substantial variations in cost are found depending on the total available physician working hours. In an academic institution, a physician working 40 hours a week would have to spend an average of about 60% of available time on clinical services to break even on a 2D treatment process and over 74% of available time on clinical work to break even on a 3D treatment process. The same physician working 50 hours a week would have to spend an average of about 48% of available time on 2D clinical services and about 60% of available time on 3D clinical work to break even. Current Medicare reimbursement for 3D treatment falls short of actual costs, even if physicians work 100% of a 50-hour week. Medicare reimbursement for 2D barely allows the department to break even for 2D treatments. Conclusions: Costs based on estimates of resource use can be substantially under- or overestimated. A consistent language (method) is needed to obtain and describe the costs of radiation therapy. The methodology described here can help practitioners and

  20. An Experimental Test of Buffer Utility as a Technique for Managing Pool-Breeding Amphibians.

    Science.gov (United States)

    Powell, Jessica S Veysey; Babbitt, Kimberly J

    2015-01-01

    Vegetated buffers are used extensively to manage wetland-dependent wildlife. Despite widespread application, buffer utility has not been experimentally validated for most species. To address this gap, we conducted a six-year, landscape-scale experiment, testing how buffers of different widths affect the demographic structure of two amphibian species at 11 ephemeral pools in a working forest of the northeastern U.S. We randomly assigned each pool to one of three treatments (i.e., reference, 100m buffer, 30m buffer) and clearcut to create buffers. We captured all spotted salamanders and wood frogs breeding in each pool and examined the impacts of treatment and hydroperiod on breeding-population abundance, sex ratio, and recapture rate. The negative effects of clearcutting tended to increase as forest-buffer width decreased and be strongest for salamanders and when other stressors were present (e.g., at short-hydroperiod pools). Recapture rates were reduced in the 30m, but not 100m, treatment. Throughout the experiment for frogs, and during the first year post-cut for salamanders, the predicted mean proportion of recaptured adults in the 30m treatment was only 62% and 40%, respectively, of that in the reference treatment. Frog sex ratio and abundance did not differ across treatments, but salamander sex ratios were increasingly male-biased in both cut treatments. By the final year, there were on average, only about 40% and 65% as many females predicted in the 100m and 30m treatments, respectively, compared to the first year. Breeding salamanders at short-hydroperiod pools were about 10% as abundant in the 100m versus reference treatment. Our study demonstrates that buffers partially mitigate the impacts of habitat disturbance on wetland-dependent amphibians, but buffer width and hydroperiod critically mediate that process. We provide the first experimental evidence showing that 30-m-wide buffers may be insufficient for maintaining resilient breeding populations of pool

  1. An Experimental Test of Buffer Utility as a Technique for Managing Pool-Breeding Amphibians.

    Directory of Open Access Journals (Sweden)

    Jessica S Veysey Powell

    Full Text Available Vegetated buffers are used extensively to manage wetland-dependent wildlife. Despite widespread application, buffer utility has not been experimentally validated for most species. To address this gap, we conducted a six-year, landscape-scale experiment, testing how buffers of different widths affect the demographic structure of two amphibian species at 11 ephemeral pools in a working forest of the northeastern U.S. We randomly assigned each pool to one of three treatments (i.e., reference, 100m buffer, 30m buffer and clearcut to create buffers. We captured all spotted salamanders and wood frogs breeding in each pool and examined the impacts of treatment and hydroperiod on breeding-population abundance, sex ratio, and recapture rate. The negative effects of clearcutting tended to increase as forest-buffer width decreased and be strongest for salamanders and when other stressors were present (e.g., at short-hydroperiod pools. Recapture rates were reduced in the 30m, but not 100m, treatment. Throughout the experiment for frogs, and during the first year post-cut for salamanders, the predicted mean proportion of recaptured adults in the 30m treatment was only 62% and 40%, respectively, of that in the reference treatment. Frog sex ratio and abundance did not differ across treatments, but salamander sex ratios were increasingly male-biased in both cut treatments. By the final year, there were on average, only about 40% and 65% as many females predicted in the 100m and 30m treatments, respectively, compared to the first year. Breeding salamanders at short-hydroperiod pools were about 10% as abundant in the 100m versus reference treatment. Our study demonstrates that buffers partially mitigate the impacts of habitat disturbance on wetland-dependent amphibians, but buffer width and hydroperiod critically mediate that process. We provide the first experimental evidence showing that 30-m-wide buffers may be insufficient for maintaining resilient breeding

  2. The utility of preoperative diffusion tensor imaging in the surgical management of brainstem cavernous malformations.

    Science.gov (United States)

    Flores, Bruno C; Whittemore, Anthony R; Samson, Duke S; Barnett, Samuel L

    2015-03-01

    Resection of brainstem cavernous malformations (BSCMs) may reduce the risk of stepwise neurological deterioration secondary to hemorrhage, but the morbidity of surgery remains high. Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) are neuroimaging techniques that may assist in the complex surgical planning necessary for these lesions. The authors evaluate the utility of preoperative DTI and DTT in the surgical management of BSCMs and their correlation with functional outcome. A retrospective review was conducted to identify patients who underwent resection of a BSCM between 2007 and 2012. All patients had preoperative DTI/DTT studies and a minimum of 6 months of clinical and radiographic follow-up. Five major fiber tracts were evaluated preoperatively using the DTI/DTT protocol: 1) corticospinal tract, 2) medial lemniscus and medial longitudinal fasciculus, 3) inferior cerebellar peduncle, 4) middle cerebellar peduncle, and 5) superior cerebellar peduncle. Scores were applied according to the degree of distortion seen, and the sum of scores was used for analysis. Functional outcomes were measured at hospital admission, discharge, and last clinic visit using modified Rankin Scale (mRS) scores. Eleven patients who underwent resection of a BSCM and preoperative DTI were identified. The mean age at presentation was 49 years, with a male-to-female ratio of 1.75:1. Cranial nerve deficit was the most common presenting symptom (81.8%), followed by cerebellar signs or gait/balance difficulties (54.5%) and hemibody anesthesia (27.2%). The majority of the lesions were located within the pons (54.5%). The mean diameter and estimated volume of lesions were 1.21 cm and 1.93 cm(3), respectively. Using DTI and DTT, 9 patients (82%) were found to have involvement of 2 or more major fiber tracts; the corticospinal tract and medial lemniscus/medial longitudinal fasciculus were the most commonly affected. In 2 patients with BSCMs without pial presentation, DTI

  3. Utilizing NASA EOS Data for Fire Management in el Departmento del Valle del Cauco, Colombia

    Science.gov (United States)

    Brenton, J. C.; Bledsoe, N.; Alabdouli, K.

    2012-12-01

    In the last few years, fire incidence in Colombian wild areas has increased, damaging pristine forests into savannas and sterile lands. Fire poses a significant threat to biodiversity, rural communities and established infrastructure. These events issue an urgent need to address this problem. NASA Earth Observing System (EOS) can play a significant role in the monitoring fires and natural disasters. SERVIR, the Regional Visualization and Monitoring Network, constitutes a platform for the observation, forecasting and modeling of environmental processes in Central America. A project called "The GIS for fire management in Guatemala (SIGMA-I)" has been already conducted to address the same problem in another Latin American country, Guatemala. SIGMA-I was developed by the Inter-agency work among the National protected areas council (CONAP), National Forestry Institution (INAB), the National Coordinator for Disaster Reduction / National Forest Fire Prevention and Control System (CONRED/SIPECIF), and the Ministry of the Environment and National Resources (MARN) in Guatemala under the guidance and assistance of SERVIR. With SIGMA-I as an example, we proposed to conduct a similar project for the country of Colombia. First, a pilot study in the area of the watershed of the Cali River, Colombia was conducted to ensure that the data was available and that the maps and models were accurate. The proposed study will investigate the technical resources required: 1.) A fire map with a compilation of ignition data (hot spots) utilizing Fire Information for Resource Management System (FIRMS) derived from MODIS (Moderate Resolution Imaging Spectroradiometer) products MOD14 and MYD14 2.) A map of fire scars derived from medium resolution satellite data (ASTER) during the period 2003-2011 for the entire country, and a map of fire scar recurrence and statistics derived from the datasets produced. 3.) A pattern analysis and ignition cause model derived from a matrix of variables

  4. Utilization of Remote Sensing Techniques for Monitoring and Evaluation of Solo Watershed Management

    Directory of Open Access Journals (Sweden)

    Totok Gunawan

    2004-01-01

    Full Text Available This research is an application of remote sensing technology for monitoring and evaluation of watershed management, which was conducted is Solo Watershed, Central and East Java. The research objectives were 1 to investigate the capability of photomorphic analysis of Landsat Thematic Mapper (TM and Enhanced Themmatic Mapper (ETM + imagery as the basic for analyzes of landforms, landuse, and morphometry of the land surface; 2 to calculate the overland flow – peak discharge and erosion – sediment yield as indicators of land degradation of the area; 3 to use the indicators as set of instrument for monitoring and evaluation of watershed management. In this study, visual interpretation by means of on-screen digilization of the digital imagery was carried out in order to identify and to delineate land parameters using photomorphic approach. Based on the photomorphic analysis, several image – based parameters such as relief topography, physical soil characteristic, litho – stratigraphy, and vegetation cover were integrated with other themati maps in a geographic information system (GIS environment. Estimation of overland flow (C based on Cook methods (1942 and calculation of peak disccharge (Qmax based on rational method (Qmax = C. I. A were applied. Meanwhile, estimation of surface erosion was carried out using Universal Soil Loss Equation (USLE, A = R. K. L. S. CP. The sediment yield (Sy was estimated using seddiment delivery ratio ( SDR based on the following formula: Sy = [A + (25% x A] x SDR. Both pairs of C – Qmax and A – Sy, were utilized as the basis for monitoring and evaluation of the watershed. The combination of C – Qmax and A – Sy were also used as the basis for selection of stream gauge setting / AWLR within particular sub – catchment. It was found that the photomorphic analysis is only color/tone, slope aspects, pattern, and texture, unit boundaries between volcanic – origin landscape (Wilis volcanic complex and folded

  5. Technology evaluation of control/monitoring systems for MIUS application. [utility services management

    Science.gov (United States)

    Pringle, L. M., Jr.

    1974-01-01

    Potential ways of providing control and monitoring for the Modular Integrated Utility System (MIUS) program are elaborated. Control and monitoring hardware and operational systems are described. The requirements for the MIUS program and the development requirements are discussed.

  6. [The Utilization of Health-Related Applications in Chronic Disease Self-Management].

    Science.gov (United States)

    Kao, Chi-Wen; Chuang, Hui-Wan; Chen, Ting-Yu

    2017-08-01

    The dramatic increase in smartphone usage has spurred the development of many health-related mobile applications (apps). On the other hand, population aging and the associated rise in the incidence of chronic disease is increasing the demand for long-term care. Effective chronic disease self-management has been shown to help patients improve their health condition. Numerous smartphone applications currently support patient self-management of chronic disease, facilitating health management and health promotion. The purpose of the present article was to introduce the definition, contents, and types of health-related apps; to discuss the effectiveness of self-management health-related apps in promoting chronic disease management; and to assess and evaluate these apps. We hope that the present article helps give to healthcare professionals and patients who are willing to manage their diseases a general understanding of health-related apps and their potential to facilitate the self-management of chronic diseases.

  7. Utilizing an ANP framework for prioritizing effective criteria on performance management in cooperative organization

    Directory of Open Access Journals (Sweden)

    Hosein Akhavan Alavi

    2012-09-01

    Full Text Available Performance management plays an essential role on increasing efficiency of business units. It helps find important barriers against a business unit helping us setup better strategies for handling troubles. In this paper, we present an empirical study to find important factors influencing performance management in cooperative organizations. The proposed study uses analytical hierarchy process to rank important factors in three groups of team level, individual and organization levels. The survey is based on receiving feedbacks from decision makers and making a pairwise comparison on measuring the relative importance of each criterion influencing performance management. The results of our survey indicate that setting appropriate standards for performance management is the most important item followed by relationship between organization structure and performance management, performance management based on future events. The other three factors including continuous improvement and updating systems, encouraging employee for change culture and relationship between future outlook and performance management are other important factors.

  8. Assessment of the Availability, Utilization and Management of ICT Facilities in Teaching English Language in Secondary Schools in Kaduna State, Nigeria

    Science.gov (United States)

    Yusuf, Hanna Onyi; Maina, Bashir; Dare, Michael Omotayo

    2013-01-01

    The study investigated the availability, utilization and management of ICT facilities in teaching English language in secondary schools in Kaduna State, Nigeria. The study adopted a descriptive survey research design. A questionnaire titled "Availability, Utilization and Management of Information and Communication Technology in teaching…

  9. Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation.

    Science.gov (United States)

    Rathod, Rahul H; Jurgen, Brittney; Hamershock, Rose A; Friedman, Kevin G; Marshall, Audrey C; Samnaliev, Mihail; Graham, Dionne A; Jenkins, Kathy; Lock, James E; Powell, Andrew J

    2017-12-01

    Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs. All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009). Patients were divided into "younger" (operation while maintaining quality of care. © 2017 Wiley Periodicals, Inc.

  10. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

    Science.gov (United States)

    Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

    2017-01-01

    This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

  11. Analysis of Department of Defense Organic Depot Maintenance Capacity Management and Facility Utilization Factors

    Science.gov (United States)

    1991-09-01

    System ( CAPMS ) in lieu of using DODI 4151.15H. Facility utilization rate computation is not explicitly defined; it is merely identified as a ratio of...front of a bottleneck buffers the critical resource and protects against disruption of the system. This approach optimizes facility utilization by...run titled BUFFERED BASELINE. Three different levels of inventory were used to evaluate the effect of increasing the inventory level on critical

  12. Development of an integrated utilities billing management system for the Navy Public Works Center San Diego, California

    International Nuclear Information System (INIS)

    Monsabert, S. de; Lemmer, H.; Dinwiddie, D.; Harshberger, M.

    1995-01-01

    In the past, most buildings, structures, and ship visits were not metered, and flat estimates were calculated based on various estimating techniques. The decomposition process was further complicated by the fact that many of the meters monitor consumption values only and do not provide demand or time of use data. This method of billing provides no incentives to the PWC customers to implement energy conservation programs, including load shedding, Energy Monitoring and Control Systems (EMCS), building shell improvements, low flow toilets and shower heads, efficient lighting systems, or other energy savings alternatives. Similarly, the method had no means of adjustment for seasonal or climatic variations outside of the norm. As an alternative to flat estimates, the Customized Utility Billing Integrated Control (CUBIC) system and the Graphical Data Input System (GDIS) were developed to better manage the data to the major claimant area users based on utilities usage factors, building size, weather data, and hours of operation. GDIS is a graphical database that assists PWC engineers in the development and maintenance of single-line utility diagrams of the facilities and meters. It functions as a drawing associate system and is written in AutoLISP for AutoCAD version 12. GDIS interprets the drawings and provides the facility-to-meter and meter-to-meter hierarchy data that are used by the CUBIC to allocate the billings. This paper reviews the design, development and implementation aspects of CUBIC/GDIS and discusses the benefits of this improved utilities management system

  13. Generalized Cartographic and Simultaneous Representation of Utility Networks for Decision-Support Systems and Crisis Management in Urban Environments

    Science.gov (United States)

    Becker, T.; König, G.

    2015-10-01

    Cartographic visualizations of crises are used to create a Common Operational Picture (COP) and enforce Situational Awareness by presenting relevant information to the involved actors. As nearly all crises affect geospatial entities, geo-data representations have to support location-specific analysis throughout the decision-making process. Meaningful cartographic presentation is needed for coordinating the activities of crisis manager in a highly dynamic situation, since operators' attention span and their spatial memories are limiting factors during the perception and interpretation process. Situational Awareness of operators in conjunction with a COP are key aspects in decision-making process and essential for making well thought-out and appropriate decisions. Considering utility networks as one of the most complex and particularly frequent required systems in urban environment, meaningful cartographic presentation of multiple utility networks with respect to disaster management do not exist. Therefore, an optimized visualization of utility infrastructure for emergency response procedures is proposed. The article will describe a conceptual approach on how to simplify, aggregate, and visualize multiple utility networks and their components to meet the requirements of the decision-making process and to support Situational Awareness.

  14. Managing a drought: what does a hydroelectric utility do when the rain stops?

    Energy Technology Data Exchange (ETDEWEB)

    Cormie, D.

    2004-07-01

    Measures put in place by Manitoba Hydro to combat drought resulting from the absence of precipitation, are discussed. Under normal conditions Manitoba Hydro, a provincially owned electric utility, generates over 95 per cent of its electricity from hydroelectric power stations. During the extended drought lasting from the summer of 2002 until the spring of 2004, the utility found itself forced to import electricity from outside the province. The principal reason that the utility was able to survive this long spell of no precipitation is that Manitoba Hydro's planners always assume that a drought will continue and if an option to purchase power exists, the utility will pursue that option instead of depleting its reservoirs. In most situations, Manitoba Hydro is able to import purchased power using its 12 transmission line interconnections to utilities in Saskatchewan, Ontario and the United States. The combined capacity of these lines is approximately, 1,340 MW. Manitoba Hydro also has a limited gas-fired generating capacity, which has been put into service during the drought, in particular to cap the price of purchased electricity when spot market prices exceeded the cost of producing electricity with natural gas. The third line of defence rests with a coal-fired unit at the utility's Brandon generating station which may be used as a last resort to help the utility limit its financial vulnerability to high electricity and gas prices. In addition to supplying power to to Manitobans, the utility has long-term contractual obligations to supply approximately 4,000 GWh of power to export customers. During the 2003-2004 drought Manitoba Hydro pursued offsetting purchases to these long-term sales; essentially buying back the power it had previously agreed to sell. Although retained earnings allowed the utility to cushion ratepayers from the financial shock of the drought, to rebuild those earnings, it will be necessary to increase electricity rates across all

  15. "Batter up, Student on Deck": The Utility of Moneyball in Management Education

    Science.gov (United States)

    McHugh, Patrick P.

    2009-01-01

    The book "Moneyball: The Art of Winning an Unfair Game", by Michael Lewis, has intrigued management practitioners and researchers. This article describes the use of the book as a supplementary reading in a management course. The book was found to be a useful complement to a traditional textbook when addressing topics such as organizational change…

  16. Management in the system of waste utilization of production and consumption

    Science.gov (United States)

    Azimov, U. I.; Gilmanshin, I. R.; Krainova, D. R.; Galeev, I. A.

    2017-09-01

    The main problems of waste management in accordance with the legislation are considered in the article. The economic benefits of separate waste collection are listed. The necessity of transition to a new level of waste management in the Republic of Tatarstan is determined.

  17. Alberta's systems approach to chronic disease management and prevention utilizing the expanded chronic care model.

    Science.gov (United States)

    Delon, Sandra; Mackinnon, Blair

    2009-01-01

    Alberta's integrated approach to chronic disease management programming embraces client-centred care, supports self-management and facilitates care across the continuum. This paper presents strategies implemented through collaboration with primary care to improve care of individuals with chronic conditions, evaluation evidence supporting success and lessons learned from the Alberta perspective.

  18. Project risk management for development of non-utility power generators (NUGs)

    International Nuclear Information System (INIS)

    Lau, T.

    1990-01-01

    The growing Non-Utility Generation (NUG) industry has brought new opportunities and challenges for the insurance industry. There can be unique engineering and financial risks involved in the development of Non-Utility Power Generation projects. The use of new technologies to meet stringent environmental regulations and to improve project performance and efficiency presents new challenges to the project developers and designers. The lack of funding, resources and experience of some of these projects may create unusual risks that could result in failure or deficiency in the performance of the projects

  19. Utilization and management of organic wastes in Chinese agriculture: Past, present and perspectives

    Institute of Scientific and Technical Information of China (English)

    JU; Xiaotang

    2005-01-01

    [1]King,F.H.,Farmers of forty centuries or permanent agriculture in China,Korea and Japan,German translation of first edition (Madison,Wis.,1911),1984.Georg,E.,Siebeneicher,Neu-Ulm und München,208.[2]FAO,FAO Soils Bulletin 40,China:Recycling of organic wastes in agriculture,Food and Agriculture Organization of the United Nations,Rome,2nd ed.,1978.[3]Roelcke,M.,Organic materials in rice production in the Yangtze River Delta-Investigation on the composition and effects of Waterlogged Compost (in German with English abstract),University Diploma Dissertation,Faculty of Agriculture and Horticulture,Freising-Weihenstephan:Munich Technical University,1988,114.[4]Zhu,Z.L.,Chen,D.L.,Nitrogen fertilizer use in China-Contributions to food production,impacts on the environment and best management strategies,Nutrient Cycling in Agroecosystems,2002,63:117-127.[5]Ju,X.T.,Liu,X.J.,Zhang,F.S.et al,Nitrogen fertilization,soil nitrate accumulation,and policy recommendations in several agricultural regions of China,Ambio,2004,33(6):300-305.[6]Extension Center of Agricultural Techniques in China,ed.,Organic Manure Resources in China,Beijing:China Agricultural Publishing House,1999,1-8.[7]Cao,L.G.,The Fertilization History,Beijing:China Agricultural Publishing House,1981.[8]Liu,G.L.,Food production and balanced fertilization in China,in Proceeding of Third International Conference for Balanced Fertilization (ed.Institute of Soil Science and Fertilization,Chinese Academic of Agricultural Science),Beijing:China Agricultural Publishing House,1989,16-21.[9]China Agricultural Yearbook,Editorial Committee of China Agricultural Yearbook,Beijing:China Agricultural Publishing House,1950 - 2003[10]Ellis,E.C.,Wang,S.M.,Sustainable traditional agriculture in the Tai Lake Region of China,Agriculture,Ecosystems and Environment,1997,61,177-193.[11]Ge,J.X.,The History of Chinese Population,Shanghai:Fudan University Publishing House,2001,5:831 - 832.[12]Zhang,S.X.,The Resources of Cultivable Land and

  20. E-Learning as a Knowledge Management Approach for Intellectual Capital Utilization

    Science.gov (United States)

    Shehabat, Issa; Mahdi, Saad A.; Khoualdi, Kamel

    2008-01-01

    This paper addresses human resources utilization at the university environment. We address the design issues of e-learning courses that can capture the teacher knowledge. The underlying objective is that e-learning is a key knowledge and major resources for many universities. Therefore, the design of e-learning should be an important part of the…

  1. Operational management within PGEM (Provincial Public Utility for Gelderland and Flevoland in the Netherlands)

    International Nuclear Information System (INIS)

    Nieuwland, S.

    1992-01-01

    An impression is given of the present and future electricity, natural gas, heat and water supply area of the Dutch energy utility for the provinces Gelderland and Flevoland PGEM. Also the role of power control is briefly discussed. Special attention is paid to the company's philosophy 'do locally what can be done locally'. 4 figs

  2. Impacts of farm management upon arbuscular mycorrhizal fungi and production and utilization of inoculum

    Science.gov (United States)

    Arbuscular mycorrhizal [AM] fungi are naturally-occurring soil fungi that form a mutualistic symbiosis with the roots of most crop plants. The plant benefits through increased: nutrient uptake from the soil, disease resistance, and water stress resistance. Optimal utilization of AM fungi is essen...

  3. Benchmarking to Identify Practice Variation in Test Ordering: A Potential Tool for Utilization Management.

    Science.gov (United States)

    Signorelli, Heather; Straseski, Joely A; Genzen, Jonathan R; Walker, Brandon S; Jackson, Brian R; Schmidt, Robert L

    2015-01-01

    Appropriate test utilization is usually evaluated by adherence to published guidelines. In many cases, medical guidelines are not available. Benchmarking has been proposed as a method to identify practice variations that may represent inappropriate testing. This study investigated the use of benchmarking to identify sites with inappropriate utilization of testing for a particular analyte. We used a Web-based survey to compare 2 measures of vitamin D utilization: overall testing intensity (ratio of total vitamin D orders to blood-count orders) and relative testing intensity (ratio of 1,25(OH)2D to 25(OH)D test orders). A total of 81 facilities contributed data. The average overall testing intensity index was 0.165, or approximately 1 vitamin D test for every 6 blood-count tests. The average relative testing intensity index was 0.055, or one 1,25(OH)2D test for every 18 of the 25(OH)D tests. Both indexes varied considerably. Benchmarking can be used as a screening tool to identify outliers that may be associated with inappropriate test utilization. Copyright© by the American Society for Clinical Pathology (ASCP).

  4. Handbook of evaluation of utility DSM programs. [Demand-Side Management (DSM)

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.; Reed, J. (eds.); Bronfman, B.; Fitzpatrick, G.; Hicks, E.; Hirst, E.; Hoffman, M.; Keating, K.; Michaels, H.; Nadel, S.; Peters, J.; Reed, J.; Saxonis, W.; Schoen, A.; Violette, D.

    1991-12-01

    Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility's portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough to highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to triangulate'' an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.

  5. Changes in quality management for light water reactor fuel manufacturing: A utility's view of driving forces and status

    International Nuclear Information System (INIS)

    Huettmann, A.; Skusa, J.; Ketteler, M.

    2000-01-01

    Quality management in LWR fuel manufacturing for the use in German reactors is based on international guidelines and national/local authority requirements defined in operational licenses. The quality management is twofold and comprises a quality assurance system and the check of manufacturing documents including witnessing of fabrication processes and inspections. Utility and authority appointed technical expert witness manufacturing and take part in inspections performed by the manufacturer where the scope is strictly defined and does not provide possibilities of flexible responses to manufacturing occurrences. For future developments in quality management HEW supports strengthening the ideas of quality planning. Analysis of all factors influencing fuel reliability shall be performed prior to manufacturing. This will increase the efforts in reviewing of drawings and specifications. Included here shall be a review of processes that will be used in manufacturing. The qualification and robustness of processes shall be demonstrated with special qualification programs and analysis of manufacturing statistics. Instead of product/project related inspections the use of all manufacturing data will provide a complete picture of the manufacturing quality. By applying statistical methods it will be possible to identify trends in manufacturing before deviations occur. So the basic driving force to implement statistical process control for the utilities is the wish to get comprehensive information of delivered quality, whereas for manufacturers it might be to increase production yields and thus to lower costs. The introduction and full use of statistical process control requires open information about manufacturing processes and inspection results by the manufacturers. This might include data judged to be economically sensitive. It also requires changes in attitude at the utilities and appointed experts. HEW has started to review and change internal guidelines to allow

  6. Development of a validation process for parameters utilized in optimizing construction quality management of pavements.

    Science.gov (United States)

    2006-01-01

    The implementation of an effective performance-based construction quality management requires a tool for determining impacts of construction quality on the life-cycle performance of pavements. This report presents an update on the efforts in the deve...

  7. Utilization of a computer using programless language for radiation protection management

    International Nuclear Information System (INIS)

    Masuko, Syozi; Kasahara, Shigeru

    1985-01-01

    The practice of radiation management is different for each laboratory both in point of view and in the form of recording. Therefore, the computer program for the radiation management, especially for the management of radioisotopes is required to meet many amendments. In this standpoint, we have developed a ''programless language'' or ''programless software'' and have used in our work for several years. As the result of our experience, we have found that the programless language is quite satisfactory for the management of radioisotopes and that it has an advantage in some aspects over conventional programs. It is thought that this ''programless language'' is effective not only for our own works, but also applicable to other radioisotope laboratories. (author)

  8. Operational programs in forest management and priority in the utilization of remote sensing

    Science.gov (United States)

    Douglass, R. W.

    1978-01-01

    A speech is given on operational remote sensing programs in forest management and the importance of remote sensing in forestry is emphasized. Forest service priorities in using remote sensing are outlined.

  9. Clinical Utility of Virtual Reality in Pain Management: A Comprehensive Research Review from 2009 to 2016

    OpenAIRE

    Matsangidou, Maria; Ang, Chee Siang; Sakel, Mohamed

    2017-01-01

    Virtual Reality is a technology that allows users to experience a computer-simulated reality with visual, auditory, tactile and olfactory interactions. In the past decades, there have been considerable interests in using Virtual Reality for clinical purposes, including pain management. This article provides a systematic review of research on Virtual Reality and pain management, with an aim to understand the feasibilities of current Virtual Reality technologies and content design approaches in...

  10. Making a mountain from a molehill: utility fastback management and communications

    International Nuclear Information System (INIS)

    Dixon, W.L.

    1985-01-01

    The OD strategy is discussed in which managers were asked to facilitate a program for the enhancement of management and communication among departments responsible for putting a nuclear power plant on line. The process variables include: increasing site open communication and collaboration in problem solving. The outcome variables included improved organizational performance and productivity. An internal diagnostic survey and criterion referenced objectives were used as performance indicators. A detailed project description is presented in this paper

  11. Lessons Learned: A review of utility experience with conservation and load management programs for commercial and industrial customers

    Energy Technology Data Exchange (ETDEWEB)

    Nadel, S.

    1990-10-01

    This report examines utility experience with conservation and load management (C LM) programs of commercial and industrial (C I) customers in order to summarize the lessons learned from program experiences to date and what these teach us about how to operate successful programs in the future. This analysis was motivated by a desire to learn about programs which achieve high participation rates and high electricity savings while remaining cost effective. Also, we wanted to review the very latest experiences with innovative program approaches -- approaches that might prove useful to utilities as they scale up their C LM activities. Specific objectives of this phase of the study are threefold: (1) To disseminate information on utility C LM experience to a nationwide audience. (2) To review current New York State utility programs and make suggestions on how these programs can be improved. (3) To collect data for the final phase of the American Council for an Energy-Efficient Economy/New York State Energy Research and Development Authority project, which will examine the savings that are achievable if C LM programs are pushed to the limit'' of current knowledge on how to structure and run cost-effective C LM programs. 19 tabs.

  12. Tank Operations Contract Construction Management Methodology. Utilizing The Agency Method Of Construction Management To Safely And Effectively Complete Nuclear Construction Work

    International Nuclear Information System (INIS)

    Leso, K.F.; Hamilton, H.M.; Farner, M.; Heath, T.

    2010-01-01

    Washington River Protection Solutions, LLC (WRPS) has faced significant project management challenges in managing Davis-Bacon construction work that meets contractually required small business goals. The unique challenge is to provide contracting opportunities to multiple small business construction subcontractors while performing high hazard work in a safe and productive manner. Previous to the Washington River Protection Solutions, LLC contract, Construction work at the Hanford Tank Farms was contracted to large companies, while current Department of Energy (DOE) Contracts typically emphasize small business awards. As an integral part of Nuclear Project Management at Hanford Tank Farms, construction involves removal of old equipment and structures and installation of new infrastructure to support waste retrieval and waste feed delivery to the Waste Treatment Plant. Utilizing the optimum construction approach ensures that the contractors responsible for this work are successful in meeting safety, quality, cost and schedule objectives while working in a very hazardous environment. This paper describes the successful transition from a traditional project delivery method that utilized a large business general contractor and subcontractors to a new project construction management model that is more oriented to small businesses. Construction has selected the Agency Construction Management Method. This method was implemented in the first quarter of Fiscal Year (FY) 2009, where Construction Management is performed by substantially home office resources from the URS Northwest Office in Richland, Washington. The Agency Method has allowed WRPS to provide proven Construction Managers and Field Leads to mentor and direct small business contractors, thus providing expertise and assurance of a successful project. Construction execution contracts are subcontracted directly by WRPS to small or disadvantaged contractors that are mentored and supported by DRS personnel. Each small

  13. TANK OPERATIONS CONTRACT CONSTRUCTION MANAGEMENT METHODOLOGY UTILIZING THE AGENCY METHOD OF CONSTRUCTION MANAGEMENT TO SAFELY AND EFFECTIVELY COMPLETE NUCLEAR CONSTRUCTION WORK

    Energy Technology Data Exchange (ETDEWEB)

    LESO KF; HAMILTON HM; FARNER M; HEATH T

    2010-01-14

    Washington River Protection Solutions, LLC (WRPS) has faced significant project management challenges in managing Davis-Bacon construction work that meets contractually required small business goals. The unique challenge is to provide contracting opportunities to multiple small business construction subcontractors while performing high hazard work in a safe and productive manner. Previous to the Washington River Protection Solutions, LLC contract, Construction work at the Hanford Tank Farms was contracted to large companies, while current Department of Energy (DOE) Contracts typically emphasize small business awards. As an integral part of Nuclear Project Management at Hanford Tank Farms, construction involves removal of old equipment and structures and installation of new infrastructure to support waste retrieval and waste feed delivery to the Waste Treatment Plant. Utilizing the optimum construction approach ensures that the contractors responsible for this work are successful in meeting safety, quality, cost and schedule objectives while working in a very hazardous environment. This paper describes the successful transition from a traditional project delivery method that utilized a large business general contractor and subcontractors to a new project construction management model that is more oriented to small businesses. Construction has selected the Agency Construction Management Method. This method was implemented in the first quarter of Fiscal Year (FY) 2009, where Construction Management is performed by substantially home office resources from the URS Northwest Office in Richland, Washington. The Agency Method has allowed WRPS to provide proven Construction Managers and Field Leads to mentor and direct small business contractors, thus providing expertise and assurance of a successful project. Construction execution contracts are subcontracted directly by WRPS to small or disadvantaged contractors that are mentored and supported by DRS personnel. Each small

  14. Application of physical separation techniques for waste utilization and management - case studies from Indian uranium deposits

    International Nuclear Information System (INIS)

    Anand Rao, K.; Sreenivas, T.

