WorldWideScience

Sample records for setting initial evaluation

  1. Systemic characterization and evaluation of particle packings as initial sets for discrete element simulations

    Science.gov (United States)

    Morfa, Carlos Recarey; Cortés, Lucía Argüelles; Farias, Márcio Muniz de; Morales, Irvin Pablo Pérez; Valera, Roberto Roselló; Oñate, Eugenio

    2018-07-01

    A methodology that comprises several characterization properties for particle packings is proposed in this paper. The methodology takes into account factors such as dimension and shape of particles, space occupation, homogeneity, connectivity and isotropy, among others. This classification and integration of several properties allows to carry out a characterization process to systemically evaluate the particle packings in order to guarantee the quality of the initial meshes in discrete element simulations, in both the micro- and the macroscales. Several new properties were created, and improvements in existing ones are presented. Properties from other disciplines were adapted to be used in the evaluation of particle systems. The methodology allows to easily characterize media at the level of the microscale (continuous geometries—steels, rocks microstructures, etc., and discrete geometries) and the macroscale. A global, systemic and integral system for characterizing and evaluating particle sets, based on fuzzy logic, is presented. Such system allows researchers to have a unique evaluation criterion based on the aim of their research. Examples of applications are shown.

  2. Systemic characterization and evaluation of particle packings as initial sets for discrete element simulations

    Science.gov (United States)

    Morfa, Carlos Recarey; Cortés, Lucía Argüelles; Farias, Márcio Muniz de; Morales, Irvin Pablo Pérez; Valera, Roberto Roselló; Oñate, Eugenio

    2017-10-01

    A methodology that comprises several characterization properties for particle packings is proposed in this paper. The methodology takes into account factors such as dimension and shape of particles, space occupation, homogeneity, connectivity and isotropy, among others. This classification and integration of several properties allows to carry out a characterization process to systemically evaluate the particle packings in order to guarantee the quality of the initial meshes in discrete element simulations, in both the micro- and the macroscales. Several new properties were created, and improvements in existing ones are presented. Properties from other disciplines were adapted to be used in the evaluation of particle systems. The methodology allows to easily characterize media at the level of the microscale (continuous geometries—steels, rocks microstructures, etc., and discrete geometries) and the macroscale. A global, systemic and integral system for characterizing and evaluating particle sets, based on fuzzy logic, is presented. Such system allows researchers to have a unique evaluation criterion based on the aim of their research. Examples of applications are shown.

  3. Evaluation of an Implementation Initiative for Embedding Dialectical Behavior Therapy in Community Settings

    Science.gov (United States)

    Herschell, Amy D.; Lindhiem, Oliver J.; Kogan, Jane N.; Celedonia, Karen L.; Stein, Bradley D.

    2014-01-01

    We examined the effectiveness of Dialectical Behavior Therapy (DBT) training in community-based agencies. Data were gathered at four time points over a two-year period from front-line mental health therapists (N = 64) from 10 community-based agencies that participated in a DBT implementation initiative. We examined change on therapist attitudes towards consumers with Borderline Personality Disorder (BPD), confidence in the effectiveness of DBT, and use of DBT model components. All measures were self-report. Participating in DBT training resulted in positive changes over time, including improved therapist attitudes toward consumers with BPD, improved confidence in the effectiveness of DBT, and increased use of DBT components. Therapists who had the lowest baseline scores on the study outcomes had the greatest self-reported positive change in outcomes over time. Moreover, there were notable positive correlations in therapist characteristics; therapists who had the lowest baseline attitudes towards individuals with BPD, confidence in the effectiveness of DBT, or who were least likely to use DBT modes and components were the therapists who had the greatest reported increase over time in each respective area. DBT training with ongoing support resulted in changes not commonly observed in standard training approaches typically used in community settings. It is encouraging to observe positive outcomes in therapist self-reported skill, perceived self-efficacy and DBT component use, all of which are important to evidence-based treatment (EBT) implementation. Our results underscore the importance to recognize and target therapist diversity of learning levels, experience, and expertise in EBT implementation. PMID:24333657

  4. Mobile Landing Platform with Core Capability Set (MLP w/CCS): Combined Initial Operational Test and Evaluation and Live Fire Test and Evaluation Report

    Science.gov (United States)

    2015-07-01

    SUBTITLE Mobile Landing Platform with Core Capability Set (MLP w/CCS) Combined Initial Operational Test and Evaluation ( IOT &E) and Live Fire Test and...based on data from a series of integrated test events, a dedicated end-to-end Initial Operational Test and Evaluation ( IOT &E), and two Marine Corps...Internally Transportable Vehicles (ITVs).   ii the LMSR to anchor within a few miles of the shore. Using MLP (CCS), the equipment is transported ashore

  5. Evaluation of Shear Strength of RC Beams with Multiple Interfaces Formed before Initial Setting Using 3D Printing Technology

    Directory of Open Access Journals (Sweden)

    Kyeongjin Kim

    2017-11-01

    Full Text Available With the recent development of 3D printing technology, concrete materials are sometimes used in 3D printing. Concrete structures based on 3D printing have been characterized to have the form of multiple layer build-up. Unlike general concrete structures, therefore, the 3D-printed concrete can be regarded as an orthotropic material. The material property of the 3D-printed concrete’s interface between layers is expected to be far different from that of general concrete bodies since there are no aggregate interlocks and weak chemical bonding. Such a difference finally affects the structural performance of concrete structures even though the interfaces are formed before initial setting of the concrete. The current study mainly reviewed the changes in fracture energy (toughness with respect to various environmental conditions of such interface. Changes in fracture energies of interfaces between concrete layers were measured using low-speed Crack Mouth Opening Displacement (CMOD closed loop concrete fracture test. The experimental results indicated reduction in fracture energy as well as tensile strengths. To improve the tensile strength of interfaces, the use of bridging materials is suggested. Since it was assumed that reduction in fracture energy could be a cause of shear strength, to evaluate the reduced structural performance of concrete structure constructed with multiple interfaces by 3D printing technology, the shear strength of RC beam by 3D printing technology was predicted and compared with that of plain RC beam. Based on the fracture energy measured in this study, Modified Compression Field Theory (MCFT theory-applied Vector 2 program was employed to predict the degree of reduction in shear strength without considering stirrups. Reduction factors were presented based on the obtained results to predict the reduction in shear strength due to interfaces before initial setting of the concrete.

  6. Initial data sets for the Schwarzschild spacetime

    International Nuclear Information System (INIS)

    Gomez-Lobo, Alfonso Garcia-Parrado; Kroon, Juan A. Valiente

    2007-01-01

    A characterization of initial data sets for the Schwarzschild spacetime is provided. This characterization is obtained by performing a 3+1 decomposition of a certain invariant characterization of the Schwarzschild spacetime given in terms of concomitants of the Weyl tensor. This procedure renders a set of necessary conditions--which can be written in terms of the electric and magnetic parts of the Weyl tensor and their concomitants--for an initial data set to be a Schwarzschild initial data set. Our approach also provides a formula for a static Killing initial data set candidate--a KID candidate. Sufficient conditions for an initial data set to be a Schwarzschild initial data set are obtained by supplementing the necessary conditions with the requirement that the initial data set possesses a stationary Killing initial data set of the form given by our KID candidate. Thus, we obtain an algorithmic procedure of checking whether a given initial data set is Schwarzschildean or not

  7. Test set for initial value problem solvers

    NARCIS (Netherlands)

    W.M. Lioen (Walter); J.J.B. de Swart (Jacques)

    1998-01-01

    textabstractThe CWI test set for IVP solvers presents a collection of Initial Value Problems to test solvers for implicit differential equations. This test set can both decrease the effort for the code developer to test his software in a reliable way, and cross the bridge between the application

  8. Evaluation Program initiative

    International Nuclear Information System (INIS)

    Rich, B.L.

    1987-01-01

    The purpose of this paper is to provide the Department of Energy's (DOE) safeguards and security community with some insights on an important management initiative by the Office of Security Evaluations (OSE). The paper will present the ''what, where, who, when, and why'' of a new Evaluation Program. The Evaluation Program will be comprised of a continuing series of regular and special evaluations of DOE safeguards and security programs and policies. The evaluations will be integrative and ''crosscutting,'' i.e. will extend across DOE organizational lines. Evaluations will be offered as positive advisories to DOE managers with safeguards and security responsibilities and will not be rated. They will complement the ongoing OSE Inspection Program of inspections conducted by OSE's Inspection Division. The purpose for the evaluations is to establish an accurate and current assessment of the effectiveness and status of safeguards and security programs and policies and to provide DOE managers with required information on program and policy effectiveness

  9. KRAS early testing: consensus initiative and cost-effectiveness evaluation for metastatic colorectal patients in an Italian setting.

    Directory of Open Access Journals (Sweden)

    Carlo Barone

    Full Text Available KRAS testing is relevant for the choice of the most appropriate first-line therapy of metastatic colorectal cancer (CRC. Strategies for preventing unequal access to the test should be implemented, but their relevance in the practice is related to economic sustainability. The study adopted the Delphi technique to reach a consensus on several topics. Issues related to execution of KRAS testing were identified by an expert's board and proposed to 108 Italian oncologists and pathologists through two subsequent questionnaires. The emerging proposal was evaluated by decision analyses models employed by technology assessment agencies in order to assess cost-effectiveness. Alternative therapeutic strategies included most commonly used chemotherapy regimens alone or in combination with cetuximab or bevacizumab. The survey indicated that time interval for obtaining KRAS test should not exceed 15 days, 10 days being an optimal interval. To assure the access to proper treatment, a useful strategy should be to anticipate the test after radical resection in patients at high risk of relapse. Early KRAS testing in high risk CRC patients generates incremental cost-effectiveness ratios between 6,000 and 13,000 Euro per quality adjusted life year (QALY gained. In extensive sensitivity analyses ICER's were always below 15,000 Euro per QALY gained, far within the threshold of 60,000 Euro/QALY gained accepted by regulatory institutions in Italy. In metastatic CRC a time interval higher than 15 days for result of KRAS testing limits access to therapeutic choices. Anticipating KRAS testing before the onset of metastatic disease in patients at high risk does not affect the sustainability and cost-effectiveness profile of cetuximab in first-line mCRC. Early KRAS testing may prevent this inequality in high-risk patients, whether they develop metastases, and is a cost-effective strategy. Based on these results, present joined recommendations of Italian societies of

  10. Teaching Evaluation: Waiting for Initiatives

    Directory of Open Access Journals (Sweden)

    Alejandro Canales Sánchez

    2008-08-01

    Full Text Available In this text, it is sustained that, despite the fact that the teaching activity is one of the main functions of higher education institutions or even the only one in most of them, it hasn’t been reflected in the leading initiatives that have been set in motion in this area for the last two decades. In particular, it points out that the wide evaluation politics established in the education system during the late eighties, didn’t consider the teaching activity as a concern issue for the mechanisms or rewards in the evaluation system. Even though the implementation of new actions tried to repair the situation, mainly by improving the quality of working time and the qualifications of the personnel performing these activities; teaching, in strict sense, and the design or application of a new evaluation scheme to strengthen it, didn’t get better.

