WorldWideScience

Sample records for selection proper care

  1. Strategy Guideline: Proper Water Heater Selection

    Energy Technology Data Exchange (ETDEWEB)

    Hoeschele, M. [Alliance for Residential Building Innovation, Davis, CA (United States); Springer, D. [Alliance for Residential Building Innovation, Davis, CA (United States); German, A. [Alliance for Residential Building Innovation, Davis, CA (United States); Staller, J. [Alliance for Residential Building Innovation, Davis, CA (United States); Zhang, Y. [Alliance for Residential Building Innovation, Davis, CA (United States)

    2015-04-01

    This Strategy Guideline on proper water heater selection was developed by the Building America team Alliance for Residential Building Innovation to provide step-by-step procedures for evaluating preferred cost-effective options for energy efficient water heater alternatives based on local utility rates, climate, and anticipated loads.

  2. Strategy Guideline. Proper Water Heater Selection

    Energy Technology Data Exchange (ETDEWEB)

    Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Springer, D. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Staller, J. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Zhang, Y. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

    2015-04-09

    This Strategy Guideline on proper water heater selection was developed by the Building America team Alliance for Residential Building Innovation to provide step-by-step procedures for evaluating preferred cost-effective options for energy efficient water heater alternatives based on local utility rates, climate, and anticipated loads.

  3. Proper Lens Care (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. In this podcast, Dr. Jennifer Cope discusses the importance of proper lens hygiene and maintenance.

  4. Proper Lens Care (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. This podcast discusses the importance of proper lens hygiene and maintenance.

  5. Limited-memory adaptive snapshot selection for proper orthogonal decomposition

    Energy Technology Data Exchange (ETDEWEB)

    Oxberry, Geoffrey M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kostova-Vassilevska, Tanya [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Arrighi, Bill [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Chand, Kyle [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-04-02

    Reduced order models are useful for accelerating simulations in many-query contexts, such as optimization, uncertainty quantification, and sensitivity analysis. However, offline training of reduced order models can have prohibitively expensive memory and floating-point operation costs in high-performance computing applications, where memory per core is limited. To overcome this limitation for proper orthogonal decomposition, we propose a novel adaptive selection method for snapshots in time that limits offline training costs by selecting snapshots according an error control mechanism similar to that found in adaptive time-stepping ordinary differential equation solvers. The error estimator used in this work is related to theory bounding the approximation error in time of proper orthogonal decomposition-based reduced order models, and memory usage is minimized by computing the singular value decomposition using a single-pass incremental algorithm. Results for a viscous Burgers’ test problem demonstrate convergence in the limit as the algorithm error tolerances go to zero; in this limit, the full order model is recovered to within discretization error. The resulting method can be used on supercomputers to generate proper orthogonal decomposition-based reduced order models, or as a subroutine within hyperreduction algorithms that require taking snapshots in time, or within greedy algorithms for sampling parameter space.

  6. Proper Lens Care (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-17

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. In this podcast, Dr. Jennifer Cope discusses the importance of proper lens hygiene and maintenance.  Created: 8/17/2017 by MMWR.   Date Released: 8/17/2017.

  7. Proper Lens Care (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2017-08-17

    Wearing contact lenses is a convenient way to improve vision without having to wear glasses. But unlike glasses, improper care and maintenance of lenses can result in severe eye problems, including blindness. In this podcast, Dr. Jennifer Cope discusses the importance of proper lens hygiene and maintenance.  Created: 8/17/2017 by MMWR.   Date Released: 8/17/2017.

  8. Preconditioned dynamic mode decomposition and mode selection algorithms for large datasets using incremental proper orthogonal decomposition

    Science.gov (United States)

    Ohmichi, Yuya

    2017-07-01

    In this letter, we propose a simple and efficient framework of dynamic mode decomposition (DMD) and mode selection for large datasets. The proposed framework explicitly introduces a preconditioning step using an incremental proper orthogonal decomposition (POD) to DMD and mode selection algorithms. By performing the preconditioning step, the DMD and mode selection can be performed with low memory consumption and therefore can be applied to large datasets. Additionally, we propose a simple mode selection algorithm based on a greedy method. The proposed framework is applied to the analysis of three-dimensional flow around a circular cylinder.

  9. The Importance of a Proper Selection Area to be Biopsied in Nodular Leukoplakia: a Case Report

    Directory of Open Access Journals (Sweden)

    Paulo Sérgio da Silva Santos

    2014-01-01

    Full Text Available Nodular leukoplakia is a non-homogeneous type of oral leukoplakia presenting a white surface with verrucous, nodular, ulcerated or erythematous features with a greater risk of malignant transformation when compared to the homogeneous type. Common sites of involvement include lip commissures, buccal mucosa and soft palate. It is often associated with epithelial dysplasia or carcinoma and requires detailed microscopic assessment and regular follow-up. The importance of a proper selection of the area to be biopsied and the close teamwork between a dentist and oral pathologist is the basis of providing an accurate final diagnosis.

  10. Managing pediatric dental patients: issues raised by the law and changing views of proper child care.

    Science.gov (United States)

    Bross, Donald C

    2004-01-01

    The purpose of this paper was to examine legal issues regarding the management of pediatric dental patients and changing views of proper child care. Standards of care in pediatric dentistry are not static. They change in response to research, patterns of reimbursement, patient and parental expectations of reasonable care, and consensus among practitioners. The law pertaining to accountability for pediatric dental patient treatment largely reflects standards of care established by the pediatric dentistry profession. However, the law can also reflect changes in public expectations of reasonable care that can effectively outrun the discipline's efforts to reflect new knowledge or changing public concerns. A major impetus for considering the care of children in all settings has been the increasing recognition of suboptimal children's care, as well as concerns that children have either been abused or neglected in a number of settings. Too often, practices towards children have been untested and based only on the assumption that what is done is "for the child's own good." Pediatric dentists can respond to changing standards of reasonable care for pediatric dental patients, as expressed in legal decisions. They can also usefully consider how attention to child maltreatment has sensitized parents to be better consumers of services on their children's behalf. Rather than reacting only to public pressures for better means of behavior management, the challenge is to exceed expectations via new research and thoughtful anticipation of improvements that can be made.

  11. COMMON PROPER-MOTION WIDE WHITE DWARF BINARIES SELECTED FROM THE SLOAN DIGITAL SKY SURVEY

    International Nuclear Information System (INIS)

    Andrews, Jeff J.; Agüeros, Marcel A.; Belczynski, Krzysztof; Dhital, Saurav; Kleinman, S. J.; West, Andrew A.

    2012-01-01

    Wide binaries made up of two white dwarfs (WDs) receive far less attention than their tight counterparts. However, our tests using the binary population synthesis code StarTrack indicate that, for any set of reasonable initial conditions, there exists a significant observable population of double white dwarfs (WDWDs) with orbital separations of 10 2 -10 5 AU. We adapt the technique of Dhital et al. to search for candidate common proper-motion WD companions separated by 12,000 spectroscopically confirmed hydrogen-atmosphere WDs recently identified in the Sloan Digital Sky Survey. Using two techniques to separate random alignments from high-confidence pairs, we find nine new high-probability wide WDWDs and confirm three previously identified candidate wide WDWDs. This brings the number of known wide WDWDs to 45; our new pairs are a significant addition to the sample, especially at small proper motions ( –1 ) and large angular separations (>10''). Spectroscopic follow-up and an extension of this method to a larger, photometrically selected set of SDSS WDs may eventually produce a large enough dataset for WDWDs to realize their full potential as testbeds for theories of stellar evolution.

  12. COMMON PROPER-MOTION WIDE WHITE DWARF BINARIES SELECTED FROM THE SLOAN DIGITAL SKY SURVEY

    Energy Technology Data Exchange (ETDEWEB)

    Andrews, Jeff J.; Agueeros, Marcel A. [Department of Astronomy, Columbia University, 550 West 120th Street, New York, NY 10027 (United States); Belczynski, Krzysztof [Astronomical Observatory, University of Warsaw, Al. Ujazdowskie 4, 00-478 Warsaw (Poland); Dhital, Saurav [Department of Physics and Astronomy, Vanderbilt University, 6301 Stevenson Center, Nashville, TN 37235 (United States); Kleinman, S. J. [Gemini Observatory, Northern Operations Center, Hilo, HI 96720 (United States); West, Andrew A. [Department of Astronomy, Boston University, 725 Commonwealth Ave, Boston, MA 02215 (United States)

    2012-10-01

    Wide binaries made up of two white dwarfs (WDs) receive far less attention than their tight counterparts. However, our tests using the binary population synthesis code StarTrack indicate that, for any set of reasonable initial conditions, there exists a significant observable population of double white dwarfs (WDWDs) with orbital separations of 10{sup 2}-10{sup 5} AU. We adapt the technique of Dhital et al. to search for candidate common proper-motion WD companions separated by <10' around the >12,000 spectroscopically confirmed hydrogen-atmosphere WDs recently identified in the Sloan Digital Sky Survey. Using two techniques to separate random alignments from high-confidence pairs, we find nine new high-probability wide WDWDs and confirm three previously identified candidate wide WDWDs. This brings the number of known wide WDWDs to 45; our new pairs are a significant addition to the sample, especially at small proper motions (<200 mas yr{sup -1}) and large angular separations (>10''). Spectroscopic follow-up and an extension of this method to a larger, photometrically selected set of SDSS WDs may eventually produce a large enough dataset for WDWDs to realize their full potential as testbeds for theories of stellar evolution.

  13. Data re-arranging techniques leading to proper variable selections in high energy physics

    Science.gov (United States)

    Kůs, Václav; Bouř, Petr

    2017-12-01

    We introduce a new data based approach to homogeneity testing and variable selection carried out in high energy physics experiments, where one of the basic tasks is to test the homogeneity of weighted samples, mainly the Monte Carlo simulations (weighted) and real data measurements (unweighted). This technique is called ’data re-arranging’ and it enables variable selection performed by means of the classical statistical homogeneity tests such as Kolmogorov-Smirnov, Anderson-Darling, or Pearson’s chi-square divergence test. P-values of our variants of homogeneity tests are investigated and the empirical verification through 46 dimensional high energy particle physics data sets is accomplished under newly proposed (equiprobable) quantile binning. Particularly, the procedure of homogeneity testing is applied to re-arranged Monte Carlo samples and real DATA sets measured at the particle accelerator Tevatron in Fermilab at DØ experiment originating from top-antitop quark pair production in two decay channels (electron, muon) with 2, 3, or 4+ jets detected. Finally, the variable selections in the electron and muon channels induced by the re-arranging procedure for homogeneity testing are provided for Tevatron top-antitop quark data sets.

  14. Implementation of Provider Perspectives Resulted in Proper Health Care Resource Utilization

    National Research Council Canada - National Science Library

    Mclean, Hugh

    2001-01-01

    .... One such system is Provider Perspectives. This study shows that Provider Perspectives significantly decreased Emergency Room utilization and subsequently increased the usage of primary care clinics at Martin Army Community Hospital and Winn...

  15. Atomic density effects on temperature characteristics and thermal transport at grain boundaries through a proper bin size selection

    Energy Technology Data Exchange (ETDEWEB)

    Vo, Truong Quoc; Kim, BoHung, E-mail: muratbarisik@iyte.edu.tr, E-mail: bohungk@ulsan.ac.kr [School of Mechanical Engineering, University of Ulsan, Daehak-ro 93, Namgu, Ulsan 680-749 (Korea, Republic of); Barisik, Murat, E-mail: muratbarisik@iyte.edu.tr, E-mail: bohungk@ulsan.ac.kr [Department of Mechanical Engineering, Izmir Institute of Technology, Urla, Izmir 35430 (Turkey)

    2016-05-21

    This study focuses on the proper characterization of temperature profiles across grain boundaries (GBs) in order to calculate the correct interfacial thermal resistance (ITR) and reveal the influence of GB geometries onto thermal transport. The solid-solid interfaces resulting from the orientation difference between the (001), (011), and (111) copper surfaces were investigated. Temperature discontinuities were observed at the boundary of grains due to the phonon mismatch, phonon backscattering, and atomic forces between dissimilar structures at the GBs. We observed that the temperature decreases gradually in the GB area rather than a sharp drop at the interface. As a result, three distinct temperature gradients developed at the GB which were different than the one observed in the bulk solid. This behavior extends a couple molecular diameters into both sides of the interface where we defined a thickness at GB based on the measured temperature profiles for characterization. Results showed dependence on the selection of the bin size used to average the temperature data from the molecular dynamics system. The bin size on the order of the crystal layer spacing was found to present an accurate temperature profile through the GB. We further calculated the GB thickness of various cases by using potential energy (PE) distributions which showed agreement with direct measurements from the temperature profile and validated the proper binning. The variation of grain crystal orientation developed different molecular densities which were characterized by the average atomic surface density (ASD) definition. Our results revealed that the ASD is the primary factor affecting the structural disorders and heat transfer at the solid-solid interfaces. Using a system in which the planes are highly close-packed can enhance the probability of interactions and the degree of overlap between vibrational density of states (VDOS) of atoms forming at interfaces, leading to a reduced ITR. Thus, an

  16. Proper Antibiotic Use in a Home-Based Primary Care Population Treated for Urinary Tract Infections.

    Science.gov (United States)

    Gee, Megan E; Ford, James; Conway, Erin L; Ott, Michael C; Sellick, John A; Mergenhagen, Kari A

    2018-02-01

    To evaluate the trends associated with diagnosis and treatment of urinary tract infections (UTI) in a home-based primary care population of Veterans Health System patients from 2006 to 2015. Retrospective cohort study. Veterans Healthcare System. Home-based primary care patients treated for UTI from 2006 to 2015. None. Appropriate therapy was determined based on the McGeer criteria. Multivariate logistic regression was used to determine factors leading to appropriate UTI treatment. Of 366 available patients, 68 (18.6%) were tested for a UTI. Appropriate therapy occurred in 26% of patients. Allergy to any antibiotic increased the odds of appropriate treatment (odds ratio [OR] = 5.6, 95% confidence interval [CI] 1.5-23.2). Flank pain and increased urinary frequency also increased the likelihood of being treated appropriately (OR = 25.9, 95% CI 2.9-584.0 and OR = 4.49, 95% CI 0.99-21.2, respectively). Antibiotics were overused for treating UTIs in the homebound population. Patients with flank pain, increased urinary frequency, and antibiotic allergy were more likely to receive appropriate treatment. Pharmacists, therefore, have a viable opportunity to increase appropriate antibiotic prescribing in the home-based primary care population.

  17. The proper care and feeding of administrators. How to bridge individual performance and organizational effectiveness? Start by caring for your professional self.

    Science.gov (United States)

    Pope, Christina

    2004-09-01

    As many medical practice administrators focus on the proper care and feeding of their organizations, they've developed the same ailment as other "caregivers"--they tend to their own professional development and needs as an afterthought. But as any self-preserving caregiver can tell you, nurturing yourself actually helps those you serve. How should administrators balance and respond to their own goals and preferences and their organization's needs--while anticipating changes in the broader environment?

  18. Proper Acknowledgment?

    Science.gov (United States)

    East, Julianne

    2005-01-01

    The concern in Australian universities about the prevalence of plagiarism has led to the development of policies about academic integrity and in turn focused attention on the need to inform students about how to avoid plagiarism and how to properly acknowledge. Teaching students how to avoid plagiarism can appear to be straightforward if based on…

  19. ProSelection: A Novel Algorithm to Select Proper Protein Structure Subsets for in Silico Target Identification and Drug Discovery Research.

    Science.gov (United States)

    Wang, Nanyi; Wang, Lirong; Xie, Xiang-Qun

    2017-11-27

    Molecular docking is widely applied to computer-aided drug design and has become relatively mature in the recent decades. Application of docking in modeling varies from single lead compound optimization to large-scale virtual screening. The performance of molecular docking is highly dependent on the protein structures selected. It is especially challenging for large-scale target prediction research when multiple structures are available for a single target. Therefore, we have established ProSelection, a docking preferred-protein selection algorithm, in order to generate the proper structure subset(s). By the ProSelection algorithm, protein structures of "weak selectors" are filtered out whereas structures of "strong selectors" are kept. Specifically, the structure which has a good statistical performance of distinguishing active ligands from inactive ligands is defined as a strong selector. In this study, 249 protein structures of 14 autophagy-related targets are investigated. Surflex-dock was used as the docking engine to distinguish active and inactive compounds against these protein structures. Both t test and Mann-Whitney U test were used to distinguish the strong from the weak selectors based on the normality of the docking score distribution. The suggested docking score threshold for active ligands (SDA) was generated for each strong selector structure according to the receiver operating characteristic (ROC) curve. The performance of ProSelection was further validated by predicting the potential off-targets of 43 U.S. Federal Drug Administration approved small molecule antineoplastic drugs. Overall, ProSelection will accelerate the computational work in protein structure selection and could be a useful tool for molecular docking, target prediction, and protein-chemical database establishment research.

  20. MOTION VERIFIED RED STARS (MoVeRS): A CATALOG OF PROPER MOTION SELECTED LOW-MASS STARS FROM WISE, SDSS, AND 2MASS

    Energy Technology Data Exchange (ETDEWEB)

    Theissen, Christopher A.; West, Andrew A. [Department of Astronomy, Boston University, 725 Commonwealth Avenue, Boston, MA 02215 (United States); Dhital, Saurav, E-mail: ctheisse@bu.edu [Department of Physical Sciences, Embry-Riddle Aeronautical University, 600 South Clyde Morris Blvd., Daytona Beach, FL 32114 (United States)

    2016-02-15

    We present a photometric catalog of 8,735,004 proper motion selected low-mass stars (KML-spectral types) within the Sloan Digital Sky Survey (SDSS) footprint, from the combined SDSS Data Release 10 (DR10), Two Micron All-Sky Survey (2MASS) point-source catalog (PSC), and Wide-field Infrared Survey Explorer (WISE) AllWISE catalog. Stars were selected using r − i, i − z, r − z, z − J, and z − W1 colors, and SDSS, WISE, and 2MASS astrometry was combined to compute proper motions. The resulting 3,518,150 stars were augmented with proper motions for 5,216,854 earlier type stars from the combined SDSS and United States Naval Observatory B1.0 catalog (USNO-B). We used SDSS+USNO-B proper motions to determine the best criteria for selecting a clean sample of stars. Only stars whose proper motions were greater than their 2σ uncertainty were included. Our Motion Verified Red Stars catalog is available through SDSS CasJobs and VizieR.

  1. PropeR revisited

    NARCIS (Netherlands)

    van der Linden, Helma; Talmon, Jan; Tange, Huibert; Grimson, Jane; Hasman, Arie

    2005-01-01

    INTRODUCTION: The PropeR EHR system (PropeRWeb) is a multidisciplinary electronic health record (EHR) system for multidisciplinary use in extramural patient care for stroke patients. DESIGN: The system is built using existing open source components and is based on open standards. It is implemented

  2. Multi-criteria decision analysis to select the optimum position and proper field of view of a photosensor

    International Nuclear Information System (INIS)

    Doulos, L.; Tsangrassoulis, A.; Topalis, F.V.

    2014-01-01

    Highlights: • A new methodology for the determination of proper FOV and position of a photosensor is proposed. • Model takes into account illuminance ratio, energy savings and lighting adequacy. • A multiple criteria decision method (ELECTRE) is used to estimate best solution. • A number of simulations were performed in order to clarify the calculation procedure. • An experimental procedure was performed in order to verify the simulation procedure. - Abstract: The lack of knowledge concerning the commissioning of a daylight responsive system constitutes a serious impediment to their widespread use. Furthermore, installation details and tools regarding their photosensor position and field of view (FOV) are insufficient. This paper presents a decision making method capable to estimate the best position of a photosensor on the ceiling and its proper FOV based on multiple criteria analysis. The criteria used are (a) the correlation of the lighting levels between the working plane and the ceiling, (b) the corresponding energy savings and (c) the lighting adequacy which is defined as the percentage for occupied time with total illuminance exceeding design illuminance (i.e 500 lux EN 12464-1, 2011) and is strongly affected by the control algorithm. A number of simulations with variable FOV and position of photosensors were performed in order to clarify the calculation procedure of the proposed methodology. Three different typical room geometries have been used with variable window sizes and orientation. Furthermore a prototype photosensor with variable FOV through the use of a telescopic cylinder was constructed and placed in a scale room (1:10) in order to verify the results of simulations. The verification was based on a set of experimental procedures concerning measurements of the spatial response of the prototype photosensor (for various FOVs) and measurements of ceiling/workplane illuminance inside the scaled room for various combinations of position and

  3. HUBBLE SPACE TELESCOPE PROPER MOTION (HSTPROMO) CATALOGS OF GALACTIC GLOBULAR CLUSTERS. I. SAMPLE SELECTION, DATA REDUCTION, AND NGC 7078 RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Bellini, A.; Anderson, J.; Van der Marel, R. P.; Watkins, L. L. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States); King, I. R. [Department of Astronomy, University of Washington, Box 351580, Seattle, WA 98195 (United States); Bianchini, P. [Max Planck Institute for Astronomy, Königstuhl 17, D-69117 Heidelberg (Germany); Chanamé, J. [Instituto de Astrofísica, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul 782-0436, Santiago (Chile); Chandar, R. [Department of Physics and Astronomy, The University of Toledo, 2801 West Bancroft Street, Toledo, OH 43606 (United States); Cool, A. M. [Department of Physics and Astronomy, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA 94132 (United States); Ferraro, F. R.; Massari, D. [Dipartimento di Fisica e Astronomia, Università di Bologna, via Ranzani 1, I-40127 Bologna (Italy); Ford, H., E-mail: bellini@stsci.edu [Department of Physics and Astronomy, The Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 (United States)

    2014-12-20

    We present the first study of high-precision internal proper motions (PMs) in a large sample of globular clusters, based on Hubble Space Telescope (HST) data obtained over the past decade with the ACS/WFC, ACS/HRC, and WFC3/UVIS instruments. We determine PMs for over 1.3 million stars in the central regions of 22 clusters, with a median number of ∼60,000 stars per cluster. These PMs have the potential to significantly advance our understanding of the internal kinematics of globular clusters by extending past line-of-sight (LOS) velocity measurements to two- or three-dimensional velocities, lower stellar masses, and larger sample sizes. We describe the reduction pipeline that we developed to derive homogeneous PMs from the very heterogeneous archival data. We demonstrate the quality of the measurements through extensive Monte Carlo simulations. We also discuss the PM errors introduced by various systematic effects and the techniques that we have developed to correct or remove them to the extent possible. We provide in electronic form the catalog for NGC 7078 (M 15), which consists of 77,837 stars in the central 2.'4. We validate the catalog by comparison with existing PM measurements and LOS velocities and use it to study the dependence of the velocity dispersion on radius, stellar magnitude (or mass) along the main sequence, and direction in the plane of the sky (radial or tangential). Subsequent papers in this series will explore a range of applications in globular-cluster science and will also present the PM catalogs for the other sample clusters.

  4. How to select a proper early warning threshold to detect infectious disease outbreaks based on the China infectious disease automated alert and response system (CIDARS).

    Science.gov (United States)

    Wang, Ruiping; Jiang, Yonggen; Michael, Engelgau; Zhao, Genming

    2017-06-12

    China Centre for Diseases Control and Prevention (CDC) developed the China Infectious Disease Automated Alert and Response System (CIDARS) in 2005. The CIDARS was used to strengthen infectious disease surveillance and aid in the early warning of outbreak. The CIDARS has been integrated into the routine outbreak monitoring efforts of the CDC at all levels in China. Early warning threshold is crucial for outbreak detection in the CIDARS, but CDCs at all level are currently using thresholds recommended by the China CDC, and these recommended thresholds have recognized limitations. Our study therefore seeks to explore an operational method to select the proper early warning threshold according to the epidemic features of local infectious diseases. The data used in this study were extracted from the web-based Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), and data for infectious disease cases were organized by calendar week (1-52) and year (2009-2015) in Excel format; Px was calculated using a percentile-based moving window (moving window [5 week*5 year], x), where x represents one of 12 centiles (0.40, 0.45, 0.50….0.95). Outbreak signals for the 12 Px were calculated using the moving percentile method (MPM) based on data from the CIDARS. When the outbreak signals generated by the 'mean + 2SD' gold standard were in line with a Px generated outbreak signal for each week during the year of 2014, this Px was then defined as the proper threshold for the infectious disease. Finally, the performance of new selected thresholds for each infectious disease was evaluated by simulated outbreak signals based on 2015 data. Six infectious diseases were selected in this study (chickenpox, mumps, hand foot and mouth diseases (HFMD), scarlet fever, influenza and rubella). Proper thresholds for chickenpox (P75), mumps (P80), influenza (P75), rubella (P45), HFMD (P75), and scarlet fever (P80) were identified. The selected proper thresholds for these

  5. Localizing obstructive sites with dynamic MRI and consequentially proper therapy selection for obstructive sleep apnea/hypopnea syndrome

    International Nuclear Information System (INIS)

    Oda, Makoto

    2004-01-01

    At present, selection of therapies for obstructive sleep apnea/hypopnea syndrome (OSAHS) relies on the localizing the obstructive sites and determination of its severity by polysomnography (PSG). Many methods have been applied to localize the obstructive sites. We attempted to evaluate the morphology of upper airway during sleep with dynamic MRI, and assessed the severity of OSAHS and results of therapies in groups classified by the patterns of obstructive sites. A categorizing system was set up, by which the obstructive sites were reviewed on axial and sagittal sections and accordingly classified into four patterns: front-to-back pattern, left-to-right pattern, circular pattern and epiglottis pattern. Comparison of apnea/hypopnea index (AHI), lowest SpO2 and BMI was performed between the different patterns. The results showed that the left-to-right pattern and circular pattern had a higher AHI and lower lowest SpO2, and more cases of obesity with higher BMI were found in these two groups. We also evaluated the results of different therapies for different obstructive site patterns. Radiofrequency coblation of soft palate was found to be effective for the front-to-back pattern. Improvement was found in 67% of all the cases that received uvulopalatopharyngoplasty (UPPP), while a significant postoperative improvement of AHI was confirmed in left-to-right pattern and circular pattern groups. No significant difference in the results was found between different obstructive sites or patterns when nasal continuous positive airway pressure (n-CPAP) was applied alone. Being completely free from CPAP (completed treatment with improvement of symptoms) was achieved in 71.4% of all the cases and 85.7% in the left-to-right pattern group who received UPPP. We conclude that an optimal treatment results could be achieved by selecting the therapies based on the severity of OSAHS and result of localizing the obstructive sites by dynamic MRI. (author)

  6. Proper use of antibiotics: situation of linezolid at the intensive care unit of the Tunisian Military Hospital.

    Science.gov (United States)

    Safa, Louhichi; Afif, Neffati; Zied, Hajjej; Mehdi, Dridi; Ali, Yousfi Mohamed

    2016-01-01

    Linezolid was introduced in clinical practice in the early 2000s. It was considered to be an ideal reserve drug for treatment of vancomycin-resistant Enterococcus spp. (VRE) and vancomycin-resistant Staphylococcus aureus (VRSA). The aim of our study was to describe and evaluate the use of linezolid in clinical practice at the intensive care unit (ICU) of the Tunisian military hospital. This is a thirty-month retrospective study including patients treated with linezolid at the ICU of the Tunisian military hospital. Data collection was realized using the patients' medical files and prescriptions. A pharmacist conducted an extended medication history and checked if an advice from an infectious disease-physician and a microbiological documentation were requested. A total of 80 patients were included. Forty-one per cent of indications were outside the Marketing Authorization (MA) criteria, and were mainly sepsis and postoperative mediastinitis (32% and 4% of total prescriptions, respectively). This antibiotic was used as a first-line therapy in 58% of cases. The advice from an infectious-disease physician was requested for 33% of prescriptions. Only 20% of infections were documented microbiologically, of which 35% were caused by methicillin resistant coagulase-negative Staphylococcus. Linezolid is an interesting therapeutic alternative in case of infections due to multi-resistant bacteria and/or complex clinical situations. Therefore, its prescription must be rationalized in order to slow down the emergence of resistance to this antibiotic. The high frequency of its use outside the MA criteria shows the importance of carrying out more clinical trials to evaluate its effectiveness and safety for new indications.

  7. Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm

    Science.gov (United States)

    Vaisman, Fernanda; Momesso, Denise; Bulzico, Daniel A.; Pessoa, Cencita H. C. N.; da Cruz, Manuel Domingos Gonçalves; Dias, Fernando; Corbo, Rossana; Vaisman, Mario; Tuttle, R. Michael

    2013-01-01

    Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1%) recurred and 5 had a completion for benign lesions, while 60 patients (86%) continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P < 0.001). Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P = 0.01). After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes. PMID:24455413

  8. Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm

    Directory of Open Access Journals (Sweden)

    Fernanda Vaisman

    2013-01-01

    Full Text Available Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1% recurred and 5 had a completion for benign lesions, while 60 patients (86% continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P<0.001. Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P=0.01. After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes.

  9. PRIMARY HEALTH CARE, SELECTIVE OR COMPREHENSIVE ...

    African Journals Online (AJOL)

    hi-tech

    2003-01-01

    Jan 1, 2003 ... and basic sanitation, health education in prevention and control of prevailing health ... to support introduction of a selective version of PHC in ... Governments and collaborating donor organizations could concentrate the ...

  10. Laminoplasty Does not Lead to Worsening Axial Neck Pain in the Properly Selected Patient With Cervical Myelopathy: A Comparison With Laminectomy and Fusion.

    Science.gov (United States)

    Stephens, Byron F; Rhee, John M; Neustein, Thomas M; Arceo, Rafael

    2017-12-15

    Retrospective cohort study of prospectively collected data. To determine if laminoplasty (LP) is associated with worsening axial neck pain in patients with multilevel cervical myelopathy, and to compare neck pain, clinical outcomes, and radiographic measures in a group undergoing laminectomy and fusion (LF). Postoperative new or worsening axial neck pain is commonly cited as a major disadvantage of laminoplasty. However, there remains a paucity of corroborative data from large series. Following institutional review board approval, we reviewed the medical records, radiographs, and prospective clinical outcomes database of 85 patients undergoing LP and 52 patients undergoing LF for cervical myelopathy with minimum 1-year radiographic follow-up and average clinical follow-up of 18.5 months. LP was performed in those with neutral to lordotic C2-7 alignment and who did not complain of diffuse axial pain. Otherwise, LF was performed. Clinical outcomes included visual analogue score (VAS)-neck pain, VAS-total pain, neck disability index (NDI), short form 36, modified Japanese Orthopaedic Association (mJOA), and several radiographic parameters. VAS-neck did not worsen in LP (-0.2, P = 0.54) and did improve in LF (-2.0, P = 0.0013). VAS-total improved significantly in both groups (LF -1.04 ± 0.52, P = 0.05; LP -1.4 ± 0.51, P = 0.008). NDI improved in both groups, but was significant in only LP (LP decreased 6.79 ± 2.25, P = 0.0032; LF decreased 4.01 ± 3.05, P = 0.19). mJOA scores improved significantly in both groups (LP improved 2.89 ± 0.27, P cervical lordosis in both groups that was significant in LP (LP 2.92° loss, P = 0.0181; LF 1.25° loss, P = 0.53). In a carefully selected group of myelopathic patients without significant diffuse axial pain preoperatively and appropriate sagittal alignment, laminoplasty did not lead to worsening axial neck pain, and it was associated with significant improvements in other

  11. National Survey of Prison Health Care: Selected Findings.

    Science.gov (United States)

    Maruschak, Laura; Chari, Karishma A; Simon, Alan E; DeFrances, Carol J

    2016-07-01

    This report presents selected findings on the provision of health care services in U.S. state prisons. Findings on admissions testing for infectious disease, cardiovascular risk factors, and mental health conditions, as well as the location of the provision of care and utilization of telemedicine are all included. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  12. Use of selective digestive tract decontamination in European intensive cares

    DEFF Research Database (Denmark)

    Reis Miranda, D; Citerio, G; Perner, A

    2015-01-01

    BACKGROUND: Several studies have shown that the use of selective digestive tract decontamination (SDD) reduces mortality. However, fear for increasing multi drug resistance might prevent wide acceptance. A survey was performed among the units registered in the European Registry for Intensive Care...

  13. Characterizations of proper actions

    Science.gov (United States)

    Biller, Harald

    2004-03-01

    Three kinds of proper actions of increasing strength are defined. We prove that the three definitions specialize to the definitions by Bourbaki, by Palais and by Baum, Connes and Higson in their respective settings. The third of these, which thus turns out to be the strongest, originally only concerns actions of second countable locally compact groups on metrizable spaces. In this situation, it is shown to coincide with the other two definitions if the total space locally has the Lindelöf property and the orbit space is regular.

  14. Proper Islamic Consumption

    DEFF Research Database (Denmark)

    Fischer, Johan

    mobile, religiously committed communities to the opportunities and perils presented by modernisation. It also tells us something about the debates concerning the meanings and practices of Islam within an aggressive, globalised, secularised modernity. In Malaysia this is an especially intriguing issue...... spite of a long line of social theory analyzing the spiritual in the economic, and vice versa, very little of the recent increase in scholarship on Islam addresses its relationship with capitalism. Johan Fischer’s book,Proper Islamic Consumption, begins to fill this gap. […] Fischer’s detailed...

  15. Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

    Science.gov (United States)

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

    2015-01-01

    (1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

  16. Price elasticity and pharmaceutical selection: the influence of managed care.

    Science.gov (United States)

    Domino, Marisa Elena; Salkever, David S

    2003-07-01

    State Medicaid programs are turning increasingly to managed care to control expenditures, although the types of managed care programs in use have changed dramatically. Little is known about the influence of the shifting Medicaid managed care arena on treatment decisions. This paper investigates factors affecting the selection of treatments for depression by providers participating in either of two Medicaid managed care programs. Of particular interest is the influence of medication price on the choice of treatment, since one vehicle through which managed care organizations can reduce total expenditures is by increasing the price sensitivity of participating providers. We take a new approach by phrasing the problem as a discrete choice, using a nested multinomial logit model for the analyses. Contrary to earlier literature, we find some evidence that physicians in both programs do take price into consideration when selecting among treatment options. HMO providers in particular demonstrate increased price sensitivity in the two most commonly prescribed categories of antidepressants. Copyright 2002 John Wiley & Sons, Ltd.

  17. Archetypes: the PropeR way

    NARCIS (Netherlands)

    van der Linden, Helma; Grimson, Jane; Tange, Huibert; Talmon, Jan; Hasman, Arie

    2004-01-01

    The PropeR project studies the effect of Decision Support in an Electronic Health Record system (EHR) on the quality of care. One of the applications supports a multidisciplinary primary care team rehabilitating stroke patients in their home environment. This project required an EHR system that

  18. Machine safety: proper safeguarding techniques.

    Science.gov (United States)

    Martin, K J

    1992-06-01

    1. OSHA mandates certain safeguarding of machinery to prevent accidents and protect machine operators. OSHA specifies moving parts that must be guarded and sets criteria for the guards. 2. A 1989 OSHA standard for lockout/tagout requires locking the energy source during maintenance, periodically inspecting for power transmission, and training maintenance workers. 3. In an amputation emergency, first aid for cardiopulmonary resuscitation, shock, and bleeding are the first considerations. The amputated part should be wrapped in moist gauze, placed in a sealed plastic bag, and placed in a container of 50% water and 50% ice for transport. 4. The role of the occupational health nurse in machine safety is to conduct worksite analyses to identify proper safeguarding and to communicate deficiencies to appropriate personnel; to train workers in safe work practices and observe compliance in the use of machine guards; to provide care to workers injured by machines; and to reinforce safe work practices among machine operators.

  19. Selecting, adapting, and sustaining programs in health care systems

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2015-04-01

    Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

  20. Managing the health care solid waste in selected districts of Punjab, Pakistan

    International Nuclear Information System (INIS)

    Ullah, J.H.; Ahmad, K.

    2010-01-01

    Hospital and other health care facilities (HCFs) are known to generate lot of waste for which its management is a matter of considerable public health and environmental concern. The study was undertaken to describe the current practices, gaps and quantify the load of health care solid waste. Out of one hundred and fifty health care facilities (HCFs) in Punjab, the largest province of Pakistan, a sample of fifteen (HCFs) was taken from a few selected Districts, to include six large hospitals and nine without indoor facilities. Only 40% of studied institutions had some program to dispose-off the waste. Even these programs were deficient in many areas and could hardly be considered as scientific. One third of institutional personnel interviewed had proper awareness or existence of a training program. Only one institution had some concept of taking safety steps from infectious materials. The process of solid waste collection, storing, transporting and final disposal was highly inefficient in almost all the institutions. No regulatory body or system of waste was in place in any of the hospitals. There was no allocated budget in 27% of the hospitals for covering the cost of waste disposal. An average of 0.3 kg/bed/day of solid unsafe waste demands a systematic program of its disposal, failing which serious environmental hazards would develop for within and surroundings communities. (author)

  1. Selective mutism: are primary care physicians missing the silence?

    Science.gov (United States)

    Schwartz, Richard H; Freedy, Alicia S; Sheridan, Michael J

    2006-01-01

    To survey parents of children with selective mutism (SM) in regard to (1) the role of the primary care physician in the diagnosis of SM; (2) the social and school consequences of SM; and (3) their opinion of the effectiveness of different treatment modalities, a 39-item written survey was mailed to 27 parents with at least one child diagnosed with SM on the basis of diagnostic and statistical manual IV-text revision (DSM IV-TR) criteria. Twenty-seven parents (100%), with a total of 33 children with SM, completed the survey. There were 24 girls and 9 boys. The mean age when parents had strong concerns about symptoms of SM was 3.8 years, but diagnosis did not occur until nearly a year later. Twenty-three (69.7%) of the children with SM were never diagnosed accurately or referred by their primary care physicians. SM caused important school/social problems for 17 (51.5%) of the children. Speech therapy was provided for 36.4% of children and was thought to have been helpful for 30% of them. Behavior modification was the treatment for 45.5% of children and perceived to be helpful for 66.7% of them. Selective serotonin re-uptake inhibitor pharmacotherapy was prescribed for 17 (51.5%) of the children and believed to be effective for 11 (65%) of them. Primary care physicians in this study rarely diagnosed accurately or referred children with SM in a timely fashion, even though symptoms of the condition were generally very apparent and parents had expressed concern. Behavioral modification, pharmacotherapy with SSRIs, and early intervention are viable treatment options. Early diagnosis is key to preventing long-term effects of this condition.

  2. Adults with Disabilities and Proper Dental Care

    Science.gov (United States)

    Waldman, H. Barry; Perlman, Steven P.; Cinotti, Debra A.

    2009-01-01

    Repeated studies of graduating dental students indicate limited preparation to provide services for individuals with special healthcare needs. By the end of the 1990s and into the present decade, more than half of the U.S. dental schools provided less than five hours of class room presentations and about three quarters of the schools provided 0-5…

  3. Selective decontamination of the digestive tract and selective oropharyngeal decontamination in intensive care unit patients: a cost-effectiveness analysis

    NARCIS (Netherlands)

    Oostdijk, E.A.; Wit, G.A. de; Bakker, M; Smet, A.M. de; Bonten, M.J.; Hoeven, J.G. van der; Pickkers, P.; Sturm, P.D.J.; Voss, A.; et al.,

    2013-01-01

    OBJECTIVE: To determine costs and effects of selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) as compared with standard care (ie, no SDD/SOD (SC)) from a healthcare perspective in Dutch Intensive Care Units (ICUs). DESIGN: A post hoc analysis of a

  4. Selective decontamination of the digestive tract and selective oropharyngeal decontamination in intensive care unit patients : a cost-effectiveness analysis

    NARCIS (Netherlands)

    Oostdijk, Evelien A. N.; de Wit, G. A.; Bakker, Marina; de Smet, Anne-Marie; Bonten, M. J. M.

    2013-01-01

    Objective: To determine costs and effects of selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) as compared with standard care (ie, no SDD/SOD (SC)) from a healthcare perspective in Dutch Intensive Care Units (ICUs). Design: A post hoc analysis of a

  5. Selective mutism: a consensus based care pathway of good practice.

    Science.gov (United States)

    Keen, D V; Fonseca, S; Wintgens, A

    2008-10-01

    Selective mutism (SM) now acknowledged as an anxiety condition, tends to be a poorly understood, highly complex and vastly under-recognised clinical entity. Children with SM are a vulnerable group as the condition is not the remit of any one professional group. This inevitably leads to delay in formal diagnosis and management. There is a lack of systematic research on which to base guidelines for management. To develop, agree and validate key principles underlying the management of SM through a consensus process involving international experts, in order to create a local care pathway. A local multi-agency consultation process developed 11 statements, which were felt to be the key principles underpinning a potential care pathway for managing SM. Thirteen recognised experts from North America, Europe and Australia participated in a modified Delphi process involving two rounds using a Likert-scale and free commentary. Both quantitative and qualitative analyses were used in the validation or revision of the statements at each stage. Response rates were 100% for Round 1 and 84.6% for Round 2. Despite the differing professional backgrounds and service contexts, by successive revision and/or revalidation of statements, it was possible to arrive at a consensus about key principles relating to early recognition, assessment and intervention. The agreed key principles are presented together with the resulting local care pathway. Through a Delphi process, agreement was reached by a multidisciplinary group of professionals, on key principles that underpin the timely identification, assessment and management of children with SM. These include the potential for staff in school/preschool settings to identify SM and that intervention programmes should generally be based in these settings. Children with SM should receive assessment for possible coexisting disorders, whether developmental, emotional or behavioural and additional specific intervention given for these. Agreement was

  6. Selective decline of neurotrophin and neurotrophin receptor genes within CA1 pyramidal neurons and hippocampus proper: Correlation with cognitive performance and neuropathology in mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Ginsberg, Stephen D; Malek-Ahmadi, Michael H; Alldred, Melissa J; Che, Shaoli; Elarova, Irina; Chen, Yinghua; Jeanneteau, Freddy; Kranz, Thorsten M; Chao, Moses V; Counts, Scott E; Mufson, Elliott J

    2017-09-09

    Hippocampal CA1 pyramidal neurons, a major component of the medial temporal lobe memory circuit, are selectively vulnerable during the progression of Alzheimer's disease (AD). The cellular mechanism(s) underlying degeneration of these neurons and the relationship to cognitive performance remains largely undefined. Here, we profiled neurotrophin and neurotrophin receptor gene expression within microdissected CA1 neurons along with regional hippocampal dissections from subjects who died with a clinical diagnosis of no cognitive impairment (NCI), mild cognitive impairment (MCI), or AD using laser capture microdissection (LCM), custom-designed microarray analysis, and qPCR of CA1 subregional dissections. Gene expression levels were correlated with cognitive test scores and AD neuropathology criteria. We found a significant downregulation of several neurotrophin genes (e.g., Gdnf, Ngfb, and Ntf4) in CA1 pyramidal neurons in MCI compared to NCI and AD subjects. In addition, the neurotrophin receptor transcripts TrkB and TrkC were decreased in MCI and AD compared to NCI. Regional hippocampal dissections also revealed select neurotrophic gene dysfunction providing evidence for vulnerability within the hippocampus proper during the progression of dementia. Downregulation of several neurotrophins of the NGF family and cognate neurotrophin receptor (TrkA, TrkB, and TrkC) genes correlated with antemortem cognitive measures including the Mini-Mental State Exam (MMSE), a composite global cognitive score (GCS), and Episodic, Semantic, and Working Memory, Perceptual Speed, and Visuospatial domains. Significant correlations were found between select neurotrophic expression downregulation and neuritic plaques (NPs) and neurofibrillary tangles (NFTs), but not diffuse plaques (DPs). These data suggest that dysfunction of neurotrophin signaling complexes have profound negative sequelae within vulnerable hippocampal cell types, which play a role in mnemonic and executive dysfunction

  7. Larmor time and proper time

    Energy Technology Data Exchange (ETDEWEB)

    Kudaka, Shoju [Department of Physics, University of the Ryukyus, Okinawa 903-0129 (Japan); Matsumoto, Shuichi, E-mail: shuichi@edu.u-ryukyu.ac.jp [Department of Mathematics, University of the Ryukyus, Okinawa 903-0129 (Japan)

    2012-10-01

    The idea of a Larmor clock is reexamined in the relativistic regime. We propose a concept of proper time for quantum theoretical particles. The Larmor clock can measure, under some relevant conditions, the proper time that passes while the particle stays in a space region. Our approach to Larmor clock is different than those of other researchers in the following two aspects: our concept of Larmor clock does not distinguish whether the particle is transmitted or reflected at the end of its stay, and pointer of our Larmor clock is not the spin but the total angular momentum. -- Highlights: ► The idea of a Larmor clock is reexamined in the relativistic regime. ► We propose a concept of proper time for quantum theoretical particles. ► The Larmor clock measures the passage of this quantum theoretical proper time.

  8. TOWARDS PROPER CULTURAL RESOURCE MANAGEMENT ...

    African Journals Online (AJOL)

    GRACE

    proper harnessing and management of cultural resources in Nigeria for sustainable development .... and knowledge) to organize the resources available to man with the aim of optimizing their use in the ... needs‖ (World Bank 1992). Thus, as ...

  9. Readmissions for Selected Infections Due to Medical Care: Expanding the Definition of a Patient Safety Indicator

    National Research Council Canada - National Science Library

    Gallagher, Brian; Cen, Liyi; Hannan, Edward L

    2005-01-01

    Objective: Evaluate the Agency for Healthcare Research and Quality's Patient Safety Indicator that identifies patients with selected infections that result from medical care during hospital inpatient treatment...

  10. Properly colored connectivity of graphs

    CERN Document Server

    Li, Xueliang; Qin, Zhongmei

    2018-01-01

    A comprehensive survey of proper connection of graphs is discussed in this book with real world applications in computer science and network security. Beginning with a brief introduction, comprising relevant definitions and preliminary results, this book moves on to consider a variety of properties of graphs that imply bounds on the proper connection number. Detailed proofs of significant advancements toward open problems and conjectures are presented with complete references. Researchers and graduate students with an interest in graph connectivity and colorings will find this book useful as it builds upon fundamental definitions towards modern innovations, strategies, and techniques. The detailed presentation lends to use as an introduction to proper connection of graphs for new and advanced researchers, a solid book for a graduate level topics course, or as a reference for those interested in expanding and further developing research in the area.

  11. Factors associated with late antenatal care attendance in selected ...

    African Journals Online (AJOL)

    Background: Despite antenatal care services being provided free of charge or sometimes at a minimal cost in Zambia, only 19% of women attend antenatal care by their fourth month of pregnancy, as recommended by World Health Organization (WHO). An estimated 21% of pregnant women in urban and 18% in rural ...

  12. Shaping the future medical workforce: take care with selection tools.

    Science.gov (United States)

    Poole, Phillippa; Shulruf, Boaz

    2013-12-01

    Medical school selection is a first step in developing a general practice workforce. To determine the relationship between medical school selection scores and intention to pursue a career in general practice. A longitudinal cohort study of students selected in 2006 and 2007 for The University of Auckland medical programme, who completed an exit survey on career intentions. Students are ranked for selection into year 2 of a six-year programme by combining grade point average from prior university achievement (60%), interview (25%) and Undergraduate Medicine and Health Sciences Admission Test (UMAT) scores (15%). The main outcome measure was level of interest in general practice at exit. Logistic regression assessed whether any demographic variables or admission scores predicted a 'strong' interest in general practice. None of interview scores, grade point average, age, gender, or entry pathway predicted a 'strong' interest in general practice. Only UMAT scores differentiated between those with a 'strong' interest versus those with 'some' or 'no' interest, but in an inverse fashion. The best predictor of a 'strong' interest in general practice was a low UMAT score of between 45 and 55 on all three UMAT sections (OR 3.37, p=0.020). Yet, the academic scores at entry of students with these UMAT scores were not lower than those of their classmates. Setting inappropriately high cut-points for medical school selection may exclude applicants with a propensity for general practice. These findings support the use of a wider lens through which to view medical school selection tools.

  13. Proper motion survey for solar nearby stars

    International Nuclear Information System (INIS)

    Goldman, Bertrand

    2001-01-01

    For its microlensing observations EROS 2 built one of the largest CCD mosaic opera ting since 1996. This instrument allowed us to survey a large area of the sky, to look for faint, cool compact objects in the Solar neighborhood that may contribute to the Dark Matter revealed by flat rotation curves of spiral galaxies and the Milky Way. We imaged over 400 square degrees, at least three times over four years, with a single, stable instrument. The aim of this work is the reduction, the analysis and the detection of high proper motion objects that would look like those expected in a dark halo. We selected and analyzed thousands of images taken in two bands, visible and near-infrared, and obtained a catalogue of several thousand stars with proper motion typically higher than 80 milli-arc-seconds per year. None of these candidates displays the expected properties of the halo objects: very high proper motion and faintness. The second part of our work was to put constraints on the contributions of white dwarfs and brown dwarfs ta the halo. To do that, we simulated our data set and estimated our sensitivity to halo objects. We compared our results about moderately high proper motion stars with existing Galactic models, and confirmed the robustness of these models. We deduced a upper limit ta the contribution of M_v = 17.5 white dwarfs to the standard halo of 10% (at the 95% confidence level), or 5% of a 14 Gyr old halo, and to the contribution of brown dwarfs of 7% (95% C.L.). Finally, among our candidates, several interesting objects, that do not belong to the halo but are among the coolest and faintest known, have been discovered. Systematic search for faint, nearby objects thus lead us to study disk L dwarfs, as well as old white dwarfs of the disk. (author) [fr

  14. Obstacles to HIV prevention, treatment and care in selected public ...

    African Journals Online (AJOL)

    South Africa, like the rest of Southern Africa, is ravaged by AIDS. Higher education in South Africa has a significant role to play in the fight against the spread of HIV and AIDS. This article reports the factors contributing to the spread of HIV and AIDS in three selected public universities in South Africa. To achieve the stated ...

  15. Decontamination of cephalosporin-resistant Enterobacteriaceae during selective digestive tract decontamination in intensive care units

    NARCIS (Netherlands)

    Oostdijk, E.A.; Smet, A.M. de; Kesecioglu, J.; Bonten, M.J.; Hoeven, J.G. van der; Pickkers, P.; Sturm, P.D.; Voss, A.; et al.,

    2012-01-01

    OBJECTIVES: Prevalences of cephalosporin-resistant Enterobacteriaceae are increasing globally, especially in intensive care units (ICUs). The effect of selective digestive tract decontamination (SDD) on the eradication of cephalosporin-resistant Enterobacteriaceae from the intestinal tract is

  16. Decontamination of cephalosporin-resistant Enterobacteriaceae during selective digestive tract decontamination in intensive care units

    NARCIS (Netherlands)

    Oostdijk, Evelien A. N.; de Smet, Anne Marie G. A.; Kesecioglu, Jozef; Bonten, Marc J. M.

    Prevalences of cephalosporin-resistant Enterobacteriaceae are increasing globally, especially in intensive care units (ICUs). The effect of selective digestive tract decontamination (SDD) on the eradication of cephalosporin-resistant Enterobacteriaceae from the intestinal tract is unknown. We

  17. Transforming Health Care Service Delivery and Provider Selection

    OpenAIRE

    Reiner, Bruce I.

    2011-01-01

    Commoditization pressures in medicine have risked transforming service provider selection from “survival of the fittest” to “survival of the cheapest.” Quality- and safety-oriented mandates by the Institute of Medicine have led to the creation of a number of data-driven quality-centric initiatives including Pay for Performance and Evidence-Based Medicine. A synergistic approach to creating quantitative accountability in medical service delivery is through the creation of consumer-oriented per...

  18. The use of the waiting list in a fair selection of patients for nursing home care

    NARCIS (Netherlands)

    Meiland, F. J.; Danse, J. A.; Hoos, A. M.; Wendte, J. F.; Gunning-Schepers, L. J.

    1996-01-01

    When health care resources are scarce, waiting lists may be used as a distribution measure in order to enhance the fair allocation of resources through selection of patients. In this study, the structure and use of a waiting list for a fair selection of patients for nursing home admission was

  19. Defense Health Care: DOD Lacks Assurance That Selected Reserve Members Are Informed about TRICARE Reserve Select

    Science.gov (United States)

    2011-06-01

    percentages include members of the Selected Reserve and their dependents. Selected Reserve members living overseas, in unknown locations, and in Puerto Rico ...8 Diabetes mellitush 1.7 Asthmai 1.8 9 Adjustment reaction 1.7 Acute upper respiratory infections of multiple or unspecified sites 1.6 10 Special...heterogeneous disorders that have an increase in blood glucose concentrations. The current classifications for diabetes mellitus Types 1 through 4

  20. Employer Satisfaction With an Injured Employee's Health Care: How Does It Affect the Selection of an Occupational Health Care Provider?

    Science.gov (United States)

    Keleher, Myra P; Stanton, Marietta P

    2016-01-01

    The purpose of this article is to explore the most important factors that an employer utilizes in selecting an occupational health care provider for their employees injured on the job. The primary practice setting is the attending physician's office who is an occupational health care provider. The responding employers deemed "work restrictions given after each office visit" as their most important factor in selecting an occupational health care provider, with a score of 43. This was followed in order in the "very important" category by communication, appointment availability, employee return to work within nationally recognized guidelines, tied were medical provider professionalism and courtesy with diagnostics ordered timely, next was staff professionalism and courtesy, and tied with 20 responses in the "very important" category were wait time and accurate billing by the provider.The selection of an occupational health care provider in the realm of workers' compensation plays a monumental role in the life of a claim for the employer. Safe and timely return to work is in the best interest of the employer and their injured employee. For the employer, it can represent hard dollars saved in indemnity payments and insurance premiums when the employee can return to some form of work. For the injured employee, it can have a positive impact on their attitude of going back to work as they will feel they are a valued asset to their employer. The case managers, who are the "eyes and ears" for the employer in the field of workers' compensation, have a valuable role in a successful outcome of dollars saved and appropriate care rendered for the employees' on the job injury. The employers in the study were looking for case managers who could ensure their employees received quality care but that this care is cost-effective. The case manager can be instrumental in assisting the employer in developing and monitoring a "stay-at-work" program, thereby reducing the financial exposure

  1. Proper alignment of the microscope.

    Science.gov (United States)

    Rottenfusser, Rudi

    2013-01-01

    The light microscope is merely the first element of an imaging system in a research facility. Such a system may include high-speed and/or high-resolution image acquisition capabilities, confocal technologies, and super-resolution methods of various types. Yet more than ever, the proverb "garbage in-garbage out" remains a fact. Image manipulations may be used to conceal a suboptimal microscope setup, but an artifact-free image can only be obtained when the microscope is optimally aligned, both mechanically and optically. Something else is often overlooked in the quest to get the best image out of the microscope: Proper sample preparation! The microscope optics can only do its job when its design criteria are matched to the specimen or vice versa. The specimen itself, the mounting medium, the cover slip, and the type of immersion medium (if applicable) are all part of the total optical makeup. To get the best results out of a microscope, understanding the functions of all of its variable components is important. Only then one knows how to optimize these components for the intended application. Different approaches might be chosen to discuss all of the microscope's components. We decided to follow the light path which starts with the light source and ends at the camera or the eyepieces. To add more transparency to this sequence, the section up to the microscope stage was called the "Illuminating Section", to be followed by the "Imaging Section" which starts with the microscope objective. After understanding the various components, we can start "working with the microscope." To get the best resolution and contrast from the microscope, the practice of "Koehler Illumination" should be understood and followed by every serious microscopist. Step-by-step instructions as well as illustrations of the beam path in an upright and inverted microscope are included in this chapter. A few practical considerations are listed in Section 3. Copyright © 2013 Elsevier Inc. All rights

  2. Assigned value improves memory of proper names.

    Science.gov (United States)

    Festini, Sara B; Hartley, Alan A; Tauber, Sarah K; Rhodes, Matthew G

    2013-01-01

    Names are more difficult to remember than other personal information such as occupations. The current research examined the influence of assigned point value on memory and metamemory judgements for names and occupations to determine whether incentive can improve recall of proper names. In Experiment 1 participants studied face-name and face-occupation pairs assigned 1 or 10 points, made judgements of learning, and were given a cued recall test. High-value names were recalled more often than low-value names. However, recall of occupations was not influenced by value. In Experiment 2 meaningless nonwords were used for both names and occupations. The name difficulty disappeared, and value influenced recall of both names and occupations. Thus value similarly influenced names and occupations when meaningfulness was held constant. In Experiment 3 participants were required to use overt rote rehearsal for all items. Value did not boost recall of high-value names, suggesting that differential processing could not be implemented to improve memory. Thus incentives may improve memory for proper names by motivating people to engage in selective rehearsal and effortful elaborative processing.

  3. Selective digestive tract decontamination and selective oropharyngeal decontamination and antibiotic resistance in patients in intensive-care units: an open-label, clustered group-randomised, crossover study

    NARCIS (Netherlands)

    Smet, A.M. de; Kluytmans, J.A.; Blok, H.E.; Mascini, E.M.; Benus, R.F.; Bernards, A.T.; Kuijper, E.J.; Leverstein-van Hall, M.A.; Jansz, A.R.; Jongh, B.M. de; Asselt, G.J. van; Frenay, I.H.; Thijsen, S.F.; Conijn, S.N.; Kaan, J.A.; Arends, J.P.; Sturm, P.D.J.; Bootsma, M.C.; Bonten, M.J.

    2011-01-01

    BACKGROUND: Previously, we assessed selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) on survival and prevention of bacteraemia in patients in intensive-care units. In this analysis, we aimed to assess effectiveness of these interventions for

  4. Selective digestive tract decontamination and selective oropharyngeal decontamination and antibiotic resistance in patients in intensive-care units : an open-label, clustered group-randomised, crossover study

    NARCIS (Netherlands)

    de Smet, Anne Marie G. A.; Kluytmans, Jan A. J. W.; Blok, Hetty E. M.; Mascini, Ellen M.; Benus, Robin F. J.; Bernards, Alexandra T.; Kuijper, Ed J.; Leverstein-van Hall, Maurine A.; Jansz, Arjan R.; de Jongh, Bartelt M.; van Asselt, Gerard J.; Frenay, Ine H. M. E.; Thijsen, Steven F. T.; Conijn, Simon N. M.; Kaan, Jan A.; Arends, Jan P.; Sturm, Patrick D. J.; Bootsma, Martin C. J.; Bonten, Marc J. M.

    Background Previously, we assessed selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) on survival and prevention of bacteraemia in patients in intensive-care units. In this analysis, we aimed to assess effectiveness of these interventions for prevention

  5. Sex differences in parental care: Gametic investment, sexual selection, and social environment.

    Science.gov (United States)

    Liker, András; Freckleton, Robert P; Remeš, Vladimir; Székely, Tamás

    2015-11-01

    Male and female parents often provide different type and amount of care to their offspring. Three major drivers have been proposed to explain parental sex roles: (1) differential gametic investment by males and females that precipitates into sex difference in care, (2) different intensity of sexual selection acting on males and females, and (3) biased social environment that facilitates the more common sex to provide more care. Here, we provide the most comprehensive assessment of these hypotheses using detailed parental care data from 792 bird species covering 126 families. We found no evidence for the gametic investment hypothesis: neither gamete sizes nor gamete production by males relative to females was related to sex difference in parental care. However, sexual selection correlated with parental sex roles, because the male share in care relative to female decreased with both extra-pair paternity and frequency of male polygamy. Parental sex roles were also related to social environment, because male parental care increased with male-biased adult sex ratios (ASRs). Taken together, our results are consistent with recent theories suggesting that gametic investment is not tied to parental sex roles, and highlight the importance of both sexual selection and ASR in influencing parental sex roles. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

  6. Cataclysmic variables in the SUPERBLINK proper motion survey

    Energy Technology Data Exchange (ETDEWEB)

    Skinner, Julie N.; Thorstensen, John R. [Department of Physics and Astronomy, 6127 Wilder Laboratory, Dartmouth College, Hanover, NH 03755-3528 (United States); Lépine, Sébastien, E-mail: jns@dartmouth.edu [Department of Physics and Astronomy, Georgia State University, 25 Park Place NE, Atlanta, GA 30303 (United States)

    2014-12-01

    We have discovered a new high proper motion cataclysmic variable (CV) in the SUPERBLINK proper motion survey, which is sensitive to stars with proper motions greater than 40 mas yr{sup −1}. This CV was selected for follow-up observations as part of a larger search for CVs selected based on proper motions and their near-UV−V and V−K{sub s} colors. We present spectroscopic observations from the 2.4 m Hiltner Telescope at MDM Observatory. The new CV's orbital period is near 96 minutes, its spectrum shows the double-peaked Balmer emission lines characteristic of quiescent dwarf novae, and its V magnitude is near 18.2. Additionally, we present a full list of known CVs in the SUPERBLINK catalog.

  7. Feeling-of-knowing for proper names.

    Science.gov (United States)

    Izaute, Marie; Chambres, Patrick; Larochelle, Serge

    2002-12-01

    The main objective of the presented study was to study feeling-of-knowing (FOK) in proper name retrieval. Many studies show that FOK can predict performance on a subsequent criterion test. Although feeling-of-knowing studies involve questions about proper names, none make this distinction between proper names and common names. Nevertheless, the specific character of proper names as a unique label referring to a person should allow participants to target precisely the desired verbal label. Our idea here was that the unique character of proper name information should result in more accurate FOK evaluations. In the experiment, participants evaluated feeling-of-knowing for proper and common name descriptions. The study demonstrates that FOK judgments are more accurate for proper names than for common names. The implications of the findings for proper names are briefly discussed in terms of feeling-of-knowing hypotheses.

  8. 7 CFR 29.112 - Proper light.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Proper light. 29.112 Section 29.112 Agriculture... INSPECTION Regulations Inspectors, Samplers, and Weighers § 29.112 Proper light. Tobacco shall not be inspected or sampled for the purposes of the Act except when displayed in proper light for correct...

  9. Towards proper name generation : A corpus analysis

    NARCIS (Netherlands)

    Castro Ferreira, Thiago; Wubben, Sander; Krahmer, Emiel

    We introduce a corpus for the study of proper name generation. The corpus consists of proper name references to people in webpages, extracted from the Wikilinks corpus. In our analyses, we aim to identify the different ways, in terms of length and form, in which a proper names are produced

  10. Selected problems associated with the treatment and care for patients with colostomy – part 2

    Science.gov (United States)

    Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care. PMID:24596509

  11. Selected problems associated with the treatment and care for patients with colostomy - part 2.

    Science.gov (United States)

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care.

  12. Contents of polyethylene microplastic in some selected personal care products in Denmark

    DEFF Research Database (Denmark)

    Strand, Jakob

    Some personal care products include primary microplastic particles as particulate material, which may not be efficiently removed in WWTPs and therefore they will probably end up in aquatic environments. Microplastics in personal care products were focus in a prime time program DR Kontant...... on national TV - April 30, 2013. For this program Aarhus University contributed with analyses of microplastic particles (>40 μm) in some selected products and in the field. The results for microplastic contents in the nine analysed personal care products are presented here....