    2013-01-01

    The importance of physical beneficiation techniques in metallurgical industry showed gradual decline due to decreasing ore grades and very-fine size dissemination of valuable minerals in the host matrix. However, this technology regained prominence in recent past due to their utility in resource recycle, waste utilization, waste treatment and environmental remediation. Hybrid processes combined with physical, chemical and biological technology is now developing such that the idea of sustainable development is implemented. The uranium ore processing industry has always been under intense public scanner for some of the apprehensions, chiefly radioactivity, inspite of its immense energy delivering potential. Besides this, the chemical compounds formed due to gangue mineral reactivity and their carry-over to tailings pond added further owes. However, conscious scientific efforts are being made to contain these hazards to permissible levels by application of various remedial methods of which the physical separation techniques too are quite prominent

  15. Fuel utilization experience in Bohunice NPP and regulatory requirements for implementation of progressive fuel management strategies

    Energy Technology Data Exchange (ETDEWEB)

    Patenyi, V [Nuclear Regulatory Authority, Bratislava (Slovakia); Darilek, P; Majercik, J [Vyskumny Ustav Jadrovych Elektrarni, Trnava (Slovakia)

    1994-12-31

    The experience gained in fuel utilization and the basic requirements for fuel licensing in the Slovak NPPs is described. The original project of WWER-440 reactors supposes 3-year fuel cycle with cycle length of about 320 full power days (FPD). Since 1984 it was reduced to 290 FPD. Based on the experience of other countries, a 4-year fuel cycle utilization started in 1987. It is illustrated with data from the Bohunice NPP units. Among 504 fuel assemblies left for the fourth burnup cycle no leakage was observed. The mean burnup achieved in the different units varied from 33.1 to 38.5 Mwd/kg U. The new fuel assemblies used are different from the recent ones in construction, thermohydraulics, water-uranium ratio, enrichment and material design. To meet the safety criteria, regulatory requirements for exploitation of new fuel in WWER-440 were formulated by the Nuclear Regulatory Authority of Slovak Republic. 1 tab., 5 refs.

  16. Availability of anesthetic effect monitoring: utilization, intraoperative management and time to extubation in liver transplantation.

    Science.gov (United States)

    Schumann, R; Hudcova, J; Bonney, I; Cepeda, M S

    2010-12-01

    Titration of volatile anesthetics to anesthetic effect monitoring using the bispectral index (BIS) has been shown to decrease anesthetic requirements and facilitate recovery from anesthesia unrelated to liver transplantation (OLT). To determine whether availability of such monitoring influences its utilization pattern and affect anesthetic care and outcomes in OLT, we conducted a retrospective analysis in recipients with and without such monitoring. We evaluated annual BIS utilization over a period of 7 years, and compared 41 BIS-monitored patients to 42 controls. All received an isoflurane/air/oxygen and opioid-based anesthetic with planned postoperative ventilation. Data collection included age, body mass index (BMI), gender, Model for End-stage Liver Disease (MELD) score, and time to extubation (TtE). Mean preanhepatic, anhepatic, and postanhepatic end-tidal isoflurane concentrations were compared, as well as BIS values for each phase of OLT using the Kruskal-Wallis and Wilcoxon signed-rank tests, respectively. The use of anesthetic effect monitoring when available increased steadily from 15% of cases in the first year to almost 93% by year 7. There was no significant difference in age, gender, BMI, MELD, or TtE between groups. The BIS group received less inhalational anesthetic during each phase of OLT compared to the control group. However, this difference was statistically significant only during the anhepatic phase (P = .026), and was clinically not impressive. Within the BIS group, the mean BIS value was 38.74 ± 5.25 (mean ± standard deviation), and there was no difference for the BIS value between different transplant phases. Availability of anesthetic effect monitoring as an optional monitoring tool during OLT results in its increasing utilization by anesthesia care teams over time. However, unless integrated into an intraoperative algorithm and an early extubation protocol for fast tracking of OLT recipients, this utilization does not appear to provide

  17. Intraoperative utilization of dexamethasone/bupivacaine/gentamicin solution in laparoscopic assisted vaginal hysterectomy and pain management.

    Science.gov (United States)

    Fulcher, Paul H; Granese, Marsha; Chun, Yoon; Welch, Christine A; Seybold, Dara J; Randall, Gary; DePond, R Todd

    2014-01-01

    Adequately controlling pain is a key component of postoperative care after a hysterectomy. The purpose of this study was to evaluate the effects of two intraperitoneal (IP) administered solutions during Laparoscopic Assisted Vaginal Hysterectomy (LAVH), on the amount of postoperative self-administered morphine. In this prospective, randomized, double blinded study, twenty women undergoing LAVH randomly distributed to two treatment groups: (1) 100 ml dexamethasone/ bupivacaine/ gentamicin (DMG) solution: 60 cc injected vaginally at cuff and 40 cc placed topically via laparoscopy over intra-peritoneal postoperative surfaces (IP) and 5 ml bupivacaine or 5 ml saline injected at the laparoscopic incision sites, (2) 100 ml saline solution: 60 cc injected vaginally at cuff and 40 cc placed topically via laparoscopy over intra-peritoneal postoperative surfaces (IP) and 5 ml bupivacaine or 5 ml saline injected at the laparoscopic incision sites. The amount of morphine utilized by the patients was documented from their patient controlled anesthesia (PCA) pump. Patient parameters recorded included perceived pain score, height, weight, age, race, reason for surgery, pre-surgery medications, American Society of Anesthesiologist (ASA) classification, length of the surgery and estimated blood loss (EBL). Age, EBL, length of surgery, and ASA classification were not significantly different between the groups. The postoperative amount of morphine utilized was higher at 4 (p=.02) and 16 hours (p = .04) and tended to be higher at 8, 12 hours (p=.06), and 24 hours (p=.09) in the saline IP group. Overall the saline IP group (n=10) used (median; range) 21.5; 8-82 mg of morphine while the DMG IP group (n=10) used 10.5; 1-23 mg. No participants reported a postoperative infection. This study demonstrates that intraoperative utilization of DMG solution during LAVH enables patients clinically to have less perceived pain and subsequently tend to utilize about half the amount of morphine

  18. Managing female urinary incontinence: A regional prospective analysis of cost-utility ratios (curs and effectiveness

    Directory of Open Access Journals (Sweden)

    Elisabetta Costantini

    2014-06-01

    Full Text Available Introduction: To evaluate the cost-utility of incontinence treatments, particularly anticholinergic therapy, by examining costs and quality-adjusted life years. Materials and methods: A prospective cohort study of women who were consecutively referred by general practitioners (GPs to the Urology Department because of urinary incontinence. The primary outcome was evaluation of the cost-utility of incontinence treatments (surgery, medical therapy and physiotherapy for stress and/or urgency incontinence by examining costs and quality-adjusted life years. Results: 137 consecutive female patients (mean age 60.6 ± 11.6; range 36-81 were enrolled and stratified according to pathologies: SUI and UUI. Group A: SUI grade II-III: 43 patients who underwent mid-urethral sling (MUS; Group B: SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C: UUI: 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily. The cost utility ratio (CUR was estimated as saving more than €1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy. Conclusions: This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life.

  19. Temira Pachmuss 75 / Uno Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2003-01-01

    24. dets. 2002 USA-s oma juubelit tähistanud rahvusvaheliselt tuntud baltisaksa päritolu kirjandusteadlase ja professori eluteest, õpingutest ning uurimistöödest, mille huvikeskmeks on põhiliselt Dostojevski ja välisvene kirjandus, sealhulgas vene kirjandus Eestis ja Soomes

  20. Anaerobic digestion and related best management practices : utilizing life cycle assessment

    Energy Technology Data Exchange (ETDEWEB)

    Venczel, M.Z. [Clarkson Univ., Potsdam, NY (United States); Powers, S.E. [Clarkson Univ., Potsdam, NY (United States)

    2010-07-01

    This paper reported on a life cycle assessment (LCA) study that compared the environmental impacts of business-as-usual manure management with those of a manure management operation incorporating anaerobic digestion with combined heat and power generation. The case study was based on a medium sized dairy farm in northern New York State. The study identified the benefits resulting from the displacement of fossil fuels, and reduction of related emissions. Although anaerobic digestion of dairy manure with energy recovery through biogas combustion is viewed as a positive environmental approach to increase the use of renewable energy, there are potential negative impacts that can counteract the environmental benefits. The negative impacts are associated with emissions of methane and nitrogen species during digestion and after spreading of digester effluent. The environmental impacts and their causes should be evaluated in order to promote best management practices. Knowledge gained from an LCA was used in this study to assess the benefits associated with various management practices. The study showed that the design and construction of biogas systems must minimize the potential for fugitive emissions of biogas that can readily outweigh the benefits associated fossil fuel displacement. The environmental trade-offs associated with various manure management and energy recovery systems were also described.

  1. Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study

    Energy Technology Data Exchange (ETDEWEB)

    Potter, Jennifer [Hawaii Natural Energy Institute, Honolulu, HI (United States); Stuart, Elizabeth [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.; Cappers, P [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Analysis and Environmental Impacts Div.

    2018-02-13

    Integrated demand-side management (IDSM) is a strategic approach to designing and delivering a portfolio of demand side management (DSM) programs to customers. IDSM typically delivers customer centric strategies with the goal of increasing the amount of DSM in the field, but doing so in a way that integrates various measures and technologies to improve their collective performance and/or penetration. Specifically, IDSM can be defined as the integrated or coordinated delivery of three or more of: (1) energy efficiency (EE), (2) demand response (DR), (3) distributed generation (DG), (4) storage, (5) electric vehicle (EV) technologies, and (6) time-based rate programs to residential and commercial electric utility customers. The electric industry’s limited experience deploying IDSM to date suggests that significant barriers may exist. A Berkeley Lab report “Barriers and Opportunities to Broader Adoption of Integrated Demand Side Management at Electric Utilities: A Scoping Study” explores recent electric utility experience with IDSM to provide an assessment of the barriers and potential benefits perceived or experienced by program administrators in their attempts to implement integrated programs. The research draws on surveys and interviews with eleven staff from a sample of eight DSM program administrators and program implementers who were currently implementing or had previously attempted to implement an IDSM program or initiative. Respondents provided their perspectives on drivers for IDSM and barriers to broader deployment. They also reported on actions they had undertaken to promote expanded delivery of IDSM and provided their assessments of the most important under-tapped opportunities for expanding IDSM efforts, both for program administrator and regulatory organizations.

  2. Management plan of useful life; Plan de gestion de vida util

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez Zapata, J. D.

    2009-07-01

    The Cofrentes NPP Life Management Plan is a plant management program that covers all those activities aimed at monitoring, controlling and mitigating the effects of ageing in the safety-related structures, systems and components, as well as in the equipment that is of particular importance for long-term availability of the plant. the methodology used is based on the system and methods of the so-called UNESA Methodology, whose safety-related aspects have been updated with the application of criteria defined in Licensing Renewal regulation 10 CFR 54. the text develops the details of this plan and describes its status at the present time. (Author)

  3. Reducing the risk of cyber threats in utilities through log management

    Energy Technology Data Exchange (ETDEWEB)

    Patnaik, A. [ArcSight, Cupertino, CA (United States)

    2010-01-15

    Electrical blackouts caused by terrorists hacking into targeted control systems have already occurred in Brazil. A patchwork of security tools is needed to reduce potential threats. The continuous collection and analysis of data is also needed to detect cyber threats. The real time correlation of logs across all systems, applications and users is needed to ensure the reliability and security of the power grid. Solutions must also integrate well with identity management sources in order to prevent remote access account hijacking. Effective log management can be used to detect threats and reduce the risk of power outages. 1 fig.

  4. Agricultural management legacy affects microbial energetics, resource utilization and active bacterial community membership during 13C-glucose consumption

    Science.gov (United States)

    Helgason, B. L.; Levy-Booth, D.; Arcand, M. M.

    2017-12-01

    Over the long-term, differences in soil management can result in fundamental changes in biogeochemical cycling. The Alternative Cropping Systems (ACS) Study at Scott, SK, Canada (est. 1994) compares organic (ORG) vs. conventionally (CON) managed crop rotations in a loamy Typic Borall. Nitrogen (N) and phosphorus (P) deficiency in the ORG systems have limited crop growth and thus plant carbon (C) inputs for over two decades, ultimately resulting in a C deficiency which has further altered biogeochemical cycling. We conducted a short-term microcosm experiment using 13C-glucose stable isotope probing (SIP) of DNA to test whether ORG soils have greater microbial C use efficiency due to long term resource limitation. Glucose-utilizing populations were dominated by Proteobacteria and Actinobacteria, with differing species-level identities and physiological capacities between CON and ORG systems. Of the 13C-utilizing taxa, relative abundance of Proteobacteria was greater in CON while Actinobacteria (and notably Firmicutes) were more dominant in ORG soils. Using isothermal calorimetry, we measured a thermodynamic efficiency (ηeff) of 0.68, which was not significantly different between soils indicating that the metabolic cost of glucose utilization was similar in CON and ORG soils. In spite of this, differential abundance analysis of 13C-labelled OTUs revealed that ORG soils had distinct active bacterial populations that were positively correlated with ηeff, ηsoil (glucose energy retained in soil) and primed soil organic matter (pSOM). In contrast, differentially abundant OTUs in the CON soils were negatively correlated with measures of thermodynamic efficiency but positively correlated with glucose-derived heat and CO2 production as well as NO3- and PO4- availability. ORG bacterial communities may co-metabolize other resources (N and P) from SOM to meet their metabolic requirements during glucose utilization, while the active bacteria in the CON soils could access these

  5. Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

    Science.gov (United States)

    Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

    2012-01-01

    Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

  6. Efficient Utilization of Hierarchical iJTAG Networks for Interrupts Management

    NARCIS (Netherlands)

    Ibrahim, Ahmed Mohammed Youssef; Kerkhoff, Hans G.

    2016-01-01

    Modern systems-on-chips rely on embedded instruments for testing and debugging, the same instruments could be used for managing the lifetime dependability of the chips. The IEEE 1687 (iJTAG) standard introduces an access network to the instruments based on reconfigurable scan paths. During lifetime,

  7. Life cycle impacts of forest management and wood utilization on carbon mitigation : knowns and unknowns

    Science.gov (United States)

    Bruce Lippke; Elaine Oneil; Rob Harrison; Kenneth Skog; Leif Gustavsson; Roger Sathre

    2011-01-01

    This review on research on life cycle carbon accounting examines the complexities in accounting for carbon emissions given the many different ways that wood is used. Recent objectives to increase the use of renewable fuels have raised policy questions, with respect to the sustainability of managing our forests as well as the impacts of how best to use wood from our...

  8. Breathing Life into Business Concepts: Utilizing Simulations in Management Information Systems

    Science.gov (United States)

    Hendrix, Stephen

    2016-01-01

    The Department of Computing at East Tennessee State University provides students exposure to the enterprise application SAP as a part of the Information Systems curriculum. Over the past two years, the use of SAP has expanded beyond the Department of Computing into the Management Information Systems course offered by the Department of Management…

  9. Utility of 16S rRNA PCR performed on clinical specimens in patient management

    Directory of Open Access Journals (Sweden)

    A. Akram

    2017-04-01

    Conclusions: Despite the low diagnostic yield, results of 16S rRNA PCR can still have a significant impact on patient management due to rationalization or cessation of the antimicrobial therapy. The yield of 16S rRNA PCR was highest for heart valves.

  10. A Retention Assessment Process: Utilizing Total Quality Management Principles and Focus Groups

    Science.gov (United States)

    Codjoe, Henry M.; Helms, Marilyn M.

    2005-01-01

    Retaining students is a critical topic in higher education. Methodologies abound to gather attrition data as well as key variables important to retention. Using the theories of total quality management and focus groups, this case study gathers and reports data from current college students. Key results, suggestions for replication, and areas for…

  11. Utilization of Information Technology for Non Domestic Waste Management in Semarang City

    Science.gov (United States)

    Ali, Muhammad; Hadi, Sudharto P.; Soemantri, Maman

    2018-02-01

    Garbage problem is often very complex in urban areas. The handling pattern of collecting, transporting and disposing that has been applied up to this day has not yet produced an appropriate solution. This is evident from the data of statistic centre institution in 2015 that 76.31% of the existing waste in the community has not been sorted, while 10.28% sorted to be used and 13.41% sorted to be discarded, showing the community amount of unsorted garbage large enough to necessitate managerial efforts at the waste sources. In designing a systematic and structured waste management system, the generations, compositions, and characteristics of the waste are indispensable. Therefore, a research is conducted on these three dimensions to the non-domestic waste in Semarang City, which involves commercial waste (from the markets, restaurants, and hotels), institutional waste (from the offices and schools). From the research result the average of 0,24kgs/person/day in weight unit of the City's non-domestical waste generation is derived. The waste composition is dominated by organic waste of around 61.95%, while the rest percentage is inorganic. The management policy is directed with the application of Management Information System model based on Information Technology because of the system's abilities to effectuate the waste management.

  12. On Representing, Purging, and Utilizing Change Logs in Process Management Systems

    NARCIS (Netherlands)

    Rinderle, S.B.; Reichert, M.U.; Jurisch, M.; Kreher, U

    In recent years adaptive process management technolgy has emerged in order to increase the flexibility of business process implementations and to support process changes at different levels. Usually, respective systems log comprehensive information about changes, which can then be used for different

  13. Utilization of mathematical models to manage risk of holding cold food without temperature control.

    Science.gov (United States)

    Schaffner, Donald W

    2013-06-01

    This document describes the development of a tool to manage the risk of the transportation of cold food without temperature control. The tool uses predictions from ComBase predictor and builds on the 2009 U.S. Food and Drug Administration Model Food Code and supporting scientific data in the Food Code annex. I selected Salmonella spp. and Listeria monocytogenes as the organisms for risk management. Salmonella spp. were selected because they are associated with a wide variety of foods and grow rapidly at temperatures >17°C. L. monocytogenes was selected because it is frequently present in the food processing environment, it was used in the original analysis contained in the Food Code Annex, and it grows relatively rapidly at temperatures supplier collected as part of this project. The resulting model-based tool will be a useful aid to risk managers and customers of wholesale cash and carry food service suppliers, as well as to anyone interested in assessing and managing the risks posed by holding cold foods out of temperature control in supermarkets, delis, restaurants, cafeterias, and homes.

  14. The management of energy utilization in a spacecraft tracking station and its industrial applications

    Science.gov (United States)

    Reynolds, R.; White, R. L.; Hume, P.

    1978-01-01

    The mission of a tracking station within the NASA/Jet Propulsion Deep Space Network is characterized by a wide diversity of spacecraft types, communications ranges, and data accuracy requirements. In the present paper, the system architecture, communications techniques, and operators interfaces for a utility controller are described. The control equipment as designed and installed is meant to be a tool to study applications of automated control in the dynamic environment of a tracking station. It allows continuous experimenting with new technology without disruption of the tracking activities.

  15. Radioactive waste management: a series of bibliographies. Formerly utilized sites: remedial action. Supplement 1

    International Nuclear Information System (INIS)

    McLaren, L.H.

    1985-04-01

    This bibliography contains information on formerly utilized sites included in the Department of Energy's Energy Data Base from November 1982 through December 1983. The abstracts are grouped by subject category as shown in the table of contents. Entries in the subject index also facilitate access by subject, e.g., Abandoned Sites/Decontamination. Within each category the arrangement is by report number for reports, followed by nonreports in reverse chronological order. These citations are to research reports, journal articles, books, patents, theses, and conference papers from worldwide sources. Five indexes, each preceded by a brief description, are provided: Corporate Author, Personal Author, Subject, Contract Number, and Report Number

  16. Infrastructures of Urban Religious Management: Who Should Pay for the Utilities of Cemevis in Turkey?

    Directory of Open Access Journals (Sweden)

    Nazlı Özkan

    2018-06-01

    Full Text Available In Turkey, electricity and water expenses for houses of prayer, such as mosques and churches, are covered by the state. Cemevis, places of worship for Turkey’s marginalized religious minority of Alevis, however, cannot benefit from from this regulation. By analyzing the political negotiations between the Turkish state and Alevis about cemevis’ utility bills, this paper argues that unequal distribution of infrastructural funds becomes a means for governing religion in urban contexts. In so doing, I focus on a less studied dimension of infrastructures by examining how infrastructural governance is an arena both to reproduce and to contest hegemonic state religiosity.

  17. Maximizing the utility of monitoring to the adaptive management of natural resources

    Science.gov (United States)

    Kendall, William L.; Moore, Clinton T.; Gitzen, Robert A.; Cooper, Andrew B.; Millspaugh, Joshua J.; Licht, Daniel S.

    2012-01-01

    Data collection is an important step in any investigation about the structure or processes related to a natural system. In a purely scientific investigation (experiments, quasi-experiments, observational studies), data collection is part of the scientific method, preceded by the identification of hypotheses and the design of any manipulations of the system to test those hypotheses. Data collection and the manipulations that precede it are ideally designed to maximize the information that is derived from the study. That is, such investigations should be designed for maximum power to evaluate the relative validity of the hypotheses posed. When data collection is intended to inform the management of ecological systems, we call it monitoring. Note that our definition of monitoring encompasses a broader range of data-collection efforts than some alternative definitions – e.g. Chapter 3. The purpose of monitoring as we use the term can vary, from surveillance or “thumb on the pulse” monitoring (see Nichols and Williams 2006), intended to detect changes in a system due to any non-specified source (e.g. the North American Breeding Bird Survey), to very specific and targeted monitoring of the results of specific management actions (e.g. banding and aerial survey efforts related to North American waterfowl harvest management). Although a role of surveillance monitoring is to detect unanticipated changes in a system, the same result is possible from a collection of targeted monitoring programs distributed across the same spatial range (Box 4.1). In the face of limited budgets and many specific management questions, tying monitoring as closely as possible to management needs is warranted (Nichols and Williams 2006). Adaptive resource management (ARM; Walters 1986, Williams 1997, Kendall 2001, Moore and Conroy 2006, McCarthy and Possingham 2007, Conroy et al. 2008a) provides a context and specific purpose for monitoring: to evaluate decisions with respect to achievement

  18. Chronic disease self-management education courses: utilization by low-income, middle-aged participants.

    Science.gov (United States)

    Horrell, Lindsey N; Kneipp, Shawn M; Ahn, SangNam; Towne, Samuel D; Mingo, Chivon A; Ory, Marcia G; Smith, Matthew Lee

    2017-06-27

    Individuals living in lower-income areas face an increased prevalence of chronic disease and, oftentimes, greater barriers to optimal self-management. Disparities in disease management are seen across the lifespan, but are particularly notable among middle-aged adults. Although evidence-based Chronic Disease Self-management Education courses are available to enhance self-management among members of this at-risk population, little information is available to determine the extent to which these courses are reaching those at greatest risk. The purpose of this study is to compare the extent to which middle-aged adults from lower- and higher-income areas have engaged in CDSME courses, and to identify the sociodemographic characteristics of lower-income, middle aged participants. The results of this study were produced through analysis of secondary data collected during the Communities Putting Prevention to Work: Chronic Disease Self-Management Program initiative. During this initiative, data was collected from 100,000 CDSME participants across 45 states within the United States, the District of Columbia, and Puerto Rico. Of the entire sample included in this analysis (19,365 participants), 55 people lived in the most impoverished counties. While these 55 participants represented just 0.3% of the total study sample, researchers found this group completed courses more frequently than participants from less impoverished counties once enrolled. These results signal a need to enhance participation of middle-aged adults from lower-income areas in CDSME courses. The results also provide evidence that can be used to inform future program delivery choices, including decisions regarding recruitment materials, program leaders, and program delivery sites, to better engage this population.

  19. A prior authorization program of a radiology benefits management company and how it has affected utilization of advanced diagnostic imaging.

    Science.gov (United States)

    Levin, David C; Bree, Robert L; Rao, Vijay M; Johnson, Jean

    2010-01-01

    Radiology benefits management companies have evolved in recent years to meet the need to control the rapid growth in advanced diagnostic imaging. The Obama administration and other key policymakers have proposed using them as a cost-control mechanism, but little is known about how they operate or what results they have produced. The main tool they use is prior authorization. The authors describe the inner workings of the call center of one radiology benefits management company and how its prior authorization program seems to have slowed the growth in the utilization of MRI, CT, and PET in the large markets of one commercial payer. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. Phosphorus management and its utilization by berseem (Trifolium alexandrinum L.) and residual effect on forage crops

    International Nuclear Information System (INIS)

    Sinha, M.N.; Rai, R.K.

    1990-01-01

    Placement of phosphorus even to a broadcast sown crop like berseem helped in boosting up 10 per cent higher forage production over the conventional practice of broadcast application of phosphatic fertilizer without altering the normal practice of sowing broadcast. Likewise, P from fertilizer source and its utilization by the crop increased substantially and were higher in favour of placement of P. Closer the rows of phosphorus placement, greater was the recovery of applied P. The yield of forage increased with the increase in the level of P ranging from 75 to 225 kg P 2 O 5 /ha and the optimum dose was 173 kg P 2 O 5 /ha while the utilization of P decreased with increase in levels. There was enormous response to residual P after berseem and the residual forage yield increased with increase in P levels. A fertilized cereal crop after berseem was in no way better than unfertilized crop after berseem from productivity point of view. (author). 11 refs., 5 tabs

  1. Utility of intraoperative diagnostic C-arm angiography for management of high grade subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Zhikui Wei

    2015-06-01

    Full Text Available The accurate and efficient localization of underlying vascular lesions is crucial for prompt and definitive treatment of subarachnoid hemorrhage (SAH. To demonstrate the utility and feasibility of intraoperative C-arm angiography in cerebrovascular emergencies, we report five cases of high grade SAH and/or intracerebral hemorrhage (ICH where intraoperative diagnostic C-arm angiography was safely and effectively utilized. Initial evaluations of all patients included a non-contrast head CT scan, which was followed by urgent decompressive hemicraniectomy as a life-saving measure in the presence of markedly elevated intracranial pressure. Further diagnostic evaluations were performed intraoperatively using a multi-purpose C-arm angiography system. The C-arm angiography findings greatly aided the intraoperative planning and led to definitive treatments in four cases of SAH by elucidating the underlying neurovascular lesions. With this treatment strategy, two of the patients made moderately good recoveries from their SAH and/or ICH with a Glasgow outcome score (GOS of 4. Three of the patients expired despite maximal therapy mostly due to unfavorable presenting grade. These results suggest that C-arm angiography is a reasonable diagnostic and surgical planning tool for selected patients with high grade diffuse SAH who require immediate decompression.

  2. Current status of nuclear research reactor management and utilization program in Thailand

    International Nuclear Information System (INIS)

    Aramrattana, M.; Busamongkol, Y.

    1999-01-01

    The TRR1/M1 is the first research reactor and has been in operational for more than 20 years. During the three decades of research reactor operation in Thailand the utilization of research reactor have been broadened in different fields such as agriculture, medicine and industry. Limitation on utilization of the existing reactor in various fields has led to establishing of a new nuclear research center, Ongkharak Nuclear Research Center (ONRC). The ONRC comprises three major facilities, namely Reactor Island, Isotope Production Facility and Waste Processing and Storage Facility. The reactor itself is a 10 MW TRIGA-type fuels, moderated and cooled by light water with beryllium and heavy water as the reflectors. It is a multi-purpose reactor consisting of different facilities inside and around the core for radioisotope production, medical and industrial uses; and for beam experiments such as High Resolution Powder Diffractometry (HRPD), Neutron Radiography (NR), Prompt Gamma Neutron Activation Analysis (PGNAA), and Boron Neutron Capture Therapy (BNCT). The center is expected to be operational by year 2001. (author)

  3. Report of the advisory committee on the management and disposition of Ontario Hydro's contracts with non-utility generators

    International Nuclear Information System (INIS)

    Anon.

    1999-01-01

    The report from the advisory committee on the management and disposition of Ontario Hydro's contracts with non-utility generators on the future management and disposition of the power purchase agreements entered into by Ontario Hydro with each non-utility generator (a NUG) is discussed. The integration of NUG contracts into a restructured competitive electricity market, the complexity of the contracts and the disparity of size, resources and approach to the integration exercise of the NUGs produces to an array of challenging issues. The committee identified three alternative strategies for dealing with NUG contracts in Ontario. The first is to use the independent Electricity Market Operator as a purely passive contract holder and above-market cost collection agent. The second is to make the Ontario Electricity Financial Corporation (OEFC) the contract holder and use a commercially oriented manager to administer the NUG contracts. This would minimize above-market costs and to advise on buyouts, compute above-market costs as an amount based on the difference between estimated future contract payments and estimated future market revenues for NUG power and recover them from domestic customers as a part of a single pooled Competition Transfer Charge. The third is to make the OEFC the contract holder, use a commercially oriented manager to administer the NUG contracts, to minimize above-market costs and to advise on buyouts. The OEFC would compute above-market costs as an amount based on the difference between estimated future contract payments and estimated future market revenues for NUG power and recover them from domestic customers as a part of a pooled CTC. The IMO would be used to collect the above-market NUG contract part of the pooled CTC as agent of the contract holder, in a contract uplift that would, like the levy in the first strategy, be charged to wholesale market participants and be included in rates paid by domestic end-use customers.1

  4. Utilization of Patient-Reported Outcomes to Guide Symptom Management during Stereotactic Body Radiation Therapy for Clinically Localized Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Malika Danner

    2017-10-01

    Full Text Available IntroductionUtilization of patient-reported outcomes (PROs to guide symptom management during radiation therapy is increasing. This study focuses on the use of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP as a tool to assess urinary and bowel bother during stereotactic body radiation therapy (SBRT and its utility in guiding medical management.MethodsBetween September 2015 and January 2017, 107 patients with clinically localized prostate cancer were treated with 35–36.25 Gy via SBRT in five fractions. PROs were assessed using EPIC-CP 1 h prior to the first fraction and after each subsequent fraction. Symptom management medications were prescribed based on the physician clinical judgment or if patients reported a moderate to big problem. Clinical significance was assessed using a minimally important difference of 1/2 SD from baseline score.ResultsA median baseline EPIC-CP urinary symptom score of 1.5 significantly increased to 3.7 on the day of the final treatment (p < 0.0001. Prior to treatment, 9.3% of men felt that their overall urinary function was a moderate to big problem that increased to 28% by the end of the fifth treatment. A median baseline EPIC-CP bowel symptom score of 0.3 significantly increased to 1.4 on the day of the final treatment (p < 0.0001. Prior to treatment, 1.9% of men felt that their overall bowel function was a moderate to big problem that increased to 3.7% by the end of the fifth treatment. The percentage of patients requiring an increased dose of alpha-antagonist increased to 47% by the end of treatment, and an additional 28% of patients required a short steroid taper to manage moderate to big urinary problems. Similarly, the percentage of patients requiring antidiarrheals reached 12% by the fifth treatment.ConclusionDuring the course of SBRT, an increasing percentage of patients experienced clinically significant symptoms many of which required medical management

  5. Cost-effectiveness in the management of Dupuytren's contracture. A Canadian cost-utility analysis of current and future management strategies.