  11. Evaluating Domestic Violence Initiatives

    OpenAIRE

    Parmar, Alpa; Sampson, Alice

    2006-01-01

    This paper critiques the approach of identifying ‘best practice’ projects and discusses the problem with simply transferring projects into different contexts. The argument is illustrated by explaining the evaluation process of three domestic violence projects which all had the same aim, which was to reduce domestic violence. The evaluated projects all delivered advocacy programmes and were located in disadvantaged areas in the United Kingdom. A more suitable evaluation approach is proposed wh...

  12. Initial Ada components evaluation

    Science.gov (United States)

    Moebes, Travis

    1989-01-01

    The SAIC has the responsibility for independent test and validation of the SSE. They have been using a mathematical functions library package implemented in Ada to test the SSE IV and V process. The library package consists of elementary mathematical functions and is both machine and accuracy independent. The SSE Ada components evaluation includes code complexity metrics based on Halstead's software science metrics and McCabe's measure of cyclomatic complexity. Halstead's metrics are based on the number of operators and operands on a logical unit of code and are compiled from the number of distinct operators, distinct operands, and total number of occurrences of operators and operands. These metrics give an indication of the physical size of a program in terms of operators and operands and are used diagnostically to point to potential problems. McCabe's Cyclomatic Complexity Metrics (CCM) are compiled from flow charts transformed to equivalent directed graphs. The CCM is a measure of the total number of linearly independent paths through the code's control structure. These metrics were computed for the Ada mathematical functions library using Software Automated Verification and Validation (SAVVAS), the SSE IV and V tool. A table with selected results was shown, indicating that most of these routines are of good quality. Thresholds for the Halstead measures indicate poor quality if the length metric exceeds 260 or difficulty is greater than 190. The McCabe CCM indicated a high quality of software products.

  13. Evaluation and Evaluating the Community Initiative "URBAN"

    DEFF Research Database (Denmark)

    Alves, Sonia

    2013-01-01

    focus on a more open and democratic process of evaluation. This paper presents and compares different conceptual and methodological frameworks created for the assessment of the European initiative Urban II, including the one that was used by the author in the context of an academic evaluation...... in the city of Porto. The comparative analysis of the results leads us to the recommendation for more democratic processes of evaluation and intervention, in order to improve their quality and accountability and promote the important goal of learning with this type of experimental initiatives....

  14. Comparing initial-data sets for binary black holes

    International Nuclear Information System (INIS)

    Pfeiffer, Harald P.; Cook, Gregory B.; Teukolsky, Saul A.

    2002-01-01

    We compare the results of constructing binary black hole initial data with three different decompositions of the constraint equations of general relativity. For each decomposition we compute the initial data using a superposition of two Kerr-Schild black holes to fix the freely specifiable data. We find that these initial-data sets differ significantly, with the ADM energy varying by as much as 5% of the total mass. We find that all initial-data sets currently used for evolutions might contain unphysical gravitational radiation of the order of several percent of the total mass. This is comparable to the amount of gravitational-wave energy observed during the evolved collision. More astrophysically realistic initial data will require more careful choices of the freely specifiable data and boundary conditions for both the metric and extrinsic curvature. However, we find that the choice of extrinsic curvature affects the resulting data sets more strongly than the choice of conformal metric

  15. Early visual cortex reflects initiation and maintenance of task set

    Science.gov (United States)

    Elkhetali, Abdurahman S.; Vaden, Ryan J.; Pool, Sean M.

    2014-01-01

    The human brain is able to process information flexibly, depending on a person's task. The mechanisms underlying this ability to initiate and maintain a task set are not well understood, but they are important for understanding the flexibility of human behavior and developing therapies for disorders involving attention. Here we investigate the differential roles of early visual cortical areas in initiating and maintaining a task set. Using functional Magnetic Resonance Imaging (fMRI), we characterized three different components of task set-related, but trial-independent activity in retinotopically mapped areas of early visual cortex, while human participants performed attention demanding visual or auditory tasks. These trial-independent effects reflected: (1) maintenance of attention over a long duration, (2) orienting to a cue, and (3) initiation of a task set. Participants performed tasks that differed in the modality of stimulus to be attended (auditory or visual) and in whether there was a simultaneous distractor (auditory only, visual only, or simultaneous auditory and visual). We found that patterns of trial-independent activity in early visual areas (V1, V2, V3, hV4) depend on attended modality, but not on stimuli. Further, different early visual areas play distinct roles in the initiation of a task set. In addition, activity associated with maintaining a task set tracks with a participant's behavior. These results show that trial-independent activity in early visual cortex reflects initiation and maintenance of a person's task set. PMID:25485712

  16. Evaluating in a Healthcare Setting

    DEFF Research Database (Denmark)

    Jensen, Janne Jul

    2007-01-01

    The think-aloud protocol, also known as concurrent verbalisation protocol, is widely used in the field of HCI today, but as the technology and applications have evolved the protocol has had to cope with this. Therefore new variations of the protocol have seen the light of day. One example...... is retrospective verbalisation. To compare concurrent and retrospective verbalisation an experiment was conducted. A home healthcare application was evaluated with 15 participants using both protocols. The results of the experiment show that the two protocols have each their strengths and weaknesses...

  17. Framework for Evaluation of Equity Initiatives

    Science.gov (United States)

    Bexley, Emmaline; Harris, Kerri-Lee; James, Richard

    2010-01-01

    The Framework for Evaluation of Equity Initiatives has been prepared to support the Go8 Equity Strategy. Its purpose is to assist Group of Eight (Go8) universities to evaluate the effectiveness of their equity initiatives and interventions in the context of federal policies and the distinctive missions and responsibilities of the individual Go8…

  18. Evaluation of integrated data sets: four examples

    International Nuclear Information System (INIS)

    Bolivar, S.L.; Freeman, S.B.; Weaver, T.A.

    1982-01-01

    Several large data sets have been integrated and utilized for rapid evaluation on a reconnaissance scale for the Montrose 1 0 x 2 0 quadrangle, Colorado. The data sets include Landsat imagery, hydrogeochemical and stream sediment analyses, airborne geophysical data, known mineral occurrences, and a geologic map. All data sets were registered to a 179 x 119 rectangular grid and projected onto Universal Transverse Mercator coordinates. A grid resolution of 1 km was used. All possible combinations of three, for most data sets, were examined for general geologic correlations by utilizing a color microfilm output. In addition, gray-level pictures of statistical output, e.g., factor analysis, have been employed to aid evaluations. Examples for the data sets dysprosium-calcium, lead-copper-zinc, and equivalent uranium-uranium in water-uranium in sediment are described with respect to geologic applications, base-metal regimes, and geochemical associations

  19. Using evaluation theory in priority setting and resource allocation.

    Science.gov (United States)

    Smith, Neale; Mitton, Craig; Cornelissen, Evelyn; Gibson, Jennifer; Peacock, Stuart

    2012-01-01

    Public sector interest in methods for priority setting and program or policy evaluation has grown considerably over the last several decades, given increased expectations for accountable and efficient use of resources and emphasis on evidence-based decision making as a component of good management practice. While there has been some occasional effort to conduct evaluation of priority setting projects, the literatures around priority setting and evaluation have largely evolved separately. In this paper, the aim is to bring them together. The contention is that evaluation theory is a means by which evaluators reflect upon what it is they are doing when they do evaluation work. Theories help to organize thinking, sort out relevant from irrelevant information, provide transparent grounds for particular implementation choices, and can help resolve problematic issues which may arise in the conduct of an evaluation project. A detailed review of three major branches of evaluation theory--methods, utilization, and valuing--identifies how such theories can guide the development of efforts to evaluate priority setting and resource allocation initiatives. Evaluation theories differ in terms of their guiding question, anticipated setting or context, evaluation foci, perspective from which benefits are calculated, and typical methods endorsed. Choosing a particular theoretical approach will structure the way in which any priority setting process is evaluated. The paper suggests that explicitly considering evaluation theory makes key aspects of the evaluation process more visible to all stakeholders, and can assist in the design of effective evaluation of priority setting processes; this should iteratively serve to improve the understanding of priority setting practices themselves.

  20. Interprofessional oral health initiative in a nondental, American Indian setting.

    Science.gov (United States)

    Murphy, Kate L; Larsson, Laura S

    2017-12-01

    Tooth decay is the most common chronic childhood disease and American Indian (AI) children are at increased risk. Pediatric primary care providers are in an opportune position to reduce tooth decay. The purpose of this study was to integrate and evaluate a pediatric oral health project in an AI, pediatric primary care setting. The intervention set included caregiver education, caries risk assessment, and a same-day dental home referral. All caregiver/child dyads age birth to 5 years presenting to the pediatric clinic were eligible (n = 47). Most children (n = 35, 91.1%) were scored as high risk for caries development. Of those with first tooth eruption (n = 36), ten had healthy teeth (27.8%) and seven had seen a dentist in the past 3 months (19.4%). All others were referred to a dentist (n = 29) and 21 families (72.4%) completed the referral. In fewer than 5 min per appointment (x = 4.73 min), the primary care provider integrated oral health screening, education, and referral into the well-child visit. Oral health is part of total health, and thus should be incorporated into routine well-child visits. ©2017 American Association of Nurse Practitioners.

  1. WHAT SETS THE INITIAL ROTATION RATES OF MASSIVE STARS?

    International Nuclear Information System (INIS)

    Rosen, Anna L.; Krumholz, Mark R.; Ramirez-Ruiz, Enrico

    2012-01-01

    The physical mechanisms that set the initial rotation rates in massive stars are a crucial unknown in current star formation theory. Observations of young, massive stars provide evidence that they form in a similar fashion to their low-mass counterparts. The magnetic coupling between a star and its accretion disk may be sufficient to spin down low-mass pre-main-sequence (PMS) stars to well below breakup at the end stage of their formation when the accretion rate is low. However, we show that these magnetic torques are insufficient to spin down massive PMS stars due to their short formation times and high accretion rates. We develop a model for the angular momentum evolution of stars over a wide range in mass, considering both magnetic and gravitational torques. We find that magnetic torques are unable to spin down either low-mass or high-mass stars during the main accretion phase, and that massive stars cannot be spun down significantly by magnetic torques during the end stage of their formation either. Spin-down occurs only if massive stars' disk lifetimes are substantially longer or their magnetic fields are much stronger than current observations suggest.