  13. Nonmaternal Care's Association With Mother's Parenting Sensitivity: A Case of Self-Selection Bias?

    Science.gov (United States)

    Nomaguchi, Kei M; Demaris, Alfred

    2013-06-01

    Although attachment theory posits that the use of nonmaternal care undermines quality of mothers' parenting, empirical evidence for this link is inconclusive. Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development ( N = 1,233), the authors examined the associations between nonmaternal care characteristics and maternal sensitivity during the first 3 years of children's lives, with special attention to selection effects and moderation by resource levels. Findings from fixed-effects regression models suggested that, on average, there is little relationship between nonmaternal care characteristics and maternal sensitivity, once selection factors are held constant. Some evidence of moderation effects was found, however. Excellent-quality care is related to more sensitivity for mothers with lower family income. Poor-quality care is related to lower sensitivity for single mothers, but not partnered mothers. In sum, nonmaternal care characteristics do not seem to have as much influence on mothers' parenting as attachment theory claims.

  14. PropeR: a multi disciplinary EPR system

    NARCIS (Netherlands)

    van der Linden, Helma; Boers, Gerrit; Tange, Huibert; Talmon, Jan; Hasman, Arie

    2003-01-01

    This article describes the architecture of an EPR system developed for the PropeR project. This EPR system not only aims at supporting home care of stroke patients, but is also designed in such a way that it can be ported to other medical services without much effort. We will briefly describe the

  15. Analysing the Costs of Integrated Care: A Case on Model Selection for Chronic Care Purposes

    Directory of Open Access Journals (Sweden)

    Marc Carreras

    2016-08-01

    Full Text Available Background: The objective of this study is to investigate whether the algorithm proposed by Manning and Mullahy, a consolidated health economics procedure, can also be used to estimate individual costs for different groups of healthcare services in the context of integrated care. Methods: A cross-sectional study focused on the population of the Baix Empordà (Catalonia-Spain for the year 2012 (N = 92,498 individuals. A set of individual cost models as a function of sex, age and morbidity burden were adjusted and individual healthcare costs were calculated using a retrospective full-costing system. The individual morbidity burden was inferred using the Clinical Risk Groups (CRG patient classification system. Results: Depending on the characteristics of the data, and according to the algorithm criteria, the choice of model was a linear model on the log of costs or a generalized linear model with a log link. We checked for goodness of fit, accuracy, linear structure and heteroscedasticity for the models obtained. Conclusion: The proposed algorithm identified a set of suitable cost models for the distinct groups of services integrated care entails. The individual morbidity burden was found to be indispensable when allocating appropriate resources to targeted individuals.

  16. Selective digestive decontamination in patients in intensive care. The Dutch Working Group on Antibiotic Policy

    NARCIS (Netherlands)

    Bonten, M. J.; Kullberg, B. J.; van Dalen, R.; Girbes, A. R.; Hoepelman, I. M.; Hustinx, W.; van der Meer, J. W.; Speelman, P.; Stobberingh, E. E.; Verbrugh, H. A.; Verhoef, J.; Zwaveling, J. H.

    2000-01-01

    Selective digestive decontamination (SDD) is the most extensively studied method for the prevention of infection in patients in intensive care units (ICUs). Despite 27 prospective randomized studies and six meta-analyses, routine use of SDD is still controversial. In this review, we summarize the

  17. Sexual minorities and selection of a primary care physician in a midwestern U.S. city.

    Science.gov (United States)

    Labig, Chalmer E; Peterson, Tim O

    2006-01-01

    How and why sexual minorities select a primary care physician is critical to the development of methods for attracting these clients to a physician's practice. Data obtained from a sample of sexual minorities in a mid-size city in our nation's heartland would indicate that these patients are loyal when the primary care physician has a positive attitude toward their sexual orientation. The data also confirms that most sexual minorities select same sex physicians but not necessarily same sexual orientation physicians because of lack of knowledge of physicians' sexual orientation. Family practice physicians and other primary care physicians can reach out to this population by encouraging word of mouth advertising and by displaying literature on health issues for all sexual orientations in their offices.

  18. Analysis of the evidence-practice gap to facilitate proper medical care for the elderly: investigation, using databases, of utilization measures for National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).

    Science.gov (United States)

    Nakayama, Takeo; Imanaka, Yuichi; Okuno, Yasushi; Kato, Genta; Kuroda, Tomohiro; Goto, Rei; Tanaka, Shiro; Tamura, Hiroshi; Fukuhara, Shunichi; Fukuma, Shingo; Muto, Manabu; Yanagita, Motoko; Yamamoto, Yosuke

    2017-06-06

    As Japan becomes a super-aging society, presentation of the best ways to provide medical care for the elderly, and the direction of that care, are important national issues. Elderly people have multi-morbidity with numerous medical conditions and use many medical resources for complex treatment patterns. This increases the likelihood of inappropriate medical practices and an evidence-practice gap. The present study aimed to: derive findings that are applicable to policy from an elucidation of the actual state of medical care for the elderly; establish a foundation for the utilization of National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), and present measures for the utilization of existing databases in parallel with NDB validation.Cross-sectional and retrospective cohort studies were conducted using the NDB built by the Ministry of Health, Labor and Welfare of Japan, private health insurance claims databases, and the Kyoto University Hospital database (including related hospitals). Medical practices (drug prescription, interventional procedures, testing) related to four issues-potential inappropriate medication, cancer therapy, chronic kidney disease treatment, and end-of-life care-will be described. The relationships between these issues and clinical outcomes (death, initiation of dialysis and other adverse events) will be evaluated, if possible.

  19. Selective decontamination of the digestive tract and selective oropharyngeal decontamination in intensive care unit patients: a cost-effectiveness analysis.

    Science.gov (United States)

    Oostdijk, Evelien A N; de Wit, G A; Bakker, Marina; de Smet, Anne Marie G A; Bonten, M J M

    2013-03-05

    To determine costs and effects of selective digestive tract decontamination (SDD) and selective oropharyngeal decontamination (SOD) as compared with standard care (ie, no SDD/SOD (SC)) from a healthcare perspective in Dutch Intensive Care Units (ICUs). A post hoc analysis of a previously performed cluster-randomised trial (NEJM 2009;360:20). 13 Dutch ICUs. Patients with ICU-stay of >48 h that received SDD (n=2045), SOD (n=1904) or SC (n=1990). SDD or SOD. Effects were based on hospital survival, expressed as crude Life Years Gained (cLYG). The incremental cost-effectiveness ratio (ICER) was calculated, with corresponding cost acceptability curves. Sensitivity analyses were performed for discount rates, costs of SDD, SOD and mechanical ventilation. Total costs per patient were €41 941 for SC (95% CI €40 184 to €43 698), €40 433 for SOD (95% CI €38 838 to €42 029) and €41 183 for SOD (95% CI €39 408 to €42 958). SOD and SDD resulted in crude LYG of +0.04 and +0.25, respectively, as compared with SC, implying that both SDD and SOD are dominant (ie, cheaper and more beneficial) over SC. In cost-effectiveness acceptability curves probabilities for cost-effectiveness, compared with standard care, ranged from 89% to 93% for SOD and from 63% to 72% for SDD, for acceptable costs for 1 LYG ranging from €0 to €20 000. Sensitivity analysis for mechanical ventilation and discount rates did not change interpretation. Yet, if costs of the topical component of SDD and SOD would increase 40-fold to €400/day and €40/day (maximum values based on free market prices in 2012), the estimated ICER as compared with SC for SDD would be €21 590 per LYG. SOD would remain cost-saving. SDD and SOD were both effective and cost-saving in Dutch ICUs.

  20. Dashboard report on performance on select quality indicators to cancer care providers.

    Science.gov (United States)

    Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats

    2016-01-01

    Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.

  1. Selection Behavior in the Market for Private Complementary Long-term Care Insurance in Germany

    DEFF Research Database (Denmark)

    Bauer, Jan; Schiller, Jörg; Schreckenberger, Christopher

    is dominating in this market, with respect to both the decision to buy a CompLTCI policy and the decision about the extent of CompLTCI coverage. We identify occupational status, residential location and the holding of further supplementary health insurance policies as unused observables contributing...... to selection effects in this market. Our results suggest that non-linearitiesin the relationship of potential sources of selection to insurance coverage and risk should be considered. A panel data analysis shows that an increase in health insurance payouts is positively correlated with the uptake of Comp......In this paper, we analyze selection effects in the German market for private complementary longterm care insurance contracts (CompLTCI) within a static and dynamic framework. Using data on more than 98,000 individuals from a German insurance company, we provide evidence that advantageous selection...

  2. Large proper motions in the Orion nebula

    International Nuclear Information System (INIS)

    Cudworth, K.M.; Stone, R.C.

    1977-01-01

    Several nebular features, as well as one faint star, with large proper motions were identified within the Orion nebula. The measured proper motions correspond to tangential velocities of up to approximately 70 km sec -1 . One new probable variable star was also found

  3. Proper motions and distances of quasars

    International Nuclear Information System (INIS)

    Varshni, Y.P.

    1982-01-01

    The author's theory that quasars are stars raises the question of their proper motions. From the evidence presented in a previous paper, it is hypothesised that planetary nuclei and quasars are related objects and that their distributions in the galaxy are not very different. Proper motions of 30 quasars, calculated from existing measurements, are discussed. It is shown that three of these, namely PHL 1033, LB 8956 and LB 8991, have proper motions comparable to the largest proper motion known amongst the planetary nuclei. From this it is estimated that these three quasars lie within a few hundred parsecs from the sun. The evidence presented in a previous paper and the present one clearly supports the theory that quasars are stars. The possibility of using the interstellar K and H lines as distance indicators of quasars is discussed and the available evidence summarised. The desirability of determining more accurate values of the proper motions of quasars is emphasised. (Auth.)

  4. KINERJA PENGELOLAAN LIMBAH HOTEL PESERTA PROPER DAN NON PROPER DI KABUPATEN BADUNG, PROVINSI BALI

    Directory of Open Access Journals (Sweden)

    Putri Nilakandi Perdanawati Pitoyo

    2016-07-01

    Full Text Available Bali tourism development can lead to positive and negative impacts that threatening environmental sustainability. This research evaluates the hotel performance of the waste management that includes management of waste water, emission, hazardous, and solid waste by hotel that participate at PROPER and non PROPER. Research using qualitative descriptive method. Not all of non PROPER doing test on waste water quality, chimney emissions quality, an inventory of hazardous waste and solid waste sorting. Wastewater discharge of PROPER hotels ranged from 290.9 to 571.8 m3/day and non PROPER ranged from 8.4 to 98.1 m3/day with NH3 parameter values that exceed the quality standards. The quality of chimney emissions were still below the quality standard. The volume of the hazardous waste of PROPER hotels ranged from 66.1 to 181.9 kg/month and non PROPER ranged from 5.003 to 103.42 kg/month. Hazardous waste from the PROPER hotel which has been stored in the TPS hazardous waste. The volume of the solid waste of PROPER hotel ranged from 342.34 to 684.54 kg/day and non PROPER ranged from 4.83 to 181.51 kg/day. The PROPER and non PROPER hotel not sort the solid waste. The hotel performance in term of wastewater management, emission, hazardous, and solid waste is better at the PROPER hotel compared to non PROPER participants.

  5. The secret bread tests: selective primary health care or experimentation on human-beings?

    Science.gov (United States)

    Kamien, M

    1987-01-01

    This is a case history which describes an attempt to fortify the bread of Australian Aborigines in an isolated area of New South Wales. The medically successful intervention was accomplished by the publication of scientific enquiry and by attention to the culture of Aborigines. Paradoxically the long-term failure of the project was also due to the power of the written word and the neglect of the culture of the more densely populated and politically dominant white community. The need for doctors to be aware of the different approaches of primary health care and selective primary health care is stressed so that a general practitioner who provides health care for minority groups of the Fourth World can better define his role and relevance.

  6. Thallium-201 myocardial imaging as a selection method for the coronary care unit

    International Nuclear Information System (INIS)

    Wackers, F.J.Th.; Lie, K.I.; Sokole, E.B.; Samson, G.; Schoot, J.B. van der

    1980-01-01

    In many patients admitted to the coronary care unit, the diagnosis of acute myocardial infarction is evident at the time of arrival at the hospital. Nevertheless, a substantial group of patients still remains in whom initial evaluation provides a questionable history and a nondiagnostic electrocardiogram. Results suggested that 201 Tl scintigraphy may have potential value to serve as an appropriate means of selecting patients for admission to the coronary care unit. In order to evaluate this possibility, the authors performed a prospective study from September 1975 to September 1976. During this period 1861 patients were refered to the coronary care unit because of presumed acute myocardial infarction. The study concludes that for patients in whom the history and the electrocardiogram are of little help in decision making, thallium-201 scintigraphy can be viewed as an additional and important diagnostic method, which improves efficient management of patients with potential coronary artery disease syndrome. (Auth.)

  7. Selected aspects of nursing care for an elderly patient with chronic obstructive pulmonary disease

    OpenAIRE

    Budnik, Marta; Galikowska, Anna; Marzec, Izabela; Balcerak, Dominika; Kobus, Edyta; Posieczek, Zuzanna

    2017-01-01

    Budnik Marta, Galikowska Anna, Marzec Izabela, Balcerak Dominika, Kobus Edyta, Posieczek Zuzanna. Selected aspects of nursing care for an elderly patient with chronic obstructive pulmonary disease. Journal of Education, Health and Sport. 2017;7(6):34-44. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.802926 http://ojs.ukw.edu.pl/index.php/johs/article/view/4501 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation...

  8. Selected problems associated with the treatment and care for patients with colostomy – part 2

    OpenAIRE

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and maste...

  9. FACTORS THAT INFLUENCE THE SELECTION OF LEARNING OPPORTUNITIES FOR STUDENT NURSES IN PRIMARY HEALTH CARE

    Directory of Open Access Journals (Sweden)

    H. lita

    2002-11-01

    The study therefore focused on the following objective: To identify the factors that influence the selection of learning opportunities for primary health care in hospital units. A qualitative research design utilising focus group discussions were used. The population consisted of conveniently selected lecturers, student nurses and registered nurses. The same initial question was asked in each focus group to initiate the discussions. The data were analysed according to Tesch's method. The results indicated that there is positive commitment from the lecturers and registered nurses to be involved in selecting appropriate learning opportunities. The student nurses also demonstrated a willingness to learn and to be exposed to learning opportunities in primary health care. There were however certain constraints that emerged as themes, namely: • Managerial constraints • Educational constraints Under the theme "managerial constraints" categories such as workload, nursing staff shortages and communication problems were identified. Under the theme "educational constraints" categories such as a lack of guidance, and the correlation of theory and practice emerged. Recommendations based on this research report include improvement of in-service education on managerial and educational aspects to facilitate the primary health care approach in hospitals.

  10. Selection of a cardiac surgery provider in the managed care era.

    Science.gov (United States)

    Shahian, D M; Yip, W; Westcott, G; Jacobson, J

    2000-11-01

    Many health planners promote the use of competition to contain cost and improve quality of care. Using a standard econometric model, we examined the evidence for "value-based" cardiac surgery provider selection in eastern Massachusetts, where there is significant competition and managed care penetration. McFadden's conditional logit model was used to study cardiac surgery provider selection among 6952 patients and eight metropolitan Boston hospitals in 1997. Hospital predictor variables included beds, cardiac surgery case volume, objective clinical and financial performance, reputation (percent out-of-state referrals, cardiac residency program), distance from patient's home to hospital, and historical referral patterns. Subgroup analyses were performed for each major payer category. Distance from patient's home to hospital (odds ratio 0.90; P =.000) and the historical referral pattern from each patient's hometown (z = 45.305; P =.000) were important predictors in all models. A cardiac surgery residency enhanced the probability of selection (odds ratio 5.25; P =.000), as did percent out-of-state referrals (odds ratio 1.10; P =.001). Higher mortality rates were associated with decreased probability of selection (odds ratio 0.51; P =.027), but higher length of stay was paradoxically associated with greater probability (odds ratio 1.72; P =.000). Total hospital costs were irrelevant (odds ratio 1.00; P =.179). When analyzed by payer subgroup, Medicare patients appeared to select hospitals with both low mortality (odds ratio 0.43; P =.176) and short length of stay (odds ratio 0.76; P =.213), although the results did not achieve statistical significance. The commercial managed care subgroup exhibited the least "value-based" behavior. The odds ratio for length of stay was the highest of any group (odds ratio = 2.589; P =.000) and there was a subset of hospitals for which higher mortality was actually associated with greater likelihood of selection. The observable

  11. Non-adaptive territory selection by a bird with exceptionally long parental care

    Directory of Open Access Journals (Sweden)

    Radosław Włodarczyk

    2016-03-01

    Full Text Available High-quality territories are expected to provide greater fitness return for breeding individuals and, thus, are likely to have higher long-term occupation rate in comparison to low-quality territories. However, if environmental and ecological cues used for territory selection cannot reliably predict true territory quality, a mismatch between preferences and fitness may occur. We suggest that this kind of non-adaptive territory selection is more likely in species with long reproductive cycles, as a long time interval between territory establishment and young fledgling should reduce predictability of conditions during the critical stages of brood care. In this study, we investigated adaptiveness of territory selection in a migratory bird with exceptionally long parental care, the mute swan Cygnus olor, which requires over four months to complete the entire reproductive cycle from egg laying to young fledging. For this purpose, we collected information on the long-term (10–19 years occupancy of 222 swan breeding territories and correlated it with reproductive performance (n = 1,345 breeding attempts and body condition of breeding adults. We found that long-term occupancy positively correlated with the timing of breeding, suggesting that individuals settled earlier in the attractive, frequently occupied territories. By contrast, we found no relationship between territory occupancy and reproductive output (hatching and fledging success or adult body condition. The results indicate that at the time of territory selection swans might not be able to reliably assess territory quality, likely due to: (1 exceptionally long period of parental care, which reduces temporal correlation between the conditions at the time of territory selection and conditions during chick rearing; and (2 unpredictability of human-related activities that had a major impact on reproductive output of swan pairs in our population.

  12. Comparative Evaluations of Randomly Selected Four Point-of-Care Glucometer Devices in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Wolde, Mistire; Tarekegn, Getahun; Kebede, Tedla

    2018-05-01

    Point-of-care glucometer (PoCG) devices play a significant role in self-monitoring of the blood sugar level, particularly in the follow-up of high blood sugar therapeutic response. The aim of this study was to evaluate blood glucose test results performed with four randomly selected glucometers on diabetes and control subjects versus standard wet chemistry (hexokinase) methods in Addis Ababa, Ethiopia. A prospective cross-sectional study was conducted on randomly selected 200 study participants (100 participants with diabetes and 100 healthy controls). Four randomly selected PoCG devices (CareSens N, DIAVUE Prudential, On Call Extra, i-QARE DS-W) were evaluated against hexokinase method and ISO 15197:2003 and ISO 15197:2013 standards. The minimum and maximum blood sugar values were recorded by CareSens N (21 mg/dl) and hexokinase method (498.8 mg/dl), respectively. The mean sugar values of all PoCG devices except On Call Extra showed significant differences compared with the reference hexokinase method. Meanwhile, all four PoCG devices had strong positive relationship (>80%) with the reference method (hexokinase). On the other hand, none of the four PoCG devices fulfilled the minimum accuracy measurement set by ISO 15197:2003 and ISO 15197:2013 standards. In addition, the linear regression analysis revealed that all four selected PoCG overestimated the glucose concentrations. The overall evaluation of the selected four PoCG measurements were poorly correlated with standard reference method. Therefore, before introducing PoCG devices to the market, there should be a standardized evaluation platform for validation. Further similar large-scale studies on other PoCG devices also need to be undertaken.

  13. Cost efficient CFD simulations: Proper selection of domain partitioning strategies

    Science.gov (United States)

    Haddadi, Bahram; Jordan, Christian; Harasek, Michael

    2017-10-01

    Computational Fluid Dynamics (CFD) is one of the most powerful simulation methods, which is used for temporally and spatially resolved solutions of fluid flow, heat transfer, mass transfer, etc. One of the challenges of Computational Fluid Dynamics is the extreme hardware demand. Nowadays super-computers (e.g. High Performance Computing, HPC) featuring multiple CPU cores are applied for solving-the simulation domain is split into partitions for each core. Some of the different methods for partitioning are investigated in this paper. As a practical example, a new open source based solver was utilized for simulating packed bed adsorption, a common separation method within the field of thermal process engineering. Adsorption can for example be applied for removal of trace gases from a gas stream or pure gases production like Hydrogen. For comparing the performance of the partitioning methods, a 60 million cell mesh for a packed bed of spherical adsorbents was created; one second of the adsorption process was simulated. Different partitioning methods available in OpenFOAM® (Scotch, Simple, and Hierarchical) have been used with different numbers of sub-domains. The effect of the different methods and number of processor cores on the simulation speedup and also energy consumption were investigated for two different hardware infrastructures (Vienna Scientific Clusters VSC 2 and VSC 3). As a general recommendation an optimum number of cells per processor core was calculated. Optimized simulation speed, lower energy consumption and consequently the cost effects are reported here.

  14. Ocean Models and Proper Orthogonal Decomposition

    Science.gov (United States)

    Salas-de-Leon, D. A.

    2007-05-01

    The increasing computational developments and the better understanding of mathematical and physical systems resulted in an increasing number of ocean models. Long time ago, modelers were like a secret organization and recognize each other by using secret codes and languages that only a select group of people was able to recognize and understand. The access to computational systems was reduced, on one hand equipment and the using time of computers were expensive and restricted, and on the other hand, they required an advance computational languages that not everybody wanted to learn. Now a days most college freshman own a personal computer (PC or laptop), and/or have access to more sophisticated computational systems than those available for research in the early 80's. The resource availability resulted in a mayor access to all kind models. Today computer speed and time and the algorithms does not seem to be a problem, even though some models take days to run in small computational systems. Almost every oceanographic institution has their own model, what is more, in the same institution from one office to the next there are different models for the same phenomena, developed by different research member, the results does not differ substantially since the equations are the same, and the solving algorithms are similar. The algorithms and the grids, constructed with algorithms, can be found in text books and/or over the internet. Every year more sophisticated models are constructed. The Proper Orthogonal Decomposition is a technique that allows the reduction of the number of variables to solve keeping the model properties, for which it can be a very useful tool in diminishing the processes that have to be solved using "small" computational systems, making sophisticated models available for a greater community.

  15. Genomic selection needs to be carefully assessed to meet specific requirements in livestock breeding programs

    Directory of Open Access Journals (Sweden)

    Elisabeth eJonas

    2015-02-01

    Full Text Available Genomic selection is a promising development in agriculture, aiming improved production by exploiting molecular genetic markers to design novel breeding programs and to develop new markers-based models for genetic evaluation. It opens opportunities for research, as novel algorithms and lab methodologies are developed. Genomic selection can be applied in many breeds and species. Further research on the implementation of genomic selection in breeding programs is highly desirable not only for the common good, but also the private sector (breeding companies. It has been projected that this approach will improve selection routines, especially in species with long reproduction cycles, late or sex-limited or expensive trait recording and for complex traits. The task of integrating genomic selection into existing breeding programs is, however, not straightforward. Despite successful integration into breeding programs for dairy cattle, it has yet to be shown how much emphasis can be given to the genomic information and how much additional phenotypic information is needed from new selection candidates. Genomic selection is already part of future planning in many breeding companies of pigs and beef cattle among others, but further research is needed to fully estimate how effective the use of genomic information will be for the prediction of the performance of future breeding stock. Genomic prediction of production in crossbreeding and across-breed schemes, costs and choice of individuals for genotyping are reasons for a reluctance to fully rely on genomic information for selection decisions. Breeding objectives are highly dependent on the industry and the additional gain when using genomic information has to be considered carefully. This review synthesizes some of the suggested approaches in selected livestock species including cattle, pig, chicken and fish. It outlines tasks to help understanding possible consequences when applying genomic information in

  16. Computation of Asteroid Proper Elements: Recent Advances

    Science.gov (United States)

    Knežević, Z.

    2017-12-01

    The recent advances in computation of asteroid proper elements are briefly reviewed. Although not representing real breakthroughs in computation and stability assessment of proper elements, these advances can still be considered as important improvements offering solutions to some practical problems encountered in the past. The problem of getting unrealistic values of perihelion frequency for very low eccentricity orbits is solved by computing frequencies using the frequency-modified Fourier transform. The synthetic resonant proper elements adjusted to a given secular resonance helped to prove the existence of Astraea asteroid family. The preliminary assessment of stability with time of proper elements computed by means of the analytical theory provides a good indication of their poorer performance with respect to their synthetic counterparts, and advocates in favor of ceasing their regular maintenance; the final decision should, however, be taken on the basis of more comprehensive and reliable direct estimate of their individual and sample average deviations from constancy.

  17. On the Determination of Proper Time

    OpenAIRE

    Hurl, Bing; Zhang, Zhi-Yong Wang Hai-Dong

    1998-01-01

    Through the analysis of the definition of the duration of proper time of a particle given by the length of its world line, we show that there is no transitivity of the coordinate time function derived from the definition, so there exists an ambiguity in the determination of the duration of the proper time for the particle. Its physical consequence is illustrated with quantum measurement effect.

  18. Genomic selection needs to be carefully assessed to meet specific requirements in livestock breeding programs.

    Science.gov (United States)

    Jonas, Elisabeth; de Koning, Dirk-Jan

    2015-01-01

    Genomic selection is a promising development in agriculture, aiming improved production by exploiting molecular genetic markers to design novel breeding programs and to develop new markers-based models for genetic evaluation. It opens opportunities for research, as novel algorithms and lab methodologies are developed. Genomic selection can be applied in many breeds and species. Further research on the implementation of genomic selection (GS) in breeding programs is highly desirable not only for the common good, but also the private sector (breeding companies). It has been projected that this approach will improve selection routines, especially in species with long reproduction cycles, late or sex-limited or expensive trait recording and for complex traits. The task of integrating GS into existing breeding programs is, however, not straightforward. Despite successful integration into breeding programs for dairy cattle, it has yet to be shown how much emphasis can be given to the genomic information and how much additional phenotypic information is needed from new selection candidates. Genomic selection is already part of future planning in many breeding companies of pigs and beef cattle among others, but further research is needed to fully estimate how effective the use of genomic information will be for the prediction of the performance of future breeding stock. Genomic prediction of production in crossbreeding and across-breed schemes, costs and choice of individuals for genotyping are reasons for a reluctance to fully rely on genomic information for selection decisions. Breeding objectives are highly dependent on the industry and the additional gain when using genomic information has to be considered carefully. This review synthesizes some of the suggested approaches in selected livestock species including cattle, pig, chicken, and fish. It outlines tasks to help understanding possible consequences when applying genomic information in breeding scenarios.

  19. Game Theoretic Approach for Systematic Feature Selection; Application in False Alarm Detection in Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Fatemeh Afghah

    2018-03-01

    Full Text Available Intensive Care Units (ICUs are equipped with many sophisticated sensors and monitoring devices to provide the highest quality of care for critically ill patients. However, these devices might generate false alarms that reduce standard of care and result in desensitization of caregivers to alarms. Therefore, reducing the number of false alarms is of great importance. Many approaches such as signal processing and machine learning, and designing more accurate sensors have been developed for this purpose. However, the significant intrinsic correlation among the extracted features from different sensors has been mostly overlooked. A majority of current data mining techniques fail to capture such correlation among the collected signals from different sensors that limits their alarm recognition capabilities. Here, we propose a novel information-theoretic predictive modeling technique based on the idea of coalition game theory to enhance the accuracy of false alarm detection in ICUs by accounting for the synergistic power of signal attributes in the feature selection stage. This approach brings together techniques from information theory and game theory to account for inter-features mutual information in determining the most correlated predictors with respect to false alarm by calculating Banzhaf power of each feature. The numerical results show that the proposed method can enhance classification accuracy and improve the area under the ROC (receiver operating characteristic curve compared to other feature selection techniques, when integrated in classifiers such as Bayes-Net that consider inter-features dependencies.

  20. Transformation management of primary health care services in two selected local authorities in Gauteng

    Directory of Open Access Journals (Sweden)

    W Sibaya

    2000-09-01

    Full Text Available The transformation of health services in South Africa today is governed by the political, policy and legislative frameworks. This article focuses on the transformation of a primary health care service within a local authority in Gauteng. The purpose with this article is to explore and describe the perceptions (expectations and fears of selected managers employed in this primary health care service. The results are utilised to compile a strategy (framework for transformation management and leadership within the primary health care service. A qualitative research design was utilised and the data was collected by means of individual interviews with selected managers in the service, followed by a content analysis. The expectations and fears of managers focus mainly on personnel matters, community participation/satisfaction, salaries and parity, inadequate stocks/supplies and medication, the deterioration of quality service delivery and the need for training and empowerment. These results are divided into structure, process and outcome dimensions and are embodied in the conceptual framework for the transformation and leadership strategy. It is recommended that standards for transformation management be formulated and that the quality of transformation management be evaluated accordingly.

  1. Proper Installation of Replacement Windows | Efficient Windows

    Science.gov (United States)

    Collaborative Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring

  2. Sri Lanka's Health Unit Program: A Model of "Selective" Primary Health Care

    Directory of Open Access Journals (Sweden)

    Soma Hewa

    2011-12-01

    Full Text Available This paper argues that the health unit program developed in Sri Lanka in the early twentieth century was an earlier model of selective primary health care promoted by the Rockefeller Foundation in the 1980s in opposition to comprehensive primary health care advocated by the Alma-Ata Declaration of the World Health Organization. A key strategy of the health unit program was to identify the most common and serious infectious diseases in each health unit area and control them through improved sanitation, health education, immunization and treatment with the help of local communities. The health unit program was later introduced to other countries in South and Southeast Asia as part of the Rockefeller Foundation's global campaign to promote public health.

  3. Adverse selection in a voluntary Rural Mutual Health Care health insurance scheme in China.

    Science.gov (United States)

    Wang, Hong; Zhang, Licheng; Yip, Winnie; Hsiao, William

    2006-09-01

    This study examines adverse selection in a subsidized voluntary health insurance scheme, the Rural Mutual Health Care (RMHC) scheme, in a poor rural area of China. The study was made possible by a unique longitudinal data set: the total sample includes 3492 rural residents from 1020 households. Logistic regression was employed for the data analysis. The results show that although this subsidized scheme achieved a considerable high enrollment rate of 71% of rural residents, adverse selection still exists. In general, individuals with worse health status are more likely to enroll in RMHC than individuals with better health status. Although the household is set as the enrollment unit for the RMHC for the purpose of reducing adverse selection, nearly 1/3 of enrolled households are actually only partially enrolled. Furthermore, we found that adverse selection mainly occurs in partially enrolled households. The non-enrolled individuals in partially enrolled households have the best health status, while the enrolled individuals in partially enrolled households have the worst health status. Pre-RMHC, medical expenditure for enrolled individuals in partially enrolled households was 206.6 yuan per capita per year, which is 1.7 times as much as the pre-RMHC medical expenditure for non-enrolled individuals in partially enrolled households. The study also reveals that the pre-enrolled medical expenditure per capita per year of enrolled individuals was 9.6% higher than the pre-enrolled medical expenditure of all residents, including both enrolled and non-enrolled individuals. In conclusion, although the subsidized RMHC scheme reached a very high enrollment rate and the household is set as the enrollment unit for the purpose of reducing adverse selection, adverse selection still exists, especially within partially enrolled households. Voluntary RMHC will not be financially sustainable if the adverse selection is not fully taken into account.

  4. Parent Experiences with State Child Care Subsidy Systems and Their Perceptions of Choice and Quality in Care Selected

    Science.gov (United States)

    Raikes, Helen; Torquati, Julia; Wang, Cixin; Shjegstad, Brinn

    2012-01-01

    Research Findings: This study investigated parents' experiences using Child Care and Development Fund and other state-dispersed child care subsidies, reasons for choosing their current child care program, and perceptions of the quality of child care received from their current program. A telephone survey of 659 parents receiving child care…

  5. Systemic tobramycin concentrations during selective decontamination of the digestive tract in intensive care unit patients on continuous venovenous hemofiltration

    NARCIS (Netherlands)

    Mol, Meriel; van Kan, H. J. M.; Schultz, Marcus J.; de Jonge, Evert

    2008-01-01

    OBJECTIVE: To study whether selective decontamination of the digestive tract (SDD) results in detectable serum tobramycin concentrations in intensive care unit (ICU) patients with acute renal failure treated with continuous venovenous hemofiltration (CVVH). DESIGN AND SETTING: Prospective,

  6. Health-Care Waste Treatment Technology Selection Using the Interval 2-Tuple Induced TOPSIS Method

    Directory of Open Access Journals (Sweden)

    Chao Lu

    2016-06-01

    Full Text Available Health-care waste (HCW management is a major challenge for municipalities, particularly in the cities of developing nations. Selecting the best treatment technology for HCW can be regarded as a complex multi-criteria decision making (MCDM issue involving a number of alternatives and multiple evaluation criteria. In addition, decision makers tend to express their personal assessments via multi-granularity linguistic term sets because of different backgrounds and knowledge, some of which may be imprecise, uncertain and incomplete. Therefore, the main objective of this study is to propose a new hybrid decision making approach combining interval 2-tuple induced distance operators with the technique for order preference by similarity to an ideal solution (TOPSIS for tackling HCW treatment technology selection problems with linguistic information. The proposed interval 2-tuple induced TOPSIS (ITI-TOPSIS can not only model the uncertainty and diversity of the assessment information given by decision makers, but also reflect the complex attitudinal characters of decision makers and provide much more complete information for the selection of the optimum disposal alternative. Finally, an empirical example in Shanghai, China is provided to illustrate the proposed decision making method, and results show that the ITI-TOPSIS proposed in this paper can solve the problem of HCW treatment technology selection effectively.

  7. Globular Clusters: Absolute Proper Motions and Galactic Orbits

    Science.gov (United States)

    Chemel, A. A.; Glushkova, E. V.; Dambis, A. K.; Rastorguev, A. S.; Yalyalieva, L. N.; Klinichev, A. D.

    2018-04-01

    We cross-match objects from several different astronomical catalogs to determine the absolute proper motions of stars within the 30-arcmin radius fields of 115 Milky-Way globular clusters with the accuracy of 1-2 mas yr-1. The proper motions are based on positional data recovered from the USNO-B1, 2MASS, URAT1, ALLWISE, UCAC5, and Gaia DR1 surveys with up to ten positions spanning an epoch difference of up to about 65 years, and reduced to Gaia DR1 TGAS frame using UCAC5 as the reference catalog. Cluster members are photometrically identified by selecting horizontal- and red-giant branch stars on color-magnitude diagrams, and the mean absolute proper motions of the clusters with a typical formal error of about 0.4 mas yr-1 are computed by averaging the proper motions of selected members. The inferred absolute proper motions of clusters are combined with available radial-velocity data and heliocentric distance estimates to compute the cluster orbits in terms of the Galactic potential models based on Miyamoto and Nagai disk, Hernquist spheroid, and modified isothermal dark-matter halo (axisymmetric model without a bar) and the same model + rotating Ferre's bar (non-axisymmetric). Five distant clusters have higher-than-escape velocities, most likely due to large errors of computed transversal velocities, whereas the computed orbits of all other clusters remain bound to the Galaxy. Unlike previously published results, we find the bar to affect substantially the orbits of most of the clusters, even those at large Galactocentric distances, bringing appreciable chaotization, especially in the portions of the orbits close to the Galactic center, and stretching out the orbits of some of the thick-disk clusters.

  8. Proper Wound Care: How to Minimize a Scar

    Science.gov (United States)

    ... Registration General information Housing & travel Education Exhibit hall Mobile app 2019 Annual Meeting Derm Exam Prep Course ... SkinPAC State societies Scope of practice Truth in advertising NP/PA laws Action center Public and patients ...

  9. Dynamical systems of proper characteristic 0

    International Nuclear Information System (INIS)

    Ahmad, K.H.; Hamoui, A.

    1991-07-01

    Flows with orbits of proper characteristics 0 exhibit recurrent behaviour, a feature of basic importance in the description of their dynamics. Here, we analyze flows with such orbits relating them with recurrent flows and with flows that exhibit orbital, Poisson or Lagrange stability. (author). 11 refs

  10. Improved Industrial Development In Nigeria Through Proper ...

    African Journals Online (AJOL)

    The paper noted that most industrial development strategies in Nigeria did not give attention to technology education. And that technology education as recognized by few of the strategies were not only properly articulated for the tertiary institutions, but also poorly implemented. Therefore, to put technology and thus ...

  11. INTERNAL PROPER MOTIONS IN THE ESKIMO NEBULA

    International Nuclear Information System (INIS)

    García-Díaz, Ma. T.; Gutiérrez, L.; Steffen, W.; López, J. A.; Beckman, J.

    2015-01-01

    We present measurements of internal proper motions at more than 500 positions of NGC 2392, the Eskimo Nebula, based on images acquired with WFPC2 on board the Hubble Space Telescope at two epochs separated by 7.695 yr. Comparisons of the two observations clearly show the expansion of the nebula. We measured the amplitude and direction of the motion of local structures in the nebula by determining their relative shift during that interval. In order to assess the potential uncertainties in the determination of proper motions in this object, in general, the measurements were performed using two different methods, used previously in the literature. We compare the results from the two methods, and to perform the scientific analysis of the results we choose one, the cross-correlation method, because it is more reliable. We go on to perform a ''criss-cross'' mapping analysis on the proper motion vectors, which helps in the interpretation of the velocity pattern. By combining our results of the proper motions with radial velocity measurements obtained from high resolution spectroscopic observations, and employing an existing 3D model, we estimate the distance to the nebula to be 1.3 kpc

  12. INTERNAL PROPER MOTIONS IN THE ESKIMO NEBULA

    Energy Technology Data Exchange (ETDEWEB)

    García-Díaz, Ma. T.; Gutiérrez, L.; Steffen, W.; López, J. A. [Instituto de Astronomía, Universidad Nacional Autónoma de México, Km 103 Carretera Tijuana-Ensenada, 22860 Ensenada, B.C. (Mexico); Beckman, J., E-mail: tere@astro.unam.mx, E-mail: leonel@astro.unam.mx, E-mail: wsteffen@astro.unam.mx, E-mail: jal@astro.unam.mx, E-mail: jeb@iac.es [Instituto de Astrofísica de Canarias, La Laguna, Tenerife (Spain)

    2015-01-10

    We present measurements of internal proper motions at more than 500 positions of NGC 2392, the Eskimo Nebula, based on images acquired with WFPC2 on board the Hubble Space Telescope at two epochs separated by 7.695 yr. Comparisons of the two observations clearly show the expansion of the nebula. We measured the amplitude and direction of the motion of local structures in the nebula by determining their relative shift during that interval. In order to assess the potential uncertainties in the determination of proper motions in this object, in general, the measurements were performed using two different methods, used previously in the literature. We compare the results from the two methods, and to perform the scientific analysis of the results we choose one, the cross-correlation method, because it is more reliable. We go on to perform a ''criss-cross'' mapping analysis on the proper motion vectors, which helps in the interpretation of the velocity pattern. By combining our results of the proper motions with radial velocity measurements obtained from high resolution spectroscopic observations, and employing an existing 3D model, we estimate the distance to the nebula to be 1.3 kpc.

  13. The Essentials of Proper Wine Service.

    Science.gov (United States)

    Manago, Gary H.

    This instructional unit was designed to assist the food services instructor and/or the restaurant manager in training students and/or staff in the proper procedure for serving wines to guests. The lesson plans included in this unit focus on: (1) the different types of wine glasses and their uses; (2) the parts of a wine glass; (3) the proper…

  14. Quality Improvement in Critical Care: Selection and Development of Quality Indicators

    Science.gov (United States)

    Martin, Claudio M.; Project, The Quality Improvement in Critical Care

    2016-01-01

    Background. Caring for critically ill patients is complex and resource intensive. An approach to monitor and compare the function of different intensive care units (ICUs) is needed to optimize outcomes for patients and the health system as a whole. Objective. To develop and implement quality indicators for comparing ICU characteristics and performance within and between ICUs and regions over time. Methods. Canadian jurisdictions with established ICU clinical databases were invited to participate in an iterative series of face-to-face meetings, teleconferences, and web conferences. Eighteen adult intensive care units across 14 hospitals and 5 provinces participated in the process. Results. Six domains of ICU function were identified: safe, timely, efficient, effective, patient/family satisfaction, and staff work life. Detailed operational definitions were developed for 22 quality indicators. The feasibility was demonstrated with the collection of 3.5 years of data. Statistical process control charts and graphs of composite measures were used for data display and comparisons. Medical and nursing leaders as well as administrators found the system to be an improvement over prior methods. Conclusions. Our process resulted in the selection and development of 22 indicators representing 6 domains of ICU function. We have demonstrated the feasibility of such a reporting system. This type of reporting system will demonstrate variation between units and jurisdictions to help identify and prioritize improvement efforts. PMID:27493476

  15. Boltzmann babies in the proper time measure

    Energy Technology Data Exchange (ETDEWEB)

    Bousso, Raphael; Bousso, Raphael; Freivogel, Ben; Yang, I-Sheng

    2007-12-20

    After commenting briefly on the role of the typicality assumption in science, we advocate a phenomenological approach to the cosmological measure problem. Like any other theory, a measure should be simple, general, well defined, and consistent with observation. This allows us to proceed by elimination. As an example, we consider the proper time cutoff on a geodesic congruence. It predicts that typical observers are quantum fluctuations in the early universe, or Boltzmann babies. We sharpen this well-known youngness problem by taking into account the expansion and open spatial geometry of pocket universes. Moreover, we relate the youngness problem directly to the probability distribution for observables, such as the temperature of the cosmic background radiation. We consider a number of modifications of the proper time measure, but find none that would make it compatible with observation.

  16. The quality of care in occupational therapy: an assessment of selected Michigan hospitals.

    Science.gov (United States)

    Kirchman, M M

    1979-07-01

    In this study, a methodology was developed and tested for assessing the quality of care in occupational therapy between educational and noneducational clinical settings, as measured by process and outcome. An instrument was constructed for an external audit of the hospital record. Standards drafted by the investigator were established as normative by a panel of experts for use in judging the programs. Hospital records of 84 patients with residual hemiparesis or hemiplegia in three noneducational settings and of 100 patients with similar diagnoses in two educational clinical settings from selected Michigan facilities were chosen by proportionate stratified random sampling. The process study showed that occupational therapy was of significantly higher quality in the educational settings. The outcome study did not show significant differences between types of settings. Implications for education and practice are discussed.

  17. [Transparency and replicability of nursing intervention studies in long-term care: A selective literature review].

    Science.gov (United States)

    Gspörer, Irene; Schrems, Berta M

    2018-05-01

    The development and evaluation of interventions in long-term care is time-consuming and expensive due to their complexity. To ensure reproducibility and successful implementation, these interventions must be described and published in a comprehensible and qualitative manner. The aim of this study is to analyze intervention studies from the inpatient long-term care setting with regard to their completeness, reporting quality, transparency and thus reproducibility. The completeness and the reporting quality of the interventions described in the publications were examined in the context of a selective literature review by means of intervention studies from the long-term care setting (n=22). To this end, the Template for Intervention Description and Replication (TIDieR) checklist and the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare 2 (CReDECI2-DE) list were used. Transparency criteria included study registration and access to study protocols. The TIDieR checklist examination revealed that only three studies contained all the information necessary; the CReDECI2 test provided a complete description for only one study. Frequent shortcomings were observed concerning the information on modifications and titrations for the study participants and the location. Protocols were available for eight studies, 14 studies were registered. In terms of science, this means that the reproducibility of scientific findings is limited, which is why they cannot provide secure knowledge. As a result, the practical benefit to be derived from published studies that are accessible to decision-makers is limited as well. As far as publishers are concerned they should pay more attention to the completeness, registration and availability of materials. Copyright © 2018. Published by Elsevier GmbH.

  18. The care connection: The World Bank and women's unpaid care work in select sub-Saharan African countries

    OpenAIRE

    Bibler, Sarah; Zuckerman, Elaine

    2013-01-01

    With the aim of reducing women's greater unpaid care work than men&'s and increasing women's paid employment, this paper examines the extent to which World Bank investments address unpaid care work. The paper conducts an in-depth gender analysis of 36 World Bank employment-related projects in Malawi, Mali, Niger, and Rwanda. It concludes that the vast majority (92 per cent) of reviewed projects fail to account for unpaid care work. Exceptionally, Malawi's Shire River Basin Management Program ...

  19. Challenging nurse student selection policy: Using a lifeworld approach to explore the link between care experience and student values.

    Science.gov (United States)

    Scammell, Janet; Tait, Desiree; White, Sara; Tait, Michael

    2017-10-01

    This study uses a lifeworld perspective to explore beginning students' values about nursing. Internationally, increasing care demand, a focus on targets and evidence of dehumanized care cultures have resulted in scrutiny of practitioner values. In England, selection policy dictates that prospective nursing students demonstrate person-centred values and care work experience. However, there is limited recent evidence exploring values at programme commencement or the effect of care experience on values. Mixed method study. A total of 161 undergraduate nursing students were recruited in 2013 from one English university. Thematic content analysis and frequency distribution to reveal descriptive statistics were used. Statistical analysis indicated that most of the values identified in student responses were not significantly affected by paid care experience. Five themes were identified: How I want care to be; Making a difference; The value of learning; Perceived characteristics of a nurse; and Respecting our humanity. Students readily drew on their experience of living to identify person-centred values about nursing.

  20. uvby photometry in McCormick proper motion fields

    Science.gov (United States)

    Degewij, J.

    1982-01-01

    The Danish 50 cm telescope at the European Southern Observatory was used to obtain high-precision uvby photometry for 50 F2 to G2 stars, with V values in the 9.4-12.3 mag range, which were selected in the southern galactic polar regions of the McCormick proper motion fields and measured on six different nights. The brighter stars are found to systematically exhibit smaller m(1) indices, of about 0.02 mag, upon comparison with the earlier data of Blaauw et al (1976). Single measurements are given for 98 stars in eight McCormick fields at intermediate southern galactic latitudes.

  1. Inviting parents to take part in paediatric palliative care research: A mixed-methods examination of selection bias

    OpenAIRE

    Crocker, Joanna C; Beecham, Emma; Kelly, Paula; Dinsdale, Andrew P; Hemsley, June; Jones, Louise; Bluebond-Langner, Myra

    2015-01-01

    Background: Recruitment to paediatric palliative care research is challenging, with high rates of non-invitation of eligible families by clinicians. The impact on sample characteristics is unknown. Aim: To investigate, using mixed methods, non-invitation of eligible families and ensuing selection bias in an interview study about parents? experiences of advance care planning (ACP). Design: We examined differences between eligible families invited and not invited to participate by clinicians us...

  2. How to Use Rectal Suppositories Properly

    Science.gov (United States)

    ... Follow directions carefully Do not miss doses Store suppositories in a cool place and avoid melting; refrigerate them if so labeled Store medications out of reach of children Copyright 2013, American Society of Health-System Pharmacists. ...

  3. Characterization of the selection of medicines for the Brazilian primary health care

    Directory of Open Access Journals (Sweden)

    Margô Gomes de Oliveira Karnikowski

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To characterize the process of selection of medicines for primary health care in the Brazilian regions. METHODS This article is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015, a cross-sectional study that consisted of an information gathering in a sample of cities in the five regions of Brazil. The data used were collected by interviews with those responsible for pharmaceutical services (PS (n = 506, professionals responsible for the dispensing of medicines (n = 1,139, and physicians (n = 1,558. To evaluate the difference between ratios, we adopted the Chi-square test for complex samples. The differences between the averages were analyzed in generalized linear models with F-test with Bonferroni correction for multiple comparisons. The analyses considered significant had p≤0.05. RESULTS The professionals responsible for pharmaceutical services reported non-existence of a formally constituted Pharmacy and Therapeutics Committee (PTC (12.5%. They claimed to have an updated (80.4% list of Essential Medicines (85.3% and being active participants of this process (88.2%. However, in the perception of respondents, the list only partially (70.1% meets the health demands. Of the interviewed professionals responsible for the dispensing of medicines, only 16.6% were pharmacists; even so, 47.8% reported to know the procedures to change the list. From the perspective of most of these professionals (70.9%, the list meets the health demands of the city. Among physicians, only 27.2% reported to know the procedures to change the list, but 76.5% would have some claim to change it. Most of them reported to base their claims in clinical experiences (80.0%. For 13.0% of them, the list meets the health demands. CONCLUSIONS As this is the first national survey of

  4. THE PROPER MOTION OF PALOMAR 5

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, T. K.; Kallivayalil, N., E-mail: tkf4w@astro.virginia.edu [Department of Astronomy, University of Virginia, Charlottesville, 3530 McCormick Road, VA 22904-4325 (United States)

    2015-10-01

    Palomar 5 (Pal 5) is a faint halo globular cluster associated with narrow tidal tails. It is a useful system to understand the process of tidal dissolution, as well as to constrain the potential of the Milky Way. A well-determined orbit for Pal 5 would enable detailed study of these open questions. We present here the first CCD-based proper motion measurement of Pal 5 obtained using SDSS as a first epoch and new Large Binocular Telescope/Large Binocular Camera (LBC) images as a second, giving a baseline of 15 years. We perform relative astrometry, using SDSS as a distortion-free reference, and images of the cluster and also of the Pal 5 stream for the derivation of the distortion correction for LBC. The reference frame is made up of background galaxies. We correct for differential chromatic refraction using relations obtained from SDSS colors as well as from flux-calibrated spectra, finding that the correction relations for stars and for galaxies are different. We obtain μ{sub α} = −2.296 ± 0.186 mas yr{sup −1} and μ{sub δ} = −2.257 ± 0.181 mas yr{sup −1} for the proper motion of Pal 5. We use this motion, and the publicly available code galpy, to model the disruption of Pal 5 in different Milky Way models consisting of a bulge, a disk, and a spherical dark matter halo. Our fits to the observed stream properties (streak and radial velocity gradient) result in a preference for a relatively large Pal 5 distance of around 24 kpc. A slightly larger absolute proper motion than what we measure also results in better matches but the best solutions need a change in distance. We find that a spherical Milky Way model, with V{sub 0} = 220 km s{sup −1} and V{sub 20} {sub kpc}, i.e., approximately at the apocenter of Pal 5, of 218 km s{sup −1}, can match the data well, at least for our choice of disk and bulge parametrization.

  5. The status of IT service management in health care - ITIL® in selected European countries.

    Science.gov (United States)

    Hoerbst, Alexander; Hackl, Werner O; Blomer, Roland; Ammenwerth, Elske

    2011-12-21

    Due to the strained financial situation in the healthcare sector, hospitals and other healthcare providers are facing an increasing pressure to improve their efficiency and to reduce costs. These trends challenge health care organizations to introduce innovative information technology (IT) based supportive processes. To guarantee that IT supports the clinical processes perfectly, IT must be managed proactively. However, until now, there is only very few research on IT service management especially on ITIL® implementations in the health care context. The current study aims at exploring knowledge about and acceptance of IT service management (especially ITIL®) in hospitals in Austria and its neighboring regions Bavaria (Germany), Slovakia, South Tyrol (Italy) and Switzerland. Therefore highly standardized interviews with the respective head of information technology (CIO, IT manager) were conducted for selected hospitals from the different regions. In total 75 hospitals were interviewed. Data gathered was analyzed using descriptive statistics and where necessary methods of qualitative content analysis. In most regions, two-thirds or more of the participating IT managers claim to be familiar with the concepts of IT service management and of ITIL®. IT managers expect from ITIL® mostly better IT services, followed by an increased productivity and a reduction of IT cost. But only five hospitals said to have implemented at least parts of ITIL®, and eight hospitals stated to be planning to do this in the next two years. When it comes to ITIL®, Switzerland and Bavaria seem to be ahead of the other countries. There, the highest levels of knowledge, the highest number of implementations or plans of an implementation as well as the highest number of ITIL® certified staff members were observed. The results collected through this study indicate that the idea of IT services and IT service management is still not widely recognized in hospitals in the countries and regions

  6. Precedent Proper Names in Informal Oikonymy

    Directory of Open Access Journals (Sweden)

    Maria V. Akhmetova

    2013-06-01

    Full Text Available The paper deals with the Russian language informal city names (oikonyms motivated by other toponyms (with reference to Russia and the CIS. The author shows that the motivating proper name can replace the city name (e. g. Глазго < Glasgow ‘Glazov’ or contaminate with it (e. g. Экибостон < Ekibastuz + Boston, the “alien” onym being attracted to construct an informal oikonym due to its phonetic similarity or, on occasion, due to an affinity, either real or imaginary, between the two settlements. The author argues that the phonetic motivation is more characteristic for the modern urban tradition, than for popular dialects.

  7. Proper body mechanics from an engineering perspective.

    Science.gov (United States)

    Mohr, Edward G

    2010-04-01

    The economic viability of the manual therapy practitioner depends on the number of massages/treatments that can be given in a day or week. Fatigue or injuries can have a major impact on the income potential and could ultimately reach the point which causes the practitioner to quit the profession, and seek other, less physically demanding, employment. Manual therapy practitioners in general, and massage therapists in particular, can utilize a large variety of body postures while giving treatment to a client. The hypothesis of this paper is that there is an optimal method for applying force to the client, which maximizes the benefit to the client, and at the same time minimizes the strain and effort required by the practitioner. Two methods were used to quantifiably determine the effect of using "poor" body mechanics (Improper method) and "best" body mechanics (Proper/correct method). The first approach uses computer modeling to compare the two methods. Both postures were modeled, such that the biomechanical effects on the practitioner's elbow, shoulder, hip, knee and ankle joints could be calculated. The force applied to the client, along with the height and angle of application of the force, was held constant for the comparison. The second approach was a field study of massage practitioners (n=18) to determine their maximal force capability, again comparing methods using "Improper and Proper body mechanics". Five application methods were tested at three different application heights, using a digital palm force gauge. Results showed that there was a definite difference between the two methods, and that the use of correct body mechanics can have a large impact on the health and well being of the massage practitioner over both the short and long term. Copyright 2009 Elsevier Ltd. All rights reserved.

  8. Structuring the Environmental Experience Design Research Framework through Selected Aged Care Facility Data Analyses in Victoria

    Directory of Open Access Journals (Sweden)

    Nan Ma

    2017-11-01

    Full Text Available Humans relate to the living environment physically and psychologically. Environmental psychology has a rich developed history while experience design emerged recently in the industrial design domain. Nonetheless, these approaches have barely been merged, understood or implemented in architectural design practices. This study explored the correlation between experience design and environmental psychology. Moreover, it conducted literature reviews on theories about emotion, user experience design, experience design and environmental psychology, followed by the analyses of spatial settings and environmental quality data of a selected aged care facility in Victoria, Australia, as a case study. Accordingly, this study led to proposing a research framework on environmental experience design (EXD. It can be defined as a deliberate attempt that affiliates experience design and environmental psychology with creation of the built environment that should accommodate user needs and demands. The EXD research framework proposed in this study was tailored for transforming related design functions into the solutions that contribute to improving the built environment for user health and wellbeing.

  9. Removal of Selected Pharmaceutical and Personal Care Products by the Green Alga Nannochloris sp.

    Science.gov (United States)

    Bai, X.; Acharya, K.

    2016-12-01

    Emerging contaminants have become an increasing concern in the environment due to their ubiquitous distribution and potential adverse effects on wildlife and humans. Municipal wastewater is a major source of pharmaceutical and personal care products (PPCPs) in the Las Vegas metropolitan area. The ecotoxic impacts of PPCPs on aquatic organisms include development of antimicrobial resistance, decreases in plankton diversity, and endocrine disruption. Freshwater algae can be responsible for the uptake and transfer of the contaminants because they are a major food source for most aquatic organisms. This research applied laboratory-based incubation studies to evaluate the removal efficiency and uptake mechanisms of the selected PPCPs (trimethoprim, sulfamethoxazole, and triclosan) by the green alga Nannochloris sp. The results showed that trimethoprim and sulfamethoxazole remained in the algal culture at 100% and 68%, respectively, after 14 days of incubation, and therefore were not significantly removed from the medium. However, the antimicrobial triclosan was significantly removed from the medium. Immediately after incubation began, 74% of triclosan dissipated and 100% of triclosan was removed after 7 days of incubation. Additionally, over 42% of triclosan was found associated with the algal cells throughout the incubation. The results demonstrate that the presence of Nannochloris sp. eliminated triclosan in the aquatic system, but could not significantly remove the antibiotics trimethoprim and sulfamethoxazole. This study provided crucial information that toxicity of triclosan in aquatic organisms is a critical concern because of its high uptake by phytoplankton. The resistance of trimethoprim and sulfamethoxazole to uptake by phytoplankton may threaten water quality.

  10. Sorption and biodegradation characteristics of the selected pharmaceuticals and personal care products onto tropical soil.

    Science.gov (United States)

    Foolad, Mahsa; Hu, Jiangyong; Tran, Ngoc Han; Ong, Say Leong

    2016-01-01

    In the present study, the sorption and biodegradation characteristics of five pharmaceutical and personal care products (PPCPs), including acetaminophen (ACT), carbamazepine (CBZ), crotamiton (CTMT), diethyltoluamide (DEET) and salicylic acid (SA), were studied in laboratory-batch experiments. Sorption kinetics experimental data showed that sorption systems under this study were more appropriately described by the pseudo second-order kinetics with a correlation coefficient (R2)>0.98. Sorption equilibrium data of almost all target compounds onto soil could be better described by the Freundlich sorption isotherm model. The adsorption results showed higher soil affinity for SA, following by ACT. Results also indicated a slight effect of pH on PPCP adsorption with lower pH causing lower adsorption of compounds onto the soil except for SA at pH 12. Moreover, adsorption of PPCPs onto the soil was influenced by natural organic matter (NOM) since the higher amount of NOM caused lower adsorption to the soil. Biodegradation studies of selected PPCPs by indigenous microbial community present in soil appeared that the removal rates of ACT, SA and DEET increased with time while no effect had been observed for the rest. This study suggests that the CBZ and CTMT can be considered as suitable chemical sewage indicators based on their low sorption affinity and high resistance to biodegradation.

  11. A proper strategy for combating mould.

    Science.gov (United States)

    Cheong, Cedric

    2014-02-01

    managing director of Mycologia & Mould Worx, MSc, B.(Env. Sci.), TAE40110, examines the topic of mould exposure in healthcare facilities, and the associated duty of care for hospital facility managers and engineers. The article, published here in slightly adapted form, also focuses on the need for additional training of key personnel on the risks associated with exposure to environmental microbial contamination.

  12. Effects of selective decontamination of digestive tract on mortality and antibiotic resistance in the intensive-care unit

    NARCIS (Netherlands)

    de Jonge, Evert

    2005-01-01

    Purpose of review Since its introduction in 1984 several small trials have studied the infection prevention regimen of selective decontamination of the digestive tract (SDD) in intensive care patients. Although meta-analyses of these studies suggested that SDD could reduce mortality, it continued to

  13. Comparative gut microbiota and resistome profiling of intensive care patients receiving selective digestive tract decontamination and healthy subjects.

    NARCIS (Netherlands)

    Buelow, Elena; Bello González, Teresita D J; Fuentes, Susana; de Steenhuijsen Piters, Wouter A A; Lahti, Leo; Bayjanov, Jumamurat R; Majoor, Eline A M; Braat, Johanna C; van Mourik, Maaike S M; Oostdijk, Evelien A N; Willems, Rob J L; Bonten, Marc J M; van Passel, Mark W J; Smidt, Hauke; van Schaik, Willem

    2017-01-01

    The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective

  14. [Optimizing antibiotics policy in the Netherlands. VI. SWAB advice: no selective decontamination of intensive care patients on mechanical ventilation

    NARCIS (Netherlands)

    Bonten, M.J.; Kullberg, B.J.; Filius, P.M.

    2001-01-01

    The Working Party on Antibiotic Policy (Dutch acronym is SWAB) has issued a guideline in which the pro and cons of the routine use of selective decontamination (SD) in patients in intensive care (IC) on mechanical ventilation are compared in order to decide whether SD is indicated. The effectiveness

  15. Using aspen for artist stretcher frames: adding value through quality service, direct marketing, and careful material selection

    Science.gov (United States)

    Chris Polson

    2001-01-01

    Aspen wood, when carefully selected and kiln dried, makes excellent stock for artist stretcher frames. Direct marketing techniques including the Internet and word of mouth give access to national markets, providing a more diverse and stable customer base for operations from a rural area. High-quality service, as shown by product performance and rapid order fulfillment...

  16. Inviting parents to take part in paediatric palliative care research: a mixed-methods examination of selection bias.

    Science.gov (United States)

    Crocker, Joanna C; Beecham, Emma; Kelly, Paula; Dinsdale, Andrew P; Hemsley, June; Jones, Louise; Bluebond-Langner, Myra

    2015-03-01

    Recruitment to paediatric palliative care research is challenging, with high rates of non-invitation of eligible families by clinicians. The impact on sample characteristics is unknown. To investigate, using mixed methods, non-invitation of eligible families and ensuing selection bias in an interview study about parents' experiences of advance care planning (ACP). We examined differences between eligible families invited and not invited to participate by clinicians using (1) field notes of discussions with clinicians during the invitation phase and (2) anonymised information from the service's clinical database. Families were eligible for the ACP study if their child was receiving care from a UK-based tertiary palliative care service (Group A; N = 519) or had died 6-10 months previously having received care from the service (Group B; N = 73). Rates of non-invitation to the ACP study were high. A total of 28 (5.4%) Group A families and 21 (28.8%) Group B families (p research findings. Non-invitation and selection bias should be considered, assessed and reported in palliative care studies. © The Author(s) 2014.