    Science.gov (United States)

    Baltzer, H; Binhammer, P A

    2013-08-01

    In Canada, Dupuytren's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy (PNA). Injectable collagenase will soon be available. The optimal management of Dupuytren's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren's contracture it and the threshold at which collagenase is cost-effective. We developed an expected-value decision analysis model for Dupuytren's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Cost-effectiveness, one-way sensitivity and variability analyses were performed using standard thresholds for cost effective treatment ($50 000 to $100 000/QALY gained). Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger. The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. Collagenase was cost-effective relative to and preferred over aponeurotomy at $875 and $470 per course of treatment, respectively. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing.

  6. Personalised Care Plan Management Utilizing Guideline-Driven Clinical Decision Support Systems.

    Science.gov (United States)

    Laleci Erturkmen, Gokce Banu; Yuksel, Mustafa; Sarigul, Bunyamin; Lilja, Mikael; Chen, Rong; Arvanitis, Theodoros N

    2018-01-01

    Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans.

  7. Collective in exile: Utilizing terror management theory to understand women's wailing performance.

    Science.gov (United States)

    Gamliel, Tova

    2017-08-01

    Although women's wailing at death rites in various cultures typically amplifies mortality salience, this ritual phenomenon is absent in the research literature on terror management theory (TMT). This study explored Yemenite-Jewish wailing in Israel as an example of how a traditional performance manages death anxiety in a community context. Observations of wailing events and interviews with Yemenite-Jewish wailers and mourners in Israel were analyzed to understand respondents' perceptions of the experience of wailing as well as the anxiety-oriented psychotherapeutic expertise involved. The findings are discussed to propose an alternative outlook on the intersubjective adaptive value of death anxiety. After describing TMT's view on the role of culture in coping with death anxiety, I consider the extent to which Yemenite-Jewish wailing is consistent with the premises of TMT.

  8. The Utility of Corporate-Style Balance Sheets for DoD Managers

    Science.gov (United States)

    2014-06-01

    rate than sales in the presence of fixed costs. A doubling of sales, for example, usually implies a more than doubling of net income (Stickney...users. Corporations possess the jurisdiction to employ the assets on their books in any manner that management chooses. For instance, inventory can be...federal government leverages its ability to raise revenue through taxation , thereby negating a relationship between debt and net position. Instead, net

  9. Dynamic Gene-Resource Landscape Management of Norway Spruce: Combining Utilization and Conservation

    Directory of Open Access Journals (Sweden)

    Milan Lstibůrek

    2017-10-01

    Full Text Available Traditional gene-resource management programs for forest trees are long-term endeavors requiring sustained organizational commitment covering extensive landscapes. While successful in maintaining adaptation, genetic diversity and capturing traditional growth attributes gains, these programs are dependent on rigid methods requiring elaborate mating schemes, thus making them slow in coping with climate change challenges. Here, we review the significance of Norway spruce in the boreal region and its current management practices. Next, we discuss opportunities offered by novel technologies and, with the use of computer simulations, we propose and evaluate a dynamic landscape gene-resource management in Norway. Our suggested long-term management approach capitalizes on: (1 existing afforestation activities, natural crosses, and DNA-based pedigree assembly to create structured pedigree for evaluation, thus traditional laborious control crosses are avoided and (2 landscape level genetic evaluation, rather than localized traditional progeny trials, allowing for screening of adapted individuals across multiple environmental gradients under changing climate. These advantages lead to greater genetic response to selection in adaptive traits without the traditional breeding and testing scheme, facilitating conservation of genetic resources within the breeding population of the most important forest tree species in Norway. The use of in situ selection from proven material exposed to realistic conditions over vast territories has not been conducted in forestry before. Our proposed approach is in contrast to worldwide current programs, where genetic evaluation is constrained by the range of environments where testing is conducted, which may be insufficient to capture the broad environmental variation necessary to tackle adaptation under changing climate.

  10. PSA testing anxiety, psychological morbidity, and PSA utility in the management of prostate cancer.

    OpenAIRE

    Micsunescu, Anamaria Elia

    2017-01-01

    Anecdotal reports from urologists and medical oncologists have suggested that patients with prostate cancer (PCa) often present with anxiety related to ongoing monitoring of their PSA levels as part of their disease management. The purpose of the current study, therefore, was to determine the prevalence and severity of prostate specific antigen (PSA) testing anxiety in a population of patients with either localised or metastatic PCa living in Australia. Other aspects of psychological morbidit...

  11. The utility owner experience in the fuel management of the SENA reactor

    International Nuclear Information System (INIS)

    Charransol, P.

    1975-01-01

    The calculation method developed to solve fuel management problems of the SENA reactor is presented. Comparison between measurements and predictions shows that the computation method used for the reactor loaded with UO 2 assemblies gives: cycle length with an associated uncertainty of 3%, power distribution with an associated uncertainty of 2 to 5% and isotopic fuel composition with an uncertainty of 2 to 4% [fr

  12. Proposing a Conceptual Framework to Utilize Storytelling Mechanism into Project Management Life Cycle

    Directory of Open Access Journals (Sweden)

    mahdi shami zanjani

    2013-10-01

    Full Text Available It is rather difficult to exploit knowledge in project organizations due to their unique characteristics and temporal behavior of activities. Therefore, development of knowledge management capability among projects is accounted for an important source to gain competitive advantage. This paper tries to provide a conceptual framework in order to introduce applications of storytelling as an effective and inexpensive mechanism for projects knowledge management. At first, a conceptual framework was designed including 58 story applications in activities of project life cycle by studying and analyzing the related literature. Then, validation of this conceptual framework was investigated and verified by relevant experts. Finally, application of storytelling was assessed within the projects of Sanam industrial and commercial company, using the framework designed. Analysis of data demonstrates that out of 58 applications introduced, this company benefit from just 28 applications. Research method in this section was survey. According to the available information, this paper is one of the first researches which have adopted to introduce applications of storytelling in the life cycle of project management by providing a conceptual framework.

  13. Deep-Burn High Temperature Reactor - TRU Utilization and Nuclear Waste Management

    International Nuclear Information System (INIS)

    Tsvetkov, Pavel V.

    2013-01-01

    Summary of our historical and ongoing efforts: • We have a long history of R and Ds supporting DB-HTRs. Our R and Ds carry V and V and are consistent with ongoing benchmark efforts. • We are looking at DB-HTR configurations based on HTTR block and GA block (NGNP). Both offer advantages. • MAs as a Fuel lead to the designs of Ultra-Long Life VHTRs, which may be focused on Deep Burn or autonomy (not HLW management). • Our role in the Deep Burn Project R and D package was focused on 3D optimization and related software development. • Scenario studies towards an Environmentally Benign Sustainable and Secure Energy Source (integration of DB-HTRs within a fuel cycle) demonstrate advantages of DB-HTRs. • Advanced sensing and 3D mapping are of importance to DB-HTRs. • Fission product management in HTRs is a viable supplementary option in addition to their potential TRU management role in advanced fuel cycle scenarios

  14. Bilateral vocal fold immobility: a 13 year review of etiologies, management and the utility of the Empey index.

    Science.gov (United States)

    Brake, Maria K; Anderson, Jennifer

    2015-06-26

    Bilateral vocal fold immobility (BVFI) is a rare diagnosis causing dyspnea, dysphonia and dysphagia. Management depends on respiratory performance, airway patency, vocal ability, and quality-of-life priorities. The authors review the presentation, management and outcome in patients diagnosed with BVFI. The utility and efficacy of the Empey index (EI) and the Expiratory Disproportion Index (EDI) are evaluated as an objective monitoring tools for BVFI patients. A 13-year retrospective review was performed of BVFI patients at St. Michael's Hospital, University of Toronto, a tertiary referral centre for laryngology. Forty-eight patients were included; 46 presented with airway obstruction symptoms. Tracheotomy was required for airway management in 40% of patients throughout the course of their treatment, which was reduced to 19% at the end of the study period. Twenty-one patients underwent endoscopic arytenoidectomy/cordotomy. Non-operative management included continuous positive airway pressure devices. Pulmonary function testing was carried out in 29 patients. Only a portion of the BVFI patients met the defined upper airway obstruction criteria (45% EI and 52% EDI). Seven patients had complete pre- and post-operative PFTs for comparison and all seven had ratios that significantly improved post-operatively which correlated clinically. The EI and EDI have limited use in evaluating patients with who have variable upper airway obstruction, but may be helpful in monitoring within subject airway function changes.

  15. The study of knowledge management capability and organizational effectiveness in Taiwanese public utility: the mediator role of organizational commitment.

    Science.gov (United States)

    Chiu, Chia-Nan; Chen, Huei-Huang

    2016-01-01

    Many studies on the significance of knowledge management (KM) in the business world have been performed in recent years. Public sector KM is a research area of growing importance. Findings show that few authors specialize in the field and there are several obstacles to developing a cohesive body of literature. In order to examine their effect of the knowledge management capability [which consists of knowledge infrastructure capability (KIC) and knowledge process capability (KPC)] and organizational effectiveness (OE), this study conducted structural equation modeling to test the hypotheses with 302 questionnaires of Taipei Water Department staffs in Taiwan. In exploring the model developed in this study, the findings show that there exists a significant relationship between KPC and OE, while KIC and OE are insignificant. These results are different from earlier findings in the literature. Furthermore, this research proposed organizational commitment (OC) as the mediator role. The findings suggest that only OC has significant mediating effects between KPC and OE, whereas this is not the case for KIC and OE. It is noteworthy that the above findings inspired managers, in addition to construct the knowledge infrastructure more than focus on social media tools on the Internet, which engage knowledge workers in "peer-to-peer" knowledge sharing across organizational and company boundaries. The results are likely to help organizations (particularly public utilities) sharpen their knowledge management strategies. Academic and practical implications were drawn based on the findings.

  16. Combined energy production and waste management in manned spacecraft utilizing on-demand hydrogen production and fuel cells

    Science.gov (United States)

    Elitzur, Shani; Rosenband, Valery; Gany, Alon

    2016-11-01

    Energy supply and waste management are among the most significant challenges in human spacecraft. Great efforts are invested in managing solid waste, recycling grey water and urine, cleaning the atmosphere, removing CO2, generating and saving energy, and making further use of components and products. This paper describes and investigates a concept for managing waste water and urine to simultaneously produce electric and heat energies as well as fresh water. It utilizes an original technique for aluminum activation to react spontaneously with water at room temperature to produce hydrogen on-site and on-demand. This reaction has further been proven to be effective also when using waste water and urine. Applying the hydrogen produced in a fuel cell, one obtains electric energy as well as fresh (drinking) water. The method was compared to the traditional energy production technology of the Space Shuttle, which is based on storing the fuel cell reactants, hydrogen and oxygen, in cryogenic tanks. It is shown that the alternative concept presented here may provide improved safety, compactness (reduction of more than one half of the volume of the hydrogen storage system), and management of waste liquids for energy generation and drinking water production. Nevertheless, it adds mass compared to the cryogenic hydrogen technology. It is concluded that the proposed method may be used as an emergency and backup power system as well as an additional hydrogen source for extended missions in human spacecraft.

  17. Guidelines in the management of diabetic nerve pain clinical utility of pregabalin

    Directory of Open Access Journals (Sweden)

    Vinik AI

    2013-02-01

    Full Text Available Aaron I Vinik, Carolina M Casellini Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA, USA Abstract: Diabetic peripheral neuropathy is a common complication of diabetes. It presents as a variety of syndromes for which there is no universally accepted unique classification. Sensorimotor polyneuropathy is the most common type, affecting about 30% of diabetic patients in hospital care and 25% of those in the community. Pain is the reason for 40% of patient visits in a primary care setting, and about 20% of these have had pain for greater than 6 months. Chronic pain may be nociceptive, which occurs as a result of disease or damage to tissue with no abnormality in the nervous system. In contrast, neuropathic pain is defined as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system.” Persistent neuropathic pain interferes significantly with quality of life, impairing sleep and recreation; it also significantly impacts emotional well-being, and is associated with depression, anxiety, and noncompliance with treatment. Painful diabetic peripheral neuropathy is a difficult-to-manage clinical problem, and patients with this condition are more apt to seek medical attention than those with other types of diabetic neuropathy. Early recognition of psychological problems is critical to the management of pain, and physicians need to go beyond the management of pain per se if they are to achieve success. This evidence-based review of the assessment of the patient with pain in diabetes addresses the state-of-the-art management of pain, recognizing all the conditions that produce pain in diabetes and the evidence in support of a variety of treatments currently available. A search of the full Medline database for the last 10 years was conducted in August 2012 using the terms painful diabetic peripheral neuropathy, painful diabetic peripheral polyneuropathy

  18. Guidelines in the management of diabetic nerve pain: clinical utility of pregabalin.

    Science.gov (United States)

    Vinik, Aaron I; Casellini, Carolina M

    2013-01-01

    Diabetic peripheral neuropathy is a common complication of diabetes. It presents as a variety of syndromes for which there is no universally accepted unique classification. Sensorimotor polyneuropathy is the most common type, affecting about 30% of diabetic patients in hospital care and 25% of those in the community. Pain is the reason for 40% of patient visits in a primary care setting, and about 20% of these have had pain for greater than 6 months. Chronic pain may be nociceptive, which occurs as a result of disease or damage to tissue with no abnormality in the nervous system. In contrast, neuropathic pain is defined as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system." Persistent neuropathic pain interferes significantly with quality of life, impairing sleep and recreation; it also significantly impacts emotional well-being, and is associated with depression, anxiety, and noncompliance with treatment. Painful diabetic peripheral neuropathy is a difficult-to-manage clinical problem, and patients with this condition are more apt to seek medical attention than those with other types of diabetic neuropathy. Early recognition of psychological problems is critical to the management of pain, and physicians need to go beyond the management of pain per se if they are to achieve success. This evidence-based review of the assessment of the patient with pain in diabetes addresses the state-of-the-art management of pain, recognizing all the conditions that produce pain in diabetes and the evidence in support of a variety of treatments currently available. A search of the full Medline database for the last 10 years was conducted in August 2012 using the terms painful diabetic peripheral neuropathy, painful diabetic peripheral polyneuropathy, painful diabetic neuropathy and pain in diabetes. In addition, recent reviews addressing this issue were adopted as necessary. In particular, reports from the American Academy of Neurology

  19. A Canadian case study : the value of real time electricity monitoring : a real-time cost utility management solution

    International Nuclear Information System (INIS)

    Rouse, S.; Dittburner, D.

    2006-01-01

    Energy prices can vary significantly over the course of a single day in response to changing levels in energy demand and availability of supply. The impacts of varying energy prices on business and industry means that hourly electricity costs can fluctuate widely over the course of a day even though energy use remains stable. This presentation gave details of an energy efficiency initiative at Unilever's Rexdale site which has resulted in $4 million saved through reductions in energy consumption and equipment retrofits. The Rexdale plant won an energy efficiency award in 2005, and the success of the initiative was attributed to the use of Utility 3 + , an energy management software tool. A turn key system with integrated software and hardware, Utility 3 + is capable of measuring how much energy is being used and can provide details of costs using a combination of historical and forecast prices. The tool is equipped with alarms with pre-set thresholds to match real-time rises in energy prices. Real-time prices are relayed from the Internet along with a 2 way data communication system. It was concluded that use of the tool has resulted in improved cash flow management and greater control of energy costs. A system description of the tool was provided, as well as details of various equipment retrofits. refs.., tabs., figs

  20. A Canadian case study : the value of real time electricity monitoring : a real-time cost utility management solution

    Energy Technology Data Exchange (ETDEWEB)

    Rouse, S. [Energy at Work, Toronto, ON (Canada); Dittburner, D. [Unilever Canada, Toronto, ON (Canada)

    2006-07-01

    Energy prices can vary significantly over the course of a single day in response to changing levels in energy demand and availability of supply. The impacts of varying energy prices on business and industry means that hourly electricity costs can fluctuate widely over the course of a day even though energy use remains stable. This presentation gave details of an energy efficiency initiative at Unilever's Rexdale site which has resulted in $4 million saved through reductions in energy consumption and equipment retrofits. The Rexdale plant won an energy efficiency award in 2005, and the success of the initiative was attributed to the use of Utility 3{sup +}, an energy management software tool. A turn key system with integrated software and hardware, Utility 3{sup +} is capable of measuring how much energy is being used and can provide details of costs using a combination of historical and forecast prices. The tool is equipped with alarms with pre-set thresholds to match real-time rises in energy prices. Real-time prices are relayed from the Internet along with a 2 way data communication system. It was concluded that use of the tool has resulted in improved cash flow management and greater control of energy costs. A system description of the tool was provided, as well as details of various equipment retrofits. refs.., tabs., figs.

  1. The European Community eco-management and audit regulations and the ISO standard 14001 for eco-management systems: significance and consequences for the eco-management of utilities

    International Nuclear Information System (INIS)

    Gudet, C.

    1996-01-01

    Various companies in the electrical industries have concerned themselves with the EMAS regulations and the private sector industries standards BS 7750 and ISO 14001. In various pilot experiments, investigations were carried out on the suitability of these management instruments for utilities. Several power plants in Holland and England have already instituted standards-complying environmental management systems and had them partly certificated. The paper shows in which existing legal frameworks the new management instruments have an effect and what elements they consist of. There is shown, on the basis of an example, which regions of the utility are affected by the environmental management system and how it is co-ordinated into the whole company organisation. (author) 4 figs., 11 refs

  2. Utilization of a Clinical Trial Management System for the Whole Clinical Trial Process as an Integrated Database: System Development.

    Science.gov (United States)

    Park, Yu Rang; Yoon, Young Jo; Koo, HaYeong; Yoo, Soyoung; Choi, Chang-Min; Beck, Sung-Ho; Kim, Tae Won

    2018-04-24

    Clinical trials pose potential risks in both communications and management due to the various stakeholders involved when performing clinical trials. The academic medical center has a responsibility and obligation to conduct and manage clinical trials while maintaining a sufficiently high level of quality, therefore it is necessary to build an information technology system to support standardized clinical trial processes and comply with relevant regulations. The objective of the study was to address the challenges identified while performing clinical trials at an academic medical center, Asan Medical Center (AMC) in Korea, by developing and utilizing a clinical trial management system (CTMS) that complies with standardized processes from multiple departments or units, controlled vocabularies, security, and privacy regulations. This study describes the methods, considerations, and recommendations for the development and utilization of the CTMS as a consolidated research database in an academic medical center. A task force was formed to define and standardize the clinical trial performance process at the site level. On the basis of the agreed standardized process, the CTMS was designed and developed as an all-in-one system complying with privacy and security regulations. In this study, the processes and standard mapped vocabularies of a clinical trial were established at the academic medical center. On the basis of these processes and vocabularies, a CTMS was built which interfaces with the existing trial systems such as the electronic institutional review board health information system, enterprise resource planning, and the barcode system. To protect patient data, the CTMS implements data governance and access rules, and excludes 21 personal health identifiers according to the Health Insurance Portability and Accountability Act (HIPAA) privacy rule and Korean privacy laws. Since December 2014, the CTMS has been successfully implemented and used by 881 internal and

  3. Estimating safety effects of pavement management factors utilizing Bayesian random effect models.

    Science.gov (United States)

    Jiang, Ximiao; Huang, Baoshan; Zaretzki, Russell L; Richards, Stephen; Yan, Xuedong

    2013-01-01

    Previous studies of pavement management factors that relate to the occurrence of traffic-related crashes are rare. Traditional research has mostly employed summary statistics of bidirectional pavement quality measurements in extended longitudinal road segments over a long time period, which may cause a loss of important information and result in biased parameter estimates. The research presented in this article focuses on crash risk of roadways with overall fair to good pavement quality. Real-time and location-specific data were employed to estimate the effects of pavement management factors on the occurrence of crashes. This research is based on the crash data and corresponding pavement quality data for the Tennessee state route highways from 2004 to 2009. The potential temporal and spatial correlations among observations caused by unobserved factors were considered. Overall 6 models were built accounting for no correlation, temporal correlation only, and both the temporal and spatial correlations. These models included Poisson, negative binomial (NB), one random effect Poisson and negative binomial (OREP, ORENB), and two random effect Poisson and negative binomial (TREP, TRENB) models. The Bayesian method was employed to construct these models. The inference is based on the posterior distribution from the Markov chain Monte Carlo (MCMC) simulation. These models were compared using the deviance information criterion. Analysis of the posterior distribution of parameter coefficients indicates that the pavement management factors indexed by Present Serviceability Index (PSI) and Pavement Distress Index (PDI) had significant impacts on the occurrence of crashes, whereas the variable rutting depth was not significant. Among other factors, lane width, median width, type of terrain, and posted speed limit were significant in affecting crash frequency. The findings of this study indicate that a reduction in pavement roughness would reduce the likelihood of traffic

  4. Utility of hand-held echocardiography in outpatient pediatric cardiology management.

    Science.gov (United States)

    Riley, Alan; Sable, Craig; Prasad, Aparna; Spurney, Christopher; Harahsheh, Ashraf; Clauss, Sarah; Colyer, Jessica; Gierdalski, Marcin; Johnson, Ashley; Pearson, Gail D; Rosenthal, Joanna

    2014-12-01

    Adult patient series have shown hand-held echocardiography (echo) units (HHE) to be accurate for rapid diagnosis and triage. This is the first study to evaluate the ability of HHE to inform decision making in outpatient pediatric cardiology. New pediatric cardiology patients in outpatient clinics staffed by six pediatric cardiologists (experience 1-17 years) were prospectively enrolled if an echocardiogram (echo) was ordered during their initial visit. After history and physical examination and before a standard echo, the cardiologists performed a bedside HHE examination (GE Vscan 1.7-3.8 MHz), documented findings, and made a clinical decision. Diagnoses and decisions based on HHE were compared with final management after the standard echo. The study enrolled 101 subjects (ages 9 days to 19 years). The cardiologists considered HHE imaging adequate for decision making for 80 of the 101 subjects. For 77 of the 80 subjects with acceptable HHE imaging (68/68 normal and 9/12 abnormal standard echoes), the HHE-based primary diagnoses and decisions agreed with the final management. The sensitivity of HHE was 75 % (95 % confidence interval [CI] 43-94 %) and the positive predictive value 100 % (95 % CI 66-100 %) for pediatric heart disease. The agreement between standard echocardiography and HHE imaging was substantial (κ = 0.82). Excluding one of the least experienced cardiologists, HHE provided the basis for correct cardiac diagnoses and management for all the subjects with acceptable HHE imaging (58/58 normal and 9/9 abnormal echoes). In outpatient pediatric cardiology, HHE has potential as a tool to complement physical examination. Further investigation is needed to evaluate how value improves with clinical experience.

  5. The Utility of Routine Ultrasound in the Diagnosis and Management of Adolescents with Abnormal Uterine Bleeding.

    Science.gov (United States)

    Pecchioli, Yael; Oyewumi, Lamide; Allen, Lisa M; Kives, Sari

    2017-04-01

    Despite the fact that most cases of abnormal uterine bleeding (AUB) in adolescence are due to an immature hypothalamic-pituitary-ovarian (HPO) axis, the current approach to investigating adolescents who present with AUB often includes pelvic ultrasound to exclude rare structural causes. The aim of this study was to determine whether an ultrasound ordered for the investigation of AUB in adolescents detects any significant anatomic pathology or alters diagnosis and management. A retrospective chart review of 230 patients younger than 18 years of age who presented with AUB to the gynecology clinic at the Hospital for Sick Children in Toronto, Canada between January 2010 and December 2012 was completed. Findings on pelvic ultrasound and any further imaging as well as management choices for these patients were examined. Of all patients, 67.8% (156/230) had ultrasound done as part of their AUB workup. The most common diagnosis for the patients who received ultrasound examinations and the patients who did not was AUB due to an immature HPO axis. Of the patients who received an ultrasound examination, 72.4% (113/156) had normal findings; incidental findings were identified in 17.9% (28/156) and polycystic ovary syndrome morphology in 6.4% (10/156). Structural causes of AUB were found in only 2 (1.3%) of the adolescents imaged. No patient had a change in her AUB management plan because of ultrasound findings. Our results strongly suggest that pelvic ultrasound examination is not required in the initial investigation of AUB in the adolescent population because it did not alter treatment in any of our patients. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  6. Knowledge Shared is Power: Utilizing Knowledge Management Activities to Replicate Lean Sigma Best Practices

    Directory of Open Access Journals (Sweden)

    Dennis C. Chen

    2009-06-01

    Full Text Available Lean Sigma programs produce localized gains within corporations. The knowledge generated by these local successes should be manipulated by the organization, so that the gains can be replicated, and savings multiplied across the organization. However, why does knowledge often fail to be successfully manipulated within an organization? This paper discusses a case study analysis in knowledge manipulation activities of a multi- national consumer products company through the lens of the Knowledge Management (KM Ontology. We then identify and document common obstacles, and offer potential solutions.

  7. Utilization of a virtual patient for advanced assessment of student performance in pain management.

    Science.gov (United States)

    Smith, Michael A; Waite, Laura H

    2017-09-01

    To assess student performance and achievement of course objectives following the integration of a virtual patient case designed to promote active, patient-centered learning in a required pharmacy course. DecisionSim™ (Kynectiv, Inc., Chadsford, PA), a dynamic virtual patient platform, was used to implement an interactive patient case to augment pain management material presented during a didactic session in a pharmacotherapy course. Simulation performance data were collected and analyzed. Student exam performance on pain management questions was compared to student exam performance on nearly identical questions from a prior year when a paper-based case was used instead of virtual patient technology. Students who performed well on the virtual patient case performed better on exam questions related to patient assessment (p = 0.0244), primary pharmacological therapy (p = 0.0001), and additional pharmacological therapy (p = 0.0001). Overall exam performance did not differ between the two groups. However, students with exposure to the virtual patient case demonstrated significantly better performance on higher level Bloom's Taxonomy questions that required them to create pharmacotherapy regimens (p=0.0005). Students in the previous year (exposed only to a paper patient case) performed better in calculating conversions of opioids for patients (p = 0.0001). Virtual patient technology may enhance student performance on high-level Bloom's Taxonomy examination questions. This study adds to the current literature demonstrating the value of virtual patient technology as an active-learning strategy. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. NASA's Management and Utilization of the Small Business Innovative Research (SBIR) Program

    Science.gov (United States)

    Mexcur, Winfield Paul

    2003-01-01

    The United Space Congress established the SBIR program in 1982 for the following purposes: ( 1) Stimulate technological innovation (2) Increase private-sector commercialization derived from federal R&D (3) Use small business to meet federal R&D needs (4) Foster and encourage participation by disadvantaged persons and women in technological innovation The STTR program was established in 1992 with the additional requirement of having a small business partner with a research institution (usually a university) for the purpose of transferring intellectual property from the research institution to the small business concern for enabling a government technical need and furthering the technological development for the purpose of developing commercial products. The government of Japan has established a program that models portions of the U.S. SBIR and STTR programs. They are very interested in how NASA has been so successful in fulfilling the Congressional objectives of these programs. In particular, they want to understand the management practices and incentives that are provided to enable partnerships between business enterprises, academia and government. The speech will also focus on some of the many successful technologies (on a conceptual level) that have been developed through NASA s SBIR and STTR programs and mechanisms used to promote cooperation between small businesses, large businesses, academia and government agencies within the United States. The speech is on a conceptual level, focusing on U.S. and NASA policies and management implementation practices. No enabling technical discussion will be held.

  9. Managing disclosure following recent-onset psychosis: utilizing the individual placement and support model.

    Science.gov (United States)

    Allott, Kelly A; Turner, Luana R; Chinnery, Gina L; Killackey, Eoin J; Nuechterlein, Keith H

    2013-08-01

    Individual Placement and Support is the most defined and evidence-based approach to supported employment for severe mental illness, including recent-onset psychosis. However, there is limited evidence or detailed guidelines informing the management of mental illness disclosure to educators or employers when delivering individual placement and support. In this paper, we describe the initial disclosure preferences of young people with recent-onset psychosis enrolled in individual placement and support and provide guidance for managing disclosure when delivering Individual Placement and Support with this population. Drawing from sites in Melbourne, Australia and Los Angeles, USA, clients' initial disclosure preferences were examined. We describe approaches to providing individual placement and support when no disclosure is permitted compared with when disclosure is permitted, including two illustrative case vignettes. No disclosure of mental illness or disability was requested by 54-59% of clients; 41-46% of clients permitted partial or complete disclosure. The 'no disclosure' scenario required the individual placement and support worker to provide support 'behind the scenes', whereas when disclosure was permitted, the individual placement and support worker could have contact with instructors/employers and work 'on the front lines'. The case vignettes illustrate how both approaches can lead to successful vocational outcomes. We found that Individual Placement and Support can be provided in an educative, flexible, creative and collaborative manner according to client disclosure preferences. We suggest that disclosure preferences do not prevent successful vocational outcomes, although this supposition requires empirical investigation. © 2013 Wiley Publishing Asia Pty Ltd.

  10. Construction and utilization of linear empirical core models for PWR in-core fuel management

    International Nuclear Information System (INIS)

    Okafor, K.C.

    1988-01-01

    An empirical core-model construction procedure for pressurized water reactor (PWR) in-core fuel management is developed that allows determining the optimal BOC k ∞ profiles in PWRs as a single linear-programming problem and thus facilitates the overall optimization process for in-core fuel management due to algorithmic simplification and reduction in computation time. The optimal profile is defined as one that maximizes cycle burnup. The model construction scheme treats the fuel-assembly power fractions, burnup, and leakage as state variables and BOC zone enrichments as control variables. The core model consists of linear correlations between the state and control variables that describe fuel-assembly behavior in time and space. These correlations are obtained through time-dependent two-dimensional core simulations. The core model incorporates the effects of composition changes in all the enrichment control zones on a given fuel assembly and is valid at all times during the cycle for a given range of control variables. No assumption is made on the geometry of the control zones. A scatter-composition distribution, as well as annular, can be considered for model construction. The application of the methodology to a typical PWR core indicates good agreement between the model and exact simulation results

  11. The utility of FloSeal haemostatic agent in the management of epistaxis.

    Science.gov (United States)

    Khan, M K; Reda El Badawey, M; Powell, J; Idris, M

    2015-04-01

    FloSeal, a locally applied haemostatic agent, has been shown to be effective in a variety of clinical situations. This study investigated its potential benefits in the management of epistaxis. The outcomes of a series of patients with epistaxis presenting to one ENT unit, over a two-month period, were compared. Patients were either treated with FloSeal or traditional epistaxis management techniques. Success of FloSeal was classed as complete haemostasis after its application, without the need for further interventions and no readmission with epistaxis within 7 days. Our study comprised 101 adults, with a mean age of 70 years (range, 22-98 years). The overall success rate for FloSeal was 14 per cent (5 out of 36 cases). It was successful in 66 per cent of anterior epistaxis cases (2 out of 3) and in only 9 per cent of posterior epistaxis cases (3 out of 33). There was a significantly higher failure rate of FloSeal compared with nasal packing in posterior epistaxis (p epistaxis.