  2. Digital breast tomosynthesis (DBT): initial experience in a clinical setting

    International Nuclear Information System (INIS)

    Skaane, Per; Gullien, Randi; Eben, Ellen B.; Haakenaasen, Unni; Naess Jebsen, Ingvild; Krager, Mona; Bjoerndal, Hilde; Ekseth, Ulrika; Jahr, Gunnar

    2012-01-01

    Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated. Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies. Material and Methods: The study had ethics committee approval. A total of 129 women underwent 2D digital mammography including supplementary cone-down and magnification views and breast ultrasonography if indicated, as well as digital breast tomosynthesis. The indication for conventional imaging in the clinical setting included a palpable lump in 30 (23%), abnormal mammographic screening findings in 54 (42%), and surveillance in 45 (35%) of the women. The women were examined according to present guidelines, including spot-magnification views, ultrasonography, and needle biopsies, if indicated. The DBT examinations were interpreted several weeks after the conventional imaging without knowledge of the conventional imaging findings. In a later session, three radiologists performed a side-by-side feature analysis for cancer conspicuity in a sample of 50 cases. Results: State-of-the-art conventional imaging resulted in needle biopsy of 45 breasts, of which 20 lesions were benign and a total of 25 cancers were diagnosed. The remaining 84 women were dismissed with a normal/definitely benign finding and without indication for needle biopsy. The subsequent DBT interpretation found suspicious findings in four of these 84 women, and these four women had to be called back for repeated work-up with knowledge of the tomosynthesis findings. These delayed work-ups resulted in two cancers (increasing the cancer detection by 8%) and two

  3. Low Complexity Track Initialization from a Small Set of Non-Invertible Measurements

    Directory of Open Access Journals (Sweden)

    Wolfgang Koch

    2008-02-01

    Full Text Available Target tracking from non-invertible measurement sets, for example, incomplete spherical coordinates measured by asynchronous sensors in a sensor network, is a task of data fusion present in a lot of applications. Difficulties in tracking using extended Kalman filters lead to unstable behavior, mainly caused by poor initialization. Instead of using high complexity numerical batch-estimators, we offer an analytical approach to initialize the filter from a minimum number of observations. This directly pertains to multi-hypothesis tracking (MHT, where in the presence of clutter and/or multiple targets (i low complexity algorithms are desirable and (ii using a small set of measurements avoids the combinatorial explosion. Our approach uses no numerical optimization, simply evaluating several equations to find the state estimates. This is possible since we avoid an over-determined setup by initializing only from the minimum necessary subset of measurements. Loss in accuracy is minimized by choosing the best subset using an optimality criterion and incorporating the leftover measurements afterwards. Additionally, we provide the possibility to estimate only sub-sets of parameters, and to reliably model the resulting added uncertainties by the covariance matrix. We compare two different implementations, differing in the approximation of the posterior: linearizing the measurement equation as in the extended Kalman filter (EKF or employing the unscented transform (UT. The approach will be studied in two practical examples: 3D track initialization using bearingsonly measurements or using slant-range and azimuth only.

  4. The telephone effect: Overcoming initiation deficits in two settings.

    Science.gov (United States)

    Vickers, Kayci L; Keesler, Michael E; Williams, Kelli S; Charles, Jeremy Y; Hamilton, Roy H

    2018-04-19

    Disorders of motivation substantially impair an individual's ability to communicate with their families, therapists, and doctors. One method of overcoming initiation deficits is by utilizing the telephone effect, which is the ability for individuals with severe motivation deficits to communicate more readily when speaking on a telephone. However, little is available in the extant literature on how this effect works or how best to integrate this into patient care. This article aims to provide the first report of a proposed mechanism underlying the telephone effect and the first published procedures for eliciting this effect. This is largely a review article that also contains descriptions of clinical procedures for eliciting the telephone effect with 2 patient populations: acute inpatients following brain injury and dementia residents. A case vignette is also provided. We propose that the telephone effect is the result of an interaction between the patient and environment, and occurs because of Gibson's (1979) law of affordances. The use of this theory provides an explanation of the behaviors often observed when attempting to elicit this effect (i.e., disruption of the effect when using a cellular phone). Moreover, we argue that this can, and does, apply to social interactions as well. The telephone effect is an understudied phenomenon that provides a means of improving care for individuals with disorders of motivation. Future directions include systematic research into the telephone effect and further investigation of the mechanism underlying this effect. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. Initial Evaluation of Patients with Presumed Syncope

    Directory of Open Access Journals (Sweden)

    Ilknur Can, MD

    2008-01-01

    Full Text Available Syncope is a common clinical problem, but nevertheless is but one element of the broader issue of ‘transient loss of consciousness’ (TLOC. The first step is to ascertain whether the patient actually suffered a syncopal episode, and thereafter the goal must be to determine the basis of symptoms with sufficient confidence to assess prognosis and initiate an effective treatment strategy. The initial evaluation of these patients, which usually takes place in an emergency department (ED. or acute care facility, is challenging since patients are usually asymptomatic when they come for medical attention, may have little or no recall of the event, and witnesses, if any, often cannot provide reliable information. Given these circumstances, it is understandable that frontline physicians often tend to take a seemingly ‘safe’ approach, and admit both high-risk and intermediate-risk syncope patients to hospital. This strategy has many implications, including life-style and economic concerns for the patient, and health care management issues for physicians, hospital administrators and the overall health care system. The European Society of Cardiology (ESC. guidelines and several clinical studies provide helpful advice regarding “risk stratification” to help guide physicians in selecting patients for either early hospital admission or later oupatient subspeciality evaluation. The utility of syncope management units in the ED, and a guideline-based approach to the syncope patient, has tended to both diminish the number of undiagnosed cases and reduce the hospital admission rate. In this review, we have attempted to both highlight a cost-effective diagnostic pathway beginning with the initial evaluation of the patient with suspected syncope, and to provide criteria which may help frontline physicians better base their decisions regarding need for in-hospital versus outpatient clinic evaluation of syncope patients.

  6. Patterns of opioid initiation at first visits for pain in United States primary care settings.

    Science.gov (United States)

    Mundkur, Mallika L; Rough, Kathryn; Huybrechts, Krista F; Levin, Raisa; Gagne, Joshua J; Desai, Rishi J; Patorno, Elisabetta; Choudhry, Niteesh K; Bateman, Brian T

    2018-05-01

    The primary objective of this study was to characterize variation in patterns of opioid prescribing within primary care settings at first visits for pain, and to describe variation by condition, geography, and patient characteristics. 2014 healthcare utilization data from Optum's Clinformatics™ DataMart were used to evaluate individuals 18 years or older with an initial presentation to primary care for 1 of 10 common pain conditions. The main outcomes assessed were (1) the proportion of first visits for pain associated with an opioid prescription fill and (2) the proportion of opioid prescriptions with >7 days' supply. We identified 205 560 individuals who met inclusion criteria; 9.1% of all visits were associated with an opioid fill, ranging from 4.1% (headache) to 28.2% (dental pain). Approximately half (46%) of all opioid prescriptions supplied more than 7 days, and 10% of prescriptions supplied ≥30 days. We observed a 4-fold variation in rates of opioid initiation by state, with highest rates of prescribing in Alabama (16.6%) and lowest rates in New York (3.7%). In 2014, nearly half of all patients filling opioid prescriptions received more than 7 days' of opioids in an initial prescription. Policies limiting initial supplies have the potential to substantially impact opioid prescribing in the primary care setting. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Evaluating online diagnostic decision support tools for the clinical setting.

    Science.gov (United States)

    Pryor, Marie; White, David; Potter, Bronwyn; Traill, Roger

    2012-01-01

    Clinical decision support tools available at the point of care are an effective adjunct to support clinicians to make clinical decisions and improve patient outcomes. We developed a methodology and applied it to evaluate commercially available online clinical diagnostic decision support (DDS) tools for use at the point of care. We identified 11 commercially available DDS tools and assessed these against an evaluation instrument that included 6 categories; general information, content, quality control, search, clinical results and other features. We developed diagnostically challenging clinical case scenarios based on real patient experience that were commonly missed by junior medical staff. The evaluation was divided into 2 phases; an initial evaluation of all identified and accessible DDS tools conducted by the Clinical Information Access Portal (CIAP) team and a second phase that further assessed the top 3 tools identified in the initial evaluation phase. An evaluation panel consisting of senior and junior medical clinicians from NSW Health conducted the second phase. Of the eleven tools that were assessed against the evaluation instrument only 4 tools completely met the DDS definition that was adopted for this evaluation and were able to produce a differential diagnosis. From the initial phase of the evaluation 4 DDS tools scored 70% or more (maximum score 96%) for the content category, 8 tools scored 65% or more (maximum 100%) for the quality control category, 5 tools scored 65% or more (maximum 94%) for the search category, and 4 tools score 70% or more (maximum 81%) for the clinical results category. The second phase of the evaluation was focused on assessing diagnostic accuracy for the top 3 tools identified in the initial phase. Best Practice ranked highest overall against the 6 clinical case scenarios used. Overall the differentiating factor between the top 3 DDS tools was determined by diagnostic accuracy ranking, ease of use and the confidence and

  8. The Role of Proprioception in the Sagittal Setting of Anticipatory Postural Adjustments During Gait Initiation

    OpenAIRE

    Pereira Marcelo P.; Pelicioni Paulo H. Silva; Gobbi Lilian T.B.

    2015-01-01

    Purpose. Previous studies have studied the role of proprioception on the setting of anticipatory postural adjustments (APA) during gait initiation. However, these studies did not investigate the role of proprioception in the sagittal APA setting. We aimed to investigate the role of proprioception manipulation to induce APA sagittal adaptations on gait initiation. Methods. Fourteen healthy adults performed gait initiation without, and with, vibration applied before movement onset, and during m...

  9. Software Dependability and Safety Evaluations ESA's Initiative

    Science.gov (United States)

    Hernek, M.

    ESA has allocated funds for an initiative to evaluate Dependability and Safety methods of Software. The objectives of this initiative are; · More extensive validation of Safety and Dependability techniques for Software · Provide valuable results to improve the quality of the Software thus promoting the application of Dependability and Safety methods and techniques. ESA space systems are being developed according to defined PA requirement specifications. These requirements may be implemented through various design concepts, e.g. redundancy, diversity etc. varying from project to project. Analysis methods (FMECA. FTA, HA, etc) are frequently used during requirements analysis and design activities to assure the correct implementation of system PA requirements. The criticality level of failures, functions and systems is determined and by doing that the critical sub-systems are identified, on which dependability and safety techniques are to be applied during development. Proper performance of the software development requires the development of a technical specification for the products at the beginning of the life cycle. Such technical specification comprises both functional and non-functional requirements. These non-functional requirements address characteristics of the product such as quality, dependability, safety and maintainability. Software in space systems is more and more used in critical functions. Also the trend towards more frequent use of COTS and reusable components pose new difficulties in terms of assuring reliable and safe systems. Because of this, its dependability and safety must be carefully analysed. ESA identified and documented techniques, methods and procedures to ensure that software dependability and safety requirements are specified and taken into account during the design and development of a software system and to verify/validate that the implemented software systems comply with these requirements [R1].

  10. A Test Set for stiff Initial Value Problem Solvers in the open source software R: Package deTestSet

    NARCIS (Netherlands)

    Mazzia, F.; Cash, J.R.; Soetaert, K.