  17. Facial skin care products and cosmetics.

    Science.gov (United States)

    Draelos, Zoe Diana

    2014-01-01

    Facial skin care products and cosmetics can both aid or incite facial dermatoses. Properly selected skin care can create an environment for barrier repair aiding in the re-establishment of a healing biofilm and diminution of facial redness; however, skin care products that aggressively remove intercellular lipids or cause irritation must be eliminated before the red face will resolve. Cosmetics are an additive variable either aiding or challenging facial skin health. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Assessment of selected quality fields of nursing care in neurosurgical wards: a prospective study of 530 people – multicenter studies

    Directory of Open Access Journals (Sweden)

    Ślusarz R

    2014-08-01

    Full Text Available Robert Ślusarz,1 Monika Biercewicz,2 Ewa Barczykowska,3 Beata Haor,4 Mariola Głowacka5 1Neurological and Neurosurgical Nursing Department, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, 2Clinic of Geriatrics, 3Nursing Department, Collegium Medicum, Nicolaus Copernicus University, Torun, 4Faculty of Health Science, University of Humanities and Economics in Wloclawek, Wloclawek, 5Institute of Health Sciences, State School of Higher Professional Education in Plock, Plock, Poland Background: One of the elements influencing the assessment of nursing care quality is the assessment of the nurse’s functions that determine the nurse’s particular tasks. The aim of this work was to assess selected tasks involved in the nurse’s caring function, which influence nursing care quality on neurosurgical wards, on the basis of patients’ and nursing staff’s opinions.Materials and methods: The research was carried out on neurosurgical wards in Poland on a group of 455 patients and 75 nurses. In order to assess nursing care quality, an author’s original questionnaire (Questionnaire – Patient Satisfaction was used.Results: Statistically significant differences concerned particular groups (both patients and nurses in the assessment of selected issues: providing information about performed activities and operations (P=0.000 and P=0.040, respecting personal dignity and assuring discretion during the operations (P=0.000 and P=0.001, speed of response to patient’s requests (P=0.000 and P=0.000, time availability of nurses for the patient (P=0.000 and P=0.000, providing information about further self-care at home (P=0.032, P=0.008, and nurses’ attitude (kindness, courtesy, tenderness, care to patients (patient’s assessment only P=0.000.Conclusion: Selected tasks in the field of the caring function of nurses were assessed differently by particular groups. There were no statistically significant differences in the assessment of particular

  19. Securing radioactive sources through a proper management

    International Nuclear Information System (INIS)

    Mourao, Rogerio Pimenta

    2009-01-01

    The safety and security of radioactive sources have become a hot issue for the nuclear community in the last two decades. The Goiania accident in Brazil and the September 11th attack alerted governments and nuclear agencies around the world to the vulnerability of the thousands of disused radioactive sources ill-stored or misplaced in a myriad of ways, especially in countries with less developed infra-structure. Once the threat of environmental contamination or malevolent use of these sources became clear, the International Atomic Energy Agency and the American Government spawned initiatives to reduce this risk, basically stimulating the proper conditioning of the sources and, whenever possible, seeking their repatriation to the countries of origin. Since 1996 Brazil has been participating actively in this effort, having carried out hands-on operations to condition old radium sources in Latin American and Caribbean countries and also repatriated its own neutron sources to the United States. A new operation is presently being organized: the reconditioning of the high activity sources contained in teletherapy units stored in the country using a mobile hot cell developed in South Africa. Also an agreement is being negotiated between the US National Nuclear Security Agency and the Brazilian CNEN to repatriate hundreds of radioactive gauges presently stored at CNEN's source storage buildings. (author)

  20. Knowledge of the inhabitants of Lubelskie region on proper eating habits

    Directory of Open Access Journals (Sweden)

    Dorota Weber

    2017-08-01

      Due to the fact that care about health, where proper eating habits are one of its constituents, exerts a strong impact on both social and economic life of a country, it is not just an individual case of each person, but a public matter.  The state of health status is obviously subject to a number of factors. However, the habits and customs with regard to daily habits are of particular importance due to the significance of food for the physical existence of each human body. These habits are formed in childhood and youth, however they undergo modifications throughout the whole life. Quite frequently the possessed knowledge is not a sufficient motivation to make great changes in the manner of eating, thus it does not change the eating habits. The aim of the paper is to determine the level of knowledge of clinic patients, selected at random, on proper eating habits. Materials and methods The research was conducted during the period of January-February 2016 year in a Lublin clinic. The investigation comprised 148 respondents. The method used in the research was a diagnostic survey, and the selected technique was a questionnaire conducted among the respondents, using a birth certificate, an interview and an anthropometric study. The study included 148 persons, who were further divided into two groups: students and workers. The respondents were the inhabitants of Lublin and nearby villages. The survey findings underwent a static programme analysis in Statistica 9.1 software (StatSoft, Poland. Conclusions The identification of nutritional knowledge and dietary behaviours of consumers as well as determination of the level and diversity of their nutritional awareness should become the basis for the preparation of guidelines on the content of broadcasts in order to promote healthy eating habits among consumers of different groups.

  1. Prenatal care of African American women in selected USA urban and rural cultural contexts.

    Science.gov (United States)

    Morgan, M

    1996-01-01

    The purpose of this ethnonursing research was to systematically discover, describe, and analyze the beliefs, practices, and values of African American women related to prenatal care. The domain of inquiry was prenatal care of African American women within their familiar cultural contexts. The study was conceptualized within Leininger's Theory of Culture Care Diversity and Universality which enabled the researcher to study professional and generic care as influenced by the worldview, social structural factors, cultural values and beliefs, ethnohistory, and environmental context. The goal of the study was to discover knowledge that could be used by health professionals to provide culturally congruent prenatal care that would increase the health and well being of the people. The rationale for the study was based on studies that showed the lack of prenatal care in the African American cultural group leads to low birth weights and high infant mortality rates. Four major themes that focused on the domain of inquiry were identified: 1) Cultural care meant protection, presence, and sharing; 2) social structural factors that greatly influenced the health and well being were spirituality, kinship, and economics; 3) professional prenatal care was seen by the women as necessary and essential but there was distrust of noncaring professionals, and barriers to such care; and 4) folk health beliefs, practices, and indigenous health care providers were widely used by women in the African American community.

  2. Taxonomic and Thematic Organisation of Proper Name Conceptual Knowledge

    Directory of Open Access Journals (Sweden)

    Sebastian J. Crutch

    2011-01-01

    Full Text Available We report the investigation of the organisation of proper names in two aphasic patients (NBC and FBI. The performance of both patients on spoken word to written word matching tasks was inconsistent, affected by presentation rate and semantic relatedness of the competing responses, all hallmarks of a refractory semantic access dysphasia. In a series of experiments we explored the semantic relatedness effects within their proper name vocabulary, including brand names and person names. First we demonstrated the interaction between very fine grain organisation and personal experience, with one patient with a special interest in the cinema demonstrating higher error rates when identifying the names of actors working in a similar film genre (e.g. action movies: Arnold Schwarzenegger, Bruce Willis, Sylvester Stallone, Mel Gibson than those working in different genres (e.g. Arnold Schwarzenegger, Gregory Peck, Robin Williams, Gene Kelly. Second we compared directly two potential principles of semantic organisation – taxonomic and thematic. Furthermore we considered these principles of organisation in the context of the individuals' personal knowledge base. We selected topics matching the interests and experience of each patient, namely cinema and literature (NBC and naval history (FBI. The stimulus items were arranged in taxonomic arrays (e.g. Jane Austen, Emily Bronte, Agatha Christie, thematic arrays (e.g. Jane Austen, Pride and Prejudice, Mr Darcy, and unrelated arrays (e.g. Jane Austen, Wuthering Heights, Hercule Poirot. We documented that different patterns of taxonomic and thematic organisation were constrained by whether the individual has limited knowledge, moderate knowledge or detailed knowledge of a particular vocabulary. It is suggested that moderate proper name knowledge is primarily organised by taxonomy whereas extensive experience results in a more detailed knowledge base in which theme is a powerful organising principle.

  3. Taxonomic and thematic organisation of proper name conceptual knowledge.

    Science.gov (United States)

    Crutch, Sebastian J; Warrington, Elizabeth K

    2011-01-01

    We report the investigation of the organisation of proper names in two aphasic patients (NBC and FBI). The performance of both patients on spoken word to written word matching tasks was inconsistent, affected by presentation rate and semantic relatedness of the competing responses, all hallmarks of a refractory semantic access dysphasia. In a series of experiments we explored the semantic relatedness effects within their proper name vocabulary, including brand names and person names. First we demonstrated the interaction between very fine grain organisation and personal experience, with one patient with a special interest in the cinema demonstrating higher error rates when identifying the names of actors working in a similar film genre (e.g., action movies: Arnold Schwarzenegger, Bruce Willis, Sylvester Stallone, Mel Gibson) than those working in different genres (e.g., Arnold Schwarzenegger, Gregory Peck, Robin Williams, Gene Kelly). Second we compared directly two potential principles of semantic organisation - taxonomic and thematic. Furthermore we considered these principles of organisation in the context of the individuals' personal knowledge base. We selected topics matching the interests and experience of each patient, namely cinema and literature (NBC) and naval history (FBI). The stimulus items were arranged in taxonomic arrays (e.g., Jane Austen, Emily Bronte, Agatha Christie), thematic arrays (e.g., Jane Austen, Pride and Prejudice, Mr Darcy), and unrelated arrays (e.g., Jane Austen, Wuthering Heights, Hercule Poirot). We documented that different patterns of taxonomic and thematic organisation were constrained by whether the individual has limited knowledge, moderate knowledge or detailed knowledge of a particular vocabulary. It is suggested that moderate proper name knowledge is primarily organised by taxonomy whereas extensive experience results in a more detailed knowledge base in which theme is a powerful organising principle.

  4. Editorial: The proper place for knowledge

    Directory of Open Access Journals (Sweden)

    Yngve Nordkvelle

    2009-11-01

    Full Text Available Knowledge is an interesting word, which never goes out of fashion. In the political context, knowledge is something everyone hails and cherishes. An example is that the Socialist Government in Norway renamed its "Ministry of Education and Research" to the "Ministry of Knowledge". It would probably be politically wrong to defy the word "knowledge". The word "knowledge" stirs, however, different sentiments in people. In modern education, the word signifies something notable, discernable, visual or at least possible to distinguish from what it is not. In learning in higher education, knowledge is most often considered as the raw material for learning, with the little extra that distinguishes it from "information". Knowledge is information with a direction, a purpose and meaning, but without the implied cultivation of a teaching and learning process. Given knowledge is used for educational purposes, the processing of knowledge from its basic concepts to embodied and reflected knowledge, properly understood and reconceptualised by the learner, transforms not only the learner, but also the knowledge. In a peripatetic tradition, one likes to think of knowledge as foundation elements for constructions of ethical wisdom as its highest reflective level. Probably we will never see a "Ministry of Wisdom" established, because what is "wisdom" is probably so much more politically charged than "Knowledge". One can only wonder why anyone would degrade a ministry for education to something less. In Europe a rewriting of university curricula is underway all over the continent, because "knowledge" is a key concept in the writing of "learning outcomes". It appears every college is absorbed in sorting out what knowledge is and how knowledge can be classified in categories and levels, and then composed to readable descriptions of syllabi, course descriptions and schemes. Let us hope they are more able than what has been the case. Professor Ronald Barnett of the

  5. Injuries in recreational curling include head injuries and may be prevented by using proper footwear.

    Science.gov (United States)

    Ting, D K; Brison, R J

    2015-04-01

    Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston, Ontario, sites for emergency department (ED) care and participate in CHIRPP. Each retrieved entry underwent a chart review. A secondary survey was mailed to select individuals who had experienced curling injuries to solicit details on their injury and attitudes towards equipment to prevent injury. We used descriptive statistics for rates and proportions. Over 90% of acute curling injuries resulted from a fall, and 31.7% were head impacts. We found that acute injuries requiring ED presentation occur at a rate of approximately 0.17 per 1000 athlete-exposures (95% CI: 0.12-0.22). The secondary survey was completed by 54% of potential respondents. Of survey respondents, 41.3% attributed their fall to a lack of proper footwear and 73.5% of respondents agreed with mandatory sport-specific footwear as a prevention strategy, but only 8% agreed with mandatory helmet wear. Although curling injuries requiring medical care are not common, head injuries make up a large proportion. Mandated use of appropriate footwear appears to be the most effective prevention strategy, as well as the measure deemed most acceptable by players.

  6. Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities.

    Science.gov (United States)

    Daneman, Nick; Campitelli, Michael A; Giannakeas, Vasily; Morris, Andrew M; Bell, Chaim M; Maxwell, Colleen J; Jeffs, Lianne; Austin, Peter C; Bronskill, Susan E

    2017-06-26

    Understanding the extent to which current antibiotic prescribing behaviour is influenced by clinicians' historical patterns of practice will help target interventions to optimize antibiotic use in long-term care. Our objective was to evaluate whether clinicians' historical prescribing behaviours influence the start, prolongation and class selection for treatment with antibiotics in residents of long-term care facilities. We conducted a retrospective cohort study of all physicians who prescribed to residents in long-term care facilities in Ontario between Jan. 1 and Dec. 31, 2014. We examined variability in antibiotic prescribing among physicians for 3 measures: start of treatment with antibiotics, use of prolonged durations exceeding 7 days and selection of fluoroquinolones. Funnel plots with control limits were used to determine the extent of variation and characterize physicians as extreme low, low, average, high and extreme high prescribers for each tendency. Multivariable logistic regression was used to assess whether a clinician's prescribing tendency in the previous year predicted current prescribing patterns, after accounting for residents' demographics, comorbidity, functional status and indwelling devices. Among 1695 long-term care physicians, who prescribed for 93 132 residents, there was wide variability in the start of antibiotic treatment (median 45% of patients, interquartile range [IQR] 32%-55%), use of prolonged treatment durations (median 30% of antibiotic prescriptions, IQR 19%-46%) and selection of fluoroquinolones (median 27% of antibiotic prescriptions, IQR 18%-37%). Prescribing tendencies for antibiotics by physicians in 2014 correlated strongly with tendencies in the previous year. After controlling for individual resident characteristics, prior prescribing tendency was a significant predictor of current practice. Physicians prescribing antibiotics exhibited individual, measurable and historical tendencies toward start of antibiotic treatment

  7. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...

  8. Assessment of provider competence and quality of maternal/newborn care in selected Latin American and Caribbean countries

    Directory of Open Access Journals (Sweden)

    Joyce E Thompson

    2015-05-01

    Full Text Available OBJECTIVE: To obtain a snapshot of the maternal and newborn care provided by different types of maternal and child health providers in Latin America and the Caribbean (LAC to 1 better inform advocacy and programmatic strategies and interventions to improve the quality of those services in the region, and 2 determine the need for more rigorous study of the issues. METHODS: A rapid assessment of 83 health workers providing antepartum, intrapartum, and immediate postpartum and newborn care (within two hours of birth in eight LAC countries was conducted in November and December of 2011. Health workers were observed by two-person expert maternal/newborn clinician teams using pretested forms based on international quality-of-care standards. A total of 105 care encounters were observed, primarily in urban, public, referral-level settings. Providers of care included obstetricians, midwives, generalist physicians, medical residents, registered nurses, auxiliary nurses, and students of medicine, midwifery, and nursing. RESULTS: Hand washing, as an indicator of quality of antepartum care, was observed in only 41% of the observed encounters. Labor management often lacked certain elements of respectful maternity care across all provider groups. Several clinical tasks of high importance in the identification and prevention of common complications of antepartum, intrapartum, and immediate postpartum/newborn care were not documented as performed during the observation periods. Providers self-reported limited competence (ability to perform to a defined level of proficiency in manual removal of the placenta, bimanual compression of the uterus, and newborn resuscitation. CONCLUSIONS: The findings suggest that 1 the quality of maternal and newborn care and 2 the competence of maternal and child health providers in the diverse selection of LAC countries that were studied require substantial attention.

  9. Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

    Science.gov (United States)

    Tucker, Larry A.; Clegg, Alan G.

    2002-01-01

    Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

  10. Associations between structural capabilities of primary care practices and performance on selected quality measures.

    Science.gov (United States)

    Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Zaslavsky, Alan M; Schneider, Eric C

    2009-10-06

    Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown. To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures. Cross-sectional analysis. Massachusetts. 412 primary care practices. During 2007, 1 physician from each participating primary care practice (median size, 4 physicians) was surveyed about structural capabilities of the practice (responses representing 308 practices were obtained). Data on practice structural capabilities were linked to multipayer performance data on 13 Healthcare Effectiveness Data and Information Set (HEDIS) process measures in 4 clinical areas: screening, diabetes, depression, and overuse. Frequently used multifunctional electronic health records were associated with higher performance on 5 HEDIS measures (3 in screening and 2 in diabetes), with statistically significant differences in performance ranging from 3.1 to 7.6 percentage points. Frequent meetings to discuss quality were associated with higher performance on 3 measures of diabetes care (differences ranging from 2.3 to 3.1 percentage points). Physician awareness of patient experience ratings was associated with higher performance on screening for breast cancer and cervical cancer (1.9 and 2.2 percentage points, respectively). No other structural capabilities were associated with performance on more than 1 measure. No capabilities were associated with performance on depression care or overuse. Structural capabilities of primary care practices were assessed by physician survey. Among the investigated structural capabilities of primary care practices, electronic health records were associated with higher performance across multiple HEDIS measures. Overall, the modest magnitude and

  11. Chiropractic physicians: toward a select conceptual understanding of bureaucratic structures and functions in the health care institution.

    Science.gov (United States)

    Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael Wv

    2011-12-01

    The purpose of this article is to present select concepts and theories of bureaucratic structures and functions so that chiropractic physicians and other health care professionals can use them in their respective practices. The society-culture-personality model can be applied as an organizational instrument for assisting chiropractors in the diagnosis and treatment of their patients irrespective of locality. Society-culture-personality and social meaningful interaction are examined in relationship to the structural and functional aspects of bureaucracy within the health care institution of a society. Implicit in the examination of the health care bureaucratic structures and functions of a society is the focus that chiropractic physicians and chiropractic students learn how to integrate, synthesize, and actualize values and virtues such as empathy, integrity, excellence, diversity, compassion, caring, and understanding with a deep commitment to self-reflection. It is essential that future and current chiropractic physicians be aware of the structural and functional aspects of an organization so that chiropractic and other health care professionals are able to deliver care that involves the ingredients of quality, affordability, availability, accessibility, and continuity for their patients.

  12. Chiropractic physicians: toward a select conceptual understanding of bureaucratic structures and functions in the health care institution

    Science.gov (United States)

    Fredericks, Marcel; Kondellas, Bill; Hang, Lam; Fredericks, Janet; Ross, Michael WV

    2011-01-01

    Objective The purpose of this article is to present select concepts and theories of bureaucratic structures and functions so that chiropractic physicians and other health care professionals can use them in their respective practices. The society-culture-personality model can be applied as an organizational instrument for assisting chiropractors in the diagnosis and treatment of their patients irrespective of locality. Discussion Society-culture-personality and social meaningful interaction are examined in relationship to the structural and functional aspects of bureaucracy within the health care institution of a society. Implicit in the examination of the health care bureaucratic structures and functions of a society is the focus that chiropractic physicians and chiropractic students learn how to integrate, synthesize, and actualize values and virtues such as empathy, integrity, excellence, diversity, compassion, caring, and understanding with a deep commitment to self-reflection. Conclusion It is essential that future and current chiropractic physicians be aware of the structural and functional aspects of an organization so that chiropractic and other health care professionals are able to deliver care that involves the ingredients of quality, affordability, availability, accessibility, and continuity for their patients. PMID:22693481

  13. HIV-positive patients’ perceptions of care received at a selected antiretroviral therapy clinic in Vhembe district, South Africa

    Directory of Open Access Journals (Sweden)

    Tshifhiwa V. Ndou

    2016-04-01

    Full Text Available Background: Patients’ experiences are a reflection of what has happened during the care process and, therefore, provide information about the performance of health care professional workers. They refer to the process of care provision at the antiretroviral therapy (ART sites. Aim and setting: This article explored the perceptions of HIV-positive patients of care received at the Gateway Clinic of the regional hospital that provides antiretroviral treatment in the Vhembe district. Methods: A qualitative, explorative and descriptive design was used. A non-probability, convenient sampling method was used to select 20 HIV-positive patients who were above 18 years of age. In-depth individual interviews were used to collect data. Data were analysed through Tech’s open coding method. Results: One theme and two sub-themes emerged, namely positive experiences related to the environment and attitudes of health professionals, and negative experiences concerning the practices by health care providers. Conclusion: Patients’ perceptions of quality of, and satisfaction with, health care may affect health outcomes. Recommendations are made to consider, practice and strengthen the protocols, the standard operating procedures and the principles of infection control in the health facilities. Keywords: Human Immunodeficiecy Virus, Antiretroviral Treatment, HIV positive, Limpopo

  14. The Nordic Maintenance Care Program – An interview study on the use of maintenance care in a selected group of Danish chiropractors

    Directory of Open Access Journals (Sweden)

    Leboeuf-Yde Charlotte

    2009-06-01

    Full Text Available Abstract Background Although maintenance care appears to be relatively commonly used among chiropractors, the indications for its use are incompletely understood. A questionnaire survey was recently carried out among Swedish chiropractors in order to identify their choice of various management strategies, including maintenance care. That study revealed a common pattern of choice of strategies. However, it would be necessary to verify these findings in another study population and to obtain some additional information best collected through an interview. Objectives The main aim of the present study was to attempt to reproduce the findings in the Swedish study and to obtain more information on the use of maintenance care. Method A group of 11 chiropractors were selected because they used maintenance care. They were interviewed using the questionnaire from the previous Swedish survey. The questionnaire consisted of a simple description of a hypothetical patient with low back pain and nine possible ways in which the case could develop ("scenarios". They could choose between six different management strategies for each scenario. In addition, the chiropractors were encouraged to provide their own definition of maintenance care in an open-ended question. Interviews were taped, transcribed and analyzed. For the open-ended question, statements were identified relating to six pre hoc defined topics on the inclusion criteria/rationale for maintenance care, the frequency of treatments, and the duration of the maintenance care program. Results The open-ended question revealed that in patients with low back pain, maintenance care appears to be offered to prevent new events. The rationale was to obtain optimal spinal function. There appears to be no common convention on the frequency of treatments and duration of the treatment program was not mentioned by any of the interviewees. Conclusion The results from the questionnaire in the Danish survey showed that

  15. An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long Term Care

    Science.gov (United States)

    Yap, Tracey L.; Kennerly, Susan M.; Bergstrom, Nancy; Hudak, Sandra L.; Horn, Susan D.

    2015-01-01

    Pressure ulcers (PrUs) have consistently resisted prevention efforts in long term care (LTC) facilities nationwide. Recent research has described cueing innovations that – when selected according to the assumptions and resources of particular facilities – support best practices of PrU prevention. This paper synthesizes that research into a unified, dynamic logic model to facilitate effective staff implementation of a PrU prevention program. PMID:26066791

  16. Regional differences in the validity of self-reported use of health care in Belgium: selection versus reporting bias

    Directory of Open Access Journals (Sweden)

    J. Van der Heyden

    2016-08-01

    Full Text Available Abstract Background The Health Care Module of the European Health Interview Survey (EHIS is aimed to obtain comparable information on the use of inpatient and ambulatory care in all EU member states. In this study we assessed the validity of self-reported information on the use of health care, collected through this instrument, in the Belgian Health Interview Survey (BHIS, and explored the impact of selection and reporting bias on the validity of regional differences in health care use observed in the BHIS. Methods To assess reporting bias, self-reported BHIS 2008 data were linked with register-based data from the Belgian compulsory health insurance (BCHI. The latter were compared with similar estimates from a random sample of the BCHI to investigate the selection bias. Outcome indicators included the prevalence of a contact with a GP, specialist, dentist and a physiotherapist, as well as inpatient and day patient hospitalisation. The validity of the estimates and the regional differences were explored through measures of agreement and logistic regression analyses. Results Validity of self-reported health care use varies by type of health service and is more affected by reporting than by selection bias. Compared to health insurance estimates, self-reported results underestimate the percentage of people with a specialist contact in the past year (50.5 % versus 65.0 % and a day patient hospitalisation (7.8 % versus 13.9 %. Inversely, survey results overestimated the percentage of people having visited a dentist in the past year: 58.3 % versus 48.6 %. The best concordance was obtained for an inpatient hospitalisation (kappa 0.75. Survey data overestimate the higher prevalence of a contact with a specialist [OR 1.51 (95 % CI 1.33–1.72 for self-report and 1.08 (95 % CI 1.05–1.15 for register] and underestimate the lower prevalence of a contact with a GP [ORs 0.59 (95 % CI 0.51–0.70 and 0.41 (95 % CI 0.39–0.42 respectively] in

  17. The proper time for antioxidant consumption.

    Science.gov (United States)

    Beaulieu, Michaël; Schaefer, H Martin

    2014-04-10

    Consuming food rich in antioxidants may help organisms to increase their antioxidant defences and avoid oxidative damage. Under the hypothesis that organisms actively consume food for its antioxidant properties, they would need to do so in view of other physiological requirements, such as energy requirements. Here, we observed that Gouldian finches (Erythrura gouldiae) consumed most seeds rich in antioxidants in the middle of the day, while their consumption of staple seeds more profitable in energy intake (and poor in antioxidants) was maximal in the morning and the evening. This consumption of seeds rich in antioxidants in the middle of the day may be explicable (1) because birds took advantage of a time window associated with relaxed energy requirements to ingest antioxidant resources, or (2) because birds consumed antioxidant resources as a response to the highest antioxidant requirements in the middle of the day. If the latter hypothesis holds true, having the possibility to ingest antioxidants should be most beneficial in terms of oxidative balance in the middle of the day. Even though feeding on seeds rich in antioxidants improved Gouldian finches' overall antioxidant capacity, we did not detect any diurnal effect of antioxidant intake on plasma oxidative markers (as measured by the d-ROM and the OXY-adsorbent tests). This indicates that the diurnal pattern of antioxidant intake that we observed was most likely constrained by the high consumption of staple food to replenish or build up body reserves in the morning and in the evening, and not primarily determined by elevated antioxidant requirements in the middle of the day. Consequently, animals appear to have the possibility to increase antioxidant defences by selecting food rich in antioxidants, only when energetic constraints are relaxed. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. The impact of the Brazilian family health strategy on selected primary care sensitive conditions: A systematic review.

    Directory of Open Access Journals (Sweden)

    Mayara Lisboa Bastos

    Full Text Available Brazil has the largest public health-system in the world, with 120 million people covered by its free primary care services. The Family Health Strategy (FHS is the main primary care model, but there is no consensus on its impact on health outcomes. We systematically reviewed published evidence regarding the impact of the Brazilian FHS on selective primary care sensitive conditions (PCSC.We searched Medline, Web of Science and Lilacs in May 2016 using key words in Portuguese and English, without language restriction. We included studies if intervention was the FHS; comparison was either different levels of FHS coverage or other primary health care service models; outcomes were the selected PCSC; and results were adjusted for relevant sanitary and socioeconomic variables, including the national conditional cash transfer program (Bolsa Familia. Due to differences in methods and outcomes reported, pooling of results was not possible.Of 1831 records found, 31 met our inclusion criteria. Of these, 25 were ecological studies. Twenty-one employed longitudinal quasi-experimental methods, 27 compared different levels the FHS coverage, whilst four compared the FHS versus other models of primary care. Fourteen studies found an association between higher FHS coverage and lower post-neonatal and child mortality. When the effect of Bolsa Familia was accounted for, the effect of the FHS on child mortality was greater. In 13 studies about hospitalizations due to PCSC, no clear pattern of association was found. In four studies, there was no effect on child and elderly vaccination or low-birth weight. No included studies addressed breast-feeding, dengue, HIV/AIDS and other neglected infectious diseases.Among these ecological studies with limited quality evidence, increasing coverage by the FHS was consistently associated with improvements in child mortality. Scarce evidence on other health outcomes, hospitalization and synergies with cash transfer was found.

  19. Maternal Health Care Practices among Mothers of a Selected Slum in Dhaka City

    Directory of Open Access Journals (Sweden)

    Mohoshina Karim

    2015-09-01

    Full Text Available Background: Bangladesh is a small South Asian country which became independent in 1971 after a bloody war. Rapid urbanisation in Bangladesh (26% of the 147.1 million inhabitants live in urban areas is fuelling a growth in urban poverty, particularly in the urban slums where the quality of life is extremely poor. The average population density in slums was reported in 2005 as 831 persons per acre or 205,415 people per square kilometre.1 Early commencement of antenatal care by pregnant women as well as regular visits has the potential to affect maternal and foetal outcome. Objective: To assess the status of ANC service used by the pregnant mothers and their socio-demographic characteristics. Materials and Methods: A community-based cross-sectional study was conducted at Moghbazar slum area in Dhaka district of Bangladesh, during January to June 2014. A total of 161 slum dwellers were enrolled in the study. Information regarding education, occupation, monthly family income, antenatal care was gathered using a pretested structured questionnnare and data were analysed. Results: The majority respondents had knowledge about antenatal care and of them 89 (55.2% completed ≥3 visits. Forty five (47.8% pregnant women received ANC from government hospitals. Nearly 72% mothers received ANC service from doctors and 16.9% received from family welfare visitors (FWV. Half of mothers were satisfied with the overall care provided to them. About 86.2% mothers said that they had to wait for more than two hours for check-ups. More than 50% received information about exercise and 36% were reassured about discussing fear and anxiety about pregnancy. Conclusion: This study reveals that antenatal care provided was not up to the mark of standard care and measures should be taken to improve it.

  20. [Proper antibiotic therapy. From penicillin to pharmacogenomic].

    Science.gov (United States)

    Caramia, G; Ruffini, E

    2012-04-01

    Antibiotics have always been considered one of the wonder discoveries of the 20th century. The use of penicillin by Flaming, opened up the golden era of antibiotics and now is hard to imagine the practice of medicine without antibiotics. Life-threatening infections, such as meningitis, endocarditis, bacteremic pneumonia sepsis, would again prove fatal. Also aggressive chemotherapy and transplant procedures would prove impossible. Another real wonder has been the rise of antibiotic resistance soon after the clinical use of penicillin in hospitals and communities. Several study demonstrated an excessive amount of antibiotic prescribing for communities patients and inpatients and in some hospital up to 50% of antibiotic usage is inappropriate: the benefits of antibiotic treatment come with the risk of antibiotic resistance development. In hospitals, infections caused by antibiotic-resistant bacteria are associated with higher mortality, morbidity and prolonged hospital stay compared with infections caused by antibiotic-susceptible bacteria. A variety of strategies has been proposed to reduce the cost and improve the quality of medication use. Education, guidelines and evidence based recommendations are considered to be essential elements of any program designed to influence prescribing behavior and can provide a foundation of knowledge that will enhance and increase the acceptance of stewardship strategies. Evidence-based recommendations, an approach to clinical practice helping to make decisions based on clinical expertise and on intimate knowledge of the individual patient's situations, beliefs, and priorities, enhance antimicrobial stewardship, that include appropriate selection, dosing, route, and duration of antimicrobial therapy can maximize clinical cure or prevention of infection while limiting the unintended consequences, such as the emergence of resistance, adverse drug events, and cost. These evidence-based guidelines are not a substitute for clinical

  1. Presence of selected priority and personal care substances in an onsite bathroom greywater treatment facility

    DEFF Research Database (Denmark)

    Eriksson, Eva; Donner, E.; Ledin, Anna

    2010-01-01

    -out Priority/Priority Hazardous Substances (PS/PHS) is growing, and it is vital to know their sources and flows in order to generate sustainable emission control strategies. The main objective of this study was to quantify the concentrations and loads of PS/PHS and personal care substances in bathroom...

  2. Participation in prenatal screening tests and intentions concerning selective termination in Finnish maternity care

    DEFF Research Database (Denmark)

    Santalahti, P; Hemminki, E; Aro, A R

    1999-01-01

    AIMS: The study examined how prenatal screening tests are presented to women, factors associated with women's participation in screening, their experience of decision-making and intentions concerning pregnancy termination, and hospital data on rates of selective terminations. METHODS: Questionnai......AIMS: The study examined how prenatal screening tests are presented to women, factors associated with women's participation in screening, their experience of decision-making and intentions concerning pregnancy termination, and hospital data on rates of selective terminations. METHODS...... as a routine procedure. Most women (92%) underwent serum screening and most (86%) found the decision to participate or not easy. In almost every aspect of presentation and participation studied, serum and ultrasound screening differed from each other. 85% of respondents to ultrasound screening answered...... in screening and with intentions about selective termination, women's perceptions of lives of the disabled should receive more attention in future studies....

  3. Selected problems associated with the treatment and care for patients with colostomy ? part 1

    OpenAIRE

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzis?awa; Charzy?ska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    The study presents a short historical background and practical application of intestinal ostomy as a treatment method of various intestinal disorders and injuries. Ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. After the surgical formation of the intestinal fistula, the patient must adjust to the new situation, gain basic knowledge and learn procedures of ostomy care. Thus, professional medical assistance is extremely important. The stud...

  4. Emotional Intelligence in Applicant Selection for Care-Related Academic Programs

    Science.gov (United States)

    Zysberg, Leehu; Levy, Anat; Zisberg, Anna

    2011-01-01

    Two studies describe the development of the Audiovisual Test of Emotional Intelligence (AVEI), aimed at candidate selection in educational settings. Study I depicts the construction of the test and the preliminary examination of its psychometric properties in a sample of 92 college students. Item analysis allowed the modification of problem items,…

  5. More Careful or Less Marriageable? Parental Divorce, Spouse Selection and Entry into Marriage

    Science.gov (United States)

    Erola, Jani; Harkonen, Juho; Dronkers, Jaap

    2012-01-01

    Despite the large literature on the long-term effects of parental divorce, few studies have analyzed the effects of parental divorce on spouse selection behavior. However, the characteristics of one's spouse can have important effects on economic well-being and on marital success. We use discrete-time, event-history data from Finnish population…

  6. [Selective digestive tract decontamination in intensive care medicine. Fundamentals and current evaluation].

    Science.gov (United States)

    Krueger, W A; Heininger, A; Unertl, K E

    2003-02-01

    Selective digestive tract decontamination (SDD) is a method where topical non-absorbable antibiotics are applied to the oropharynx and stomach which primarily is aimed at the prevention of ventilator-associated pneumonia. The rationale for SDD is that ventilator associated pneumonia usually originates from the patients'own oropharyngeal microflora. SDD is also used for the prevention of gut-derived infections in acute necrotizing pancreatitis and in liver transplantation. Despite numerous clinical trials and several meta-analyses, SDD is still a controversial topic. It is now commonly accepted that the incidence of pneumonia is reduced,however, the concept of using topical antibiotics has its inherent limitations and the best results have been obtained by combination with a short course of intravenous antibiotics. Several issues surrounding the notorious difficulties in establishing the diagnosis of ventilator-associated pneumonia especially in the presence of antibiotics are an on-going matter of debate.Furthermore, pneumonia is the leading cause of death from nosocomial infections and its prevention was not adequately followed by reduced mortality in most individual trials, however, a benefit was suggested by recalculation of data in meta-analyses. Patients are not well defined by their need for ICU admission and mechanical ventilation and the attributable mortality of infections depends more on the type and severity of the underlying diseases. Recently published trials substantially improved our understanding as to which patients may derive most benefit from SDD.Currently, it seems that an improved survival can be achieved in surgical and trauma patients with severe but salvageable diseases, which might be classified e.g.by calculation of APACHE-II scores on admission.However, the most important drawback of SDD is the development of resistance and an increased selection pressure towards Gram-positive pathogens, especially in institutions with endemic multi

  7. Differences in selected medical care parameters in rheumatic disease ward patients of different ages of life

    Directory of Open Access Journals (Sweden)

    Piotr Pobrotyn

    2016-06-01

    Full Text Available Introduction : Rheumatic diseases are becoming more and more common in Poland with the ageing of the population. Nearly 18% of the total hospital admissions in Poland result from rheumatic diseases, which was equivalent to 350 thousand cases in the year 2008. These diseases tend to last for many decades, decreasing both the quality of life and income of the patients as well as increasing the medical institutions’ workload and society’s financial burden. The aim of the study was to determine whether the medical care parameters in a rheumatic disease hospital ward show any significant differences among different patient age groups – especially such that would support taking them into account as a basis for adjusting the financial coverage level of medical services. Material and methods : Data on hospitalizations at the Rheumatic Diseases Ward of Wroclaw University Hospital in Wroclaw in the years 2009–2015 were analyzed, taking into account the age groups, number of hospital admissions, their duration and causes. Relevant statistical data analysis was performed. Discussion: The study revealed that the number of old patients hospitalized at the rheumatic diseases ward increased over the last 6 years and that such statistically significant differences do exist: on average the old patients not only tend to stay much longer at the hospital, but also suffer from a different and more diverse spectrum of diseases in comparison to their younger counterparts. Conclusions : The detected differences in medical care parameters support the need for more individualized medical care and increased cost of the hospital stay in the case of older patients. Consequently, those factors justify the necessity to increase the value of medical services in the case of old patients, possibly also taking into account the variation between age subgroups.

  8. Injuries in recreational curling include head injuries and may be prevented by using proper footwear

    Directory of Open Access Journals (Sweden)

    D. K. Ting

    2015-04-01

    Full Text Available Introduction: Our study examines a recreational curling population to describe patterns of injury occurrence, estimate risk of injury and to gauge attitudes towards equipment-based prevention strategies. Methods: In a retrospective case series, we queried the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP, a national injury surveillance database, for curling injuries entered between 1993 and 2011. Kingston General Hospital and Hotel Dieu Hospital provide the two Kingston, Ontario, sites for emergency department (ED care and participate in CHIRPP. Each retrieved entry underwent a chart review. A secondary survey was mailed to select individuals who had experienced curling injuries to solicit details on their injury and attitudes towards equipment to prevent injury. We used descriptive statistics for rates and proportions. Results: Over 90% of acute curling injuries resulted from a fall, and 31.7% were head impacts. We found that acute injuries requiring ED presentation occur at a rate of approximately 0.17 per 1000 athlete-exposures (95% CI: 0.12–0.22. The secondary survey was completed by 54% of potential respondents. Of survey respondents, 41.3% attributed their fall to a lack of proper footwear and 73.5% of respondents agreed with mandatory sport-specific footwear as a prevention strategy, but only 8% agreed with mandatory helmet wear. Conclusions: Although curling injuries requiring medical care are not common, head injuries make up a large proportion. Mandated use of appropriate footwear appears to be the most effective prevention strategy, as well as the measure deemed most acceptable by players.

  9. The proper contributions of social workers in health practice.

    Science.gov (United States)

    Huntington, J

    1986-01-01

    of the clinician. Provision of social work services to the health system has become a questionable priority and raises the issue of whether much of what is now termed "health care' could more appropriately be termed "social care' and provided in a primary social work setting to which medicine and nursing would make their "proper contributions'.

  10. Personal Care Product Use in Men and Urinary Concentrations of Select Phthalate Metabolites and Parabens

    DEFF Research Database (Denmark)

    Nassan, Feiby L; Coull, Brent A; Gaskins, Audrey J

    2017-01-01

    BACKGROUND: Personal care products (PCPs) are exposure sources to phthalates and parabens; however, their contribution to men's exposure is understudied. OBJECTIVES: We examined the association between PCP use and urinary concentrations of phthalate metabolites and parabens in men. METHODS...... in urinary concentrations associated with PCP use using linear mixed and Tobit mixed regressions. We also estimated weights for each PCP in a weighted binary score regression and modeled the resulting composite weighted PCP use. RESULTS: Four hundred men contributed 1,037 urine samples (mean of 3/man...

  11. Opening a Pandora's Box: Proper Names in English Phraseology

    Directory of Open Access Journals (Sweden)

    Pierini, Patrizia

    2008-01-01

    Full Text Available This article explores the linguistic-cultural aspects and usage of phraseological units involving personal and place names in English. The introductory sections outline the linguistic features of proper names and phraseological units. The qualitative part of this study provides a list of units belonging to four phraseological types (idioms, stereotyped similes, binomials, formulae, drawn from idiom dictionaries. An investigation of the sources of names shows that the personal and place names involved are historically, socially or culturally prominent in British culture. Here is noted a predominance of personal over place names, and within the former, a predominance of male over female names, and first names over family names, with a number of hypocorisms. The quantitative part of the study consists of a corpus search of the selected units in the British National Corpus in order to find their frequency and distribution across registers. The search reveals that they have very low levels of occurrence, and are more commonly used in written registers, in particular, in fiction, journalism and miscellaneous texts.

  12. Deriving proper uniform priors for regression coefficients, Parts I, II, and III

    NARCIS (Netherlands)

    van Erp, H.R.N.; Linger, R.O.; van Gelder, P.H.A.J.M.

    2017-01-01

    It is a relatively well-known fact that in problems of Bayesian model selection, improper priors should, in general, be avoided. In this paper we will derive and discuss a collection of four proper uniform priors which lie on an ascending scale of informativeness. It will turn out that these

  13. Comparison of Methods of Teaching Children Proper Lifting ...

    African Journals Online (AJOL)

    Objective: This study was designed to determine the effects of three teaching methods on children\\'s ability to demonstrate and recall their mastery of proper lifting techniques. Method: Ninety-three primary five and six public school children who had no knowledge of proper lifting technique were assigned into three equal ...

  14. 5 CFR 2635.205 - Proper disposition of prohibited gifts.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Proper disposition of prohibited gifts... STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH Gifts From Outside Sources § 2635.205 Proper disposition of prohibited gifts. (a) An employee who has received a gift that cannot be accepted...

  15. The proper name as starting point for basic reading skills

    NARCIS (Netherlands)

    Both-De Vries, Anna C.; Bus, Adriana G

    Does alphabetic-phonetic writing start with the proper name and how does the name affect reading and writing skills? Sixty 4- to 5(1/2)-year-old children from middle SES families with Dutch as their first language wrote their proper name and named letters. For each child we created unique sets of

  16. The burden of selected cancers in the US: health behaviors and health care resource utilization

    Directory of Open Access Journals (Sweden)

    Iadeluca L

    2017-11-01

    Full Text Available Laura Iadeluca,1 Jack Mardekian,1 Pratibha Chander,2 Markay Hopps,1 Geoffrey T Makinson1 1Pfizer Inc., 2Atrium Staffing, New York, NY, USA Objective: To characterize the disease burden among survivors of those cancers having the highest incidence in the US.Methods: Adult (≥18 years survivors of the 11 most frequently diagnosed cancers were identified from publically available data sources, including the Surveillance Epidemiology and End Results 9 1973–2012, National Health Interview Survey 2013, and the Medical Expenditure Panel Survey 2011. Chi-square tests and one-way analyses of variance were utilized to assess differences between cancer survivors and non-cancer controls in behavioral characteristics, symptoms and functions, preventative screenings, and health care costs.Results: Hematologic malignancies, melanoma, and breast, prostate, lung, colon/rectal, bladder, kidney/renal, uterine, thyroid, and pancreatic cancers had the highest incidence rates. Breast cancer had the highest incidence among women (156.4 per 100,000 and prostate cancer among men (167.2 per 100,000. The presence of pain (P=0.0003, fatigue (P=0.0005, and sadness (P=0.0012 was consistently higher in cancer survivors 40–64 years old vs. non-cancer controls. Cancer survivors ≥65 years old had higher rates of any functional limitations (P=0.0039 and reported a lack of exercise (P<0.0001 compared with the non-cancer controls. However, obesity rates were similar between cancer survivors and non-cancer controls. Among cancer survivors, an estimated 13.5 million spent $169.4 billion a year on treatment, with the highest direct expenditures for breast cancer ($39 billion, prostate cancer ($37 billion, and hematologic malignancies ($25 billion. Prescription medications and office-based visits contributed equally as the cost drivers of direct medical spending for breast cancer, while inpatient hospitalization was the driver for prostate (52.8% and lung (38.6% cancers

  17. Determination of proper motions in the Pleiades cluster

    Science.gov (United States)

    Schilbach, E.

    1991-04-01

    For 458 stars in the Pleiades field from the catalog of Eichhorn et al. (1970) proper motions were derived on Tautenburg and CERGA Schmidt telescope plates measured with the automated measuring machine MAMA in Paris. The catalog positions were considered as first epoch coordinates with an epoch difference of ca. 33 years to the observations. The results show good coincidence of proper motions derived with both Schmidt telescopes within the error bars. Comparison with proper motions determined by Vasilevskis et al. (1979) displays some significant differences but no systematic effects depending on plate coordinates or magnitudes could be found. An accuracy of 0.3 arcsec/100a for one proper motion component was estimated. According to the criterion of common proper motion 34 new cluster members were identified.

  18. The Southern Proper Motion Program. IV. The SPM4 Catalog

    Science.gov (United States)

    Girard, Terrence M.; van Altena, William F.; Zacharias, Norbert; Vieira, Katherine; Casetti-Dinescu, Dana I.; Castillo, Danilo; Herrera, David; Lee, Young Sun; Beers, Timothy C.; Monet, David G.; López, Carlos E.

    2011-07-01

    We present the fourth installment of the Yale/San Juan Southern Proper Motion Catalog, SPM4. The SPM4 contains absolute proper motions, celestial coordinates, and B, V photometry for over 103 million stars and galaxies between the south celestial pole and -20° declination. The catalog is roughly complete to V = 17.5 and is based on photographic and CCD observations taken with the Yale Southern Observatory's double astrograph at Cesco Observatory in El Leoncito, Argentina. The proper-motion precision, for well-measured stars, is estimated to be 2-3 mas yr-1, depending on the type of second-epoch material. At the bright end, proper motions are on the International Celestial Reference System by way of Hipparcos Catalog stars, while the faint end is anchored to the inertial system using external galaxies. Systematic uncertainties in the absolute proper motions are on the order of 1 mas yr-1.

  19. Selecting an interprofessional education model for a tertiary health care setting.

    Science.gov (United States)

    Menard, Prudy; Varpio, Lara

    2014-07-01

    The World Health Organization describes interprofessional education (IPE) and collaboration as necessary components of all health professionals' education - in curriculum and in practice. However, no standard framework exists to guide healthcare settings in developing or selecting an IPE model that meets the learning needs of licensed practitioners in practice and that suits the unique needs of their setting. Initially, a broad review of the grey literature (organizational websites, government documents and published books) and healthcare databases was undertaken for existing IPE models. Subsequently, database searches of published papers using Scopus, Scholars Portal and Medline was undertaken. Through this search process five IPE models were identified in the literature. This paper attempts to: briefly outline the five different models of IPE that are presently offered in the literature; and illustrate how a healthcare setting can select the IPE model within their context using Reeves' seven key trends in developing IPE. In presenting these results, the paper contributes to the interprofessional literature by offering an overview of possible IPE models that can be used to inform the implementation or modification of interprofessional practices in a tertiary healthcare setting.

  20. Nest site selection and nutritional provision through excreta: a form of parental care in a tropical endogeic earthworm

    Directory of Open Access Journals (Sweden)

    Angel I. Ortiz-Ceballos

    2016-05-01

    Full Text Available Nest construction is a common form of parental care in soil organisms. However, it is unknown whether the tropical earthworm Pontoscolex corethrurus produces nests in soils with low nutritional quality habitats. Here we studied the reproductive behaviour and nest site selection of P. corethrurus, and tested the hypothesis whether P. corethrurus produces more cocoons in habitats with low nutritional quality. In bidimensional terrariums we evaluated the combined effect of the nutritional quality of habitat: (Poor Quality Habitat = PQH, Medium Quality Habitat = MQH, High Quality Habitat = HQH and soil depth (Shallow, Intermediate, Deep in a factorial 32 design. The number and biomass of cocoons, progeny and the production of internal and external excreta were evaluated. The quality habitat and depth of soil and their interaction had a significant effect on nest site construction and the deposition of internal excreta. Pontoscolex corethrurus built a higher amount of nests in the PQH-Intermediate and MQH-Intermediate treatments while more internal excreta were found in the HQH-Intermediate treatment. Offspring biomass was positively associated with internal excreta in the PQH (soil only and MQH (soil + grass treatments, suggesting that this could be a form of parental care. Since P. corethrurus produces more cocoons in low and medium quality habitats, while produces more internal excreta at high quality habitats, there does not seem to be an association between number of offspring and parental care. We suggest P. corethrurus could have two reproductive strategies that act as diversified bet-hedging (do not put all cocoons in one basket behavior in unpredictable environment, and thus build a higher amount of nests in low and medium quality habitats; and another where they produce more internal excreta as a form of parental care in high quality habitats. Parental care in the form of internal excreta may be particularly important in poor and medium

  1. Solving a More Flexible Home Health Care Scheduling and Routing Problem with Joint Patient and Nursing Staff Selection

    Directory of Open Access Journals (Sweden)

    Jamal Abdul Nasir

    2018-01-01

    Full Text Available Development of an efficient and effective home health care (HHC service system is a quite recent and challenging task for the HHC firms. This paper aims to develop an HHC service system in the perspective of long-term economic sustainability as well as operational efficiency. A more flexible mixed-integer linear programming (MILP model is formulated by incorporating the dynamic arrival and departure of patients along with the selection of new patients and nursing staff. An integrated model is proposed that jointly addresses: (i patient selection; (ii nurse hiring; (iii nurse to patient assignment; and (iv scheduling and routing decisions in a daily HHC planning problem. The proposed model extends the HHC problem from conventional scheduling and routing issues to demand and capacity management aspects. It enables an HHC firm to solve the daily scheduling and routing problem considering existing patients and nursing staff in combination with the simultaneous selection of new patients and nurses, and optimizing the existing routes by including new patients and nurses. The model considers planning issues related to compatibility, time restrictions, contract durations, idle time and workload balance. Two heuristic methods are proposed to solve the model by exploiting the variable neighborhood search (VNS approach. Results obtained from the heuristic methods are compared with a CPLEX based solution. Numerical experiments performed on different data sets, show the efficiency and effectiveness of the solution methods to handle the considered problem.

  2. Success/Failure Prediction of Noninvasive Mechanical Ventilation in Intensive Care Units. Using Multiclassifiers and Feature Selection Methods.

    Science.gov (United States)

    Martín-González, Félix; González-Robledo, Javier; Sánchez-Hernández, Fernando; Moreno-García, María N

    2016-05-17

    This paper addresses the problem of decision-making in relation to the administration of noninvasive mechanical ventilation (NIMV) in intensive care units. Data mining methods were employed to find out the factors influencing the success/failure of NIMV and to predict its results in future patients. These artificial intelligence-based methods have not been applied in this field in spite of the good results obtained in other medical areas. Feature selection methods provided the most influential variables in the success/failure of NIMV, such as NIMV hours, PaCO2 at the start, PaO2 / FiO2 ratio at the start, hematocrit at the start or PaO2 / FiO2 ratio after two hours. These methods were also used in the preprocessing step with the aim of improving the results of the classifiers. The algorithms provided the best results when the dataset used as input was the one containing the attributes selected with the CFS method. Data mining methods can be successfully applied to determine the most influential factors in the success/failure of NIMV and also to predict NIMV results in future patients. The results provided by classifiers can be improved by preprocessing the data with feature selection techniques.

  3. Application of interval 2-tuple linguistic MULTIMOORA method for health-care waste treatment technology evaluation and selection.

    Science.gov (United States)

    Liu, Hu-Chen; You, Jian-Xin; Lu, Chao; Shan, Meng-Meng

    2014-11-01

    The management of health-care waste (HCW) is a major challenge for municipalities, particularly in the cities of developing countries. Selection of the best treatment technology for HCW can be viewed as a complicated multi-criteria decision making (MCDM) problem which requires consideration of a number of alternatives and conflicting evaluation criteria. Additionally, decision makers often use different linguistic term sets to express their assessments because of their different backgrounds and preferences, some of which may be imprecise, uncertain and incomplete. In response, this paper proposes a modified MULTIMOORA method based on interval 2-tuple linguistic variables (named ITL-MULTIMOORA) for evaluating and selecting HCW treatment technologies. In particular, both subjective and objective importance coefficients of criteria are taken into consideration in the developed approach in order to conduct a more effective analysis. Finally, an empirical case study in Shanghai, the most crowded metropolis of China, is presented to demonstrate the proposed method, and results show that the proposed ITL-MULTIMOORA can solve the HCW treatment technology selection problem effectively under uncertain and incomplete information environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Forecasting need and demand for home health care: a selective review.

    Science.gov (United States)

    Sharma, R K

    1980-01-01

    THREE MODELS FOR FORECASTING HOME HEALTH CARE (HHC) NEEDS ARE ANALYZED: HSA/SP model (Health Systems Agency of Southwestern Pennsylvania); Florida model (Florida State Department of Health and Rehabilitative Services); and Rhode Island model (Rhode Island Department of Community Affairs). A utilization approach to forecasting is also presented.In the HSA/SP and Florida models, need for HHC is based on a certain proportion of (a) hospital admissions and (b) patients entering HHC from other sources. The major advantage of these models is that they are relatively easy to use and explain; their major weaknesses are an imprecise definition of need and an incomplete model specification.The Rhode Island approach defines need for HHC in terms of the health status of the population as measured by chronic activity limitations. The major strengths of this approach are its explicit assumptions and its emphasis on consumer needs. The major drawback is that it requires considerable local area data.The utilization approach is based on extrapolation from observed utilization experience of the target population. Its main limitation is that it is based on current market imperfections; its major advantage is that it exposes existing deficiencies in HHC.The author concludes that each approach should be tested empirically in order to refine it, and that need and demand approaches be used jointly in the planning process.

  5. STUDY OF PRESCRIBING PATTERN OF ANTIMICROBIAL AGENTS IN SELECTED PATIENTS ATTENDING TERTIARY CARE HOSPITAL IN INDIA

    Directory of Open Access Journals (Sweden)

    Anjan Adhikari

    2013-06-01

    Full Text Available Antibiotics are the most commonly prescribed drugs in hospitals and their irrational use is one of the important factors for the development and spread of resistance. The objective of this study was to evaluate the antibiotic prescription pattern in the patient attending the tertiary care hospital. It was found that a total of 333 antibiotics where prescribed in 245 prescriptions. The average number of antibiotics per prescription was approximately1.4. The most commonly used antibiotics were moxifloxacin 19.5%, metronidazole 10.4%, amoxicillin + cloxacillin 10.2% and ciprofloxacin 6%. antibiotics were almost equally prescribed to both male and female. 45.5% of the antibiotics shows adherence with the National List of Essential Medicines of India. 76.6% of the antibiotics were single products while 23.4% were fixed dose combination. The most commonly used dosage forms were tablets (57%, drops (23.5% and creams (11.7%.57.3% were prescribed irrationally. Quinolones (48.2% and antifungals (21.5% were the most common types of prescribed antibiotics in which irrationality was found.

  6. Screening the Toxicity of Selected Personal Care Products Using Embryo Bioassays: 4-MBC, Propylparaben and Triclocarban

    Directory of Open Access Journals (Sweden)

    Tiago Torres

    2016-10-01

    Full Text Available Recently, several emerging pollutants, including Personal Care Products (PCPs, have been detected in aquatic ecosystems, in the ng/L or µg/L range. Available toxicological data is limited, and, for certain PCPs, evidence indicates a potential risk for the environment. Hence, there is an urgent need to gather ecotoxicological data on PCPs as a proxy to improve risk assessment. Here, the toxicity of three different PCPs (4-Methylbenzylidene Camphor (4-MBC, propylparaben and triclocarban was tested using embryo bioassays with Danio rerio (zebrafish and Paracentrotus lividus (sea urchin. The No Observed Effect Concentration (NOEC for triclocarban was 0.256 µg/L for sea urchin and 100 µg/L for zebrafish, whereas NOEC for 4-MBC was 0.32 µg/L for sea urchin and 50 µg/L for zebrafish. Both PCPs impacted embryo development at environmentally relevant concentrations. In comparison with triclocarban and 4-MBC, propylparaben was less toxic for both sea urchin (NOEC = 160 µg/L and zebrafish (NOEC = 1000 µg/L. Overall, this study further demonstrates the sensitivity of embryo bioassays as a high-throughput approach for testing the toxicity of emerging pollutants.

  7. Young Adults’ Selection and Use of Dependent Coverage under the Affordable Care Act

    Directory of Open Access Journals (Sweden)

    Weiwei Chen

    2018-01-01

    Full Text Available The dependent coverage expansion under the Affordable Care Act (ACA required health insurance policies that cover dependents to offer coverage for policyholder’ children up to age 26. It has been well documented that the provision successfully reduced the uninsured rate among the young adults. However, less is known about whether dependent coverage crowded out other insurance types and whether young adults used dependent coverage as a fill-in-the-gap short-term option. Using data from the Survey of Income and Program Participation 2008 Panel, the paper assesses dependent coverage uptake and duration before and after the ACA provision among young adults aged 19–26 versus those aged 27–30. Regressions for additional coverage outcomes were also performed to estimate the crowd-out rate. It was found that the ACA provision had a significant positive impact on dependent coverage uptake and duration. The estimated crowd-out rate ranges from 27 to 42%, depending on the definition. Most dependent coverage enrollees used the coverage for 1 or 2 years. Differences in dependent coverage uptake and duration remained among racial groups. Less healthy individuals were also less likely to make use of dependent coverage.

  8. Proper laboratory notebook practices: protecting your intellectual property.

    Science.gov (United States)

    Nickla, Jason T; Boehm, Matthew B

    2011-03-01

    A laboratory notebook contains a wealth of knowledge that can be critical for establishing evidence in support of intellectual property rights and for refuting claims of research misconduct. The proper type, organization, use, maintenance, and storage of laboratory notebooks should be a priority for everyone at research institutions. Failure to properly document research activities can lead to serious problems, including the loss of valuable patent rights. Consequences of improper laboratory notebook practices can be harsh; numerous examples are described in court cases and journal articles, indicating a need for research institutions to develop strict policies on the proper use and storage of research documentation.

  9. Selected personal care products and endocrine disruptors in biosolids: an Australia-wide survey.

    Science.gov (United States)

    Langdon, Kate A; Warne, Michael St J; Smernik, Ronald J; Shareef, Ali; Kookana, Rai S

    2011-02-15

    Personal care products (PCPs) and endocrine disrupting compounds (EDCs) are groups of organic contaminants that have been detected in biosolids around the world. There is a shortage of data on these types on compounds in Australian biosolids, making it difficult to gain an understanding of their potential risks in the environment following land application. In this study, 14 biosolids samples were collected from 13 Australian wastewater treatment plants (WWTPs) to determine concentrations of eight compounds that are PCPs and/or EDCs: 4-t-octylphenol (4tOP), 4-nonylphenol (4NP), triclosan (TCS), bisphenol A (BPA), estrone (E1), 17β-estradiol (E2), estriol (E3) and 17α-ethinylestradiol (EE2). Concentration data were evaluated to determine if there were any differences between samples that had undergone anaerobic or aerobic treatment. The concentration data were also compared to other Australian and international data. Only 4tOP, 4NP, TCS, and BPA were detected in all samples and E1 was detected in four of the 14 samples. Their concentrations ranged from 0.05 to 3.08 mg/kg, 0.35 to 513 mg/kg, treatment showed significantly higher concentrations of the compounds than those obtained from WWTPs that used aerobic treatment. Overall, 4NP, TCS and BPA concentrations in Australian biosolids were lower than global averages (by 42%, 12% and 62%, respectively) and 4tOP concentrations were higher (by 25%), however, of these differences only that for BPA was statistically significant. The European Union limit value for NP in biosolids is 50 mg/kg, which 4 of the 14 samples in this study exceeded. Copyright © 2010 Elsevier B.V. All rights reserved.

  10. Handling medical negligence: necessity of a proper system

    Directory of Open Access Journals (Sweden)

    Nuwadatta Subedi

    2017-12-01

    field by the councils framed to settle the cases of medical negligence, especially the consumer protection council, Nepal Medical Council, etc.It is a high time for the government to play role to address to this sensitive and quai-legal issue. If this trend is not ended, the trust of patients towards the doctors may nullify. The doctors also cannot work effectively when there is no safe working environment and may begin to have tendency to abandon handling critical cases with a fear of vulnerability to defamation if not physical assault in worst case. The situation is ultimately disastrous to the entire health care system. The very sensitive issue of health care delivery cannot be compared to any other commercial issues. The proper mechanism of addressing the issue of medical negligence should be practiced alongside encouragement from governmental urge to come up with better medicolegal systems in this regard. This is highly essential for balancing expectations of the patients and performance of medical professionals.

  11. Out-of-pocket costs, primary care frequent attendance and sample selection: Estimates from a longitudinal cohort design.

    Science.gov (United States)

    Pymont, Carly; McNamee, Paul; Butterworth, Peter

    2018-03-20

    This paper examines the effect of out-of-pocket costs on subsequent frequent attendance in primary care using data from the Personality and Total Health (PATH) Through Life Project, a representative community cohort study from Canberra, Australia. The analysis sample comprised 1197 respondents with two or more GP consultations, and uses survey data linked to administrative health service use (Medicare) data which provides data on the number of consultations and out-of-pocket costs. Respondents identified in the highest decile of GP use in a year were defined as Frequent Attenders (FAs). Logistic regression models that did not account for potential selection effects showed that out-of-pocket costs incurred during respondents' prior two consultations were significantly associated with subsequent FA status. Respondents who incurred higher costs ($15-$35; or >$35) were less likely to become FAs than those who incurred no or low (attenders. Copyright © 2018. Published by Elsevier B.V.

  12. A Case of Ruptured Aneurysm of the Proper Esophageal Artery with Symptomatic Mediastinal Hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Jiajia; Sato, Yusuke, E-mail: yusuke@doc.med.akita-u.ac.jp [Akita University Graduate School of Medicine, Department of Thoracic Surgery (Japan); Takahashi, Satoshi [Akita University Graduate School of Medicine, Department of Radiology (Japan); Motoyama, Satoru; Yoshino, Kei; Sasaki, Tomohiko; Imai, Kazuhiro; Saito, Hajime; Minamiya, Yoshihiro [Akita University Graduate School of Medicine, Department of Thoracic Surgery (Japan)

    2016-08-15

    Mediastinal aneurysms are rare but potentially life-threatening. Among these, bronchial artery aneurysms are most frequently reported, whereas up to now aneurysms of the proper esophageal artery had never been reported. A 69-year-old woman was referred to our hospital for treatment of a massive mediastinal hematoma. Enhanced computed tomography and selective proper esophageal arteriography revealed a 5-mm aneurysm in the proper esophageal artery that arises from the thoracic aorta at the Th8 level and has an anastomotic branch with the bronchial artery peripherally. Transcatheter arterial embolization was successfully performed using a mixture of N-butyl cyanoacrylate and lipiodol (1:3 ratio, 0.3 ml). Post-embolization angiography showed no filling into the aneurysm. The patient recovered with no complications and was discharged on the 25th post-procedure day.

  13. Possible Relativistic Definitions of Parallax, Proper Motion and Radial Velocity

    National Research Council Canada - National Science Library

    Klioner, S

    2000-01-01

    .... In this paper, the authors briefly describe a relativistic model of space-based optical positional observations valid at a high level of accuracy, and suggest definitions of parallax, proper motion...

  14. Proper Use of Audio-Visual Aids: Essential for Educators.

    Science.gov (United States)

    Dejardin, Conrad

    1989-01-01

    Criticizes educators as the worst users of audio-visual aids and among the worst public speakers. Offers guidelines for the proper use of an overhead projector and the development of transparencies. (DMM)

  15. Proper time axis of a closed relativistic system

    International Nuclear Information System (INIS)

    Chernikov, N.A.; Fadeev, N.G.; Shavokhina, N.S.

    1997-01-01

    The definition of a proper time axis of a closed relativistic system of colliding particles is given. The solution of the proper time axis problem is presented. If the light velocity c equals the imaginary unit i, then in the case of a plane motion of the system the problem about the proper time axis turns out to be equivalent to the known in engineering mechanics problem about the reduction of any system of forces, applied to a rigid body, to the dynamic screw. In the general case, when c=i, the problem about the proper time axis turns out to be equivalent to the problem about the reduction to the dynamic screw of a system of forces, applied to a rigid body in a four-dimensional Euclidean space

  16. A properly adjusted forage harvester can save time and money

    Science.gov (United States)

    A properly adjusted forage harvester can save fuel and increase the realizable milk per ton of your silage. This article details the adjustments necessary to minimize energy while maximizing productivity and forage quality....

  17. Experiences of primary health care nurses in implementing integrated management of childhood illnesses strategy at selected clinics of Limpopo Province.