  12. Exploration and mining. Predevelopment studies for mine methane management and utilization

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    With an objective to reduce influence on the environment, studies have been performed on recovery and utilization of methane gas discharged from mines, and on simulation of discharge of methane gas from coal being mined. The studies included data collection of the Hunter Valley regional coal and gas resources, a review of gas recovery technologies and practice, Wambo site data collection and geological characterization, rock tests for compressive strength and shear strength, testing of a CSIRO/CMTE automatic analysis method, and preparation of a preliminary 3D Vulcan model. The result of the studies during this year reveals that the lower Hunter Coalfield contains 1,324 Mt recoverable reserve and 1,033 Mt marketable reserve; the area contains 83.96 billion m{sup 3} in-situ gas; gas content in the Arrowfield and Bowfield seams at the Wambo mine is around 8 m{sup 3}/t, and 10 m{sup 3}/t, and a typical gas composition is 70% CH{sub 4} and 30% CO2; and the gas content increases with depth. (NEDO)

  13. Increasing feasibility and utility of 18F-FDOPA PET for the management of glioma

    International Nuclear Information System (INIS)

    Bell, Christopher; Dowson, Nicholas; Puttick, Simon; Gal, Yaniv; Thomas, Paul; Fay, Mike; Smith, Jye; Rose, Stephen

    2015-01-01

    Introduction: Despite radical treatment therapies, glioma continues to carry with it a uniformly poor prognosis. Patients diagnosed with WHO Grade IV glioma (glioblastomas; GBM) generally succumb within two years, even those with WHO Grade III anaplastic gliomas and WHO Grade II gliomas carry prognoses of 2–5 and 2 years, respectively. PET imaging with 18 F-FDOPA allows in vivo assessment of the metabolism of glioma relative to surrounding tissues. The high sensitivity of 18 F-DOPA imaging grants utility for a number of clinical applications. Methods: A collection of published work about 18 F-FDOPA PET was made and a critical review was discussed and written. Results: A number of research papers have been published demonstrating that in conjunction with MRI, 18 F-FDOPA PET provides greater sensitivity and specificity than these modalities in detection, grading, prognosis and validation of treatment success in both primary and recurrent gliomas. In further comparisons with 11 C-MET, 18 F-FLT, 18 F-FET and MRI, 18 F-FDOPA has shown similar or better efficacy. Recently synthesis cassettes have become available, making 18 F-FDOPA more accessible. Conclusions: According to the available data, 18 F-FDOPA PET is a viable radiotracer for imaging and treatment planning of gliomas. Advances in knowledge and implication for patient care: 18 F-FDOPA PET appears to be a viable radiopharmaceutical for the diagnosis and treatment planning of gliomas cases, improving on that of MRI and 18 F-FDG PET

  14. BioMake: a GNU make-compatible utility for declarative workflow management.

    Science.gov (United States)

    Holmes, Ian H; Mungall, Christopher J

    2017-11-01

    The Unix 'make' program is widely used in bioinformatics pipelines, but suffers from problems that limit its application to large analysis datasets. These include reliance on file modification times to determine whether a target is stale, lack of support for parallel execution on clusters, and restricted flexibility to extend the underlying logic program. We present BioMake, a make-like utility that is compatible with most features of GNU Make and adds support for popular cluster-based job-queue engines, MD5 signatures as an alternative to timestamps, and logic programming extensions in Prolog. BioMake is available for MacOSX and Linux systems from https://github.com/evoldoers/biomake under the BSD3 license. The only dependency is SWI-Prolog (version 7), available from http://www.swi-prolog.org/. ihholmes + biomake@gmail.com or cmungall + biomake@gmail.com. Feature table comparing BioMake to similar tools. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  15. The Ef fects of Technology Usabilitiy and Individual Technology Readiness on Utilization of Electronic Document Management System (EDMS: A Research on Employee of University Hospital

    Directory of Open Access Journals (Sweden)

    Asuman Atilla

    2015-06-01

    Full Text Available Electronic Document Management System (EDMS is software which is utilized for writing, sending and storing, briefly managing the processes and operations of the corporations and institutions. In this empirical research, the statistical differences are investigated between users’ concerns about usability of mentioned technology, users’ technological readiness levels and users’ utilization status of EDMS sample is formed by 189 administrative staff of a university hospital in Ankara. According to findings, significant statistical differences are found between some dimensions of technology usability (usability effectiveness, learnability,helpfulness satisfaction, some dimensions of technology readiness (discomfort and insecurity and the utilization status (user, nonuser of EDMS.

  16. Flight management research utilizing an oculometer. [pilot scanning behavior during simulated approach and landing

    Science.gov (United States)

    Spady, A. A., Jr.; Kurbjun, M. C.

    1978-01-01

    This paper presents an overview of the flight management work being conducted using NASA Langley's oculometer system. Tests have been conducted in a Boeing 737 simulator to investigate pilot scan behavior during approach and landing for simulated IFR, VFR, motion versus no motion, standard versus advanced displays, and as a function of various runway patterns and symbology. Results of each of these studies are discussed. For example, results indicate that for the IFR approaches a difference in pilot scan strategy was noted for the manual versus coupled (autopilot) conditions. Also, during the final part of the approach when the pilot looks out-of-the-window he fixates on his aim or impact point on the runway and holds this point until flare initiation.

  17. High Resource Utilization Does Not Affect Mortality in Acute Respiratory Failure Patients Managed With Tracheostomy

    Science.gov (United States)

    Freeman, Bradley D; Stwalley, Dustin; Lambert, Dennis; Edler, Joshua; Morris, Peter E; Medvedev, Sofia; Hohmann, Samuel F; Kymes, Steven M

    2015-01-01

    BACKGROUND Tracheostomy practice in patients with acute respiratory failure (ARF) varies greatly among institutions. This variability has the potential to be reflected in the resources expended providing care. In various healthcare environments, increased resource expenditure has been associated with a favorable effect on outcome. OBJECTIVE To examine the association between institutional resource expenditure and mortality in ARF patients managed with tracheostomy. METHODS We developed analytic models employing the University Health Systems Consortium (Oakbrook, Illinois) database. Administrative coding data were used to identify patients with the principal diagnosis of ARF, procedures, complications, post-discharge destination, and survival. Mean resource intensity of participating academic medical centers was determined using risk-adjusted estimates of costs. Mortality risk was determined using a multivariable approach that incorporated patient-level demographic and clinical variables and institution-level resource intensity. RESULTS We analyzed data from 44,124 ARF subjects, 4,776 (10.8%) of whom underwent tracheostomy. Compared to low-resource-intensity settings, treatment in high-resource-intensity academic medical centers was associated with increased risk of mortality (odds ratio 1.11, 95% CI 1.05–1.76), including those managed with tracheostomy (odds ratio high-resource-intensity academic medical center with tracheostomy 1.10, 95% CI 1.04 –1.17). We examined the relationship between complication development and outcome. While neither the profile nor number of complications accumulated differed comparing treatment environments (P > .05 for both), mortality for tracheostomy patients experiencing complications was greater in high-resource-intensity (95/313, 30.3%) versus low-resource-intensity (552/2,587, 21.3%) academic medical centers (P tracheostomy. PMID:23650434

  18. Utility of Vaccum Pressed Silicon Sheet as a Bite Raising Appliance in the Management of TMJ Dysfunction Syndrome.

    Science.gov (United States)

    Datarkar, Abhay; Daware, Surendra; Dande, Ravi

    2017-09-01

    Temporomandibular disorders (TMDs) represent a group of painful conditions involving the muscles of mastication and the temporomandibular joint (TMJ) that frequently encountered in general clinical practice. This study is designed to assess the utility of vacuum pressed silicon sheet as a bite raising appliance in the management of TMJ dysfunction syndrome. The patients for this study were selected from those with the chief complaint of TMJ disorder. Out of 200 patients, 104 patients were diagnosed with subluxation and 96 patients were diagnosed with internal derangement of temporomandibular joint. All the reported cases were managed conservatively with physiotherapy and muscle relaxant therapy for one week period and followed with silicon bite raising appliance over both the arches in the subsequent period. All the patients had pain relief within six months duration as graded over verbal analog scale. ANOVA scale was used for comparision of VAS scores. The use of vacuum pressed bite raising appliance in the management of TMJ disorder was found to be satisfactorily effective in alleviation of pain symptom in our study group.

  19. Dynamics of production and forage utilization on elephant grass pastures managed with different post-grazing heights

    Directory of Open Access Journals (Sweden)

    Braulio Maia de Lana Sousa

    2012-08-01

    Full Text Available This study was conducted to evaluate the daily production of forage and its morphological components, as well as the potential of forage utilization in pastures of Pennisetum purpureum cv. Napier managed with three post-grazing heights (30, 50 and 70 cm. Two experiments were carried out: one from February to May 2009 and another from December 2009 to May 2010, characterizing months of summer and fall. The experimental design was of completely randomized blocks with three replicates. The grazing was performed by crossbred heifers of approximately 270 kg body weight, when the sward intercepted 95% of the incoming light. In both experiments, the pastures managed with post-grazing height of 30 cm, in the summer months (December to March, presented lower daily production of leaves and stems, as well as less daily leaf senescence, which resulted in lower daily forage production and accumulation in comparison with those managed at 70 and 50 cm. In the period from February to March 2009 (experiment 1 and December 2009 to March 2010 (experiment 2, pastures presented greater daily production of leaves and forage, greater daily forage accumulation and more daily leaf senescence in relation to the months of April and May 2009 and 2010. On the other hand, the daily production of stems was higher in the fall, in comparison with the summer. Therefore, elevation in the post-grazing height, especially in the summer, increases the regrowth vigor of elephant grass cv. Napier.

  20. The utility of peripheral thyrotropin receptor mRNA in the management of differentiated thyroid cancer.

    Science.gov (United States)

    Aliyev, Altay; Soundararajan, Saranya; Bucak, Emre; Gupta, Manjula; Hatipoglu, Betul; Nasr, Christian; Siperstein, Allan; Berber, Eren

    2015-10-01

    Our aim was to analyze the utility of peripheral thyrotropin receptor (TSHR) messenger RNA (mRNA) in predicting and detecting the recurrence of differentiated thyroid cancer. Peripheral blood TSHR-mRNA was obtained in 103 patients before and after total thyroidectomy. An analysis was performed to correlate peripheral blood TSHR-mRNA concentration with oncologic outcomes. Tumor types were papillary (n = 92), follicular (n = 9) and Hürthle cell (n = 2) cancer. Preoperative TSHR-mRNA was ≥1.02 ng/μg in 85% (88/103). On follow-up (median 48 months), 10 patients (10 %) developed recurrence. Recurrence rate in patients with a preoperative TSHR-mRNA ≥ 1.02 ng/μg was 11% versus 0% in those with a lesser concentration. TSHR-mRNA correctly diagnosed 7 (70%) of 10 recurrences. Of 19 patients with positive thyroglobulin (Tg) antibodies, TSHR-mRNA confirmed disease-free status in 12 (63%) and recurrence in 1 (5%). For Tg, TSHR-mRNA and whole-body radioactive iodine scan, sensitivity was 70%, 70%, and 75%; specificity 94%, 76%, 97%; PPV 54%, 24%, and 67%; and NPV 97%, 96%, and 98%, respectively, in detecting recurrent disease. This study shows that patients with preoperative TSHR-mRNA ≥1.02 ng/μg may be at a greater risk for recurrence compared with those with a lesser concentration. In the presence of Tg antibodies, TSHR-mRNA accurately predicted disease status in 68% of patients. Its overall performance in detecting recurrence was similar to Tg and whole-body radioactive iodine scan, albeit with lower specificity and PPV. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. An approach to link water resource management with landscape art to enhance its aesthetic appeal, ecological utility and social benefits

    Science.gov (United States)

    Mukherjee, Anita; Sen, Somnath; Paul, Saikat Kumar

    2017-04-01

    Landscape art or land art is the discourse of scientific application of artistic skill to integrate man-made structures with the natural landscape for planning, design, management, preservation and rehabilitation of natural and built environment. It does beautification of the landscape enhancing its utility for habitats. Availability of water with acceptable quality is crucial for economic growth, social peace and equality and of course for environmental sustainability. Development of new and growth of existing urban and suburban units are obvious. It postulates the increase of population density and percent of the impervious area in an urban unit. The demand for water is increasing with progressive concentration of population, the volume and velocity of surface runoff increase and the travel time decreases. At the same time, an increase in the volume of gray water not only contaminate water bodies, it also reduces the quantity of available freshwater transforming a portion of blue and green water to gray one and would intensify the pressure on water resources of the area. Therefore, to meet the incremental pressure of demand for and pollution of water collection, treatment and reuse of wastewater, both sewage and storm water, are on the requirement to improve urban water security. People must be concerned not to stifle urban lives with concrete; rather must provide all basic amenities for achieving a higher standard of life than the previous one with the essence of natural green spaces. The objective of the study is to propose a conceptual design and planning guidelines for developing urban and suburban drainage network and reuse of surface runoff and sewage water utilizing less used natural water bodies, such as paleo-channels or lakes or moribund channels as retention or detention basin. In addition to wastewater management, the proposal serves to promote the aesthetics of environmental engagement, ecological utility and restoration of moribund channels

  2. International symposium on research reactor utilization, safety and management. Book of extended synopses

    International Nuclear Information System (INIS)

    1999-01-01

    The Symposium, considered as an important meeting of the owners and operators of research reactors as well as scientists concerned with problems of research reactors operation, management and safety covered the following topics: global and regional overview of research reactors, research reactors utilisation, research reactors safety, research reactors management, research reactors engineering. IAEA Research Reactors Database (RRDB) contains data concerning 291 operational research reactors, 247 shutdown reactors, 106 decommissioned reactors, 15 under construction and 15 new reactors planned. There is quite an even distribution of operational research reactors among 58 countries. Although about 66% of operational research reactors described in the RRDB are over 30 years old, the number of research reactors under construction or planned appears to have increased in recent years. According to the RRDB, the major applications of research reactors are in the field of neutron activation analysis, isotope production and neutron scattering work. Great concern was shown for several aspects of research reactors safety, especially since the average age of the operating research reactors is almost 30 years. Ageing problems involve more than the degradation of properties of the materials. Issues such as outdated equipment, lack of spare parts, outdating of the control and documentation systems related to the reactor, as well as budgetary limitations, affect the safety of some reactors. There are serious problems related to the spent fuel condition and the ageing of fuel storage facilities, in particular corrosion and leakage. The outstanding issues of concern are life extension of the spent fuel storage facilities and the future of take-back programmes of foreign research reactor fuels that will not be continued. A number of discussions related to safety requirements were focused on licensing and regulatory issues, especially in the case of older research reactors and those

  3. Utility of different glycemic control metrics for optimizing management of diabetes.

    Science.gov (United States)

    Kohnert, Klaus-Dieter; Heinke, Peter; Vogt, Lutz; Salzsieder, Eckhard

    2015-02-15

    The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin (HbA1c). Despite its importance as an indicator for the development of diabetic complications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between HbA1c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to HbA1c in routine diabetes care is self-monitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize

  4. International symposium on research reactor utilization, safety and management. Book of extended synopses

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-11-01

    The Symposium, considered as an important meeting of the owners and operators of research reactors as well as scientists concerned with problems of research reactors operation, management and safety covered the following topics: global and regional overview of research reactors, research reactors utilisation, research reactors safety, research reactors management, research reactors engineering. IAEA Research Reactors Database (RRDB) contains data concerning 291 operational research reactors, 247 shutdown reactors, 106 decommissioned reactors, 15 under construction and 15 new reactors planned. There is quite an even distribution of operational research reactors among 58 countries. Although about 66% of operational research reactors described in the RRDB are over 30 years old, the number of research reactors under construction or planned appears to have increased in recent years. According to the RRDB, the major applications of research reactors are in the field of neutron activation analysis, isotope production and neutron scattering work. Great concern was shown for several aspects of research reactors safety, especially since the average age of the operating research reactors is almost 30 years. Ageing problems involve more than the degradation of properties of the materials. Issues such as outdated equipment, lack of spare parts, outdating of the control and documentation systems related to the reactor, as well as budgetary limitations, affect the safety of some reactors. There are serious problems related to the spent fuel condition and the ageing of fuel storage facilities, in particular corrosion and leakage. The outstanding issues of concern are life extension of the spent fuel storage facilities and the future of take-back programmes of foreign research reactor fuels that will not be continued. A number of discussions related to safety requirements were focused on licensing and regulatory issues, especially in the case of older research reactors and those

  5. The Utilization of Imaging Features in the Management of Intraductal Papillary Mucinous Neoplasms

    Directory of Open Access Journals (Sweden)

    Stefano Palmucci

    2014-01-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs represent a group of cystic pancreatic neoplasms with large range of clinical behaviours, ranging from low-grade dysplasia or borderline lesions to invasive carcinomas. They can be grouped into lesions originating from the main pancreatic duct, main duct IPMNs (MD-IPMNs, and lesions which arise from secondary branches of parenchyma, denominated branch-duct IPMNs (BD-IPMNs. Management of these cystic lesions is essentially based on clinical and radiological features. The latter have been very well described in the last fifteen years, with many studies published in literature showing the main radiological features of IPMNs. Currently, the goal of imaging modalities is to identify “high-risk stigmata” or “worrisome feature” in the evaluation of pancreatic cysts. Marked dilatation of the main duct (>1 cm, large size (3–5 cm, and intramural nodules have been associated with increased risk of degeneration. BD-IPMNs could be observed as microcystic or macrocystic in appearance, with or without communication with main duct. Their imaging features are frequently overlapped with cystic neoplasms. The risk of progression for secondary IPMNs is lower, and subsequently an imaging based follow-up is very often proposed for these lesions.

  6. An aging management program focused on the full utilization of existing licenses

    International Nuclear Information System (INIS)

    Esselman, Thomas C.; McDevitt, Robert

    2004-01-01

    An Aging Management Enhancement Program has been developed to identify and mitigate the risk and uncertainties that unusual, accelerated, or previously unanticipated aging of Systems, Structures, and Components pose to the continued long term safe, economic, and reliable operation of nuclear facilities. This paper defines a process intended to enhance the understanding and control of the aging of systems, structures, and components (SSCs). The program is selective and proactive. It largely employs the experience and knowledge of personnel that have hands-on responsibility for engineering, maintaining, and operating the facility. The identification of SSCs and associated age related degradation mechanisms (ARDMs) that present future vulnerabilities to a plant allow focused actions to be implemented to remedy or abate the risk prior to the aging degradation adversely impacting plant operation. Selection of structures and components susceptible to accelerated aging degradation and appropriate remedial corrective and/or preventive actions are based on a recognized need to achieve a balance between plant safety, plant economics, and plant reliability. (author)

  7. Mothers Value and Utilize Early Outpatient Education on Breast Massage and Hand Expression in Their Self-Management of Engorgement.

    Science.gov (United States)

    Witt, Ann M; Bolman, Maya; Kredit, Sheila

    2016-11-01

    Breast engorgement is a major cause of pain and weaning in the early postpartum period. While protocols reinforce the need for anticipatory engorgement advice and continued outpatient health professional breastfeeding support, there remains limited information on the efficacy of focused postdischarge engorgement education. This study sought to explore if outpatient postpartum engorgement education changed mothers' home management and if mothers found instruction on specific massage and hand expression techniques helpful. This was a prospective descriptive cohort study. Subjects received engorgement-specific postpartum support from a healthcare professional at the posthospital discharge (PD) newborn visit. Email surveys at 1, 2, and 12 weeks postpartum collected data on engorgement home management, clinical course, and postpartum education. After the office visit, mothers changed their engorgement home management. Significantly more mothers utilized massage toward the axillae (25% versus 1%, p ≤ 0.001), reverse pressure softening (18% versus 3%, p = 0.001), and feeding more frequently (32% versus 16%, p = 0.04). Sixty-one percent would not have used massage and hand expression before education in the office. At 12 weeks, 96% of women reported massage and hand expression instruction as helpful. Mothers reported engorgement peaked at a median of 5 days postpartum, corresponding well to the office visit at a median of 4 days postpartum. Maternal engorgement symptoms are commonly present at the PD newborn visit. Education on engorgement, massage, and hand expression at this visit significantly changes home management strategies. Mothers find massage and hand expression instruction helpful.

  8. PWR in-core nuclear fuel management optimization utilizing nodal (non-linear NEM) generalized perturbation theory

    International Nuclear Information System (INIS)

    Maldonado, G.I.; Turinsky, P.J.; Kropaczek, D.J.

    1993-01-01

    The computational capability of efficiently and accurately evaluate reactor core attributes (i.e., k eff and power distributions as a function of cycle burnup) utilizing a second-order accurate advanced nodal Generalized Perturbation Theory (GPT) model has been developed. The GPT model is derived from the forward non-linear iterative Nodal Expansion Method (NEM) strategy, thereby extending its inherent savings in memory storage and high computational efficiency to also encompass GPT via the preservation of the finite-difference matrix structure. The above development was easily implemented into the existing coarse-mesh finite-difference GPT-based in-core fuel management optimization code FORMOSA-P, thus combining the proven robustness of its adaptive Simulated Annealing (SA) multiple-objective optimization algorithm with a high-fidelity NEM GPT neutronics model to produce a powerful computational tool used to generate families of near-optimum loading patterns for PWRs. (orig.)

  9. Utility of collecting metadata to manage a large scale conditions database in ATLAS

    International Nuclear Information System (INIS)

    Gallas, E J; Albrand, S; Borodin, M; Formica, A

    2014-01-01

    The ATLAS Conditions Database, based on the LCG Conditions Database infrastructure, contains a wide variety of information needed in online data taking and offline analysis. The total volume of ATLAS conditions data is in the multi-Terabyte range. Internally, the active data is divided into 65 separate schemas (each with hundreds of underlying tables) according to overall data taking type, detector subsystem, and whether the data is used offline or strictly online. While each schema has a common infrastructure, each schema's data is entirely independent of other schemas, except at the highest level, where sets of conditions from each subsystem are tagged globally for ATLAS event data reconstruction and reprocessing. The partitioned nature of the conditions infrastructure works well for most purposes, but metadata about each schema is problematic to collect in global tools from such a system because it is only accessible via LCG tools schema by schema. This makes it difficult to get an overview of all schemas, collect interesting and useful descriptive and structural metadata for the overall system, and connect it with other ATLAS systems. This type of global information is needed for time critical data preparation tasks for data processing and has become more critical as the system has grown in size and diversity. Therefore, a new system has been developed to collect metadata for the management of the ATLAS Conditions Database. The structure and implementation of this metadata repository will be described. In addition, we will report its usage since its inception during LHC Run 1, how it has been exploited in the process of conditions data evolution during LSI (the current LHC long shutdown) in preparation for Run 2, and long term plans to incorporate more of its information into future ATLAS Conditions Database tools and the overall ATLAS information infrastructure.

  10. Beneficial effect of compost utilization on reducing greenhouse gas emissions in a rice cultivation system through the overall management chain.

    Science.gov (United States)

    Jeong, Seung Tak; Kim, Gil Won; Hwang, Hyun Young; Kim, Pil Joo; Kim, Sang Yoon

    2018-02-01

    Livestock manure application can stimulate greenhouse gas (GHG) emissions, especially methane (CH 4 ) in rice paddy. The stabilized organic matter (OM) is recommended to suppress CH 4 emission without counting the additional GHG emission during the composting process. To evaluate the effect of compost utilization on the net global warming potential (GWP) of a rice cropping system, the fluxes of GHGs from composting to land application were calculated by a life cycle assessment (LCA) method. The model framework was composed of GHG fluxes from industrial activities and biogenic GHG fluxes from the composting and rice cultivation processes. Fresh manure emitted 30MgCO 2 -eq.ha -1 , 90% and 10% of which were contributed by CH 4 and nitrous oxide (N 2 O) fluxes, respectively, during rice cultivation. Compost utilization decreased net GWP by 25% over that of the fresh manure during the whole process. The composting process increased the GWP of the industrial processes by 35%, but the 60% reduction in CH 4 emissions from the rice paddy mainly influenced the reduction of GWP during the overall process. Therefore, compost application could be a good management strategy to reduce GHG emissions from rice paddy systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. How gender, age, and geography influence the utilization of radiation therapy in the management of malignant melanoma

    International Nuclear Information System (INIS)

    French, John; McGahan, Colleen; Duncan, Graeme; Lengoc, Sonca; Soo, Jenny; Cannon, Jerry

    2006-01-01

    Purpose: Comparing radiation therapy utilization rates (RTUR) to those predicted by best evidence is a useful measure of the equity and accessibility of service delivery. In this study the RTUR for melanoma was established for British Columbia, Canada, and compared with the rate suggested by the evidence. Demographic variables, specifically age, gender, and geography that influenced the RTUR were examined with a view to identifying methods of improving underutilization. Methods and Materials: The RTUR in the management of malignant melanoma was taken from British Columbia Cancer registry data for 1986 to 1998. Variations in utilization based on age, gender, health authority, stage of disease, and referral patterns were analyzed. Results: An RTUR of 11% was identified. This was consistent over time. Referral rates decreased between 1986 and 1998. RT is used mostly for later stage disease. Males were more likely to receive RT than females, related to later stage of disease in men. Referral rates decreased, but RTUR for referred cases increased, in health authorities that did not have a cancer center. Conclusions: Use of RT is influenced by age and by stage of disease. Overall RTUR in British Columbia is lower than suggested by best evidence. Referral patterns are influenced by geography. RTUR was higher in males, consistent with a different pattern of disease in males compared with females

  12. European perspective on the management of rheumatoid arthritis: clinical utility of tofacitinib

    Directory of Open Access Journals (Sweden)

    Kawalec P

    2017-12-01

    Full Text Available Paweł Kawalec,1 Katarzyna Śladowska,2 Iwona Malinowska-Lipień,3 Tomasz Brzostek,3 Maria Kózka4 1Drug Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 2Department of Experimental Hematology, Institute of Zoology and Biomedical Research, Faculty of Biology and Earth Sciences, Jagiellonian University, Krakow, Poland; 3Department of Internal and Community Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland; 4Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland Abstract: Xeljanz® (tofacitinib is an oral small-molecule inhibitor that reversibly inhibits Janus-activated kinase (JAK-dependent cytokine signaling, thus reducing inflammation. As a result of these mechanisms, effects on the immune system such as a moderate decrease in the total lymphocyte count, a dose-dependent decrease in natural killer (NK cell count, and an increase in B-cell count have been observed. Therefore, tofacitinib provides an innovative approach to modulating the immune and inflammatory responses in patients with rheumatoid arthritis (RA, which is especially important in individuals who do not respond to tumor necrosis factor inhibitors or show a loss of response over time. The aim of this article was to review studies on the pharmacology, mode of action, pharmacokinetics, efficacy, and safety of tofacitinib in patients with RA. Tofacitinib has been shown to reduce symptoms of RA and improve the quality of life in the analyzed groups of patients. Moreover, it showed high efficacy and an acceptable safety profile in Phase III randomized clinical trials on RA and was the first JAK inhibitor approved by the US Food and Drug Administration (FDA and European Medicines Agency (EMA in the RA therapy, thus providing a useful alternative

  13. A future Demand Side Management (DSM) opportunity for utility as variable renewable penetrate scale up using agriculture.

    Science.gov (United States)

    Ines, A.; Bhattacharjee, A.; Modi, V.; Robertson, A. W.; Lall, U.; Kocaman Ayse, S.; Chaudhary, S.; Kumar, A.; Ganapathy, A.; Kumar, A.; Mishra, V.

    2015-12-01

    Energy demand management, also known as demand side management (DSM), is the modification of consumer demand for energy through various methods such as smart metering, incentive based schemes, payments for turning off loads or rescheduling loads. Usually, the goal of demand side management is to encourage the consumer to use less power during periods of peak demand, or to move the time of energy use to off-peak times. Peak demand management does not necessarily decrease total energy consumption, but could be expected to reduce the need for investments in networks and/or power plants for meeting peak demands. Electricity use can vary dramatically on short and medium time frames, and the pricing system may not reflect the instantaneous cost as additional higher-cost that are brought on-line. In addition, the capacity or willingness of electricity consumers to adjust to prices by altering elasticity of demand may be low, particularly over short time frames. In the scenario of Indian grid setup, the retail customers do not follow real-time pricing and it is difficult to incentivize the utility companies for continuing the peak demand supply. A question for the future is how deeper penetration of renewable will be handled? This is a challenging problem since one has to deal with high variability, while managing loss of load probabilities. In the case of managing the peak demand using agriculture, in the future as smart metering matures with automatic turn on/off for a pump, it will become possible to provide an ensured amount of water or energy to the farmer while keeping the grid energized for 24 hours. Supply scenarios will include the possibility of much larger penetration of solar and wind into the grid. While, in absolute terms these sources are small contributors, their role will inevitably grow but DSM using agriculture could help reduce the capital cost. The other option is of advancing or delaying pump operating cycle even by several hours, will still ensure

  14. Utilization and cost of a new model of care for managing acute knee injuries: the Calgary acute knee injury clinic

    Directory of Open Access Journals (Sweden)

    Lau Breda HF

    2012-12-01

    Full Text Available Abstract Background Musculoskeletal disorders (MSDs affect a large proportion of the Canadian population and present a huge problem that continues to strain primary healthcare resources. Currently, the Canadian healthcare system depicts a clinical care pathway for MSDs that is inefficient and ineffective. Therefore, a new inter-disciplinary team-based model of care for managing acute knee injuries was developed in Calgary, Alberta, Canada: the Calgary Acute Knee Injury Clinic (C-AKIC. The goal of this paper is to evaluate and report on the appropriateness, efficiency, and effectiveness of the C-AKIC through healthcare utilization and costs associated with acute knee injuries. Methods This quasi-experimental study measured and evaluated cost and utilization associated with specific healthcare services for patients presenting with acute knee injuries. The goal was to compare patients receiving care from two clinical care pathways: the existing pathway (i.e. comparison group and a new model, the C-AKIC (i.e. experimental group. This was accomplished through the use of a Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ. Results Data from 138 questionnaires were analyzed in the experimental group and 136 in the comparison group. A post-hoc analysis determined that both groups were statistically similar in socio-demographic characteristics. With respect to utilization, patients receiving care through the C-AKIC used significantly less resources. Overall, patients receiving care through the C-AKIC incurred 37% of the cost of patients with knee injuries in the comparison group and significantly incurred less costs when compared to the comparison group. The total aggregate average cost for the C-AKIC group was $2,549.59 compared to $6,954.33 for the comparison group (p Conclusions The Calgary Acute Knee Injury Clinic was able to manage and treat knee injured patients for less cost than the existing state of healthcare delivery. The

  15. Utility of Preoperative CA125 Assay in the Management Planning of Women Diagnosed with Uterine Cancer

    Directory of Open Access Journals (Sweden)

    N. Povolotskaya

    2014-01-01

    grade did not (P=0.5. Overall, at five-year follow-up, while there were no deaths among the women with preoperative serum CA125 less than 12 U/mL, eleven of the twenty-three deaths (47.82% in the study occurred in women with a preoperative CA125 more than 28 U/mL. Conclusions. A preoperative CA125 assay for women with uterine cancer is a relatively inexpensive, reproducible, and objective test which provides valuable information regarding the risk of metastatic disease and overall likelihood of long term survival. Patients with a low likelihood of metastatic/nodal disease (favourable tissue type and CA125 level < 28 U/mL and significant comorbidities may benefit from avoiding an extended complete staging procedure. Alternatively, a high level of CA125 may prompt further imaging and multidisciplinary discussions to plan for individualised management and consideration for recruitment to clinical trials.

  16. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.

    2001-07-15

    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  17. Utilizing a programmatic focus on energy efficiency and customer feedback to improve the effectiveness of demand side management

    International Nuclear Information System (INIS)

    Smith, S.; Tharp, A.