    2012-01-01

    In this paper we present the R package deTestSet that includes challenging test problems written as ordinary differential equations (ODEs), differential algebraic equations (DAEs) of index up to 3 and implicit differential equations (IDES). In addition it includes 6 new codes to solve initial value

  11. Systematic evaluation program. Status report and initial evaluation

    International Nuclear Information System (INIS)

    1983-06-01

    The MHB Ongoing Systematic Evaluation Program (SEP) Assessment Study was initiated by the Swedish Nuclear Power Inspectorate (SKI) in 1980. This MHB report is a status report and initial evaluation of SEP. The methodology and results of SEP are disscused with particular emphasis on the first two SEP plant reviews - the Palisades and R.E. Ginna nuclear power plants. The comments of cognizant persons in the NRC and the ACRS, as well as private consultants, are included herein. MHBs major findings are as follows: The SEP plant review methodology was acceptable to the NRC Commissioners, the ACRS, and the NRC Staffs consultants who evaluated the first two SEP plant reviews. A concern raised by all who commented on SEP was the absence of Three Mile Island Action Plan Items and Unresolved Safety Issues from current SEP reviews. The SEP reviews of the Palisades and R.E. Ginna plants concluded that the two plant designs were adequate with respect to a majority of safety topics. Several topics remain unresolved in both the Palisades and R.E. Ginna SEP reviews. In the case of the Ginna plant, several related topics have been grouped together in a major structural reevaluation study. In general, due to the number of unresolved and excluded topics, SEP has not at this time produced a plant safety evaluation which can be considered complete and integrated. (author)

  12. Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare

    Directory of Open Access Journals (Sweden)

    Andersson Ann-Christine

    2013-02-01

    Full Text Available Abstract Background Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods A questionnaire, founded on the Minnesota Innovation Survey (MIS, was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

  13. 75 FR 62686 - Health Information Technology: Revisions to Initial Set of Standards, Implementation...

    Science.gov (United States)

    2010-10-13

    ... Health Information Technology: Revisions to Initial Set of Standards, Implementation Specifications, and... Health Information Technology (ONC), Department of Health and Human Services. ACTION: Interim final rule... Coordinator for Health Information Technology, Attention: Steven Posnack, Hubert H. Humphrey Building, Suite...

  14. A common evaluation framework for the African Health Initiative

    Science.gov (United States)

    2013-01-01

    Background The African Health Initiative includes highly diverse partnerships in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia), each of which is working to improve population health by strengthening health systems and to evaluate the results. One aim of the Initiative is to generate cross-site learning that can inform implementation in the five partnerships during the project period and identify lessons that may be generalizable to other countries in the region. Collaborators in the Initiative developed a common evaluation framework as a basis for this cross-site learning. Methods This paper describes the components of the framework; this includes the conceptual model, core metrics to be measured in all sites, and standard guidelines for reporting on the implementation of partnership activities and contextual factors that may affect implementation, or the results it produces. We also describe the systems that have been put in place for data management, data quality assessments, and cross-site analysis of results. Results and conclusions The conceptual model for the Initiative highlights points in the causal chain between health system strengthening activities and health impact where evidence produced by the partnerships can contribute to learning. This model represents an important advance over its predecessors by including contextual factors and implementation strength as potential determinants, and explicitly including equity as a component of both outcomes and impact. Specific measurement challenges include the prospective documentation of program implementation and contextual factors. Methodological issues addressed in the development of the framework include the aggregation of data collected using different methods and the challenge of evaluating a complex set of interventions being improved over time based on continuous monitoring and intermediate results. PMID:23819778

  15. Core outcome sets in dermatology: report from the second meeting of the International Cochrane Skin Group Core Outcome Set Initiative.

    Science.gov (United States)

    Kottner, J; Jacobi, L; Hahnel, E; Alam, M; Balzer, K; Beeckman, D; Busard, C; Chalmers, J; Deckert, S; Eleftheriadou, V; Furlan, K; Horbach, S E R; Kirkham, J; Nast, A; Spuls, P; Thiboutot, D; Thorlacius, L; Weller, K; Williams, H C; Schmitt, J

    2018-04-01

    Results of clinical trials are the most important information source for generating external clinical evidence. The use of different outcomes across trials, which investigate similar interventions for similar patient groups, significantly limits the interpretation, comparability and clinical application of trial results. Core outcome sets (COSs) aim to overcome this limitation. A COS is an agreed standardized collection of outcomes that should be measured and reported in all clinical trials for a specific clinical condition. The Core Outcome Set Initiative within the Cochrane Skin Group (CSG-COUSIN) supports the development of core outcomes in dermatology. In the second CSG-COUSIN meeting held in 2017, 11 COS development groups working on skin diseases presented their current work. The presentations and discussions identified the following overarching methodological challenges for COS development in dermatology: it is not always easy to define the disease focus of a COS; the optimal method for outcome domain identification and level of detail needed to specify such domains is challenging to many; decision rules within Delphi surveys need to be improved; appropriate ways of patient involvement are not always clear. In addition, there appear to be outcome domains that may be relevant as potential core outcome domains for the majority of skin diseases. The close collaboration between methodologists in the Core Outcome Set Initiative and the international Cochrane Skin Group has major advantages for trialists, systematic reviewers and COS developers. © 2018 British Association of Dermatologists.

  16. Practical recommendations for the evaluation of improvement initiatives

    Science.gov (United States)

    Parry, Gareth; Coly, Astou; Goldmann, Don; Rowe, Alexander K; Chattu, Vijay; Logiudice, Deneil; Rabrenovic, Mihajlo; Nambiar, Bejoy

    2018-01-01

    Abstract A lack of clear guidance for funders, evaluators and improvers on what to include in evaluation proposals can lead to evaluation designs that do not answer the questions stakeholders want to know. These evaluation designs may not match the iterative nature of improvement and may be imposed onto an initiative in a way that is impractical from the perspective of improvers and the communities with whom they work. Consequently, the results of evaluations are often controversial, and attribution remains poorly understood. Improvement initiatives are iterative, adaptive and context-specific. Evaluation approaches and designs must align with these features, specifically in their ability to consider complexity, to evolve as the initiative adapts over time and to understand the interaction with local context. Improvement initiatives often identify broadly defined change concepts and provide tools for care teams to tailor these in more detail to local conditions. Correspondingly, recommendations for evaluation are best provided as broad guidance, to be tailored to the specifics of the initiative. In this paper, we provide practical guidance and recommendations that funders and evaluators can use when developing an evaluation plan for improvement initiatives that seeks to: identify the questions stakeholders want to address; develop the initial program theory of the initiative; identify high-priority areas to measure progress over time; describe the context the initiative will be applied within; and identify experimental or observational designs that will address attribution. PMID:29447410

  17. Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study.

    Science.gov (United States)

    Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

    2007-11-16

    As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy) with special attention to public

  18. Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

    Directory of Open Access Journals (Sweden)

    Laupacis Andreas

    2007-11-01

    Full Text Available Abstract Background As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. Methods This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1 over 25 documents (e.g. strategic planning reports, public updates, and (2 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system resulting from the Ontario Wait Times Strategy. Conclusion We described and evaluated a wait time management initiative (the Ontario

  19. Measuring and Analyzing the Scholarly Impact of Experimental Evaluation Initiatives

    DEFF Research Database (Denmark)

    Angelini, Marco; Ferro, Nicola; Larsen, Birger

    2014-01-01

    Evaluation initiatives have been widely credited with contributing highly to the development and advancement of information access systems, by providing a sustainable platform for conducting the very demanding activity of comparable experimental evaluation in a large scale. Measuring the impact...

  20. Evaluating the benefits of risk prevention initiatives

    Science.gov (United States)

    Di Baldassarre, G.

    2012-04-01

    The likelihood and adverse impacts of water-related disasters, such as floods and landslides, are increasing in many countries because of changes in climate and land-use. This presentation illustrates some preliminary results of a comprehensive demonstration of the benefits of risk prevention measures, carried out within the European FP7 KULTURisk project. The study is performed by using a variety of case studies characterised by diverse socio-economic contexts, different types of water-related hazards (floods, debris flows and landslides, storm surges) and space-time scales. In particular, the benefits of state-of-the-art prevention initiatives, such as early warning systems, non-structural options (e.g. mapping and planning), risk transfer strategies (e.g. insurance policy), and structural measures, are showed. Lastly, the importance of homogenising criteria to create hazard inventories and build memory, efficient risk communication and warning methods as well as active dialogue with and between public and private stakeholders, is highlighted.

  1. Initial evaluation of the "Trauma surgery course"

    Directory of Open Access Journals (Sweden)

    Tugnoli Gregorio

    2006-03-01

    Full Text Available Abstract Background The consequence of the low rate of penetrating injuries in Europe and the increase in non-operative management of blunt trauma is a decrease in surgeons' confidence in managing traumatic injuries has led to the need for new didactic tools. The aim of this retrospective study was to present the Corso di Chirurgia del Politrauma (Trauma Surgery Course, developed as a model for teaching operative trauma techniques, and assess its efficacy. Method the two-day course consisted of theoretical lectures and practical experience on large-sized swine. Data of the first 126 participants were collected and analyzed. Results All of the 126 general surgeons who had participated in the course judged it to be an efficient model to improve knowledge about the surgical treatment of trauma. Conclusion A two-day course, focusing on trauma surgery, with lectures and life-like operation situations, represents a model for simulated training and can be useful to improve surgeons' confidence in managing trauma patients. Cooperation between organizers of similar initiatives would be beneficial and could lead to standardizing and improving such courses.

  2. Preparing for Evaluation: Lessons from the Evaluability Assessment of the Teagle Foundation's College-Community Connections Initiative. Report

    Science.gov (United States)

    Black, Kristin

    2016-01-01

    Funders, policymakers, and program leaders recognize the value of high-quality evidence. To make good use of a program evaluation, initiatives must contend with a set of fundamental questions first. Some of these are about the initiative itself: What outcomes does it seek to affect? Are daily activities in line with long-term goals? Others are…

  3. 75 FR 44589 - Health Information Technology: Initial Set of Standards, Implementation Specifications, and...

    Science.gov (United States)

    2010-07-28

    ... Part III Department of Health and Human Services 45 CFR Part 170 Health Information Technology... Secretary 45 CFR Part 170 RIN 0991-AB58 Health Information Technology: Initial Set of Standards... of the National Coordinator for Health Information Technology (ONC), Department of Health and Human...

  4. The Role of Proprioception in the Sagittal Setting of Anticipatory Postural Adjustments During Gait Initiation

    Directory of Open Access Journals (Sweden)

    Pereira Marcelo P.

    2015-12-01

    Full Text Available Purpose. Previous studies have studied the role of proprioception on the setting of anticipatory postural adjustments (APA during gait initiation. However, these studies did not investigate the role of proprioception in the sagittal APA setting. We aimed to investigate the role of proprioception manipulation to induce APA sagittal adaptations on gait initiation. Methods. Fourteen healthy adults performed gait initiation without, and with, vibration applied before movement onset, and during movement. In addition, the effects of two different vibration frequencies (80 and 120Hz were tested. Vibration was applied bilaterally on the tibialis anterior, rectus femoris and trapezius superior. The first step characteristics, ground reaction forces and CoP behaviour were assessed. Results. Vibration improved gait initiation performance regardless of the moment it was applied. CoP velocity during the initial phase of APA was increased by vibration only when it was applied before movement. When vibration was applied to disturb the movement, no effects on the CoP behaviour were observed. Manipulation of vibration frequency had no effects. Conclusions. Rather than proprioception manipulation, the results suggest that post-vibratory effects and attentional mechanisms were responsible for our results. Taken together, the results show that sagittal APA setting is robust to proprioception manipulation.