    Science.gov (United States)

    Vhuromu, E N; Davhana-Maselesele, M

    2009-09-01

    Treatment of the under five years is a national priority as an attempt in curbing deaths and deformities affecting children. Primary health care was implemented in the clinics in order to help in the treatment of illnesses affecting the community, including children. As a result of childhood illnesses; the World Health Organization (WHO) and United Nation Children's Fund (UNICEF) came up with Integrated Management of Childhood illnesses (IMCI) strategy to enhance treatment of such illnesses in developing countries. Primary health care nurses (PHCNS) in Limpopo Province were also trained to implement the strategy. This study is intended to explore and describe the experiences of PHCNS in implementing the IMCI strategy at selected clinics in Vhembe District in the Limpopo Province. A qualitative, explorative, descriptive and contextual design was used. In-depth interviews were conducted with PHCNS who are IMCI trained and have implemented the strategy for a period of not less than two years. Data analysis was done through using Tesch 's method of open coding for qualitative analysis. Findings revealed that PHCNS had difficulty in rendering IMCI services due to lack of resources and poor working conditions. Recommendations address the difficulties experienced by PHCNS when implementing the IMCI strategy.

  18. Fast algorithms for finding proper strategies in game trees

    DEFF Research Database (Denmark)

    Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    We show how to find a normal form proper equilibrium in behavior strategies of a given two-player zero-sum extensive form game with imperfect information but perfect recall. Our algorithm solves a finite sequence of linear programs and runs in polynomial time. For the case of a perfect information...... game, we show how to find a normal form proper equilibrium in linear time by a simple backwards induction procedure....

  19. Research on orbit prediction for solar-based calibration proper satellite

    Science.gov (United States)

    Chen, Xuan; Qi, Wenwen; Xu, Peng

    2018-03-01

    Utilizing the mathematical model of the orbit mechanics, the orbit prediction is to forecast the space target's orbit information of a certain time based on the orbit of the initial moment. The proper satellite radiometric calibration and calibration orbit prediction process are introduced briefly. On the basis of the research of the calibration space position design method and the radiative transfer model, an orbit prediction method for proper satellite radiometric calibration is proposed to select the appropriate calibration arc for the remote sensor and to predict the orbit information of the proper satellite and the remote sensor. By analyzing the orbit constraint of the proper satellite calibration, the GF-1solar synchronous orbit is chose as the proper satellite orbit in order to simulate the calibration visible durance for different satellites to be calibrated. The results of simulation and analysis provide the basis for the improvement of the radiometric calibration accuracy of the satellite remote sensor, which lays the foundation for the high precision and high frequency radiometric calibration.

  20. [Selection of indicators for continuous monitoring of the impact of programs optimizing antimicrobial use in Primary Care].

    Science.gov (United States)

    Fernández-Urrusuno, Rocío; Flores-Dorado, Macarena; Moreno-Campoy, Eva; Montero-Balosa, M Carmen

    2015-05-01

    To determine core indicators for monitoring quality prescribing in Primary Care based on the evidence, and to assess the feasibility of these indicators for monitoring the use of antibiotics. A literature review was carried out on quality indicators for antimicrobial prescribing through an electronic search limited to the period 2001-2012. It was completed with an "ad hoc" search on the websites of public national and international health services. Finally, indicators were chosen by consensus by a multidisciplinary group of professionals dedicated to managing infections from several areas. The feasibility and applicability of these indicators was verified through the reporting and use of data in the prescription database. Twenty two indicators were found. The consensus group selected 16 indicators. Eleven of them measure the specific antimicrobial selection, and 5 are consumption rates. The indicators were successfully applied to the prescription database, being able to make comparisons between different geographical areas and to observe trends in prescriptions. The definition of a basic set of indicators to monitor antibiotic use adapted to local conditions is required. The results of these indicators can be used for feedback to professionals and for evaluating the impact of programs aimed at improving antimicrobial use. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  1. Comparative gut microbiota and resistome profiling of intensive care patients receiving selective digestive tract decontamination and healthy subjects.

    Science.gov (United States)

    Buelow, Elena; Bello González, Teresita D J; Fuentes, Susana; de Steenhuijsen Piters, Wouter A A; Lahti, Leo; Bayjanov, Jumamurat R; Majoor, Eline A M; Braat, Johanna C; van Mourik, Maaike S M; Oostdijk, Evelien A N; Willems, Rob J L; Bonten, Marc J M; van Passel, Mark W J; Smidt, Hauke; van Schaik, Willem

    2017-08-14

    The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown. Here, we characterize the composition of the gut microbiota and its antimicrobial resistance genes ("the resistome") of ICU patients during SDD and of healthy subjects. From ten patients that were acutely admitted to the ICU, 30 fecal samples were collected during ICU stay. Additionally, feces were collected from five of these patients after transfer to a medium-care ward and cessation of SDD. Feces from ten healthy subjects were collected twice, with a 1-year interval. Gut microbiota and resistome composition were determined using 16S rRNA gene phylogenetic profiling and nanolitre-scale quantitative PCRs. The microbiota of the ICU patients differed from the microbiota of healthy subjects and was characterized by lower microbial diversity, decreased levels of Escherichia coli and of anaerobic Gram-positive, butyrate-producing bacteria of the Clostridium clusters IV and XIVa, and an increased abundance of Bacteroidetes and enterococci. Four resistance genes (aac(6')-Ii, ermC, qacA, tetQ), providing resistance to aminoglycosides, macrolides, disinfectants, and tetracyclines, respectively, were significantly more abundant among ICU patients than in healthy subjects, while a chloramphenicol resistance gene (catA) and a tetracycline resistance gene (tetW) were more abundant in healthy subjects. The gut microbiota of SDD-treated ICU patients deviated strongly from the gut microbiota of healthy subjects. The negative effects on the resistome were limited to selection

  2. Proper Installation of New Windows | Efficient Windows Collaborative

    Science.gov (United States)

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  3. “On the Margins and Not the Mainstream:” Case Selection for the Implementation of Community based Primary Health Care in Canada and New Zealand

    Directory of Open Access Journals (Sweden)

    Kerry Kuluski

    2017-06-01

    Full Text Available Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC to better meet the needs of the population. Across the world CBPHC is at varying stages of development and few standard models exist. In order to scale up and spread successful models of care it is important to study what works and why. The first step is to select ‘appropriate’ cases to study. In this commentary we reflect on our journey in the selection of CBPHC models for older adults, revealing the limited utility of sourcing the empirical literature; the difficulty in identifying “successful” models to study when outcomes of importance differ across stakeholders; the value of drawing on clinical and organisational networks and experts; and the association between policy context and ease of case selection. Such insights have important implications for case study methodology in health services and policy research.

  4. Dental care - child

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002213.htm Dental care - child To use the sharing features on ... please enable JavaScript. Proper care of your child's teeth and gums includes brushing and rinsing daily. It ...

  5. Proper generalized decompositions an introduction to computer implementation with Matlab

    CERN Document Server

    Cueto, Elías; Alfaro, Icíar

    2016-01-01

    This book is intended to help researchers overcome the entrance barrier to Proper Generalized Decomposition (PGD), by providing a valuable tool to begin the programming task. Detailed Matlab Codes are included for every chapter in the book, in which the theory previously described is translated into practice. Examples include parametric problems, non-linear model order reduction and real-time simulation, among others. Proper Generalized Decomposition (PGD) is a method for numerical simulation in many fields of applied science and engineering. As a generalization of Proper Orthogonal Decomposition or Principal Component Analysis to an arbitrary number of dimensions, PGD is able to provide the analyst with very accurate solutions for problems defined in high dimensional spaces, parametric problems and even real-time simulation. .

  6. Application of group theory to proper vibrations in an electric circuit

    OpenAIRE

    Hosoya, Masahiko; 細谷, 将彦

    2010-01-01

    Group-theoretical analysis is first presented to three-dimensional behavior of an electric circuit. All the modes of proper vibration are found and assigned to each irreducible representation of symmetrical group of the circuit without solving its circuit equations. In order that an electromagnetic radiation from the outside may induce each vibration, a selection rule which is similar to that in infrared absorption must be fulfilled. The circuit may be used as a directive antenna.

  7. Quantitative measures of sexual selection reveal no evidence for sex-role reversal in a sea spider with prolonged paternal care

    OpenAIRE

    Barreto, Felipe S.; Avise, John C.

    2010-01-01

    Taxa in which males alone invest in postzygotic care of offspring are often considered good models for investigating the proffered relationships between sexual selection and mating systems. In the pycnogonid sea spider Pycnogonum stearnsi, males carry large egg masses on their bodies for several weeks, so this species is a plausible candidate for sex-role reversal (greater intensity of sexual selection on females than on males). Here, we couple a microsatellite-based assessment of the mating ...

  8. An evidence-based approach to case management model selection for an acute care facility: is there really a preferred model?

    Science.gov (United States)

    Terra, Sandra M

    2007-01-01

    This research seeks to determine whether there is adequate evidence-based justification for selection of one acute care case management model over another. Acute Inpatient Hospital. This article presents a systematic review of published case management literature, resulting in classification specific to terms of level of evidence. This review examines the best available evidence in an effort to select an acute care case management model. Although no single case management model can be identified as preferred, it is clear that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and to form a foundation for the efficacy of hospital case management practice. Although no single case management model can be identified as preferred, this systematic review demonstrates that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and forming a foundation for the efficacy of hospital case management practice. Distinctive aspects of case management frameworks can be used to guide the development of an acute care case management model. The study illustrates: * The effectiveness of case management when there is direct patient contact by the case manager regardless of disease condition: not only does the quality of care increase but also length of stay (LOS) decreases, care is defragmented, and both patient and physician satisfaction can increase. * The preferred case management models result in measurable outcomes that can directly relate to, and demonstrate alignment with, organizational strategy. * Acute care management programs reduce cost and LOS, and improve outcomes. * An integrated case management program that includes social workers, as well as nursing, is the most effective acute care management model. * The successful case management model will recognize physicians, as well as patients, as valued customers with whom partnership can positively affect financial outcomes in terms of

  9. Selecting new health technologies for evaluation:Can clinical experts predict which new anticancer drugswill impact Danish health care?

    DEFF Research Database (Denmark)

    Douw, Karla; Vondeling, Hindrik

    2007-01-01

    Several countries have systems in place to support the managed entry of new health technologies. The big challenge for these so-called horizon-scanning systems is to select those technologies that require decision support by means of an early evaluation. Clinical experts are considered a valuable...... source of information on new health technologies, but research on the relevance of their input is scarce. In 2000, we asked six Danish expert oncologists to predict whether a sample of 19 new anticancer drugs would impact Danish health care over the next 5 years. In 2005, we assessed the accuracy...... of these predictions in a delayed type cross-sectional study. The specificity of the Danish experts' prediction was 1 (95% confidence interval 0.74-1.00) and the sensitivity was 0.63 (0.31-0.86). The negative predictive value was 0.79 (0.52-0.92) and the positive predictive value was 1 (0.57-1.00). This indicates...

  10. Implementing the Free Water Protocol does not Result in Aspiration Pneumonia in Carefully Selected Patients with Dysphagia: A Systematic Review.

    Science.gov (United States)

    Gillman, Anna; Winkler, Renata; Taylor, Nicholas F

    2017-06-01

    The Frazier Free Water Protocol was developed with the aim of providing patients with dysphagia an option to consume thin (i.e. unthickened) water in-between mealtimes. A systematic review was conducted of research published in peer-reviewed journals. An electronic search of the EMBASE, CINAHL and MEDLINE databases was completed up to July 2016. A total of 8 studies were identified for inclusion: 5 randomised controlled trials, 2 cohort studies with matched cases and 1 single group pre-post intervention prospective study. A total of 215 rehabilitation inpatients and 30 acute patients with oropharyngeal dysphagia who required thickened fluids or were to remain 'nil by mouth', as determined by bedside swallow assessment and/or videofluoroscopy/fiberoptic endoscopic evaluation of swallowing, were included. Meta-analyses of the data from the rehabilitation studies revealed (1) low-quality evidence that implementing the protocol did not result in increased odds of having lung complications and (2) low-quality evidence that fluid intake may increase. Patients' perceptions of swallow-related quality of life appeared to improve. This review has found that when the protocol is closely adhered to and patients are carefully selected using strict exclusion criteria, including an evaluation of their cognition and mobility, adult rehabilitation inpatients with dysphagia to thin fluids can be offered the choice of implementing the Free Water Protocol. Further research is required to determine if the Free Water Protocol can be implemented in settings other than inpatient rehabilitation.

  11. Systemic tobramycin concentrations during selective decontamination of the digestive tract in intensive care unit patients on continuous venovenous hemofiltration.

    Science.gov (United States)

    Mol, Meriel; van Kan, Hendrikus J M; Schultz, Marcus J; de Jonge, Evert

    2008-05-01

    To study whether selective decontamination of the digestive tract (SDD) results in detectable serum tobramycin concentrations in intensive care unit (ICU) patients with acute renal failure treated with continuous venovenous hemofiltration (CVVH). Prospective, observational, single-center study in a mixed medical-surgical ICU. Adult ICU patients receiving SDD for at least 3 days and being treated with CVVH because of acute renal failure. Tobramycin serum concentrations were measured at the 3rd day after start of CVVH and every 3 days thereafter. Detectable serum concentrations of tobramycin were found in 12 (63%) of 19 patients and in 15 (58%) of the 26 samples. With a toxic tobramycin concentration defined as more than 2.0 mg/l, we found one patient with a toxic concentration of 3.0 mg/l. In three other patients tobramycin concentrations of >or=1.0 mg/l were found. In patients with acute renal failure treated with CVVH, administration of SDD with tobramycin can lead to detectable and potentially toxic serum tobramycin concentrations.

  12. Positions and proper motions of dwarf carbon stars

    Science.gov (United States)

    Deutsch, Eric W.

    1994-01-01

    Recent-epochs positions and proper motions of nine dwarf carbon star candidates are presented along with finding charts for each object. Measurements are obtained from digitized Palomar Observatory Sky Survey (POSS) and Quik V plate archives at the Space Telescope Science Institute, and from recent CCD images.

  13. 32 CFR 842.63 - Who are not proper claimants.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Who are not proper claimants. 842.63 Section 842.63 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE CLAIMS AND... accompanying US military and US national civilian employees. (c) Foreign military personnel suffering property...

  14. Fast algorithms for finding proper strategies in game trees

    DEFF Research Database (Denmark)

    Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    We show how to find a normal form proper equilibrium in behavior strategies of a given two-player zero-sum extensive form game with imperfect information but perfect recall. Our algorithm solves a finite sequence of linear programs and runs in polynomial time. For the case of a perfect informatio...

  15. Computing more proper covariances of energy dependent nuclear data

    International Nuclear Information System (INIS)

    Vanhanen, R.

    2016-01-01

    Highlights: • We present conditions for covariances of energy dependent nuclear data to be proper. • We provide methods to detect non-positive and inconsistent covariances in ENDF-6 format. • We propose methods to find nearby more proper covariances. • The methods can be used as a part of a quality assurance program. - Abstract: We present conditions for covariances of energy dependent nuclear data to be proper in the sense that the covariances are positive, i.e., its eigenvalues are non-negative, and consistent with respect to the sum rules of nuclear data. For the ENDF-6 format covariances we present methods to detect non-positive and inconsistent covariances. These methods would be useful as a part of a quality assurance program. We also propose methods that can be used to find nearby more proper energy dependent covariances. These methods can be used to remove unphysical components, while preserving most of the physical components. We consider several different senses in which the nearness can be measured. These methods could be useful if a re-evaluation of improper covariances is not feasible. Two practical examples are processed and analyzed. These demonstrate some of the properties of the methods. We also demonstrate that the ENDF-6 format covariances of linearly dependent nuclear data should usually be encoded with the derivation rules.

  16. Asteroid proper elements from an analytical second order theory

    International Nuclear Information System (INIS)

    Knezevic, Z.; Milani, A.

    1989-01-01

    The authors have computed by a fully analytical method a new set of proper elements for 3322 numbered main-belt asteroids. They are presented in the following format: asteroid number, proper semimajor axis (AU), proper eccentricity, sine of proper inclination and quality code (see below). This new set is significantly more accurate than all the previous ones at low to moderate eccentricities and inclinations, and especially near the main mean-motion resonances (e.g., the Themis region). This is because the short periodic perturbations are rigorously removed, and the main effects of the second-order (containing the square of the ratio [the mass of Jupiter/mass of the Sun]) are accounted for. Effects arising from the terms in the Hamiltonian of degree up to four in the eccentricity and inclination of both the asteroid and Jupiter are taken into account, and the fundamental frequencies g (for the perihelion) and s(for the node) of the asteroid are computed with a interative algorithm consistent with the basic results of modern dynamics (e.g., Kolmogorov-Arnold-Moser theory)

  17. Proper-time quantum-mechanics and the Klein paradox

    International Nuclear Information System (INIS)

    Thaller, B.

    1981-01-01

    Scattering at high potential-steps is treated in the framework of relativistic proper-time theory. No paradox arises in contrast to Dirac's wavemechanics (''Klein's paradox''); pair creation may happen with a certain probability and may be described as a scattering process with ordinary quantum-mechanical methods. (author)

  18. Computing Proper Equilibria of Zero-Sum Games

    DEFF Research Database (Denmark)

    Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2007-01-01

    We show that a proper equilibrium of a matrix game can be found in polynomial time by solving a linear (in the number of pure strategies of the two players) number of linear programs of roughly the same dimensions as the standard linear programs describing the Nash equilibria of the game....

  19. On proper Shapley values for monotone TU-games

    NARCIS (Netherlands)

    van den Brink, J.R.; Levinsky, R.; Zeleny, M.

    2015-01-01

    The Shapley value of a cooperative transferable utility game distributes the dividend of each coalition in the game equally among its members. Given exogenous weights for all players, the corresponding weighted Shapley value distributes the dividends proportionally to their weights. A proper Shapley

  20. Twisted equivariant K-theory, groupoids and proper actions

    OpenAIRE

    Cantarero, Jose

    2009-01-01

    In this paper we define twisted equivariant K-theory for actions of Lie groupoids. For a Bredon-compatible Lie groupoid, this defines a periodic cohomology theory on the category of finite CW-complexes with equivariant stable projective bundles. A classification of these bundles is shown. We also obtain a completion theorem and apply these results to proper actions of groups.

  1. Radiating c metric: an example of a proper Ricci Collineation

    International Nuclear Information System (INIS)

    Aulestia, L.; Nunez, L.; Patino, A.; Rago, H.; Herrera, L.

    1984-01-01

    A generalization of the charged c metric to the nonstationary case is given. The possibility of associating the energy-momentum tensor with the electromagnetic or neutrino field is discussed. It is shown that, for a specific choice of the time-dependent parameters, the metric admits at least a two-parameter group of proper Ricci collineations

  2. Secular Extragalactic Parallax and Geometric Distances with Gaia Proper Motions

    Science.gov (United States)

    Paine, Jennie; Darling, Jeremiah K.

    2018-06-01

    The motion of the Solar System with respect to the cosmic microwave background (CMB) rest frame creates a well measured dipole in the CMB, which corresponds to a linear solar velocity of about 78 AU/yr. This motion causes relatively nearby extragalactic objects to appear to move compared to more distant objects, an effect that can be measured in the proper motions of nearby galaxies. An object at 1 Mpc and perpendicular to the CMB apex will exhibit a secular parallax, observed as a proper motion, of 78 µas/yr. The relatively large peculiar motions of galaxies make the detection of secular parallax challenging for individual objects. Instead, a statistical parallax measurement can be made for a sample of objects with proper motions, where the global parallax signal is modeled as an E-mode dipole that diminishes linearly with distance. We present preliminary results of applying this model to a sample of nearby galaxies with Gaia proper motions to detect the statistical secular parallax signal. The statistical measurement can be used to calibrate the canonical cosmological “distance ladder.”

  3. Proper comparison among methods using a confusion matrix

    CSIR Research Space (South Africa)

    Salmon

    2015-07-01

    Full Text Available -1 IGARSS 2015, Milan, Italy, 26-31 July 2015 Proper comparison among methods using a confusion matrix 1,2 B.P. Salmon, 2,3 W. Kleynhans, 2,3 C.P. Schwegmann and 1J.C. Olivier 1School of Engineering and ICT, University of Tasmania, Australia 2...

  4. A turbulent jet in crossflow analysed with proper orthogonal decomposition

    DEFF Research Database (Denmark)

    Meyer, Knud Erik; Pedersen, Jakob Martin; Özcan, Oktay

    2007-01-01

    and pipe diameter was 2400 and the jet to crossflow velocity ratios were R = 3.3 and R = 1.3. The experimental data have been analysed by proper orthogonal decomposition (POD). For R = 3.3, the results in several different planes indicate that the wake vortices are the dominant dynamic flow structures...

  5. Effect of selective decontamination on antimicrobial resistance in intensive care units: a systematic review and meta-analysis.

    Science.gov (United States)

    Daneman, Nick; Sarwar, Syed; Fowler, Robert A; Cuthbertson, Brian H

    2013-04-01

    Many meta-analyses have shown reductions in infection rates and mortality associated with the use of selective digestive decontamination (SDD) or selective oropharyngeal decontamination (SOD) in intensive care units (ICUs). These interventions have not been widely implemented because of concerns that their use could lead to the development of antimicrobial resistance in pathogens. We aimed to assess the effect of SDD and SOD on antimicrobial resistance rates in patients in ICUs. We did a systematic review of the effect of SDD and SOD on the rates of colonisation or infection with antimicrobial-resistant pathogens in patients who were critically ill. We searched for studies using Medline, Embase, and Cochrane databases, with no limits by language, date of publication, study design, or study quality. We included all studies of selective decontamination that involved prophylactic application of topical non-absorbable antimicrobials to the stomach or oropharynx of patients in ICUs, with or without additional systemic antimicrobials. We excluded studies of interventions that used only antiseptic or biocide agents such as chlorhexidine, unless antimicrobials were also included in the regimen. We used the Mantel-Haenszel model with random effects to calculate pooled odds ratios. We analysed 64 unique studies of SDD and SOD in ICUs, of which 47 were randomised controlled trials and 35 included data for the detection of antimicrobial resistance. When comparing data for patients in intervention groups (those who received SDD or SOD) versus data for those in control groups (who received no intervention), we identified no difference in the prevalence of colonisation or infection with Gram-positive antimicrobial-resistant pathogens of interest, including meticillin-resistant Staphylococcus aureus (odds ratio 1·46, 95% CI 0·90-2·37) and vancomycin-resistant enterococci (0·63, 0·39-1·02). Among Gram-negative bacilli, we detected no difference in aminoglycoside-resistance (0

  6. The VMC survey. XXX. Stellar proper motions in the central parts of the Small Magellanic Cloud

    Science.gov (United States)

    Niederhofer, F.; Cioni, M.-R. L.; Rubele, S.; Schmidt, T.; Bekki, K.; Grijs, R. de; Emerson, J.; Ivanov, V. D.; Marconi, M.; Oliveira, J. M.; Petr-Gotzens, M. G.; Ripepi, V.; van Loon, J. Th.; Zaggia, S.

    2018-05-01

    We present the first spatially resolved map of stellar proper motions within the central ( 3.1 × 2.4 kpc) regions of the Small Magellanic Cloud (SMC). The data used for this study encompasses four tiles from the ongoing near-infrared VISTA survey of the Magellanic Clouds system and covers a total contiguous area on the sky of 6.81 deg2. Proper motions have been calculated independently in two dimensions from the spatial offsets in the Ks filter over time baselines between 22 and 27 months. The reflex motions of approximately 33 000 background galaxies are used to calibrate the stellar motions to an absolute scale. The resulting catalog is composed of more than 690 000 stars which have been selected based on their position in the (J - Ks, Ks) color-magnitude diagram. For the median absolute proper motion of the SMC, we find (μαcos(δ), μδ) = (1.087 ± 0.192 (sys.) ± 0.003 (stat.), -1.187 ± 0.008 (sys.) ± 0.003 (stat.)) mas yr-1, consistent with previous studies. Mapping the proper motions as a function of position within the SMC reveals a nonuniform velocity pattern indicative of a tidal feature behind the main body of the SMC and a flow of stars in the south-east moving predominantly along the line-of-sight. Based on observations made with VISTA at the Paranal Observatory under program ID 179.B-2003.

  7. Resistance exercise-induced rhabdomyolysis: Need for immediate intervention and proper counselling.

    Science.gov (United States)

    Khalil, Maysaa A; Saab, Basem R

    2016-12-01

    Rhabdomyolysis results from damage to skeletal muscle. Improper resistance training may result in rhabdomyolysis, which can cause acute kidney injury, serious metabolic abnormalities, compartmental syndrome and even death. Proper counselling for athletes may prevent this condition. We present two patients with unilateral swelling after resistance exercise. The workup revealed rhabdomyolysis. We highlight the importance of counselling to prevent rhabdomyolysis secondary to resistance exercise. Trainers and primary care physicians need to be educated about the main features of rhabdomyolysis and urgently refer trainees suspected of having this condition. Treatment consists mainly of hydration and correction of metabolic abnormalities. Primary care physicians need to counsel patients on ways to prevent rhabdomyolysis. Trainers and primary care physicians should instruct novice trainees who are performing resistance exercise to start low and gradually increase the load. Training with loads of 60-70% of one repetition maximum for 8-12 repetitions and use of one to three sets per exercise is recommended.

  8. An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long-term Care.

    Science.gov (United States)

    Yap, Tracey L; Kennerly, Susan M; Bergstrom, Nancy; Hudak, Sandra L; Horn, Susan D

    2016-01-01

    Pressure ulcers have consistently resisted prevention efforts in long-term care facilities nationwide. Recent research has described cueing innovations that-when selected according to the assumptions and resources of particular facilities-support best practices of pressure ulcer prevention. This article synthesizes that research into a unified, dynamic logic model to facilitate effective staff implementation of a pressure ulcer prevention program.

  9. Selecting effective incentive structures in health care: A decision framework to support health care purchasers in finding the right incentives to drive performance

    NARCIS (Netherlands)

    Custers, Thomas; Hurley, Jeremiah; Klazinga, Niek S.; Brown, Adalsteinn D.

    2008-01-01

    Background: The Ontario health care system is devolving planning and funding authority to community based organizations and moving from steering through rules and regulations to steering on performance. As part of this transformation, the Ontario Ministry of Health and Long-Term Care (MOHLTC) are

  10. Consensus on quality indicators to assess the organisation of palliative cancer and dementia care applicable across national healthcare systems and selected by international experts.

    Science.gov (United States)

    van Riet Paap, Jasper; Vernooij-Dassen, Myrra; Dröes, Rose-Marie; Radbruch, Lukas; Vissers, Kris; Engels, Yvonne

    2014-09-17

    Large numbers of vulnerable patients are in need of palliative cancer and dementia care. However, a wide gap exists between the knowledge of best practices in palliative care and their use in everyday clinical practice. As part of a European policy improvement program, quality indicators (QIs) have been developed to monitor and improve the organisation of palliative care for patients with cancer and those with dementia in various settings in different European countries. A multidisciplinary, international panel of professionals participated in a modified RAND Delphi procedure to compose a set of palliative care QIs based on existing sets of QIs on the organisation of palliative care. Panellists participated in three written rounds, one feedback round and one meeting. The panel's median votes were used to identify the final set of QIs. The Delphi procedure resulted in 23 useful QIs. These QIs represent key elements of the organisation of good clinical practice, such as the availability of palliative care teams, the availability of special facilities to provide palliative care for patients and their relatives, and the presence of educational interventions for professionals. The final set also includes QIs that are related to the process of palliative care, such as documentation of pain and other symptoms, communication with patients in need of palliative care and their relatives, and end-of-life decisions. International experts selected a set of 23 QIs for the organisation of palliative care. Although we particularly focused on the organisation of cancer and dementia palliative care, most QIs are generic and are applicable for other types of diseases as well.

  11. Traditional open-bay versus single-family room neonatal intensive care unit: a comparison of selected nutrition outcomes

    Directory of Open Access Journals (Sweden)

    Christina Erickson

    2011-03-01

    Full Text Available Christina Erickson1, Kendra Kattelmann1, Jessica Remington1, Cuirong Ren2, Carol C Helseth3, Dennis C Stevens31Department of Health and Nutritional Sciences, 2Department of Plant Science, South Dakota State University, Brookings, SD, USA; 3Sanford Children's Hospital, Sioux Falls, SD, USABackground: In contrast to the traditional open-bay–type design of the neonatal intensive care unit (tNICU, infants in developmentally appropriate NICU (dNICU are housed in individual rooms with greater control of light and noise. Previous reports have documented positive influence of the dNICU in cardiorespiratory status, physiologic stability, and weight gain of the infants. The objective of this study was to explore selected nutrition outcomes of infants in the dNICU versus tNICU.Method: A prospective cohort study was conducted on infants with birth weight of 1500 g or less cared for in dNICU (n = 42 or tNICU (n = 31. Differences between days to reach full parenteral nutrition, full enteral nutrition, or full bottling were determined using analysis of covariance controlling for gestational age, birth weight, and clinical risk index for babies (CRIB acuity score.Results: There were no differences between the two groups in days to reach full parenteral and bottle feeding. The infants in the dNICU took fewer days to reach full enteral nutrition (20.8 days, 95% confidence intervals [CI]: 17, 24.6 (dNICU vs 23.3 days, 95% CI: 17.1, 29.6 (tNICU, P = 0.04 than those in the tNICU.Conclusions: Although the two groups of infants only differed in the days to reach full enteral feeding, it is important to remember that the lack of difference may be clinically significant. Clinically, the infants in the dNICU were younger (gestational age and sicker (CRIB acuity score than the infants in the tNICU. Consequently, the results of this study support the change to dNICU, as the private room model provides a supportive environment for growth as evidenced by similar

  12. A patient and community-centered approach selecting endpoints for a randomized trial of a novel advance care planning tool

    Directory of Open Access Journals (Sweden)

    Bridges JFP

    2018-02-01

    Full Text Available John FP Bridges,1,2 Norah L Crossnohere,2 Anne L Schuster,1 Judith A Miller,3 Carolyn Pastorini,3,† Rebecca A Aslakson2,4,5 1Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 2Department of Health, Behavior, and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 3Patient-Centered Outcomes Research Institute (PCORI Project, Baltimore, MD, 4Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, 5Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, Baltimore, MD, USA †Carolyn Pastorini passed away on August 24, 2015 Background: Despite a movement toward patient-centered outcomes, best practices on how to gather and refine patients’ perspectives on research endpoints are limited. Advanced care planning (ACP is inherently patient centered and would benefit from patient prioritization of endpoints for ACP-related tools and studies.Objective: This investigation sought to prioritize patient-centered endpoints for the content and evaluation of an ACP video being developed for patients undergoing major surgery. We also sought to highlight an approach using complementary engagement and research strategies to document priorities and preferences of patients and other stakeholders.Materials and methods: Endpoints identified from a previously published environmental scan were operationalized following rating by a caregiver co-investigator, refinement by a patient co-investigator, review by a stakeholder committee, and validation by patients and family members. Finalized endpoints were taken to a state fair where members of the public who indicated that they or a loved one had undergone major surgery prioritized their most relevant endpoints and provided comments.Results: Of the initial 50 ACP endpoints identified from the review, 12 endpoints were selected for public

  13. Compressors selection and sizing

    CERN Document Server

    Brown, Royce N

    2005-01-01

    This practical reference provides in-depth information required to understand and properly estimate compressor capabilities and to select the proper designs. Engineers and students will gain a thorough understanding of compression principles, equipment, applications, selection, sizing, installation, and maintenance. The many examples clearly illustrate key aspects to help readers understand the ""real world"" of compressor technology.Compressors: Selection and Sizing, third edition is completely updated with new API standards. Additions requested by readers include a new section on di

  14. What is the proper evaluation method: Some basic considerations

    International Nuclear Information System (INIS)

    Leeb, Helmut; Schnabel, Georg; Srdinko, Thomas

    2014-01-01

    Recent developments and applications demand for an extension of the energy range and the inclusion of reliable uncertainty information in nuclear data libraries. Due to the scarcity of neutron-induced reaction data beyond 20 MeV the extension of the energy range up to at least 150 MeV is not trivial because the corresponding nuclear data evaluations depend heavily on nuclear models and proper evaluation methods are still under discussion. Restricting to evaluation techniques based on Bayesian statistics the influence of the a priori knowledge on the final result of the evaluation is considered. The study clearly indicates the need to account properly for the deficiencies of the nuclear model. Concerning the covariance matrices it is argued that they depend not only on the model, but also on the method of generation and an additional consent is required for the comparison of different evaluations of the same data sets. (authors)

  15. Proper Motion and Secular Variations of Keplerian Orbital Elements

    Directory of Open Access Journals (Sweden)

    Alexey G. Butkevich

    2018-05-01

    Full Text Available High-precision observations require accurate modeling of secular changes in the orbital elements in order to extrapolate measurements over long time intervals, and to detect deviation from pure Keplerian motion caused, for example, by other bodies or relativistic effects. We consider the evolution of the Keplerian elements resulting from the gradual change of the apparent orbit orientation due to proper motion. We present rigorous formulae for the transformation of the orbit inclination, longitude of the ascending node and argument of the pericenter from one epoch to another, assuming uniform stellar motion and taking radial velocity into account. An approximate treatment, accurate to the second-order terms in time, is also given. The proper motion effects may be significant for long-period transiting planets. These theoretical results are applicable to the modeling of planetary transits and precise Doppler measurements as well as analysis of pulsar and eclipsing binary timing observations.

  16. An assessment of the quality of care for children in eighteen randomly selected district and sub-district hospitals in Bangladesh

    Directory of Open Access Journals (Sweden)

    Hoque Dewan ME

    2012-12-01

    Full Text Available Abstract Background Quality hospital care is important in ensuring that the needs of severely ill children are met to avert child mortality. However, the quality of hospital care for children in developing countries has often been found poor. As the first step of a country road map for improving hospital care for children, we assessed the baseline situation with respect to the quality of care provided to children under-five years age in district and sub-district level hospitals in Bangladesh. Methods Using adapted World Health Organization (WHO hospital assessment tools and standards, an assessment of 18 randomly selected district (n=6 and sub-district (n=12 hospitals was undertaken. Teams of trained assessors used direct case observation, record review, interviews, and Management Information System (MIS data to assess the quality of clinical case management and monitoring; infrastructure, processes and hospital administration; essential hospital and laboratory supports, drugs and equipment. Results Findings demonstrate that the overall quality of care provided in these hospitals was poor. No hospital had a functioning triage system to prioritise those children most in need of immediate care. Laboratory supports and essential equipment were deficient. Only one hospital had all of the essential drugs for paediatric care. Less than a third of hospitals had a back-up power supply, and just under half had functioning arrangements for safe-drinking water. Clinical case management was found to be sub-optimal for prevalent illnesses, as was the quality of neonatal care. Conclusion Action is needed to improve the quality of paediatric care in hospital settings in Bangladesh, with a particular need to invest in improving newborn care.

  17. Towards the Proper Integration of Extra-Functional Requirements

    OpenAIRE

    Elke Hochmuller

    1999-01-01

    In spite of the many achievements in software engineering, proper treatment of extra-functional requirements (also known as non-functional requirements) within the software development process is still a challenge to our discipline. The application of functionality-biased software development methodologies can lead to major contradictions in the joint modelling of functional and extra-functional requirements. Based on a thorough discussion on the nature of extra-functional requirements as wel...

  18. Parallaxes and Proper Motions From the MCCormick Observatory: List 47

    Science.gov (United States)

    Ianna, Philip A.; Patterson, Richard J.; Swain, Melanie A.

    1996-01-01

    Trigonometric parallaxes and proper motions are presented for 32 late-type stars observed photographically with the Leander McCormick 67 cm refractor. Eighteen of the stars have no previously published parallaxes. Twenty one of the stars are K and M dwarfs identified by Vyssotsky and his collaborators. The list includes several x-ray luminous M dwarfs, a rapidly rotating spotted flare star, and two astrometric binaries.

  19. NATIONAL EXPERIENCES REGARDING CORPORATE GOVERNANCE PROPER PRACTICE CODES

    Directory of Open Access Journals (Sweden)

    Durgheu Liliana

    2010-12-01

    Full Text Available This paper is about the principles of proper governance codes, which even tough have blossomed in all parts of the world for more than a decade, the degree in which companies adopt the codes vary in different countries, and the decision to adopt a certain code does not automatically guarranty efficient corporate governance. The paper trys to identify the mechanisms needed for implementing the codes and that will lead to higher efficiency.

  20. Radar Measurements of Ocean Surface Waves using Proper Orthogonal Decomposition

    Science.gov (United States)

    2017-03-30

    Golinval, 2002, Physical interpretation of the proper orthogonal modes using the singular value decomposition, Journal of Sound and Vibration, 249...complex and contain contributions from the environment (e.g., wind, waves, currents) as well as artifacts associated with electromagnetic (EM) (wave...Although there is no physical basis/ interpretation inherent to the method because it is purely a mathematical tool, there has been an increasing

  1. THE COMMON AND PROPER NOUNS BETWEEN ALBANIAN AND ENGLISH

    OpenAIRE

    Shkelqim Millaku

    2017-01-01

    The noun in Albanian language classified as common and proper. The common nouns in turn divide into countable and uncountable. Collective nouns and substance nouns are subclasses of the other classes. The structure of noun formation between Albanian and English on the general aspect of morphology and syntax still didn’t study in the way of comparative, contrast and generative. Those fields are our object of study. In Albanian and English we find some concepts of studies for noun for exam...

  2. Broad-scale recombination patterns underlying proper disjunction in humans.

    Directory of Open Access Journals (Sweden)

    Adi Fledel-Alon

    2009-09-01

    Full Text Available Although recombination is essential to the successful completion of human meiosis, it remains unclear how tightly the process is regulated and over what scale. To assess the nature and stringency of constraints on human recombination, we examined crossover patterns in transmissions to viable, non-trisomic offspring, using dense genotyping data collected in a large set of pedigrees. Our analysis supports a requirement for one chiasma per chromosome rather than per arm to ensure proper disjunction, with additional chiasmata occurring in proportion to physical length. The requirement is not absolute, however, as chromosome 21 seems to be frequently transmitted properly in the absence of a chiasma in females, a finding that raises the possibility of a back-up mechanism aiding in its correct segregation. We also found a set of double crossovers in surprisingly close proximity, as expected from a second pathway that is not subject to crossover interference. These findings point to multiple mechanisms that shape the distribution of crossovers, influencing proper disjunction in humans.

  3. Computation of Asteroid Proper Elements on the Grid

    Science.gov (United States)

    Novakovic, B.; Balaz, A.; Knezevic, Z.; Potocnik, M.

    2009-12-01

    A procedure of gridification of the computation of asteroid proper orbital elements is described. The need to speed up the time consuming computations and make them more efficient is justified by the large increase of observational data expected from the next generation all sky surveys. We give the basic notion of proper elements and of the contemporary theories and methods used to compute them for different populations of objects. Proper elements for nearly 70,000 asteroids are derived since the beginning of use of the Grid infrastructure for the purpose. The average time for the catalogs update is significantly shortened with respect to the time needed with stand-alone workstations. We also present basics of the Grid computing, the concepts of Grid middleware and its Workload management system. The practical steps we undertook to efficiently gridify our application are described in full detail. We present the results of a comprehensive testing of the performance of different Grid sites, and offer some practical conclusions based on the benchmark results and on our experience. Finally, we propose some possibilities for the future work.

  4. Computation of Asteroid Proper Elements on the Grid

    Directory of Open Access Journals (Sweden)

    Novaković, B.

    2009-12-01

    Full Text Available A procedure of gridification of the computation of asteroid proper orbital elements is described. The need to speed up the time consuming computations and make them more efficient is justified by the large increase of observational data expected from the next generation all sky surveys. We give the basic notion of proper elements and of the contemporary theories and methods used to compute them for different populations of objects. Proper elements for nearly 70,000 asteroids are derived since the beginning of use of the Grid infrastructure for the purpose. The average time for the catalogs update is significantly shortened with respect to the time needed with stand-alone workstations. We also present basics of the Grid computing, the concepts of Grid middleware and its Workload management system. The practical steps we undertook to efficiently gridify our application are described in full detail. We present the results of a comprehensive testing of the performance of different Grid sites, and offer some practical conclusions based on the benchmark results and on our experience. Finally, we propose some possibilities for the future work.

  5. Proper Names in Dialectal Idioms: Stages of Idiomatization

    Directory of Open Access Journals (Sweden)

    Ekaterina S. Kogan

    2014-06-01

    Full Text Available The article deals with the functioning of proper names (both personal and place names and their derivatives in dialectal idioms. Based upon the criteria of the establishing of the idiomatic status of word combinations, traditionally used in contemporary lexicology, the author marks out four stages of the entry of units containing proper names and their derivatives into a regional idiomatic inventory: 1 word combinations with figurative meanings and transparent motivation easily decoded by every member of the local community (e. g., naryaditsa kak Anisya Klimovskaya ‘to be slovenly dressed’; 2 word combinations with a proper name localizing a nationally known idiom (e. g., zhelninsky telyonok ‘screaming person’; 3 word combinations including a name with a general meaning (e. g., Masha s Yashey ‘two inseparable persons’; 4 idioms with non-transparent motivation (e. g., tutursky pop ‘cuckoo male’. The analyzed data are retrieved from dialect dictionaries (including those of idioms and notes made by the Ural Federal University Toponymic Expeditions in Kostroma Region in 2011–2013.

  6. Computation of asteroid proper elements on the Grid

    Directory of Open Access Journals (Sweden)

    Novaković B.

    2009-01-01

    Full Text Available A procedure of gridification of the computation of asteroid proper orbital elements is described. The need to speed up the time consuming computations and make them more efficient is justified by the large increase of observational data expected from the next generation all sky surveys. We give the basic notion of proper elements and of the contemporary theories and methods used to compute them for different populations of objects. Proper elements for nearly 70,000 asteroids are derived since the beginning of use of the Grid infrastructure for the purpose. The average time for the catalogs update is significantly shortened with respect to the time needed with stand-alone workstations. We also present basics of the Grid computing, the concepts of Grid middleware and its Workload management system. The practical steps we undertook to efficiently gridify our application are described in full detail. We present the results of a comprehensive testing of the performance of different Grid sites, and offer some practical conclusions based on the benchmark results and on our experience. Finally, we propose some possibilities for the future work.

  7. Angiographic manifestation and transcatheter arterial embolization of proper esophageal artery in hemoptysis

    International Nuclear Information System (INIS)

    Jiang Sen; Zhu Xiaohua; Sun Xiwen; Zhi Wenxiang; Jie Bing; You Zhengqian; Yu Dong; Peng Gang

    2008-01-01

    Objective: To investigate the angiographic manifestation of the proper esophageal artery (PEA), the high risk factors for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter arterial embolization (TAE) of the PEA using gelatin sponge (GS). Methods: Selective esophageal arteriography was performed in forty-three patients with hemoptysis, including 15 cases of pulmonary tuberculosis, 18 cases of bronchiectasis, 7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs was studied. The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS. Results: Thirty-nine PEAs were catheterized selectively in 37 patients (86.0%). Eighteen anomalous PEAs (46.2%) were catheterized selectively in 17 patients (45.9%). The anomalous PEAs showed tortuosity, dilatation, hyperplasia, shunting with pulmonary artery and anastomosis with the bronchial artery. All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect was achieved with TAE of the anomalous PEAs. Conclusions: It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis. Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis. (authors)

  8. DECOMPOSING THE SOCIOECONOMIC INEQUALITY IN UTILIZATION OF MATERNAL HEALTH CARE SERVICES IN SELECTED COUNTRIES OF SOUTH ASIA AND SUB-SAHARAN AFRICA.

    Science.gov (United States)

    Goli, Srinivas; Nawal, Dipty; Rammohan, Anu; Sekher, T V; Singh, Deepshikha

    2017-10-30

    The gap in access to maternal health care services is a challenge of an unequal world. In 2015, each day about 830 women died due to complications of pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented. This study quantified the contributions of the socioeconomic determinants of inequality to the utilization of maternal health care services in four countries in diverse geographical and cultural settings: Bangladesh, Ethiopia, Nepal and Zimbabwe. Data from the 2010-11 Demographic and Health Surveys of the four countries were used, and methods developed by Wagstaff and colleagues for decomposing socioeconomic inequalities in health were applied. The results showed that although the Concentration Index (CI) was negative for the selected indicators, meaning maternal health care was poorer among lower socioeconomic status groups, the level of CI varied across the different countries for the same outcome indicator: CI of -0.1147, -0.1146, -0.2859 and -0.0638 for inequalities in maternal health care varied across the selected countries. The findings are significant for a global understanding of the various determinants of maternal health care use in high-maternal-mortality settings in different geographical and socio-cultural contexts.

  9. A Comparative Study of the Situation of Bereavement Care for Children with Cancer in Iran with Selected Countries

    Directory of Open Access Journals (Sweden)

    Maryam Pakseresht

    2018-02-01

    Full Text Available Background Death of a child with cancer is one of the most painful events that results in traumatic reactions of bereavement. Care should be taken into account during the bereavement period. The present study aimed to develop bereavement care in Iran and comparing it with Jordan, England, Australia and Canada, which have achieved the desired situation in the above area. Materials and Methods In this comparative study, the necessary data was made to databases of reputable and sovereign centers of the countries and palliative care programs. After accessing the pioneering patterns of world-wide palliative care, Iran's palliative care program, which came from children's service centers and access to the databases of those centers, was also examined. Results In the developed countries of Canada, England and Australia, a wide range of bereavement care is provided in care facilities. for example following the death of a child, in Canada family members are covered by all the bereavement care, in Australia formal caregivers increase their relationship with parents and are available to listen to feelings and in England all family members are supported. Jordan provides significant services in this regard such as visits at the bereavement ceremony, however, it is provided limitedly only in one center in Iran. Conclusion In the developed countries, pediatric palliative care is well developed. But in some developing countries, including Iran, there are only a few of these services for dying children and their families. As a result, the traumatic results emerge in social and family life activities.

  10. Correlated evolution in parental care in females but not males in response to selection on paternity assurance behaviour

    NARCIS (Netherlands)

    Head, M.L.; Hinde, C.A.; Moore, A.J.; Royle, N.J.

    2014-01-01

    According to classical parental care theory males are expected to provide less parental care when offspring in a brood are less likely to be their own, but empirical evidence in support of this relationship is equivocal. Recent work predicts that social interactions between the sexes can modify

  11. Measuring the quality of renal care: things to keep in mind when selecting and using quality indicators

    NARCIS (Netherlands)

    van der Veer, Sabine N.; van Biesen, Wim; Couchoud, Cécile; Tomson, Charles R. V.; Jager, Kitty J.

    2014-01-01

    This educational paper discusses a variety of indicators that can be used to measure the quality of care in renal medicine. Based on what aspect of care they reflect, indicators can be grouped into four main categories: structure, process, surrogate outcome and outcome indicators. Each category has

  12. Legal size limit implies strong fisheries selection on sexually selected traits in a temperate wrasse providing male-only parental care

    Directory of Open Access Journals (Sweden)

    Kim Aleksander Tallaksen Halvorsen

    2015-12-01

    Full Text Available Corkwing wrasse (Symphodus melops is a temperate wrasse displaying both sex and male dimorphism and is targeted in a size selective commercial fishery which has increased dramatically since 2008. Wrasses are supplied alive to salmon farms as cleaner fish to combat infestations of Salmon lice. In previous studies, growth and maturation has been found to differ among male morphs and sexes and these groups might therefore be targeted unevenly by the size selective fishery. In the present study, we address this by comparing size regulations and fishing practice with data on sex specific growth and maturation from Western and Southern Norway, two regions varying in density and life histories. Two years of field data on density and length measures was used together with a subsample of otoliths to determine sex specific growth patterns. In the region with high density, nesting males were found to grow faster and mature later than sneaker males and females. Here, most nesting males will reach the minimum size as juveniles, one and two years before females and sneakers respectively. In contrast, sexual dimorphism was much less pronounced in the low density region, and relaxed male-male competition over nesting sites seems a likely explanation for this pattern. Intensive harvesting with selective removal of the larger nesting males could potentially lead to short term effect such as sperm limitation and reduced offspring survival and thus affect the productivity of juveniles. In addition, the current fishing regime may select for reduced growth rates and earlier maturation and oppose sexual selection.

  13. THE TEACHERS ROLE IN FORMING PROPER BODY POSTURE

    Directory of Open Access Journals (Sweden)

    Zoran Bogdanović

    2007-05-01

    Full Text Available Being acquainted and well aware of the presence of physical deformation in school population, this study is based on the research of postural deformity of the pupils of the 5th grade of elementary school and determination of dependance of deformations appearance in relation to frequency of remonstration and indication to correct sitting position from proffesors’ perspective. The complete program content is conducted in the territory of the city of Kragujevac in several elementary schools comprising 299 students of the 5th grade. The object was to determine the number of students with kyphotic and lordotic deformity, to determine the presence of deformation in depandance of gender and to determine the presence of kyphotic and lordotic deformity in depandance of the frequency of proffesors indication to improper sitting. We can notice higher presence of kyphotic deformity at the probationers of male population that it is the case with female population while the higher presence of lordotic deformity is at female population.The highest number of probationers have reported that none of the proffesors warn them about proper sitting. The measures inside the groups sorted by gender qualifi cation, indicate on high percentage of both boys and girls who are not warned on proper sitting. Also, inside the groups of improper body holders, we can notice the most signifi cant kyphotic and lordotic deformity in the category of students who are never warned to sit properly. These indicators report us that is necessary to invest much more work on the education of parents and children as well as school stuff at the preschool and school institutions which would result in reducing the appearence and development of postural deformity at the population who is more liable to transformations of such kind.

  14. Proper Elements and Secular Resonances for Irregular Satellites

    Science.gov (United States)

    Beaugé, C.; Nesvorný, D.

    2007-06-01

    We present results of an analytical study of proper elements and secular resonances for the irregular satellites of the outer planets. In the case of the Jovian system we identify three satellite families, two of them previously known (Carme and Ananke), plus a new agglomeration of four bodies that includes Pasiphae as its largest member. While the distribution of proper elements for Saturn's moons seems to be more random, a small cluster was found for the direct moons formed by Albiorix, Erriapo, and 2004 S1, slightly different from the so-called Gaulish cluster. No significant families are detected in the present study for the Uranian or Neptunian satellite systems. For each satellite system we determine the location of several secular resonances in the proper element space. Apart from the well-known resonance locks of Pasiphae, Sinope, and Siarnaq, a comparison between the resonance locations and proper elements shows that Saturn's satellite Narvi also exhibits temporary librations in the ϖ-ϖsolar resonance. However, unlike the resonant Jovian moons that are located in the same configuration, Narvi's critical argument librates alternately around values near 90° and 270°. Neither the Uranian nor Neptunian systems seem to have resonant moons. The resonant dynamics of the real satellites in the vicinity of ϖ˙-ϖ˙solar=0 is studied with a simple model for secular resonances based on the restricted three-body problem. Depending on the initial conditions, we show the existence of one or two modes of libration that can occur at different values of the critical angle, showing a good correspondence with the observed behavior of all the resonant moons. Finally, we discuss the global distribution of the real satellites with respect to the secular resonances, as compared with synthetic populations of bodies drawn solely from stability conditions. For Saturn, we find that the present satellite population appears compatible with simple random distributions. Although

  15. Topic B. Disposal objectives: are they fair and properly defined

    International Nuclear Information System (INIS)

    McComble, C.

    1994-01-01

    In this work the author was asked to make some connections between the ethical issues that are presently being discussed and the objectives and the principles which have been espoused in the nuclear waste disposal area. He tries to group it under the following set of questions : are the objectives and principles which we espouse properly defined. Are they sufficiently complete. Have we missed any out. Did we make any additional suggestions. Are they fair when we measure them against these ethical principles. Are they too ambitious. Are we going too far in one direction. (O.L.)

  16. The observable defects and the proper functioning guarantee in trading

    Directory of Open Access Journals (Sweden)

    Jorge Oviedo Albán

    2014-12-01

    Full Text Available This paper discusses two legal mechanisms for buyer´s protection contained in the Colombian Commercial Code, parallel to building regulations, because of hidden defects in the sale, which are: guarantee by observable defects at delivery and guarantee for proper functioning. The author analyzes the poor way such actions are enshrined in the Code as a consequence of a fragmented and dispersed regime for defective compliance actions in the laws of Private Law. This paper proposes a reinterpretation of such actions from the perspective of the lack of conformity that is based on a unified system of remedies for breach, concepts embodied in modern instruments of contract law.

  17. Proper and incorrect body posture in students from music schools

    OpenAIRE

    Hadlich, Roland

    2017-01-01

    Hadlich Roland. Proper and incorrect body posture in students from music schools. Journal of Education, Health and Sport. 2017;7(2):562-584. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.556100 http://ojs.ukw.edu.pl/index.php/johs/article/view/4405 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author...

  18. Proper Living - Exploring Domestic Ideals in Medieval Denmark

    DEFF Research Database (Denmark)

    Kristiansen, Mette Svart

    2014-01-01

    Houses frame homes, households, and daily life, and it is reasonable to suggest that ideas of domestic space in medieval society, and ideas of how to live in an orderly and acceptable manner in the eyes of one’s peers and oneself are reflected in domestic architecture, its layout, fittings......, and ornaments. This paper addresses ideas of proper living in affluent rural and urban milieus in medieval Denmark, particularly as they are expressed through houses, inventories, and murals, and it also addresses current challenges in understanding the materialized ideas based on excavations and analysis...

  19. Laboratory studies on enhancing the throughput of demineraliser units by proper selection of ion exchange resins

    Energy Technology Data Exchange (ETDEWEB)

    Rao, S V; Unny, V K.P.; Shetiya, R S [Reactor Services and Maintenance Division, Bhabha Atomic Research Centre, Mumbai (India)

    1994-06-01

    In water treatment plants of nuclear reactors, type I strong base anion resins are extensively used in anion units along with strong acid cation resins in cation units for demineralisation of water. There is another kind of strong base anion resin called type II resin which is chemically slightly different from type I resin. Type II resins differ from the type I in that one of the methyl groups in the quaternary ammonium functional group of the latter, is replaced by an ethanol group. This results in lower basicity of the resin and hence, higher regeneration efficiency. However, the resin is not like a weak base resin in its properties since it is capable of removing silica from water, though not with the same efficiency as that of the type I strong base resin. Studies were carried out to compare the performance of presently used type I resins with that of type II resins supplied by local manufacturers to assess the suitability of the latter for use in the DM plants of Trombay reactors. This paper discusses the results of the studies. (author). 2 figs., 6 tabs.

  20. Increasing the rewriting speed of optical rewritable e-paper by selecting proper liquid crystals

    International Nuclear Information System (INIS)

    Geng Yu; Sun Jiatong; Kwok Hoi Sing; Murauski Anatoli; Chigrinov Vladimir

    2012-01-01

    The effect of interaction between liquid crystal (LC) and photoalignment material on the speed of optical rewriting process is investigated. The theoretical analysis shows that a smaller frank elastic constant K 22 of liquid crystal corresponds to a larger twist angle, which gives rise to a larger rewriting speed. Six different LC cells with the same boundary conditions (one substrate is covered with rubbed polyimide (PI) and the other with photo sensitive rewritable sulfuric dye 1(SD1)) are tested experimentally under the same illumination intensity (450 nm, 80 mW/cm 2 ). The results demonstrate that with a suitable liquid crystal, the LC optical rewriting speed for e-paper application can be obviously improved. For two well known LC materials E7 (K 22 is larger) and 5CB (K 22 is smaller), they require 11 s and 6 s corresponding to change alignment direction for generating image information. (general)

  1. Selected principles of proper education of women with rheumatic diseases in respect of pregnancy planning

    Directory of Open Access Journals (Sweden)

    Mariola Kosowicz

    2014-03-01

    Full Text Available One of the more important problems resulting from the specificity of a chronic disease, its treatment and associated adverse effects is a permanent inability or limited ability to initiate and realize the requirements relevant to a given developmental stage of the patient. For women at reproductive age this includes family planning and giving birth to babies. The problem of pregnancy in women with the diagnosis of rheumatic disease is associated not only with physical but also psychological factors. A significant percentage of women with rheumatic diseases make no attempts to conceive. It is caused among other things by lacking knowledge on the possibilities of realization of the motherhood plans and the influence of social stereotypes concerning limitations resulting from disability. Therefore, an important element of influencing the patients’ attitudes is solid education providing information and instrumental support including practical training in precise ways of management of a given situation.

  2. Determination of Proper Motions of Circumpolar Stars by Using Images from Ukrvo Plate Archives

    Science.gov (United States)

    Protsyuk, Yu.; Andruk, V.; Mazhaev, A.; Kovylianska, O.; Protsyuk, S.; Golovnya, V.

    UkrVO plate archives contain informationobtained at different time periods and in different observatories for the same regions of the sky [3, 5, 6, 7, 8]. It allows us to carry out joint processing of plates and to receive new results for interesting objects. To obtain proper motions of stars in circumpolar areas, we selected 34 photographic plates from the RI NAO archive and 161 plates from the archive of the MAO NAS. A mean epoch difference between the plates from these archives is 55 years. Scanning of the plates and data processing were independently carried out by both observatories. A catalog of equatorial positions for 195 thousand stars up to 15m was compiled in the RI NAO (black dots in Fig. 1). A catalog of equatorial positions for 1050 thousand stars up to 16.5m was compiled in MAO (gray dots in Fig. 1). A comparison of positions for common stars contained in these catalogs was conducted. A catalog of proper motions for 30 thousand common stars up to 15m was compiled using these two input catalogs. The obtained result suggests the advisability of processing of all observations to receive proper motions of stars up to 14-15m in the declination zone of 65° to 90°.

  3. PROPER MOTIONS OF THE HH 110/270 SYSTEM

    Energy Technology Data Exchange (ETDEWEB)

    Kajdic, P. [Instituto de Astronomia, UNAM, Mexico D.F. (Mexico); Reipurth, B.; Walawender, J. [Institute for Astronomy, University of Hawaii at Manoa, 640 N. A' ohoku Place, Hilo, HI 96720 (United States); Raga, A. C. [Instituto de Ciencias Nucleares, UNAM, Mexico D.F. (Mexico); Bally, J., E-mail: primoz@geofisica.unam.mx, E-mail: reipurth@IfA.Hawaii.Edu, E-mail: raga@nucleares.unam.mx, E-mail: John.Bally@casa.colorado.edu, E-mail: joshw@ifa.hawaii.edu [CASA, University of Colorado, 389 UCB, Boulder, CO 80309-0389 (United States)

    2012-05-15

    We present a study of the HH 110/270 system based on three sets of optical images obtained with the ESO New Technology Telescope, the Subaru Telescope, and the Hubble Space Telescope (HST). The ground-based observations are made in the H{alpha} and [S II] emission lines and the HST observations are made in the H{alpha} line only. Ground-based observations reveal the existence of nine knots, which have not been previously discussed and offer some important insight into the HH 110/270 history. We perform a kinematic study of the HH 110/270 system and an analysis of its emission properties. We measure proper motions of all the knots in the system. Four of the newly identified knots belong to the HH 270 jet. Their positions indicate that the jet's axis changed its direction in the past. We speculate that similar changes may have occurred many times in the past and this could be part of the reason for the unusual structure of the HH 110 jet. The HST observations allow us to resolve individual knots into their substructures and to measure their proper motions. These measurements show that the knots are highly turbulent structures. Finally, we report the discovery of four new Herbig-Haro (HH) objects located near the HH 110/270 system.

  4. How to get properly rid of confidential data?

    CERN Multimedia

    Computer Security Team

    2012-01-01

    Have you ever bought a used laptop on ebay? Try it and you might not only get (hopefully) functional hardware, but also a bunch of personal files, intriguing photos, sensitive documents, etc. Not everybody worries enough to clean the local hard disks properly before selling their equipment or giving it away. So the next owner of the hard disk can comfortably crawl through the remaining data, and use it at his or her convenience...   In fact, properly cleaning a hard disk is difficult! Deleting local files or formatting the hard disk usually just purges the files from being listed in the folder, but the actual data remains intact on the hard disk. Freely available tools can easily reconstruct those files and, thus, expose it. It is better practice to get rid of your files by running tools like “shred” on the Linux platform (try “shred –fuvzn1 [FILENAME]” or check “man shred” for details), or “File Shredder&rdqu...

  5. PROPER MOTIONS OF THE HH 110/270 SYSTEM

    International Nuclear Information System (INIS)

    Kajdič, P.; Reipurth, B.; Walawender, J.; Raga, A. C.; Bally, J.

    2012-01-01

    We present a study of the HH 110/270 system based on three sets of optical images obtained with the ESO New Technology Telescope, the Subaru Telescope, and the Hubble Space Telescope (HST). The ground-based observations are made in the Hα and [S II] emission lines and the HST observations are made in the Hα line only. Ground-based observations reveal the existence of nine knots, which have not been previously discussed and offer some important insight into the HH 110/270 history. We perform a kinematic study of the HH 110/270 system and an analysis of its emission properties. We measure proper motions of all the knots in the system. Four of the newly identified knots belong to the HH 270 jet. Their positions indicate that the jet's axis changed its direction in the past. We speculate that similar changes may have occurred many times in the past and this could be part of the reason for the unusual structure of the HH 110 jet. The HST observations allow us to resolve individual knots into their substructures and to measure their proper motions. These measurements show that the knots are highly turbulent structures. Finally, we report the discovery of four new Herbig-Haro (HH) objects located near the HH 110/270 system.

  6. Nuclear Power Plant project site selection geotechnical considerations

    International Nuclear Information System (INIS)

    Katti, V.J.; Banerjee, D.C.

    1997-01-01

    During the selection of a site for Nuclear Power Plant (NPP) and Radioactive Waste Plant (RWP), geotechnical investigations play a significant role in deciding merits and demerits of the sites. Any accidents in these units can play havoc on mankind and may leave bitter imprints on generations to come. Hence proper care has to be taken at the early stage for selecting the sites. Site selection procedure is a complicated one, because it involves experts from various disciplines like geology, geophysics, civil, mechanical electrical engineering, health-physics and other fields

  7. Management of select bacterial and parasitic conditions of raptors.

    Science.gov (United States)

    Willette, Michelle; Ponder, Julia; Cruz-Martinez, Luis; Arent, Lori; Bueno Padilla, Irene; de Francisco, Olga Nicolas; Redig, Patrick

    2009-09-01

    Raptors are susceptible to a broad array of established and emerging bacterial and parasitic diseases, including babesiosis, chlamydiosis, clostridiosis, coccidiosis, cryptosporidiosis, malaria, mycobacteriosis, pasteurellosis, salmonellosis, trichomoniasis, and pododermatitis. Many of these conditions are opportunistic and can be easily managed or averted with proper preventive measures related to captive management, husbandry and diet, and veterinary care. Once infected, treatment must be prompt, appropriate, and judicious. This article examines the significance, diagnosis, management, and prevention of select bacterial and parasitic pathogens of raptors.

  8. Chemically Dissected Rotation Curves of the Galactic Bulge from Main-sequence Proper Motions

    Science.gov (United States)

    Clarkson, William I.; Calamida, Annalisa; Sahu, Kailash C.; Brown, Thomas M.; Gennaro, Mario; Avila, Roberto J.; Valenti, Jeff; Debattista, Victor P.; Rich, R. Michael; Minniti, Dante; Zoccali, Manuela; Aufdemberge, Emily R.