    2006-01-01

    A project to encourage effective demand side management (DSM) programs through price-responsive load management was presented. The project was conducted through literature searches, surveys of utility programs and interviews with experts. National security, environmental awareness and economic factors were identified as the primary drivers for DSM. A overview of DSM strategies included details of: price responsive programs; power buyback; direct load control; and conservation-based rebates. Target sectors for DSM programs were divided into 4 sectors: (1) residential; (2) agricultural; (3) commercial/industrial; and (4) institutional. A customer decision cycle for DSM was presented, and various programs were evaluated. A comparison between DR and energy efficiency programs in the United States suggested that an increased focus on energy efficiency will benefit DR programs. However, perception of risk due to pricing exposure and the potential for loss of comfort are significant barriers to effective DSM. Studies have shown that DSM is most effective when participants receive direct feedback on consumption. Simple mechanisms for alerting participants of peak periods were recommended, as well as disaggregation tools to highlight areas of high energy usage and spotlight corrective measures. National and regional coordination of DSM activities was also recommended. It was concluded that DSM programs are successful when both customers and suppliers have an equal stake in their success. refs., tabs., figs

  18. Utilization of a cardiometabolic health nurse – a novel strategy to manage comorbid physical and mental illness

    Directory of Open Access Journals (Sweden)

    Brenda Happell

    2014-07-01

    Full Text Available Background: Comorbid chronic illnesses, such as cardiovascular disease, respiratory conditions, and type 2 diabetes are common among people with serious mental illness. Management of comorbid illness in the mental health setting is sometimes ad hoc and poorly delivered. Use of a cardiometabolic health nurse (CHN is proposed as one strategy to improve the delivery of physical health care to this vulnerable population. Objective: To report the CHN’s utilization of primary care and allied health referrals from a trial carried out in a regional community mental health service. Design: Feasibility study. Mental health consumers were referred by their case manager or mental health nurse to the CHN. The CHN coordinated the physical health care of community-based mental health consumers by identifying the need for, and providing referrals to, additional services, including primary care, allied health, and community-based services. Results: Sixty-two percent of participants referred to the CHN received referrals for primary care, allied health, and community-based services. Almost all referrals received follow-up by the CHN. Referrals were most commonly directed to a general practitioner and for nurse-delivered services. Conclusion: The CHN role shows promise in coordinating the physical health of community-based mental health consumers. More studies on role integration and development of specific outcome measurement tools are needed.

  19. Managing globalisation in public utilities : public service transnational corporations and the case of the global water industry

    OpenAIRE

    Finger, Matthias; Lobina, Emanuele

    1999-01-01

    Liberalisation, deregulation and privatisation of water and other public utilities have not produced the alleged efficiency gains of open international competition in public utilities, as the result has been restricted access to utilities rather than unleashed competition. Where water utilities have been privatised, TNCs have reproduced the typically monopolistic behaviour, enhancing concentration through vertical and horizontal integration, collusive conduct and other restrictive practices o...

  20. Electric portfolio modeling with stochastic water - climate interactions: Implications for co-management of water and electric utilities

    Science.gov (United States)

    Woldeyesus, Tibebe Argaw

    Water supply constraints can significantly restrict electric power generation, and such constraints are expected to worsen with future climate change. The overarching goal of this thesis is to incorporate stochastic water-climate interactions into electricity portfolio models and evaluate various pathways for water savings in co-managed water-electric utilities. Colorado Springs Utilities (CSU) is used as a case study to explore the above issues. The thesis consists of three objectives: Characterize seasonality of water withdrawal intensity factors (WWIF) for electric power generation and develop a risk assessment framework due to water shortages; Incorporate water constraints into electricity portfolio models and evaluate the impact of varying capital investments (both power generation and cooling technologies) on water use and greenhouse gas emissions; Compare the unit cost and overall water savings from both water and electric sectors in co-managed utilities to facilitate overall water management. This thesis provided the first discovery and characterization of seasonality of WWIF with distinct summertime and wintertime variations of +/-17% compared to the power plant average (0.64gal/kwh) which itself is found to be significantly higher than the literature average (0.53gal/kwh). Both the streamflow and WWIF are found to be highly correlated with monthly average temperature (r-sq = 89%) and monthly precipitation (r-sq of 38%) enabling stochastic simulation of future WWIF under moderate climate change scenario. Future risk to electric power generation also showed the risk to be underestimated significantly when using either the literature average or the power plant average WWIF. Seasonal variation in WWIF along with seasonality in streamflow, electricity demand and other municipal water demands along with storage are shown to be important factors for more realistic risk estimation. The unlimited investment in power generation and/or cooling technologies is also

  1. Integrated management model. Methodology and software-enabled tood designed to assist a utility in developing a station-wide optimization

    International Nuclear Information System (INIS)

    Llovet, R.; Ibanez, R.; Woodcock, J.

    2005-01-01

    A key concern for utilities today is optimizing station aging and realibility management activities in a manner that maximizes the value of those activities withing an affordable budget. The Westinghouse Proactive Asset Management Model is a methodology and software-enabled tood designed to assist a utility in developing a station-wide optimization of those activities. The process and tool support the development of an optimized, station-wide plan for inspection, testing, maintenance, repaor and replacement of aging components. The optimization identifies the benefit and optimal timing of those activities based on minimizing unplanned outage costs (avoided costs) and maximizing station Net Present Value. (Author)

  2. Feasibility and utility of an integrated medical imaging and informatics smartphone system for management of acute stroke.

    Science.gov (United States)

    Shkirkova, Kristina; Akam, Eftitan Y; Huang, Josephine; Sheth, Sunil A; Nour, May; Liang, Conrad W; McManus, Michael; Trinh, Van; Duckwiler, Gary; Tarpley, Jason; Vinuela, Fernando; Saver, Jeffrey L

    2017-12-01

    Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center. Results From May 2014 to October 2014, the Synapse ERm application was used by 33 stroke team members in 84 Code Stroke alerts. Patient age was 69.6 (±17.1), with 41.5% female. Final diagnosis was: ischemic stroke 64.6%, transient ischemic attack 7.3%, intracerebral hemorrhage 6.1%, and cerebrovascular-mimic 22.0%. Each patient Synapse ERm record was viewed by a median of 10 (interquartile range 6-18) times by a median of 3 (interquartile range 2-4) team members. The most used feature was computerized tomography, magnetic resonance, and catheter angiography image display. In-app tweet team, communications were sent by median 1 (interquartile range 0-1, range 0-13) users per case and viewed by median 1 (interquartile range 0-3, range 0-44) team members. Use of the system was associated with rapid treatment times, faster than national guidelines, including median door-to-needle 51.0 min (interquartile range 40.5-69.5) and median door-to-groin 94.5 min (interquartile range 85.5-121.3). In user surveys, the mobile information platform was judged easy to employ in 91% (95% confidence interval 65%-99%) of uses and of added help in stroke management in 50% (95% confidence interval 22%-78%). Conclusion The Synapse ERm mobile platform for stroke team distribution and integration of clinical and imaging data was feasible to implement, showed high ease of use, and moderate perceived added utility in therapeutic management.

  3. Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

    Directory of Open Access Journals (Sweden)

    Davis-Ajami ML

    2014-04-01

    Full Text Available Mary Lynn Davis-Ajami,1 Jun Wu,2 Katherine Downton,3 Emilie Ludeman,3 Virginia Noxon4 1Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA; 2South Carolina College of Pharmacy, University of South Carolina, Greenville, SC, USA; 3Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA; 4Department of Clinical Pharmacy and Outcomes Science, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA Abstract: Epoetin zeta was granted marketing authorization in October 2007 by the European Medicines Agency as a recombinant human erythropoietin erythropoiesis-stimulating agent to treat symptomatic anemia of renal origin in adult and pediatric patients on hemodialysis and adults on peritoneal dialysis, as well as for symptomatic renal anemia in adult patients with renal insufficiency not yet on dialysis. Currently, epoetin zeta can be administered either subcutaneously or intravenously to correct for hemoglobin concentrations ≤10 g/dL (6.2 mmol/L or with dose adjustment to maintain hemoglobin levels at desired levels not in excess of 12 g/dL (7.5 mmol/L. This review article focuses on epoetin zeta indications in chronic kidney disease, its use in managing anemia of renal origin, and discusses its pharmacology and clinical utility. Keywords: biosimilar, chronic kidney disease, epoetin alfa, erythropoiesis, renal anemia, Retacrit®

  4. The Enforcement of Criminal Law in the Utilization and Management of Forest Area Having Impact Toward Global Warming

    Directory of Open Access Journals (Sweden)

    Ifrani Ifrani

    2017-07-01

    Full Text Available The rampant corruption is in the utilization and its influence on global warming. It is expected in the future, in addition to the availability of maps of forest area easily accessible with some clear regional boundaries, there are also institutional and human resource capacity strengthening in the areas permitting the process to prevent corruption in the management of forest areas in Indonesia resulted in the destruction of natural resources, especially forests. Various activities in that sector become a critical point of the occurrence of corruption cases. In addition to the inadequacy of the forest area maps, unclear set of area boundaries, and the violations of licensing criteria, the cases of illegal logging become the factors that cause damages to the forest land in Indonesia. The purpose of this paper is to find out the relationship between corruption in the permitting conversion of forest land field of the ministry. The method used in this study was descriptive analytical research describing and analyzing the available facts in accordance with the issue that became the object of the research study.

  5. Evaluating the utility of syndromic case management for three sexually transmitted infections in women visiting hospitals in Delhi, India.

    Science.gov (United States)

    Sonkar, Subash Chandra; Wasnik, Kirti; Kumar, Anita; Sharma, Vineeta; Mittal, Pratima; Mishra, Prashant Kumar; Bharadwaj, Mausumi; Saluja, Daman

    2017-05-03

    Utility of syndromic case management (SCM) in women visiting obstetrics & gynecology department needs to be evaluated as it is subjective and imperfect. Consequently, antibiotic resistance has accelerated along with increased risk of infection to the partners. To understand the effectiveness and/or inadequacies of SCM, 11000 women were recruited and examined by clinicians for infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Bacterial vaginosis (BV) and others. Amongst these patients, 1797 (16.3%) reported vaginal discharge (VD). Other symptoms included: vaginitis (97%), cervicitis (75%), genital ulcers (60%), abnormal vaginal discharge (55%) and lower abdominal pain (48%). The patients were treated for single or co-infections using pre-packed National Aids Control Program III STI/RTI Kits. However, based on PCR diagnostics, 1453/1797 (81%) subjects were uninfected for NG/TV/CT. Amongst 344 (19%) infected patients, 257 (75%) carried infection with single pathogen (TV/NG/CT) while 87/344 (25%) were co-infected with multiple pathogens. Prevalence of TV, NG & CT was 4%, 7% and 8% respectively. Co-infection with CT + NG was highest, 51% (44/87), whereas, co-infection with CT + TV was 21% and NG + TV was 18% while co-infection with all three pathogens was 1.3%. We conclude that SCM is imprecise and successful intervention requires accurate and confirmatory diagnostic approach.

  6. Expected utility without utility

    OpenAIRE

    Castagnoli, E.; Licalzi, M.

    1996-01-01

    This paper advances an interpretation of Von Neumann–Morgenstern’s expected utility model for preferences over lotteries which does not require the notion of a cardinal utility over prizes and can be phrased entirely in the language of probability. According to it, the expected utility of a lottery can be read as the probability that this lottery outperforms another given independent lottery. The implications of this interpretation for some topics and models in decision theory are considered....

  7. Activities of research-reactor-technology project in FNCA from FY2005 to FY2007. Sharing neutronics calculation technique for core management and utilization of research reactors

    International Nuclear Information System (INIS)

    2010-07-01

    RRT project (Research-Reactor-Technology Project) was carried out with the theme of 'sharing neutronics calculation technique for core management and utilization of research reactors' in the framework of FNCA (Forum for Nuclear Cooperation in Asia) from FY2005 to FY2007. The objective of the project was to improve and equalize the level of neutronics calculation technique for the reactor core management among participating countries to assure the safe and stable operation of research reactors and the promotion of the effective utilization. Neutronics calculation codes, namely SRAC code system and MVP code, were adopted as common codes. Participating countries succeeded in applying the common codes to analyzing the core of each domestic research reactor. Some participating countries succeeded in applying the common codes to analyzing for utilization of own research reactors. Activities of RRT project have improved and equalized the level of neutronics calculation technique among participating countries. (author)

  8. Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City.

    Science.gov (United States)

    Kupprat, Sandra A; Dayton, Alex; Guschlbauer, Andrea; Halkitis, Perry N

    2009-07-01

    A retrospective, longitudinal analysis of case management and medical charts was used to evaluate utilization of support group, mental health, and substance abuse treatment services among HIV-positive women in New York City. Analyses of 4134 case management and supportive service transactions revealed that 70% utilized support groups over the two-year study period. In contrast, only 35% utilized mental health services (therapy) and of those identified as using substances, only 48% utilized substance abuse treatment services. Considering the high prevalence of mental illness (63%, n=29) and substance use (54%, n=25) in the sample, the low utilization rates highlight unmet needs for service. Significant differences were found in utilization of mental health and substance abuse treatment services, with those who received services at a medical model agency (integrated care) being more likely to receive both types of treatment. In contrast, participants attending support groups in non-medical model agencies (77.8%, n=7) were significantly more likely to be retained in group (i.e., attend 11 or more sessions) than those at medical model agencies (39.1%, n=9). Based on the higher utilization rates of support groups among seropositive women, perhaps these groups could be a vehicle for establishing rapport between mental health professionals and group members to bridge the utilization gap and reduce the stigma associated with therapy and substance abuse treatment services. These findings both taut the success and highlight weaknesses regarding accessing mental health and substance abuse care, and support group retention. Sharing of information regarding recruitment and retention efforts between agencies of different modalities would be beneficial and also could identify service niches that capitalize on their subsequent strengths.

  9. Clinical utility of the Prostate Health Index (phi) for biopsy decision management in a large group urology practice setting.

    Science.gov (United States)

    White, Jay; Shenoy, B Vittal; Tutrone, Ronald F; Karsh, Lawrence I; Saltzstein, Daniel R; Harmon, William J; Broyles, Dennis L; Roddy, Tamra E; Lofaro, Lori R; Paoli, Carly J; Denham, Dwight; Reynolds, Mark A

    2018-04-01

    Deciding when to biopsy a man with non-suspicious DRE findings and tPSA in the 4-10 ng/ml range can be challenging, because two-thirds of such biopsies are typically found to be benign. The Prostate Health Index (phi) exhibits significantly improved diagnostic accuracy for prostate cancer detection when compared to tPSA and %fPSA, however only one published study to date has investigated its impact on biopsy decisions in clinical practice. An IRB approved observational study was conducted at four large urology group practices using a physician reported two-part questionnaire. Physician recommendations were recorded before and after receiving the phi test result. A historical control group was queried from each site's electronic medical records for eligible men who were seen by the same participating urologists prior to the implementation of the phi test in their practice. 506 men receiving a phi test were prospectively enrolled and 683 men were identified for the historical control group (without phi). Biopsy and pathological findings were also recorded for both groups. Men receiving a phi test showed a significant reduction in biopsy procedures performed when compared to the historical control group (36.4% vs. 60.3%, respectively, P phi score impacted the physician's patient management plan in 73% of cases, including biopsy deferrals when the phi score was low, and decisions to perform biopsies when the phi score indicated an intermediate or high probability of prostate cancer (phi ≥36). phi testing significantly impacted the physician's biopsy decision for men with tPSA in the 4-10 ng/ml range and non-suspicious DRE findings. Appropriate utilization of phi resulted in a significant reduction in biopsy procedures performed compared to historical patients seen by the same participating urologists who would have met enrollment eligibility but did not receive a phi test.

  10. Utilizing NASA Earth Observations to Monitor Land Management Practices and the Development of Marshlands to Rice Fields in Rwanda

    Science.gov (United States)

    Dusabimana, M. R.; Blach, D.; Mwiza, F.; Muzungu, E.; Swaminathan, R.; Tate, Z.

    2014-12-01

    Rwanda, a small country with the highest population density in Sub-Saharan Africa, is one of the world's poorest countries. Although agriculture is the backbone of Rwandan economy, agricultural productivity is extremely low. Over 90 % of the population is engaged in subsistence farming and only 52 % of the total land surface area is arable. Of this land, approximately 165,000 hectares are marshlands, of which only 57 % has been cultivated. Rwandan government has invested in the advancement of agriculture with activities such as irrigation, marshland reclamation, and crop regionalization. In 2001, Ministry of Agriculture and Animal Resources (MINAGRI) released the Rural Sector Support Program (RSSP), which aimed at converting marshlands into rice fields at various development sites across the country. The focus of this project was to monitor rice fields in Rwanda utilizing NASA Earth observations such as Landsat 5 Thematic Mapper and Landsat 8 Operational Land Imager. Modified Normalized Difference Water Index (MNDWI) was used to depict the progress of marshland to rice field conversion as it highlights the presence of irrigated rice fields from the surrounding area. Additionally, Decision Support System for Agrotechnology Transfer (DSSAT) was used to estimate rice yield at RSSP sites. Various simulations were run to find perfect conditions for cultivating the highest yield for a given farm. Furthermore, soil erosion susceptibility masks were created by combining factors derived from ASTER, MERRA, and ground truth data using Revised Universal Soil Loss Equation (RUSLE). The end results, maps, and tutorials were delivered to the partners and policy makers in Rwanda to help make informed decisions. It can be clearly seen that Earth observations can be successfully used to monitor agricultural and land management practices as a cost effective method that will enable farmers to improve crop yield production and food security.

  11. Risk management for drinking water safety in low and middle income countries - cultural influences on water safety plan (WSP) implementation in urban water utilities.

    Science.gov (United States)

    Omar, Yahya Y; Parker, Alison; Smith, Jennifer A; Pollard, Simon J T

    2017-01-15

    We investigated cultural influences on the implementation of water safety plans (WSPs) using case studies from WSP pilots in India, Uganda and Jamaica. A comprehensive thematic analysis of semi-structured interviews (n=150 utility customers, n=32 WSP 'implementers' and n=9 WSP 'promoters'), field observations and related documents revealed 12 cultural themes, offered as 'enabling', 'limiting', or 'neutral', that influence WSP implementation in urban water utilities to varying extents. Aspects such as a 'deliver first, safety later' mind set; supply system knowledge management and storage practices; and non-compliance are deemed influential. Emergent themes of cultural influence (ET1 to ET12) are discussed by reference to the risk management, development studies and institutional culture literatures; by reference to their positive, negative or neutral influence on WSP implementation. The results have implications for the utility endorsement of WSPs, for the impact of organisational cultures on WSP implementation; for the scale-up of pilot studies; and they support repeated calls from practitioner communities for cultural attentiveness during WSP design. Findings on organisational cultures mirror those from utilities in higher income nations implementing WSPs - leadership, advocacy among promoters and customers (not just implementers) and purposeful knowledge management are critical to WSP success. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Utilization of health care services in rural and urban areas: a determinant factor in planning and managing health care delivery systems.

    Science.gov (United States)

    Oladipo, Jimoh Ayanda

    2014-06-01

    Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.

  13. Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data.

    Science.gov (United States)

    Jaglal, Susan B; Guilcher, Sara J T; Hawker, Gillian; Lou, Wendy; Salbach, Nancy M; Manno, Michael; Zwarenstein, Merrick

    2014-05-01

    Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups.

  14. Toward utilization of data for program management and evaluation: quality assessment of five years of health management information system data in Rwanda.

    Science.gov (United States)

    Nisingizwe, Marie Paul; Iyer, Hari S; Gashayija, Modeste; Hirschhorn, Lisa R; Amoroso, Cheryl; Wilson, Randy; Rubyutsa, Eric; Gaju, Eric; Basinga, Paulin; Muhire, Andrew; Binagwaho, Agnès; Hedt-Gauthier, Bethany

    2014-01-01

    Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over a 5-year period. The World Health Organization (WHO) data quality report card framework was used to assess the quality of HMIS data captured from 2008 to 2012 and is a census of all 495 publicly funded health facilities in Rwanda. Factors assessed included completeness and internal consistency of 10 indicators selected based on WHO recommendations and priority areas for the Rwanda national health sector. Completeness was measured as percentage of non-missing reports. Consistency was measured as the absence of extreme outliers, internal consistency between related indicators, and consistency of indicators over time. These assessments were done at the district and national level. Nationally, the average monthly district reporting completeness rate was 98% across 10 key indicators from 2008 to 2012. Completeness of indicator data increased over time: 2008, 88%; 2009, 91%; 2010, 89%; 2011, 90%; and 2012, 95% (pservice output increased from 3% (2011) to 9% (2012). Eighty-three percent of districts reported ratios between related indicators (ANC/DTP1, DTP1/DTP3) consistent with HMIS national ratios. Conclusion and policy implications: Our findings suggest that HMIS data quality in Rwanda has been improving over time. We recommend maintaining these assessments to identify remaining gaps in data quality and that results are shared publicly to support increased use of HMIS data.

  15. Assessment Of The Availability, Utilization And Management Of ICT Facilities In Teaching English Language In Secondary Schools In Kaduna State, Nigeria

    Directory of Open Access Journals (Sweden)

    Hanna Onyi Yusuf

    2013-01-01

    Full Text Available The study investigated the availability, utilization and management of ICT facilities in teaching English language in secondary schools in Kaduna State, Nigeria. The study adopted a descriptive survey research design. A questionnaire titled “Availability, Utilization and Management of Information and Communication Technology in teaching English Language in Secondary Schools” (AUMICTSS was used for data collection. Twenty randomly selected secondary schools from Kaduna metropolis were used for the study. A total of 100 teachers participated by responding to the items on the questionnaire. The data collected was analysed using frequencies and percentages. The findings of the study revealed that there is a dearth of ICT facilities in secondary schools in Kaduna as there are only very few of such facilities available in most of the schools visited. It also revealed that most teachers were not competent in the use of these facilities as the management of these facilities requires training and re-training. It was recommended as a matter of urgency that government should provide more ICT facilities in schools and ensure the provision of electricity in every secondary school for optimal utilization of these facilities. Teachers should equally be trained and re-trained regularly in the use and management of ICT facilities for effective English Language curriculum delivery.

  16. Local knowledge and socio-economic determinants of traditional medicines' utilization in livestock health management in Southwest Nigeria

    Directory of Open Access Journals (Sweden)

    Mafimisebi Taiwo E

    2012-01-01

    Full Text Available Abstract Smallholder livestock farmers in Nigeria utilize traditional medicines derived from medicinal plants (PMs for the maintenance of their animals' health. This study was designed to determine the PMs used in the study area and their level of utilization by livestock farmers, compare the level of utilization of PMs across the three states surveyed and identify the socio-economic factors influencing farmer's utilization of PMs. Thirty-five PMs were identified. Farmers had considerable knowledge about the identified PMs but about 80.0% of them used the PMs to poor/moderate extent. There were statistical differences in the utilization level of PMs among the three states. Six socio-economic variables were found to be statistically significant in influencing PMs' utilization. Farmer's age, household size, distance to the nearest veterinary hospital/clinic and extent of travels, had positive effects while negative effects were exhibited by farm income and number of heads of livestock. It was concluded that there was considerable knowledge about PMs and that utilization of PMs varied between the three states. It was recommended that local knowledge of PMs be preserved in the study area through screening and documentation.

  17. Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review

    OpenAIRE

    Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

    2017-01-01

    Background Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Methods Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: “Healthcar...

  18. THEORETICAL ASPECTS OF BASIC PROVISIONS OF THE ENERGY SAVING MANAGEMENT SYSTEM IN THE FIELD OF HOUSING AND PUBLIC UTILITIES THROUGH INTRODUCTION OF SMALL INNOVATIVE ENTERPRISES

    Directory of Open Access Journals (Sweden)

    Kiseleva Ekaterina Alexandrovna

    2012-10-01

    Full Text Available The author addresses solutions to problems of the housing and utilities sector (including a substantial depreciation of fixed assets of the municipal infrastructure, a gap between domestic utilities management technologies and those employed worldwide, and the fund raising problem through power saving actions to be facilitated by small innovative enterprises. The proposed solutions contribute to formation of new jobs in the regions, reduction of power consumption and higher efficiency of regional economies due to reduced costs and rates (prices set for utilities-related services, and improvement of the standard and quality of living. The principal objective is to develop a set of procedures and criteria to serve as the basis for the selection of tools of power saving innovations in the housing and utilities sector of regions and municipalities. The above actions are to be implemented through the involvement of small innovative enterprises. The basic tools (instruments of the state social and economic (including innovation-related policy, that are to stimulate subjects of innovative activities to implement innovative projects in this sector stimulate energy efficiency innovations in the housing and utilities sector. The proposed set of tools includes tax holidays, subsidies, grants, soft loans, concessional loans, state and municipal orders, etc. The procedure of selection of instruments of state-initiated innovations designated for the improvement of the power efficiency of the housing and public utilities sector to be implemented by regional and municipal authorities is proposed by the author. The author identifies several types of energy saving innovations in the housing and utilities sector, based on their systemic effects. Upon identification of the top-priority recipients of state support, financial resources are to be distributed. Advantages of innovative energy saving projects in the housing and utilities sector, developed and implemented

  19. Consistent workforce management cuts the cost incurred for network maintenance, fault clearance, and other utility services; Konsequentes Einsatzmanagement senkt die Kosten im Servicebereich. Mehr Leistungen fuer weniger Geld

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, M. [Deneg GmbH, Garbsen (Germany); Hillmann, G. [Tema Technologie Marketing AG, Berlin (Germany)

    2003-02-10

    The electric utilities and grid operators have to cope with a wide range of difficult, new challenges since the onset of electricity market liberalisation in 1998. The sometimes contradictory requirements of the customers or the legal regime can be managed only by a consistent optimization of procedures and operational processes in the service environment, as for example workforce management, order processing and execution. Workforce management is the particularly efficient approach at the organizational and service leve, which is demonstrated in the article. (orig./CB) [German] Alle Netzbetreiber sehen sich als Folge der Liberalisierung des Strommarktes seit 1998 erhoehten Anforderungen ausgesetzt. Diese sich teilweise widersprechenden Anforderungen sind aber nur durch eine Optimierung der Ablaeufe im Servicebereich bei Einsatzplanung, Auftragserfassung und -abwicklung zu bewaeltigen. Workforce Management ist das geeignete Hilfsmittel, um organisatorisch und technisch die Folgen der erforderlichen Einsparungen abzufangen und trotzdem die Qualitaet der Versorgung aufrecht zu erhalten, auch mit weniger Mitarbeitern. (orig./CB)

  20. A combined model to assess technical and economic consequences of changing conditions and management options for wastewater utilities.

    Science.gov (United States)

    Giessler, Mathias; Tränckner, Jens

    2018-02-01

    The paper presents a simplified model that quantifies economic and technical consequences of changing conditions in wastewater systems on utility level. It has been developed based on data from stakeholders and ministries, collected by a survey that determined resulting effects and adapted measures. The model comprises all substantial cost relevant assets and activities of a typical German wastewater utility. It consists of three modules: i) Sewer for describing the state development of sewer systems, ii) WWTP for process parameter consideration of waste water treatment plants (WWTP) and iii) Cost Accounting for calculation of expenses in the cost categories and resulting charges. Validity and accuracy of this model was verified by using historical data from an exemplary wastewater utility. Calculated process as well as economic parameters shows a high accuracy compared to measured parameters and given expenses. Thus, the model is proposed to support strategic, process oriented decision making on utility level. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. A preliminary assessment of system cost impacts of using transportable storage casks and other shippable metal casks in the utility/DOE spent fuel management system

    International Nuclear Information System (INIS)

    Johnson, E.R.

    1988-01-01

    In view of the foregoing, a study was conducted by E.R. Johnson Associates, Inc. and H and R Technical Associates, Inc. to determine the prospective viability of the use of TSCs and shippable SOCs in the combined utility/DOE system. This study considered costs, ALARA considerations and the logistics of the use and delivery of casks to the DOE system by utilities. It was intended that this study would result in a technical and cost resource base that could be used for evaluating various strategies and scenarios for deploying TSCs or SOCs in the combined utility/DOE spent fuel management system with respect to the prospective economic advantage that could be realized

  2. Emergency management of major bleeding in a case of maxillofacial trauma and anticoagulation: utility of prothrombin complex concentrates in the shock room

    Directory of Open Access Journals (Sweden)

    Alessandro Morotti

    2015-03-01

    Full Text Available Life-threatening bleeding in anticoagulation with Warfarin is an emergency challenging issue. Several approaches are available to treat bleeding in either over-anticoagulation or propeanticoagulation, including vitamin K, fresh frozen plasma and prothrombin complex concentrates (PCC administration. In coexisting trauma-induced bleeding and anticoagulation, reversal of anticoagulation must be a rapid and highly effective procedure. Furthermore the appropriate treatment must be directly available in each shock rooms to guarantee the rapid management of the emergency. PCC require a simple storage, rapid accessibility, fast administration procedures and high effectiveness. Here we report the utility of PCC in management of a craniofacial trauma in proper-anticoagulation.

  3. THE INCREASING PRODUCTIVITY AND VALUE ADDED FOR CRAFTSMEN GEM STONE IN SANGIRAN SRAGEN THROUGH ACCESS TECHNOLOGY, MANAGEMENT, AND UTILIZATION OF RESOURCES POWER BASED LOCAL WISDOM

    OpenAIRE

    Rahmawati; Soenarto; Sri Murni; Agung Nur Probohudono

    2016-01-01

    Small and Medium Enterprises (SMEs) could get great opportunities of ACFTA implementation. Formulation of the problem in this research are: How to design the industrial models of gemstones and fossils souvenirs align with the market taste? How to improve the utilization of the technology used in the low skills and business management of gemstones and fossils souvenirs industry? How to optimize the role of support institutions which are research, education, and banking i...

  4. 77: Development, utilization and evolution of a computer system for treatment follow-up and medical management of a radiotherapy department

    International Nuclear Information System (INIS)

    Costa, A.; Leca, M.; Marcie, S.; Rameau, P.; Lagrange, J.L.; Chauvel, P.; Hery, M.; Lalanne, C.M.

    1987-01-01

    SISGRAD, a computer system developed in the Radiotherapy Dept. of the Centre A. Lacassagne, has been operational for 5 years. This network of microcomputers is connected to the computers used for dosimetry, and is integrated in the hospital's general computer system. SISGRAD was designed primarily to verify that prescribed irradiation treatments are given properly and to improve medical and administrative management of the Dept. SISGRAD is also utilized to provide information to data bases. 22 refs.; 2 figs.; 1 table

  5. Utilization of Rural Primary Care Physicians' Visit Services for Diabetes Management of Public Health in Southwestern China: A Cross-Sectional Study from Patients' View.

    Science.gov (United States)

    Miao, Yudong; Ye, Ting; Qian, Dongfu; Li, Jinlong; Zhang, Liang

    2014-06-01

    Primary care physicians' visit services for diabetes management are now widely delivered in China's rural public health care. Current studies mainly focus on supply but risk factors from patients' view have not been previously explored. This study aims to present the utilization of rural primary care physicians' visit services for diabetes management in the last 12 months in southwestern China, and to explore risk factors from patients' view. This cross sectional study selected six towns at random and all 385 diabetics managed by primary care physicians were potential participants. Basing on the inclusion and exclusion criteria, 374 diabetics were taken as valid subjects and their survey responses formed the data resource of analyses. Descriptive indicators, χ2 contingency table analyses and Logistic regression were used. 54.8% respondents reported the utilization of visit services. According to the multivariate analysis, the positive factors mainly associated with utilization of visit services include disease duration (OR=1.654), use of diabetic drugs (OR=1.869), consulting diabetes care knowledge (OR=1.602), recognition of diabetic complications (OR=1.662), needs of visit services (OR=2.338). The utilization of rural primary care physicians' visit services still remains unsatisfactory. Mass rural health policy awareness, support, and emphasis are in urgent need and possible risk factors including disease duration, use of diabetic drugs, consulting diabetes care knowledge, recognition of diabetic complications and needs of visit services should be taken into account when making rural health policy of visit services for diabetes management in China and many other low- and middle-income countries.

  6. Conflict free implementation of strategic project management office at the Entitie level utilizing “Evaporated cloud” diagram

    OpenAIRE

    Oganov, A.; Gogunsky, V.

    2015-01-01

    The analysis of reports on the last researches in area of project management office (PMO) in the organizations is carried out. Comparison of approaches in project management at the entities with PMO of different levels of a maturity and without it is executed. It is shown that the effectiveness of organizations orientation determined by the level of activity on project approaches, implemented with the help of Project Management Office through continuous improvement of design processes and ope...

  7. NNP-LANL Utilities - Condition Assessment and Project Approach

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Grant Lorenz [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-11-21

    This report is a presentation on LANL Utilities & Transportation Asset Management; Utility Assets Overview; Condition Assessment; Utilities Project Nominations & Ranking; and Utilities Project Execution.

  8. Climate Narratives: Combing multiple sources of information to develop risk management strategies for a municipal water utility

    Science.gov (United States)

    Yates, D. N.; Basdekas, L.; Rajagopalan, B.; Stewart, N.