  5. Diode laser prostatectomy (VLAP): initial canine evaluation

    Science.gov (United States)

    Kopchok, George E.; Verbin, Chris; Ayres, Bruce; Peng, Shi-Kaung; White, Rodney A.

    1995-05-01

    This study evaluated the acute and chronic effects of diode laser (960 nm) prostatectomy using a Prolase II fiber in a canine model (n equals 5). The laser fiber consists of a 1000 um quartz fiber which reflects a cone of laser energy, at 45 degree(s) to the axis of the fiber, into the prostatic urethra (Visual Laser Ablation of Prostate). Perineal access was used to guide a 15.5 Fr cystoscope to the level of the prostate. Under visual guidance and continual saline irrigation, 60 watts of laser power was delivered for 60 seconds at 3, 9, and 12 o'clock and 30 seconds at the 6 o'clock (posterior) positions for a total energy fluence of 12,600 J. One prostate received an additional 60 second exposure at 3 and 9 o'clock for a total fluence of 19,800 J. The prostates were evaluated at one day (n equals 1) and 8 weeks (n equals 4). The histopathology of laser effects at one day show areas of necrosis with loss of glandular structures and stromal edema. Surrounding this area was a zone of degenerative glandular structures extending up to 17.5 mm (cross sectional diameter). The histopathology of the 8 week laser treated animals demonstrated dilated prostatic urethras with maximum cross- sectional diameter of 23.4 mm (mean equals 18.5 +/- 3.9 mm). This study demonstrates the effectiveness of diode laser energy for prostatic tissue coagulation and eventual sloughing. The results also demonstrate the safety of diode laser energy, with similar tissue response as seen with Nd:YAG laser, for laser prostatectomy.

  6. CNSC EOC technical assessment and evaluation initiatives

    International Nuclear Information System (INIS)

    Cole, Christopher

    2014-01-01

    (ERP). International codes, such as the US NRC developed dispersion code RASCAL are also employed to assist in dispersion and dose projections. This paper outlines the architecture of the TAS along with a brief description of the Sections' present tool set. Although the Section is now considered fully functional, plans are being developed to further improve its ability to diagnose accidents in an efficient and timely manner. A high-level outline of the future of the TAS is also presented. (author)

  7. Developing a service improvement initiative for people with learning disabilities in hospice settings.

    Science.gov (United States)

    Springall, Fiona

    2018-03-21

    People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme. This proposed initiative aimed to enhance end of life care for people with learning disabilities through the implementation of a community learning disability link nurse in the hospice setting. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  8. Initial investigation into development of accelerated pavement evaluation (APE) vehicle

    CSIR Research Space (South Africa)

    Steyn, WJvdM

    2002-08-01

    Full Text Available n e n t d e f o r m a t i o n [ m m ] Test 1 Test 2 Test 3 Test 4 Initial indication of performance Indication of performance after traffic application TR-2003/9: Initial investigation into development of APE vehicle. 6 2... Restricted Contract Report Initial Investigation into Development of Accelerated Pavement Evaluation (APE) Vehicle. Author: WJvdM Steyn M de Beer PREPARED FOR: PREPARED BY: CSIR Transportek STEP CSIR Transportek PO...

  9. National Evaluation of the Youth Firearms Violence Initiative.

    Science.gov (United States)

    Dunworth, Terence

    Between 1985 and 1994 the rate of violent criminal acts committed by juveniles rose sharply. Juvenile homicides committed with a handgun more than doubled. This bulletin discusses the national evaluation of the Youth Firearms Violence Initiative (YFVI), a program initiated by the Office of Community Oriented Policing Services (COPS) to fund…

  10. Automatic evaluations and exercise setting preference in frequent exercisers.

    Science.gov (United States)

    Antoniewicz, Franziska; Brand, Ralf

    2014-12-01

    The goals of this study were to test whether exercise-related stimuli can elicit automatic evaluative responses and whether automatic evaluations reflect exercise setting preference in highly active exercisers. An adapted version of the Affect Misattribution Procedure was employed. Seventy-two highly active exercisers (26 years ± 9.03; 43% female) were subliminally primed (7 ms) with pictures depicting typical fitness center scenarios or gray rectangles (control primes). After each prime, participants consciously evaluated the "pleasantness" of a Chinese symbol. Controlled evaluations were measured with a questionnaire and were more positive in participants who regularly visited fitness centers than in those who reported avoiding this exercise setting. Only center exercisers gave automatic positive evaluations of the fitness center setting (partial eta squared = .08). It is proposed that a subliminal Affect Misattribution Procedure paradigm can elicit automatic evaluations to exercising and that, in highly active exercisers, these evaluations play a role in decisions about the exercise setting rather than the amounts of physical exercise. Findings are interpreted in terms of a dual systems theory of social information processing and behavior.

  11. Evaluating priority setting success in healthcare: a pilot study

    Directory of Open Access Journals (Sweden)

    Upshur Ross

    2010-05-01

    Full Text Available Abstract Background In healthcare today, decisions are made in the face of serious resource constraints. Healthcare managers are struggling to provide high quality care, manage resources effectively, and meet changing patient needs. Healthcare managers who are constantly making difficult resource decisions desire a way to improve their priority setting processes. Despite the wealth of existing priority setting literature (for example, program budgeting and marginal analysis, accountability for reasonableness, the 'describe-evaluate-improve' strategy there are still no tools to evaluate how healthcare resources are prioritised. This paper describes the development and piloting of a process to evaluate priority setting in health institutions. The evaluation process was designed to examine the procedural and substantive dimensions of priority setting using a multi-methods approach, including a staff survey, decision-maker interviews, and document analysis. Methods The evaluation process was piloted in a mid-size community hospital in Ontario, Canada while its leaders worked through their annual budgeting process. Both qualitative and quantitative methods were used to analyze the data. Results The evaluation process was both applicable to the context and it captured the budgeting process. In general, the pilot test provided support for our evaluation process and our definition of success, (i.e., our conceptual framework. Conclusions The purpose of the evaluation process is to provide a simple, practical way for an organization to better understand what it means to achieve success in its priority setting activities and identify areas for improvement. In order for the process to be used by healthcare managers today, modification and contextualization of the process are anticipated. As the evaluation process is applied in more health care organizations or applied repeatedly in an organization, it may become more streamlined.

  12. Conditional Probabilities in the Excursion Set Theory. Generic Barriers and non-Gaussian Initial Conditions

    CERN Document Server

    De Simone, Andrea; Riotto, Antonio

    2011-01-01

    The excursion set theory, where density perturbations evolve stochastically with the smoothing scale, provides a method for computing the dark matter halo mass function. The computation of the mass function is mapped into the so-called first-passage time problem in the presence of a moving barrier. The excursion set theory is also a powerful formalism to study other properties of dark matter halos such as halo bias, accretion rate, formation time, merging rate and the formation history of halos. This is achieved by computing conditional probabilities with non-trivial initial conditions, and the conditional two-barrier first-crossing rate. In this paper we use the recently-developed path integral formulation of the excursion set theory to calculate analytically these conditional probabilities in the presence of a generic moving barrier, including the one describing the ellipsoidal collapse, and for both Gaussian and non-Gaussian initial conditions. The non-Markovianity of the random walks induced by non-Gaussi...

  13. Development and initial evaluation of the SCI-FI/AT.

    Science.gov (United States)

    Jette, Alan M; Slavin, Mary D; Ni, Pengsheng; Kisala, Pamela A; Tulsky, David S; Heinemann, Allen W; Charlifue, Susie; Tate, Denise G; Fyffe, Denise; Morse, Leslie; Marino, Ralph; Smith, Ian; Williams, Steve

    2015-05-01

    To describe the domain structure and calibration of the Spinal Cord Injury Functional Index for samples using Assistive Technology (SCI-FI/AT) and report the initial psychometric properties of each domain. Cross sectional survey followed by computerized adaptive test (CAT) simulations. Inpatient and community settings. A sample of 460 adults with traumatic spinal cord injury (SCI) stratified by level of injury, completeness of injury, and time since injury. None SCI-FI/AT RESULTS: Confirmatory factor analysis (CFA) and Item response theory (IRT) analyses identified 4 unidimensional SCI-FI/AT domains: Basic Mobility (41 items) Self-care (71 items), Fine Motor Function (35 items), and Ambulation (29 items). High correlations of full item banks with 10-item simulated CATs indicated high accuracy of each CAT in estimating a person's function, and there was high measurement reliability for the simulated CAT scales compared with the full item bank. SCI-FI/AT item difficulties in the domains of Self-care, Fine Motor Function, and Ambulation were less difficult than the same items in the original SCI-FI item banks. With the development of the SCI-FI/AT, clinicians and investigators have available multidimensional assessment scales that evaluate function for users of AT to complement the scales available in the original SCI-FI.

  14. Early initiation of night-time NIV in an outpatient setting: a randomized non-inferiority study in ALS patients.

    Science.gov (United States)

    Bertella, Enrica; Banfi, Paolo; Paneroni, Mara; Grilli, Silvia; Bianchi, Luca; Volpato, Eleonora; Vitacca, Michele

    2017-12-01

    In patients with amyotrophic lateral sclerosis (ALS), non-invasive ventilation (NIV) is usually initiated in an in-hospital regime. We investigated if NIV initiated in an outpatient setting can be as effective in terms of patients' acceptance/adherence. We also evaluated factors predicting NIV acceptance and adherence and disease progression. Prospective randomized study. Outpatient versus inpatient rehabilitation. ALS patients. ALS patients were randomized to two groups for NIV initiation: outpatients versus inpatients. At baseline (T0), end of NIV trial program (T1) and after 3 months from T1 (T2), respiratory function tests, blood gas analysis, and sleep study were performed. At T1, we assessed: NIV acceptance (>4 h/night), and dyspnea symptoms (day/night) by Visual analogue scale (VAS), staff and patients' experience (how difficult NIV was to accept, how difficult ventilator was to manage, satisfaction); at T2: NIV adherence (>120 h/month) and patients' experience. Fifty patients participated. There were no differences in acceptance failure (P=0.733) or adherence failure (P=0.529). At T1, outpatients had longer hours of nocturnal ventilation (PNIV acceptance/adherence failure. There were no between-group differences in progression of respiratory impairment, symptoms and sleep quality. Early outpatient initiation of NIV in ALS is as effective as inpatient initiation.

  15. Using Population Dose to Evaluate Community-level Health Initiatives.

    Science.gov (United States)

    Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

    2018-05-01

    Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Building clinicians-researchers partnerships: lessons from diverse natural settings and practice-oriented initiatives.