    2018-05-01

    We report results from an exploratory study implementing a new probe of Galactic evolution using archival Hubble Space Telescope imaging observations. Precise proper motions are combined with photometric relative metallicity and temperature indices, to produce the proper-motion rotation curves of the Galactic bulge separately for metal-poor and metal-rich main-sequence samples. This provides a “pencil-beam” complement to large-scale wide-field surveys, which to date have focused on the more traditional bright giant branch tracers. We find strong evidence that the Galactic bulge rotation curves drawn from “metal-rich” and “metal-poor” samples are indeed discrepant. The “metal-rich” sample shows greater rotation amplitude and a steeper gradient against line-of-sight distance, as well as possibly a stronger central concentration along the line of sight. This may represent a new detection of differing orbital anisotropy between metal-rich and metal-poor bulge objects. We also investigate selection effects that would be implied for the longitudinal proper-motion cut often used to isolate a “pure-bulge” sample. Extensive investigation of synthetic stellar populations suggests that instrumental and observational artifacts are unlikely to account for the observed rotation curve differences. Thus, proper-motion-based rotation curves can be used to probe chemodynamical correlations for main-sequence tracer stars, which are orders of magnitude more numerous in the Galactic bulge than the bright giant branch tracers. We discuss briefly the prospect of using this new tool to constrain detailed models of Galactic formation and evolution. Based on observations made with the NASA/ESA Hubble Space Telescope and obtained from the data archive at the Space Telescope Science Institute. STScI is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555.

  9. Transcultural nursing in perioperative patient care.

    Directory of Open Access Journals (Sweden)

    Anna Kostka

    2017-06-01

    Full Text Available Jehovah's Witnesses is a religious association, who refuses blood transfusions even in life-threatening conditions. There are several alternative methods, implemented for use with patients that religion, whose task is to reduce the risk of bleeding and hemorrhage in the perioperative period. Good cooperation of the therapeutic team, the selection of appropriate treatment, the use of recommended methods of anesthesia, surgical techniques and proper nursing care with careful monitoring of post-operative complications and quick response if they leave, they contribute to the improvement of health.

  10. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

    Science.gov (United States)

    Bosch-Capblanch, Xavier; Marceau, Claudine

    2014-12-01

    To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which

  11. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

    Science.gov (United States)

    Bosch–Capblanch, Xavier; Marceau, Claudine

    2014-01-01

    Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong

  12. Identifying barriers to emergency care services.

    Science.gov (United States)

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

    This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

  13. Towards the Proper Integration of Extra-Functional Requirements

    Directory of Open Access Journals (Sweden)

    Elke Hochmuller

    1999-05-01

    Full Text Available In spite of the many achievements in software engineering, proper treatment of extra-functional requirements (also known as non-functional requirements within the software development process is still a challenge to our discipline. The application of functionality-biased software development methodologies can lead to major contradictions in the joint modelling of functional and extra-functional requirements. Based on a thorough discussion on the nature of extra-functional requirements as well as on open issues in coping with them, this paper emphasizes the role of extra-functional requirements in the software development process. Particularly, a framework supporting the explicit integration of extra functional requirements into a conventional phase-driven process model is proposed and outlined.

  14. Preschoolers' knowledge about the appearance of proper names.

    Science.gov (United States)

    Stewart, Kathryn Maycumber; Pasnak, Robert

    2010-10-01

    Preschoolers' knowledge of the appearance of proper names was tested in three experiments with 25 boys and 22 girls from low-income families. Children from a Head Start program, whose parents signed a permission letter, participated. Their ages ranged from 3 yr. 6 mo. to 5 yr. 6 mo. (M = 52.2 mo., SD = 4.9). When shown consonant-vowel-consonant trigrams such as Rit or baF or dEg with various capitalization patterns, the children showed a tendency to recognize that CVC trigrams with the first letter capitalized or all letters capitalized were the ones most likely to represent a person's name. When their own names were substituted, which typically contained more than three letters, their performance was markedly better. Children also had a strong tendency to consider trigrams of Latin letters as more likely to be a person's name than trigrams of non-Latin characters (e.g., Sanskrit).

  15. Social inequalities in health: a proper concern of epidemiology.

    Science.gov (United States)

    Marmot, Michael; Bell, Ruth

    2016-04-01

    Social inequalities are a proper concern of epidemiology. Epidemiological thinking and modes of analysis are central, but epidemiological research is one among many areas of study that provide the evidence for understanding the causes of social inequalities in health and what can be done to reduce them. Understanding the causes of health inequalities requires insights from social, behavioral and biological sciences, and a chain of reasoning that examines how the accumulation of positive and negative influences over the life course leads to health inequalities in adult life. Evidence that the social gradient in health can be reduced should make us optimistic that reducing health inequalities is a realistic goal for all societies. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The proper generalized decomposition for advanced numerical simulations a primer

    CERN Document Server

    Chinesta, Francisco; Leygue, Adrien

    2014-01-01

    Many problems in scientific computing are intractable with classical numerical techniques. These fail, for example, in the solution of high-dimensional models due to the exponential increase of the number of degrees of freedom. Recently, the authors of this book and their collaborators have developed a novel technique, called Proper Generalized Decomposition (PGD) that has proven to be a significant step forward. The PGD builds by means of a successive enrichment strategy a numerical approximation of the unknown fields in a separated form. Although first introduced and successfully demonstrated in the context of high-dimensional problems, the PGD allows for a completely new approach for addressing more standard problems in science and engineering. Indeed, many challenging problems can be efficiently cast into a multi-dimensional framework, thus opening entirely new solution strategies in the PGD framework. For instance, the material parameters and boundary conditions appearing in a particular mathematical mod...

  17. Selecting a change and evaluating its impact on the performance of a complex adaptive health care delivery system

    Directory of Open Access Journals (Sweden)

    Malaz A Boustani

    2010-05-01

    Full Text Available Malaz A Boustani1,2,3,4, Stephanie Munger1,2, Rajesh Gulati3,4, Mickey Vogel4, Robin A Beck3,4, Christopher M Callahan1,2,3,41Indiana University Center for Aging Research, 2Regenstrief Institute Inc., 3Indiana University School of Medicine, Department of Medicine, Division of General Internal Medicine and Geriatrics, 4Indiana University Medical Group-Primary Care; Indianapolis, IN USAAbstract: Complexity science suggests that our current health care delivery system acts as a complex adaptive system (CAS. Such systems represent a dynamic and flexible network of individuals who can coevolve with their ever changing environment. The CAS performance fluctuates and its members’ interactions continuously change over time in response to the stress generated by its surrounding environment. This paper will review the challenges of intervening and introducing a planned change into a complex adaptive health care delivery system. We explore the role of the “reflective adaptive process” in developing delivery interventions and suggest different evaluation methodologies to study the impact of such interventions on the performance of the entire system. We finally describe the implementation of a new program, the Aging Brain Care Medical Home as a case study of our proposed evaluation process.Keywords: complexity, aging brain, implementation, complex adaptive system, sustained change, care delivery

  18. The effectiveness of introducing Group Prenatal Care (GPC) in selected health facilities in a district of Bangladesh: study protocol.

    Science.gov (United States)

    Sultana, Marufa; Mahumud, Rashidul Alam; Ali, Nausad; Ahmed, Sayem; Islam, Ziaul; Khan, Jahangir A M; Sarker, Abdur Razzaque

    2017-01-31

    Despite high rates of antenatal care and relatively good access to health facilities, maternal and neonatal mortality remain high in Bangladesh. There is an immediate need for implementation of evidence-based, cost-effective interventions to improve maternal and neonatal health outcomes. The aim of the study is to assess the effect of the intervention namely Group Prenatal Care (GPC) on utilization of standard number of antenatal care, post natal care including skilled birth attendance and institutional deliveries instead of usual care. The study is quasi-experimental in design. We aim to recruit 576 pregnant women (288 interventions and 288 comparisons) less than 20 weeks of gestational age. The intervention will be delivered over around 6 months. The outcome measure is the difference in maternal service coverage including ANC and PNC coverage, skilled birth attendance and institutional deliveries between the intervention and comparison group. Findings from the research will contribute to improve maternal and newborn outcome in our existing health system. Findings of the research can be used for planning a new strategy and improving the health outcome for Bangladeshi women. Finally addressing the maternal health goal, this study is able to contribute to strengthening health system.

  19. Principles of Proper Nutrition in Children with Celiac Disease

    Directory of Open Access Journals (Sweden)

    H Khajavikia

    2014-04-01

    Full Text Available   Introduction: Celiac disease (CD is a hereditary disorder of the immune system which damages the mucosa of the small intestine caused by gluten consumption(even very small amounts. Villous atrophy, leads to malabsorption, which is due to decreased absorption levels. The first bowel symptoms are seen during the first 2 years of life. Currently, the only treatment is to compliance with a gluten-free diet lifelong. The purpose of this study was to introduce the principles of proper nutrition in children with CD to prevent complications of malabsorption.   Results: The patients do not tolerate the proteins of cereals in bread such as wheat, barley, black barley and rye. Substituting wheat flour with rice flour, corn and potatoes and using olive oil, sunflower, corn oil and peanut oil for cooking is recommended. Until the disappearance of symptoms, consumption of milk, fat and high-fiber foods should be avoided. Deficiency of folic acid, iron, vitamin B12 and calcium are common. If necessary, iron, folic acid and multivitamin can be used. These children need proper energy according to their personal needs and should have a diet high in protein. Consumption of potatoes, corn, vegetables, fruits, meat, fish, poultry, eggs, dairy and nuts (non- roasted in any form is allowed. Identifying foods which contain gluten (prepared sauces, sausages, salami, herbal supplements, all canned meat products, crushed barbecue, prepared soups, espresso and coffee , white vinegar, curd, dried milk, pasta, pastries prepared by wheat flour, compote and food supplements is recommended.   Conclusions: The identification of substances containing gluten by parents and children, and removal of harmful substances from the diet causes the intestines to quickly begin to rebuild itself. Keywords: Nutrition, Child, Celiac, Diet.

  20. Morphometric characteristics of the neurons of the human subiculum proper

    Directory of Open Access Journals (Sweden)

    Živanović-Mačužić Ivana

    2012-01-01

    Full Text Available The human subiculum is a significant part of the hippocampal formation positioned between the hippocampus proper and the entorhinal and other cortices. It plays an important role in spatial navigation, memory processing and control of the response to stress. The aim of our study was identification of the morphometric characteristics of the neurons of the human subiculum proper: the maximum length and width of cell body and total dendritic length and volume of cell body. Comparing the measured parameters of different types of subicular neurons (bipolar, multipolar, pyramidal neurons with triangular-shaped soma and neurons with oval-shaped soma, we can conclude that bipolar neurons have the lowest values of the measured parameters: the maximum length of their cell body is 14.1 ± 0.2 µm, the maximum width is 13.9 ± 0.5 µm, and total dendritic length is 14597 ± 3.1 µm. The lowest volume value was observed in bipolar neurons; the polymorphic layer is 1152.99 ± 662.69 µm3. The pyramidal neurons of the pyramidal layer have the highest value for the maximal length of the cell body (44.43 ± 7.94 µm, maximum width (23.64 ± 1.89 µm, total dendritic length (1830 ± 466.3 µm and volume (11768.65±4004.9 µm3 These characteristics of the pyramidal neurons indicate their importance, because the axons of these neurons make up the greatest part of the fornix, along with the axons of neurons of the CA1 hippocampal field.

  1. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium

    NARCIS (Netherlands)

    Gribble, P.A.; Delahunt, E.; Bleakley, C.; Caulfield, B.; Docherty, C.; Fourchet, F.; Fong, D.T.; Hertel, J.; Hiller, C.; Kaminski, T.; McKeon, P.; Refshauge, K.; Wees, P.J. van der; Vincenzino, B.; Wikstrom, E.

    2014-01-01

    While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant/patient selection criteria across studies presents a potential obstacle to addressing the problem properly.

  2. The Importance Of Proper Evaluation Of The Geological Conditions For The Design Of Industrial Floor Subbase

    Directory of Open Access Journals (Sweden)

    Drusa Marián

    2015-06-01

    Full Text Available Nowadays many problems concerning industrial floors or floors in shopping centres occurred when local geological characterization is not adequately considered by structural designers, material selection is not evaluated properly and in time for future stability, or consolidation of soft organic subsoil laid in active zone is not taken into account during design evaluation. Similar problems occur when flooding effects on subbase layers cause a new settlement of the upper floor structure. Generally speaking, majority of these symptoms of floor damage have their origin in underestimation of the geotechnical risk. At some locations, the selection of support structure and material type is not adequate due to lack of experience and in order to offer the lowest price as a contractor.

  3. PERCEPTION ABOUT BOTTLE FEEDING AMONG MOTHERS IN SELECTED HEALTH CARE SETTINGS IN ABA SOUTH LGA, ABIA STATE, NIGERIA

    OpenAIRE

    Achema.G.; Chigbo.R

    2011-01-01

    The study determined the perception of bottle feeding among mothers attending child welfare clinic in selected health centers in Aba South LGA. It also ascertained the knowledge of mothers about the breast feeding and factors responsible for chosen bottle feeding. A descriptive research design was adopted for the study where a total survey of 45 mothers who were selected systematically from the centers were interviewed as a method of data collection. The findings of the study showed that 93% ...

  4. Occurrence of transmitted HIV-1 drug resistance among Drug-naïve pregnant women in selected HIV-care centres in Ghana.

    Science.gov (United States)

    Martin-Odoom, Alexander; Adiku, Theophilus; Delgado, Elena; Lartey, Margaret; Ampofo, William K

    2017-03-01

    Access to antiretroviral therapy in Ghana has been scaled up across the country over the last decade. This study sought to determine the occurrence of transmitted HIV-1 drug resistance in pregnant HIV-1 positive women yet to initiate antiretroviral therapy at selected HIV Care Centres in Ghana. Plasma specimens from twenty-six (26) HIV seropositive pregnant women who were less than 28weeks pregnant with their first pregnancy and ART naïve were collected from selected HIV care centres in three (3) regions in Ghana. Genotypic testing was done for the reverse transcriptase gene and the sequences generated were analyzed for HIV-1 drug resistance mutations using the Stanford University HIV Drug Resistance Database. Resistance mutations associated with the reverse transcriptase gene were detected in 4 (15.4%) of the participants. At least one major drug resistance mutation in the reverse transcriptase gene was found in 3 (11.5%) of the women. The detection of transmitted HIV-1 drug resistance in this drug-naïve group in two regional HIV care sites is an indication of the need for renewed action in monitoring the emergence of transmitted HIV-1 drug resistance in Ghana. None declared.

  5. Comparative gut microbiota and resistome profiling of intensive care patients receiving selective digestive tract decontamination and healthy subjects

    NARCIS (Netherlands)

    Buelow, Elena; Bello González, Teresita D J; Fuentes, Susana; de Steenhuijsen Piters, Wouter A A; Lahti, Leo; Bayjanov, Jumamurat R; Majoor, Eline A M; Braat, Johanna C; van Mourik, Maaike S M; Oostdijk, Evelien A N; Willems, Rob J L; Bonten, Marc J M; van Passel, Mark W J; Smidt, Hauke; van Schaik, Willem

    2017-01-01

    BACKGROUND: The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed

  6. Measuring the quality of renal care: things to keep in mind when selecting and using quality indicators.

    Science.gov (United States)

    van der Veer, Sabine N; van Biesen, Wim; Couchoud, Cécile; Tomson, Charles R V; Jager, Kitty J

    2014-08-01

    This educational paper discusses a variety of indicators that can be used to measure the quality of care in renal medicine. Based on what aspect of care they reflect, indicators can be grouped into four main categories: structure, process, surrogate outcome and outcome indicators. Each category has its own advantages and disadvantages, and we give some pointers on how to balance these pros and cons while taking into account the aim of the measurement initiative. Especially within initiatives that link payment or reputation to indicator measurement, this balancing should be done with utmost care to avoid potential, unintended consequences. Furthermore, we suggest consideration of (i) a causal chain-i.e. subsequent aspects of care connected by evidence-based links-as a starting point for composing a performance indicator set and (ii) adequate case-mix adjustment, not only of (surrogate) outcomes, but also of process indicators in order to obtain fair comparisons between facilities and within facilities over time. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  7. Why do adults entitled to free or highly subsidized dental services select fully out-of-pocket-paid care?

    Science.gov (United States)

    Bayat, Fariborz; Vehkalahti, Miira M; Murtomaa, Heikki; Tala, Heikki

    2010-02-01

    To investigate patients' reasons for selecting a dental clinic given their choice of free or highly-subsidized dental services. The study was based on cross-sectional data obtained through phone interviews with adults in Tehran, Iran. The present study included those entitled to free or highly-subsidized dental services (n = 726). The data covered the patients' awareness of subsidized dental services and type of dental clinic for their most recent visit and their reasons for selecting that clinic. Awareness of subsidized dental services was dichotomized as being either aware or unaware of such subsidy. The type of clinic was dichotomized as providing either free or highly-subsidized (FHS) or fully out-of-pocket paid (FOP) services. Free format answers about the subjects' reasons for selecting a particular clinic were later sub-grouped as: convenient access, good technical aspects, good interpersonal aspects, low or reasonable fees, recommendation by a friend, and no reason. Socio-demographic status was based on background. Data analysis included the chi-square test and logistic regression model. Of the subjects (n = 726), 60% were women and 58% were under 35 years of age. The subjects' mean age was 33.5 years with no difference by gender (P = 0.24) and the majority had public insurance (91%). Of all the subjects, 60% selected FOP. Good interpersonal aspects were the strongest reason for selecting FOP (OR = 4.6), follow by good technical aspects (OR = 2.3). Those subjects who were unaware of their benefit had 4.6 times the odds of selecting FOP. Despite the opportunity to use highly-subsidized dental services, good interpersonal and good technical aspects lead patients to select private dentists and to pay fully out of pocket.

  8. What can Gaia proper motions tell us about Milky Way dwarf galaxies?

    NARCIS (Netherlands)

    Jin, S.; Helmi, A.; Breddels, M.

    We present a proper-motion study on models of the dwarf spheroidal galaxy Sculptor, based on the predicted proper-motion accuracy of Gaia measurements. Gaia will measure proper motions of several hundreds of stars for a Sculptor-like system. Even with an uncertainty on the proper motion of order 1.5

  9. it is vital that proper care and attention is taken for success depends ...

    African Journals Online (AJOL)

    concept of the role of armour in warfare. They only needed one general order - to seek out the enemy, trap and destroy him; this they did, driving on in fair weather and foul, across good going and bad. It is also the story of a triumph of administration as thousands of trucks carried forward the supplies so vital to keep an Army ...

  10. Palliative care and end-of-life care for polypathological patients.

    Science.gov (United States)

    Martinez-Litago, E; Martínez-Velasco, M C; Muniesa-Zaragozano, M P

    2017-12-01

    Patients with advanced chronic diseases receive fragmented care, which entails high resource consumption and a poor quality of life. Uncertainty in the prognosis and scarce investigation into the importance of symptomatic control in this patient group hinders a proper therapeutic approach. Palliative care teams optimise the use of resources through comprehensive patient care, the optimization of the patient's environment, communication, the preparation of early care plans and the creation of coordinated healthcare circuits, which improve the quality of the patient's care in advanced stages of the disease. In the end-of-life phase, the therapeutic approach is focused on symptomatic control, selecting treatments according to the cause, comorbidities and the patient's wishes. To control refractory symptoms, palliative sedation is considered an indispensable option. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  11. Indwelling catheter care

    Science.gov (United States)

    Foley catheter ... You will need to make sure your indwelling catheter is working properly. You will also need to ... not get an infection or skin irritation. Make catheter and skin care part of your daily routine. ...

  12. Aeroelastic System Development Using Proper Orthogonal Decomposition and Volterra Theory

    Science.gov (United States)

    Lucia, David J.; Beran, Philip S.; Silva, Walter A.

    2003-01-01

    This research combines Volterra theory and proper orthogonal decomposition (POD) into a hybrid methodology for reduced-order modeling of aeroelastic systems. The out-come of the method is a set of linear ordinary differential equations (ODEs) describing the modal amplitudes associated with both the structural modes and the POD basis functions for the uid. For this research, the structural modes are sine waves of varying frequency, and the Volterra-POD approach is applied to the fluid dynamics equations. The structural modes are treated as forcing terms which are impulsed as part of the uid model realization. Using this approach, structural and uid operators are coupled into a single aeroelastic operator. This coupling converts a free boundary uid problem into an initial value problem, while preserving the parameter (or parameters) of interest for sensitivity analysis. The approach is applied to an elastic panel in supersonic cross ow. The hybrid Volterra-POD approach provides a low-order uid model in state-space form. The linear uid model is tightly coupled with a nonlinear panel model using an implicit integration scheme. The resulting aeroelastic model provides correct limit-cycle oscillation prediction over a wide range of panel dynamic pressure values. Time integration of the reduced-order aeroelastic model is four orders of magnitude faster than the high-order solution procedure developed for this research using traditional uid and structural solvers.

  13. TMAP/CKAP2 is essential for proper chromosome segregation.

    Science.gov (United States)

    Hong, Kyung Uk; Kim, Eunhee; Bae, Chang-Dae; Park, Joobae

    2009-01-15

    Tumor-associated microtubule-associated protein (TMAP), also known as cytoskeleton associated protein 2 (CKAP2), is a novel mitotic spindle-associated protein which is frequently up-regulated in various malignances. However, its cellular functions remain unknown. Previous reports suggested that the cellular functions of TMAP/CKAP2 pertain to regulation of the dynamics and assembly of the mitotic spindle. To investigate its role in mitosis, we studied the effects of siRNA-mediated depletion of TMAP/CKAP2 in cultured mammalian cells. Unexpectedly, TMAP/CKAP2 knockdown did not result in significant alterations of the spindle apparatus. However, TMAP/CKAP2-depleted cells often exhibited abnormal nuclear morphologies, which were accompanied by abnormal organization of the nuclear lamina, and chromatin bridge formation between two daughter cell nuclei. Time lapse video microscopy revealed that the changes in nuclear morphology and chromatin bridge formations observed in TMAP/CKAP2-depleted cells are the result of defects in chromosome segregation. Consistent with this, the spindle checkpoint activity was significantly reduced in TMAP/CKAP2-depleted cells. Moreover, chromosome missegregation induced by depletion of TMAP/CKAP2 ultimately resulted in reduced cell viability and increased chromosomal instability. Our present findings demonstrate that TMAP/CKAP2 is essential for proper chromosome segregation and for maintaining genomic stability.

  14. Training waste generators: The first responder in proper waste management

    International Nuclear Information System (INIS)

    Jones, E.

    1989-01-01

    Dealing with waste effectively requires a ''cradle to grave'' approach to waste management. The first step in that chain of custody is the waste generator. The waste generator plays the key role in the correct identification, packaging, and disposal of waste. The Technical Resources and Training Section at the Oak Ridge National Laboratory (ORNL) has developed several short training programs for waste generators. This training presents a consistent approach to proper handling of waste within the ORNL waste management system. This training has been developed for generators of solid low-level radioactive waste, hazardous and mixed waste, and transuranic waste. In addition to the above, a Waste Minimization training program has been developed for use by all organizations at ORNL who generate any type of hazardous waste. These training programs represent a combined effort of the training staff and the technical staff to assure that all ORNL staff accept their responsibility for handling all types of radioactive and hazardous wastes correctly from its generation to its disposal. 4 refs

  15. The health system burden of chronic disease care: an estimation of provider costs of selected chronic diseases in Uganda.

    Science.gov (United States)

    Settumba, Stella Nalukwago; Sweeney, Sedona; Seeley, Janet; Biraro, Samuel; Mutungi, Gerald; Munderi, Paula; Grosskurth, Heiner; Vassall, Anna

    2015-06-01

    To explore the chronic disease services in Uganda: their level of utilisation, the total service costs and unit costs per visit. Full financial and economic cost data were collected from 12 facilities in two districts, from the provider's perspective. A combination of ingredients-based and step-down allocation costing approaches was used. The diseases under study were diabetes, hypertension, chronic obstructive pulmonary disease (COPD), epilepsy and HIV infection. Data were collected through a review of facility records, direct observation and structured interviews with health workers. Provision of chronic care services was concentrated at higher-level facilities. Excluding drugs, the total costs for NCD care fell below 2% of total facility costs. Unit costs per visit varied widely, both across different levels of the health system, and between facilities of the same level. This variability was driven by differences in clinical and drug prescribing practices. Most patients reported directly to higher-level facilities, bypassing nearby peripheral facilities. NCD services in Uganda are underfunded particularly at peripheral facilities. There is a need to estimate the budget impact of improving NCD care and to standardise treatment guidelines. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  16. Selecting an appropriate strategy to make quality 7.1 % chlorhexidine digluconate accessible for umbilical cord care.

    Science.gov (United States)

    Metzler, Mutsumi; Coffey, Patricia S

    2016-01-01

    Achieving increased access to medicines in low- and middle-income countries is a complex issue that requires a holistic approach. Choosing an appropriate manufacturing strategy that can ensure a sustainable supply of these medicines is an essential component of that approach. The Chlorhexidine Working Group, a consortium of more than 25 international organizations, donors, and manufacturers led by PATH, has been working to increase access to 7.1 % chlorhexidine digluconate for umbilical cord care in low- and middle-income countries to reduce neonatal mortality due to infection. The working group initially considered two strategies for manufacture of this commodity: (1) production and global distribution by a multinational company; and (2) production and regional distribution by locally owned companies or subsidiaries of multinational companies based in low- and middle-income countries. Local production may be beneficial to public health and economic development in these countries, yet capability and capacity of pharmaceutical manufacturers, regulatory and legal provisions, and market factors must be carefully assessed and addressed to ensure that local production is the correct strategy and that it contributes to improved access to the medicine. To date, this effort to implement a local production strategy has resulted in successful registration of 7.1 % chlorhexidine digluconate for umbilical cord care by manufacturers in Bangladesh, Kenya, Nepal, and Nigeria. Additionally, the product is now available in domestic and export markets.

  17. Selective epitaxy of semiconductor nanopyramids for nanophotonics

    Energy Technology Data Exchange (ETDEWEB)

    Poole, P J; Dalacu, D; Lefebvre, J; Williams, R L, E-mail: philip.poole@nrc-cnrc.gc.ca [Institute for Microstructural Sciences, National Research Council, Ottawa, ON, K1A 0R6 (Canada)

    2010-07-23

    We present a detailed study of the parameters which affect the geometrical perfection of nanopyramids used for the site-selected nucleation of quantum dots. Through an understanding of crystal facet formation, we demonstrate that undesirable high index planes can be suppressed using carefully optimized lithography together with properly orientated source fluxes in the growth reactor. High quality InP nanopyramids are reported with individual InAs/InP quantum dots positioned with high precision. This represents an important milestone for the fabrication of complex quantum dot based nanophotonic devices.

  18. The relation between maturity and sophistication shall be properly dealt with in nuclear power development

    International Nuclear Information System (INIS)

    Li Yongjiang

    2009-01-01

    The paper analyses the advantages and disadvantages of the second generation improved technologies and third generation technologies mainly developed in China in terms of safety and economy. The paper also discusses the maturity of the second generation improved technologies and the sophistication of the third generation technologies respectively. Meanwhile, the paper proposes that the advantage and disadvantage of second generation improved technologies and third generation technologies should be carefully taken into consideration and the relationship between the maturity and sophistication should be properly dealt with in the current stage. A two-step strategy shall be taken as a solution to solve the problem of insufficient capacity of nuclear power, trace and develop the third generation technologies, so as to ensure the sound and fast development of nuclear power. (authors)

  19. Selected Abstracts of the 2nd International Workshop “Intensive Care of the Newborn”; Verona (Italy); March 9-10, 2018

    OpenAIRE

    --- Various Authors

    2018-01-01

    Selected Abstracts of the 2nd International Workshop “Intensive Care of the Newborn”; Verona (Italy); March 9-10, 2018CONGRESS PRESIDENTPaolo Biban  Guest Editor: Paolo BibanABS 1. DOES DELAYED CORD CLAMPING (DCC) AFFECT UMBILICAL CORD pH IN PRETERM INFANTS? • V.M. Samedi, L. Irvine, S. Thomas, D. Kowal, J. Rabi, A. Stritzke, N. Singhal, A. Abou MehremABS 2. SNAP-PE SCORE. MORBIDITY AND MOR­TALI­TY INDEX IN NICUs • A. Konstantinidi, R. Sokou, S. Parastatidou, A. Tsantes, N. IacovidouABS 3. EA...

  20. Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia

    Directory of Open Access Journals (Sweden)

    Lebel Paule

    2007-11-01

    Full Text Available Abstract Background This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada. Methods A total of 33 clinical experts from three major urban centres in Quebec formed a panel representing two medical specialties (family medicine, geriatrics and seven health or social services specialties (nursing, occupational therapy, psychology, neuropsychology, pharmacy, nutrition, social work, from primary or secondary levels of care, including long-term care. A modified version of the RAND®/University of California at Los Angeles (UCLA appropriateness method, a two-round Delphi panel, was used to assess face and content validity of process quality indicators. The appropriateness of indicators was evaluated according to a agreement of the panel with three criteria, defined as a median rating of 7–9 on a nine-point rating scale, and b agreement among panellists, judged by the statistical measure of the interpercentile range adjusted for symmetry. Feasibility of quality assessment and reliability of appropriate indicators were then evaluated within a pilot study on 29 patients affected by cognitive impairment or dementia. For measurable indicators the inter-observer reliability was calculated with the Kappa statistic. Results Initially, 82 indicators for care of vulnerable older adults with cognitive impairment or dementia were submitted to the panellists. Of those, 72 (88% were accepted after two rounds. Among 29 patients for whom medical files of the preceding two years were evaluated, 63 (88% of these indicators were considered applicable at least once, for at least one patient. Only 22 indicators were considered applicable at least once for ten or more out

  1. Invert emulsion: Method of preparation and application as proper formulation of entomopathogenic fungi.

    Science.gov (United States)

    Batta, Yacoub A

    2016-01-01

    The present article describes the technique used for preparing the invert emulsion (water-in-oil type) then, selecting the most proper formulation of invert emulsion for being used as a carrier formulation of entomopathogenic fungi. It also describes the method used for testing the efficacy of the formulated fungi as biocontrol agents of targeted insects. Detailed examples demonstrating the efficacy of formulated strains of entomopathogenic fungi against certain species of insect pests were included in the present article. The techniques and methods described in this article are reproducible and helpful in enhancing the effectiveness of formulated fungi against wide range of targeted insects in comparison with the unformulated form of these fungi. Also, these techniques and methods can be used effectively in crop protection and in the integrated pest management programs. Finally, it is important to indicate that the ingredients used for preparation of the invert emulsion have no environmental side-effects or health risks since these ingredients are safe to use and can be used in manufacturing of cosmetics or as food additives.•Description of method used for preparation of invert emulsion (water-in-oil type) and selecting the most stable and non-viscous emulsion.•Description of technique used for introducing the entomopathogenic fungi into the selected stable and non-viscous invert emulsion.•Description of method for testing the efficacy of introduced entomopathogenic fungus into the selected invert emulsion against targeted insects with detailed examples on the efficacy testing.

  2. Knowing Our Neighbors: Four New Nearby High Proper Motion Systems

    Science.gov (United States)

    Bartlett, Jennifer L.; Lurie, John C.; Ianna, Philip A.; Riedel, Adric R.; Finch, Charlie T.; Winters, Jennifer G.; Jao, Wei-Chun; Subasavage, John P.; Henry, Todd J.

    2017-01-01

    Obtaining a well-understood, volume-limited (and ultimately volume-complete) sample of stellar systems within 25 pc is essential for determining the stellar luminosity function, the mass-luminosity relationship, the stellar velocity distribution, and the stellar multiplicity fraction. Such a sample also provides insight into the local star formation history. Towards that end, the Research Consortium On Nearby Stars (RECONS) team measures trigonometric parallaxes to establish which systems truly lie within the 25-pc radius of the Solar Neighborhood. Recent astrometric measurements with the CTIO/SMARTS 0.9-m telescope establish three high proper motion systems as members (2MASS J02511490-0352459, 2MASS J15345704-1418486, and 2MASS J09211410-2104446) and confirm a fourth (2MASS J23062928-0502285). All four proper motions exceed 0.9”/yr. 2MA0251 travels 2.1497±0.0009”/yr in 149.20±0.05° at a distance of 11.0±0.4 pc. 2M2306 moves 1.0344±0.0007”/yr in 118.50±0.08° at a distance of 12.7±0.2 pc. 2MA1534 goes 0.9726±0.0004”/yr in 251.50 ±0.05° at a distance of 10.93±0.10 pc. 2MA0921 shifts 0.9489±0.0003”/yr in 164.70±0.04° at a distance of 12.3±0.2 pc. The corresponding tangential velocities are 112.4, 62.4, 50.4, and 55.5 km/s whereas the median for parallaxes previously published by RECONS is 53 km/s. With radial velocities in the literature of -75.5 to 80.53 km/s, none of these is a candidate member of any young moving groups.To characterize these late M-early L systems more fully, RECONS obtained VRI photometry; their I -band magnitudes range from 14.10 to 16.55. Over their astrometric baselines of 7.75 to 8.99 years, these demonstrated long-term I-band variability of 0.0135 mag. or less, indicating they may be older systems.With each new confirmation, we come closer to completing the census of the Solar Neighborhood.NSF grants AST 05-07711 and AST 09-08402, NASA-SIM, Georgia State University, the University of Virginia, Hampden-Sydney College

  3. Solar radiation at the surface in the Baltic Proper

    Directory of Open Access Journals (Sweden)

    Sirje Keevallik

    2010-12-01

    Full Text Available Radiation data recorded at 12 sites around the central part of the Baltic Sea during 1996-2000 drawn from the BALTEX (Baltic Sea Experiment meteorological data archives are used to study the spatio-temporal variability of daily global radiation totals. The annual average daily global radiation total varies from about 10 MJ m-2 at Visby(on Gotland and Kołobrzeg (on the coast of Poland to less than 9 MJ m-2 at Zīlāni (inland Latvia, Šilutė (Lithuaniaand Jokioinen (Finland. The monthly average daily global radiation total over the whole region extends from 0.93 in December to 19.0 in June. The variability in global radiation is analysed on the basis of the fraction of the daily total at the top of the atmosphere.The spatial and temporal variability is the least in August - this shows that the variation in the cloud cover and atmospheric properties at this time of year is the smallest. The spatial correlation is the strongest between the two Finnish stations - Vantaa and Jokioinen. It is also high between Stockholm and Norrköping, on the east coast of Sweden. The correlation coefficients are the largest over the whole area in April. Radiation data from coastal stations are compared with an earlier parameterization basedon ship observations (Rozwadowska & Isemer 1998, Isemer & Rozwadowska 1999. It is concluded that in climatological research, actinometric data from Visby can be used to characterize the radiation field over the northern part of the Baltic Proper and those from Kołobrzeg to characterize the radiation field over the southern part of this sea.

  4. Information Superiority generated through proper application of Geoinformatics

    Science.gov (United States)

    Teichmann, F.

    2012-04-01

    Information Superiority generated through proper application of Geoinformatics Information management and especially geoscience information delivery is a very delicate task. If it is carried out successfully, geoscientific data will provide the main foundation of Information Superiority. However, improper implementation of geodata generation, assimilation, distribution or storage will not only waste valuable resources like manpower or money, but could also give rise to crucial deficiency in knowledge and might lead to potentially extremely harmful disasters or wrong decisions. Comprehensive Approach, Effect Based Operations and Network Enabled Capabilities are the current buzz terms in the security regime. However, they also apply to various interdisciplinary tasks like catastrophe relief missions, civil task operations or even in day to day business operations where geo-science data is used. Based on experience in the application of geoscience data for defence applications the following procedure or tool box for generating geodata should lead to the desired information superiority: 1. Understand and analyse the mission, the task and the environment for which the geodata is needed 2. Carry out a Information Exchange Requirement between the user or customer and the geodata provider 3. Implementation of current interoperability standards and a coherent metadata structure 4. Execute innovative data generation, data provision, data assimilation and data storage 5. Apply a cost-effective and reasonable data life cycle 6. Implement IT security by focusing of the three pillar concepts Integrity, Availability and Confidentiality of the critical data 7. Draft and execute a service level agreement or a memorandum of understanding between the involved parties 8. Execute a Continuous Improvement Cycle These ideas from the IT world should be transferred into the geoscience community and applied in a wide set of scenarios. A standardized approach of how to generate, provide

  5. Less healthy, but more active: Opposing selection biases when recruiting older people to a physical activity study through primary care

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    Carey Iain M

    2008-05-01

    Full Text Available Abstract Background Physical activity studies in older people experience poor recruitment. We wished to assess the influence of activity levels and health status on recruitment to a physical activity study in older people. Methods Comparison of participants and non-participants to a physical activity study using accelerometers in patients aged ≥ 65 years registered with a UK primary care centre. Logistic regression was used to calculate odds ratios (OR of participants in the accelerometer study with various adjustments. Analyses were initially adjusted for age, sex and household clustering; the health variables were then adjusted for physical activity levels and vice versa to look for independent effects. Results 43%(240/560 participated in the physical activity study. Age had no effect but males were more likely to participate than females OR 1.4(1.1–1.8. 46% (76/164 of non-participants sent the questionnaire returned it. The 240 participants reported greater physical activity than the 76 non-participants on all measures, eg faster walking OR 3.2(1.4–7.7, or 10.4(3.2–33.3 after adjustment for health variables. Participants reported more health problems; this effect became statistically significant after controlling for physical activity, eg disability OR 2.4(1.1–5.1. Conclusion Physical activity studies on older primary care patients may experience both a strong bias towards participants being more active and a weaker bias towards participants having more health problems and therefore primary care contact. The latter bias could be advantageous for physical activity intervention studies, where those with health problems need targeting.

  6. Quantitative measures of sexual selection reveal no evidence for sex-role reversal in a sea spider with prolonged paternal care.

    Science.gov (United States)

    Barreto, Felipe S; Avise, John C

    2010-10-07

    Taxa in which males alone invest in postzygotic care of offspring are often considered good models for investigating the proffered relationships between sexual selection and mating systems. In the pycnogonid sea spider Pycnogonum stearnsi, males carry large egg masses on their bodies for several weeks, so this species is a plausible candidate for sex-role reversal (greater intensity of sexual selection on females than on males). Here, we couple a microsatellite-based assessment of the mating system in a natural population with formal quantitative measures of genetic fitness to investigate the direction of sexual selection in P. stearnsi. Both sexes proved to be highly polygamous and showed similar standardized variances in reproductive and mating successes. Moreover, the fertility (number of progeny) of males and females appeared to be equally and highly dependent on mate access, as shown by similar Bateman gradients for the two sexes. The absence of sex-role reversal in this population of P. stearnsi is probably attributable to the fact that males are not limited by brooding space but have evolved an ability to carry large numbers of progeny. Body length was not a good predictor of male mating or reproductive success, so the aim of future studies should be to determine what traits are the targets of sexual selection in this species.

  7. A cross selectional survey in a critical care: the job satisfaction and functioning team of the health professionals.

    Science.gov (United States)

    La Sala, Rachele; Boninsegni, Katiuscia; Tani, Alice; Rasi, Alice; Ricci, Barbara; Sansovini, Linda; Scarpelli, Giulia; Artioli, Giovanna; Sarli, Leopoldo

    2015-01-01

    Health care workers, especially those who are part of the OS core, are essential in the delivery of services, as they represent the institution at the time of the contact with the user and they represent also the image of the organization. Health administrations, therefore, are called to improve the performance through a better motivation and satisfaction of the staff, in view of two strategic aspects: job satisfaction of professionals and team collaboration. Between January and September 2014, a survey at the OU (UUOO) intensive care and sub intensive has been made inside three hospitals in Emilia Romagna. It' s been a multicentre cross-sectional quantitative study by administering a self-report questionnaire designed to investigate the different constructs. On 742 questionnaires were spread 454 professionals gave it back  (response rate = 73%). Of those, 273 (60.1%) were nurses, 119 (26.2%) were physicians and 62 (13.7%) were healthcare operators. 62 (13.7%) Job Satisfaction was measured with the McCloskey Mueller Satisfaction Scale. Team Functioning was measured with the Index of Interprofessional Team Collaboration. Results from MANOVA indicated that physicians were less satisfied of scheduling than both nurses and healthcare operators. For professional opportunities, instead, healthcare operators showed the lower level of satisfaction. The participants seem to perceive a high level of team effectiveness and therefore the professionals involved in the care of critically ill patients than the two dimensions analysed, (reflection between the processes and interdependent roles), also state a greater tendency to respect the roles interdisciplinary, maintaining their professional autonomy and a lower tendency to use critical thinking to act professionally in order to improve the effectiveness of care provided. The study results oriented healthcare administrators, to take paths that feed the job satisfaction and the collaboration of professionals by developing the

  8. Proper Sterol Distribution Is Required for Candida albicans Hyphal Formation and Virulence

    Science.gov (United States)

    McCourt, Paula; Liu, Hsing-Yin; Parker, Josie E.; Gallo-Ebert, Christina; Donigan, Melissa; Bata, Adam; Giordano, Caroline; Kelly, Steven L.; Nickels, Joseph T.

    2016-01-01

    Candida albicans is an opportunistic fungus responsible for the majority of systemic fungal infections. Multiple factors contribute to C. albicans pathogenicity. C. albicans strains lacking CaArv1 are avirulent. Arv1 has a conserved Arv1 homology domain (AHD) that has a zinc-binding domain containing two cysteine clusters. Here, we explored the role of the CaAHD and zinc-binding motif in CaArv1-dependent virulence. Overall, we found that the CaAHD was necessary but not sufficient for cells to be virulent, whereas the zinc-binding domain was essential, as Caarv1/Caarv1 cells expressing the full-length zinc-binding domain mutants, Caarv1C3S and Caarv1C28S, were avirulent. Phenotypically, we found a direct correlation between the avirulence of Caarv1/Caarv1, Caarrv1AHD, Caarv1C3S, and Caarv1C28S cells and defects in bud site selection, septa formation and localization, and hyphal formation and elongation. Importantly, all avirulent mutant strains lacked the ability to maintain proper sterol distribution. Overall, our results have established the importance of the AHD and zinc-binding domain in fungal invasion, and have correlated an avirulent phenotype with the inability to maintain proper sterol distribution. PMID:27587298

  9. Proper Sterol Distribution Is Required for Candida albicans Hyphal Formation and Virulence

    Directory of Open Access Journals (Sweden)

    Paula McCourt

    2016-11-01

    Full Text Available Candida albicans is an opportunistic fungus responsible for the majority of systemic fungal infections. Multiple factors contribute to C. albicans pathogenicity. C. albicans strains lacking CaArv1 are avirulent. Arv1 has a conserved Arv1 homology domain (AHD that has a zinc-binding domain containing two cysteine clusters. Here, we explored the role of the CaAHD and zinc-binding motif in CaArv1-dependent virulence. Overall, we found that the CaAHD was necessary but not sufficient for cells to be virulent, whereas the zinc-binding domain was essential, as Caarv1/Caarv1 cells expressing the full-length zinc-binding domain mutants, Caarv1C3S and Caarv1C28S, were avirulent. Phenotypically, we found a direct correlation between the avirulence of Caarv1/Caarv1, Caarrv1AHD, Caarv1C3S, and Caarv1C28S cells and defects in bud site selection, septa formation and localization, and hyphal formation and elongation. Importantly, all avirulent mutant strains lacked the ability to maintain proper sterol distribution. Overall, our results have established the importance of the AHD and zinc-binding domain in fungal invasion, and have correlated an avirulent phenotype with the inability to maintain proper sterol distribution.

  10. Multicrack Localization in Rotors Based on Proper Orthogonal Decomposition Using Fractal Dimension and Gapped Smoothing Method

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    Zhiwen Lu

    2016-01-01

    Full Text Available Multicrack localization in operating rotor systems is still a challenge today. Focusing on this challenge, a new approach based on proper orthogonal decomposition (POD is proposed for multicrack localization in rotors. A two-disc rotor-bearing system with breathing cracks is established by the finite element method and simulated sensors are distributed along the rotor to obtain the steady-state transverse responses required by POD. Based on the discontinuities introduced in the proper orthogonal modes (POMs at the locations of cracks, the characteristic POM (CPOM, which is sensitive to crack locations and robust to noise, is selected for cracks localization. Instead of using the CPOM directly, due to its difficulty to localize incipient cracks, damage indexes using fractal dimension (FD and gapped smoothing method (GSM are adopted, in order to extract the locations more efficiently. The method proposed in this work is validated to be effective for multicrack localization in rotors by numerical experiments on rotors in different crack configuration cases considering the effects of noise. In addition, the feasibility of using fewer sensors is also investigated.

  11. Kinematics of Local, High-Velocity K dwarfs in the SUPERBLINK Proper Motion Catalog

    Science.gov (United States)

    Kim, Bokyoung; Lepine, Sebastien

    2018-01-01

    We present a study of the kinematics of 345,480 K stars within 2 kpc of the Sun, based on data from the SUPERBLINK catalog of stars with high proper motions (> 40 mas/yr), combined with data from the 2MASS survey and from the first GAIA release, which together yields proper motions accurate to ~2 mas/yr. All K dwarfs were selected based on their G-K colors, and photometric distances were estimated from a re-calibrated color-magnitude relationship for K dwarfs. We plot transverse velocities VT in various directions on the sky, to examine the local distribution of K dwarfs in velocity space. We have also obtained radial velocity information for a subsample of 10,128 stars, from RAVE and SDSS DR12, which we use to construct spatial velocity (U, V, W) plots. About a third (123,350) of the stars are high-velocity K dwarfs, with motions consistent with the local Galactic halo population. Our kinematic analysis suggests that their velocity-space distribution is very uniform, and we find no evidence of substructure that might arise, e.g., from local streams or moving groups.

  12. Selecting Health Care Improvement Projects: A Methodology Integrating Cause-and-Effect Diagram and Analytical Hierarchy Process.

    Science.gov (United States)

    Testik, Özlem Müge; Shaygan, Amir; Dasdemir, Erdi; Soydan, Guray

    It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes experts' opinions with different points of view, is needed for better decision making. The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating experts' opinions. An approach for collecting data from experts and a graphical display for summarizing the obtained information are also provided. The methodology is implemented for improving a hospital appointment system. The top-ranked 2 major project categories for improvements were identified to be system- and accessibility-related causes (45%) and capacity-related causes (28%), respectively. For each of the major project category, subprojects were then ranked for selecting the improvement needs. The methodology is useful in cases where an aggregate decision based on experts' opinions is expected. Some suggestions for practical implementations are provided.

  13. Driving with diabetes: precaution, not prohibition, is the proper approach.

    Science.gov (United States)

    Kohrman, Daniel B

    2013-03-01

    Safety issues posed by driving with diabetes are primarily related to severe hypoglycemia, yet some public authorities rely on categorical restrictions on drivers with diabetes. This approach is misguided. Regulation of all drivers with diabetes, or all drivers using insulin, ignores the diversity of people with diabetes and fails to focus on the subpopulation posing the greatest risk. Advances in diabetes care technology and understanding of safety consequences of diabetes have expanded techniques available to limit risks of driving with diabetes. New means of insulin administration and blood glucose monitoring offer greater ease of anticipating and preventing hypoglycemia, and thus, limit driving risk for persons with diabetes. So too do less sophisticated steps taken by people with diabetes and the health care professionals they consult. These include adoption and endorsement of safety-sensitive behaviors, such as testing before a drive and periodic testing on longer trips. Overall, and in most individual cases, driving risks for persons with diabetes are less than those routinely tolerated by our society. Examples include freedom to drive in dangerous conditions and lax regulation of drivers in age and medical cohorts with elevated overall rates of driving mishaps. Data linking specific diabetes symptoms or features with driving risk are quite uncertain. Hence, there is much to recommend: a focus on technological advances, human precautions, and identifying individuals with diabetes with a specific history of driving difficulty. By contrast, available evidence does not support unfocused regulation of all or most drivers with diabetes. © 2013 Diabetes Technology Society.

  14. The selection of skin care products for use in hyperbaric chamber may depend on flammability acceptability indices score.

    Science.gov (United States)

    McCord, Darlene E; Newton, Barry E; Fore, Jane; Chiffoleau, Gwenael

    2008-02-01

    Current protocols call for stopping adjunctive skin care treatments during hyperbaric oxygen therapy (HBOT) because the hyperbaric environment is considered unsafe for skin care products. The elevated oxygen fraction and the increased pressure in the hyperbaric chamber dramatically increase the flammability potential of materials, leading to the need for rigorous standards to prevent flame ignition. A scientific method of evaluating the flammability risks associated with skin care products would be helpful. Several skin care products were tested, using established industrial techniques for determining flammability potential with some modification. The information obtained from these tests can help clinicians make more rational decisions about which topical products can be used safely on patients undergoing HBOT. Wendell Hull & Associates conducted independent studies, comparing the oxygen compatibility for leading skin care products. Oxygen compatibility was determined using autogenous ignition temperature (AIT), oxygen index (OI), and heat of combustion (HoC) testing. AIT, a relative indication of a material's propensity for ignition, is the minimum temperature needed to cause a sample to self-ignite at a given pressure and oxygen concentration. OI, a relative indication of a material's flammability, is the minimum oxygen percentage that, when mixed with nitrogen, will sustain burning. HoC is the absolute value of a material's energy release when burning, if ignition occurs. Products with a high AIT, a high OI, and a low HoC are more compatible in an oxygen-enriched atmosphere (OEA). An acceptability index (AI) based on these 3 factors was calculated for the products, so the testers could rank overall material compatibility in OEAs (Lapin A. Oxygen Compatibility of Materials. International Institute of Refrigeration Commission Meeting; Brighton, England; 1973). Test results for the skin products varied widely. The AIT, OI, HoC, and AI were determined for each

  15. [The role of lactoferrin in the proper development of newborns].

    Science.gov (United States)

    Artym, Jolanta; Zimecki, Michał

    2005-01-01

    Colostrum and milk contain, in addition to nutritional constituents, also proteins crucial for the normal development of the offspring. Lactoferrin (LF) belongs to the family of iron-binding proteins and exhibits a wide spectrum of antimicrobial and immunotropic properties. LF is particularly resistant to proteolytic degradation in alimentary tract, in contrast to other milk proteins, e.g. casein. In any case, LF-derived peptides also possess potent antibacterial activities. LF is absorbed from the intestine by means of specific receptors located on brush border cells. Administered orally, LF stimulates both local and systemic immune response. LF plays a role in the absorption of nutrients. The protein can deliver such metal ions as iron, manganese, and zinc and facilitate the absorption of sugars. LF stimulates the proliferation of gut endothelial cells and the growth of gut-associated lymphatic follicles. This property suggests the possibility of applying LF in premature infants and patients with damaged intestinal mucus. LF controls the proper composition of the gut microflora. It suppresses the growth of pathogenic bacteria while promoting the multiplication of nonpathogenic Lactobacillus and Bifidobacterium. Newborns fed an artificial diet develop harmful microflora (Enterococcus, Enterobacter, Bacteroides, Escherichia). The non-pathogenic microflora ensures low pH, produces some vitamins, increases the activity of NK cells, T lymphocytes, and macrophages, promotes the production of protective immunoglobulins, and lowers the risk of allergies. In studies on mice, LF was found to be protective in bacteremia and endotoxemia. The protein stimulates the activity of reticulo-endothelial system cells and elicits myelopoiesis, thus increasing the killing and clearance of bacteria. In the model of experimental endotoxemia, LF inhibits the activity of pro-inflammatory cytokines, nitric oxide, and reactive forms of oxygen. LF can also promote the differentiation of T

  16. A Demonstration of Optimal Apodization Determination for Proper Lateral Modulation

    Science.gov (United States)

    Sumi, Chikayoshi; Komiya, Yuichi; Uga, Shinya

    2009-07-01

    We have realized effective ultrasound (US) beamformings by the steering of plural beams and apodizations for B-mode imaging with a high lateral resolution and accurate measurement of tissue or blood displacement vector and/or strain tensor using the multidimensional cross-spectrum phase gradient method (MCSPGM), or multidimensional autocorrelation or Doppler methods (MAM and MDM) using multidimensional analytic signals. For instance, the coherent superposition of the steered beams performed in the lateral cosine modulation method (LCM) has a higher potential for realizing a more accurate measurement of a displacement vector than the synthesis of the displacement vector using the accurately measured axial displacements obtained by the multidimensional synthetic aperture method (MDSAM), multidirectional transmission method (MTM) or the use of plural US transducers. Originally, the apodization function to be used for realizing a designed point spread function (PSF) was obtained by the Fraunhofer approximation (FA). However, to obtain the best approximated, designed PSF in the least-squares sense, we proposed a linear optimization (LO) method. Furthermore, on the basis of the knowledge about the losts of US energy during the propagation, we have recently developed a nonlinear optimization (NLO) method, in which the feet of the main lobes in apodization function are properly truncated. Thus, NLO also allows the decrease in the number of channels or the confinement of the effective aperture. In this study, to gain insight into the ideal shape of the PSF, the accuracies of the two-dimensional (2D) displacement vector measurements were compared for typical PSFs with distinct lateral envelope shapes, particularly, in terms of full width at half maximum (FWHM) and the length of the feet, i.e., the Gaussian function, Hanning window and parabolic function. It was confirmed that a PSF having a wide FWHM and short feet was ideal. Such a PSF yielded an echo with a high signal

  17. Health care in rural areas.

    Science.gov (United States)

    Nath, L M

    1994-02-01

    In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.

  18. 'What is not written does not exist': the importance of proper documentation of medication use history.

    Science.gov (United States)

    Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

    2017-10-01

    Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

  19. Intelligent Decisional Assistant that Facilitate the Choice of a Proper Computer System Applied in Busines

    Directory of Open Access Journals (Sweden)

    Nicolae MARGINEAN

    2009-01-01

    Full Text Available The choice of a proper computer system is not an easy task for a decider. One reason could be the present market development of computer systems applied in business. The big number of the Romanian market players determines a big number of computerized products, with a multitude of various properties. Our proposal tries to optimize and facilitate this decisional process within an e-shop where are sold IT packets applied in business, building an online decisional assistant, a special component conceived to facilitate the decision making needed for the selection of the pertinent IT package that fits the requirements of one certain business, described by the decider. The user interacts with the system as an online buyer that visit an e-shop where are sold IT package applied in economy.

  20. Determining proper strategies for health, safety, security and environmental (HSSE) management system.

    Science.gov (United States)

    Zaeimdar, Mojgan; Nasiri, Parvin; Taghdisi, Mohammadhoseyn; Abbaspour, Majid; Arjmandi, Reza; Kalatipor, Omid

    2013-01-01

    Today, managing an organization is concerned with many problems. Adopting proper strategies can promote an organization's survival. This study aimed at developing an appropriate HSSE Strategy for regional operation associated companies of Iran National Gas Company (INGS) using SWOT analysis. The analysis of the strengths, weaknesses, opportunities, and threats of HSSE was carried out and according to the results suitable strategies were recommended. In this regard, senior and junior managers, supervisors, and experts active in regional operation associated companies of Iran National Gas Company participated in SWOT analysis from HSSE angle. Then, they selected the most applicable SWOT factors pertaining to the organization. In the next step, these factors were weighted and scored. Based on the results four categories of strategies were developed including SO, WO, ST, and WT. Further examination showed that SO Strategies were the most applicable for the organization.

  1. Heavy metal content of selected personal care products (PCPs available in Ibadan, Nigeria and their toxic effects

    Directory of Open Access Journals (Sweden)

    Sunday Samuel Omenka

    Full Text Available There is a growing concern on heavy metals in consumer products due to their potential human health risks and environmental effects. In this study, the levels of zinc, cadmium, lead and nickel were assessed in 3 different classes of personal care products commonly used in Ibadan, Nigeria. Samples were analysed for heavy metals using Atomic Absorption Spectrophotometer (AAS after acid digestion. Estimated daily intake (EDI of the metals and Health Risk Index (HRI were calculated to assess the human health risks associated with the use of these PCPs. The concentrations (mg/kg of zinc ranged from 3.75 to 19.3, 1.88 to 112,000 and 19.8 to 217 respectively in creams, powders and eyeliners. Cadmium ranged from ND—0.50, ND—36.3 and ND—0.50 mg/kg while lead ranged from ND—6.25, ND—468 and 3.73–27.5 mg/kg and nickel ranged from ND—6.25, 0.13–107 and 2.75–22.7 mg/kg respectively. There were high concentrations of Cd, Pb and Ni in some of the samples when compared with the available permissible limits in cosmetics (Cd: 0.3 ppm, Pb: 10 ppm and Ni: 0.6 ppm while there is no permissible limit for Zn in cosmetics currently available. Prolonged use of PCPs may pose human health and environmental risks due to toxic metal loading through dermal contact and accumulation over a period of time. Hence, the need for necessary government agencies to regulate and enforce toxic metals in consumer products including cosmetics produced and imported into Nigeria to safeguard public health and the environment, which is the final sink. Keywords: Heavy metals, Personal care products, Health effects, Dermal contact, Exposure

  2. Selected aspects of medical care for patients with asthma and chronic obstructive pulmonary disease (COPD) in Poland.

    Science.gov (United States)

    Miłkowska-Dymanowska, Joanna; Białas, Adam J; Górski, Paweł

    2017-01-01

    Noncompliance with healthcare undoubtedly has a strong influence on the high prevalence of uncontrolled obstructive diseases. The aim of our study was to evaluate the quality of medical conduct in patients with asthma or chronic obstructive lung diseases (COPD), with encompassed two-levelled system of health care. A survey of general practitioners (GP), allergists and pulmonologists practicing in Poland was performed between September and December 2016. The basic survey included the data concerning the number of treated patients, the course of the visits, treatment regimens and whether the patients follow the instructions of the physician. The specialist survey recorded the details of the specialist visits, their frequency and character, an evaluation of the pharmacological and non-pharmacological therapies and an evaluation of the GP's actions. The basic questionnaire was completed by 807 doctors with an average of 21 ± 9.85 years of medical experience. Most of the interviewed individuals were GPs (56%), followed by pulmonologists (28%) and allergists (16%). The GP reported 47 cases/month with obstructive pulmonary conditions, including 48.94% asthma and 51.06% COPD patients. They diagnosed three new asthma and COPD patients per month. The allergists treated patients with asthma (105 patients/ month), with 19 newly-diagnosed patients/month. The pulmonologists treated fewer asthma cases than COPD: 71 and 98 patients respectively. They reported 14 patients/month of newly-diagnosed COPD cases. The patients took inhaled glucocorticoids and long-acting b adrenoceptor agonists in separate inhalers. The most frequently-used device was a disc. In opinion of the specialists, half of the therapies initiated recently by GPs for patients with asthma and COPD required modifications. There is a disparity between the true state of medical care of asthma and COPD patients and globally-accepted standards.

  3. The 'wise list'- a comprehensive concept to select, communicate and achieve adherence to recommendations of essential drugs in ambulatory care in Stockholm.

    Science.gov (United States)

    Gustafsson, Lars L; Wettermark, Björn; Godman, Brian; Andersén-Karlsson, Eva; Bergman, Ulf; Hasselström, Jan; Hensjö, Lars-Olof; Hjemdahl, Paul; Jägre, Ingrid; Julander, Margaretha; Ringertz, Bo; Schmidt, Daniel; Sjöberg, Susan; Sjöqvist, Folke; Stiller, Carl-Olav; Törnqvist, Elisabeth; Tryselius, Rolf; Vitols, Sigurd; von Bahr, Christer

    2011-04-01

    The aim was to present and evaluate the impact of a comprehensive strategy over 10 years to select, communicate and achieve adherence to essential drug recommendations (EDR) in ambulatory care in a metropolitan healthcare region. EDRs were issued and launched as a 'Wise List' by the regional Drug and Therapeutics Committee in Stockholm. This study presents the concept by: (i) documenting the process for selecting, communicating and monitoring the impact of the 'Wise List'; (ii) analysing the variation in the number of drug substances recommended between 2000 and 2010; (iii) assessing the attitudes to the 'Wise List' among prescribers and the public; (iv) evaluating the adherence to recommendations between 2003 and 2009. The 'Wise List' consistently contained 200 drug substances for treating common diseases. The drugs were selected based on their efficacy, safety, suitability and cost-effectiveness. The 'Wise List' was known among one-third of a surveyed sample of the public in 2002 after initial marketing campaigns. All surveyed prescribers knew about the concept and 81% found the recommendations trustworthy in 2005. Adherence to recommendations increased from 69% in 1999 to 77% in 2009. In primary care, adherence increased from 83% to 87% from 2003 to 2009. The coefficient of variation (CV%) decreased from 6.1% to 3.8% for 156 healthcare centres between these years. The acceptance of the 'Wise List' in terms of trust among physicians and among the public and increased adherence may be explained by clear criteria for drug recommendations, a comprehensive communication strategy, electronic access to recommendations, continuous medical education and involvement of professional networks and patients.

  4. How to (properly) strengthen Bell's theorem using counterfactuals

    Science.gov (United States)

    Bigaj, Tomasz

    Bell's theorem in its standard version demonstrates that the joint assumptions of the hidden-variable hypothesis and the principle of local causation lead to a conflict with quantum-mechanical predictions. In his latest counterfactual strengthening of Bell's theorem, Stapp attempts to prove that the locality assumption itself contradicts the quantum-mechanical predictions in the Hardy case. His method relies on constructing a complex, non-truth functional formula which consists of statements about measurements and outcomes in some region R, and whose truth value depends on the selection of a measurement setting in a space-like separated location L. Stapp argues that this fact shows that the information about the measurement selection made in L has to be present in R. I give detailed reasons why this conclusion can and should be resisted. Next I correct and formalize an informal argument by Shimony and Stein showing that the locality condition coupled with Einstein's criterion of reality is inconsistent with quantum-mechanical predictions. I discuss the possibility of avoiding the inconsistency by rejecting Einstein's criterion rather than the locality assumption.

  5. Better Measurement for Performance Improvement in Low- and Middle-Income Countries: The Primary Health Care Performance Initiative (PHCPI) Experience of Conceptual Framework Development and Indicator Selection.

    Science.gov (United States)

    Veillard, Jeremy; Cowling, Krycia; Bitton, Asaf; Ratcliffe, Hannah; Kimball, Meredith; Barkley, Shannon; Mercereau, Laure; Wong, Ethan; Taylor, Chelsea; Hirschhorn, Lisa R; Wang, Hong

    2017-12-01

    Policy Points: Strengthening accountability through better measurement and reporting is vital to ensure progress in improving quality primary health care (PHC) systems and achieving universal health coverage (UHC). The Primary Health Care Performance Initiative (PHCPI) provides national decision makers and global stakeholders with opportunities to benchmark and accelerate performance improvement through better performance measurement. Results from the initial PHC performance assessments in low- and middle-income countries (LMICs) are helping guide PHC reforms and investments and improve the PHCPI's instruments and indicators. Findings from future assessment activities will further amplify cross-country comparisons and peer learning to improve PHC. New indicators and sources of data are needed to better understand PHC system performance in LMICs. The Primary Health Care Performance Initiative (PHCPI), a collaboration between the Bill and Melinda Gates Foundation, The World Bank, and the World Health Organization, in partnership with Ariadne Labs and Results for Development, was launched in 2015 with the aim of catalyzing improvements in primary health care (PHC) systems in 135 low- and middle-income countries (LMICs), in order to accelerate progress toward universal health coverage. Through more comprehensive and actionable measurement of quality PHC, the PHCPI stimulates peer learning among LMICs and informs decision makers to guide PHC investments and reforms. Instruments for performance assessment and improvement are in development; to date, a conceptual framework and 2 sets of performance indicators have been released. The PHCPI team developed the conceptual framework through literature reviews and consultations with an advisory committee of international experts. We generated 2 sets of performance indicators selected from a literature review of relevant indicators, cross-referenced against indicators available from international sources, and evaluated through

  6. Women's empowerment and male involvement in antenatal care: analyses of Demographic and Health Surveys (DHS) in selected African countries.