    2013-12-01

    Municipal water utilities often develop Integrated Water Resource Plans (IWRP), with the goal of providing a reliable, sustainable water supply to customers in a cost-effective manner. Colorado Springs Utilities, a 5-service provider (potable and waste water, solid waste, natural gas and electricity) in Colorado USA, recently undertook an IWRP. where they incorporated water supply, water demand, water quality, infrastructure reliability, environmental protection, and other measures within the context of complex water rights, such as their critically important 'exchange potential'. The IWRP noted that an uncertain climate was one of the greatest sources of uncertainty to achieving a sustainable water supply to a growing community of users. We describe how historic drought, paleo-climate, and climate change projections were blended together into climate narratives that informed a suite of water resource systems models used by the utility to explore the vulnerabilities of their water systems.

  9. 7 CFR 1955.72 - Utilization of inventory housing by Federal Emergency Management Agency (FEMA) or under a...

    Science.gov (United States)

    2010-01-01

    ... Family Housing Servicing and Property Management (SFH/SPM) Division in the National Office. [54 FR 20523... Management Agency (FEMA) or under a Memorandum of Understanding between the Agency and the Department of... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS...

  10. The Colville Study: wood utilization for ecosystem management: preliminary results of study of product potential from small-diameter stands.

    Science.gov (United States)

    S. Willits; R. J. Barbour; J. McNeel; R. D. Fight; G. C. Myers; A. Mason

    The Colville Study was developed in 1994 to identify and evaluate a series of management options for achieving ecosystem objectives in dense stands of small-diameter trees while also producing wood products. The Colville National Forest selected the Rocky II Timber Sale as an example of this type of stand that needed management to achieve the following goals: (1)...

  11. A comparison of geospatially modeled fire behavior and fire management utility of three data sources in the southeastern United States

    Science.gov (United States)

    LaWen T. Hollingsworth; Laurie L. Kurth; Bernard R. Parresol; Roger D. Ottmar; Susan J. Prichard

    2012-01-01

    Landscape-scale fire behavior analyses are important to inform decisions on resource management projects that meet land management objectives and protect values from adverse consequences of fire. Deterministic and probabilistic geospatial fire behavior analyses are conducted with various modeling systems including FARSITE, FlamMap, FSPro, and Large Fire Simulation...

  12. Research and development of power reactor technology supporting work, 3; Development of utility facility operation management technique

    Energy Technology Data Exchange (ETDEWEB)

    1990-03-01

    Demands on utility facilities for nuclear technology development are increasingly sophisticated and diversified. It is important to meet requirements of securing the reliability of utility supply and ensuring the safety of facility operation and maintenance by means of technical supporting, data supply and quick contingency responses. A New computer system to make practicable man-machine interface, real-time data acquisition and operation data centralization has been developed based on the knowledge. Obtained from data base information and operation experience for the purpose of operation efficiency and labor saving. (author).

  13. Triage of the autistic spectrum child utilizing the congruence of case management concepts and Orem's Nursing Theories.

    Science.gov (United States)

    Oliver, Catherine J

    2003-01-01

    The purpose of this project was to design and implement a case management framework for the benefit of children diagnosed with an autistic spectrum disorder (ASD). The process consisted of selecting two children exhibiting symptoms of an ASD and managing them across a continuum of care. Methodological structure was derived from case management standards of practice and Orem's Nursing Theories. Although some objectives sustained a slight delay because of variances, findings revealed successful outcomes based on progression toward measurable case management goals. The children were directed to appropriate school placements and habilitative therapies in an efficient manner. Their parents received support and education related to special needs children. The process yielded assurance that Orem's Nursing Theories and case management concepts articulate seamlessly within nursing care boundaries.

  14. Variables Influencing the Return on Investment in Management Training Programs: A Utility Analysis of 10 Swiss Cases

    Science.gov (United States)

    Chochard, Yves; Davoine, Eric

    2011-01-01

    In this article, we present the utility analysis approach as an alternative and promising approach to measure the return on investment in managerial training programs. This approach, linking economic value with competencies developed by trainees, enables researchers and decision-makers to compare the return on investment from different programs in…

  15. The utility of system-level RAM analysis and standards for the US nuclear waste management system

    International Nuclear Information System (INIS)

    Rod, S.R.; Adickes, M.D.; Paul, B.K.

    1992-03-01

    The Department of Energy (DOE) Office of Civilian Radioactive Waste Management (OCRWM) is responsible for developing a system to manage spent nuclear fuel and high-level radioactive waste in accordance with the Nuclear Waste Policy Act of 1982 and its subsequent amendments. Pacific Northwest Laboratory (PNL) is assisting OCRWM in its investigation of whether system-level reliability, availability, and maintainability (RAM) requirements are appropriate for the waste management system and, if they are, what appropriate form should be for such requirements. Results and recommendations are presented

  16. Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.

    Science.gov (United States)

    Hasegawa, Aya; Yasuoka, Junko; Ly, Po; Nguon, Chea; Jimba, Masamine

    2013-08-23

    Malaria and other communicable diseases remain major threats in developing countries. In Cambodia, village malaria workers (VMWs) have been providing malaria control services in remote villages to cope with the disease threats. In 2009, the VMW project integrated child health services into the original malaria control services. However, little has been studied about the utilization of VMWs' child health services. This study aimed to identify determinants of caregivers' VMW service utilization for childhood illness and caregivers' knowledge of malaria management. A cross-sectional study was conducted in 36 VMW villages of Kampot and Kampong Thom provinces in July-September 2012. An equal number of VMW villages with malaria control services only (M) and those with malaria control plus child health services (M+C) were selected from each province. Using structured questionnaires, 800 caregivers of children under five and 36 VMWs, one of the two VMWs who was providing VMW services in each study village were interviewed. Among the caregivers, 23% in M villages and 52% in M+C villages utilized VMW services for childhood illnesses. Determinants of caregivers' utilization of VMWs in M villages included their VMWs' length of experience (AOR = 11.80, 95% confidence interval [CI] = 4.46-31.19) and VMWs' service quality (AOR = 2.04, CI = 1.01-4.11). In M+C villages, VMWs' length of experience (AOR = 2.44, CI = 1.52-3.94) and caregivers' wealth index (AOR = 0.35, CI = 0.18-0.68) were associated with VMW service utilization. Meanwhile, better service quality of VMWs (AOR = 3.21, CI = 1.34-7.66) and caregivers' literacy (AOR = 9.91, CI = 4.66-21.05) were positively associated with caregivers' knowledge of malaria management. VMWs' service quality and length of experience are important determinants of caregivers' utilization of VMWs' child health services and their knowledge of malaria management. Caregivers are seeking VMWs' support for childhood illnesses even if they are

  17. Strategic plan to optimize the management of right-of-way parcel and utility information at FDOT.

    Science.gov (United States)

    2013-05-01

    The Florida Department of Transportation (FDOT) manages a huge right-of-way asset. Examples of core : processes related to this asset include determining right-of-way boundaries; inventorying roadside features; : preparing right-of-way maps; acquirin...

  18. Development of exercise design, development and implementation protocol in the utilization of simulators for response management training

    International Nuclear Information System (INIS)

    Giesen, J. H.

    1997-01-01

    Development and operation of a marine oil spill management simulator system at Texas A and M University's Galveston Center for Marine Training and Safety was described. The Spill Management Simulator is a multi-year joint program between the U. S. Coast Guard and the Center. Essentially, it is a a computer-based modelling and scenario generator for conducting and evaluating incident management training. An independent evaluation group has been set up by the U.S.Coast Guard to evaluate the Galveston and similar programs established under the same legislation throughout the United States. This paper discusses the creation of a development and implementation protocol for Spill Management Team simulation as a foundation upon which to integrate available and future technology and for making it available to the response community as a whole. 12 refs.,1 tab., 4 figs

  19. Clinical utility of real-time compression ultrasonography for diagnostic management of patients with recurrent venous thrombosis

    NARCIS (Netherlands)

    Heijboer, H.; Jongbloets, L. M.; Büller, H. R.; Lensing, A. W.; ten Cate, J. W.

    1992-01-01

    In the diagnostic management of patients with clinically suspected recurrent deep-vein thrombosis (DVT), there are potential limitations to all available diagnostic techniques. Since venous abnormalities may persist for some time after an acute thrombosis, the usefulness of compression

  20. Long-term impact of a chronic disease management program on hospital utilization and cost in an Australian population with heart disease or diabetes.

    Science.gov (United States)

    Hamar, G Brent; Rula, Elizabeth Y; Coberley, Carter; Pope, James E; Larkin, Shaun

    2015-04-22

    To evaluate the longitudinal value of a chronic disease management program, My Health Guardian (MHG), in reducing hospital utilization and costs over 4 years. The MHG program provides individualized support via telephonic nurse outreach and online tools for self-management, behavior change and well-being. In follow up to an initial 18-month analysis of MHG, the current study evaluated program impact over 4 years. A matched-cohort analysis retrospectively compared MHG participants with heart disease or diabetes (treatment, N = 4,948) to non-participants (comparison, N = 28,520) on utilization rates (hospital admission, readmission, total bed days) and hospital claims cost savings. Outcomes were evaluated using regression analyses, controlling for remaining demographic, disease, and pre-program admissions or cost differences between the study groups. Over the 4 year period, program participation resulted in significant reductions in hospital admissions (-11.4%, P hospital claims was $3,549 over 4-years; savings values for each program year were significant and increased with time (P = 0.003 to P hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

  1. The management of an endodontically abscessed tooth: patient health state utility, decision-tree and economic analysis

    Directory of Open Access Journals (Sweden)

    Shepperd Sasha

    2007-12-01

    Full Text Available Abstract Background A frequent encounter in clinical practice is the middle-aged adult patient complaining of a toothache caused by the spread of a carious infection into the tooth's endodontic complex. Decisions about the range of treatment options (conventional crown with a post and core technique (CC, a single tooth implant (STI, a conventional dental bridge (CDB, and a partial removable denture (RPD have to balance the prognosis, utility and cost. Little is know about the utility patients attach to the different treatment options for an endontically abscessed mandibular molar and maxillary incisor. We measured patients' dental-health-state utilities and ranking preferences of the treatment options for these dental problems. Methods Forty school teachers ranked their preferences for conventional crown with a post and core technique, a single tooth implant, a conventional dental bridge, and a partial removable denture using a standard gamble and willingness to pay. Data previously reported on treatment prognosis and direct "out-of-pocket" costs were used in a decision-tree and economic analysis Results The Standard Gamble utilities for the restoration of a mandibular 1st molar with either the conventional crown (CC, single-tooth-implant (STI, conventional dental bridge (CDB or removable-partial-denture (RPD were 74.47 [± 6.91], 78.60 [± 5.19], 76.22 [± 5.78], 64.80 [± 8.1] respectively (p The standard gamble utilities for the restoration of a maxillary central incisor with a CC, STI, CDB and RPD were 88.50 [± 6.12], 90.68 [± 3.41], 89.78 [± 3.81] and 91.10 [± 3.57] respectively (p > 0.05. Their respective willingness-to-pay ($CDN were: 1,782.05 [± 361.42], 1,871.79 [± 349.44], 1,605.13 [± 348.10] and 1,351.28 [± 368.62]. A statistical difference was found between the utility of treating a maxillary central incisor and mandibular 1st-molar (p The expected-utility-value for a 5-year prosthetic survival was highest for the CDB and the

  2. FINANCIAL STATEMENT UTILIZATION DURING DECISION MAKING PROCESS IN SMEs: A COMPARATIVE STUDY ON EUROPEAN AND TURKISH MANAGERS

    OpenAIRE

    İbicioğlu, Hasan; Kocabıyık, Turan; Dalğar, Hüseyin

    2014-01-01

    This study examines financial information requirement for decision making in small and medium sized enterprises. 131 SME managers’ responses were collected from Turkey and 8 different European countries. According to both Turkish and European managers, financial statements are mostly important to foresee the probable liquidity and financial crisis. And they find experience more important than financial statement data. A comparative analysis of Turkish and European SME managers is stated. Smal...

  3. Pareto utility

    NARCIS (Netherlands)

    Ikefuji, M.; Laeven, R.J.A.; Magnus, J.R.; Muris, C.H.M.

    2013-01-01

    In searching for an appropriate utility function in the expected utility framework, we formulate four properties that we want the utility function to satisfy. We conduct a search for such a function, and we identify Pareto utility as a function satisfying all four desired properties. Pareto utility

  4. A Cost-Utility Analysis of 5 Strategies for the Management of Acute Otitis Media in Children.

    Science.gov (United States)

    Shaikh, Nader; Dando, Emily E; Dunleavy, Mark L; Curran, Dorothy L; Martin, Judith M; Hoberman, Alejandro; Smith, Kenneth J

    2017-10-01

    To assess whether antimicrobial therapy in young children with acute otitis media reduces time to resolution of symptoms, overall symptom burden, and persistence of otoscopic evidence of infection. We used a cost-utility model to evaluate whether immediate antimicrobial treatment seems to be worthwhile, and if so, which antimicrobial agent is most cost effective. We compared the cost per quality-adjusted life-day of 5 treatment regimens in children younger than 2 years of age with acute otitis media: immediate amoxicillin/clavulanate, immediate amoxicillin, immediate cefdinir, watchful waiting, and delayed prescription (DP) for antibiotic. The 5 treatment regimens, listed in order from least effective to most effective were DP, watchful waiting, immediate cefdinir, immediate amoxicillin, and immediate amoxicillin/clavulanate. Listed in order from least costly to most costly, the regimens were DP, immediate amoxicillin, watchful waiting, immediate amoxicillin/clavulanate, and immediate cefdinir. The incremental cost-utility ratio of immediate amoxicillin compared with DP was $101.07 per quality-adjusted life-day gained. The incremental cost-utility ratio of immediate amoxicillin/clavulanate compared with amoxicillin was $2331.28 per quality-adjusted life-day gained. In children younger than 2 years of age with acute otitis media and no recent antibiotic exposure, immediate amoxicillin seems to be the most cost-effective initial treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. OAM system based on TMN for utility telecommunication network. Proposal of modeling method about managed objects; TMN ni motozuku denryoku tsushinmo no un`yo kanri system. Kanri object no sekkei shuho ni kansuru kento

    Energy Technology Data Exchange (ETDEWEB)

    Hirozawa, T.; Yusa, H.; Otani, T. [Central Research Institute of Electric Power Industry, Tokyo (Japan); Okamura, K. [Tokyo Electric Power Co. Inc., Tokyo (Japan)

    1996-03-01

    To construct an advanced operation and management system for utility telecommunications management network (TMN), this paper proposes a modeling method of managed objects (MOs) required for managing and managed systems, such as an asynchronous transmission mode (ATM) exchanger. Flexible line setting and path switching control are required for the advanced TMN, which must cope with the extension and modification of functions, flexibly. Assignment of roles of managing sides and managed sides was determined. Then, structures of objects such as facilities and logic data, and their interaction were modeled. Common management functions and objects of each function were classified. Based on the TMN standard and MOs of the existing design peculiar to utility, new MOs peculiar to utility were defined in response to the models. The existing MOs can be effectively utilized, and the optimum MOs to be incorporated can be expected. The MOs peculiar to utility are added to the common specification of electric power industry. Since they can be reused for the extension and modification of functions, the cost can be reduced. The MOs applicable to path switching control of utility were designed as a trial. 9 refs., 16 figs., 10 tabs.

  6. Chronic Widespread Pain Drawn on a Body Diagram is a Screening Tool for Increased Pain Sensitization, Psycho-Social Load, and Utilization of Pain Management Strategies.

    Science.gov (United States)

    Visser, Eric J; Ramachenderan, Jonathan; Davies, Stephanie J; Parsons, Richard

    2016-01-01

    The aim of this study was to investigate the hypothesis that chronic widespread pain, (CWP) drawn by patients on a body diagram, could be used as a screening tool for increased pain sensitization, psycho-social load, and utilization of pain management strategies. The triage questionnaires of 144 adults attending a chronic pain outpatients' clinic were audited and the percentage pain surface area (PPSA) drawn on their body diagrams was calculated using the "rule of nines" (RON) method for burns area assessment. Outcomes were measured using the painDETECT Questionnaire (PD-Q) and other indices and compared using a nonrandomized, case-control method. It was found that significantly more subjects with CWP (defined as a PPSA ≥ 20%) reported high (≥ 19) PD-Q scores (suggesting pain "sensitization" or neuropathic pain) (P = 0.0002), "severe" or "extremely severe" anxiety scores on the Depression, Anxiety and Stress Scale-21 Items Questionnaire (P = 0.0270), ≥ 5 psycho-social stressors (P = 0.0022), ≥ 5 significant life events (P = 0.0098), and used ≥ 7 pain management strategies (PMS) (P psycho-social load, and utilizing pain management resources. © 2014 World Institute of Pain.

  7. Utilities objectives

    International Nuclear Information System (INIS)

    Cousin, Y.; Fabian, H.U.

    1996-01-01

    The policy of French and german utilities is to make use of nuclear energy as a long term, competitive and environmentally friendly power supply. The world electricity generation is due to double within the next 30 years. In the next 20 to 30 years the necessity of nuclear energy will be broadly recognized. More than for most industries, to deal properly with nuclear energy requires the combination of a consistent political will, of a proper institutional framework, of strong and legitimate control authorities, of a sophisticated industry and of operators with skilled management and human resources. One of the major risk facing nuclear energy is the loss of competitiveness. This can be achieved only through the combination of an optimized design, a consistent standardization, a proper industrial partnership and a stable long term strategy. Although the existing plants in Western Europe are already very safe, the policy is clearly to enhance the safety of the next generation of nuclear plants which are designing today. The French and German utilities have chosen an evolutionary approach based on experience and proven technologies, with an enhanced defense in depth and an objective of easier operation and maintenance. The cost objective is to maintain and improve what has been achieved in the best existing power plants in both countries. This calls for rational choices and optimized design to meet the safety objectives, a strong standardization policy, short construction times, high availability and enough flexibility to enable optimization of the fuel cycle throughout the lifetime of the plants. The conceptual design phase has proven that the French and German teams from industry and from the utilities are able to pursue both the safety and the cost objectives, basing their decision on a rational approach which could be accepted by the safety authorities. (J.S.)

  8. Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar Salaria

    2016-01-01

    Full Text Available Radicular cyst (RC is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue.

  9. Research and development of methods/utilities and rules for managing cooperation for performance improvement in government offices

    Energy Technology Data Exchange (ETDEWEB)

    Kurstedt, H.A.

    1993-03-01

    Purpose is to help managers approach their responsibilities proactively, so that they can anticipate problems and take actions to alleviate or eliminate those problems. Continuous performance improvement, the philosophy behind total quality management, requires working cooperatively to do a little better each day. The most effective tools are working through a closed set of 9 methods: setting expectations, charting, defining indicators and standards, collecting and logging data, converting data to information, organizing and presenting information, reviewing status and progress, self-management, and appraising. In addition, there are 8 rules: focus on what you can do, supply physical evidence of progress, pay attention to detail, inspect (don't expect), review progress routinely and frequently, face ''success/fail'' squarely, communicate crisply, and conduct honest, open appraisals. Scope and plans of the draft research plan (study areas) are described.

  10. Cost-utility analysis of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses.

    Science.gov (United States)

    Kaitani, Toshiko; Nakagami, Gojiro; Iizaka, Shinji; Fukuda, Takashi; Oe, Makoto; Igarashi, Ataru; Mori, Taketoshi; Takemura, Yukie; Mizokami, Yuko; Sugama, Junko; Sanada, Hiromi

    2015-01-01

    The high prevalence of severe pressure ulcers (PUs) is an important issue that requires to be highlighted in Japan. In a previous study, we devised an advanced PU management protocol to enable early detection of and intervention for deep tissue injury and critical colonization. This protocol was effective for preventing more severe PUs. The present study aimed to compare the cost-effectiveness of the care provided using an advanced PU management protocol, from a medical provider's perspective, implemented by trained wound, ostomy, and continence nurses (WOCNs), with that of conventional care provided by a control group of WOCNs. A Markov model was constructed for a 1-year time horizon to determine the incremental cost-effectiveness ratio of advanced PU management compared with conventional care. The number of quality-adjusted life-years gained, and the cost in Japanese yen (¥) ($US1 = ¥120; 2015) was used as the outcome. Model inputs for clinical probabilities and related costs were based on our previous clinical trial results. Univariate sensitivity analyses were performed. Furthermore, a Bayesian multivariate probability sensitivity analysis was performed using Monte Carlo simulations with advanced PU management. Two different models were created for initial cohort distribution. For both models, the expected effectiveness for the intervention group using advanced PU management techniques was high, with a low expected cost value. The sensitivity analyses suggested that the results were robust. Intervention by WOCNs using advanced PU management techniques was more effective and cost-effective than conventional care. © 2015 by the Wound Healing Society.

  11. Design and utilization of a Flight Test Engineering Database Management System at the NASA Dryden Flight Research Facility

    Science.gov (United States)

    Knighton, Donna L.

    1992-01-01

    A Flight Test Engineering Database Management System (FTE DBMS) was designed and implemented at the NASA Dryden Flight Research Facility. The X-29 Forward Swept Wing Advanced Technology Demonstrator flight research program was chosen for the initial system development and implementation. The FTE DBMS greatly assisted in planning and 'mass production' card preparation for an accelerated X-29 research program. Improved Test Plan tracking and maneuver management for a high flight-rate program were proven, and flight rates of up to three flights per day, two times per week were maintained.

  12. Strategic plan to optimize the management of right-of-way parcel and utility information at FDOT : [research summary].

    Science.gov (United States)

    2013-05-01

    The Florida Department of Transportation (FDOT) manages more than 12,000 centerline-miles of highway that run through hundreds of jurisdictions. The right-of-way (ROW) that these roads are built on is a massive and complex resource in its own right a...

  13. Utilizing management zones for Rotylenchulus reniformis in cotton: Effects on nematode levels, crop damage, and Pasteuria sp

    Science.gov (United States)

    Nematode management zones (MZs) based on soil electrical conductivity (EC, a proxy for soil texture) have not been published for R. reniformis. We tested 1) whether R. reniformis levels and the amount of damage caused to cotton differed among MZs, 2) if the relative effectiveness of nematicides dif...

  14. Proceedings of the symposium on the ecology, management, and utilization of California oaks, June 26-28

    Science.gov (United States)

    Timothy R. Plumb

    1980-01-01

    The symposium, held at Scripps College in Southern California, addressed most aspects of California's vast oak resource. Papers represented four major subject categories: ecological relationships, silviculture and management, damage factors, and products. Both scientific and applied information was presented, including original material not published previously....

  15. The Imprecise Science of Evaluating Scholarly Performance: Utilizing Broad Quality Categories for an Assessment of Business and Management Journals

    Science.gov (United States)

    Lange, Thomas

    2006-01-01

    In a growing number of countries, government-appointed assessment panels develop ranks on the basis of the quality of scholarly outputs to apportion budgets in recognition of evaluated performance and to justify public funds for future R&D activities. When business and management journals are being grouped in broad quality categories, a recent…

  16. Life cycle management at nuclear power plants; La gestion de la vida util de las centrales nucleares

    Energy Technology Data Exchange (ETDEWEB)

    Diez, R.I.

    2010-07-01

    The Life Management Plan (PGV) consists in a series of actions aimed at improving the reliability and availability of a plant by guaranteeing its operation in safe conditions during its design life while keeping open the option of renewing the operating license in the long term. (Author).

  17. Utility and Actual Use of European and Spanish Guidelines on the Management of Endometrial Cancer Among Gynecologic Oncologists in Spain.

    Science.gov (United States)

    Zapardiel, Ignacio; Blancafort, Claudia; Cibula, David; Jaunarena, Ibon; Gorostidi, Mikel; Gil-Moreno, Antonio; De Santiago, Javier

    2017-07-01

    The aim of the study was to analyze the current management of endometrial cancer across Spain and to evaluate the use and applicability of the national and international guidelines. An electronic 30-question survey was distributed among all Spanish Society of Obstetrics and Gynecology-registered specialists dedicated to gynecologic oncology in Spain by e-mail. Data were collected anonymously and analyzed using SPSS program. One hundred forty-five (17.8%) surveys were collected. Significant differences were observed between tertiary hospitals and secondary or private hospitals in terms of appropriate (according to European Society of Gynaecologic Oncology guidelines) nodal staging in low-risk cases (96 [95%] vs 27 [61.4%], respectively; P comparing centers with less than 20 cases per year to centers with more than 40 cases annually, with significant differences in the management of low-risk and intermediate-risk endometrial cancers. This cross-sectional study demonstrates a broad heterogeneity of care giving between the clinical national and international guidelines and the actual practice in Spain. Although most of the responders refer to base their endometrial cancer management on Spanish and European Society of Gynaecologic Oncology guidelines (64.1%), many discrepancies have been observed, mainly in the management of intermediate-risk cases and follow-up. It may be caused by the lack of consensus on certain points, lack of facilities in lower case load centers, and also due to disagreement or unawareness on the current knowledge.

  18. Utilizing Immersive Visualization Systems: How to Dynamically Revolutionize Site-based Professional Development Experiences within Human Resources Management?

    Science.gov (United States)

    Craft, Kirby A.

    2009-01-01

    How can we train today's workforce with innovative technologies when families are surrounded by state-of-the-art video games and high-definition televisions? Human resource managers and administrators are faced with difficult challenges to prepare beneficial and relevant professional development exercises that engage the minds of their employees.…

  19. A regional approach to the Co-Production of climate information for water utilities- Managing Messages, Approaches, Benefits, and Lessons learned

    Science.gov (United States)

    Yates, D. N.; Kaatz, L.

    2016-12-01

    Over the past decade, water utility managers across Colorado have joined together to advance their understanding of the role of climate information in their planning process. In an unprecedented step, managers from 5 different organizations and agencies pooled their resources and worked collaboratively to better understand the ever evolving role of science in helping understand risks, uncertainties, and opportunities that climate uncertainty and change might bring to this semi-arid region. The group developed an ongoing educational process to better understand climate projections (Scale); cohesively communicate with customers and the media (Communication); provided institutional coverage to an often contentious topic (Safety); and helped coordinate with other investigations and participants to facilitate education and training (Collaboration); and pooled finances, staff, and expert resources (Resources). We will share this experience and give examples of concrete outcomes.

  20. Clinical Utility of SPECT/CT Imaging Post-Radioiodine Therapy: Does It Enhance Patient Management in Thyroid Cancer?

    Science.gov (United States)

    Hassan, Fahim U; Mohan, Hosahalli K

    2015-12-01

    The aim of this study was to evaluate post-therapy iodine-131 single-photon emission computed tomography/computed tomography ((131)I-SPECT/CT) imaging in comparison to conventional planar (131)I whole-body imaging, and to assess its clinical impact on the management of patients. We retrospectively reviewed planar (131)I whole-body and (131)I-SPECT/CT imaging findings in 67 patients who underwent (131)I therapy for thyroid cancer. Two nuclear medicine physicians reviewed the scans independently. The foci of increased tracer uptake were identified in the neck, thorax and elsewhere. Within the neck, the foci of (131)I-increased uptake were graded qualitatively as probable or definite uptake in thyroid remnants and probable or definite uptake in the lymph nodes. Serum thyroglobulin level, histopathology and other imaging findings served as the reference standard. Of the 67 patients, 57 (85%) had radioiodine avid disease and 10 (15%) demonstrated non-radioiodine avid disease. Overall, post-therapy (131)I-SPECT/CT downstaged lymph node staging in 10 patients and upstaged it in 4 patients. This translated into a change of management for 9/57 (16%) patients with radioiodine avid disease. A change of management was observed in 5/10 patients with non-radioiodine avid disease confirmed in the post-(131)I-SPECT/CT study. Additionally, clinically significant findings such as incidental lung cancer, symptomatic pleural effusion and consolidation were also diagnosed in both groups of patients. In patients with thyroid cancer, (131)I-SPECT/CT is a valuable addition to standard post-therapy planar imaging. SPECT/CT also improved diagnostic confidence and provided crucial clinical information leading to change of management for a significant number of these patients.

  1. Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

    Science.gov (United States)

    Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

    2016-10-06

    Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery

  2. The Utilization Of Resources And Regulation Along With Companys Strategies In Managing Oil And Natural Gas Industry In Indonesia

    Directory of Open Access Journals (Sweden)

    Sigit Rahardjo

    2015-08-01

    Full Text Available Oil and gas production in Indonesia has been declined since 1995 up to now the effort to increase the production has been done but it does not result yet. In contrast day by day the investment is getting increased and huge on the other hands it becomes a problem and a challenge for Indonesia to meet oil needs as raw material for refined fuel oil either for transportation or industries. Day by day the needs of refined fuel oil is getting increased and huge as it is correlated to the increasing of the number of motorcycles either two-wheeled or four-wheeled as well as the increasing of oil and gas or non-oil and gas industries. Oil and natural industry Resource Base has specific characteristics those are internal factor that uses resource such as high technology huge investment cost as well as competent human resources. Besides the external factor those are good regulations either in the central and regional levels as well as the sector which is very important toward the production performance and the of company managements strategies to manage this industry. This paper attempts to figure out the impact of internal factor in the form of resources and external factor in the form of regulation as well as the effect of production performance toward petroleum companies of upstream sectors in Indonesia and managements role especially petroleum industrialists in managing the company. The wane of oil production and the increasing of refined fuel oil need in Indonesia as well as the increasing of oil production cost then it will affect the industrialists strategies in managing the companies. The resources consist of human resource oil reserve as well as petroleum technologies. While regulation consists of law central and regional government regulations and rules in oil and gas sector. Whereas the companys strategies are explained by production volume and selling volume of oil. Companys performance which sets to work in upstream sector is influenced by

  3. ‘Committed, motivated and joyful?’ Job satisfaction and organisational commitment of managers at a South African public utility

    Directory of Open Access Journals (Sweden)

    Claude-Hélène Mayer

    2015-08-01

    Full Text Available Objective: This study focuses on an assessment of managerial job satisfaction and commitment in the context of a vibrant and rapidly changing public utility from a positive organisational behaviour (POB perspective. It aims at contributing towards an in-depth understanding of positive micro-organisational behaviour. Problem investigated: The aim of this study was to gain deeper insights into the relationship between job satisfaction (JS and organisational commitment (OC in terms of the ‘how and why’ at a selected public utility in the Eastern Cape Province. Design: This single case study uses a mixed-method approach within the pragmatism research paradigm. Findings: Findings show that managers across cultures share a positive organisational psychology approach on JS and OC. The JS of managers is mainly influenced by their satisfaction with working with colleagues and supervisors, and with strategies of motivation, as well as their dissatisfaction with the use of power, pay and promotion. OC was mainly influenced by positive collegial relationships, the organisation’s positive influence on the environment and on others, the enabling work environment and the location of the organisation. Originality/value: The article introduces new ideas in positive organisational behaviour research and reconstructs the image of South African organisational behaviour based on qualitative and quantitative data. Conclusion: This article shows that post-modern African organisations are opening new frontiers to building positive-oriented organisational cultures whilst creating constructive and future-orientated mindsets, which may spill over into society.

  4. Where do we go from here? Now that some utilities have won the incentive regulation war, many executives are wondering how they can manage the peace

    International Nuclear Information System (INIS)

    Christensen, L.R.; Meitzen, M.E.; Schoech, P.E.

    1993-01-01

    Productivity is a measure of how efficiently a company uses its resources. The productivity budgeting model (PBM) is one tool that can aid management in the transition from cost-plus, rate-of-return regulation to the market-oriented, cost-control environment of incentive regulation. Most, if not all, utilities use some type of budgeting/forecasting process that provides the blueprint for future company activity. The PBM reveals the growth in total factor productivity (TFP) implied by a budget and, thus, provides a forecast of the company's future efficiency. The PBM can be used to guide resource usage, because it analyzes investment, labor force, and operating decisions from an economic efficiency perspective. In general, the model makes the budgeting process more relevant to the kind of decisions utility management must make for long-term success under incentive regulation. Furthermore, under many incentive regulation. Furthermore, under many incentive regulation plans (such as the FCC's price-cap plan), a company must meet or beat the productivity offset to increase its profitability. With PBM, the company can determine whether its proposed budget is on track and devise a plan to meet any offset. The PBM can also be used to track productivity using financial data from the period in question

  5. An audit of imaging test utilization for the management of lymphoma in an oncology hospital: implications for resource planning?