    Science.gov (United States)

    Castonguay, Louis G; Youn, Soo Jeong; Xiao, Henry; Muran, J Christopher; Barber, Jacques P

    2015-01-01

    In this concluding paper, we identify the type of studies conducted by 11 teams of contributors to a special issue on building clinicians-researchers partnerships. Those studies were conducted across a variety of clinical settings. We also integrate the lessons that have emerged from their collaborative initiatives in terms of obstacles faced, strategies adopted to address these challenges, benefits gained, and general recommendations offered to facilitate studies conducted with or by clinicians. The paper ends with the authors' thoughts about the future success of practice-oriented research in general.

  17. Leadership development through action learning sets: an evaluation study.

    Science.gov (United States)

    Walia, Surinder; Marks-Maran, Di

    2014-11-01

    This article examines the use of action learning sets in a leadership module delivered by a university in south east England. An evaluation research study was undertaking using survey method to evaluate student engagement with action learning sets, and their value, impact and sustainability. Data were collected through a questionnaire with a mix of Likert-style and open-ended questions and qualitative and quantitative data analysis was undertaken. Findings show that engagement in the action learning sets was very high. Action learning sets also had a positive impact on the development of leadership knowledge and skills and are highly valued by participants. It is likely that they would be sustainable as the majority would recommend action learning to colleagues and would consider taking another module that used action learning sets. When compared to existing literature on action learning, this study offers new insights as there is little empirical literature on student engagement with action learning sets and even less on value and sustainability. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. performance evaluation of feature sets of minutiae quadruplets

    African Journals Online (AJOL)

    databases. This shows that the evaluation of algorithms on just one or two databases is not sufficient to confirm the performance of tech- niques as they may be database-dependent. Much work was done to find a feature-set that would have a good performance across three. FVC databases of the FVC 2000, 2002 and. 2004 ...

  19. Psychometric evaluation of 3-set 4P questionnaire.

    Science.gov (United States)

    Akerman, Eva; Fridlund, Bengt; Samuelson, Karin; Baigi, Amir; Ersson, Anders

    2013-02-01

    This is a further development of a specific questionnaire, the 3-set 4P, to be used for measuring former ICU patients' physical and psychosocial problems after intensive care and the need for follow-up. The aim was to psychometrically test and evaluate the 3-set 4P questionnaire in a larger population. The questionnaire consists of three sets: "physical", "psychosocial" and "follow-up". The questionnaires were sent by mail to all patients with more than 24-hour length of stay on four ICUs in Sweden. Construct validity was measured with exploratory factor analysis with Varimax rotation. This resulted in three factors for the "physical set", five factors for the "psychosocial set" and four factors for the "follow-up set" with strong factor loadings and a total explained variance of 62-77.5%. Thirteen questions in the SF-36 were used for concurrent validity showing Spearman's r(s) 0.3-0.6 in eight questions and less than 0.2 in five. Test-retest was used for stability reliability. In set follow-up the correlation was strong to moderate and in physical and psychosocial sets the correlations were moderate to fair. This may have been because the physical and psychosocial status changed rapidly during the test period. All three sets had good homogeneity. In conclusion, the 3-set 4P showed overall acceptable results, but it has to be further modified in different cultures before being considered a fully operational instrument for use in clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. VideoSET: Video Summary Evaluation through Text

    OpenAIRE

    Yeung, Serena; Fathi, Alireza; Fei-Fei, Li

    2014-01-01

    In this paper we present VideoSET, a method for Video Summary Evaluation through Text that can evaluate how well a video summary is able to retain the semantic information contained in its original video. We observe that semantics is most easily expressed in words, and develop a text-based approach for the evaluation. Given a video summary, a text representation of the video summary is first generated, and an NLP-based metric is then used to measure its semantic distance to ground-truth text ...

  1. Clinical evaluation of a new set of image quality criteria for mammography

    International Nuclear Information System (INIS)

    Grahn, A.; Hemdal, B.; Andersson, I.; Ruschin, M.; Thilander-Klang, A.; Boerjesson, S.; Tingberg, A.; Mattsson, S.; Haakansson, M.; Baath, M.; Maansson, L. G.; Medin, J.; Wanninger, F.; Panzer, W.

    2005-01-01

    The European Commission (EC) quality criteria for screen-film mammography are used as a tool to asses image quality. A new set of criteria was developed and initially tested in a previous study. In the present study, these criteria are further evaluated using screen-film mammograms that have been digitised, manipulated to simulated different image quality level and reprinted on film. Expert radiologists have evaluated these manipulated to simulate different image quality levels and reprinted on film. Expert radiologists have evaluated these manipulated images using both the original (EC) and the new criteria. A comparison of three different simulated dose levels that the new criteria yield a larger separation of image criteria scores than the old ones. These results indicated that the new set of image quality criteria has a higher discriminative power than the old set and thus seems to be more suitable for evaluation of image quality in mammography. (authors)

  2. Evaluating U.S. States climate change initiatives

    Energy Technology Data Exchange (ETDEWEB)

    Silva, P

    2004-07-01

    This paper evaluates sub-federal efforts to mitigate climate change in the United States through a range of climate-relevant initiatives, identifying principal trends and detailing climate-relevant initiatives in several states. These strategies include renewable electricity mandates, State and regional greenhouse gas emissions inventories, mandatory greenhouse gas emissions reporting, State greenhouse gas emissions caps, greenhouse gas emissions reductions from motor vehicles, and greenhouse gas emissions cap-and-trade programs for electric generation in several States. Many municipalities in the United States are also pursuing a range of climate-relevant initiatives, those actions are beyond the scope of this paper, but it should be noted they also influence state and national consideration of climate-relevant initiatives in the United States. (author)

  3. Evaluating U.S. States climate change initiatives

    International Nuclear Information System (INIS)

    Silva, P.

    2004-01-01

    This paper evaluates sub-federal efforts to mitigate climate change in the United States through a range of climate-relevant initiatives, identifying principal trends and detailing climate-relevant initiatives in several states. These strategies include renewable electricity mandates, State and regional greenhouse gas emissions inventories, mandatory greenhouse gas emissions reporting, State greenhouse gas emissions caps, greenhouse gas emissions reductions from motor vehicles, and greenhouse gas emissions cap-and-trade programs for electric generation in several States. Many municipalities in the United States are also pursuing a range of climate-relevant initiatives, those actions are beyond the scope of this paper, but it should be noted they also influence state and national consideration of climate-relevant initiatives in the United States. (author)

  4. The evaluation of set of criticality parameters using scale system

    International Nuclear Information System (INIS)

    Abe, Alfredo; Sanchez, Andrea; Yamaguchi, Mistuo

    2009-01-01

    In evaluating the criticality safety of the nuclear fuel facility, it is important to apply a consistent methodology, which consider every aspects concerning various types of criticality parameters. Usually, the critical parameters are compiled and arranged into handbooks, and these handbooks are based on experience with nuclear facilities, experimental data from criticality safety research facilities, and theoretical studies performed using numerical simulations. Most of criticality safety evaluation can be addressed using the criticality parameters data directly from handbook, but some critical parameters for a specific chemical mixtures and/or enrichment are not be available. Consequently, not available parameters has to be evaluated. This work present the methodology to evaluate a set of critical parameters using SCALE system for various types of mixtures present at nuclear fuel cycle facilities for two different level of enrichment, the results are verified in the independent calculation using MCNP Monte Carlo Code. (author)

  5. Managing the clinical setting for best nursing practice: a brief overview of contemporary initiatives.

    Science.gov (United States)

    Henderson, Amanda; Winch, Sarah

    2008-01-01

    Leadership strategies are important in facilitating the nursing profession to reach their optimum standards in the practice environment. To compare and contrast the central tenets of contemporary quality initiatives that are commensurate with enabling the environment so that best practice can occur. Democratic leadership, accessible and relevant education and professional development, the incorporation of evidence into practice and the ability of facilities to be responsive to change are core considerations for the successful maintenance of practice standards that are consistent with best nursing practice. While different concerns of management drive the adoption of contemporary approaches, there are many similarities in the how these approaches are translated into action in the clinical setting. Managers should focus on core principles of professional nursing that add value to practice rather than business processes.

  6. California Breast Cancer Prevention Initiatives: Setting a research agenda for prevention.

    Science.gov (United States)

    Sutton, P; Kavanaugh-Lynch, M H E; Plumb, M; Yen, I H; Sarantis, H; Thomsen, C L; Campleman, S; Galpern, E; Dickenson, C; Woodruff, T J

    2015-07-01

    The environment is an underutilized pathway to breast cancer prevention. Current research approaches and funding streams related to breast cancer and the environment are unequal to the task at hand. We undertook the California Breast Cancer Prevention Initiatives, a four-year comprehensive effort to set a research agenda related to breast cancer, the environment, disparities and prevention. We identified 20 topics for Concept Proposals reflecting a life-course approach and the complex etiology of breast cancer; considering the environment as chemical, physical and socially constructed exposures that are experienced concurrently: at home, in the community and at work; and addressing how we should be modifying the world around us to promote a less carcinogenic environment. Redirecting breast cancer research toward prevention-oriented discovery could significantly reduce the incidence and associated disparities of the disease among future generations. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Automated work packages architecture: An initial set of human factors and instrumentation and controls requirements

    Energy Technology Data Exchange (ETDEWEB)

    Agarwal, Vivek [Idaho National Lab. (INL), Idaho Falls, ID (United States); Oxstrand, Johanna H. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Le Blanc, Katya L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-09-01

    The work management process in current fleets of national nuclear power plants is so highly dependent on large technical staffs and quality of work instruction, i.e., paper-based, that this puts nuclear energy at somewhat of a long-term economic disadvantage and increase the possibility of human errors. Technologies like mobile portable devices and computer-based procedures can play a key role in improving the plant work management process, thereby increasing productivity and decreasing cost. Automated work packages are a fundamentally an enabling technology for improving worker productivity and human performance in nuclear power plants work activities because virtually every plant work activity is accomplished using some form of a work package. As part of this year’s research effort, automated work packages architecture is identified and an initial set of requirements identified, that are essential and necessary for implementation of automated work packages in nuclear power plants.

  8. A public data set of human balance evaluations

    Directory of Open Access Journals (Sweden)

    Damiana A. Santos

    2016-11-01

    Full Text Available The goal of this study was to create a public data set with results of qualitative and quantitative evaluations related to human balance. Subject’s balance was evaluated by posturography using a force platform and by the Mini Balance Evaluation Systems Tests. In the posturography test, we evaluated subjects standing still for 60 s in four different conditions where vision and the standing surface were manipulated: on a rigid surface with eyes open; on a rigid surface with eyes closed; on an unstable surface with eyes open; on an unstable surface with eyes closed. Each condition was performed three times and the order of the conditions was randomized. In addition, the following tests were employed in order to better characterize each subject: Short Falls Efficacy Scale International; International Physical Activity Questionnaire Short Version; and Trail Making Test. The subjects were also interviewed to collect information about their socio-cultural, demographic, and health characteristics. The data set comprises signals from the force platform (raw data for the force, moments of forces, and centers of pressure of 163 subjects plus one file with information about the subjects and balance conditions and the results of the other evaluations. All the data is available at PhysioNet and at Figshare.