    Science.gov (United States)

    Jennings, Larissa; Na, Muzi; Cherewick, Megan; Hindin, Michelle; Mullany, Britta; Ahmed, Saifuddin

    2014-08-30

    Increasing women's status and male involvement are important strategies in reducing preventable maternal morbidity and mortality. While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. This study examines whether a woman's empowerment status, in sum and across economic, socio-familial, and legal dimensions, is associated with male partner accompaniment to antenatal care (ANC). Women's empowerment was measured based on the sum of nine empowerment items in the 2010-2011 Demographic and Health Surveys in eight sub-Saharan African countries: Burkina Faso (n = 2,490), Burundi (n = 1,042), Malawi (n = 1,353), Mozambique (n = 414), Rwanda (n = 1,211), Senegal (n = 505), Uganda (n = 428) and Zimbabwe (n = 459). In cross-sectional analyses, bivariate and multivariable logistic regressions models were used to examine the odds of male partner accompaniment to ANC between women with above-average versus below-average composite and dimensional empowerment scores. In the majority of countries, male accompaniment to ANC was not uncommon. However, findings were mixed. Positive associations in women's composite empowerment and male involvement were observed in Burkina Faso (OR = 1.27, 95% CI: 1.08, 1.50) and Uganda (OR = 1.53, 95% CI: 1.00-2.35), and in the economic empowerment dimension in Burkina Faso (OR = 1.24, 95% CI: 1.05-1.47). In Malawi, significant negative associations were observed in the odds of male accompaniment to ANC and women's composite (OR = 0.77, 95% CI: 0.62-0.97) and economic empowerment scores (OR = 0.75, 95% CI: 0.59-0.94). No significant differences were observed in Burundi, Mozambique, Rwanda, Senegal, or Zimbabwe. Women's empowerment can be positively or negatively associated with male antenatal accompaniment. Male involvement efforts may benefit from empowerment initiatives that promote women's participation in social and economic spheres

  7. Importance of proper initial treatment of moderate and major burns

    Directory of Open Access Journals (Sweden)

    Vulović Dejan

    2008-01-01

    Full Text Available Background/Aim. Burns are common injuries with frequency depending on human factors, development of protection, industry and traffic, eventual wars. Organized treatment of major burn injuries has tremendous medical, social and economic importance. The aim of this study was to analyze initial treatment of major and moderate burns, to compare it with the current recommendations and to signify the importance of organized management of burns. Methods. In a prospective study 547 adult patients with major burns were analyzed, covering a period of eight years, with the emphasis on the initial hospital admission and emergency care for burns greater than 10% of total body surface area (TBSA. Results. In the different groups of major burns, the percentage of hospital admission was: 81.5 in burns greater than 10% TBSA, 37.7 in burns of the functional areas, 54.5 in the III degree burns, 81.6 in electrical burns, 55.9 in chemical burns, 61.9 in inhalation injury, 41.0 in burns in patients with the greater risk and 100 in burns with a concomitant trauma. In the group of 145 patients with burns greater than 10% TBSA, intravenous fluids were given in 87 patients, analgesics in 45, corticosteroids in 29, antibiotics in 23 and oxygen administration in 14. In the same group, wound irrigation was done in 14.4%, removing of the clothing and shoes in 29.6%, elevation of the legs in 8.9% and prevention of hypothermia in 7.6% of the victims. There were no initial estimations of burn extent (percentage of a burn, notes about the patient and injury and tetanus immunizations. Conclusion. Based on these findings, it is concluded that there should be much more initial hospital admissions of major burns, and also, necessary steps in the emergency care of burns greater than 10% TBSA should be taken more frequently. On the other side, unnecessary or wrong steps should be avoided in the initial burn treatment.

  8. Injury severity and disability in the selection of next level of care following acute medical treatment for traumatic brain injury.

    Science.gov (United States)

    Malec, James F; Mandrekar, Jayawant N; Brown, Allen W; Moessner, Anne M

    2009-01-01

    To evaluate the association of demographic factors, post-traumatic amnesia (PTA) and a standardized measure of ability limitations with clinical decisions for Next Level of Care following acute hospital treatment for moderate-severe traumatic brain injury (TBI). A TBI Clinical Nurse specialist recorded PTA for 212 individuals and rated 159 on the Ability and Adjustment Indices of the Mayo-Portland Adaptability Inventory (MPAI-4) for comparison with clinical decisions. Multivariate logistic regression analyses revealed that independent ratings on the MPAI-4 Ability Index and PTA were associated with the clinical decision to admit to Inpatient Rehabilitation vs discharge to Home in 92.7% of the sample; ratings on the Ability Index alone were associated with this decision in 92.2% of cases. Age over 65 was the only variable associated with discharge to a Skilled Nursing Facility, correctly predicting this decision in 64% of cases. Use of a standardized measure of ability limitations appears feasible to provide supportive documentation and potentially improve the consistency of decision-making in recommending Inpatient Rehabilitation vs discharge to Home. Although age is a significant factor in the decision to discharge to a Skilled Nursing Facility, this decision appears complex and merits further study.

  9. Smarandachely Adjacent-Vertex-Distinguishing Proper Edge Chromatic Number of Cm∨Kn

    OpenAIRE

    Shunqin Liu

    2016-01-01

    According to different conditions, researchers have defined a great deal of coloring problems and the corresponding chromatic numbers. Such as, adjacent-vertex-distinguishing total chromatic number, adjacent-vertex-distinguishing proper edge chromatic number, smarandachely-adjacent-vertex-distinguishing proper edge chromatic number, smarandachely-adjacent-vertex-distinguishing proper total chromatic number. And we focus on the smarandachely adjacent-vertex-distinguishing proper edge chromatic...

  10. The impact of stroke unit care on outcome in a Scottish stroke population, taking into account case mix and selection bias.

    Science.gov (United States)

    Turner, Melanie; Barber, Mark; Dodds, Hazel; Dennis, Martin; Langhorne, Peter; Macleod, Mary Joan

    2015-03-01

    Randomised trials indicate that stroke unit care reduces morbidity and mortality after stroke. Similar results have been seen in observational studies but many have not corrected for selection bias or independent predictors of outcome. We evaluated the effect of stroke unit compared with general ward care on outcomes after stroke in Scotland, adjusting for case mix by incorporating the six simple variables (SSV) model, also taking into account selection bias and stroke subtype. We used routine data from National Scottish datasets for acute stroke patients admitted between 2005 and 2011. Patients who died within 3 days of admission were excluded from analysis. The main outcome measures were survival and discharge home. Multivariable logistic regression was used to estimate the OR for survival, and adjustment was made for the effect of the SSV model and for early mortality. Cox proportional hazards model was used to estimate the hazard of death within 365 days. There were 41 692 index stroke events; 79% were admitted to a stroke unit at some point during their hospital stay and 21% were cared for in a general ward. Using the SSV model, we obtained a receiver operated curve of 0.82 (SE 0.002) for mortality at 6 months. The adjusted OR for survival at 7 days was 3.11 (95% CI 2.71 to 3.56) and at 1 year 1.43 (95% CI 1.34 to 1.54) while the adjusted OR for being discharged home was 1.19 (95% CI 1.11 to 1.28) for stroke unit care. In routine practice, stroke unit admission is associated with a greater likelihood of discharge home and with lower mortality up to 1 year, after correcting for known independent predictors of outcome, and excluding early non-modifiable mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. 77 FR 70484 - Preoperational Testing of Onsite Electric Power Systems To Verify Proper Load Group Assignments...

    Science.gov (United States)

    2012-11-26

    ...-1294, ``Preoperational Testing of On-Site Electric Power Systems to Verify Proper Load Group... entitled ``Preoperational Testing of On- Site Electric Power Systems to Verify Proper Load Group... Electric Power Systems to Verify Proper Load Group Assignments, Electrical Separation, and Redundancy...

  12. The Requirement of Being a "Fit and Proper" Person for the Legal ...

    African Journals Online (AJOL)

    An important requirement for admission as an attorney or advocate is to be a "fit and proper" person. Lawyers are also struck from the respective rolls of advocates or attorneys if they cease to be "fit and proper". This requirement of being a "fit and proper" person is not defined or described in legislation. It is left to the ...

  13. Collaborative efforts are needed to ensure proper knowledge dissemination of telemedicine projects.

    Science.gov (United States)

    Jakobsen, Neel Kolthoff; Jensen, Lena Sundby; Kayser, Lars

    2014-09-01

    Telemedicine is often seen as the solution to the challenge of providing health care for an increasing number of people with chronic conditions. Projects are often organised locally and based on the involvement of stakeholders with a wide range of backgrounds. It can be challenging to ensure that projects are based on previous experience and that they do not repeat previous studies. To better understand these challenges and current practice, we examined telemedicine projects funded in the 2008-2010 period to explore where, how and to what extent results from the projects were documented and disseminated. Public and private funds were contacted for information about telemedicine studies focusing on people residing in their homes. After an initial screening of titles and abstracts, 19 projects were identified. The managers of the projects were contacted and information about project results and dissemination were obtained. More than half of all projects were disseminated to professionals as well as to the public and used two-way communication. However, it was generally difficult to obtain an overview of the projects due to dynamic changes in names and scopes. We propose that the funding authorities require designs comprising proper evaluation models that will subsequently allow the investigators to publish their findings. Furthermore, a dissemination plan comprising both peers and other professions should be made mandatory. The investigators should ensure proper documentation and dissemination of changes both during and after the projects in order to ensure transparency, and national or international organisations should establish a database with relevant data fields. not relevant. not relevant.

  14. Knowledge and Practices Relating to Acute Pesticide Poisoning Among Health Care Providers in Selected Regions of Tanzania

    Directory of Open Access Journals (Sweden)

    Elikana Lekei

    2017-02-01

    Full Text Available Background: Acute pesticide poisoning (APP is commonly underdiagnosed in Tanzania. Studies in developing countries suggest that a lack of diagnostic skills among health care providers (HCPs undermines surveillance for APP. This study aimed at characterizing experience and skills of Tanzanian HCPs regarding APP diagnosis and management. Methodology: The population included HCPs responsible for managing APP in Kilimanjaro and Arusha regions (n = 91. The resulting sample included 66 respondents (response rate: 73%. The data were collected in 2005 using a standardized questionnaire. Results: Half of all respondents (50% reported handling at least 1 APP case with 15% reporting handling more than 5 cases in the past. Reported experience of handling an APP case was marginally higher in respondents who reported ⩾4 years of work experience in the health sector compared with those with <4 years of work experience (odds ratio = 1.32; 95% confidence interval = 0.9-1.5. Most of the respondents had high knowledge of exposure routes, reporting awareness of oral (98.5%, inhalational (93.9%, and dermal (77% routes. The study revealed low awareness of pesticide classification by chemical groups (29% or World Health Organization hazard (0% and weak knowledge on pesticide label instructions (55%. Organophosphates accounted for 35% of the pesticide products reported by respondents as being responsible for poisoning. Some treatment options were incorrectly reported as first aid options, and some reported first aid options were wrong or inappropriate. Conclusions: The study revealed that HCPs in northern Tanzania lack adequate skills to diagnose and manage APP. For effective surveillance of APP, there is a need to include training on hazards, classification, diagnosis, and health effects in the training programmes for all HCPs in Tanzania.

  15. Hepatic transplantation outcomes for carefully selected cirrhotic patients with hepatocellular carcinoma: experience at a small- to medium-volume centre.

    LENUS (Irish Health Repository)

    Qasim, A

    2012-02-01

    BACKGROUND: Hepatic transplantation outcomes for cirrhotic patients with hepatocellular carcinoma (HCC) at a small- to medium-volume centre are not fully known due to relative novelty of patient selection criteria. AIM: To determine hepatic transplantation outcomes for HCC at a small- to medium-volume centre. Patients and methods Hepatocellular carcinoma patients were listed for transplantation according to the International Guideline and further categorized as those fulfilling or exceeding Milan or University of San Francisco (UCSF) criteria on explanted liver morphology. Outcomes including mortality, retransplantation, and tumour recurrence rate were analysed. RESULTS: Twenty-six patients had HCC and on explanted liver morphology, Milan and UCSF criteria met 15 and 18 patients, respectively. Patients and graft survival at 3 months, 1 and 5 years were 100, 96, 84, and 88, 84, 77%, respectively. Outcomes favoured Milan criteria but did not reach statistical significance. CONCLUSIONS: Hepatic transplantation for HCC at a small-to medium-volume transplant centre had comparable survival outcomes to high-volume centres.

  16. Can CCM law properly represent all extinction curves?

    International Nuclear Information System (INIS)

    Geminale, Anna; Popowski, Piotr

    2005-01-01

    We present the analysis of a large sample of lines of sight with extinction curves covering wavelength range from near-infrared (NIR) to ultraviolet (UV). We derive total to selective extinction ratios based on the Cardelli, Clayton and Mathis (1989, CCM) law, which is typically used to fit the extinction data both for diffuse and dense interstellar medium. We conclude that the CCM law is able to fit most of the extinction curves in our sample. We divide the remaining lines of sight with peculiar extinction into two groups according to two main behaviors: a) the optical/IR or/and UV wavelength region cannot be reproduced by the CCM formula; b) the optical/NIR and UV extinction data are best fit by the CCM law with different values of R v . We present examples of such curves. The study of both types of peculiar cases can help us to learn about the physical processes that affect dust in the interstellar medium, e.g., formation of mantles on the surface of grains, evaporation, growing or shattering

  17. Minimally invasive burn care: a review of seven clinical studies of rapid and selective debridement using a bromelain-based debriding enzyme (Nexobrid®)

    Science.gov (United States)

    Rosenberg, L.; Shoham, Y.; Krieger, Y.; Rubin, G.; Sander, F.; Koller, J.; David, K.; Egosi, D.; Ahuja, R.; Singer, A.J.

    2015-01-01

    Summary Current surgical and non-surgical eschar removal-debridement techniques are invasive or ineffective. A bromelainbased rapid and selective enzymatic debriding agent was developed to overcome these disadvantages and compared with the standard of care (SOC). The safety and efficacy of a novel Debriding Gel Dressing (DGD) was determined in patients with deep partial and full thickness burns covering up to 67% total body surface area (TBSA). This review summarizes data from seven studies, four of which were randomized clinical trials that included a SOC or control vehicle. DGD eschar debridement efficacy was >90% in all studies, comparable to the SOC and significantly greater than the control vehicle. The total area excised was less in patients treated with DGD compared with the control vehicle (22.9% vs. 73.2%, Pburn debridement that offers an alternative to surgical and non-surgical SOC. PMID:27777547

  18. Anesthesia for day-care surgeries: Current perspectives

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2017-01-01

    Full Text Available Day-care surgery has become a popular modality of surgical intervention throughout the globe. Numerous factors including the economic and financial issues are driving this therapeutic modality to a widespread acceptance among surgeons and anesthesiologists. Advancements in anesthesia and surgical techniques as well as availability of newer drugs are largely responsible for the progress of day-care surgeries. Numerous challenges are still faced by anesthesiologists and surgeons in carrying out day-care surgeries, especially in spite of these advancements, at resource-limited setups. The first right step in successfully delivering the day-care surgical services includes proper selection of the patients. The preanesthetic evaluation is highly essential in determining the suitability of the patient for day-care anesthesia and surgery as well as the formulation of various anesthetic plans and strategies. The current review is intended to highlight inherent challenges and probable solutions to them for this rapidly progressing anesthesia.

  19. Monitoring selective components of primary health care: methodology and community assessment of vaccination, diarrhoea, and malaria practices in Conakry, Guinea. ACSI-CCCD team.

    Science.gov (United States)

    Dabis, F; Breman, J G; Roisin, A J; Haba, F

    1989-01-01

    The Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (ACSI-CCCD) Project is a primary health care activity that focuses on antenatal care, immunization, diarrhoeal disease control, and malaria control in children under 5 years of age. In order to gauge progress made in the project, a community-based health interview survey to measure simultaneously several prevention and treatment indicators was carried out in 1986 in Conakry, Guinea. A sample of 1415 caretakers and their 2048 children aged under 5 years was visited using a cluster sampling technique. The survey documented the levels of literacy and health education awareness of the caretakers, measured the vaccination coverage levels for children and women of childbearing age, and determined treatment practices for diarrhoea and malaria. Of the 637 women who reported having given birth in the previous 12 months, 96% had visited an antenatal clinic, but only 49% had had two or more doses of tetanus toxoid, and 13% took weekly chemoprophylaxis against malaria. The vaccination coverage for measles was 16% for children aged 12-23 months. Oral rehydration therapy (ORT) was given to 16% of children with diarrhoea; however, only 43% of those who were administered ORT at home were treated according to standard guidelines. Of children with diarrhoea, 51% were given antidiarrhoeal or antimicrobial drugs by caretakers. Fever was treated at home for 79% of the febrile children, and 43% of those with fever also visited health units. The use of injectable antimalarials and prolonged treatments with chloroquine were common. Combining findings from a population-based community study with an assessment of practices in health facilities can provide reliable information for the implementation and monitoring of selective components of primary health care.

  20. Evaluation of Student Care Process in Urban and Rural Health Care Centers and Health House in Tabriz Using Tracer Methodology

    Directory of Open Access Journals (Sweden)

    Neda Kabiri

    2015-08-01

    Full Text Available Background and Objectives : Tracer methodology is a novel evaluation method which its purpose is to provide an accurate assessment of systems and processes for the delivery of care, treatment, and services at a health care organization. This study aimed to assess student care process in Tabriz using Tracer methodology. Material and Methods : This cross-sectional study was conducted in autumn 1391. Population study consisted of all the students who were covered by Tabriz health care center and study sample included an urban health care center, a rural health care center, a health house, and two schools in urban and rural areas which were selected by simple sampling method. Also, all the complicated and problematic processes were chosen to be assessed. Data were collected by interviewing, observing, and surveying documents and were compared with current standards. Results : The results of this study declared the percentage of points that each target group gained from tracer evaluation in student care process was 77% in health house, 90% in rural health care center and 83% in urban health care center. Findings indicated that documentation was the main weak point. Conclusion : According to the results of this study, student care process is sufficient; despite the fact that there are some deficiencies in caring process, as it may be improved through appropriate strategies. Furthermore, tracer methodology seems to be a proper method to evaluate various levels of health care system. ​

  1. Masseter muscle tension, chewing ability, and selected parameters of physical fitness in elderly care home residents in Lodz, Poland

    Directory of Open Access Journals (Sweden)

    Gaszynska E

    2014-07-01

    Full Text Available Ewelina Gaszynska,1 Malgorzata Godala,2 Franciszek Szatko,1 Tomasz Gaszynski3 1Department of Hygiene and Health Promotion, Medical University of Lodz, Poland; 2Department of Nutrition and Epidemiology, Medical University of Lodz, Poland; 3Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Poland Background: Maintaining good physical fitness and oral function in old age is an important element of good quality of life. Disability-related impairment of oral function contributes to a deterioration of the diet of older people and to the reduction of their social activity.Objectives: Investigate the association between masseter muscle tension, dental status, and physical fitness parameters.Materials and methods: Two hundred fifty-nine elderly care home residents (97 men, 162 women; mean age, 75.3±8.9 years were involved in this cross-sectional study. Their chewing ability was evaluated by masseter muscle tension palpation, differences of masseter muscle thickness, self-reported chewing ability, number of present and functional teeth, and number of posterior tooth pairs. Masseter muscle thickness was measured by ultrasonography. To assess physical fitness, hand grip strength and the timed up-and-go test were performed. Nutritional status was assessed using body mass index and body cell mass index (BCMI, calculated on the basis of electrical bioimpedance measurements. Medical records were used to collect information on systemic diseases and the number of prescribed medications. Subjects were also evaluated for their ability to perform ten activities of daily living.Results: Ninety-seven percent of the subjects suffered from systemic diseases. The three most prevalent illnesses were cardiac/circulatory 64.5%, musculoskeletal 37.3%, and endocrine/metabolic/nutritional 29.3%. Of the participants, 1.5% were underweight and more than one third (34.4% were overweight. Malnutrition (BCMI below normal was found in almost

  2. AHRQ series paper 3: identifying, selecting, and refining topics for comparative effectiveness systematic reviews: AHRQ and the effective health-care program.

    Science.gov (United States)

    Whitlock, Evelyn P; Lopez, Sarah A; Chang, Stephanie; Helfand, Mark; Eder, Michelle; Floyd, Nicole

    2010-05-01

    This article discusses the identification, selection, and refinement of topics for comparative effectiveness systematic reviews within the Agency for Healthcare Research and Quality's Effective Health Care (EHC) program. The EHC program seeks to align its research topic selection with the overall goals of the program, impartially and consistently apply predefined criteria to potential topics, involve stakeholders to identify high-priority topics, be transparent and accountable, and continually evaluate and improve processes. A topic prioritization group representing stakeholder and scientific perspectives evaluates topic nominations that fit within the EHC program (are "appropriate") to determine how "important" topics are as considered against seven criteria. The group then judges whether a new comparative effectiveness systematic review would be a duplication of existing research syntheses, and if not duplicative, if there is adequate type and volume of research to conduct a new systematic review. Finally, the group considers the "potential value and impact" of a comparative effectiveness systematic review. As the EHC program develops, ongoing challenges include ensuring the program addresses truly unmet needs for synthesized research because national and international efforts in this arena are uncoordinated, as well as engaging a range of stakeholders in program decisions while also achieving efficiency and timeliness.

  3. A Feasibility Assessment of Behavioral-based Interviewing to Improve Candidate Selection for a Pulmonary and Critical Care Medicine Fellowship Program.

    Science.gov (United States)

    Tatem, Geneva; Kokas, Maria; Smith, Cathy L; DiGiovine, Bruno

    2017-04-01

    Traditional interviews for residency and fellowship training programs are an important component in the selection process, but can be of variable value due to a nonstandardized approach. We redesigned the candidate interview process for our large pulmonary and critical care medicine fellowship program in the United States using a behavioral-based interview (BBI) structure. The primary goal of this approach was to standardize the assessment of candidates within noncognitive domains with the goal of selecting those with the best fit for our institution's fellowship program. Eight faculty members attended two BBI workshops. The first workshop identified our program's "best fit" criteria using the framework of the Accreditation Council for Graduate Medical Education's six core competencies and additional behaviors that fit within our programs. BBI questions were then selected from a national database and refined based on the attributes deemed most important by our faculty. In the second workshop, faculty practiced the BBI format in mock interviews with third-year fellows. The interview process was further refined based on feedback from the interviewees, and then applied with fellowship candidates for the 2014 recruitment season. The 1-year pilot of behavioral-based interviewing allowed us to achieve consensus on the traits sought for our incoming fellows and to standardize the interview process for our program using the framework of the Accreditation Council for Graduate Medical Education core competencies. Although the effects of this change on the clinical performance of our fellows have not yet been assessed, this description of our development and implementation processes may be helpful for programs seeking to redesign their applicant interviews.

  4. Selective decontamination of the digestive tract in critically ill patients treated in intensive care units: a mixed-methods feasibility study (the SuDDICU study).

    Science.gov (United States)

    Francis, Jill J; Duncan, Eilidh M; Prior, Maria E; Maclennan, Graeme S; Dombrowski, Stephan; Bellingan, Geoff U; Campbell, Marion K; Eccles, Martin P; Rose, Louise; Rowan, Kathryn M; Shulman, Rob; Peter R Wilson, A; Cuthbertson, Brian H

    2014-04-01

    Hospital-acquired infections (HAIs) are a major cause of morbidity and mortality. Critically ill patients in intensive care units (ICUs) are particularly susceptible to these infections. One intervention that has gained much attention in reducing HAIs is selective decontamination of the digestive tract (SDD). SDD involves the application of topical non-absorbable antibiotics to the oropharynx and stomach and a short course of intravenous (i.v.) antibiotics. SDD may reduce infections and improve mortality, but has not been widely adopted in the UK or internationally. Hence, there is a need to identify the reasons for low uptake and whether or not further clinical research is needed before wider implementation would be considered appropriate. The project objectives were to (1) identify and describe the SDD intervention, (2) identify views about the evidence base, (3) identify acceptability of further research and (4) identify feasibility of further randomised controlled trials (RCTs). A four-stage approach involving (1) case studies of two ICUs in which SDD is delivered including observations, interviews and documentary analysis, (2) a three-round Delphi study for in-depth investigation of clinicians' views, including semi-structured interviews and two iterations of questionnaires with structured feedback, (3) a nationwide online survey of consultants in intensive care medicine and clinical microbiology and (4) semistructured interviews with international clinical triallists to identify the feasibility of further research. Case studies were set in two UK ICUs. Other stages of this research were conducted by telephone and online with NHS staff working in ICUs. (1) Staff involved in SDD adoption or delivery in two UK ICUs, (2) ICU experts (intensive care consultants, clinical microbiologists, hospital pharmacists and ICU clinical leads), (3) all intensive care consultants and clinical microbiologists in the UK with responsibility for patients in ICUs were invited and

  5. VizieR Online Data Catalog: WD+dMs from the SUPERBLINK proper motion survey (Skinner+, 2017)

    Science.gov (United States)

    Skinner, J. N.; Morgan, D. P.; West, A. A.; Lepine, S.; Thorstensen, J. R.

    2018-06-01

    To select for nearby WD+dMs, we used the SUPERBLINK proper motion survey (Lepine et al. 2002, J/AJ/124/1190; Lepine & Shara 2005, Cat. I/298), an ongoing all-sky survey that identifies and characterizes stars with proper motions μ>40 mas/yr. For this study, we used the 2011 July version of SUPERBLINK, which listed 2270481 stars, and was estimated to be >90% complete to V=19.0. We selected WD+dMs based on a combination of V magnitudes derived from the DSS plates (see Lepine & Shara 2005, Cat. I/298), near-UV magnitudes from GALEX, and Ks magnitudes from 2MASS. Using the UV-optical-IR color selection outlined in Skinner et al. (2014AJ....148..115S), we selected targets for spectroscopic follow-up (see bottom panel of Figure 1). We acquired optical spectroscopy of 178 newly identified WD+dM candidates, with the Boller and Chivens CCD spectrograph (CCDS), using both the Hiltner 2.4 m and McGraw-Hill 1.3 m telescopes located at the MDM Observatory. (3 data files).

  6. The relationship between organizational commitment and nursing care behavior.

    Science.gov (United States)

    Naghneh, Mohammad Hossein Khalilzadeh; Tafreshi, Mansoureh Zagheri; Naderi, Manijeh; Shakeri, Nehzat; Bolourchifard, Fariba; Goyaghaj, Naser Sedghi

    2017-07-01

    Nursing care encompasses physical, emotional, mental and social needs, in order to improve a patient's health and wellbeing. Caring is the central core and the essence of nursing. The important issue of care is access to proper care and increasing patients' satisfaction. Job performance of nurses is affected by many factors including organizational commitment. This study aimed to determine the relationship between organizational commitment and nurses caring behavior. In this cross-sectional study, 322 nurses from selected Hospitals of Shahid Beheshti University of Medical Sciences in Tehran were randomly selected and enrolled in the study in 2015. The self-reported data by nurses were collected through demographic characteristics questionnaire, Meyer & Allen organizational commitment model and Caring Behavior Inventory (CBI). Data were analyzed with SPSS statistical software version 20, using t-test and ANOVA. The majority of nurses (63%) were female. The mean score and standard deviation of organizational commitment and caring behavior of nurses were 74.12±9.61 and 203.1±22.46, respectively. The results showed a significantly positive correlation between organizational commitment and caring behavior (p=0.001). In this study the caring behavior of nurses with higher organizational commitment were significantly better than the others. Managers and nurse leaders should pay more attention to improve organizational commitment of nurses, in order to improve nurses' performance.

  7. Selecting a dynamic simulation modeling method for health care delivery research-part 2: report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force.

    Science.gov (United States)

    Marshall, Deborah A; Burgos-Liz, Lina; IJzerman, Maarten J; Crown, William; Padula, William V; Wong, Peter K; Pasupathy, Kalyan S; Higashi, Mitchell K; Osgood, Nathaniel D

    2015-03-01

    In a previous report, the ISPOR Task Force on Dynamic Simulation Modeling Applications in Health Care Delivery Research Emerging Good Practices introduced the fundamentals of dynamic simulation modeling and identified the types of health care delivery problems for which dynamic simulation modeling can be used more effectively than other modeling methods. The hierarchical relationship between the health care delivery system, providers, patients, and other stakeholders exhibits a level of complexity that ought to be captured using dynamic simulation modeling methods. As a tool to help researchers decide whether dynamic simulation modeling is an appropriate method for modeling the effects of an intervention on a health care system, we presented the System, Interactions, Multilevel, Understanding, Loops, Agents, Time, Emergence (SIMULATE) checklist consisting of eight elements. This report builds on the previous work, systematically comparing each of the three most commonly used dynamic simulation modeling methods-system dynamics, discrete-event simulation, and agent-based modeling. We review criteria for selecting the most suitable method depending on 1) the purpose-type of problem and research questions being investigated, 2) the object-scope of the model, and 3) the method to model the object to achieve the purpose. Finally, we provide guidance for emerging good practices for dynamic simulation modeling in the health sector, covering all aspects, from the engagement of decision makers in the model design through model maintenance and upkeep. We conclude by providing some recommendations about the application of these methods to add value to informed decision making, with an emphasis on stakeholder engagement, starting with the problem definition. Finally, we identify areas in which further methodological development will likely occur given the growing "volume, velocity and variety" and availability of "big data" to provide empirical evidence and techniques

  8. Prostate cancer as a chronic disease: cost-effectiveness and proper follow-up

    International Nuclear Information System (INIS)

    Guttilla, A.; Bortolami, A.; Evangelista, L.

    2015-01-01

    In western countries, prostate cancer (PCa) is the most common non-dermatological malignant disease in men. Bone metastases more often develop in patients with advanced PCa; the associated complications present a substantial disease and economic burden. Although the introduction of new therapeutic strategies have provided some advantages in terms of overall survival and quality of life in patients with metastatic PCa, the skeletal related events and side effects due to the therapies are associated with an important impact on the health care costs. In particular, the number of hospital admission, clinical consultation and the introduction of new expensive diagnostic modalities have changed the management of metastatic patients. However, the National and International guidelines suggest to follow patients with metastatic PCa by using clinical assessment, biochemical evaluation and, when necessary, diagnostic imaging. The aims of the present review were: 1) to summarize the information regarding the clinical and economic burden of metastasis; 2) to evaluate the quality of life; and 3) to suggest a proper follow-up in advanced PCa patients.

  9. Selected Lectures of the 2nd International Workshop “Intensive Care of the Newborn”; Verona (Italy; March 9-10, 2018

    Directory of Open Access Journals (Sweden)

    --- Various Authors

    2018-03-01

    Full Text Available Selected Lectures of the 2nd International Workshop “Intensive Care of the Newborn”; Verona (Italy; March 9-10, 2018 CONGRESS PRESIDENT Paolo Biban  Guest Editor: Paolo BibanLECT 1. RESUSCITATION OF EXTREMELY PREMATURE INFANTS: HOW TO IMPROVE EVEN FURTHER • J.M. PerlmanLECT 2. MAINTAINING NORMAL TEMPERATURE IN THE NEWLY BORN: NOT A TRIVIAL GAME • J. WyllieLECT 3. PRESENT AND FUTURE OF SURFACTANT AD­MINISTRATION IN PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME (RDS • A. KribsLECT 4. CONTINUOUS POSITIVE AIRWAY PRES­SURE (CPAP, SURFACTANT, OR BOTH? A DILEMMA STILL WAITING TO BE SOLVED • D. De LucaLECT 5. NON-INVASIVE RESPIRATORY SUPPORT AND RESPIRATORY DISTRESS SYNDROME (RDS: IS NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE (nCPAP ALWAYS ENOUGH? • G. Lista, I. BresestiLECT 6. NEURALLY ADJUSTED VENTILATORY ASSIST (NAVA IN THE NEWBORN: A NEW STANDARD OF CARE? • H. SteinLECT 7. HIGH-FREQUENCY, MULTI-FREQUENCY OSCIL­LA­TION, JET VENTILATION: WHERE ARE WE? • J.J. PillowLECT 8. SURVIVAL AND NEURODEVELOPMENTAL OUT­COME IN PERIVIABLE INFANTS • N. YoungeLECT 9. PATHOPHYSIOLOGY AND TREATMENT OF SEPTIC SHOCK IN NEONATES • H.R. WongLECT 10. CLINICAL METABOLOMICS IN NEONATAL SEPSIS • V. FanosLECT 11. OPTIMIZING EARLY NUTRITION SUPPORT IN VERY LOW BIRTH WEIGHT (VLBW INFANTS • T. SenterreLECT 12. LONG-TERM ADVERSE EFFECTS OF EARLY GROWTH ACCELERATION OR CATCH-UP GROWTH • A. SinghalLECT 13. ROLE OF NEAR INFRARED SPECTROSCOPY DURING NEONATAL TRANSITION • B. UrlesbergerLECT 14. HEART RATE CHARACTERISTICS AS PHYSIO­MARKERS FOR DETECTION OF SEPSIS AND OTHER DISEASES • K.D. FairchildLECT 15. ENHANCED CARDIORESPIRATORY MONI­TORING OF THE PRETERM INFANT DURING STABILIZA­TION IN THE DELIVERY ROOM • E. Dempsey

  10. Dexterity test data contribute to proper glovebox over-glove use

    International Nuclear Information System (INIS)

    Cournoyer, Michael E.; Lawton, Cindy M.; Castro, Armanda M.; Costigan, Stephen A.; Apel, D.M.; Neal, G.E.; Castro, J.M.; Michelotti, R.A.

    2010-01-01

    Programmatic operations at the Los Alamos National Laboratory Plutonium Facility (TA-55) involve working with various amounts of plutonium and other highly toxic, alpha-emitting materials. The spread of radiological contamination on surfaces, airborne contamination, and excursions of contaminants into the operator's breathing zone are prevented through the use of a variety of gloveboxes (the glovebox, coupled with an adequate negative pressure gradient, provides primary confinement). The glovebox gloves are the weakest part of this engineering control. The Glovebox Glove Integrity Program, which controls glovebox gloves from procurement to disposal at TA-55, manages this vulnerability. A key element of this program is to consider measures that lower the overall risk of glovebox operations. Proper selection of over-gloves is one of these measures. Line management owning glovebox processes have the responsibility to approve the appropriate personal protective equipment/glovebox glove/over-glove combination. As low as reasonably achievable (ALARA) considerations to prevent unplanned glovebox glove openings must be balanced with glove durability and worker dexterity, both of which affect the final overall risk to the worker. In this study, the causes of unplanned glovebox glove openings, the benefits of over-glove features, the effect of over-gloves on task performance using standard dexterity tests, the pollution prevention benefits, and the recommended over-gloves for a task are presented.

  11. The VMC survey. XXVIII. Improved measurements of the proper motion of the Galactic globular cluster 47 Tucanae

    Science.gov (United States)

    Niederhofer, Florian; Cioni, Maria-Rosa L.; Rubele, Stefano; Schmidt, Thomas; Bekki, Kenji; de Grijs, Richard; Emerson, Jim; Ivanov, Valentin D.; Oliveira, Joana M.; Petr-Gotzens, Monika G.; Ripepi, Vincenzo; Sun, Ning-Chen; van Loon, Jacco Th.

    2018-05-01

    We use deep multi-epoch point-spread function (PSF) photometry taken with the Visible and Infrared Survey Telescope for Astronomy (VISTA) to measure and analyze the proper motions of stars within the Galactic globular cluster 47 Tucanae (47 Tuc, NGC 104). The observations are part of the ongoing near-infrared VISTA survey of the Magellanic Cloud system (VMC). The data analyzed in this study correspond to one VMC tile, which covers a total sky area of 1.77 deg2. Absolute proper motions with respect to 9070 background galaxies are calculated from a linear regression model applied to the positions of stars in 11 epochs in the Ks filter. The data extend over a total time baseline of about 17 months. We found an overall median proper motion of the stars within 47 Tuc of (μαcos(δ), μδ) = (+5.89 ± 0.02 (statistical) ± 0.13 (systematic), -2.14 ± 0.02 (statistical) ± 0.08 (systematic)) mas yr-1, based on the measurements of 35 000 individual sources between 5' and 42' from the cluster center. We compared our result to the proper motions from the newest US Naval Observatory CCD Astrograph Catalog (UCAC5), which includes data from the Gaia data release 1. Selecting cluster members ( 2700 stars), we found a median proper motion of (μαcos(δ), μδ) = (+5.30 ± 0.03 (statistical) ± 0.70 (systematic), -2.70 ± 0.03 (statistical) ± 0.70 (systematic)) mas yr-1. Comparing the results with measurements in the literature, we found that the values derived from the VMC data are consistent with the UCAC5 result, and are close to measurements obtained using the Hubble Space Telescope. We combined our proper motion results with radial velocity measurements from the literature and reconstructed the orbit of 47 Tuc, finding that the cluster is on an orbit with a low ellipticity and is confined within the inner 7.5 kpc of the Galaxy. We show that the use of an increased time baseline in combination with PSF-determined stellar centroids in crowded regions significantly improves

  12. Critical Care Organizations: Building and Integrating Academic Programs.

    Science.gov (United States)

    Moore, Jason E; Oropello, John M; Stoltzfus, Daniel; Masur, Henry; Coopersmith, Craig M; Nates, Joseph; Doig, Christopher; Christman, John; Hite, R Duncan; Angus, Derek C; Pastores, Stephen M; Kvetan, Vladimir

    2018-04-01

    Academic medical centers in North America are expanding their missions from the traditional triad of patient care, research, and education to include the broader issue of healthcare delivery improvement. In recent years, integrated Critical Care Organizations have developed within academic centers to better meet the challenges of this broadening mission. The goal of this article was to provide interested administrators and intensivists with the proper resources, lines of communication, and organizational approach to accomplish integration and Critical Care Organization formation effectively. The Academic Critical Care Organization Building section workgroup of the taskforce established regular monthly conference calls to reach consensus on the development of a toolkit utilizing methods proven to advance the development of their own academic Critical Care Organizations. Relevant medical literature was reviewed by literature search. Materials from federal agencies and other national organizations were accessed through the Internet. The Society of Critical Care Medicine convened a taskforce entitled "Academic Leaders in Critical Care Medicine" on February 22, 2016 at the 45th Critical Care Congress using the expertise of successful leaders of advanced governance Critical Care Organizations in North America to develop a toolkit for advancing Critical Care Organizations. Key elements of an academic Critical Care Organization are outlined. The vital missions of multidisciplinary patient care, safety, and quality are linked to the research, education, and professional development missions that enhance the value of such organizations. Core features, benefits, barriers, and recommendations for integration of academic programs within Critical Care Organizations are described. Selected readings and resources to successfully implement the recommendations are provided. Communication with medical school and hospital leadership is discussed. We present the rationale for critical

  13. Dimension invariants for groups admitting a cocompact model for proper actions

    DEFF Research Database (Denmark)

    Degrijse, Dieter Dries; Martínez-Pérez, Conchita

    2016-01-01

    Let G be a group that admits a cocompact classifying space for proper actions X. We derive a formula for the Bredon cohomological dimension for proper actions of G in terms of the relative cohomology with compact support of certain pairs of subcomplexes of X. We use this formula to compute the Br...

  14. 20 CFR 658.415 - Transferring complaints to proper JS office.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Transferring complaints to proper JS office... Agency Js Complaint System § 658.415 Transferring complaints to proper JS office. (a) Where a JS-related... local office serving the area in which the employer is located. Where a JS-related complaint deals with...

  15. 32 CFR 725.7 - Contents of a proper request or demand.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Contents of a proper request or demand. 725.7 Section 725.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL RELEASE... § 725.7 Contents of a proper request or demand. (a) Routine requests. If official information is sought...

  16. Treatment of Proper Name Retrieval Deficits in an Individual with Temporal Lobe Epilepsy

    Science.gov (United States)

    Minkina, Irene; Ojemann, Jeffrey G.; Grabowski, Thomas J.; Silkes, JoAnn P.; Phatak, Vaishali; Kendall, Diane L.

    2013-01-01

    Purpose: Studies investigating language deficits in individuals with left temporal-lobe epilepsy have consistently demonstrated impairments in proper name retrieval. The aim of this Phase I rehabilitation study was to investigate the effects of a linguistically distributed word retrieval treatment on proper name retrieval in an individual with…

  17. 25 CFR 87.12 - Insuring the proper performance of approved plans.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Insuring the proper performance of approved plans. 87.12... DISTRIBUTION OF INDIAN JUDGMENT FUNDS § 87.12 Insuring the proper performance of approved plans. A timetable... regarding the maintenance of the timetable, a full accounting of any per capita distribution, and the...

  18. 45 CFR 170.423 - Principles of proper conduct for ONC-ATCBs.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Principles of proper conduct for ONC-ATCBs. 170... § 170.423 Principles of proper conduct for ONC-ATCBs. An ONC-ATCB shall: (a) Operate its certification... EHR Module developer conspicuously include the following text on its Web site and in all marketing...

  19. HARMONIC DRIVE SELECTION

    Directory of Open Access Journals (Sweden)

    Piotr FOLĘGA

    2014-03-01

    Full Text Available The variety of types and sizes currently in production harmonic drive is a problem in their rational choice. Properly selected harmonic drive must meet certain requirements during operation, and achieve the anticipated service life. The paper discusses the problems associated with the selection of the harmonic drive. It also presents the algorithm correct choice of harmonic drive. The main objective of this study was to develop a computer program that allows the correct choice of harmonic drive by developed algorithm.

  20. Bilirubin glucuronidation revisited: proper assay conditions to estimate enzyme kinetics with recombinant UGT1A1.

    Science.gov (United States)

    Zhou, Jin; Tracy, Timothy S; Remmel, Rory P

    2010-11-01

    Bilirubin, an end product of heme catabolism, is primarily eliminated via glucuronic acid conjugation by UGT1A1. Impaired bilirubin conjugation, caused by inhibition of UGT1A1, can result in clinical consequences, including jaundice and kernicterus. Thus, evaluation of the ability of new drug candidates to inhibit UGT1A1-catalyzed bilirubin glucuronidation in vitro has become common practice. However, the instability of bilirubin and its glucuronides presents substantial technical challenges to conduct in vitro bilirubin glucuronidation assays. Furthermore, because bilirubin can be diglucuronidated through a sequential reaction, establishment of initial rate conditions can be problematic. To address these issues, a robust high-performance liquid chromatography assay to measure both bilirubin mono- and diglucuronide conjugates was developed, and the incubation conditions for bilirubin glucuronidation by human embryonic kidney 293-expressed UGT1A1 were carefully characterized. Our results indicated that bilirubin glucuronidation should be assessed at very low protein concentrations (0.05 mg/ml protein) and over a short incubation time (5 min) to assure initial rate conditions. Under these conditions, bilirubin total glucuronide formation exhibited a hyperbolic (Michaelis-Menten) kinetic profile with a K(m) of ∼0.2 μM. In addition, under these initial rate conditions, the relative proportions between the total monoglucuronide and the diglucuronide product were constant across the range of bilirubin concentration evaluated (0.05-2 μM), with the monoglucuronide being the predominant species (∼70%). In conclusion, establishment of appropriate incubation conditions (i.e., very low protein concentrations and short incubation times) is necessary to properly characterize the kinetics of bilirubin glucuronidation in a recombinant UGT1A1 system.

  1. Occurrence of Selected Pharmaceuticals, Personal-Care Products, Organic Wastewater Compounds, and Pesticides in the Lower Tallapoosa River Watershed near Montgomery, Alabama, 2005

    Science.gov (United States)

    Oblinger, Carolyn J.; Gill, Amy C.; McPherson, Ann K.; Meyer, Michael T.; Furlong, Edward T.

    2007-01-01

    Synthetic and natural organic compounds derived from agricultural operations, residential development, and treated and untreated sanitary and industrial wastewater discharges can contribute contaminants to surface and ground waters. To determine the occurrence of these compounds in the lower Tallapoosa River watershed, Alabama, new laboratory methods were used that can detect human and veterinary antibiotics; pharmaceuticals; and compounds found in personal-care products, food additives, detergents and their metabolites, plasticizers, and other industrial and household products in the environment. Well-established methods for detecting 47 pesticides and 19 pesticide degradates also were used. In all, 186 different compounds were analyzed by using four analytical methods. The lower Tallapoosa River serves as the water-supply source for more than 100,000 customers of the Montgomery Water Works and Sanitary Sewer Board. Source-water protection is a high priority for the Board, which is responsible for providing safe drinking water. The U.S. Geological Survey, in cooperation with the Montgomery Water Works and Sanitary Sewer Board, conducted this study to provide baseline data that could be used to assess the effects of agriculture and residential development on the occurrence of selected organic compounds in the lower Tallapoosa River watershed. Twenty samples were collected at 10 sites on the Tallapoosa River and its tributaries. Ten samples were collected in April 2005 during high base streamflow, and 10 samples were collected in October 2005 when base streamflow was low. Thirty-two of 186 compounds were detected in the lower Tallapoosa River watershed. Thirteen compounds, including atrazine, 2-chloro-4-isopropylamino-6-amino-s-triazine (CIAT), hexazinone, metalaxyl, metolachlor, prometryn, prometon, simazine, azithromycin, oxytetracycline, sulfamethoxazole, trimethoprim, and tylosin, had measurable concentrations above their laboratory reporting levels

  2. Managing care.

    Science.gov (United States)

    Sandifer, Q D

    1997-09-01

    The terms 'managed care' and 'disease management' are gaining common usage in the health service but their meaning is not widely understood. Managed care is a generic term describing any health care system that integrates the financing and delivery of medical care. Its growth in the United States has been driven by pressure to control costs, and there is circumstantial evidence that costs are slowing as a result of better management of resources. However, it is not clear how much of this is due to managed care, the selection of more favourable enrollees to health plans or other factors. Research evidence is limited, and that available is constrained by the rapidly changing nature of managed care. In the United States a bewildering variety of managed care arrangements have emerged, although several common characteristics can be identified: limited choice of physician providers; controlled access to secondary care; selective contracting; financial incentives; quality management; and utilization management. All are present in the National Health Service (NHS), which exemplifies a nationalized managed care system. Disease management is an extension of managed care that takes a global approach to patient care by attempting to co-ordinate resources across the entire health care delivery system throughout the life cycle of the disease. This is poorly developed in the NHS, so that the attention of commercial organizations has been attracted. However, concern has been expressed about the implications of commercial involvement: the fragmentation of general medical services; effect of for-profit status; and use of patient-based data. Recent policy developments could allow disease management to develop within the NHS.

  3. The costs of heart failure in Poland from the public payer's perspective. Polish programme assessing diagnostic procedures, treatment and costs in patients with heart failure in randomly selected outpatient clinics and hospitals at different levels of care: POLKARD.

    Science.gov (United States)

    Czech, Marcin; Opolski, Grzegorz; Zdrojewski, Tomasz; Dubiel, Jacek S; Wizner, Barbara; Bolisęga, Dorota; Fedyk-Łukasik, Małgorzata; Grodzicki, Tomasz

    2013-01-01

    Heart failure (HF) is a chronic disease of great clinical and economic significance for both the healthcare system and patients themselves. To determine the consumption of medical resources for treatment and care of HF patients and to estimate the related costs. The study involved 400 primary care practices and 396 specialist outpatient clinics, as well as 259 hospitals at all reference levels. The sample was representative and supplemented with patient interview data. Based on the consumption of particular resources and the unit costs of services in 2011, costs of care for HF patients in Poland were estimated. Separate analyses were conducted depending on the stage of the disease (according to NYHA classification I-IV). The public payer's perspective and a one year time horizon were adopted. Direct annual costs of an HF patient's treatment in Poland may range between PLN 3,373.23 and 7,739.49 (2011), the main cost item being hospitalisation. The total costs for the healthcare system could be as high as PLN 1,703 million, which is 3.16% of the National Health Fund's budget (Ex. rate from 05.03.2012: 1 EUR = 4.14 PLN). The costs of treating heart failure in Poland are high; proper allocation of resources to diagnostic procedures and treatment may contribute to rationalisation of the relevant expenditure.

  4. LocZ Is a New Cell Division Protein Involved in Proper Septum Placement in Streptococcus pneumoniae

    Science.gov (United States)

    Holečková, Nela; Molle, Virginie; Buriánková, Karolína; Benada, Oldřich; Kofroňová, Olga; Ulrych, Aleš; Branny, Pavel

    2014-01-01

    ABSTRACT How bacteria control proper septum placement at midcell, to guarantee the generation of identical daughter cells, is still largely unknown. Although different systems involved in the selection of the division site have been described in selected species, these do not appear to be widely conserved. Here, we report that LocZ (Spr0334), a newly identified cell division protein, is involved in proper septum placement in Streptococcus pneumoniae. We show that locZ is not essential but that its deletion results in cell division defects and shape deformation, causing cells to divide asymmetrically and generate unequally sized, occasionally anucleated, daughter cells. LocZ has a unique localization profile. It arrives early at midcell, before FtsZ and FtsA, and leaves the septum early, apparently moving along with the equatorial rings that mark the future division sites. Consistently, cells lacking LocZ also show misplacement of the Z-ring, suggesting that it could act as a positive regulator to determine septum placement. LocZ was identified as a substrate of the Ser/Thr protein kinase StkP, which regulates cell division in S. pneumoniae. Interestingly, homologues of LocZ are found only in streptococci, lactococci, and enterococci, indicating that this close phylogenetically related group of bacteria evolved a specific solution to spatially regulate cell division. PMID:25550321

  5. Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province

    Directory of Open Access Journals (Sweden)

    Rhulani C. Shihundla

    2016-05-01

    Full Text Available Background: Recording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART wellness register; ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. Objectives: The objective of this study was to investigate and describe the effects of increased nurses’ workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. Methods: The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses’ workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in

  6. Effects of increased nurses' workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province.

    Science.gov (United States)

    Shihundla, Rhulani C; Lebese, Rachel T; Maputle, Maria S

    2016-05-13

    Recording of information on multiple documents increases professional nurses' responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient's information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. The objective of this study was to investigate and describe the effects of increased nurses' workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses' workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who

  7. Surveillance-guided selective digestive decontamination of carbapenem-resistant Enterobacteriaceae in the intensive care unit: A cost-effectiveness analysis.

    Science.gov (United States)

    You, Joyce H S; Li, Hong-Kiu; Ip, Margaret

    2018-03-01

    Clinical findings have shown effectiveness and safety of selective digestive decontamination (SDD) for eradication of carbapenem-resistant Enterobacteriaceae (CRE) in high-risk carriers. We aimed to evaluate the cost-effectiveness of SDD guided by CRE surveillance in the intensive care unit (ICU). Outcomes of surveillance-guided SDD (test-guided SDD) and no screening (control) in the ICU were compared by Markov model simulations. Model outcomes were CRE infection and mortality rates, direct costs, and quality-adjusted life year (QALY) loss. Model inputs were estimated from clinical literature. Sensitivity analyses were conducted to examine the robustness of base case results. Test-guided SDD reduced infection (4.8% vs 5.0%) and mortality (1.8% vs 2.1%) rates at a higher cost ($1,102 vs $1,074) than the control group in base case analysis, respectively. Incremental cost per QALY saved (incremental cost-effectiveness ratio [ICER]) by the test-guided SDD group was $557 per QALY. Probabilistic sensitivity analysis showed that test-guided SDD was effective in saving QALYs in 100% of 10,000 Monte Carlo simulations, and cost-saving 59.1% of time. The remaining 40.9% of simulations found SDD to be effective at an additional cost, with ICERs accepted as cost-effective per the willingness-to-pay threshold. Surveillance-guided SDD appears to be cost-effective in reducing CRE infection and mortality with QALYs saved. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  8. Proper Consumption of Sugary Drinks and its Association with Adolescent Girls’ Knowledge and Skill

    Directory of Open Access Journals (Sweden)

    Ali Ramezankhani

    2017-02-01

    Full Text Available Background: Changes in the nutritional behaviors from consumption of traditional nutriments to intakes of high energy, concerned in powering the increasing problem in adolescents and children's obesity. The current study intended to evaluate Proper consumption of sugary drinks and its association with adolescent girls’ knowledge and skill in Shahr-e-kord city, Iran.Materials and Methods: This was a cross-sectional study carried out on girl's students in Shahr-e-kord city. Using random sampling method and based on sampling size formula, a total of 308 of the girls students were randomly selected from the schools and were registered into the study. Then they received a research-made questionnaire containing questions about the knowledge, skill and Food Frequency Questionnaire (FFQ. The collected data were analyzed using SPSS version 18.0 by ANOVA, and Pearson correlation coefficient.Results: The mean age of the participating adolescent girls was 13.86 ± 1.3 years old. The mean score for knowledge was 36.53 ± 21.87 and the mean score for the skill of preparing and consumption of sugar free drinks was 35.77 ± 24.67. The average amount of daily consumption of sugary drinks among studied adolescent girls was 2.95 glasses.There was a direct significant association between students’ knowledge and skill (P = 0.002, r = 0.182, There was also a significant reverse association between adolescents’ skill(P = 0. 006 r = -0.228 and knowledge (P = 0. 05 r = -0.322 with consumption of sugary drinks.Conclusion: According to the findings of this study, to increase the consumption of valuable foods and improving adolescents’ nutritional habits, more attention should be paid to the health education and promotion and by using effective relevant patterns and theories.

  9. Selected Abstracts of the 6th International Congress of UENPS; Valencia (Spain; November 23rd-25th 2016; Session “Neonatology and NICU clinical care and practices”

    Directory of Open Access Journals (Sweden)

    --- Various Authors

    2016-11-01

    Full Text Available Selected Abstracts of the 6th International Congress of UENPS; Valencia (Spain; November 23rd-25th 2016; Session “Neonatology and NICU clinical care and practices”ABS 1. BILATERAL CLAVICLE FRACTURE: A RARE CAUSE OF PERSISTENT CRYING • P. Cruz, P. Mendes, M. Anselmo, L. GonçalvesABS 2. NEONATAL TRANSPORT DURATION AND SHORT-TERM OUTCOME IN VERY-LOW-GESTATIONAL-AGE NEONATES • A. Matic, M. Gavrilovic LatinovicABS 3. PEMPHIGOID GESTATIONIS – A RARE CASE IN TWIN PREGNANCY • L. Gonçalves, E. Scortenschi, P. Cruz, P. Mendes, M. AnselmoABS 4. DEVELOPMENT OF A CLINICIAN-REPORTED OUTCOME (ClinRO MEASURE TO ASSESS READINESS FOR DISCHARGE FROM NEONATAL CARE AMONG EXTREMELY PRETERM INFANTS • M. Turner, R. Ward, J. Higginson, I. Hansen-Pupp, M. Vanya, E. Flood, G. Quiggle, A. Tocoian, A. Mangili, N. Barton, S. SardaABS 5. THE EFFECT OF THYROID HORMONES ON NICU ADMISSION DUE TO TRANSIENT TACHYPNEA OF NEWBORN IN LATE PRETERM AND TERM INFANTS • T. Gursoy, S. Ercin, P. Kayiran, B. GurakanABS 6. IMPROVING THE QUALITY OF PROLONGED JAUNDICE WORK-UPS IN THE OUTPATIENT DEPARTMENT IN A TERTIARY NEONATAL CENTRE • C.M. Moore, J. O’Loughlin, B.C. HayesABS 7. SAVE THE DATE? CORRECT RECORDING OF DAY OF LIFE AND CORRECTED GESTATIONAL AGE IN NICU • C.M. Moore, A.F. El-KhuffashABS 8. PARENTS IN NICU: THE IMPORTANCE OF INTEGRATION BETWEEN THE CURE AND THE CARE • G. De Bernardo, M. Svelto, M. Giordano, D. SordinoABS 9. THE PREVALENCE OF HEREDITARY HEARING LOSS IN 41,152 NEWBORNS DURING THE PERIOD 2011-2015 • S.T. Hsu, C.C. Hung, Y.N. Su, C.Y. Chen, H.C. Chou, W.S. Hsieh, C.C. Wu, P.N. TsaoABS 10. DEFICIENCY OF MULTIPLE acyl-CoA DEHYDROGENASE OR GLUTARIC ACIDURIA TYPE II • M. Torres, L. Geronès, J. Herrero, M.C. Cèspedes, F. Camba, J.A. Arranz, M. del Toro, F. CastilloABS 11. TEN YEARS OF EXPERIENCE IN CARRIER SCREENING FOR SPINAL MUSCULAR ATROPHY IN TAIWAN • C.Y. Chuang, C.C. Hung, Y.N. Su, P.N. TsaoABS 12. REDUCING MEDICATION ERRORS ON THE

  10. Clinician‐selected Electronic Information Resources do not Guarantee Accuracy in Answering Primary Care Physicians’ Information Needs. A review of: McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician‐selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006: 653‐9.

    Directory of Open Access Journals (Sweden)

    Martha Ingrid Preddie

    2008-03-01

    Full Text Available Objective – To determine if electronic information resources selected by primary care physicians improve their ability to answer simulated clinical questions.Design – An observational study utilizing hour‐long interviews and think‐aloud protocols.Setting – The offices and clinics of primary care physicians in Canada and the United States.Subjects – Twenty‐five primary care physicians of whom 4 were women, 17 were from Canada, 22 were family physicians,and 24 were board certified.Methods – Participants provided responses to 23 multiple‐choice questions. Each physician then chose two questions and looked for the answers utilizing information resources of their own choice. The search processes, chosen resources and search times were noted. These were analyzed along with data on the accuracy of the answers and certainties related to the answer to each clinical question prior to the search.Main results – Twenty‐three physicians sought answers to 46 simulated clinical questions. Utilizing only electronic information resources, physicians spent a mean of 13.0 (SD 5.5 minutes searching for answers to the questions, an average of 7.3(SD 4.0 minutes for the first question and 5.8 (SD 2.2 minutes to answer the second question. On average, 1.8 resources were utilized per question. Resources that summarized information, such as the Cochrane Database of Systematic Reviews, UpToDate and Clinical Evidence, were favored 39.2% of the time, MEDLINE (Ovid and PubMed 35.7%, and Internet resources including Google 22.6%. Almost 50% of the search and retrieval strategies were keyword‐based, while MeSH, subheadings and limiting were used less frequently. On average, before searching physicians answered 10 of 23 (43.5% questions accurately. For questions that were searched using clinician‐selected electronic resources, 18 (39.1% of the 46 answers were accurate before searching, while 19 (42.1% were accurate after searching. The difference of

  11. The Requirement of Being a "Fit and Proper" Person for the Legal Profession

    Directory of Open Access Journals (Sweden)

    M Slabbert

    2011-07-01

    Full Text Available An important requirement for admission as an attorney or advocate is to be a "fit and proper" person. Lawyers are also struck from the respective rolls of advocates or attorneys if they cease to be "fit and proper". This requirement of being a "fit and proper" person is not defined or described in legislation. It is left to the subjective interpretation of and application by seniors in the profession and ultimately the court. In the apartheid years this requirement was applied arbitrarily but today the question may be asked why some lawyers who have been found to be "fit and proper" do not act as such. The pre-admission character screening of lawyers seems not to be effective any more. Post- admission moral development is imperative.

  12. 78 FR 33891 - Safety Advisory: Compressed Gas Cylinders That Have Not Been Tested Properly

    Science.gov (United States)

    2013-06-05

    ... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... Properly AGENCY: Pipeline and Hazardous Materials Safety Administration (PHMSA), DOT. ACTION: Safety... otherwise safely discharged. Cylinders that are filled with a material other than an atmospheric gas should...

  13. Possible Solution to Publication Bias Through Bayesian Statistics, Including Proper Null Hypothesis Testing

    NARCIS (Netherlands)

    Konijn, Elly A.; van de Schoot, Rens; Winter, Sonja D.; Ferguson, Christopher J.

    2015-01-01

    The present paper argues that an important cause of publication bias resides in traditional frequentist statistics forcing binary decisions. An alternative approach through Bayesian statistics provides various degrees of support for any hypothesis allowing balanced decisions and proper null

  14. Investigating differences between proper and common nouns using novel word learning

    Directory of Open Access Journals (Sweden)

    Anastasiya Romanova

    2014-04-01

    Full Text Available Empirical studies have shown higher rates of tip-of-the-tongue states for proper nouns, in comparison to common nouns, in non-brain-damaged speakers (e.g., Valentine & Moore, 1995, and higher retrieval failure rates for proper nouns relative to common nouns in people with aphasia (e.g., Semenza, 2009. Some authors suggest the source of these differences lies in logical properties (e.g., Semenza, 2009. That is, common nouns refer to a category of beings or objects that share certain semantic properties, while proper nouns designate specific individual beings or objects with unique features. Other authors attribute the distinction in processing to a number of statistical properties that differ across common and proper nouns (Kay, Hanley, & Miles, 2001. The aims of the present study were: 1 to dissociate the effects of logical and statistical properties by using novel words with equal statistical properties; 2 to determine whether people with aphasia show disproportionate impairments in learning proper nouns relative to common nouns, compared to aged-matched subjects. Methods We tested young (n=16 and elderly (n=14 adult non-brain-damaged participants and people with aphasia (n=2. Items-to-be-learnt were given as representatives of an unknown species (n=10 in the common noun condition, or as individual creatures (n=10 in the proper noun condition. The experiment consisted of 5 sessions. Each session included a learning phase and a test phase with naming and word-picture verification tasks. Results and Discussion Preliminary analysis showed learning of both common and proper nouns for both younger (F(4=140.68, p<.01 and elderly (F(4=34.87, p<.01 non-brain-damaged participants, with learning being significantly better for the younger group (F(4=6.5, p<.01. Contrary to expectations, performance on proper nouns was better than that for common nouns for both young and elderly subjects (F(1=6.47, p=.02 and F(1=9.75, p<.01, respectively, possibly due to

  15. Optimizing chain life in bucket elevators through proper design and elongation measurement

    Energy Technology Data Exchange (ETDEWEB)

    Luglio, J.J. [Rexnord, Inc., Milwaukee, WI (United States)

    2001-04-01

    Since down time in the bulk solids handling industry is so expensive, bucket elevators must operate with extreme reliability, and, of course, the cost per ton of material conveyed must be minimized. This means balancing initial costs, operating and maintenance costs as well as minimizing the inventory of parts required in order to insure reliability. The elevator must be designed properly for each application. It must also be operated and maintained properly. (orig.)