    Science.gov (United States)

    Schwartz, A; Gospodarowicz, M K; Khalili, K; Pintilie, M; Goddard, S; Keller, A; Tsang, R W

    2006-02-01

    The purpose of this study was to assist with resource planning by examining the pattern of physician utilization of imaging procedures for lymphoma patients in a dedicated oncology hospital. The proportion of imaging tests ordered for routine follow up with no specific clinical indication was quantified, with specific attention to CT scans. A 3-month audit was performed. The reasons for ordering all imaging procedures (X-rays, CT scans, ultrasound, nuclear scan and MRI) were determined through a retrospective chart review. 411 lymphoma patients had 686 assessments (sets of imaging tests) and 981 procedures (individual imaging tests). Most procedures were CT scans (52%) and chest radiographs (30%). The most common reasons for ordering imaging were assessing response (23%), and investigating new symptoms (19%). Routine follow up constituted 21% of the assessments (142/686), and of these, 82% were chest radiographs (116/142), while 24% (34/142) were CT scans. With analysis restricted to CT scans (296 assessments in 248 patients), the most common reason for ordering CT scans were response evaluation (40%), and suspicion of recurrence and/or new symptom (23%). Follow-up CT scans done with no clinical indication comprised 8% (25/296) of all CT assessments. Staging CT scans were under-represented at 6% of all assessments. Imaging with CT scans for follow up of asymptomatic patients is infrequent. However, scans done for staging new lymphoma patients were unexpectedly low in frequency, due to scans done elsewhere prior to referral. This analysis uncovered utilization patterns, helped resource planning and provided data to reduce unnecessary imaging procedures.

  6. Managing Expectations: Results from Case Studies of US Water Utilities on Preparing for, Coping with, and Adapting to Extreme Events

    Science.gov (United States)

    Beller-Simms, N.; Metchis, K.

    2014-12-01

    Water utilities, reeling from increased impacts of successive extreme events such as floods, droughts, and derechos, are taking a more proactive role in preparing for future incursions. A recent study by Federal and water foundation investigators, reveals how six US water utilities and their regions prepared for, responded to, and coped with recent extreme weather and climate events and the lessons they are using to plan future adaptation and resilience activities. Two case studies will be highlighted. (1) Sonoma County, CA, has had alternating floods and severe droughts. In 2009, this area, home to competing water users, namely, agricultural crops, wineries, tourism, and fisheries faced a three-year drought, accompanied at the end by intense frosts. Competing uses of water threatened the grape harvest, endangered the fish industry and resulted in a series of regulations, and court cases. Five years later, new efforts by partners in the entire watershed have identified mutual opportunities for increased basin sustainability in the face of a changing climate. (2) Washington DC had a derecho in late June 2012, which curtailed water, communications, and power delivery during a record heat spell that impacted hundreds of thousands of residents and lasted over the height of the tourist-intensive July 4th holiday. Lessons from this event were applied three months later in anticipation of an approaching Superstorm Sandy. This study will help other communities in improving their resiliency in the face of future climate extremes. For example, this study revealed that (1) communities are planning with multiple types and occurrences of extreme events which are becoming more severe and frequent and are impacting communities that are expanding into more vulnerable areas and (2) decisions by one sector can not be made in a vacuum and require the scientific, sectoral and citizen communities to work towards sustainable solutions.

  7. Utilize target motion to cover clinical target volume (ctv) - a novel and practical treatment planning approach to manage respiratory motion

    International Nuclear Information System (INIS)

    Jin Jianyue; Ajlouni, Munther; Kong Fengming; Ryu, Samuel; Chetty, Indrin J.; Movsas, Benjamin

    2008-01-01

    Purpose: To use probability density function (PDF) to model motion effects and incorporate this information into treatment planning for lung cancers. Material and methods: PDFs were calculated from the respiratory motion traces of 10 patients. Motion effects were evaluated by convolving static dose distributions with various PDFs. Based on a differential dose prescription with relatively lower dose to the clinical target volume (CTV) than to the gross tumor volume (GTV), two approaches were proposed to incorporate PDFs into treatment planning. The first approach uses the GTV-based internal target volume (ITV) as the planning target volume (PTV) to ensure full dose to the GTV, and utilizes the motion-induced dose gradient to cover the CTV. The second approach employs an inhomogeneous static dose distribution within a minimized PTV to best match the prescription dose gradient. Results: Motion effects on dose distributions were minimal in the anterior-posterior (AP) and lateral directions: a 10-mm motion only induced about 3% of dose reduction in the peripheral target region. The motion effect was remarkable in the cranial-caudal direction. It varied with the motion amplitude, but tended to be similar for various respiratory patterns. For the first approach, a 10-15 mm motion would adequately cover the CTV (presumed to be 60-70% of the GTV dose) without employing the CTV in planning. For motions 15-mm. An example of inhomogeneous static dose distribution in a reduced PTV was given, and it showed significant dose reduction in the normal tissue without compromising target coverage. Conclusions: Respiratory motion-induced dose gradient can be utilized to cover the CTV and minimize the lung dose without the need for more sophisticated technologies

  8. A survey of factors associated with the utilization of community health centers for managing hypertensive patients in Chengdu, China.

    Directory of Open Access Journals (Sweden)

    Yun Chai

    Full Text Available BACKGROUND: For decades the development of community health services has been emphasized in China to cope with the growing burden of chronic diseases by providing basic medical services. This survey aims at investigating factors associated with the use of Community Health Centers (CHCs for the management of hypertensive patients in Chengdu, China. METHODS: We used a systematic sampling method to select 2,030 patients with hypertension or diabetes registered in 29 CHCs in Chengdu in 2007. Researchers interviewed patients who consented to participate at their home. This paper reports findings from the survey of 1,716 hypertensive patients with completed questionnaires. Univariate analyses and multiple logistic regression analyses were conducted to explore factors influencing the use of CHCs for the management of hypertensive patients. RESULTS: 81.4% of hypertensive patients regularly used CHCs for hypertension monitoring and treatment in Chengdu. Univariate analyses indicated that use of CHCs was associated with the education level, occupation, types of medical insurance, Body Mass Index(BMI, patients' knowledge on hypertension, awareness of CHCs functions, satisfaction of the service of CHCs. Multiple regression analyses found that use of CHCs was positively associated with the following factors: the Urban Resident Basic Medical Insurance(URBMI, knowledge on blood pressure, awareness of the sites in CHCs to measure blood pressure, awareness of having to take life-long antihypertensive medicine once the treatment started, awareness of the health records registration in CHCs, regular follow up, improved convenience of seeing doctor. Patients with professional job were less likely to use the services of CHCs. CONCLUSIONS: The use of CHCs for hypertension management could be increased by improving residents' knowledge on the monitoring and treatment of hypertension, and the awareness of CHCs functions. The CHCs could play an important role in

  9. Can miRNA Biomarkers Be Utilized to Improve the Evaluation and Management of Pancreatic Cystic Lesions?

    Directory of Open Access Journals (Sweden)

    Lee Linda S.

    2014-01-01

    Full Text Available This article reviews the current strategies and challenges of diagnosing pancreatic cystic lesions, and presents an overview of molecular tools that are available to enhance diagnostic accuracy. Specifically, we highlight the emergence of microRNAs (miRNAs as diagnostic markers. miRNA signatures have been reported for both solid tissue and biofluid specimens, including cyst fluid, collected from patients with solid and cystic pancreatic lesions. These miRNA signatures offer the opportunity to improve molecular characterization of pancreatic lesions, to help guide clinical management through early diagnosis and informed prognosis, and to provide novel therapeutic targets for pancreatic cancer.

  10. Management and Beneficial Reuse of Overburden Material - Linde Formerly Utilized Sites Remedial Action Program (FUSRAP) Remediation Project

    International Nuclear Information System (INIS)

    Boyle, J.D.; Schwippert, M.; Lorenz, W.D.

    2009-01-01

    This paper outlines three separate and distinct situations where the proper management of overburden material allows for the beneficial reuse of overburden material. Beneficial reuse of overburden material at the Linde Project was made possible by a simultaneous combination of physical conditions at the site in conjunction with collaborative planning and cooperation between U.S. Army Corps of Engineers - Buffalo District, New York State Department of Energy and Conservation, the Owner and Shaw Environmental and Infrastructure. Efforts by the project team focused on maintaining compliance with project plan requirements, communicating the plan to all parties, executing the plan safely and efficiently, and emphasizing fiscal responsibility to ensure maximum cost savings. (authors)

  11. Black-tailed jack rabbit movements and habitat utilization at the Idaho National Engineering Laboratory radioactive waste management complex

    International Nuclear Information System (INIS)

    Grant, J.C.

    1983-01-01

    In June 1982, a study of black-tailed jack rabbit (Lepus californicus) ecology was initiated at the Idaho National Engineering Laboratory Radioactive Waste Management Complex (RWMC). This study will provide data necessary to evaluate the role of jack rabbits in radionuclide transport away from the Subsurface Disposal Area of the RWMC. Primary goals are to document radionuclide concentrations in jack rabbit tissues, and determine population size, movement patterns, habitat use, and food habits of jack rabbits inhabiting the RWMC area. Study design and prelimianry results are discussed

  12. [Psychological approaches in hypertension management].

    Science.gov (United States)

    Abgrall-Barbry, Gaëlle; Consoli, Silla M

    2006-06-01

    Stress factors, especially high levels of occupational stress, are associated with hypertension. Several so-called psychological techniques have been applied to hypertension: biofeedback, relaxation techniques (Schultz' autogenic training, Jacobson's progressive relaxation), transcendental meditation, and cognitive behavioral techniques for stress management. Randomized studies show that the best results come from cognitive behavioral methods, whether or not they include relaxation techniques. Other forms of psychotherapy (such as psychoanalysis) may be useful, although their benefits for blood pressure have not been tested in controlled trials. Patients should be informed about the personal benefits they may obtain from psychological treatment. Indications are hyperreactivity to stress, high levels of occupational stress, and difficulty in tolerating or complying with antihypertensive drugs.

  13. A study on electric power management for power producer-suppliers utilizing output of megawatt-solar power plants

    Directory of Open Access Journals (Sweden)

    Hirotaka Takano

    2016-01-01

    Full Text Available The growth in penetration of photovoltaic generation units (PVs has brought new power management ideas, which achieve more profitable operation, to Power Producer-Suppliers (PPSs. The expected profit for the PPSs will improve if they appropriately operate their controllable generators and sell the generated electricity to contracted customers and Power Exchanges together with the output of Megawatt-Solar Power Plants (MSPPs. Moreover, we can expect that the profitable cooperation between the PPSs and the MSPPs decreases difficulties in the supply-demand balancing operation for the main power grids. However, it is necessary that the PPSs treat the uncertainty in output prediction of PVs carefully. This is because there is a risk for them to pay a heavy imbalance penalty. This paper presents a problem framework and its solution to make the optimal power management plan for the PPSs in consideration with the electricity procurement from the MSPPs. The validity of the authors’ proposal is verified through numerical simulations and discussions of their results.

  14. Leaching tests as a tool in waste management to evaluate the potential for utilization of waste materials

    Energy Technology Data Exchange (ETDEWEB)

    Sloot, H.A. van der [Netherlands Energy Research Foundation (ECN), Petten (Netherlands); Kosson, D.S. [Rutgers Univ., Piscataway, NJ (United States)

    1995-12-01

    Several waste materials from large scale industrial processes possess technical properties that would allow their use in certain construction applications, e.g. coal fly ash, slags from large scale industrial melting and ore processing, and incinerator residues. The disposal of such materials requires space and controlled landfills to minimize long term environmental risks. The beneficial use of such bulk materials is an attractive alternative, if it can be shown that such applications are environmentally acceptable. For this management of wastes and the decision to either dispose or use, information on the environmental properties of materials is needed. Leaching tests have been developed to assess such properties. These have been designed typically in relation to regulatory tools, not as instruments to guide the management of wastes and the possibilities to improve material properties. New methods have been designed to address this aspect, in which maximum benefit can be derived from knowledge of the systematic behaviour of materials and the already existing knowledge in other countries producing similar residues. After initial detailed characterization, concise procedures can be used for control purposes focused on the typical aspects of a certain residue stream. Examples of existing knowledge in this field will be presented.

  15. Systematic review of model-based analyses reporting the cost-effectiveness and cost-utility of cardiovascular disease management programs.

    Science.gov (United States)

    Maru, Shoko; Byrnes, Joshua; Whitty, Jennifer A; Carrington, Melinda J; Stewart, Simon; Scuffham, Paul A

    2015-02-01

    The reported cost effectiveness of cardiovascular disease management programs (CVD-MPs) is highly variable, potentially leading to different funding decisions. This systematic review evaluates published modeled analyses to compare study methods and quality. Articles were included if an incremental cost-effectiveness ratio (ICER) or cost-utility ratio (ICUR) was reported, it is a multi-component intervention designed to manage or prevent a cardiovascular disease condition, and it addressed all domains specified in the American Heart Association Taxonomy for Disease Management. Nine articles (reporting 10 clinical outcomes) were included. Eight cost-utility and two cost-effectiveness analyses targeted hypertension (n=4), coronary heart disease (n=2), coronary heart disease plus stoke (n=1), heart failure (n=2) and hyperlipidemia (n=1). Study perspectives included the healthcare system (n=5), societal and fund holders (n=1), a third party payer (n=3), or was not explicitly stated (n=1). All analyses were modeled based on interventions of one to two years' duration. Time horizon ranged from two years (n=1), 10 years (n=1) and lifetime (n=8). Model structures included Markov model (n=8), 'decision analytic models' (n=1), or was not explicitly stated (n=1). Considerable variation was observed in clinical and economic assumptions and reporting practices. Of all ICERs/ICURs reported, including those of subgroups (n=16), four were above a US$50,000 acceptability threshold, six were below and six were dominant. The majority of CVD-MPs was reported to have favorable economic outcomes, but 25% were at unacceptably high cost for the outcomes. Use of standardized reporting tools should increase transparency and inform what drives the cost-effectiveness of CVD-MPs. © The European Society of Cardiology 2014.

  16. Facility Utilization Reports - FAA Aviation Information Utilization Reports

    Data.gov (United States)

    Department of Transportation — Provides: (1) Space management and planning, including area calculations, tracking space by organization and employee, and monitoring space utilization information....

  17. Collaborative Approaches to Increase the Utility of Spatial Data for the Wildfire Management Community Through NASA's Applied Remote Sensing Training Program

    Science.gov (United States)

    McCullum, A. J. K.; Schmidt, C.; Blevins, B.; Weber, K.; Schnase, J. L.; Carroll, M.; Prados, A. I.

    2015-12-01

    The utility of spatial data products and tools to assess risk and effectively manage wildfires has increased, highlighting the need for communicating information about these new capabilities to decision makers, resource managers, and community leaders. NASA's Applied Remote Sensing Training (ARSET) program works directly with agencies and policy makers to develop in-person and online training courses that teach end users how to access, visualize, and apply NASA Earth Science data in their profession. The expansion of ARSET into wildfire applications began in 2015 with a webinar and subsequent in-person training hosted in collaboration with Idaho State University's (ISU) GIS Training and Research Center (TReC). These trainings featured presentations from the USDA Forest Service's Remote Sensing Training and Applications Center, the Land Processes DAAC, Northwest Nazarene University, NASA Goddard Space Flight Center, and ISU's GIS TReC. The webinar focused on providing land managers, non-governmental organizations, and international management agencies with an overview of 1) remote sensing platforms for wildfire applications, 2) products for pre- and post-fire planning and assessment, 3) the use of terrain data, 4) new techniques and technologies such as Unmanned Aircraft Systems and the Soil Moisture Active Passive Mission (SMAP), and 5) the RECOVER Decision Support System. This training highlighted online tools that engage the wildfire community through collaborative monitoring and assessment efforts. Webinar attendance included 278 participants from 178 organizations in 42 countries and 33 US states. The majority of respondents (93%) from a post-webinar survey indicated they displayed improvement in their understanding of specific remote-sensing data products appropriate for their work needs. With collaborative efforts between federal, state, and local agencies and academic institutions, increased use of NASA Earth Observations may lead to improved near real

  18. Utility of therapeutic drug monitoring in the management of HIV-infected pregnant women in receipt of lopinavir.

    LENUS (Irish Health Repository)

    Caswell, R J

    2011-01-01

    The pharmacokinetics of antiretroviral drugs in pregnancy is poorly understood. We reviewed the use of therapeutic drug monitoring (TDM) in clinical settings to document plasma concentrations of lopinavir during pregnancy and investigated how clinicians acted upon TDM results. A retrospective review was carried out of all HIV-infected pregnant women taking boosted lopinavir-based highly active antiretroviral therapy (HAART) at five National Health Service (NHS) centres in the UK between May 2004 and March 2007. Seventy-three women in receipt of lopinavir were identified, of whom 89% had plasma lopinavir concentrations above the suggested minimum recommended for wild-type HIV. Initial TDM results prompted dosage change in 10% and assessment of adherence and\\/or pharmacist review in 11%. TDM was repeated in 29%. TDM can play an important role in the clinical management of HIV-positive pregnant women, allowing informed dose modification and an alternative measure of adherence.

  19. Imaging in the diagnosis and management of peripheral psoriatic arthritis-The clinical utility of magnetic resonance imaging and ultrasonography

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Eder, Lihi; Christiansen, Sara Nysom

    2016-01-01

    Psoriatic arthritis (PsA) is an inflammatory joint disease characterised by the presence of arthritis and often enthesitis and/or spondylitis in patients with psoriasis. However, it presents a wide range of disease manifestations in various patterns. Imaging is an important part of management of PsA...... or clinical studies. Magnetic resonance imaging (MRI) allows detailed assessment of all peripheral and axial joints involved in PsA, and can visualise both inflammation and structural changes. Ultrasonography (US) can visualise many of the peripheral heterogeneous tissue compartments affected by PsA....... In contrast to MRI, US is not useful for assessing axial involvement in the spine and sacroiliac joints. In this paper, we will provide an overview of the status, strengths and limitations of MRI and US in peripheral PsA in routine clinical practice and clinical trials....

  20. Assessment of fuel resource diversity and utilization patterns in Askot Wildlife Sanctuary in Kumaun Himalaya, India, for conservation and management

    Energy Technology Data Exchange (ETDEWEB)

    Samant, Sher S.; Dhar, Uppeandra; Rawal, Ranbeer S. [G.B. Pant Inst. of Himalayan Environment and Development, Uttar Pradesh (India)

    2000-07-01

    A general decrease in abundance of wood plant species used as sources of fuel suggests that more detailed information is urgently needed on species-level trends and their conservation. Such studies have not been carried out so far in India and elsewhere; we therefore quantified the species-wise extraction of fuel from a site (Gori Ganga Valley) in Askot Wildlife Sanctuary in the Kumaun Himalaya. In all, 31 species (26 trees and 5 shrubs) were used as fuel, of which 14 were native to the Himalaya. Utilisation patterns, distributions, probabilities of use (PU), resources use indices (RUI), preferences and availabilities in forest communities of these species were determined. Use pattern did not vary much amongst low altitude villages (Similarity: 52-74%), whereas along the vertical (elevational) gradient it varied considerably (Similarity: 15-31%). Woodfordia fruticosa (L.) Kurz, Pinus roxburghii Sarg., Quercus leucotrichophora A. Camus, Macaranga pustulata King ex Hk. F., Quercus lanuginosa Don, Engelhardtia spicata Bl. and Mallotus philippensis (Lamk.) Muell. contributed most to collections, while Pyracantha crenulata (Don) Roem., Syzygium cuminii (L.) Skeels, Alnus nepalensis Don and Bauhinia vahlii Wt. and Arn. were in lesser demand. W. fruticosa, P. roxburghii, M. pustulata, Casearia elliptica Willd., E. spicata, M. philippensis, Q. leucotrichophora and Phoebe lanceolata (Nees) Nees showed high values of PU and RUI, indicating high pressure. Higher density of P. roxburghii, Rhododendron arboreum Sm., Q. lanuginosa, Q. leucotrichophora, Lyonia ovalifolia (Wall.) Drude, C. elliptica and M. pustulata amongst trees and Maesa indica A.DC., P. crenulata and W. fruticosa amongst shrubs exhibited high density but the remaining species showed low density indicating the possible depletion. Intensive management of natural habitats of species highly-referred for fuel, diversification of choice of species from natives to non-natives, large scale propagation of highly

  1. Barcode Technology Acceptance and Utilization in Health Information Management Department at Academic Hospitals According to Technology Acceptance Model.

    Science.gov (United States)

    Ehteshami, Asghar

    2017-03-01

    Nowdays, due to the increasing importance of quality care, organizations focuse on the improving provision, management and distribution of health. On one hand, incremental costs of the new technologies and on the other hand, increased knowledge of health care recipients and their expectations for high quality services have doubled the need to make changes in order to respond to resource constraints (financial, human, material). For this purpose, several technologies, such as barcode, have been used in hospitals to improve services and staff productivity; but various factors effect on the adoption of new technologies and despite good implementation of a technology and its benefits, sometimes personnel don't accept and don't use it. This is an applied descriptive cross-sectional study in which all the barcode users in health information management department of the three academic hospitals (Feiz, Al-Zahra, Ayatollah Kashani) affiliated to Isfahan University of Medical Sciences were surveyed by the barcode technology acceptance questionnaire, in six areas as following: barcode ease of learning, capabilities, perception of its usefulness and its ease of use, users attitudes towards its using, and users intention. The finding showed that barcode technology total acceptance was relatively desirable (%76.9); the most compliance with TAM model was related to the user perceptions about the ease of use of barcode technology and the least compliance was related to the ease of learning barcode technology (respectively %83.7 and %71.5). Ease of learning and barcode capability effect of usefulness and perceived ease of barcode technology. Users perceptions effect their attitudes toward greater use of technology and their attitudes have an effect on their intention to use the technology and finally, their intention makes actual use of the technology (acceptance). Therefore, considering the six elements related to technology implementation can be important in the barcode

  2. Frisby v. Schultz, 27 June 1988.

    Science.gov (United States)

    1988-01-01

    The plaintiffs, anti-abortion protesters, challenged a Brookfield Wisconsin ordinance making it "unlawful for any person to engage in picketing before or about the residence or dwelling of any individual" and declaring that the primary purpose of the ban is to "protec[t] and preserv[e] the home" through assurance "that members of the community enjoy in their homes . . . a feeling of well-being, tranquillity, and privacy." They claimed that the ordinance violated their First Amendment rights of free speech. The Court reversed lower court rulings finding the ordinance unconstitutional. It held that the ban on picketing did not ban all picketing in residential areas, but, rather, only "focused picketing" taking place solely in front of a specific residence, and that the ordinance left ample means of alternative channels of communication. It concluded that the ordinance served a significant government interest of protecting residential privacy and that there was no constitutional right to force speech into the home of an unwilling listener. In 1988, US courts reached the following decisions with respect to the activities of anti-abortion protesters: 1) action charging anti-abortionists with conspiracy under federal laws is allowed (Portland Feminist Women's Health Center vs. Advocates for Life, US District Court, D. Oregon, 28 June 1988 [712 F.Supp. 165]); 2) action charging anti-abortionists with conspiracy under federal laws not allowed, but action charging anti-abortionists with violation of racketeering laws allowed (Feminist Women's Health Center vs. Roberts, US District Court, W.D. Washington, 11 March 1988 [1988 US Dist. Lexis 16325]); 3) action charging anti-abortionists with violation of racketeering laws allowed (Northeast Women's Center, Inc. vs. McMonagle, US District Court, E.D. Pennsylvania, 31 March 1988 [689 F.Supp. 465]); and 4) action charging anti-abortionists with conspiracy under federal laws and with violation of racketeering laws is allowed (Roe vs. Operation Rescue, US District Court for the Eastern District of Pennsylvania, 19 December 1988 [1988 US District Lexis 14484]). full text

  3. Application and utility of a low-cost unmanned aerial system to manage and conserve aquatic resources in four Texas rivers

    Science.gov (United States)

    Birdsong, Timothy W.; Bean, Megan; Grabowski, Timothy B.; Hardy, Thomas B.; Heard, Thomas; Holdstock, Derrick; Kollaus, Kristy; Magnelia, Stephan J.; Tolman, Kristina

    2015-01-01

    Low-cost unmanned aerial systems (UAS) have recently gained increasing attention in natural resources management due to their versatility and demonstrated utility in collection of high-resolution, temporally-specific geospatial data. This study applied low-cost UAS to support the geospatial data needs of aquatic resources management projects in four Texas rivers. Specifically, a UAS was used to (1) map invasive salt cedar (multiple species in the genus Tamarix) that have degraded instream habitat conditions in the Pease River, (2) map instream meso-habitats and structural habitat features (e.g., boulders, woody debris) in the South Llano River as a baseline prior to watershed-scale habitat improvements, (3) map enduring pools in the Blanco River during drought conditions to guide smallmouth bass removal efforts, and (4) quantify river use by anglers in the Guadalupe River. These four case studies represent an initial step toward assessing the full range of UAS applications in aquatic resources management, including their ability to offer potential cost savings, time efficiencies, and higher quality data over traditional survey methods.

  4. Distance learning strategies for weight management utilizing social media: A comparison of phone conference call versus social media platform. Rationale and design for a randomized study.

    Science.gov (United States)

    Willis, Erik A; Szabo-Reed, Amanda N; Ptomey, Lauren T; Steger, Felicia L; Honas, Jeffery J; Al-Hihi, Eyad M; Lee, Robert; Vansaghi, Lisa; Washburn, Richard A; Donnelly, Joseph E

    2016-03-01

    Management of obesity in the context of the primary care physician visit is of limited efficacy in part because of limited ability to engage participants in sustained behavior change between physician visits. Therefore, healthcare systems must find methods to address obesity that reach beyond the walls of clinics and hospitals and address the issues of lifestyle modification in a cost-conscious way. The dramatic increase in technology and online social networks may present healthcare providers with innovative ways to deliver weight management programs that could have an impact on health care at the population level. A randomized study will be conducted on 70 obese adults (BMI 30.0-45.0 kg/m(2)) to determine if weight loss (6 months) is equivalent between weight management interventions utilizing behavioral strategies by either a conference call or social media approach. The primary outcome, body weight, will be assessed at baseline and 6 months. Secondary outcomes including waist circumference, energy and macronutrient intake, and physical activity will be assessed on the same schedule. In addition, a cost analysis and process evaluation will be completed. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Market research for electric utilities

    International Nuclear Information System (INIS)

    Shippee, G.

    1999-01-01

    Marketing research is increasing in importance as utilities become more marketing oriented. Marketing research managers need to maintain autonomy from the marketing director or ad agency and make sure their work is relevant to the utility's operation. This article will outline a model marketing research program for an electric utility. While a utility may not conduct each and every type of research described, the programs presented offer a smorgasbord of activities which successful electric utility marketers often use or have access to

  6. What was tropical about tropical neurasthenia? The utility of the diagnosis in the management of British East Africa.

    Science.gov (United States)

    Crozier, Anna

    2009-10-01

    During the first quarter of the twentieth century, tropical neurasthenia was a popular diagnosis for a nervous condition experienced by Europeans in the topics. Tropical neurasthenia was not psychosis or madness, but was rather an ennui or loss of "edge" brought about by the strains of tropical life, especially the unfamiliar, hot climate. A catch-all for a wide range of symptoms, many missionaries, colonial staff, and settlers throughout Empire were repatriated because of it, although this article concentrates on Colonial Service employees working in British East Africa. While histories of tropical neurasthenia have usefully (and correctly) explained this diagnosis as an expression of the anxieties of the colonial regime, this article adds a new dimension to the historiography by arguing that tropical neurasthenia can only be properly understood as a hybrid form, dependent not only upon the peculiarities of the colonial situation, but also descended from British and American clinical understandings of neurasthenia. Moreover, once tropical neurasthenia is properly acknowledged as being typical of clinical understandings of the time, other reasons for its comparatively long endurance in the colonial situation emerge. This article shows that tropical neurasthenia remained a popular diagnosis in East Africa not only because (as historians have argued previously) it dovetailed with prevalent ideas of colonial acclimatization, but also because it was a practically useful tool in the management and regulation of colonial personnel.

  7. Consolidating a Distributed Compound Management Capability into a Single Installation: The Application of Overall Equipment Effectiveness to Determine Capacity Utilization.

    Science.gov (United States)

    Green, Clive; Taylor, Daniel

    2016-12-01

    Compound management (CM) is a critical discipline enabling hit discovery through the production of assay-ready compound plates for screening. CM in pharma requires significant investments in manpower, capital equipment, repairs and maintenance, and information technology. These investments are at risk from external factors, for example, new technology rendering existing equipment obsolete and strategic site closures. At AstraZeneca, we faced the challenge of evaluating the number of CM sites required to support hit discovery in response to site closures and pressure on our operating budget. We reasoned that overall equipment effectiveness, a tool used extensively in the manufacturing sector, could determine the equipment capacity and appropriate number of sites. We identified automation downtime as the critical component governing capacity, and a connection between automation downtime and the availability of skilled staff. We demonstrated that sufficient production capacity existed in two sites to meet hit discovery demand without the requirement for an additional investment of $7 million in new facilities. In addition, we developed an automated capacity model that incorporated an extended working-day pattern as a solution for reducing automation downtime. The application of this solution enabled the transition to a single site, with an annual cost saving of $2.1 million. © 2015 Society for Laboratory Automation and Screening.

  8. Management of cerebrospinal fluid leakage after anterior decompression for ossification of posterior longitudinal ligament in the thoracic spine: the utilization of a volume-controlled pseudomeningocele.

    Science.gov (United States)

    Cho, Ji Young; Chan, Chee Keong; Lee, Sang-Ho; Choi, Won-Chul; Maeng, Dae Hyeon; Lee, Ho-Yeon

    2012-06-01

    Retrospective review To determine the efficacy of management of cerebrospinal fluid (CSF) leakage after the anterior thoracic approach. CSF leakage after incidental durotomy commonly occurs after anterior thoracic ossification of posterior longitudinal ligament (OPLL) surgery. Pseudomeningocele will invariably form under such circumstances. Among them, uncontrolled CSF leakage with a fistulous condition is problematic. As a solution, we have managed these durotomies with chest drains alone without any CSF drainage by the concept of a "volume-controlled pseudomeningocele." Between 2001 and 2009, CSF leakage occurred in 26 patients (37.7%) of the total 69 patients who underwent anterior decompression for thoracic OPLL. In the initial 11 cases, subarachnoid drainage was utilized as an augmentive measure in combination with chest tube drainage in the postoperative period (group A). In the subsequent 15 cases, the durotomy was managed in a similar manner but in the absence of any subarachnoid drainage (group B). Various parameters such as the duration of postoperative hospital stay, clinical outcome score, drainage output, resolution of CSF leakage, complications, and additional surgery performed were analyzed and compared between the 2 groups. A resolution of the CSF leakage grading system was also proposed for the residual pseudomeningocele that formed in each group. There were statistically no significant differences in the outcome parameters between the 2 groups and also in patients with grade I or grade II residual pseudomeningocele of the new grading system. Two complications occurred in group A. No reexploration for persistent CSF leakage was required in both groups. CSF leakage managed with controlled chest tube drainage can produce a comparable result with those with additional subarachnoid drainage when watertight dural repair is impossible. The concept of controlled pseudomeningocele may be a useful and practical technique for the treatment of CSF leakage

  9. Multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study.

    Science.gov (United States)

    Halligan, E; Edgeworth, J; Bisnauthsing, K; Bible, J; Cliff, P; Aarons, E; Klein, J; Patel, A; Goldenberg, S

    2014-08-01

    Laboratory diagnosis and clinical management of inpatients with diarrhoea is complex and time consuming. Tests are often requested sequentially and undertaken in different laboratories. This causes prolonged unnecessary presumptive isolation of patients, because most cases are non-infectious. A molecular multiplex test (Luminex(®) Gastrointestinal Pathogen Panel (GPP)) was compared with conventional testing over 8 months to determine diagnostic accuracy, turnaround times, laboratory costs, use of isolation facilities and user acceptability. A total of 262 (12%) patients had a pathogen detected by conventional methods compared with 483 (22.1%) by GPP. Most additional cases were detected in patients developing symptoms in the first 4 days of admission. Additional cases were detected because of presumed improved diagnostic sensitivity but also because clinicians had not requested the correct pathogen. Turnaround time (41.8 h) was faster than bacterial culture (66.5 h) and parasite investigation (66.5 h) but slower than conventional testing for Clostridium difficile (17.3 h) and viruses (27 h). The test could allow simplified requesting by clinicians and a consolidated laboratory workflow, reducing the overall number of specimens received by the laboratory. A total of 154 isolation days were saved at an estimated cost of £30 800. Consumables and labour were estimated at £150 641 compared with £63 431 for conventional testing. Multiplex molecular testing using a panel of targets allowed enhanced detection and a consolidated laboratory workflow. This is likely to be of greater benefit to cases that present within the first 4 days of hospital admission. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  10. High-frequency ultrasound probe sonography staging for colorectal neoplasia with superficial morphology: its utility and impact on patient management.