  9. Evaluation of the separate effects tests (SET) validation matrix

    International Nuclear Information System (INIS)

    1996-11-01

    This work is the result of a one year extended mandate which has been given by the CSNI on the request of the PWG 2 and the Task Group on Thermal Hydraulic System Behaviour (TG THSB) in late 1994. The aim was to evaluate the SET validation matrix in order to define the real needs for further experimental work. The statistical evaluation tables of the SET matrix provide an overview of the data base including the parameter ranges covered for each phenomenon and selected parameters, and questions posed to obtain answers concerning the need for additional experimental data with regard to the objective of nuclear power plant safety. A global view of the data base is first presented focussing on areas lacking in data and on hot topics. A new systematic evaluation has been done based on the authors technical judgments and giving evaluation tables. In these tables, global and indicative information are included. Four main parameters have been chosen as the most important and relevant parameters: a state parameter given by the operating pressure of the tests, a flow parameter expressed as mass flux, mass flow rate or volumetric flow rate in the tests, a geometrical parameter provided through a typical dimension expressed by a diameter, an equivalent diameter (hydraulic or heated) or a cross sectional area of the test sections, and an energy or heat transfer parameter given as the fluid temperature, the heat flux or the heat transfer surface temperature of the tests

  10. EVALUATION OF CONSISTENCY AND SETTING TIME OF IRANIAN DENTAL STONES

    Directory of Open Access Journals (Sweden)

    F GOL BIDI

    2000-09-01

    Full Text Available Introduction. Dental stones are widely used in dentistry and the success or failure of many dental treatments depend on the accuracy of these gypsums. The purpose of this study was the evaluation of Iranian dental stones and comparison between Iranian and foreign ones. In this investigation, consistency and setting time were compared between Pars Dendn, Almas and Hinrizit stones. The latter is accepted by ADA (American Dental Association. Consistency and setting time are 2 of 5 properties that are necessitated by both ADA specification No. 25 and Iranian Standard Organization specification No. 2569 for evaluation of dental stones. Methods. In this study, the number and preparation of specimens and test conditions were done according to the ADA specification No. 25 and all the measurements were done with vicat apparatus. Results. The results of this study showed that the standard consistency of Almas stone was obtained by 42ml water and 100gr powder and the setting time of this stone was 11±0.03 min. Which was with in the limits of ADA specification (12±4 min. The standard consistency of Pars Dandan stone was obrianed by 31ml water and 100 gr powder, but the setting time of this stone was 5± 0.16 min which was nt within the limits of ADA specification. Discussion: Comparison of Iranian and Hinrizit stones properties showed that two probable problems of Iranian stones are:1- Unhemogrnousity of Iranian stoned powder was caused by uncontrolled temperature, pressure and humidity in the production process of stone. 2- Impurities such as sodium chloride was responsible fo shortening of Pars Dendens setting time.

  11. Implementation of a Quality Improvement Initiative: Improved Congenital Muscular Torticollis Outcomes in a Large Hospital Setting.

    Science.gov (United States)

    Strenk, Mariann L; Kiger, Michelle; Hawke, Jesse L; Mischnick, Amy; Quatman-Yates, Catherine

    2017-06-01

    The American Physical Therapy Association (APTA) published a guideline for congenital muscular torticollis (CMT) in 2013. Our division adopted the guideline as the institutional practice standard and engaged in a quality improvement (QI) initiative to increase the percentage of patients who achieved resolution of CMT within 6 months of evaluation. The aims of this report are to describe the QI activities conducted to improve patient outcomes and discuss the results and implications for other institutions and patient populations. This was a quality improvement study. In alignment with the Chronic Care Model and Model of Improvement, an aim and operationally defined key outcome and process measures were established. Interventions were tested using Plan-Do-Study-Act cycles. A CMT registry was established to store and manage data extracted from the electronic record over the course of testing. Statistical process control charts were used to monitor progress over time. The QI initiative resulted in an increase in the percentage of patients who achieved full resolution of CMT within a 6-month episode of care from 42% to 61% over an 18-month period. Themes that emerged as key drivers of improvement included: (1) timely, optimal access to care, (2) effective audit and clinician feedback, and (3) accurate, timely documentation. The initiative took place at a single institution with a supportive culture and strong QI resources, which may limit direct translation of interventions and findings to other institutions and patient populations. Improvement science methodologies provided the tools and structure to improve division-wide workflow and increase consistency in the implementation of the APTA CMT guideline. In doing so, significant CMT population outcome improvements were achieved. © 2017 American Physical Therapy Association

  12. Using Concrete and Realistic Data in Evaluating Initial Visualization Designs

    DEFF Research Database (Denmark)

    Knudsen, Søren; Pedersen, Jeppe Gerner; Herdal, Thor

    2016-01-01

    We explore means of designing and evaluating initial visualization ideas, with concrete and realistic data in cases where data is not readily available. Our approach is useful in exploring new domains and avenues for visualization, and contrasts other visualization work, which typically operate...... under the assumption that data has already been collected, and is ready to be visualized. We argue that it is sensible to understand data requirements and evaluate the potential value of visualization before devising means of automatic data collection. We base our exploration on three cases selected...... the design case and problem, the manner in which we collected data, and the findings obtained from evaluations. Afterwards, we describe four factors of our data collection approach, and discuss potential outcomes from it....

  13. Economic gains stimulate negative evaluations of corporate sustainability initiatives

    Science.gov (United States)

    Makov, Tamar; Newman, George E.

    2016-09-01

    In recent years, many organizations have sought to align their financial goals with environmental ones by identifying strategies that maximize profits while minimizing environmental impacts. Examples of this `win-win' approach can be found across a wide range of industries, from encouraging the reuse of hotel towels, to the construction of energy efficient buildings, to the large-scale initiatives of multi-national corporations. Although win-win strategies are generally thought to reflect positively on the organizations that employ them, here we find that people tend to respond negatively to the notion of profiting from environmental initiatives. In fact, observers may evaluate environmental win-wins less favourably than profit-seeking strategies that have no environmental benefits. The present studies suggest that how those initiatives are communicated to the general public may be of central importance. Therefore, organizations would benefit from carefully crafting the discourse around their win-win initiatives to ensure that they avoid this type of backlash.

  14. Multi-voxel MR spectroscopic imaging of the brain: utility in clinical setting-initial results

    International Nuclear Information System (INIS)

    Parmar, Hemant; Lim, Tchoyoson C.C.; Yin Hong; Chua, Violet; Khin, Lay-Wai; Raidy, Tom; Hui, Francis

    2005-01-01

    Background and purpose: Compared to single voxel methods, MR spectroscopic imaging (MRSI) of the brain provides metabolic information with improved anatomical coverage and spectral resolution, but may be difficult to perform in the clinical setting. We evaluate the factors influencing spectral quality in MRSI using a semi-automated method, focussing on lipid contamination, and phase correction errors related to magnetic field inhomogeneity. Methods: We retrospectively analysed MRSI studies planned by radiologists and radiographers. Two-dimensional MRSI studies using point-resolved spectroscopy (PRESS) localisation, at long echo time (135 or 144 ms) were acquired on a 1.5 T scanner. Studies that contained lipid contamination and abnormally inverted spectra were reviewed and the latter correlated with anatomic location at the base of skull, and with the area of the region of interest (ROI) studied. Results: Of 128 consecutive MRSI studies, six showed abnormal inverted spectra, of which four were acquired at the base of skull. Multivariate logistic regression analysis showed that study location at the base of skull, but not larger ROI, was a significant predictor for the risk of being affected by inverted spectra (RR for base of skull: 11.76, 95% CI: 1.86-74.18, P = 0.009. RR for area of ROI: 3.68, 95% CI: 0.57-23.67, P = 0.170). Seven studies showed lipid contamination; all were in close proximity to the overlying scalp. Conclusion: Using a semi-automated acquisition and post-processing method, MRSI can be successfully applied in the clinical setting. However, care should be taken to avoid regions of high magnetic field inhomogeneity at the base of skull, and lipid contamination in voxels prescribed near the scalp

  15. Fractal analysis on a classical hard-wall billiard with openings using a two-dimensional set of initial conditions

    International Nuclear Information System (INIS)

    Ree, Suhan

    2003-01-01

    Fractal analysis is performed to measure the chaoticity of a classical hard-wall billiard with openings. We use the circular billiard with a straight cut with two openings, and a two-dimensional (2D) set of initial conditions that produce all possible trajectories of a particle injected from one opening. We numerically compute the fractal dimension of singular points of the function that maps an initial condition to the number of collisions with the wall before the exit, using the box-counting algorithm that uses uniformly distributed points inside the 2D set of initial conditions. Finally, the classical chaotic properties are observed while the parameters of the billiard are varied, and the results are compared with those with the one-dimensional set of initial conditions

  16. Initial mechanical ventilator settings and lung protective ventilation in the ED.

    Science.gov (United States)

    Wilcox, Susan R; Richards, Jeremy B; Fisher, Daniel F; Sankoff, Jeffrey; Seigel, Todd A

    2016-08-01

    Mechanical ventilation with low tidal volumes has been shown to improve outcomes for patients both with and without acute respiratory distress syndrome. This study aims to characterize mechanically ventilated patients in the emergency department (ED), describe the initial ED ventilator settings, and assess for associations between lung protective ventilation strategies in the ED and outcomes. This was a multicenter, prospective, observational study of mechanical ventilation at 3 academic EDs. We defined lung protective ventilation as a tidal volume of less than or equal to 8 mL/kg of predicted body weight and compared outcomes for patients ventilated with lung protective vs non-lung protective ventilation, including inhospital mortality, ventilator days, intensive care unit length of stay, and hospital length of stay. Data from 433 patients were analyzed. Altered mental status without respiratory pathology was the most common reason for intubation, followed by trauma and respiratory failure. Two hundred sixty-one patients (60.3%) received lung protective ventilation, but most patients were ventilated with a low positive end-expiratory pressure, high fraction of inspired oxygen strategy. Patients were ventilated in the ED for a mean of 5 hours and 7 minutes but had few ventilator adjustments. Outcomes were not significantly different between patients receiving lung protective vs non-lung protective ventilation. Nearly 40% of ED patients were ventilated with non-lung protective ventilation as well as with low positive end-expiratory pressure and high fraction of inspired oxygen. Despite a mean ED ventilation time of more than 5 hours, few patients had adjustments made to their ventilators. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Automatic localization of landmark sets in head CT images with regression forests for image registration initialization

    Science.gov (United States)

    Zhang, Dongqing; Liu, Yuan; Noble, Jack H.; Dawant, Benoit M.