  16. Impact of Training on Improving Proper Handwashing Practices among Elementary School Students

    Directory of Open Access Journals (Sweden)

    Theruna Huthamaputiran

    2017-06-01

    Full Text Available Background: Hand washing is among the most effective ways to prevent diseases. In Indonesia, only a quarter of the entire population practice proper handwashing techniques. Of these, children are the most vulnerable group for contracting diseases. Nevertheless, they also are crucial agent for behavior transformation as they are keen and open to new ideas. Therefore, this study was conducted to determine if training would have an improvement on a proper hand washing practices among elementary school students. Methods:An observational descriptive study design using random sampling was conducted from September to November 2013 in Jatinangor Subdistrict, West Java, Indonesia using primary data of one hundred elementary school students from four elementary schools. Questionnaires were given after informed consent. A demonstration on hand washing techniques and education on proper hand washing practices was then given. Two weeks later, the same questionnaire was given to measure the influence of the training. The collected data were presented using frequency tabulation. Results: Before the training on proper hand washing practices was conducted, only 86.9% students were practicing it properly. After the training was given, 90.7% of the students were doing it properly. For the hand washing technique, only 66.8% of students knew the correct steps before the intervention was given and 78.7% students did them correctly after the intervention. Conclusions:The training shows an overall improvement on the students’ hand washing practices.   DOI: 10.15850/amj.v4n2.1073

  17. Selecting a Dynamic Simulation Modeling Method for Health Care Delivery Research—Part 2: Report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force

    NARCIS (Netherlands)

    Marshall, Deborah A.; Burgos-Liz, Lina; IJzerman, Maarten Joost; Crown, William; Padula, William V.; Wong, Peter K.; Pasupathy, Kalyan S.; Higashi, Mitchell K.; Osgood, Nathaniel D.

    2015-01-01

    In a previous report, the ISPOR Task Force on Dynamic Simulation Modeling Applications in Health Care Delivery Research Emerging Good Practices introduced the fundamentals of dynamic simulation modeling and identified the types of health care delivery problems for which dynamic simulation modeling

  18. Evaluation of a quality improvement intervention for obstetric and neonatal care in selected public health facilities across six states of India.

    Science.gov (United States)

    Sarin, Enisha; Kole, Subir K; Patel, Rachana; Sooden, Ankur; Kharwal, Sanchit; Singh, Rashmi; Rahimzai, Mirwais; Livesley, Nigel

    2017-05-02

    While increase in the number of women delivering in health facilities has been rapid, the quality of obstetric and neonatal care continues to be poor in India, contributing to high maternal and neonatal mortality. The USAID ASSIST Project supported health workers in 125 public health facilities (delivering approximately 180,000 babies per year) across six states to use quality improvement (QI) approaches to provide better care to women and babies before, during and immediately after delivery. As part of this intervention, each month, health workers recorded data related to nine elements of routine care alongside data on perinatal mortality. We aggregated facility level data and conducted segmented regression to analyse the effect of the intervention over time. Care improved to 90-99% significantly (p improving provision of routine care, yet these approaches are underused in the Indian health system. We discuss the implications of this for policy makers.

  19. Comparing and improving proper orthogonal decomposition (POD) to reduce the complexity of groundwater models

    Science.gov (United States)

    Gosses, Moritz; Nowak, Wolfgang; Wöhling, Thomas

    2017-04-01

    reduced model space, thereby allowing the recalculation of system matrices at every time-step necessary for non-linear models while retaining the speed of the reduced model. This makes POD-DEIM applicable for groundwater models simulating unconfined aquifers. However, in our analysis, the method struggled to reproduce variable river boundaries accurately and gave no advantage for variable Dirichlet boundaries compared to the original POD method. We have developed another extension for POD that targets to address these remaining problems by performing a second POD operation on the model matrix on the left-hand side of the equation. The method aims to at least reproduce the accuracy of the other methods where they are applicable while outperforming them for setups with changing river boundaries or variable Dirichlet boundaries. We compared the new extension with original POD and POD-DEIM for different combinations of model structures and boundary conditions. The new method shows the potential of POD extensions for applications to non-linear groundwater systems and complex boundary conditions that go beyond the current, relatively limited range of applications. References: Siade, A. J., Putti, M., and Yeh, W. W.-G. (2010). Snapshot selection for groundwater model reduction using proper orthogonal decomposition. Water Resour. Res., 46(8):W08539. Stanko, Z. P., Boyce, S. E., and Yeh, W. W.-G. (2016). Nonlinear model reduction of unconfined groundwater flow using pod and deim. Advances in Water Resources, 97:130 - 143.

  20. Selective Reproduction

    DEFF Research Database (Denmark)

    Svendsen, Mette N.

    2015-01-01

    This article employs a multi-species perspective in investigating how life's worth is negotiated in the field of neonatology in Denmark. It does so by comparing decision-making processes about human infants in the Danish neonatal intensive care unit with those associated with piglets who serve as...... as expectations within linear or predictive time frames are key markers in both sites. Exploring selective reproductive processes across human infants and research piglets can help us uncover aspects of the cultural production of viability that we would not otherwise see or acknowledge....

  1. Selected Abstracts of the 2nd Congress of joint European Neonatal Societies (jENS 2017); Venice (Italy); October 31-November 4, 2017; Session "Quality Improvement, Parents Centered Care"

    OpenAIRE

    --- Various Authors

    2017-01-01

    Selected Abstracts of the 2nd Congress of joint European Neonatal Societies (jENS 2017); Venice (Italy); October 31-November 4, 201758th ESPR Annual Meeting, 7th International Congress of UENPS, 3rd International Congress of EFCNIORGANIZING INSTITUTIONSEuropean Society for Paediatric Research (ESPR), European Society for Neonatology (ESN), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI)ORGANIZING COMMITTEELuc Zi...

  2. Selected Abstracts of the 2nd International Workshop “Intensive Care of the Newborn”; Verona (Italy; March 9-10, 2018

    Directory of Open Access Journals (Sweden)

    --- Various Authors

    2018-03-01

    Full Text Available Selected Abstracts of the 2nd International Workshop “Intensive Care of the Newborn”; Verona (Italy; March 9-10, 2018CONGRESS PRESIDENTPaolo Biban  Guest Editor: Paolo BibanABS 1. DOES DELAYED CORD CLAMPING (DCC AFFECT UMBILICAL CORD pH IN PRETERM INFANTS? • V.M. Samedi, L. Irvine, S. Thomas, D. Kowal, J. Rabi, A. Stritzke, N. Singhal, A. Abou MehremABS 2. SNAP-PE SCORE. MORBIDITY AND MOR­TALI­TY INDEX IN NICUs • A. Konstantinidi, R. Sokou, S. Parastatidou, A. Tsantes, N. IacovidouABS 3. EARLY PERINATAL INTERVENTIONS IM­PROVES NEONATAL OUTCOMES • A. Ansary, R. Lee, S. KinmondABS 4. DILATED CARDIOMYOPATHY AND VITAMIN D DEFICIENCY: CASE REPORT IN A PRETERM INFANT • A. Proto, S. Fiocchi, I. Gatelli, L. Ilardi, S. MartinelliABS 5. SURVEY ON PERINATAL PALLIATIVE CARE ACROSS ITALY: PRELIMINARY RESULTS • M.E. Cavicchiolo, F. Rusalen, F. Benini, P. LagoABS 6. PLASMA ERYTHROPOIETIN AND FETO-NEONATAL ASPHYXIA IN TERM AND PRETERM NEWBORNS • F. Dituri, L. Orfeo, A. Di PaoloABS 7. A CHALLENGING CASE OF CONGENITAL INFANTILE FIBROSARCOMA • A. Ganarin, F. DeCorti, P. Dall’Igna, N. Doglioni, A. Berizzi, G. Bisogno, E. Baraldi, P.G. GambaABS 8. BIRTH ASPHYXIA IN LIMITED-RESOURCE SETTINGS: ASSOCIATED FACTORS AND OUT­COMES IN RURAL AFGHANISTAN • R. Baiocchi, M. Usuelli, P. Crosignani, E. Bruni, K. Picucci, M. Valenti, M. Langer, G. StradaABS 9. NEONATAL HEMORRHAGE FOLLOWING MA­TER­NAL LOW MOLECULAR WEIGHT HEPA­RIN (LMWH ADMINISTRATION • A. Konstantinidi, R. Sokou, S. Parastatidou, G. Patsouras, E. Isaakidou, K. Lampropoulou, K. Adamopoulos, A. Tsantes, N. IacovidouABS 10. NEONATAL/INFANTILE PINOCYTOSIS. AN UN­USU­AL CASE OF HAEMOLYTIC ANEMIA • R. Sokou, G. Patsouras, K. Lampropoulou, E. Tavoulari, K. Adamopoulos, M. Theodoraki, M. Kollia, A. KonstantinidiABS 11. THROMBOCYTOSIS IN NEONATES WITH NEONATAL ABSTINENCE SYNDROME THAT WERE HOSPITALIZED AT THE NICU OF GENERAL HOSPITAL OF NIKAIA • R. Sokou, E. Isaakidou, G. Patsouras, K

  3. Preserving community in health care.

    Science.gov (United States)

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  4. Prevalence, diagnostics and management of musculoskeletal disorders in primary health care in Sweden : an investigation of 2000 randomly selected patient records

    OpenAIRE

    Wiitavaara, Birgitta; Fahlström, Martin; Djupsjöbacka, Mats

    2017-01-01

    Abstract Rationale, aims and objectives The aims of this study is to investigate the prevalence of patients seeking care due to different musculoskeletal disorders (MSDs) at primary health care centres (PHCs), to chart different factors such as symptoms, diagnosis and actions prescribed for patients that visited the PHCs due to MSD and to make comparisons regarding differences due to gender, age and rural or urban PHC. Methods Patient records (2000) for patients in working age were randomly s...

  5. Monitoring selective components of primary health care: methodology and community assessment of vaccination, diarrhoea, and malaria practices in Conakry, Guinea. ACSI-CCCD team.

    OpenAIRE

    Dabis, F.; Breman, J. G.; Roisin, A. J.; Haba, F.

    1989-01-01

    The Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (ACSI-CCCD) Project is a primary health care activity that focuses on antenatal care, immunization, diarrhoeal disease control, and malaria control in children under 5 years of age. In order to gauge progress made in the project, a community-based health interview survey to measure simultaneously several prevention and treatment indicators was carried out in 1986 in Conakry, Guinea. A sample of 1415 caretakers and...

  6. Monitoring selective components of primary health care: methodology and community assessment of vaccination, diarrhoea, and malaria practices in Conakry, Guinea. ACSI-CCCD team.

    OpenAIRE

    Dabis , François; Breman , J. G.; Roisin , A. J.; Haba , F.; Team , Acsi-Cccd

    1989-01-01

    International audience; The Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (ACSI-CCCD) Project is a primary health care activity that focuses on antenatal care, immunization, diarrhoeal disease control, and malaria control in children under 5 years of age. In order to gauge progress made in the project, a community-based health interview survey to measure simultaneously several prevention and treatment indicators was carried out in 1986 in Conakry, Guinea. A sampl...

  7. Proper motions in the VVV Survey: Results for more than 15 million stars across NGC 6544

    Science.gov (United States)

    Contreras Ramos, R.; Zoccali, M.; Rojas, F.; Rojas-Arriagada, A.; Gárate, M.; Huijse, P.; Gran, F.; Soto, M.; Valcarce, A. A. R.; Estévez, P. A.; Minniti, D.

    2017-12-01

    Context. In the last six years, the VISTA Variable in the Vía Láctea (VVV) survey mapped 562 sq. deg. across the bulge and southern disk of the Galaxy. However, a detailed study of these regions, which includes 36 globular clusters (GCs) and thousands of open clusters is by no means an easy challenge. High differential reddening and severe crowding along the line of sight makes highly hamper to reliably distinguish stars belonging to different populations and/or systems. Aims: The aim of this study is to separate stars that likely belong to the Galactic GC NGC 6544 from its surrounding field by means of proper motion (PM) techniques. Methods: This work was based upon a new astrometric reduction method optimized for images of the VVV survey. Results: PSF-fitting photometry over the six years baseline of the survey allowed us to obtain a mean precision of 0.51 mas yr-1, in each PM coordinate, for stars with Ks< 15 mag. In the area studied here, cluster stars separate very well from field stars, down to the main sequence turnoff and below, allowing us to derive for the first time the absolute PM of NGC 6544. Isochrone fitting on the clean and differential reddening corrected cluster color magnitude diagram yields an age of 11-13 Gyr, and metallicity [Fe/H] =-1.5 dex, in agreement with previous studies restricted to the cluster core. We were able to derive the cluster orbit assuming an axisymmetric model of the Galaxy and conclude that NGC 6544 is likely a halo GC. We have not detected tidal tail signatures associated to the cluster, but a remarkable elongation in the galactic center direction has been found. The precision achieved in the PM determination also allows us to separate bulge stars from foreground disk stars, enabling the kinematical selection of bona fide bulge stars across the whole survey area. Conclusions: Kinematical techniques are a fundamental step toward disentangling different stellar populations that overlap in a studied field. Our results show

  8. Demographic factors and retrieval of object and proper names after age 70.

    Directory of Open Access Journals (Sweden)

    Gitit Kavé

    Full Text Available This research aimed to investigate whether demographic factors are similarly related to retrieval of object and proper names.The sample included 5,907 individuals above age 70 who participated in the Health and Retirement Study between 2004 and 2012. Participants were asked to name two objects as well as the US President and Vice President. Latent growth curve models examined the associations of age, education, and self-rated health with baseline levels and change trajectories in retrieval.Age and education were more strongly related to retrieval of proper names than to retrieval of object names, both for baseline scores and for change trajectory. Similar effects of self-rated health emerged for both types of stimuli.The results show that examining object names and proper names together as indication of cognitive status in the HRS might overlook important differences between the two types of stimuli, in both baseline performance and longitudinal change.

  9. The Defense Logistics Agency Properly Awarded Power Purchase Agreements and the Army Obtained Fair Market Value for Leases Supporting Power Purchase Agreements

    Science.gov (United States)

    2016-09-28

    response to an allegation reported to the Defense Hotline. The allegation stated that the Army and Navy leased land to utility companies to produce...awarded the two power purchase agreements at Fort Hood and Fort Detrick, using full and open competition, in accordance with Federal and DoD guidance...Specifically, the contracting officials properly issued requests for proposals, developed source selection plans, and evaluated proposals in

  10. Predicting Factors of Worker Behavior for Proper Working Posture Based on Planed Behavior Theory

    Directory of Open Access Journals (Sweden)

    E Mohammadi Zeydi

    2008-12-01

    Introduction & Objective: Injuries resulting from ignoring proper working posture especially in employees who sitting at workplace for more than of working hours are costly, and create significant pain and discomfort. Decreasing of these injuries is most effectively accomplished through the application of ergonomic design principles. Sometimes, however, barriers (technical and economic preclude ergonomic improvement and, consequently, some organizations rely on the use of proper sitting techniques and maintaining proper working posture as a major control strategy during workday. The problem, however, is that these process performing is inconsistent and managers have a difficult time motivating use of these techniques. The main aim of this study was to understand the factors driving proper working posture among employees. Materials & Methods: This study used the theory of planned behavior to predict upright working posture maintenance among 222 of assembling, machinery and printing line’s employees at a Qazvin Alborz industrial town manufacturing organization. Structural equation modeling, explanatory and confirmatory factor analysis were employed to analyze relationships among constructs. Results: Results revealed that attitude (p< 0.05, β= 0.53 and intention (p< 0.05, β= 0.46 were the strongest predictors of proper working posture maintenance behavior. Perceived behavior control, to a lesser degree, were also important influences on intention (p< 0.05, β= 0.34 and behavior (p< 0.05, β= 0.28. Subjective norms did not surface as effective direct predictors of upright working posture maintenance, but did affect behavior and intent via mediating factors (attitudes subjective norms and perceived behavioral control. Finally, the TPB was supported as an effective model explaining upright working posture maintenance, and had potential application for many other safety-related behaviors. Conclusion: results of this study emphasis on considering factors such as

  11. Not proper ROC curves as new tool for the analysis of differentially expressed genes in microarray experiments

    Directory of Open Access Journals (Sweden)

    Pistoia Vito

    2008-10-01

    Full Text Available Abstract Background Most microarray experiments are carried out with the purpose of identifying genes whose expression varies in relation with specific conditions or in response to environmental stimuli. In such studies, genes showing similar mean expression values between two or more groups are considered as not differentially expressed, even if hidden subclasses with different expression values may exist. In this paper we propose a new method for identifying differentially expressed genes, based on the area between the ROC curve and the rising diagonal (ABCR. ABCR represents a more general approach than the standard area under the ROC curve (AUC, because it can identify both proper (i.e., concave and not proper ROC curves (NPRC. In particular, NPRC may correspond to those genes that tend to escape standard selection methods. Results We assessed the performance of our method using data from a publicly available database of 4026 genes, including 14 normal B cell samples (NBC and 20 heterogeneous lymphomas (namely: 9 follicular lymphomas and 11 chronic lymphocytic leukemias. Moreover, NBC also included two sub-classes, i.e., 6 heavily stimulated and 8 slightly or not stimulated samples. We identified 1607 differentially expressed genes with an estimated False Discovery Rate of 15%. Among them, 16 corresponded to NPRC and all escaped standard selection procedures based on AUC and t statistics. Moreover, a simple inspection to the shape of such plots allowed to identify the two subclasses in either one class in 13 cases (81%. Conclusion NPRC represent a new useful tool for the analysis of microarray data.

  12. Preventative foot care in people with diabetes: Quality patient ...

    African Journals Online (AJOL)

    Keywords: preventative foot care; diabetes; risk stratification: self care. Introduction ... diabetes is considered to be a key indicator of the quality of foot ... loss of protective sensation, the importance of foot monitoring on a daily basis, the proper ...

  13. A generalised Green-Julg theorem for proper groupoids and Banach algebras

    OpenAIRE

    Paravicini, Walther

    2009-01-01

    The Green-Julg theorem states that K_0^G(B) is isomorphic to K_0(L^1(G,B)) for every compact group G and every G-C*-algebra B. We formulate a generalisation of this result to proper groupoids and Banach algebras and deduce that the Bost assembly map is surjective for proper Banach algebras. On the way, we show that the spectral radius of an element in a C_0(X)-Banach algebra can be calculated from the spectral radius in the fibres.

  14. The c-index is not proper for the evaluation of $t$-year predicted risks.

    Science.gov (United States)

    Blanche, Paul; Kattan, Michael W; Gerds, Thomas A

    2018-02-16

    We show that the widely used concordance index for time to event outcome is not proper when interest is in predicting a $t$-year risk of an event, for example 10-year mortality. In the situation with a fixed prediction horizon, the concordance index can be higher for a misspecified model than for a correctly specified model. Impropriety happens because the concordance index assesses the order of the event times and not the order of the event status at the prediction horizon. The time-dependent area under the receiver operating characteristic curve does not have this problem and is proper in this context.

  15. Modal analysis of fluid flows using variants of proper orthogonal decomposition

    Science.gov (United States)

    Rowley, Clarence; Dawson, Scott

    2017-11-01

    This talk gives an overview of several methods for analyzing fluid flows, based on variants of proper orthogonal decomposition. These methods may be used to determine simplified, approximate models that capture the essential features of these flows, in order to better understand the dominant physical mechanisms, and potentially to develop appropriate strategies for model-based flow control. We discuss balanced proper orthogonal decomposition as an approximation of balanced truncation, and explain connections with system identification methods such as the eigensystem realization algorithm. We demonstrate the methods on several canonical examples, including a linearized channel flow and the flow past a circular cylinder. Supported by AFOSR, Grant FA9550-14-1-0289.

  16. THE PROBLEM OF PROPER CARGO SECURING IN ROAD TRANSPORT – CASE STUDY

    Directory of Open Access Journals (Sweden)

    Maria CIEŚLA

    2013-12-01

    Full Text Available This paper presents the problem of improper security of cargo in trucks as the cause of about 25% of the accidents that takes place in road transport. Attention was drawn to aspects of legal liability for errors resulting from incorrect load securing according to polish law. Article was enriched with practical examples illustrating the effects of improper cargo securing on transport unit and shows how it had to be prepared properly. When planning the proper transport protection of metal sheets rolled both calculation methods and computer applications were used.

  17. [Basic therapeutics : What are the features of modern personal care products to protect and regenerate the skin barrier?

    Science.gov (United States)

    Daniels, R

    2017-11-01

    It is international consensus that the daily use of properly selected products for the maintenance therapy is a must in the adjuvant treatment of most chronic skin diseases. In a first step, the selection of an adequate product can be guided by the classical triangle of the dermal vehicles. However, modern skin care products use diverse excipients, e. g. emulsifiers and viscosity enhancers, to improve the galenical and haptic properties of the formulations. It is thus no longer sufficient to simply have knowledge about the oil and water content of a cream in order to make a proper selection. A very positive effect on the skin barrier can be achieved using biomimetic lipids which can be incorporated into the epidermal lipid barrier. The application of such products as a foam cream is the most convenient way especially favorable when inflamed or hardly accessible skin areas have to be treated.

  18. Management of common eye conditions in a primary health care ...

    African Journals Online (AJOL)

    treated by properly trained middle cadre eye health worker working with simple diagnostic tools in a primary health care setting or by referring to secondary care in a timely ... Personal and environmental hygiene: (regular hand and face washing, proper disposal of garbage, human and animal waste and maintenance of a.

  19. Mapping stellar kinematics across the Galactic bar : HST measurements of proper motions in 35 fields

    NARCIS (Netherlands)

    Kozlowski, S.; Wozniak, P. R.; Mao, S.; Smith, M. C.; Sumi, T.; Vestrand, W. T.; Wyrzykowski, L.

    2006-01-01

    We present a proper motion mini-survey of 35 fields in the vicinity of Baade window, (l, b) = (1 degrees, -4 degrees), sampling roughly a 5 x 2.5-deg(2) region of the Galactic bar. Our second epoch observations collected with the Advanced Camera for Surveys/High Resolution Channel instrument onboard

  20. Improved proper name recall in aging after electrical stimulation of the anterior temporal lobes

    Directory of Open Access Journals (Sweden)

    Lars A Ross

    2011-10-01

    Full Text Available Evidence from neuroimaging and neuropsychology suggests that portions of the anterior temporal lobes play a critical role in proper name retrieval. We previously found that anodal transcranial direct current stimulation (tDCS to the anterior temporal lobes improved retrieval of proper names in young adult. Here we extend that finding to older adults who tend to experience greater proper-naming deficits than young adults. The task was to look at pictures of famous faces or landmarks and verbally recall the associated proper name. Our results show a numerical improvement in face naming after left or right anterior temporal lobe stimulation, but a statistically significant effect only after left-lateralized stimulation. The magnitude of the enhancing effect was similar in older and younger adults but the lateralization of the effect differed depending on age. These results provide evidence that tDCS may be a useful tool for the neurorehabilitation of cognitive function in healthy and pathological cognitive decline.

  1. Corrections to the Hipparcos Proper Motions in Declination for 807 Stars

    Directory of Open Access Journals (Sweden)

    Damljanović, G.

    2008-12-01

    Full Text Available We used the data on latitude variations obtained from observations with 10 classical photographic zenith tubes (PZT in order to improve the Hipparcos proper motions in declinations $mu_{delta} $ for 807 stars. Part of observing programmes, carried out during the last century for the purpose of studying the Earth's rotation, were realized by using PZT instruments. These observations were performed within in the intervals (tens of years much longer than that of the Hipparcos mission (less than 4 years. In addition, the annual number of observations for every PZT-programme star is several hundreds on the average. Though the accuracy of the star coordinates in the Hipparcos Catalogue is by two orders of magnitude better than that of the star coordinates from the PZT observations, the large number of observations performed a much longer time interval makes it possible to correct the Hipparcos proper motions and to improve their accuracy with respect to the accuracy given in the Hipparcos Catalogue. Long term examinations of latitude and time variations were used to form the Earth Orientation Catalogue (EOC-2, aimed at a more accurate determination of positions and proper motions for the stars included. Our method of calculating the corrections of the proper motions in declination from the latitude variations is different from the method used in obtaining the EOC-2 Catalogue. Comparing the results we have established a good agreement between our $mu_ {delta} $ and the EOC-2 ones for the star sample used in the present paper.

  2. 75 FR 7616 - Mitigation of Carrier Fines for Transporting Aliens Without Proper Documents; Modification of...

    Science.gov (United States)

    2010-02-22

    ... Transporting Aliens Without Proper Documents; Modification of Memorandum of Understanding and Recalculation of... States an alien who does not have a valid passport and an unexpired visa, as required under applicable law, is subject to a fine for each alien transported lacking the required documentation. Pursuant to...

  3. Condom Use: Slippage, Breakage, and Steps for Proper Use among Adolescents in Alternative School Settings

    Science.gov (United States)

    Coyle, Karin K.; Franks, Heather M.; Glassman, Jill R.; Stanoff, Nicole M.

    2012-01-01

    Background: School-based human immunodeficiency virus (HIV)/sexually transmitted infection (STI), and pregnancy prevention programs often focus on consistent and correct condom use. Research on adolescents' experience using condoms, including condom slippage/breakage, is limited. This exploratory study examines proper condom use and the…

  4. MEASURING THE UNDETECTABLE: PROPER MOTIONS AND PARALLAXES OF VERY FAINT SOURCES

    International Nuclear Information System (INIS)

    Lang, Dustin; Hogg, David W.; Jester, Sebastian; Rix, Hans-Walter

    2009-01-01

    The near future of astrophysics involves many large solid-angle, multi-epoch, multiband imaging surveys. These surveys will, at their faint limits, have data on a large number of sources that are too faint to be detected at any individual epoch. Here, we show that it is possible to measure in multi-epoch data not only the fluxes and positions, but also the parallaxes and proper motions of sources that are too faint to be detected at any individual epoch. The method involves fitting a model of a moving point source simultaneously to all imaging, taking account of the noise and point-spread function (PSF) in each image. By this method it is possible to measure the proper motion of a point source with an uncertainty close to the minimum possible uncertainty given the information in the data, which is limited by the PSF, the distribution of observation times (epochs), and the total signal-to-noise in the combined data. We demonstrate our technique on multi-epoch Sloan Digital Sky Survey (SDSS) imaging of the SDSS Southern Stripe (SDSSSS). We show that with our new technique we can use proper motions to distinguish very red brown dwarfs from very high-redshift quasars in these SDSS data, for objects that are inaccessible to traditional techniques, and with better fidelity than by multiband imaging alone. We rediscover all 10 known brown dwarfs in our sample and present nine new candidate brown dwarfs, identified on the basis of significant proper motion.

  5. Translating Proper Nouns: A Case Study on English Translation of Hafez's Lyrics

    Science.gov (United States)

    Shirinzadeh, Seyed Alireza; Mahadi, Tengku Sepora Tengku

    2014-01-01

    Proper nouns are regarded so simple that they might be taken for granted in translation explorations. Some may believe that they should not be translated in transmitting source texts to target texts. But, it is not the case; if one looks at present translations, he will notice that different strategies might be applied for translating proper…

  6. The Nonuse, Misuse, and Proper Use of Pilot Studies in Experimental Evaluation Research

    Science.gov (United States)

    Westlund, Erik; Stuart, Elizabeth A.

    2017-01-01

    This article discusses the nonuse, misuse, and proper use of pilot studies in experimental evaluation research. The authors first show that there is little theoretical, practical, or empirical guidance available to researchers who seek to incorporate pilot studies into experimental evaluation research designs. The authors then discuss how pilot…

  7. Translation of proper names in the novel «Hunger games» by S. Collins

    Directory of Open Access Journals (Sweden)

    Zalesova N. M.

    2016-05-01

    Full Text Available the aim of the article is to study the methods used when translating proper names in the fantasy novel «Hunger games» by S. Collins. It was found out that the most popular ones are transcription, translation with the use of the traditional variant and semantic translation.

  8. Corrections to the Hipparcos proper motions in declination for 807 stars

    Directory of Open Access Journals (Sweden)

    Damljanović G.

    2008-01-01

    Full Text Available We used the data on latitude variations obtained from observations with 10 classical photographic zenith tubes (PZT in order to improve the Hipparcos proper motions in declinations µδ for 807 stars. Part of observing programmes, carried out during the last century for the purpose of studying the Earth's rotation, were realized by using PZT instruments. These observations were performed within in the intervals (tens of years much longer than that of the Hipparcos mission (less than 4 years. In addition, the annual number of observations for every PZT programme star is several hundreds on the average. Though the accuracy of the star coordinates in the Hipparcos Catalogue is by two orders of magnitude better than that of the star coordinates from the PZT observations, the large number of observations performed a much longer time interval makes it possible to correct the Hipparcos proper motions and to improve their accuracy with respect to the accuracy given in the Hipparcos Catalogue. Long term examinations of latitude and time variations were used to form the Earth Orientation Catalogue (EOC-2, aimed at a more accurate determination of positions and proper motions for the stars included. Our method of calculating the corrections of the proper motions in declination from the latitude variations is different from the method used in obtaining the EOC-2 Catalogue. Comparing the results we have established a good agreement between our µδ and the EOC-2 ones for the star sample used in the present paper.

  9. How Students Learn from Multiple Contexts and Definitions: Proper Time as a Coordination Class

    Science.gov (United States)

    Levrini, Olivia; diSessa, Andrea A.

    2008-01-01

    This article provides an empirical analysis of a single classroom episode in which students reveal difficulties with the concept of proper time in special relativity but slowly make progress in improving their understanding. The theoretical framework used is "coordination class theory," which is an evolving model of concepts and conceptual change.…

  10. 76 FR 14543 - Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement Contracts

    Science.gov (United States)

    2011-03-16

    ..., Sequence 1] RIN 9000-AL78 Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement... other than firm-fixed-price contracts (e.g., cost-reimbursement, time-and-material, and labor-hour...-reimbursement contracts and identifies the following three areas that the Defense Acquisition Regulation Council...

  11. Proper survey methods for research of aquatic plant ecology and management

    Science.gov (United States)

    Proper survey methods are essential for objective, quantitative assessment of the distribution and abundance of aquatic plants as part of research and demonstration efforts. For research, the use of the appropriate method is an essential part of the scientific method, to ensure that the experimenta...

  12. A Study on How to Breathe Properly When Practicing Tai Chi Chuan

    Science.gov (United States)

    Yang, Hanchun

    2011-01-01

    When practicing Tai Chi Chuan, proper breath plays an important role in shaping Tai Chi Chuan's style and its fitness value. The paper aims to analyse the postures of Tai Chi Chuan and its breath characteristics. The paper also presents some new insights on how to co-ordinate breath with postures by case studies.

  13. Young children's use of contrast in word learning: the case of proper names

    NARCIS (Netherlands)

    Hall, D.G.; Rhemtulla, M.

    2014-01-01

    Recent research has established that contrast can exert a powerful effect on early word learning. This study examined the role of contrast in young children's ability to learn proper names. Preschoolers heard a novel word for an unfamiliar stuffed animal in the presence of a second stuffed animal of

  14. Statistical HR diagrams for one hundred and fifteen thousand proper-motion stars

    International Nuclear Information System (INIS)

    Luyten, W.J.

    1978-01-01

    Since regular HR diagrams require apparent magnitudes, colors or spectra, and parallaxes, and such complete data are available for relatively few stars, there may be some advantage in making up diagrams which utilize proper motions instead of parallaxes, and are thus statistically similar to an HR diagram. The reduced proper motion, first used by Hertzsprung, is defined as H=m+5+5log μ, but may also be written as H=M+5log T, where T is the tangential velocity, and is expressed in astronomical units per year. A diagram plotting H against color will thus contain the considerable dispersion in tangential velocity which is a serious disadvantage. However, this is outweighed by two practical advantages. First, the one and the same person who does the proper motion survey can, and does also determine the other two quantities needed. Second, when using data obtained from such a proper motion survey one deals, statistically, with all the stars within a given distance and the results, therefore, are much more representative of the real situation in space than many HR diagrams which often contain an unrealistic preponderance of giants. (Auth.)

  15. The transverse index theorem for proper cocompact actions of Lie groupoids

    NARCIS (Netherlands)

    Pflaum, M.J.; Posthuma, H.; Tang, X.

    2015-01-01

    Given a proper, cocompact action of a Lie groupoid, we define a higher index pairing between invariant elliptic differential operators and smooth groupoid cohomology classes. We prove a cohomological index formula for this pairing by applying the van Est map and algebraic index theory. Finally we

  16. Vantage Theory and the Use of English Demonstrative Determiners with Proper Nouns

    Science.gov (United States)

    Riddle, Elizabeth M.

    2010-01-01

    This article discusses some apparently paradoxical behavior of the English demonstratives "this/these" and "that/those" as determiners of proper nouns and as metaphorical signals of epistemic and affective stance within the proximal-distal opposition. It is argued that the apparent paradoxes are actually cases of shifting perspectives or points of…

  17. Cotranslational protein folding reveals the selective use of ...

    Indian Academy of Sciences (India)

    to fold properly by decelerating the translation rate at these sites. Thus the cotranslational protein folding is believed to be true for many proteins and is an important selection factor for the selective codon usage to optimize proper gene expres- sion and function (Komar 2009). A web server CS and S has been created by ...

  18. Day care monopolar transurethral resection of prostate: Is it feasible?

    Directory of Open Access Journals (Sweden)

    Altaf Khan

    2014-01-01

    Full Text Available Introduction: Benign prostatic hyperplasia is a common disease accounting for 30% of our OPD cases and about 25% of our surgery cases. Various treatment options are now available for more efficient care and early return to work. We wanted to determine the safety and feasibility of day care monopolar transurethral resection of prostate (m-TURP, by admitting the patients on the day of surgery and discharging the patient without catheter on the same day. We also compared the morbidity associated with conventional TURP where in the catheter is removed after 24-48 h of surgery and day care TURP where in the catheter is removed on the day of surgery. Materials and Methods: A total of 120 patients who fulfilled the criteria were included in the study which was conducted between November 2008 and December 2010. A total of 60 patients were assigned for day care and 60 for conventional monopolar TURP. There was no significant difference in age, prostatic volume or IPSS score. Day care patients were admitted on day of surgery and discharged the same day after the removal of catheter. Results: Both the groups were comparable in outcome. Stricture rate was less with day care TURP. Mean catheterization time was similar to laser TURP. Conclusion: Monopolar TURP is still the gold standard of care for BPH. If cases are selected properly and surgery performed diligently it remains the option of choice for small and medium sized glands and patients can be back to routine work early.

  19. Competencies for supporting a healthy sexual development of young people in care : interviews with a selection of professionals in Belgium, Denmark and The Netherlands

    NARCIS (Netherlands)

    Walpot, Mirjam; Riis Hansen, Gitte; Moentjes, Gwendy; Bernaards, Claire

    2017-01-01

    This report describes the results of the interviews that were held with professionals, policy makers, and researchers (working in the field of sexuality and/or residential and foster care) in three countries in order to answer the following question: ‘Which competencies (i.e. knowledge, skills, and

  20. Metabonomics and Intensive Care

    OpenAIRE

    Antcliffe, D; Gordon, AC

    2016-01-01

    This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

  1. Developing Proper Systems for Successful Cloud Computing Implementation Using Fuzzy ARAS Method (Case Study: University of Tehran Faculty of New Science and Technology

    Directory of Open Access Journals (Sweden)

    Jalil Heidaryd Dahooie

    2017-12-01

    Full Text Available Given the increasing requirements of communication and the need for advanced network-based technologies, cloud computing has been suggested as a perfect strategy to achieve these objectives. Yet, despite the development of computing applications and the increased number of alternatives, it is quite a difficult task to select the exact software platform for the implementation of cloud computing arrangements. In this line, the present paper aimed to develop a scientific framework as how to select the proper software for successful cloud computing implantation at the infrastructure level. First through a review on the related literature and using experts’ opinions, the software selection criteria were extracted. Based on the framework proposed here, the interval-valued fuzzy ARAS method was then employed for weighting and prioritizing specified alternatives. This model was applied by the Faculty of New Sciences and Technologies of Tehran University in order to select proper software platforms from among five alternatives. The results revealed that the OpenStack cloud operating system has been selected as the best alternative, most probably because this platform demonstrates significant achievement for its merits such as high level of performance, reliability and security, stability, and usability.

  2. Copper surfaces are associated with significantly lower concentrations of bacteria on selected surfaces within a pediatric intensive care unit.

    Science.gov (United States)

    Schmidt, Michael G; von Dessauer, Bettina; Benavente, Carmen; Benadof, Dona; Cifuentes, Paulina; Elgueta, Alicia; Duran, Claudia; Navarrete, Maria S

    2016-02-01

    Health care-associated infections result in significant patient morbidity and mortality. Although cleaning can remove pathogens present on hospital surfaces, those surfaces may be inadequately cleaned or recontaminated within minutes. Because of copper's inherent and continuous antimicrobial properties, copper surfaces offer a solution to complement cleaning. The objective of this study was to quantitatively assess the bacterial microbial burden coincident with an assessment of the ability of antimicrobial copper to limit the microbial burden associated with 3 surfaces in a pediatric intensive care unit. A pragmatic trial was conducted enrolling 1,012 patients from 2 high acuity care units within a 249-bed tertiary care pediatric hospital over 12 months. The microbial burden was determined from 3 frequently encountered surfaces, regardless of room occupancy, twice monthly, from 16 rooms, 8 outfitted normally and 8 outfitted with antimicrobial copper. Copper surfaces were found to be equivalently antimicrobial in pediatric settings to activities reported for adult medical intensive care units. The log10 reduction to the microbial burden from antimicrobial copper surfaced bed rails was 1.996 (99%). Surprisingly, introduction of copper objects to 8 study rooms was found to suppress the microbial burden recovered from objects assessed in control rooms by log10 of 1.863 (73%). Copper surfaces warrant serious consideration when contemplating the introduction of no-touch disinfection technologies for reducing burden to limit acquisition of HAIs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Standard guidelines of care for vitiligo surgery

    Directory of Open Access Journals (Sweden)

    Parsad Davinder

    2008-03-01

    Full Text Available Vitiligo surgery is an effective method of treatment for selected, resistant vitiligo patches in patients with vitiligo. Physician′s qualifications: The physician performing vitiligo surgery should have completed postgraduate training in dermatology which included training in vitiligo surgery. If the center for postgraduation does not provide education and training in cutaneous surgery, the training may be obtained at the surgical table (hands-on under the supervision of an appropriately trained and experienced dermatosurgeon at a center that routinely performs the procedure. Training may also be obtained in dedicated workshops. In addition to the surgical techniques, training should include local anesthesia and emergency resuscitation and care. Facility: Vitiligo surgery can be performed safely in an outpatient day care dermatosurgical facility. The day care theater should be equipped with facilities for monitoring and handling emergencies. A plan for handling emergencies should be in place, with which all nursing staff should be familiar. Vitiligo grafting for extensive areas may need general anesthesia and full operation theater facility in a hospital setting and the presence of an anesthetist is recommended in such cases. Indications for vitiligo surgery : Surgery is indicated for stable vitiligo that does not respond to medical treatment. While there is no consensus on definitive parameters for stability, the Task Force suggests the absence of progression of disease for the past one year as a definition of stability. Test grafting may be performed in doubtful cases to detect stability. Preoperative counseling and Informed consent: A detailed consent form elaborating the procedure and possible complications should be signed by the patient. The patient should be informed of the nature of the disease and that the determination of stability is only a vague guide. The consent form should specifically state the limitations of the procedure

  4. Pediatric Critical Care in Resource-Limited Settings-Overview and Lessons Learned.

    Science.gov (United States)

    Slusher, Tina M; Kiragu, Andrew W; Day, Louise T; Bjorklund, Ashley R; Shirk, Arianna; Johannsen, Colleen; Hagen, Scott A

    2018-01-01

    Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs) remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU) and high dependency areas. PICU can improve the quality of pediatric care in general and, if properly organized, can effectively treat the severe complications of high burden diseases, such as diarrhea, severe malaria, and respiratory distress using low-cost interventions. Setting up a PICU in a LMIC setting requires planning, specific resources, and most importantly investment in the nursing and permanent medical staff. A thoughtful approach to developing pediatric critical care services in LMICs starts with fundamental building blocks: training healthcare professionals in skills and knowledge, selecting resource appropriate effective equipment, and having supportive leadership to provide an enabling environment for appropriate care. If these fundamentals can be built on in a sustainable manner, an appropriate critical care service will be established with the potential to significantly decrease pediatric morbidity and mortality in the context of public health goals as we reach toward the sustainable development goals.

  5. Pediatric Critical Care in Resource-Limited Settings—Overview and Lessons Learned

    Directory of Open Access Journals (Sweden)

    Tina M. Slusher

    2018-03-01

    Full Text Available Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU and high dependency areas. PICU can improve the quality of pediatric care in general and, if properly organized, can effectively treat the severe complications of high burden diseases, such as diarrhea, severe malaria, and respiratory distress using low-cost interventions. Setting up a PICU in a LMIC setting requires planning, specific resources, and most importantly investment in the nursing and permanent medical staff. A thoughtful approach to developing pediatric critical care services in LMICs starts with fundamental building blocks: training healthcare professionals in skills and knowledge, selecting resource appropriate effective equipment, and having supportive leadership to provide an enabling environment for appropriate care. If these fundamentals can be built on in a sustainable manner, an appropriate critical care service will be established with the potential to significantly decrease pediatric morbidity and mortality in the context of public health goals as we reach toward the sustainable development goals.

  6. Modelling Seasonal GWR of Daily PM2.5 with Proper Auxiliary Variables for the Yangtze River Delta

    Directory of Open Access Journals (Sweden)

    Man Jiang

    2017-04-01

    Full Text Available Over the past decades, regional haze episodes have frequently occurred in eastern China, especially in the Yangtze River Delta (YRD. Satellite derived Aerosol Optical Depth (AOD has been used to retrieve the spatial coverage of PM2.5 concentrations. To improve the retrieval accuracy of the daily AOD-PM2.5 model, various auxiliary variables like meteorological or geographical factors have been adopted into the Geographically Weighted Regression (GWR model. However, these variables are always arbitrarily selected without deep consideration of their potentially varying temporal or spatial contributions in the model performance. In this manuscript, we put forward an automatic procedure to select proper auxiliary variables from meteorological and geographical factors and obtain their optimal combinations to construct four seasonal GWR models. We employ two different schemes to comprehensively test the performance of our proposed GWR models: (1 comparison with other regular GWR models by varying the number of auxiliary variables; and (2 comparison with observed ground-level PM2.5 concentrations. The result shows that our GWR models of “AOD + 3” with three common meteorological variables generally perform better than all the other GWR models involved. Our models also show powerful prediction capabilities in PM2.5 concentrations with only slight overfitting. The determination coefficients R2 of our seasonal models are 0.8259 in spring, 0.7818 in summer, 0.8407 in autumn, and 0.7689 in winter. Also, the seasonal models in summer and autumn behave better than those in spring and winter. The comparison between seasonal and yearly models further validates the specific seasonal pattern of auxiliary variables of the GWR model in the YRD. We also stress the importance of key variables and propose a selection process in the AOD-PM2.5 model. Our work validates the significance of proper auxiliary variables in modelling the AOD-PM2.5 relationships and

  7. PROPER MOTIONS OF YOUNG STELLAR OUTFLOWS IN THE MID-INFRARED WITH SPITZER (IRAC). I. THE NGC 1333 REGION

    International Nuclear Information System (INIS)

    Raga, A. C.; Noriega-Crespo, A.; Carey, S. J.; Arce, H. G.

    2013-01-01

    We use two 4.5 μm Spitzer (IRAC) maps of the NGC 1333 region taken over a ∼7 yr interval to determine proper motions of its associated outflows. This is a first successful attempt at obtaining proper motions of stellars' outflow from Spitzer observations. For the outflow formed by the Herbig-Haro objects HH7, 8, and 10, we find proper motions of ∼9-13 km s –1 , which are consistent with previously determined optical proper motions of these objects. We determine proper motions for a total of eight outflows, ranging from ∼10 to 100 km s –1 . The derived proper motions show that out of these eight outflows, three have tangential velocities ≤20 km s –1 . This result shows that a large fraction of the observed outflows have low intrinsic velocities and that the low proper motions are not merely a projection effect.

  8. Determinants of hardship financing in coping with out of pocket payment for care seeking of under five children in selected rural areas of Bangladesh

    Science.gov (United States)

    Ali, Nazia Binte; Siddique, Md. Abu Bakkar; Ahmed, Sameen; Rahman, Mubashshira; Islam, Sajia; Rahman, Md. Mezanur; Amena, Bushra; Hoque, D. M. Emdadul; Huda, Tanvir M.; Arifeen, Shams El

    2018-01-01

    Background Around 63% of total health care expenditure in Bangladesh is mitigated through out of pocket payment (OOP). Heavy reliance on OOP at the time of care seeking poses great threat for financial impoverishment of the households. Households employ different strategies to cope with the associated financial hardship. Objective The aim of this paper is to understand the determinants of hardship financing in coping with OOP adopted for health care seeking of under five childhood illnesses in rural setting of Bangladesh. Methods A community based cross sectional survey was conducted during August to October, 2014 in 15 low performing sub-districts of northern and north-east regions of Bangladesh. Of the 7039 mothers of under five children surveyed, 1895 children who suffered from illness and sought care for their illness episodes were reported in this study. Descriptive statistics and ordinal regression analysis were conducted. Results A total number of 7,039 under five children reported to have suffered illness by their mothers. Among these children 37% suffered from priority illness. Care was sought for 88% children suffering from illnesses. Among them 26% went to a public or private sector medically trained provider. 5% of households incurred illness cost more than 10% of the household’s monthly expenditure. The need for assistance was higher among those compared to others (31% vs 13%). Different financing mechanisms adopted to meet OOP are loan with interest (6%), loan without interest (9%) and financial help from relatives (6%) Need for financial assistance varied from 19% among households in the lowest quintile to 9% in the highest wealth. Ordinal regression analysis revealed that burden of hardship financing increases by 2.17 times when care is sought from a private trained provider compared to care seeking from untrained provider (CI: 1.49, 3.17). Similarly, for families that incur a health care expenditure that is more than 10% of their total monthly

  9. Determinants of hardship financing in coping with out of pocket payment for care seeking of under five children in selected rural areas of Bangladesh.

    Science.gov (United States)

    Tahsina, Tazeen; Ali, Nazia Binte; Siddique, Md Abu Bakkar; Ahmed, Sameen; Rahman, Mubashshira; Islam, Sajia; Rahman, Md Mezanur; Amena, Bushra; Hoque, D M Emdadul; Huda, Tanvir M; Arifeen, Shams El

    2018-01-01

    Around 63% of total health care expenditure in Bangladesh is mitigated through out of pocket payment (OOP). Heavy reliance on OOP at the time of care seeking poses great threat for financial impoverishment of the households. Households employ different strategies to cope with the associated financial hardship. The aim of this paper is to understand the determinants of hardship financing in coping with OOP adopted for health care seeking of under five childhood illnesses in rural setting of Bangladesh. A community based cross sectional survey was conducted during August to October, 2014 in 15 low performing sub-districts of northern and north-east regions of Bangladesh. Of the 7039 mothers of under five children surveyed, 1895 children who suffered from illness and sought care for their illness episodes were reported in this study. Descriptive statistics and ordinal regression analysis were conducted. A total number of 7,039 under five children reported to have suffered illness by their mothers. Among these children 37% suffered from priority illness. Care was sought for 88% children suffering from illnesses. Among them 26% went to a public or private sector medically trained provider. 5% of households incurred illness cost more than 10% of the household's monthly expenditure. The need for assistance was higher among those compared to others (31% vs 13%). Different financing mechanisms adopted to meet OOP are loan with interest (6%), loan without interest (9%) and financial help from relatives (6%) Need for financial assistance varied from 19% among households in the lowest quintile to 9% in the highest wealth. Ordinal regression analysis revealed that burden of hardship financing increases by 2.17 times when care is sought from a private trained provider compared to care seeking from untrained provider (CI: 1.49, 3.17). Similarly, for families that incur a health care expenditure that is more than 10% of their total monthly expenditure (CI:1.46, 3.88), the

  10. Women’s empowerment and male involvement in antenatal care: analyses of Demographic and Health Surveys (DHS) in selected African countries

    OpenAIRE

    Jennings, Larissa; Na, Muzi; Cherewick, Megan; Hindin, Michelle; Mullany, Britta; Ahmed, Saifuddin

    2014-01-01

    Background Increasing women’s status and male involvement are important strategies in reducing preventable maternal morbidity and mortality. While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. This study examines whether a woman’s empowerment status, in sum and across economic, socio-familial, and legal dimensions, is associated with male partner accompaniment to antenatal ...

  11. Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province

    OpenAIRE

    Rhulani C. Shihundla; Rachel T. Lebese; Maria S. Maputle

    2016-01-01

    Background: Recording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) regis...

  12. Chiasmata promote monopolar attachment of sister chromatids and their co-segregation toward the proper pole during meiosis I.

    Directory of Open Access Journals (Sweden)

    Yukinobu Hirose

    2011-03-01

    Full Text Available The chiasma is a structure that forms between a pair of homologous chromosomes by crossover recombination and physically links the homologous chromosomes during meiosis. Chiasmata are essential for the attachment of the homologous chromosomes to opposite spindle poles (bipolar attachment and their subsequent segregation to the opposite poles during meiosis I. However, the overall function of chiasmata during meiosis is not fully understood. Here, we show that chiasmata also play a crucial role in the attachment of sister chromatids to the same spindle pole and in their co-segregation during meiosis I in fission yeast. Analysis of cells lacking chiasmata and the cohesin protector Sgo1 showed that loss of chiasmata causes frequent bipolar attachment of sister chromatids during anaphase. Furthermore, high time-resolution analysis of centromere dynamics in various types of chiasmate and achiasmate cells, including those lacking the DNA replication checkpoint factor Mrc1 or the meiotic centromere protein Moa1, showed the following three outcomes: (i during the pre-anaphase stage, the bipolar attachment of sister chromatids occurs irrespective of chiasma formation; (ii the chiasma contributes to the elimination of the pre-anaphase bipolar attachment; and (iii when the bipolar attachment remains during anaphase, the chiasmata generate a bias toward the proper pole during poleward chromosome pulling that results in appropriate chromosome segregation. Based on these results, we propose that chiasmata play a pivotal role in the selection of proper attachments and provide a backup mechanism that promotes correct chromosome segregation when improper attachments remain during anaphase I.

  13. Preconception Care and Prenatal Care

    Science.gov (United States)

    ... Twitter Pinterest Email Print About Preconception Care and Prenatal Care What is preconception care? Preconception care is the ... improve the health of your child. What is prenatal care? Prenatal care is the health care a woman ...

  14. THE SOLAR NEIGHBORHOOD. XXV. DISCOVERY OF NEW PROPER MOTION STARS WITH 0.''40 yr-1 > μ ≥ 0.''18 yr-1 BETWEEN DECLINATIONS -470 AND 000

    International Nuclear Information System (INIS)

    Boyd, Mark R.; Winters, Jennifer G.; Henry, Todd J.; Jao, Wei-Chun; Finch, Charlie T.; Subasavage, John P.; Hambly, Nigel C.

    2011-01-01

    We present 2817 new southern proper motion systems with 0.''40 yr -1 > μ ≥ 0.''18 yr -1 and declination between -47 0 and 00 0 . This is a continuation of the SuperCOSMOS-RECONS (SCR) proper motion searches of the southern sky. We use the same photometric relations as previous searches to provide distance estimates based on the assumption that the objects are single main-sequence stars. We find 79 new red dwarf systems predicted to be within 25 pc, including a few new components of previously known systems. Two systems-SCR 1731-2452 at 9.5 pc and SCR 1746-3214 at 9.9 pc-are anticipated to be within 10 pc. We also find 23 new white dwarf (WD) candidates with distance estimates of 15-66 pc, as well as 360 new red subdwarf candidates. With this search, we complete the SCR sweep of the southern sky for stars with μ ≥ 0.''18 yr -1 and R 59F ≤ 16.5, resulting in a total of 5042 objects in 4724 previously unreported proper motion systems. Here we provide selected comprehensive lists from our SCR proper motion search to date, including 152 red dwarf systems estimated to be within 25 pc (9 within 10 pc), 46 WDs (10 within 25 pc), and 598 subdwarf candidates. The results of this search suggest that there are more nearby systems to be found at fainter magnitudes and lower proper motion limits than those probed so far.

  15. Locale-Specific Categorization of IT Projects for Proper Project Management

    Directory of Open Access Journals (Sweden)

    Muhammad Nasir

    2015-12-01

    Full Text Available In this paper we aim to show that not only are the project management techniques important for small-scale projects, but following proper project management techniques is one of the most important requirements. However, there come slight variations in implementing project management techniques in small projects as compared with larger projects. Therefore, proper categorization of projects holds the key to success in many situations. Our paper will show that categorization of a project as small-scale or large-scale should always be locale specific. In this regards, we develop a criteria and evaluate how the projects are categorized as small-scale and large-scale in different parts of the world with focus on IT projects. This research concludes that some methods cannot be used for projects of different scales.

  16. Proper acceleration, the geometric tachyon and the dynamics of a fundamental string near Dp branes

    International Nuclear Information System (INIS)

    Das, Ashok; Panda, Sudhakar; Roy, Shibaji

    2009-01-01

    We present a detailed analysis of our recent observation that the origin of the geometric tachyon, which arises when a Dp brane propagates in the vicinity of a stack of coincident NS5 branes, is due to the proper acceleration generated by the background dilaton field. We show that when a fundamental string (F-string), described by the Nambu-Goto action, is moving in the background of a stack of coincident Dp branes, the geometric tachyon mode can also appear since the overall conformal mode of the induced metric for the string can act as a source for proper acceleration. We also studied the detailed dynamics of the F-string as well as the instability by mapping the Nambu-Goto action of the F-string to the tachyon effective action of the non-BPS D-string. We qualitatively argue that the condensation of the geometric tachyon is responsible for the (F,Dp) bound state formation.

  17. Self-inflicted skin lesions: the importance of a proper diagnostic and therapeutic approach

    Directory of Open Access Journals (Sweden)

    Dimitre Dimitrov

    2016-12-01

    Full Text Available Introduction . Patients with self-inflicted skin lesions (SISL are most often referred to dermatologists. Since psychological and psychiatric conditions might be the underlying reasons for the behavior of these patients, the psychology-associated component should always be kept in mind when approaching such individuals. Objective. To discuss distinctive aspects of the approach towards patients with SISL and emphasize the most relevant issues concerning the management of psychodermatoses. Case report. We present a case of a 13-year-old girl with a 6-month history of skin lesions misdiagnosed as allergic contact dermatitis. Conscientious history taking and physical examination enabled the diagnosis of SISL. Conclusions. The proper approach to patients presenting with psychodermatoses differs from that for other dermatological patients and requires considering several additional aspects. We would like to emphasize the distinguishing aspects and importance of the proper approach to patients with SISL that might aid clinicians in diagnosing and treating these individuals in the future.

  18. Properly quantized history-dependent Parrondo games, Markov processes, and multiplexing circuits

    Energy Technology Data Exchange (ETDEWEB)

    Bleiler, Steven A. [Fariborz Maseeh Department of Mathematics and Statistics, Portland State University, PO Box 751, Portland, OR 97207 (United States); Khan, Faisal Shah, E-mail: faisal.khan@kustar.ac.a [Khalifa University of Science, Technology and Research, PO Box 127788, Abu Dhabi (United Arab Emirates)

    2011-05-09

    Highlights: History-dependent Parrondo games are viewed as Markov processes. Quantum mechanical analogues of these Markov processes are constructed. These quantum analogues restrict to the original process on measurement. Relationship between these analogues and a quantum circuits is exhibited. - Abstract: In the context of quantum information theory, 'quantization' of various mathematical and computational constructions is said to occur upon the replacement, at various points in the construction, of the classical randomization notion of probability distribution with higher order randomization notions from quantum mechanics such as quantum superposition with measurement. For this to be done 'properly', a faithful copy of the original construction is required to exist within the new quantum one, just as is required when a function is extended to a larger domain. Here procedures for extending history-dependent Parrondo games, Markov processes and multiplexing circuits to their quantum versions are analyzed from a game theoretic viewpoint, and from this viewpoint, proper quantizations developed.

  19. ORTHOGONAL REPRESENTATION OF THE PROPER TRANSFORMATION OF A PERSYMMETRIC MATRIX BASED ON ROTATION OPERATORS

    Directory of Open Access Journals (Sweden)

    V. M. Demko

    2018-01-01

    Full Text Available The mathematical substantiation of the algorithm for synthesis of the proper transformation and finding the eigenvalue formulae of a persymmetric matrix of dimension N = 2 k ( k =1, 4 based on orthogonal rotation operators is given. The proposed algorithm made it possible to improve the author's approach to calculating eigenvalues based on numerical examples for the maximal dimension of matrices 64×64, resulting the possibility to obtain analytical relations for calculating the eigenvalues of the persymmetric matrix. It is shown that the proper transformation has a factorized structure in the form of a product of rotation operators, each of which is a direct sum of elementary Givens and Jacobian rotation matrices. 

  20. Proper motion separation of Be stars in the Milky Way and the Magellanic Clouds

    Science.gov (United States)

    Vieira, K.; García, A.; Sabogal, B.

    2018-01-01

    We present a proper motion investigation of a sample of Be stars candidates towards the Large Magellanic Cloud (LMC), which has resulted in the identification of two separate populations, in the Galactic foreground and in the Magellanic background. OGLE BVI and 2MASS JHK photometry were used with the SPM4 proper motions to discriminate the different populations located towards the LMC. Two populations with distinctive infrared colours and noticeable different kinematics were found, the bluer sample is consistent with being in the LMC and the redder one with belonging to the Milky Way (MW) disk. This settles the nature of the redder sample which had been described in previous publications as a possible unknown subclass of stars among the Be candidates in the LMC.

  1. Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters

    Science.gov (United States)

    Ratner, Nan Bernstein

    2018-01-01

    Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for…

  2. Proper Motions of Dwarf Spheroidal Galaxies from Hubble Space Telescope Imaging. V. Final Measurement for Fornax

    Science.gov (United States)

    Piatek, Slawomir; Pryor, Carlton; Bristow, Paul; Olszewski, Edward W.; Harris, Hugh C.; Mateo, Mario; Minniti, Dante; Tinney, Christopher G.

    2007-03-01

    The measured proper motion of Fornax, expressed in the equatorial coordinate system, is (μα,μδ)=(47.6+/-4.6,-36.0+/-4.1) mas century-1. This proper motion is a weighted mean of four independent measurements for three distinct fields. Each measurement uses a quasi-stellar object as a reference point. Removing the contribution of the motion of the Sun and of the local standard of rest to the measured proper motion produces a Galactic rest-frame proper motion of (μGrfα,μGrfδ)=(24.4+/-4.6,-14.3+/-4.1) mas century-1. The implied space velocity with respect to the Galactic center has a radial component of Vr=-31.8+/-1.7 km s-1 and a tangential component of Vt=196+/-29 km s-1. Integrating the motion of Fornax in a realistic potential for the Milky Way produces orbital elements. The perigalacticon and apogalacticon are 118 (66, 137) and 152 (144, 242) kpc, respectively, where the values in the parentheses represent the 95% confidence intervals derived from Monte Carlo experiments. The eccentricity of the orbit is 0.13 (0.11, 0.38), and the orbital period is 3.2 (2.5, 4.6) Gyr. The orbit is retrograde and inclined by 101° (94°, 107°) to the Galactic plane. Fornax could be a member of a proposed ``stream'' of galaxies and globular clusters; however, the membership of another proposed galaxy in the stream, Sculptor, has been previously ruled out. Fornax is in the Kroupa-Theis-Boily plane, which contains 11 of the Galactic satellite galaxies, but its orbit will take it out of that plane. Based on observations with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS5-26555.

  3. Intelligent Decisional Assistant that Facilitate the Choice of a Proper Computer System Applied in Busines

    OpenAIRE

    Nicolae MARGINEAN

    2009-01-01

    The choice of a proper computer system is not an easy task for a decider. One reason could be the present market development of computer systems applied in business. The big number of the Romanian market players determines a big number of computerized products, with a multitude of various properties. Our proposal tries to optimize and facilitate this decisional process within an e-shop where are sold IT packets applied in business, building an online decisional assistant, a special component ...

  4. Mass estimates from stellar proper motions: the mass of ω Centauri

    Science.gov (United States)

    D'Souza, Richard; Rix, Hans-Walter

    2013-03-01

    We lay out and apply methods to use proper motions of individual kinematic tracers for estimating the dynamical mass of star clusters. We first describe a simple projected mass estimator and then develop an approach that evaluates directly the likelihood of the discrete kinematic data given the model predictions. Those predictions may come from any dynamical modelling approach, and we implement an analytic King model, a spherical isotropic Jeans equation model and an axisymmetric, anisotropic Jeans equation model. This maximum likelihood modelling (MLM) provides a framework for a model-data comparison, and a resulting mass estimate, which accounts explicitly for the discrete nature of the data for individual stars, the varying error bars for proper motions of differing signal-to-noise ratio, and for data incompleteness. Both of these two methods are evaluated for their practicality and are shown to provide an unbiased and robust estimate of the cluster mass. We apply these approaches to the enigmatic globular cluster ω Centauri, combining the proper motion from van Leeuwen et al. with improved photometric cluster membership probabilities. We show that all mass estimates based on spherical isotropic models yield (4.55 ± 0.1) × 106 M⊙[D/5.5 ± 0.2 kpc]3, where our modelling allows us to show how the statistical precision of this estimate improves as more proper motion data of lower signal-to-noise ratio are included. MLM predictions, based on an anisotropic axisymmetric Jeans model, indicate for ω Cen that the inclusion of anisotropies is not important for the mass estimates, but that accounting for the flattening is: flattened models imply (4.05 ± 0.1) × 106 M⊙[D/5.5 ± 0.2 kpc]3, 10 per cent lower than when restricting the analysis to a spherical model. The best current distance estimates imply an additional uncertainty in the mass estimate of 12 per cent.

  5. HST Proper Motions of Distant Globular Clusters: Constraining the Formation & Mass of the Milky Way

    Science.gov (United States)

    Sohn, S. Tony; van der Marel, Roeland P.; Deason, Alis; Bellini, Andrea; Besla, Gurtina; Watkins, Laura

    2018-04-01

    Proper motions (PMs) are required to calculate accurate orbits of globular clusters (GCs) in the Milky Way (MW) halo. We present our HST program to create a PM database for 20 GCs at distances of R GC = 10-100 kpc. Targets are discussed along with PM measurement methods. We also describe how our PM results can be used for Gaia as an external check, and discuss the synergy between HST and Gaia as astrometric instruments in the coming years.

  6. On the Set of the Numbers of Conjugates of Noncyclic Proper Subgroups of Finite Groups

    DEFF Research Database (Denmark)

    Shi, Jiangtao; Zhang, Cui

    2013-01-01

    Let G be a finite group and (G) the set of the numbers of conjugates of noncyclic proper subgroups of G. We prove that (1) if |(G)| ≤ 2, then G is solvable, and (2) G is a nonsolvable group with |(G)| = 3 if and only if G≅PSL(2,5) or PSL(2,13) or SL(2,5) or SL(2,13)....

  7. Synchronization of RF fields of Indus 2 RF cavities for proper injection and acceleration of beam

    International Nuclear Information System (INIS)

    Tiwari, Nitesh; Bagduwal, Pritam S.; Lad, M.; Hannurkar, P.R.