    Science.gov (United States)

    Urban, Ondrej; Kliment, Martin; Fojtik, Petr; Falt, Premysl; Orhalmi, Julius; Vitek, Petr; Holeczy, Pavol

    2011-10-01

    This prospective study aimed to evaluate the impact of high-frequency ultrasound probe sonography (HFUPS) staging on the management of patients with superficial colorectal neoplasia (SCN) as determined by the endoscopic characteristics of lesions. Consecutive patients referred for endoscopic treatment of nonpedunculated SCN were enrolled in this study. A lesion was considered high risk if a depressed area or invasive pit pattern was present. The gold standard for final staging included histology from endoscopic or surgical resection. The impact on treatment was defined as any modification of the therapeutic algorithm based on the result of the HFUPS examination compared with that based on endoscopy alone. In this study, 48 lesions in 48 patients were evaluated. Of these, 28 (58%) were considered high risk, and the remaining 20 (42%) were regarded as low risk. A total of seven lesions (15%) that could not be examined with HFUPS and another non-neoplastic lesion were excluded from final analysis. For the remaining 40 lesions, the overall accuracy of the HFUPS examination to predict the correct T-stage was 90% (95% confidence interval [CI], 77-96%). The HFUPS examination had a positive impact on the treatment of 0 low-risk and 11 high-risk (42%) lesions. The impact of HFUPS on the treatment of SCN depends on their endoscopic characteristics. It is negligible for low-risk SCNs, and these lesions can be treated on the basis of their endoscopic appearance alone. Nevertheless, compared with endoscopy alone, HFUPS changed the subsequent therapeutic approach in a positive way for up to 42% of high-risk lesions, including those with a depressed component and an invasive pit pattern. These endoscopic features can therefore be recommended as the entry criteria for an HFUPS examination.

  11. Personnel management in electric utilities. Building blocks of an integrated concept of personnel management. Personalmanagement in Energieunternehmen. Bausteine eines integrierten Personalmanagement-Konzeptes

    Energy Technology Data Exchange (ETDEWEB)

    Kolks, U. (Roland Berger und Partner GmbH, Duesseldorf (Germany))

    1992-07-01

    The enterprises of the energy industry supplying line-transmitted power are confronted with the task of adapting themselves to changing boundary conditions and scize the chances offered. Characteristic of the changes is, in particular, the introduction of elements of competition as intended by the Commission of the EC. In addition, tasks in eastern Germany must be solved, and timely attention to options in eastern Europe is necessary. All this calls for intensified thinking about the future and, in some sectors of the industry, reorientation. This is the situation that prompted Roland Berger and Partner to prepare a study on the subject of: 'Challenges to the energy industry in the 90s'. In the article, the author presents the results of the study concerning personnel management, subsequently pointing out how the framing of new concepts can be tackled. (orig.).

  12. Personnel management in electric utilities. Building blocks of an integrated concept of personnel management. Personalmanagement in Energieunternehmen. Bausteine eines integrierten Personalmanagement-Konzeptes

    Energy Technology Data Exchange (ETDEWEB)

    Kolks, U [Roland Berger und Partner GmbH, Duesseldorf (Germany)

    1992-07-01

    The enterprises of the energy industry supplying line-transmitted power are confronted with the task of adapting themselves to changing boundary conditions and scize the chances offered. Characteristic of the changes is, in particular, the introduction of elements of competition as intended by the Commission of the EC. In addition, tasks in eastern Germany must be solved, and timely attention to options in eastern Europe is necessary. All this calls for intensified thinking about the future and, in some sectors of the industry, reorientation. This is the situation that prompted Roland Berger and Partner to prepare a study on the subject of: 'Challenges to the energy industry in the 90s'. In the article, the author presents the results of the study concerning personnel management, subsequently pointing out how the framing of new concepts can be tackled. (orig.).

  13. Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan.

    Science.gov (United States)

    Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

    2015-03-06

    A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.

  14. Perceived Barriers to Utilizing Maternal and Neonatal Health Services in Contracted-Out Versus Government-Managed Health Facilities in the Rural Districts of Pakistan

    Directory of Open Access Journals (Sweden)

    Atif Riaz

    2015-05-01

    Full Text Available Background A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted. Methods A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies.

  15. [Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

    Science.gov (United States)

    Ohura, Takehiko; Sanada, Hiromi; Mino, Yoshio

    2004-01-01

    In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor. Thus, cost-effectiveness in pressure ulcer care has not yet been fully established. To provide true cost effectiveness data, a comparative prospective study was initiated in patients with stage II and III pressure ulcers. Considering the potential impact of the pressure reduction mattress on clinical outcome, in particular, the same type of pressure reduction mattresses are utilized in all the cases in the study. The cost analysis method used was Activity-Based Costing, which measures material and labor cost aspects on a daily basis. A reduction in the Pressure Sore Status Tool (PSST) score was used to measure clinical effectiveness. Patients were divided into three groups based on the treatment method and on the use of a consistent algorithm of wound care: 1. MC/A group, modern dressings with a treatment algorithm (control cohort). 2. TC/A group, traditional care (ointment and gauze) with a treatment algorithm. 3. TC/NA group, traditional care (ointment and gauze) without a treatment algorithm. The results revealed that MC/A is more cost-effective than both TC/A and TC/NA. This suggests that appropriate utilization of modern dressing materials and a pressure ulcer care algorithm would contribute to reducing health care costs, improved clinical results, and, ultimately, greater cost-effectiveness.

  16. Access, acceptability and utilization of community health workers using diagnostics for case management of fever in Ugandan children: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mukanga David

    2012-05-01

    Full Text Available Abstract Background Use of diagnostics in integrated community case management (iCCM of fever is recognized as an important step in improving rational use of drugs and quality of care for febrile under-five children. This study assessed household access, acceptability and utilization of community health workers (CHWs trained and provided with malaria rapid diagnostic tests (RDTs and respiratory rate timers (RRTs to practice iCCM. Methods A total of 423 households with under-five children were enrolled into the study in Iganga district, Uganda. Households were selected from seven villages in Namungalwe sub-county using probability proportionate to size sampling. A semi-structured questionnaire was administered to caregivers in selected households. Data were entered into Epidata statistical software, and analysed using SPSS Statistics 17.0, and STATA version 10. Results Most (86%, 365/423 households resided within a kilometre of a CHW’s home, compared to 26% (111/423 residing within 1 km of a health facility (p  Fifty-seven percent (243/423 of caregivers took their febrile children to a CHW at least once in the three month period preceding the survey. Households located 1–3 km from a health facility were 72% (AOR 1.72; 95% CI 1.11–2.68 more likely to utilize CHW services compared to households within 1 km of a health facility. Households located 1–3 km from a CHW were 81% (AOR 0.19; 95% CI 0.10–0.36 less likely to utilize CHW services compared to those households residing within 1 km of a CHW. A majority (79%, 336/423 of respondents thought CHWs services were better with RDTs, and 89% (375/423 approved CHWs’ continued use of RDTs. Eighty-six percent (209/243 of respondents who visited a CHW thought RRTs were useful. Conclusion ICCM with diagnostics is acceptable, increases access, and is the first choice for caregivers of febrile children. More than half of caregivers of febrile children utilized CHW services over a three

  17. Welcoming Address & Opening Remarks [International Conference on Research Reactors: Safe Management and Effective Utilization, Vienna (Austria), 16-20 November 2015

    International Nuclear Information System (INIS)

    Chudakov, M.

    2017-01-01

    For more than 60 years, research reactors have been centres of innovation and productivity for nuclear science and technology programmes in 67 countries around the world. Research reactors provide a multidisciplinary environment to catalyse scientific, industrial, medical and agricultural development. They are facilities for nuclear education and training of young scientists and technicians, and they can contribute to the development of nuclear power programmes. According to the IAEA Research Reactor Database, there are 246 research reactors currently in operation in 55 countries, and close to 30 new research reactor projects are at different stages of implementation. Many of the operating reactors are several decades old and face ageing management issues. These reactors must be operated and maintained with due regard to safety and security. Some reactors face challenges with sustainable supply of fresh fuel. Others are looking to improve utilization, which is linked to justifying adequate resources for operation, maintenance and refurbishment. As some of the fuel return programmes are expected to wind down in the near term, the community will need to find solutions for spent fuel and waste management. And taking into account the large number of reactors, about 140, no longer in operation, as well as ageing reactors coming to the end of their lifecycles, decommissioning is an important area of sharing experience and best practice. You will have an opportunity to discuss these and other issues over the course of the conference.

  18. Climate protection, natural resources management and soil improvement by combined Energetic and Material Utilization of lignocellulosic agricultural WAstes and residues (CEMUWA)

    International Nuclear Information System (INIS)

    Schuech, Andrea; Nelles, Michael; Tscherpel, Burckhard; El Behery, Ahmed; Menanz, Rania; Bahl, Hubert; Scheel, Michael; Nipkow, Mareen

    2015-01-01

    The project Climate protection, natural resources management and soil improvement by combined Energetic and Material Utilization of lignocellulosic agricultural WAstes and residues (CEMUWA) was implemented with long-term partners from Egypt and Germany leaded by the Department Waste Management and Material Flow from September 2011 until October 2013. Aim of the project was the development of technologies for the utilization of agricultural wastes and residues at the example of rice straw, with the focus on the energetic and material use. In the long term a contribution to climate protection and natural resource management could be reached. The focus was on investigations in the field of biogas, ethanol and butanol production including pretreatment as well as the material use in horticulture. The results show that the biogas and ethanol production with adapted pretreatments of rice straws is possible. The technical adaptation of a biogas plant (eo-digestion) would be associated with about 20% higher investment costs and higher operating costs with an approximately 15% higher energy demand. In Germany, however, this may still economically by the substitution of expensive or difficult available energy crops (reduction of substrate costs by 30 to 35% for a 600 kWel-BGP using maize silage). The investigated solutions for material use in Egypt showed good results, which in some cases exceeded the expectations. By the use of rice straw imported peat substrates could be substitute or irrigation water saved, what is ecologically and economically useful. The production of ethanol from rice straw was implemented on laboratory scale and preconditions for investigations in semi-industrial and partly pilot scale were created. The bilateral project'' was funded in the framework of the German-Egypt-Research-Fond (GERF) by the German Federal Ministry of Education and Research (BMBF) and the Egyptian Science and Technology Development Fund in Egypt (STDF). The total budget

  19. The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization--a cluster-randomised controlled trial.

    Science.gov (United States)

    Smidth, Margrethe; Christensen, Morten Bondo; Fenger-Grøn, Morten; Olesen, Frede; Vedsted, Peter

    2013-10-03

    The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was

  20. The Utility of a Syndemic Framework in Understanding Chronic Disease Management Among HIV-Infected and Type 2 Diabetic Men Who Have Sex with Men.

    Science.gov (United States)

    Byg, Blaire; Bazzi, Angela Robertson; Funk, Danielle; James, Bonface; Potter, Jennifer

    2016-12-01

    Syndemic theory posits that epidemics of multiple physical and psychosocial problems co-occur among disadvantaged groups due to adverse social conditions. Although sexual minority populations are often stigmatized and vulnerable to multiple health problems, the syndemic perspective has been underutilized in understanding chronic disease. To assess the potential utility of this perspective in understanding the management of co-occurring HIV and Type 2 diabetes, we used linear regression to examine glycemic control (A1c) among men who have sex with men (MSM) with both HIV and Type 2 diabetes (n = 88). Bivariable linear regression explored potential syndemic correlates of inadequate glycemic control. Compared to those with adequate glycemic control (A1c ≤ 7.5 %), more men with inadequate glycemic control (A1c > 7.5 %) had hypertension (70 vs. 46 %, p = 0.034), high triglycerides (93 vs. 61 %, p = 0.002), depression (67 vs. 39 %, p = 0.018), current substance abuse (15 vs. 2 %, p = 0.014), and detectable levels of HIV (i.e., viral load ≥75 copies per ml blood; 30 vs. 10 %, p = 0.019). In multivariable regression controlling for age, the factors that were independently associated with higher A1c were high triglycerides, substance use, and detectable HIV viral load, suggesting that chronic disease management among MSM is complex and challenging for patients and providers. Findings also suggest that syndemic theory can be a clarifying lens for understanding chronic disease management among sexual minority stigmatized populations. Interventions targeting single conditions may be inadequate when multiple conditions co-occur; thus, research using a syndemic framework may be helpful in identifying intervention strategies that target multiple co-occurring conditions.

  1. The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

    Science.gov (United States)

    Zamani-Hank, Yasamean

    2016-08-01

    The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $667 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-of-pocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA. (Population Health Management 2016;19:272-278).

  2. PENGELOLAAN ADAPTIF PEMANFAATAN BUAH HITAM (Haplolobus monticola Blumea ETNIS WANDAMEN-PAPUA (Adaptive Management Utilization of Black Fruit (Haplolobus monticola Blumea Ethnic Wandamen-Papua

    Directory of Open Access Journals (Sweden)

    Antoni Ungirwalu

    2016-07-01

    Full Text Available ABSTRAK Kajian ekologi budaya bertujuan untuk mendeskripsikan karakteristik lingkungan ekologi dan sosial-budaya masyarakat adat etnis Wandamen-Papua dalam mengkonstruksi pengelolaan sumberdaya alam adaptif untuk pemanfaatan buah hitam (Haplolobus monticola Blumea sebagai salah satu dasar pertimbangan penting bagi penyusunan kebijakan pengelolaan hutan berkelanjutan di Papua. Pengelolaan sumberdaya alam adaptif buah hitam dipengaruhi oleh karakteristik sosial budaya etnis Wandamen yang memiliki pola kepemilikan dan penguasaan sumber daya alam (SDA meliputi: tanah, perairan, dan hutan. Masing-masing dalam lingkungan wilayah adatnya yang bersifat komunal, dibentuk dari pola kekerabatan dengan tipe Iroquois dan diwariskan melalui sistem patrilineal. Struktur sosial etnis Wandamen-Papua bersifat askriptif dalam kemajemukan sosial-budaya (banyak sub-etnis, namun dalam perkembangnnya hanya sub-etnis Wamesa yang memiliki kearifan lokal tentang pemanfaatan tumbuhan buah hitam yang dijumpai pada tipologi habitat ekologi, meliputi: hutan alam, hutan sekunder, dan kebun-pekarangan. Konstruksi etnoekologi pemanfaatan SDA buah hitam bagi etnis Wandamen memiliki enam wujud, yaitu sebagai sumberdaya lokal, pengetahuan lokal, nilai lokal, teknologi lokal, mekanisme pengembilan keputusan lokal, serta solidaritas kelompok lokal.   ABSTRACT Study of cultural ecology aimed to describe the characteristics of the ecological factors and socio-culture of indigenous ethnic of Wandamen-Papua in constructing the adaptive management of natural resources for the use of black fruit (Haplolobus monticola Blumea that is necessary for policy-making of the sustainable forest management in Papua. Adaptive management of natural resource of black fruits depend mainly on the characteristics of social culture of Wandamen ethnic. The management have a pattern of ownership and control of Natural Resources (NR i.e.: soil, water, and forests. They are the customary territory on the

  3. Scaling Critical Zone analysis tasks from desktop to the cloud utilizing contemporary distributed computing and data management approaches: A case study for project based learning of Cyberinfrastructure concepts

    Science.gov (United States)

    Swetnam, T. L.; Pelletier, J. D.; Merchant, N.; Callahan, N.; Lyons, E.

    2015-12-01

    Earth science is making rapid advances through effective utilization of large-scale data repositories such as aerial LiDAR and access to NSF-funded cyberinfrastructures (e.g. the OpenTopography.org data portal, iPlant Collaborative, and XSEDE). Scaling analysis tasks that are traditionally developed using desktops, laptops or computing clusters to effectively leverage national and regional scale cyberinfrastructure pose unique challenges and barriers to adoption. To address some of these challenges in Fall 2014 an 'Applied Cyberinfrastructure Concepts' a project-based learning course (ISTA 420/520) at the University of Arizona focused on developing scalable models of 'Effective Energy and Mass Transfer' (EEMT, MJ m-2 yr-1) for use by the NSF Critical Zone Observatories (CZO) project. EEMT is a quantitative measure of the flux of available energy to the critical zone, and its computation involves inputs that have broad applicability (e.g. solar insolation). The course comprised of 25 students with varying level of computational skills and with no prior domain background in the geosciences, collaborated with domain experts to develop the scalable workflow. The original workflow relying on open-source QGIS platform on a laptop was scaled to effectively utilize cloud environments (Openstack), UA Campus HPC systems, iRODS, and other XSEDE and OSG resources. The project utilizes public data, e.g. DEMs produced by OpenTopography.org and climate data from Daymet, which are processed using GDAL, GRASS and SAGA and the Makeflow and Work-queue task management software packages. Students were placed into collaborative groups to develop the separate aspects of the project. They were allowed to change teams, alter workflows, and design and develop novel code. The students were able to identify all necessary dependencies, recompile source onto the target execution platforms, and demonstrate a functional workflow, which was further improved upon by one of the group leaders over

  4. Utility of the RENAL index -Radius; Exophytic/endophytic; Nearness to sinus; Anterior/posterior; Location relative to polar lines- in the management of renal masses.

    Science.gov (United States)

    Konstantinidis, C; Trilla, E; Lorente, D; Morote, J

    2016-12-01

    The growing incidence of renal masses and the wide range of available treatments require predictive tools that support the decision making process. The RENAL index -Radius; Exophytic/endophytic; Nearness to sinus; Anterior/posterior; Location relative to polar lines- helps standardise the anatomy of a renal mass by differentiating 3 groups of complexity. Since the introduction of the index, there have been a growing number of studies, some of which have been conflicting, that have evaluated the clinical utility of its implementation. To analyse the scientific evidence on the relationship between the RENAL index and the main strategies for managing renal masses. A search was conducted in the Medline database, which found 576 references on the RENAL index. In keeping with the PRISM Declaration, we selected 100 abstracts and ultimately reviewed 96 articles. The RENAL index has a high degree of interobserver correlation and has been validated as a predictive nomogram of histological results. In active surveillance, the index has been related to the tumour growth rate and probability of nephrectomy. In ablative therapy, the index has been associated with therapeutic efficacy, complications and tumour recurrence. In partial nephrectomy, the index has been related to the rate of complications, conversion to radical surgery, ischaemia time, function preservation and tumour recurrence, a finding also observed in radical nephrectomy. The RENAL index is an objective, reproducible and useful system as a predictive tool of highly relevant clinical parameters such as the rate of complications, ischaemia time, renal function and oncological results in the various currently accepted treatments for the management of renal masses. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Estimating Utility

    DEFF Research Database (Denmark)

    Arndt, Channing; Simler, Kenneth R.

    2010-01-01

    A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes a......, with the current approach tending to systematically overestimate (underestimate) poverty in urban (rural) zones.......A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes...... an information-theoretic approach to estimating cost-of-basic-needs (CBN) poverty lines that are utility consistent. Applications to date illustrate that utility-consistent poverty measurements derived from the proposed approach and those derived from current CBN best practices often differ substantially...

  6. Telemedicine utilization to support the management of the burns treatment involving patient pathways in both developed and developing countries: a case study.

    Science.gov (United States)

    Syed-Abdul, Shabbir; Scholl, Jeremiah; Chen, Chiehfeng Cliff; Santos, Martinho D P S; Jian, Wen-Shan; Liou, Der-Ming; Li, Yu-Chuan

    2012-01-01

    This case study reports on the utilization of telemedicine to support the management of the burns treatment in the islands of Sao Tome and Principe by Taipei Medical University-affiliated hospital in Taiwan. The authors share experiences about usage of telemedicine to support treatment of the burn victims in a low-income country that receive reconstructive surgery in a developed country. Throughout the entire care process, telemedicine has been used not only to provide an expert advice from distance but also to help establish and maintain the doctor-patient relationship, to keep patients in contact with their families, and to help educate and consult the medical personal physically present in Sao Tome and Principe. This case study presents the details of how this process has been conducted to date, on what were learned from this process, and on issues that should be considered to improve this process in the future. The authors plan to create instructional videos and post them on YouTube to aid clinical workers providing similar treatment during the acute care and rehabilitation process and also to support eLearning in many situations where it otherwise is not possible to use videoconferencing to establish real-time contact between doctors at the local site and remote specialists.

  7. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  8. Management of Bleeding Duodenal Varices with Combined TIPS Decompression and Trans-TIPS Transvenous Obliteration Utilizing 3% Sodium Tetradecyl Sulfate Foam Sclerosis

    Directory of Open Access Journals (Sweden)

    Wael E Saad

    2014-01-01

    Full Text Available Objectives: Endoscopic experience in the management of duodenal varices (DVs is limited and challenging given the anatomic constraints and limited experience. The endovascular management of DVs is not yet established and the controversy of whether to manage them by decompression with a transjugular intrahepatic portosystemic shunt (TIPS or by transvenous obliteration is unresolved. In the literature, the 6-12 month rebleeding rate of DVs after TIPS is 21-37% and after transvenous obliteration is 13%. The purpose of the study is to evaluate the clinical outcome of combined TIPS decompression and transvenous obliteration/sclerosis. Materials and Methods: This is a retrospective study (case series of two institutions, evaluating patients who underwent TIPS and/or transvenous obliteration/sclerosis for bleeding DVs (from January 2009 to June 2013. TIPS was performed according to a standard procedure using covered stents. Transvenous obliteration (variceal sclerosis from the systemic and/or portal venous circulation was performed utilizing 3% sodium tetradecyl sulfate foam. Transvenous obliteration was commonly augmented with coils and/or vascular plugs. Technical (technical success of establishing TIPS and completely obliterating the DVs and clinical outcomes (rebleeding rate and survival were evaluated. Results: Five patients with liver cirrhosis presenting with bleeding DVs were included in the study with all eventually (and coincidentally receiving TIPS and transvenous obliteration. Two of the five patients underwent concomitant TIPS and transvenous obliteration in the same procedural setting. However, three patients underwent transvenous obliteration due to bleeding despite a patent TIPS that had been previously placed. The average time from TIPS placement to transvenous obliteration was 125 days (range: 3-324 days. After having both procedures, there was no rebleeding in the patients during a mean follow-up period of 22 months (6-50 months

  9. Management of Bleeding Duodenal Varices with Combined TIPS Decompression and Trans-TIPS Transvenous Obliteration Utilizing 3% Sodium Tetradecyl Sulfate Foam Sclerosis.

    Science.gov (United States)

    Saad, Wael E; Lippert, Allison; Schwaner, Sandra; Al-Osaimi, Abdullah; Sabri, Saher; Saad, Nael

    2014-01-01

    Endoscopic experience in the management of duodenal varices (DVs) is limited and challenging given the anatomic constraints and limited experience. The endovascular management of DVs is not yet established and the controversy of whether to manage them by decompression with a transjugular intrahepatic portosystemic shunt (TIPS) or by transvenous obliteration is unresolved. In the literature, the 6-12 month rebleeding rate of DVs after TIPS is 21-37% and after transvenous obliteration is 13%. The purpose of the study is to evaluate the clinical outcome of combined TIPS decompression and transvenous obliteration/sclerosis. This is a retrospective study (case series) of two institutions, evaluating patients who underwent TIPS and/or transvenous obliteration/sclerosis for bleeding DVs (from January 2009 to June 2013). TIPS was performed according to a standard procedure using covered stents. Transvenous obliteration (variceal sclerosis) from the systemic and/or portal venous circulation was performed utilizing 3% sodium tetradecyl sulfate foam. Transvenous obliteration was commonly augmented with coils and/or vascular plugs. Technical (technical success of establishing TIPS and completely obliterating the DVs) and clinical outcomes (rebleeding rate and survival) were evaluated. Five patients with liver cirrhosis presenting with bleeding DVs were included in the study with all eventually (and coincidentally) receiving TIPS and transvenous obliteration. Two of the five patients underwent concomitant TIPS and transvenous obliteration in the same procedural setting. However, three patients underwent transvenous obliteration due to bleeding despite a patent TIPS that had been previously placed. The average time from TIPS placement to transvenous obliteration was 125 days (range: 3-324 days). After having both procedures, there was no rebleeding in the patients during a mean follow-up period of 22 months (6-50 months). Coils and/or metallic vascular plugs were used to augment

  10. Managing Projects with CSR in mind

    DEFF Research Database (Denmark)

    Kampf, Constance; Thomsen, Christa

    2008-01-01

    This paper examines project management as a place where CSR can be operationalized, focusing particularly on project conception processes and co-constructing CSR knowledge with emergent tertiary stakeholders. Two projects which dealt with emergent tertiary stakeholders differently are examined.......  First, the Finnish company Metsa-Botnia's paper pulp plant in Uruguay is examined as a project in which a tertiary stakeholder, Argentina, emerged during the early stages of the project.  Argentina requested dialogue about the project conception and Metsa Botnia did not include them.  In contrast......, the Danish emergency services company Falck A/S's project on redefining CSR is offered as an example of a project transformed through dialogue with the emergent tertiary stakeholder, the county of Aarhus.   To analyze the cases, the paper combines Morsing & Schultz's (2006) dialectic CSR strategy based...

  11. Multiattribute Utility Theory without Expected Utility Foundations

    NARCIS (Netherlands)

    Stiggelbout, A.M.; Wakker, P.P.

    1995-01-01

    Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

  12. Multiattribute utility theory without expected utility foundations

    NARCIS (Netherlands)

    Wakker, P.P.; Miyamoto, J.

    1996-01-01

    Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

  13. Baxter'i Balti riike halvustavad plakatid / Uno Schultz ; foto: Emil Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2007-01-01

    rahvusvahelise meditsiinifirma Baxter Rootsi osakonna, Stockholmi äärelinnas Kistas asuva Baxter Medical AB tegevusest puugihammustuste kaudu levivate haiguste vastase kaitsepookimise propageerimisel

  14. Market research for electric utilities

    Energy Technology Data Exchange (ETDEWEB)

    Shippee, G.

    1999-12-01

    Marketing research is increasing in importance as utilities become more marketing oriented. Marketing research managers need to maintain autonomy from the marketing director or ad agency and make sure their work is relevant to the utility's operation. This article will outline a model marketing research program for an electric utility. While a utility may not conduct each and every type of research described, the programs presented offer a smorgasbord of activities which successful electric utility marketers often use or have access to.

  15. Promotion of HANARO Utilization for Year 2004

    International Nuclear Information System (INIS)

    Sohn, J. M.; Kim, Y. J.; Kim, H. R.

    2005-06-01

    To activate the HANARO utilization by expanding HANARO utilization fields, recruiting and training new users. In order to promote the HANARO utilization, the following activities have been performed. The neutron usage fee in HANARO, Achievements of HANARO utilization, Project for Activation of the Research using HANARO, Operation and Management of HANARO Homepage, HANARO Workshop 2004, Management of HANARO related committees, Training of HANARO users, Related activities of HANARO publicity. The related activities to activate HANARO utilization have been carried out successfully. This report summarized the detailed activities to activate the HANARO utilization. They will be useful for expanding HANARO utilization in the near future

  16. Promotion of HANARO utilization for year 2003

    International Nuclear Information System (INIS)

    Sohn, J. M.; Park, K. B.; Kim, Y. J.

    2004-06-01

    To activate the HANARO utilization by expanding HANARO utilization fields, recruiting and training new users. In order to promote the HANARO utilization, the following activities have been performed. - The neutron usage fee in HANARO - Achievements of HANARO utilization - Project for Activation of the Research using HANARO - Management of HANARO Homepage - HANARO Workshop 2003 - Operation and Management of HANARO related committees - Training of HANARO users - Related activities of HANARO publicity. The related activities to activate HANARO utilization have been carried out successfully. This report summarized the detailed activities to activate the HANARO utilization. They will be useful for expanding HANARO utilization in the near future

  17. Promotion of HANARO utilization for year 2002

    International Nuclear Information System (INIS)

    Sohn, J. M.; Park, K. B.; Kim, Y. J.

    2003-06-01

    Object and importance to activate the HANARO utilization by expanding HANARO utilization fields, recruiting and training new users. In order to promote the HANARO utilization, the following activities have been performed. The neutron usage fee in HANARO, Achievements of HANARO utilization, Project for activation of the research using HANARO, Management of HANARO homepage, Management of HANARO related committees, Training of HANARO users, Establishment of user-room, Related activities of HANARO publicity. The related activities to activate HANARO utilization have been carried out successfully. This report summarized the detailed activities to activate the HANARO utilization. They will be useful for expanding HANARO utilization in the near future

  18. Promotion of HANARO Utilization for Year 2006

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, J. M.; Kim, H. R.; Jun, B. J. (and others)

    2007-05-15

    To activate the HANARO utilization by expanding HANARO utilization fields, recruiting and training new users. In order to promote the HANARO utilization, the following activities have been performed. The neutron usage fee in HANARO. Achievements of HANARO utilization. Project for Activation of the Research using HANARO. HANARO Symposium. Survey of the HANARO User Satisfaction Index. Operation and Management of HANARO Server. Management of HANARO related committees. Training of HANARO users. Related activities of HANARO publicity. The related activities to activate HANARO utilization have been carried out successfully. This report summarized the detailed activities to activate the HANARO utilization. They will be useful for expanding HANARO utilization in the near future.

  19. Formerly Utilized MED/AEC Sites Remedial Action Program. Project management plan for the decontamination of Jones Laboratory, Ryerson Physical Laboratory, and Eckhart Hall, the University of Chicago, Chicago, Illinois

    Energy Technology Data Exchange (ETDEWEB)

    Flynn, K.F.; Smith, W.H.; Wynveen, R.A.

    1984-01-01

    The Department of Energy (DOE) has in place a plan for the decontamination and decommissioning of contaminated sites that had been formerly utilized by the Manhattan Engineering District (MED) and/or the Atomic Energy Commission. This plan is referred to as the Formerly Utilized Sites Remedial Action Program (FUSRAP). Among these sites are Jones Laboratory, Ryerson Physical Laboratory and Eckhart Hall of The University of Chicago at Chicago, Illinois. This document represents the Project Management Plan for the decontamination of these facilities. 13 references, 3 figures, 1 table.

  20. Formerly Utilized MED/AEC Sites Remedial Action Program. Project management plan for the decontamination of Jones Laboratory, Ryerson Physical Laboratory, and Eckhart Hall, the University of Chicago, Chicago, Illinois

    International Nuclear Information System (INIS)

    Flynn, K.F.; Smith, W.H.; Wynveen, R.A.

    1984-01-01

    The Department of Energy (DOE) has in place a plan for the decontamination and decommissioning of contaminated sites that had been formerly utilized by the Manhattan Engineering District (MED) and/or the Atomic Energy Commission. This plan is referred to as the Formerly Utilized Sites Remedial Action Program (FUSRAP). Among these sites are Jones Laboratory, Ryerson Physical Laboratory and Eckhart Hall of The University of Chicago at Chicago, Illinois. This document represents the Project Management Plan for the decontamination of these facilities. 13 references, 3 figures, 1 table