    2009-01-01

    Indus-2 is a synchrotron light source with designed parameters of 2.5 GeV, 300 mA beam current. Four RF cavities fed from four RF power stations have been used for beam acceleration from 550 MeV to 2.5 GeV and synchrotron loss compensation. Particle should reach the RF cavity at the proper phase for proper acceptance of the beam in ring. At injection if the phase is not proper the acceptance efficiency reduces and the maximum stored current in the ring also gets limited. Equal contribution from four cavities at every value of current and energy level is very important. Improper phase will cause the imbalance of the power among different station hence will limit maximum stored current and reduce life time of the stored beam. Phase optimization was done in two-step, first at injection to have better injection rate and the stations were operated at the sufficient power for control loops to operate. Then at 2 GeV and 2.5 GeV energy so that beam extracts equal power from all four RF stations. Phase synchronization of all four cavities from injection to 2.5 GeV has already been done at 50 mA stored beam current. If phases of RF fields inside four RF cavities is not proper then beam will not see the total RF voltage as summation of all four cavity gap voltages, hence it is a very important parameter to be optimized and maintained during operation. (author)

  8. Taking care of Care

    NARCIS (Netherlands)

    Evelien Eggink; Debbie Oudijk; Isolde Woittiez

    2010-01-01

    Original title: Zorgen voor Zorg. The Dutch population will become increasingly older over the coming decades. This will have consequences for the use of care and consequently the demand for staff, especially in the nursing and care sectors (home care, nursing homes and residential care

  9. VizieR Online Data Catalog: Velocity and proper motion of OB associations (Melnik+, 2009)

    Science.gov (United States)

    Melnik, A. M.; Dambis, A. K.

    2009-11-01

    For every OB-association from the list by Blaha and Humphreys (1989AJ.....98.1598B) we give the mean galactic coordinates l and b, the mean heliocentric distance r, median line-of-sight velocity Vr, the dispersion of line-of-sight velocities dvr, and number of stars with known line-of-sight velocity nvr. The line-of-sight velocities were taken from the catalog by Barbier-Brossat and Figon (1999, Cat. ). We used only the velocities measured with errors of less than 10km/s which corresponds to the quality estimations A, B, and C. We also present median proper motions of OB-associations along l- and b- coordinates, mul and mub. The data obtained for the old reduction (1997, Cat. ) are denoted by the subscript 1, whereas those based on the reduction by van Leewen (2008, Cat. ) are marked by the subscript 2. For each OB association we represent the dispersions of proper motions, dml and dmb, as well as a number of stars nmu with known proper motion. The last column shows the total number of stars with known photometric measurements, Nt, used for determination of the distances for OB-associations. The distances r correspond to the short distance scale for classical Cepheids. They are equal to the distances from the catalog by Blaha and Humphreys (1989AJ.....98.1598B), rBH, multiplied by a factor of 0.8, r=0.8*rBH. (1 data file).

  10. THE PROPER MOTIONS OF THE DOUBLE RADIO SOURCE n IN THE ORION BN/KL REGION

    International Nuclear Information System (INIS)

    Rodríguez, Luis F.; Loinard, Laurent; Zapata, Luis; Lizano, Susana; Dzib, Sergio A.; Menten, Karl M.; Gómez, Laura

    2017-01-01

    We have extended the time baseline for observations of the proper motions of radio sources in the Orion BN/KL region from 14.7 to 22.5 years. We present improved determinations for the sources BN and I. In addition, we address the proper motions of the double radio source n, that have been questioned in the literature. We confirm that all three sources are moving away at transverse velocities of tens of kilometers per second from a region in-between them, where they were located about 500 years ago. Source n exhibits a new component that we interpret as due to a one-sided ejection of free–free emitting plasma that took place after 2006.36. We used the highly accurate relative proper motions between sources BN and I to determine that their closest separation took place in the year 1475 ± 6, when they were within ∼100 au or less from each other in the plane of the sky.

  11. THE PROPER MOTIONS OF THE DOUBLE RADIO SOURCE n IN THE ORION BN/KL REGION

    Energy Technology Data Exchange (ETDEWEB)

    Rodríguez, Luis F.; Loinard, Laurent; Zapata, Luis; Lizano, Susana [Instituto de Radioastronomía y Astrofísica, UNAM, Apdo. Postal 3-72 (Xangari), 58089 Morelia, Michoacán, México (Mexico); Dzib, Sergio A.; Menten, Karl M. [Max Planck Institut für Radioastronomie, Auf dem Hügel 69, D-53121 Bonn (Germany); Gómez, Laura, E-mail: l.rodriguez@crya.unam.mx [Joint ALMA Observatory, Alonso de Córdoba 3107, Vitacura, Santiago (Chile)

    2017-01-10

    We have extended the time baseline for observations of the proper motions of radio sources in the Orion BN/KL region from 14.7 to 22.5 years. We present improved determinations for the sources BN and I. In addition, we address the proper motions of the double radio source n, that have been questioned in the literature. We confirm that all three sources are moving away at transverse velocities of tens of kilometers per second from a region in-between them, where they were located about 500 years ago. Source n exhibits a new component that we interpret as due to a one-sided ejection of free–free emitting plasma that took place after 2006.36. We used the highly accurate relative proper motions between sources BN and I to determine that their closest separation took place in the year 1475 ± 6, when they were within ∼100 au or less from each other in the plane of the sky.

  12. VizieR Online Data Catalog: The VLBA Extragalactic Proper Motion Catalog (Truebenbach+, 2017)

    Science.gov (United States)

    Truebenbach, A. E.; Darling, J.

    2017-11-01

    We created our catalog of extragalactic radio proper motions using the 2017a Goddard VLBI global solution. The 2017a solution is computed from more than 30 years of dual-band VLBI observations --1979 August 3 to 2017 March 27. We also observed 28 objects with either no redshift or a "questionable" Optical Characteristic of Astrometric Radio Sources (OCARS; Malkin 2016ARep...60..996M) redshift at the Apache Point Observatory (APO) 3.5m telescope and/or at Gemini North. We conducted observations on the 3.5m telescope at Apache Point Observatory with the Dual Imaging Spectrograph (DIS) from 2015 April 18 to 2016 June 30. We chose two objects for additional observations with the Gemini Multi-Object Spectrograph-North (GMOS-N) at Gemini North Observatory. 2021+317 was observed on 2016 June 26 and 28, while 0420+417 was observed on 2016 November 8 and 26. We also observed 42 radio sources with the Very Long Baseline Array (VLBA) in the X-band (3.6cm/8.3GHz). Our targets had all been previously observed by VLBI. Our VLBA observations were conducted in two campaigns from 2015 September to 2016 January and 2016 October to November. The final extragalactic proper motion catalog (created primarily from archival Goddard VLBI data, with redshifts obtained from OCARS) contains 713 proper motions with average uncertainties of 24μas/yr. (5 data files).

  13. The SUPERBLINK catalog of stars with large proper motions, with enhancements from the first GAIA release.

    Science.gov (United States)

    Lepine, Sebastien

    2018-01-01

    The SUPERBLINK survey of stars with proper motion larger than 40 mas/yr is now complete for the entire sky down to magnitude V=20. The SUPERBLINK catalog provides astrometric and photometric data for a little over 2.7 million individual stars, and identifies their counterparts in a variety of large catalogs including ROSAT in the X-ray, GALEX in the ultraviolet, GAIA and SDSS in the optical, and 2MASS and WISE in the infrared. The addition of GAIA data notably yields proper motions to an accuracy of ~2mas/yr for 94% of the entries. Parallaxes with accuracies better than 10% are also now available for about 155,000 of these stars. Besides from identifying local populations of low-mass stars and white dwarfs, the catalog nows begins to map out with some detail the distribution in velocity space of various local stellar populations, including young M dwarfs and old metal-poor M subdwarfs. The catalog also allows one to search for common proper motion pairs, and other kinematic groups like nearby cluster members, moving group members, and local streams. This demonstrates the potential for nearby star research as more complete data becomes available from the GAIA mission.

  14. VizieR Online Data Catalog: Proper motions in M 11 (Su+ 1998)

    Science.gov (United States)

    Su, C.-G.; Zhao, J.-L.; Tian, K.-P.

    1997-07-01

    Relative proper motions of 872 stars in the open cluster M 11 region are reduced using 10 plate pairs taken over time baselines of 16~70 years with the double astrograph telescope of Shanghai Observatory. The scale is 30"/mm. The plates were measured with the PDS machines in the Purple Mountain Observatory in Nanjing and the Institute of Technology and Communication in Luoyang, China. The average proper motion accuracy is about 1.1mas/yr with 85% of the data better than 1mas/yr. Membership probabilities of 785 stars within 25' centred on M 11 are determined based on their proper motions. The method used is suggested by Su et al. (1995AcApS..15..217S) with some improvements of Zhao & He (1990A&A...237...54Z), in which the space distribution and magnitude dependencies for cluster stars are taken into account. The results are significantly good. The total integrated membership probabilities for all these stars is 547 and the number of stars with probabilities higher than 0.7 is 541. It can be found after the membership determination that there exists mass segregation in M 11. Some comparisons and discussion are also given. (1 data file).

  15. Knowledge Sharing, Control of Care Quality, and Innovation in Intensive Care Nursing

    DEFF Research Database (Denmark)

    Paunova, Minna; Li-Ying, Jason; Egerod, Ingrid Eugenie

    This study investigates the influence of nurse knowledge sharing behavior on nurse innovation, given different conditions of control of care quality within the intensive care unit (ICU). After conducting a number of interviews and a pilot study, we carried out a multi-source survey study of more...... control of care quality and innovate may be conflicting, unless handled properly....

  16. Uptake of skilled attendance along the continuum of care in rural Western Kenya: selected analysis from Global Health initiative survey-2012.

    Science.gov (United States)

    Mwangi, Winfred; Gachuno, Onesmus; Desai, Meghna; Obor, David; Were, Vincent; Odhiambo, Frank; Nyaguara, Amek; Laserson, Kayla F

    2018-05-16

    Examining skilled attendance throughout pregnancy, delivery and immediate postnatal period is proxy indicator on the progress towards reduction of maternal and neonatal mortality in developing countries. We conducted a cross-sectional baseline survey of households of mothers with at least 1 child under-5 years in 2012 within the KEMRI/CDC health and demographic surveillance system (HDSS) area in rural western Kenya. Out of 8260 mother-child pairs, data on antenatal care (ANC) in the most recent pregnancy was obtained for 89% (n = 8260); 97% (n = 7387) reported attendance. Data on number of ANC visits was available for 89% (n = 7140); 52% (n = 6335) of mothers reported ≥4 ANC visits. Data on gestation month at first ANC was available for 94% (n = 7140) of mothers; 14% (n = 6690) reported first visit was in1 st trimester (0-12 weeks), 73% in 2nd trimester (14-28 weeks) and remaining 13% in third trimester. Forty nine percent (n = 8259) of mothers delivered in a Health Facility (HF), 48% at home and 3% en route to HF. Forty percent (n = 7140) and 63% (n = 4028) of mothers reporting ANC attendance and HF delivery respectively also reported receiving postnatal care (PNC). About 36% (n = 8259) of mothers reported newborn assessment (NBA). Sixty eight percent (n = 3966) of mothers that delivered at home reported taking newborn for HF check-up, with only 5% (n = 2693) doing so within 48 h of delivery. Being ≤34 years (OR 1.8; 95% CI 1.4-2.4) and at least primary education (OR 5.3; 95% CI 1.8-15.3) were significantly associated with ANC attendance. Being ≤34 years (OR 1.7; 95% CI 1.5-2.0), post-secondary vs primary education (OR 10; 95% CI 4.4-23.4), ANC attendance (OR 4.5; 95% CI 3.2-6.1), completing ≥4 ANC visits (OR 2.0; 95% CI 1.8-2.2), were strongly associated with HF delivery. The continuum of care was such that 97% (n = 7387) mothers reported ANC attendance, 49% reported both ANC and HF delivery

  17. Radial velocities for the HIPPARCOS-Gaia Hundred-Thousand-Proper-Motion project

    Science.gov (United States)

    de Bruijne, J. H. J.; Eilers, A.-C.

    2012-10-01

    Context. The Hundred-Thousand-Proper-Motion (HTPM) project will determine the proper motions of ~113 500 stars using a ~23-year baseline. The proper motions will be based on space-based measurements exclusively, with the Hipparcos data, with epoch 1991.25, as first epoch and with the first intermediate-release Gaia astrometry, with epoch ~2014.5, as second epoch. The expected HTPM proper-motion standard errors are 30-190 μas yr-1, depending on stellar magnitude. Aims: Depending on the astrometric characteristics of an object, in particular its distance and velocity, its radial velocity can have a significant impact on the determination of its proper motion. The impact of this perspective acceleration is largest for fast-moving, nearby stars. Our goal is to determine, for each star in the Hipparcos catalogue, the radial-velocity standard error that is required to guarantee a negligible contribution of perspective acceleration to the HTPM proper-motion precision. Methods: We employ two evaluation criteria, both based on Monte-Carlo simulations, with which we determine which stars need to be spectroscopically (re-)measured. Both criteria take the Hipparcos measurement errors into account. The first criterion, the Gaussian criterion, is applicable to nearby stars. For distant stars, this criterion works but returns overly pessimistic results. We therefore use a second criterion, the robust criterion, which is equivalent to the Gaussian criterion for nearby stars but avoids biases for distant stars and/or objects without literature radial velocity. The robust criterion is hence our prefered choice for all stars, regardless of distance. Results: For each star in the Hipparcos catalogue, we determine the confidence level with which the available radial velocity and its standard error, taken from the XHIP compilation catalogue, are acceptable. We find that for 97 stars, the radial velocities available in the literature are insufficiently precise for a 68.27% confidence

  18. Outcomes in the ultrasound follow-up of the Essure micro-insert: complications and proper placement.

    Science.gov (United States)

    Thiel, John; Suchet, Ian; Tyson, Nerissa; Price, Pamela

    2011-02-01

    To review the use of three-dimensional ultrasound follow-up of the Essure micro-insert placement at three months for the identification of misplaced coils and complications. We conducted a retrospective cohort study of reproductive age women requesting permanent sterilization in a tertiary care ambulatory women's clinic. Women who underwent placement of the Essure micro-insert were assessed for appropriate positioning of the Essure micro-insert coil using three-dimensional ultrasound as well as hysterosalpingography when indicated. A total of 610 women who had undergone the Essure procedure with ultrasound follow-up at three months were retrospectively reviewed and in 524 (86%) the location and shape were both normal. The remaining 86 (15%) required hysterosalpingography to confirm proper placement, 34 because of a non-diagnostic ultrasound and the remaining 52 for a complication noted on ultrasound, including perforation, proximal or distal migration of the device, or device expulsion. Ultrasound can be used at three months after Essure placement to identify normal placement as well as misplaced and perforated devices.

  19. Customer Quality during Prenatal Care in Health Care Centers in Tabriz City

    Directory of Open Access Journals (Sweden)

    Jafar Sadegh Tabrizi

    2015-07-01

    Full Text Available Background and Objectives :  Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods :  This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire.  Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79   and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion :  The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful. ​

  20. Hepatitis B vaccination coverage and the determinants of vaccination among health care workers in selected health facilities in Lusaka district, Zambia: an exploratory study.

    Science.gov (United States)

    Mungandi, Namwaka; Makasa, Mpundu; Musonda, Patrick

    2017-01-01

    Hepatitis B is a viral infection of the liver and causes both acute and chronic disease. It is transmitted through contact with an infected person's bodily fluids. It is an occupational hazard for healthcare workers and can be prevented by the administration of a vaccine. It is recommended that healthcare workers be vaccinated against vaccine preventable diseases including hepatitis B. The study objective was to determine the prevalence and determinants of hepatitis B vaccination among healthcare workers in selected health facilities in Lusaka. The study took place in seven health facilities across Lusaka district in Zambia. A total sample size of 331 healthcare workers was selected of which; 90 were nurses, 88 were doctors, 86 were laboratory personnel and 67 were general workers. A self-administered structured questionnaire was given to a total of 331 healthcare workers. Investigator led stepwise approach was used to select the best predictor variables in a multiple logistic regression model and all analyses were performed using STATA software, version 12.1 SE (Stata Corporation, College Station, TX, USA). Only 64(19.3%) of the healthcare workers were vaccinated against hepatitis B, with 35 (54.7%) of these being fully vaccinated and 29 (45.3%) partially vaccinated. Analysis showed that; age of the healthcare worker, sharp injuries per year and training in infection control were the variables that were statistically significant in predicting a healthcare worker's vaccination status. It is reassuring to learn that healthcare workers have knowledge regarding hepatitis B and the vaccine and are willing to be vaccinated against it. Health institutions should bear the cost for vaccinating staff and efforts should be made for appropriate health education regarding hepatitis B infection and its prevention. Establishment of policies on compulsory hepatitis B vaccination for healthcare workers in Zambia is recommended.

  1. When Things Don’t Look Right: What Appear to be Proper Motion Discrepancies in the WDS

    Science.gov (United States)

    Harshaw, Richard

    2017-10-01

    Proper motion data for double stars are included for most of the records in the Washington Double Star Catalog (WDS). In many cases, the proper motion data agree well with the observed changes in the system over time. But in other cases, the proper motion data do not align well with the observations. It is therefore incumbent on the double star researcher to treat any research based on proper motions with caution to be sure that wrong conclusions are not drawn. Possible reasons for such discrepancies are explored.

  2. A method for determining the radius of an open cluster from stellar proper motions

    Science.gov (United States)

    Sánchez, Néstor; Alfaro, Emilio J.; López-Martínez, Fátima

    2018-04-01

    We propose a method for calculating the radius of an open cluster in an objective way from an astrometric catalogue containing, at least, positions and proper motions. It uses the minimum spanning tree in the proper motion space to discriminate cluster stars from field stars and it quantifies the strength of the cluster-field separation by means of a statistical parameter defined for the first time in this paper. This is done for a range of different sampling radii from where the cluster radius is obtained as the size at which the best cluster-field separation is achieved. The novelty of this strategy is that the cluster radius is obtained independently of how its stars are spatially distributed. We test the reliability and robustness of the method with both simulated and real data from a well-studied open cluster (NGC 188), and apply it to UCAC4 data for five other open clusters with different catalogued radius values. NGC 188, NGC 1647, NGC 6603, and Ruprecht 155 yielded unambiguous radius values of 15.2 ± 1.8, 29.4 ± 3.4, 4.2 ± 1.7, and 7.0 ± 0.3 arcmin, respectively. ASCC 19 and Collinder 471 showed more than one possible solution, but it is not possible to know whether this is due to the involved uncertainties or due to the presence of complex patterns in their proper motion distributions, something that could be inherent to the physical object or due to the way in which the catalogue was sampled.

  3. Proper Motions of Dwarf Spheroidal Galaxies from Hubble Space Telescope Imaging. IV. Measurement for Sculptor

    Science.gov (United States)

    Piatek, Slawomir; Pryor, Carlton; Bristow, Paul; Olszewski, Edward W.; Harris, Hugh C.; Mateo, Mario; Minniti, Dante; Tinney, Christopher G.

    2006-03-01

    This article presents a measurement of the proper motion of the Sculptor dwarf spheroidal galaxy determined from images taken with the Hubble Space Telescope using the Space Telescope Imaging Spectrograph in the imaging mode. Each of two distinct fields contains a quasi-stellar object that serves as the ``reference point.'' The measured proper motion of Sculptor, expressed in the equatorial coordinate system, is (μα, μδ)=(9+/-13, 2+/-13) mas century-1. Removing the contributions from the motion of the Sun and the motion of the local standard of rest produces the proper motion in the Galactic rest frame: (μGrfα, μGrfδ)=(-23+/-13, 45+/-13) mas century-1. The implied space velocity with respect to the Galactic center has a radial component of Vr=79+/-6 km s-1 and a tangential component of Vt=198+/-50 km s-1. Integrating the motion of Sculptor in a realistic potential for the Milky Way produces orbital elements. The perigalacticon and apogalacticon are 68 (31, 83) and 122 (97, 313) kpc, respectively, where the values in the parentheses represent the 95% confidence interval derived from Monte Carlo experiments. The eccentricity of the orbit is 0.29 (0.26, 0.60), and the orbital period is 2.2 (1.5, 4.9) Gyr. Sculptor is on a polar orbit around the Milky Way: the angle of inclination is 86° (83°, 90°). Based on observations with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS5-26555.

  4. Activity and Kinematics of White Dwarf-M Dwarf Binaries from the SUPERBLINK Proper Motion Survey

    Science.gov (United States)

    Skinner, Julie N.; Morgan, Dylan P.; West, Andrew A.; Lépine, Sébastien; Thorstensen, John R.

    2017-09-01

    We present an activity and kinematic analysis of high proper motion white dwarf-M dwarf binaries (WD+dMs) found in the SUPERBLINK survey, 178 of which are new identifications. To identify WD+dMs, we developed a UV-optical-IR color criterion and conducted a spectroscopic survey to confirm each candidate binary. For the newly identified systems, we fit the two components using model white dwarf spectra and M dwarf template spectra to determine physical parameters. We use Hα chromospheric emission to examine the magnetic activity of the M dwarf in each system, and investigate how its activity is affected by the presence of a white dwarf companion. We find that the fraction of WD+dM binaries with active M dwarfs is significantly higher than their single M dwarf counterparts at early and mid-spectral types. We corroborate previous studies that find high activity fractions at both close and intermediate separations. At more distant separations, the binary fraction appears to approach the activity fraction for single M dwarfs. Using derived radial velocities and the proper motions, we calculate 3D space velocities for the WD+dMs in SUPERBLINK. For the entire SUPERBLINK WD+dMs, we find a large vertical velocity dispersion, indicating a dynamically hotter population compared to high proper motion samples of single M dwarfs. We compare the kinematics for systems with active M dwarfs and those with inactive M dwarfs, and find signatures of asymmetric drift in the inactive sample, indicating that they are drawn from an older population. Based on observations obtained at the MDM Observatory operated by Dartmouth College, Columbia University, The Ohio State University, and the University of Michigan.

  5. A SEARCH FOR HIGH PROPER MOTION T DWARFS WITH Pan-STARRS1 + 2MASS + WISE

    International Nuclear Information System (INIS)

    Liu, Michael C.; Deacon, Niall R.; Magnier, Eugene A.; Aller, Kimberly M.; Bowler, Brendan P.; Burgett, W. S.; Chambers, K. C.; Hodapp, K. W.; Kaiser, N.; Kudritzki, R.-P.; Morgan, J. S.; Tonry, J. L.; Wainscoat, R. J.; Dupuy, Trent J.; Redstone, Joshua; Goldman, Bertrand; Price, P. A.

    2011-01-01

    We have searched ∼8200 deg 2 for high proper motion (∼0.''5-2.''7 year -1 ) T dwarfs by combining first-epoch data from the Pan-STARRS1 (PS1) 3π Survey, the Two Micron All Sky Survey (2MASS) All-Sky Point Source Catalog, and the WISE Preliminary Data Release. We identified two high proper motion objects with the very red (W1 - W2) colors characteristic of T dwarfs, one being the known T7.5 dwarf GJ 570D. Near-IR spectroscopy of the other object (PSO J043.5395+02.3995 ≡ WISEP J025409.45+022359.1) reveals a spectral type of T8, leading to a photometric distance of 7.2 ± 0.7 pc. The 2.''56 year -1 proper motion of PSO J043.5+02 is the second highest among field T dwarfs, corresponding to a tangential velocity of 87 ± 8 km s -1 . According to the Besancon galaxy model, this velocity indicates that its galactic membership is probably in the thin disk, with the thick disk an unlikely possibility. Such membership is in accord with the near-IR spectrum, which points to a surface gravity (age) and metallicity typical of the field population. We combine 2MASS, Sloan Digital Sky Survey, WISE, and PS1 astrometry to derive a preliminary parallax of 171 ± 45 mas (5.8 +2.0 -1.2 pc), the first such measurement using PS1 data. The proximity and brightness of PSO J043.5+02 will facilitate future characterization of its atmosphere, variability, multiplicity, distance, and kinematics. The modest number of candidates from our search suggests that the immediate (∼10 pc) solar neighborhood does not contain a large reservoir of undiscovered T dwarfs earlier than about T8.

  6. MERLIN observations of water maser proper motions in VY Canis Majoris

    Science.gov (United States)

    Richards, A. M. S.; Yates, J. A.; Cohen, R. J.

    1998-09-01

    MERLIN observations of the 22-GHz water masers in the circumstellar envelope of the supergiant VY CMa show an ellipsoidal distribution with a maximum extent of 700 mas east-west and 400 mas north-south. Comparison with observations made nine years earlier shows that the majority of maser features have survived and show proper motions throughout the region. The mean change in position is 28 mas and the proper motions are generally directed away from the assumed stellar position, and tend to be larger for features at greater projected distances. If the H_2O maser region is modelled as a partially filled thick spherical shell, and VY CMa is at a distance of 1.5 kpc, then the proper motion velocities in the direction of expansion are between 8kms^-1 at a distance of 75 mas from the assumed stellar position and 32kms^-1 at 360 mas. These velocities are consistent with the H_2O maser spectral line velocities which correspond to a maximum expansion velocity of 36kms^-1 at 400 mas from the assumed stellar position. These observations are consistent with radiation pressure on dust providing the force to accelerate the stellar wind as it passes through the H_2O maser shell. The H_2O maser region is elongated in the same direction as the dusty nebula around VY CMa. The water masers illuminate the small-scale dynamics and clumpiness which show the role of dust in driving the outflow. The overall ellipsoidal shape may be due to properties of the dust, such as its behaviour in the stellar magnetic field, or to interaction between the wind and circumstellar material. Maser monitoring also shows the difference between changes on the time-scale of stellar variability (a few years) and possible stages in the evolution of VY CMa to its likely fate as a supernova.

  7. Activity and Kinematics of White Dwarf-M Dwarf Binaries from the SUPERBLINK Proper Motion Survey

    Energy Technology Data Exchange (ETDEWEB)

    Skinner, Julie N. [Institute for Astrophysical Research, Boston University, 725 Commonwealth Avenue, Boston, MA 02215 (United States); Morgan, Dylan P.; West, Andrew A. [Department of Astronomy, Boston University, 725 Commonwealth Avenue, Boston, MA 02215 (United States); Lépine, Sébastien [Department of Physics and Astronomy, Georgia State University, 25 Park Place NE, Atlanta, GA, 30303 (United States); Thorstensen, John R., E-mail: jskinner@bu.edu [Department of Physics and Astronomy, 6127 Wilder Laboratory, Dartmouth College, Hanover, NH 03755 (United States)

    2017-09-01

    We present an activity and kinematic analysis of high proper motion white dwarf-M dwarf binaries (WD+dMs) found in the SUPERBLINK survey, 178 of which are new identifications. To identify WD+dMs, we developed a UV–optical–IR color criterion and conducted a spectroscopic survey to confirm each candidate binary. For the newly identified systems, we fit the two components using model white dwarf spectra and M dwarf template spectra to determine physical parameters. We use H α chromospheric emission to examine the magnetic activity of the M dwarf in each system, and investigate how its activity is affected by the presence of a white dwarf companion. We find that the fraction of WD+dM binaries with active M dwarfs is significantly higher than their single M dwarf counterparts at early and mid-spectral types. We corroborate previous studies that find high activity fractions at both close and intermediate separations. At more distant separations, the binary fraction appears to approach the activity fraction for single M dwarfs. Using derived radial velocities and the proper motions, we calculate 3D space velocities for the WD+dMs in SUPERBLINK. For the entire SUPERBLINK WD+dMs, we find a large vertical velocity dispersion, indicating a dynamically hotter population compared to high proper motion samples of single M dwarfs. We compare the kinematics for systems with active M dwarfs and those with inactive M dwarfs, and find signatures of asymmetric drift in the inactive sample, indicating that they are drawn from an older population.

  8. Activity and Kinematics of White Dwarf-M Dwarf Binaries from the SUPERBLINK Proper Motion Survey

    International Nuclear Information System (INIS)

    Skinner, Julie N.; Morgan, Dylan P.; West, Andrew A.; Lépine, Sébastien; Thorstensen, John R.

    2017-01-01

    We present an activity and kinematic analysis of high proper motion white dwarf-M dwarf binaries (WD+dMs) found in the SUPERBLINK survey, 178 of which are new identifications. To identify WD+dMs, we developed a UV–optical–IR color criterion and conducted a spectroscopic survey to confirm each candidate binary. For the newly identified systems, we fit the two components using model white dwarf spectra and M dwarf template spectra to determine physical parameters. We use H α chromospheric emission to examine the magnetic activity of the M dwarf in each system, and investigate how its activity is affected by the presence of a white dwarf companion. We find that the fraction of WD+dM binaries with active M dwarfs is significantly higher than their single M dwarf counterparts at early and mid-spectral types. We corroborate previous studies that find high activity fractions at both close and intermediate separations. At more distant separations, the binary fraction appears to approach the activity fraction for single M dwarfs. Using derived radial velocities and the proper motions, we calculate 3D space velocities for the WD+dMs in SUPERBLINK. For the entire SUPERBLINK WD+dMs, we find a large vertical velocity dispersion, indicating a dynamically hotter population compared to high proper motion samples of single M dwarfs. We compare the kinematics for systems with active M dwarfs and those with inactive M dwarfs, and find signatures of asymmetric drift in the inactive sample, indicating that they are drawn from an older population.

  9. The role of proper treatment of maxillary sinusitis in the healing of persistent oroantral fistula

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2008-09-01

    Full Text Available Background: Oroantral communication (OAC is one of the possible complications after extraction of the upper teeth. If not identified and treated properly, a large OAC may develop into oroantral fistula (OAF which means that there is a permanent epithelium-lined communication between antrum and oral cavity. Such fistulas may cause ingress of microorganism from oral cavity into the antrum leading to maxillary sinusitis. Oroantral fistula usually persists if the infection in the maxillary antrum is not eliminated. Therefore, treatment of oroantral fistula should include management of maxillary sinusitis in which surgical closure of oroantral fistula should be done only when the sinusitis has been cured. Purpose: This case report emphasizes on the importance of proper management of maxillary sinusitis in the healing of oroantral fistula. Case: A case of an oroantral fistula following removal of upper left third molar is presented. As the maxillary sinusitis was not identified pre-operatively, two surgical procedures to close the fistula had ended up in dehiscence. Case management: The diagnosis of maxillary sinusitis was finally made and the sinusitis subsequently treated with combination of trans-alveolar sinus wash out, insertion of an acrylic splint, and two series of nasal and sinus physiotherapy procedures. The size of the defect decreased gradually during the treatment of the sinusitis and finally closed up without any further surgical intervention. Conclusion: This case report points out that it is important to detect intraoperatively an antral perforation after any surgery of the maxillary teeth and to close any oroantral communication as early as possible and that it is important to treat properly any pre-existing maxillary sinusitis before any surgical method is done to close the fistula.

  10. Ultra-preconcentration and determination of selected pharmaceutical and personal care products in different water matrices by solid-phase extraction combined with dispersive liquid-liquid microextraction prior to ultra high pressure liquid chromatography tandem mass spectrometry analysis.

    Science.gov (United States)

    Celano, Rita; Piccinelli, Anna Lisa; Campone, Luca; Rastrelli, Luca

    2014-08-15

    Pharmaceutical and personal care products (PPCPs) are one of the most important classes of emerging contaminants. The potential of ecological and environmental impacts associated with PPCPs are of particular concern because they continually penetrate the aquatic environment. This work describes a novel ultra-preconcentration technique for the rapid and highly sensitive analysis of selected PPCPs in environmental water matrices at ppt levels. Selected PPCPs were rapidly extracted and concentrated from large volumes of aqueous solutions (500 and 250mL) by solid-phase extraction combined with dispersive liquid-liquid microextraction (SPE-DLLME) and then analyzed using UHPLC-MS/MS. Experimental parameters were carefully investigated and optimized to achieve the best SPE-DLLME efficiency and higher enrichment factors. The best results were obtained using the ternary mixture acetonitrile/methanol/dichloromethane 3:3:4, v/v/v, both as SPE eluent and DLLME extractant/dispersive mixture. DLLME aqueous solution (5% NaCl, 10mgL(-1) TBAB) was also modified to improve the extraction efficiency of more hydrophilic PPCPs. Under the optimal conditions, an exhaustive extraction for most of the investigated analytes (recoveries >70%), with a precision (RSD drinking, sea, river and wastewater). Method detection and quantification limits were at very low ppt levels and below 1 and 3ngL(-1), respectively, for 15 of selected PPCPs. The proposed analytical procedure offers numerous advantages such as the simplicity of operation, rapidity, a high enrichment factor and sensitivity. So it is suitable for monitoring and studies of occurrence of PPCPs in different environmental compartments. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Proper knowledge about the growing fat; Himan ni kansuru tadashii chishiki

    Energy Technology Data Exchange (ETDEWEB)

    Sakamot, Yoichi

    1999-07-01

    Body fat is substituted for the energy adopted redundantly in the inside of the body, and the deep diabetes which relates to the increase in the fat person and this, high blood pressure, high fat blood diseases, ventilation and so-called life habit sicknesses such as an arteriosclerosis disease have been increasing. It thinks with growing fat when it wants it understood why it grows fat as to something as to that fearfulness about growing fat properly. The health making based on the individual and the weight control can't be missed to get the rich old age, which it lives through the middle age. (NEDO)

  12. On the determination of proper modes in waveguides with wall losses

    International Nuclear Information System (INIS)

    Dahlberg, E.

    1977-02-01

    Various attempts at determining the proper modes (propagating with exponential attenuation but without change of form) in a straight waveguide with wall losses are discussed. It appears that for a general cross section a stringent treatment would require a quadruple series expansion along lines indicated by C.C. Johnson in 'Field and wave electrodynamics (McGraw-Hill, 1965). For the most usual cross sections, circular and rectangular, valid derivations can however be made using simpler means. Earlier, incomplete, treatments seem to have caused several widely accepted misconceptions, some of which are discussed. Detailed calculations for a rectangular guide are given in a companion note

  13. Geometry and dynamics in Gromov hyperbolic metric spaces with an emphasis on non-proper settings

    CERN Document Server

    Das, Tushar; Urbański, Mariusz

    2016-01-01

    This book presents the foundations of the theory of groups and semigroups acting isometrically on Gromov hyperbolic metric spaces. Particular emphasis is paid to the geometry of their limit sets and on behavior not found in the proper setting. The authors provide a number of examples of groups which exhibit a wide range of phenomena not to be found in the finite-dimensional theory. The book contains both introductory material to help beginners as well as new research results, and closes with a list of attractive unsolved problems.

  14. Proper names in the satirical writing 'An ugly dream' by D. M. Forski

    Directory of Open Access Journals (Sweden)

    Lilić Dragan V.

    2014-01-01

    Full Text Available In the satirical paper 'A Bad Dream', proper names form a significant lexical layer which contributes significantly to achieving a grotesque and satirical portrayal of the everyday reality of the milieu the writer describes in a humorous and sardonic way, condemning his negative and ugly sides. Transforming real names, the author builds very expressive units that become carriers of various meanings. The transformation is accomplished by the procedures of substitutional, permutational, restrictive and proscriptive metaplasm. The writer's creative approach - 'a game of names' - has a indubitable impact in modeling his artistic world.

  15. Combined time-varying forecast based on the proper scoring approach for wind power generation

    DEFF Research Database (Denmark)

    Chen, Xingying; Jiang, Yu; Yu, Kun

    2017-01-01

    Compared with traditional point forecasts, combined forecast have been proposed as an effective method to provide more accurate forecasts than individual model. However, the literature and research focus on wind-power combined forecasts are relatively limited. Here, based on forecasting error...... distribution, a proper scoring approach is applied to combine plausible models to form an overall time-varying model for the next day forecasts, rather than weights-based combination. To validate the effectiveness of the proposed method, real data of 3 years were used for testing. Simulation results...... demonstrate that the proposed method improves the accuracy of overall forecasts, even compared with a numerical weather prediction....

  16. GENDERED DOLLARS: Pin Money, Mad Money, and Changing Notions of a Woman’s Proper Place

    Directory of Open Access Journals (Sweden)

    Janice Traflet

    2008-01-01

    Full Text Available This essay examines the evolution in the meaning and usage of two types of special currencies: pin money and mad money. At the start of the twentieth century, both currencies were considered a woman’s money. By the end of the century, however, both pin money and mad money had lost a large measure of their original gendered connotations. By situating the evolving meanings of these currencies alongside concepts of domesticity, virtuous womanhood, and a woman’s proper place, this essay strives to illuminate the rise and fall of pin money and mad money as uniquely “women’s dollars." 

  17. GENDERED DOLLARS: Pin Money, Mad Money, and Changing Notions of a Woman’s Proper Place

    OpenAIRE

    Janice Traflet

    2008-01-01

    This essay examines the evolution in the meaning and usage of two types of special currencies: pin money and mad money. At the start of the twentieth century, both currencies were considered a woman’s money. By the end of the century, however, both pin money and mad money had lost a large measure of their original gendered connotations. By situating the evolving meanings of these currencies alongside concepts of domesticity, virtuous womanhood, and a woman’s proper place, this essay strives t...

  18. Modeling multipulsing transition in ring cavity lasers with proper orthogonal decomposition

    International Nuclear Information System (INIS)

    Ding, Edwin; Shlizerman, Eli; Kutz, J. Nathan

    2010-01-01

    A low-dimensional model is constructed via the proper orthogonal decomposition (POD) to characterize the multipulsing phenomenon in a ring cavity laser mode locked by a saturable absorber. The onset of the multipulsing transition is characterized by an oscillatory state (created by a Hopf bifurcation) that is then itself destabilized to a double-pulse configuration (by a fold bifurcation). A four-mode POD analysis, which uses the principal components, or singular value decomposition modes, of the mode-locked laser, provides a simple analytic framework for a complete characterization of the entire transition process and its associated bifurcations. These findings are in good agreement with the full governing equation.

  19. Perspectives on barriers and facilitators to self-care in Lebanese cardiac patients: A qualitative descriptive study.

    Science.gov (United States)

    Dumit, Nuhad Yazbik; Noureddine, Samar Nayef; Magilvy, Joan Kathy

    2016-08-01

    Cardiovascular disease is the leading cause of mortality worldwide. Cardiac self-care practices are essential for managing cardiac illness and improving quality of life. However, these practices may be affected by factors that may hinder or facilitate self-care especially in countries that experience political and economic instabilities. The purpose of this study was to explore self-care practices among Lebanese cardiac patients. Another aim was to reveal factors that might influence these self-care practices. This is a qualitative descriptive study. Participants were recruited from a referral medical center in Beirut, Lebanon and interviews took place in their homes. Purposive sample of 15 adult participants, seven females and eight males, diagnosed with coronary artery disease at least a year ago and not in critical condition recruited from the cardiology clinics of the medical center. Data were collected through semi-structured audio-recorded interviews that took place in their places of residents. Three themes emerged from the data: I. The behaviors of cardiac patients demonstrated selected self-care practices; II. Patients identified barriers to self-care reflective of the Lebanese political and socio-economic situation; and, III. Patients described facilitators to self-care consistent with the Lebanese socio-cultural values and norms. The most common self-care practices included taking medications and eating properly. Participants emphasized avoiding stress and being upset as a self-protective measure for cardiac health. Health care costs, family responsibilities, psychological factors and the country's political situation impeded self-care practices whereas family support facilitated them. Lebanese patients reported select self-care practices in dealing with their cardiac illness. Barriers and facilitators to their self-care behaviors reflected the Lebanese context and culture. Thus health care providers must assess their patients' practices within their

  20. Investigation of the Knowledge and Skill of Proper Consumption of Fruit and Vegetables among Shahrekord Adolescent Girls

    Directory of Open Access Journals (Sweden)

    Ali Ramezankhani

    2016-10-01

    Full Text Available Background: The life style is formed and stabilized in adolescence. Since consumption of fruits and vegetables may affect the risk of chronic diseases, their low consumption during adolescence is very important. Knowledge and skill is considered as one of the main determinants of this behavior. This study aimed to investigate the Knowledge and skill of proper consumption of fruit and vegetables among adolescent girls in Shahrekord, Iran. Materials and Methods: This study was a descriptive-analytic investigation conducted on high school girls in Shahrekord city during 2013 to 2014. 308 female students were selected randomly from 8 high schools and a researcher made questionnaire was used to collect the demographic, Knowledge and skill related data. Validity and reliability of the questionnaire was evaluated by internal consistency method (Cronbach's alpha = 0.70, Cronbach's alpha= 0.76, respectively. The collected data was analyzed by SPSS-21 software. Results: The mean age of students was 13.86 ± 1.3 years. There was no statistically significant association between consumption of fruit and vegetables and fathers’ education level, mothers’ job and parents’ age. However, there was a significant association between fathers’ job and adolescents’ skill of fruit and vegetables consumption (P< 0.05. In addition, a significant association between mothers’ education level and adolescents’ knowledge and skill of fruit and vegetables consumption was observed (P

  1. Characterization of the Praesepe star cluster by photometry and proper motions with 2MASS, PPMXL, and Pan-STARRS

    Energy Technology Data Exchange (ETDEWEB)

    Wang, P. F.; Chen, W. P. [Department of Physics, National Central University, 300 Jhongda Road, Jhongli 32001, Taiwan (China); Lin, C. C.; Huang, C. K.; Panwar, N.; Lee, C. H. [Graduate Institute of Astronomy, National Central University, 300 Jhongda Road, Jhongli 32001, Taiwan (China); Pandey, A. K. [Aryabhatta Research Institute of Observational Sciences, Manora Peak, Nainital 263129 (India); Tsai, M. F.; Tang, C.-H. [Department of Computer Science and Information Engineering, National Central University, 300 Jhongda Road, Jhongli 32001, Taiwan (China); Goldman, B. [Max-Planck-Institut für Astronomie, Königstuhl 17, D-69117 Heidelberg (Germany); Burgett, W. S.; Chambers, K. C.; Flewelling, H.; Heasley, J. N.; Hodapp, K. W.; Huber, M. E.; Jedicke, R.; Kaiser, N. [Institute for Astronomy, University of Hawai' i, 2680 Woodlawn Drive, Honolulu, HI 96822 (United States); Draper, P. W. [Department of Physics, Durham University, South Road, Durham DH1 3LE (United Kingdom); Grav, T. [Department of Physics and Astronomy, Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218 (United States); and others

    2014-03-20

    Membership identification is the first step in determining the properties of a star cluster. Low-mass members in particular could be used to trace the dynamical history, such as mass segregation, stellar evaporation, or tidal stripping, of a star cluster in its Galactic environment. We identified member candidates of the intermediate-age Praesepe cluster (M44) with stellar masses ∼0.11-2.4 M {sub ☉}, using Panoramic Survey Telescope And Rapid Response System and Two Micron All Sky Survey photometry, and PPMXL proper motions. Within a sky area of 3° radius, 1040 candidates are identified, of which 96 are new inclusions. Using the same set of selection criteria on field stars, an estimated false positive rate of 16% was determined, suggesting that 872 of the candidates are true members. This most complete and reliable membership list allows us to favor the BT-Settl model over other stellar models. The cluster shows a distinct binary track above the main sequence, with a binary frequency of 20%-40%, and a high occurrence rate of similar mass pairs. The mass function is consistent with that of the disk population but shows a deficit of members below 0.3 solar masses. A clear mass segregation is evidenced, with the lowest-mass members in our sample being evaporated from this disintegrating cluster.

  2. Proper orthogonal decomposition analysis of scanning laser Doppler vibrometer measurements of plaster status at the U.S. Capitol

    Science.gov (United States)

    Vignola, Joseph F.; Bucaro, Joseph A.; Tressler, James F.; Ellingston, Damon; Kurdila, Andrew J.; Adams, George; Marchetti, Barbara; Agnani, Alexia; Esposito, Enrico; Tomasini, Enrico P.

    2004-06-01

    A large-scale survey (~700 m2) of frescos and wall paintings was undertaken in the U.S. Capitol Building in Washington, D.C. to identify regions that may need structural repair due to detachment, delamination, or other defects. The survey encompassed eight pre-selected spaces including: Brumidi's first work at the Capitol building in the House Appropriations Committee room; the Parliamentarian's office; the House Speaker's office; the Senate Reception room; the President's Room; and three areas of the Brumidi Corridors. Roughly 60% of the area surveyed was domed or vaulted ceilings, the rest being walls. Approximately 250 scans were done ranging in size from 1 to 4 m2. The typical mesh density was 400 scan points per square meter. A common approach for post-processing time series called Proper Orthogonal Decomposition, or POD, was adapted to frequency-domain data in order to extract the essential features of the structure. We present a POD analysis for one of these panels, pinpointing regions that have experienced severe substructural degradation.

  3. Altered Escherichia coli membrane protein assembly machinery allows proper membrane assembly of eukaryotic protein vitamin K epoxide reductase.

    Science.gov (United States)

    Hatahet, Feras; Blazyk, Jessica L; Martineau, Eugenie; Mandela, Eric; Zhao, Yongxin; Campbell, Robert E; Beckwith, Jonathan; Boyd, Dana

    2015-12-08

    Functional overexpression of polytopic membrane proteins, particularly when in a foreign host, is often a challenging task. Factors that negatively affect such processes are poorly understood. Using the mammalian membrane protein vitamin K epoxide reductase (VKORc1) as a reporter, we describe a genetic selection approach allowing the isolation of Escherichia coli mutants capable of functionally expressing this blood-coagulation enzyme. The isolated mutants map to components of membrane protein assembly and quality control proteins YidC and HslV. We show that changes in the VKORc1 sequence and in the YidC hydrophilic groove along with the inactivation of HslV promote VKORc1 activity and dramatically increase its expression level. We hypothesize that such changes correct for mismatches in the membrane topogenic signals between E. coli and eukaryotic cells guiding proper membrane integration. Furthermore, the obtained mutants allow the study of VKORc1 reaction mechanisms, inhibition by warfarin, and the high-throughput screening for potential anticoagulants.

  4. The visual difficulties of selected artists and limitations of ophthalmological care during the 19th and early 20th centuries (an AOS thesis).

    Science.gov (United States)

    Ravin, James G

    2008-01-01

    To investigate the effects of eye diseases on several important artists who have been given little attention from a medical-historical viewpoint. The examples chosen demonstrate problems artists have had to face from different types of eye disease, including cataract, glaucoma, and retinal diseases. The ophthalmological care provided is described in terms of scientific knowledge at the time. Investigation of primary and secondary source material. Discussion with art historians and ophthalmic historians. Examination of work by the artists. Artists can be markedly affected by ocular diseases that change their ability to see the world. The individuals described here worked during the 19th century and first half of the 20th century. Homer Martin suffered from cataracts, and his works reveal changes in details and color as he aged. Henri Harpignies, who had an extremely long career, undoubtedly had cataracts and may also have had macular degeneration. Angle-closure glaucoma blinded Jules Chéret. Auguste Ravier suffered from neovascular glaucoma in one eye and was able to work with his remaining eye, which developed a cataract. Louis Valtat suffered from what was in all likelihood open-angle glaucoma, but specific changes due to this disease are not apparent in his work. Roger Bissière developed glaucoma and did well following filtration surgery. George Du Maurier lost one eye from what was probably a retinal detachment and later suffered from a central retinal problem in the other eye. Diseases of the eye may profoundly influence artists by altering their perception of the world. The specific effects may vary, depending on the disease, its severity, and the psychology of the artist. Cataracts typically affect an artist's ability to depict color and detail. The effect of glaucoma generally depends on whether central vision is preserved. Disease that affects the center of the retina has a substantial effect on an artist's ability to depict fine details. Ophthalmological

  5. Identifications and limited spectroscopy for Luyten common proper motion stars with probable white dwarf components. I - Pair brighter than 17th magnitude

    Science.gov (United States)

    Oswalt, Terry D.; Hintzen, Paul M.; Luyten, Willem J.

    1988-01-01

    Identifications are provided for 103 bright Luyten common proper motion (CPM) stellar systems with m(pg) less than 17.0 mag containing likely white dwarf (WD) components. New spectral types are presented for 55 components, and spectral types for 51 more are available in the literature. With the CPM systems previously published by Giclas et al. (1978), the Luyten stars provide a uniform sample of nearly 200 pairs or multiples brighter than 17h magnitude. Selection effects biasing the combined samples are discussed; in particular, evidence is presented that fewer than 1 percent of wide WD binaries have been detected.

  6. Prenatal Care: First Trimester Visits

    Science.gov (United States)

    ... care provider will discuss the importance of proper nutrition and prenatal vitamins. Your first prenatal visit is a good time to discuss exercise, sex during pregnancy and other lifestyle issues. You might also discuss your work environment and the use of medications during pregnancy. If ...

  7. Taking Care After A Concussion

    Centers for Disease Control (CDC) Podcasts

    2010-03-17

    This podcast describes how to take care of yourself after a concussion, including proper recognition and response recommendations.  Created: 3/17/2010 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/17/2010.

  8. Maintaining the proper connection between the centrioles and the pericentriolar matrix requires Drosophila centrosomin.

    Science.gov (United States)

    Lucas, Eliana P; Raff, Jordan W

    2007-08-27

    Centrosomes consist of two centrioles surrounded by an amorphous pericentriolar matrix (PCM), but it is unknown how centrioles and PCM are connected. We show that the centrioles in Drosophila embryos that lack the centrosomal protein Centrosomin (Cnn) can recruit PCM components but cannot maintain a proper attachment to the PCM. As a result, the centrioles "rocket" around in the embryo and often lose their connection to the nucleus in interphase and to the spindle poles in mitosis. This leads to severe mitotic defects in embryos and to errors in centriole segregation in somatic cells. The Cnn-related protein CDK5RAP2 is linked to microcephaly in humans, but cnn mutant brains are of normal size, and we observe only subtle defects in the asymmetric divisions of mutant neuroblasts. We conclude that Cnn maintains the proper connection between the centrioles and the PCM; this connection is required for accurate centriole segregation in somatic cells but is not essential for the asymmetric division of neuroblasts.

  9. Catalogue of Positions and Proper Motions of Stars in the Vicinity of Open Clusters

    Directory of Open Access Journals (Sweden)

    Protsyuk, Yu.I.

    2017-01-01

    Full Text Available In the Research Institute Mykolaiv Astronomical Observatory (MAO the catalogue of position and proper motions of stars in the 544 square areas of nearly (1×1°around the Galactic open clusters was created using photographic and CCD observations. 293 plates of (5×5°obtained with the MAO Zonal Astrograph (D=116 mm, F=2040 mm in 1962-1993 and more than 20 thousands CCD frames (0.7×0.7° obtained with KT-50 telescope (D=500 mm, F=3000 mm in 2011-2015 were used. Almost 270 thousands FITS files from the IVOA image archives with observational epoch from 1953 to 2010 were downloaded and processed. The created catalogue contains more than 2.3 million stars (7.5-18.5m in the ICRS system with the accuracy of positions on both coordinates ranged from 0.02" to 0.05". Inner accuracy of proper motions is ~0.004"/year.

  10. Catalogue of positions and proper motions of stars in the vicinity of open clusters

    Science.gov (United States)

    Protsyuk, Yu. I.; Kovalchuk, O. M.; Mazhaev, O. E.

    2017-02-01

    A catalog of positions and proper motions of stars in 544 square areas of nearly (1 × 1)° around the Galactic open clusters has been created using photographic and CCD observations, at Research Institute "Mykolaiv Astronomical Observatory" (RI "MAO"). To this end, 293 plates of (5 × 5)° obtained with the MAO Zonal Astrograph (D=116 mm, F=2040 mm) in 1962-1993 and more than 20 thousand CCD frames (0.7 × 0.7)° obtained with KT-50 telescope (D=500 mm, F=3000 mm) in 2011-2015 have been used. Almost 270 thousand FITS files from the IVOA image archives with observational epoch from 1953 to 2010 have been downloaded and processed. The created catalogue contains more than 2.3 million stars having a magnitude of (7.5-18.5)m in the ICRS system, with accuracy of positions for both coordinates ranging from 0.02" to 0.05". Internal accuracy of proper motions is estimated as ~0.004"/year.

  11. A framework provided an outline toward the proper evaluation of potential screening strategies.

    Science.gov (United States)

    Adriaensen, Wim J; Matheï, Cathy; Buntinx, Frank J; Arbyn, Marc

    2013-06-01

    Screening tests are often introduced into clinical practice without proper evaluation, despite the increasing awareness that screening is a double-edged sword that can lead to either net benefits or harms. Our objective was to develop a comprehensive framework for the evaluation of new screening strategies. Elaborating on the existing concepts proposed by experts, a stepwise framework is proposed to evaluate whether a potential screening test can be introduced as a screening strategy into clinical practice. The principle of screening strategy evaluation is illustrated for cervical cancer, which is a template for screening because of the existence of an easily detectable and treatable precursor lesion. The evaluation procedure consists of six consecutive steps. In steps 1-4, the technical accuracy, place of the test in the screening pathway, diagnostic accuracy, and longitudinal sensitivity and specificity of the screening test are assessed. In steps 5 and 6, the impact of the screening strategy on the patient and population levels, respectively, is evaluated. The framework incorporates a harm and benefit trade-off and cost-effectiveness analysis. Our framework provides an outline toward the proper evaluation of potential screening strategies before considering implementation. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Claudin5a is required for proper inflation of Kupffer's vesicle lumen and organ laterality.

    Directory of Open Access Journals (Sweden)

    Jeong-Gyun Kim

    Full Text Available Left-right asymmetric organ development is critical to establish a proper body plan of vertebrates. In zebrafish, the Kupffer's vesicle (KV is a fluid-filled sac which controls asymmetric organ development, and a properly inflated KV lumen by means of fluid influx is a prerequisite for the asymmetric signal transmission. However, little is known about the components that support the paracellular tightness between the KV luminal epithelial cells to sustain hydrostatic pressure during KV lumen expansion. Here, we identified that the claudin5a (cldn5a is highly expressed at the apical surface of KV epithelial cells and tightly seals the KV lumen. Downregulation of cldn5a in zebrafish showed a failure in organ laterality that resulted from malformed KV. In addition, accelerated fluid influx into KV by combined treatment of forskolin and 3-isobutyl-1-methylxanthine failed to expand the partially-formed KV lumen in cldn5a morphants. However, malformed KV lumen and defective heart laterality in cldn5a morphants were significantly rescued by exogenous cldn5a mRNA, suggesting that the tightness between the luminal epithelial cells is important for KV lumen formation. Taken together, these findings suggest that cldn5a is required for KV lumen inflation and left-right asymmetric organ development.

  13. Claudin5a is required for proper inflation of Kupffer's vesicle lumen and organ laterality.

    Science.gov (United States)

    Kim, Jeong-Gyun; Bae, Sung-Jin; Lee, Hye Shin; Park, Ji-Hyeon; Kim, Kyu-Won

    2017-01-01

    Left-right asymmetric organ development is critical to establish a proper body plan of vertebrates. In zebrafish, the Kupffer's vesicle (KV) is a fluid-filled sac which controls asymmetric organ development, and a properly inflated KV lumen by means of fluid influx is a prerequisite for the asymmetric signal transmission. However, little is known about the components that support the paracellular tightness between the KV luminal epithelial cells to sustain hydrostatic pressure during KV lumen expansion. Here, we identified that the claudin5a (cldn5a) is highly expressed at the apical surface of KV epithelial cells and tightly seals the KV lumen. Downregulation of cldn5a in zebrafish showed a failure in organ laterality that resulted from malformed KV. In addition, accelerated fluid influx into KV by combined treatment of forskolin and 3-isobutyl-1-methylxanthine failed to expand the partially-formed KV lumen in cldn5a morphants. However, malformed KV lumen and defective heart laterality in cldn5a morphants were significantly rescued by exogenous cldn5a mRNA, suggesting that the tightness between the luminal epithelial cells is important for KV lumen formation. Taken together, these findings suggest that cldn5a is required for KV lumen inflation and left-right asymmetric organ development.

  14. Light-cone gauge versus proper-time gauge for massless spinning particles

    International Nuclear Information System (INIS)

    Skagerstam, B.S.; Stern, A.

    1987-01-01

    Although the light-cone gauge is convenient for many applications in physics, it is known to distort topology. We show that as a consequence, some interesting, possibly physical, features of a quantum theory may be missed when working in the light-cone gauge. We shall illustrate this by examining the description of massless spinning particles in an arbitrary number of space-time dimensions. When quantizing such particles in four space-time dimensions (without introducing Grassmann degrees of freedom), the light-cone gauge yields a purely bosonic spectrum, i.e. the helicity λ is integer-valued. The problem is rectified by going to the proper-time gauge; there λ = 0, ±1/2, ±1, ... Upon using the proper-time gauge to quantize massless particle systems in more than four space-time dimensions, we find the following interesting features: Except for space-time dimension d equal to 5 and 9, (i) wave functions cannot be expressed as global functions of momentum (or position). (This is also true for d=4.) Further, for d ≠ 5 and 9, (ii) the helicity group spin (d-2) and (iii) canonical position operators do not exist, globally. (The result that helicity cannot be globally defined resembles a known property of nonabelian monopoles arising in grand unified theories. There, topological obstructions prevent one from defining the color group, globally.) All of the features (i)-(iii) are missed when working in the light-cone gauge. (orig.)

  15. Spontaneous Rectus Sheath Hematoma in the Elderly: An Unusual Case and Update on Proper Management

    Directory of Open Access Journals (Sweden)

    George Galyfos

    2014-01-01

    Full Text Available Spontaneous rectus sheath hematoma (SRSH is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient’s obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated.

  16. The Ultimate Catalog of Omega Centauri: 15-BAND Photometry and Proper Motions

    Science.gov (United States)

    Anderson, Jay

    2011-10-01

    We propose to construct the most comprehensive catalog of photometry and proper motions ever assembled for a globular cluster {GC}. The core of Omega Centauri has been imaged nearly 500 times through WFC3's UVIS and IR channels for the purposes of detector calibration. There exist 30 exposures through each of 15 filters, stretching uniformly from F225W in the UV to F160W in the infrared. Furthermore, the 8-year baseline between this data and a 2002 ACS survey will more than double the accuracy and triple the number of well-measured stars compared to our previous groundbreaking effort. This totally unprecedented complete spectral coverage for over 300,000 stars, from the red-giant branch {RGB} down to the white dwarfs {WDs}, provides the best chance yet to understand the multiple-population phenomenon in any GC. A preliminary analysis of the color-magnitude diagrams in different bands already allows us to identify more than 10 distinct sequences.We will make the full catalog of 15-band photometry and proper motions available to the community within 6 months of starting this project. We will then be the first to exploit this tremendous resource. The science we will address includes: {1} identifying all the sequences and tying them together, from the main sequence up to the RGB;{2} continuing the search for a central massive object; {3} examination of the WD sequence for any manifestations of multiple-populations; and{4} searching for cataclysmic variables and He WDs.

  17. Topoisomerase IIbeta is required for proper retinal development and survival of postmitotic cells

    Directory of Open Access Journals (Sweden)

    Ying Li

    2014-01-01

    Topoisomerase IIbeta (Top2b is an enzyme that modulates DNA supercoiling by catalyzing the passage of DNA duplexes through one another. It is ubiquitously expressed in postmitotic cells and known to function during the development of neuromuscular junctions in the diaphragm and the proper formation of laminar structure in the cerebral cortex. However, due to the perinatal death phenotype of the traditional constitutive and brain-specific Top2b knockout mice, the precise in vivo function of Top2b, especially during postnatal neural development, remains to be determined. Using both the constitutive and retina-specific knockout mouse models, we showed that Top2b deficiency resulted in delayed neuronal differentiation, degeneration of the plexiform layers and outer segment of photoreceptors, as well as dramatic reduction in cell number in the retina. Genome-wide transcriptome analysis by RNA sequencing revealed that genes involved in neuronal survival and neural system development were preferentially affected in Top2b-deficient retinas. Collectively, our findings have indicated an important function of Top2b in proper development and the maintenance/survival of postmitotic neurons in the retina.

  18. Prehepatocholedochal proper hepatic artery. Rare anatomical variant. Surgical considerations. Case report.

    Science.gov (United States)

    Ardeleanu, V; Chicoş, S; Tutunaru, D; Georgescu, C

    2014-01-01

    In classical anatomic variants, the proper hepatic artery (PHA)continues the common hepatic artery (CHA) after the gastroduodenal artery (GDA) detaches itself and divides into the right hepatic artery (RHA) and left hepatic artery (LHA), the proper hepatic artery being located to the left of the hepatocholedochal duct (HCD). This paper presents an abnormal positioning of the PHA placed before the HCD with an increased diameter of about 5-7 mm, which could be confused with the HCD. We present the case of a 57 year-old woman diagnosed with acute lithiasic cholecystitis, associated with hypersplenism and hypertension. The literature mentions manifold anatomical variants of arterial liver vascularization,including PHA. For this reason, this paper presents an overview of similar cases that can be found in medical literature. The aforementioned case is a rare topographic anatomy for the PHA that can easily pass for HCD especially during celioscopy, therefore it is crucial for this to be acknowledged by all surgeons. Celsius.

  19. A deep proper motion catalog within the Sloan digital sky survey footprint

    International Nuclear Information System (INIS)

    Munn, Jeffrey A.; Harris, Hugh C.; Tilleman, Trudy M.; Hippel, Ted von; Kilic, Mukremin; Liebert, James W.; Williams, Kurtis A.; DeGenarro, Steven; Jeffery, Elizabeth

    2014-01-01

    A new proper motion catalog is presented, combining the Sloan Digital Sky Survey (SDSS) with second epoch observations in the r band within a portion of the SDSS imaging footprint. The new observations were obtained with the 90prime camera on the Steward Observatory Bok 90 inch telescope, and the Array Camera on the U.S. Naval Observatory, Flagstaff Station, 1.3 m telescope. The catalog covers 1098 square degrees to r = 22.0, an additional 1521 square degrees to r = 20.9, plus a further 488 square degrees of lesser quality data. Statistical errors in the proper motions range from 5 mas year −1 at the bright end to 15 mas year −1 at the faint end, for a typical epoch difference of six years. Systematic errors are estimated to be roughly 1 mas year −1 for the Array Camera data, and as much as 2–4 mas year −1 for the 90prime data (though typically less). The catalog also includes a second epoch of r band photometry.

  20. The importance of proper administration and interpretation of neuropsychological baseline and postconcussion computerized testing.

    Science.gov (United States)

    Moser, Rosemarie Scolaro; Schatz, Philip; Lichtenstein, Jonathan D

    2015-01-01

    Media coverage, litigation, and new legislation have resulted in a heightened awareness of the prevalence of sports concussion in both adult and youth athletes. Baseline and postconcussion testing is now commonly used for the assessment and management of sports-related concussion in schools and in youth sports leagues. With increased use of computerized neurocognitive sports concussion testing, there is a need for standards for proper administration and interpretation. To date, there has been a lack of standardized procedures by which assessments are administered. More specifically, individuals who are not properly trained often interpret test results, and their methods of interpretation vary considerably. The purpose of this article is to outline factors affecting the validity of test results, to provide examples of misuse and misinterpretation of test results, and to communicate the need to administer testing in the most effective and useful manner. An increase in the quality of test administration and application may serve to decrease the prevalence of invalid test results and increase the accuracy and utility of baseline test results if an athlete sustains a concussion. Standards for test use should model the American Psychological Association and Centers for Disease Control and Prevention guidelines, as well as the recent findings of the joint position paper on computerized neuropsychological assessment devices.