    2016-03-01

    Cochlear Implants (CIs) are electrode arrays that are surgically inserted into the cochlea. Individual contacts stimulate frequency-mapped nerve endings thus replacing the natural electro-mechanical transduction mechanism. CIs are programmed post-operatively by audiologists but this is currently done using behavioral tests without imaging information that permits relating electrode position to inner ear anatomy. We have recently developed a series of image processing steps that permit the segmentation of the inner ear anatomy and the localization of individual contacts. We have proposed a new programming strategy that uses this information and we have shown in a study with 68 participants that 78% of long term recipients preferred the programming parameters determined with this new strategy. A limiting factor to the large scale evaluation and deployment of our technique is the amount of user interaction still required in some of the steps used in our sequence of image processing algorithms. One such step is the rough registration of an atlas to target volumes prior to the use of automated intensity-based algorithms when the target volumes have very different fields of view and orientations. In this paper we propose a solution to this problem. It relies on a random forest-based approach to automatically localize a series of landmarks. Our results obtained from 83 images with 132 registration tasks show that automatic initialization of an intensity-based algorithm proves to be a reliable technique to replace the manual step.

  18. Landscape evaluation of heterogeneous areas using fuzzy sets

    Directory of Open Access Journals (Sweden)

    Ralf-Uwe Syrbe

    1998-02-01

    Full Text Available Landscape evaluation is an interesting field for fuzzy approaches, because it happens on the transition line between natural and social systems. Both are very complex. Therefore, transformation of scientific results to politically significant statements on environmental problems demands intelligent support. Particularly landscape planners need methods to gather natural facts of an area and assess them in consideration of its meaning to society as a whole. Since each land unit is heterogeneous, a special methodology is necessary. Such an evaluation technique was developed within a Geographical Information System (ARC/INFO. The methodology combines several known methods with fuzzy approaches to catch the intrinsic fuzziness of ecological systems as well as the heterogeneity of landscape. Additionally, a way will be discussed to vary the fuzzy inference in order to consider spatial relations of various landscape elements. Fuzzy logic is used to process the data uncertainty, to simulate the vagueness of knowledge about ecological functionality, and to model the spatial structure of landscape. Fuzzy sets describe the attributes of thematically defined land units and their assessment results. In this way, the available information will be preserved in their full diversity. The fuzzy operations are executed by AML-programs (ARC/INFO Macro Language. With such a tight coupling, it is possible to use the geographical functions (neighbourhoods, distances, etc. of GIS within the fuzzy system directly.

  19. Employee Wellbeing: Evaluating a Wellbeing Intervention in Two Settings.

    Science.gov (United States)

    Keeman, Alexis; Näswall, Katharina; Malinen, Sanna; Kuntz, Joana

    2017-01-01

    This research presents two studies conducted to evaluate the Wellbeing Game in two different contexts: In a student sample and in an organizational setting. Study 1 investigated the efficacy of the Wellbeing Game, in terms of its effect of wellbeing, stress, and an image valence test, among 60 university students. The results showed that after playing the Wellbeing Game, students reported a significant positive change in wellbeing compared to those who did not play the Wellbeing Game, but there was no decrease in stress or any change in classification of image valence. Study 2 evaluated the Wellbeing Game in an organizational context. Employees ( n = 52) in a financial organization played the Wellbeing Game for 4 weeks and answered survey questions about wellbeing and stress at the beginning and end of this period. The results showed that after playing the Wellbeing Game, employees reported lower stress levels, and higher wellbeing levels for those who felt that it had helped them connect more with colleagues. The results from the two studies provide preliminary support that the Wellbeing Game may be an effective wellbeing intervention tool in both an organization and a non-organizational context.

  20. Initial laboratory evaluation of color video cameras: Phase 2

    Energy Technology Data Exchange (ETDEWEB)

    Terry, P.L.

    1993-07-01

    Sandia National Laboratories has considerable experience with monochrome video cameras used in alarm assessment video systems. Most of these systems, used for perimeter protection, were designed to classify rather than to identify intruders. The monochrome cameras were selected over color cameras because they have greater sensitivity and resolution. There is a growing interest in the identification function of security video systems for both access control and insider protection. Because color camera technology is rapidly changing and because color information is useful for identification purposes, Sandia National Laboratories has established an on-going program to evaluate the newest color solid-state cameras. Phase One of the Sandia program resulted in the SAND91-2579/1 report titled: Initial Laboratory Evaluation of Color Video Cameras. The report briefly discusses imager chips, color cameras, and monitors, describes the camera selection, details traditional test parameters and procedures, and gives the results reached by evaluating 12 cameras. Here, in Phase Two of the report, we tested 6 additional cameras using traditional methods. In addition, all 18 cameras were tested by newly developed methods. This Phase 2 report details those newly developed test parameters and procedures, and evaluates the results.

  1. Building the field of population health intervention research: The development and use of an initial set of competencies

    Directory of Open Access Journals (Sweden)

    Barbara Riley

    2015-01-01

    This initial set of competencies, released in 2013, may be used to develop graduate student curriculum, recruit trainees and faculty to academic institutions, plan non-degree professional development, and develop job descriptions for PHIR-related research and professional positions. The competencies provide some initial guideposts for the field and will need to be adapted as the PHIR field matures and to meet unique needs of different jurisdictions.

  2. Evaluating Teachers' Professional Development Initiatives: Towards an Extended Evaluative Framework

    Science.gov (United States)

    Merchie, Emmelien; Tuytens, Melissa; Devos, Geert; Vanderlinde, Ruben

    2018-01-01

    Evaluating teachers' professional development initiatives (PDI) is one of the main challenges for the teacher professionalisation field. Although different studies have focused on the effectiveness of PDI, the obtained effects and evaluative methods have been found to be widely divergent. By means of a narrative review, this study provides an…

  3. Methods for evaluating cervical range of motion in trauma settings

    Directory of Open Access Journals (Sweden)

    Voss Sarah

    2012-08-01

    Full Text Available Abstract Immobilisation of the cervical spine is a common procedure following traumatic injury. This is often precautionary as the actual incidence of spinal injury is low. Nonetheless, stabilisation of the head and neck is an important part of pre-hospital care due to the catastrophic damage that may follow if further unrestricted movement occurs in the presence of an unstable spinal injury. Currently available collars are limited by the potential for inadequate immobilisation and complications caused by pressure on the patient’s skin, restricted airway access and compression of the jugular vein. Alternative approaches to cervical spine immobilisation are being considered, and the investigation of these new methods requires a standardised approach to the evaluation of neck movement. This review summarises the research methods and scientific technology that have been used to assess and measure cervical range of motion, and which are likely to underpin future research in this field. A systematic search of international literature was conducted to evaluate the methodologies used to assess the extremes of movement that can be achieved in six domains. 34 papers were included in the review. These studies used a range of methodologies, but study quality was generally low. Laboratory investigations and biomechanical studies have gradually given way to methods that more accurately reflect the real-life situations in which cervical spine immobilisation occurs. Latterly, new approaches using virtual reality and simulation have been developed. Coupled with modern electromagnetic tracking technology this has considerable potential for effective application in future research. However, use of these technologies in real life settings can be problematic and more research is needed.

  4. EXTRA: a digital computer program for the solution of stiff sets of ordinary initial value, first order differential equations

    International Nuclear Information System (INIS)

    Sidell, J.

    1976-08-01

    EXTRA is a program written for the Winfrith KDF9 enabling the user to solve first order initial value differential equations. In this report general numerical integration methods are discussed with emphasis on their application to the solution of stiff sets of equations. A method of particular applicability to stiff sets of equations is described. This method is incorporated in the program EXTRA and full instructions for its use are given. A comparison with other methods of computation is included. (author)

  5. Can traditional birth attendants be trained to accurately identify septic infants, initiate antibiotics, and refer in a rural African setting?

    Science.gov (United States)

    Gill, Christopher John; MacLeod, William B; Phiri-Mazala, Grace; Guerina, Nicholas G; Mirochnick, Mark; Knapp, Anna B; Hamer, Davidson H

    2014-08-01

    Neonatal sepsis is a major cause of neonatal mortality. In populations with limited access to health care, early identification of bacterial infections and initiation of antibiotics by community health workers (CHWs) could be lifesaving. It is unknown whether this strategy would be feasible using traditional birth attendants (TBAs), a cadre of CHWs who typically have limited training and educational backgrounds. We analyzed data from the intervention arm of a cluster-randomized trial involving TBAs in Lufwanyama District, Zambia, from June 2006 to November 2008. TBAs followed neonates for signs of potential infection through 28 days of life. If any of 16 criteria were met, TBAs administered oral amoxicillin and facilitated referral to a rural health center. Our analysis included 1,889 neonates with final vital status by day 28. TBAs conducted a median of 2 (interquartile range 2-6) home visits (51.4% in week 1 and 48.2% in weeks 2-4) and referred 208 neonates (11%) for suspected sepsis. Of referred neonates, 176/208 (84.6%) completed their referral. Among neonates given amoxicillin, 171/183 (93.4%) were referred; among referred neonates, 171/208 (82.2%) received amoxicillin. Referral and/or initiation of antibiotics were strongly associated with neonatal death (for referral, relative risk [RR] = 7.93, 95% confidence interval [CI] = 4.4-14.3; for amoxicillin administration, RR = 4.7, 95% CI = 2.4-8.7). Neonates clinically judged to be "extremely sick" by the referring TBA were at greatest risk of death (RR = 8.61, 95% CI = 4.0-18.5). The strategy of administering a first dose of antibiotics and referring based solely on the clinical evaluation of a TBA is feasible and could be effective in reducing neonatal mortality in remote rural settings.

  6. 75 FR 82397 - Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults

    Science.gov (United States)

    2010-12-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary [CMS-2420-NC] Medicaid Program: Initial Core Set of Health Quality Measures for Medicaid-Eligible Adults AGENCY: Office of the Secretary... quality measures recommended for Medicaid-eligible adults, as required by section 2701 of the Affordable...

  7. Evaluation of Suitability of Selected Set of Coal Plant Sites for Repowering with Small Modular Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Belles, Randy [ORNL; Copinger, Donald A [ORNL; Mays, Gary T [ORNL; Omitaomu, Olufemi A [ORNL; Poore III, Willis P [ORNL

    2013-03-01

    This report summarizes the approach that ORNL developed for screening a sample set of small coal stations for possible repowering with SMRs; the methodology employed, including spatial modeling; and initial results for these sample plants. The objective in conducting this type of siting evaluation is to demonstrate the capability to characterize specific sample coal plant sites to identify any particular issues associated with repowering existing coal stations with SMRs using OR-SAGE; it is not intended to be a definitive assessment per se as to the absolute suitability of any particular site.

  8. Employment and risk of injection drug use initiation among street involved youth in Canadian setting.

    Science.gov (United States)

    Richardson, Lindsey; DeBeck, Kora; Feng, Cindy; Kerr, Thomas; Wood, Evan

    2014-09-01

    Youth unemployment has been associated with labour market and health disparities. However, employment as a determinant of high-risk health behaviour among marginalized young people has not been well described. We sought to assess a potential relationship between employment status and initiation of intravenous drug use among a prospective cohort of street-involved youth. We followed injecting naïve youth in the At-Risk Youth Study, a cohort of street-involved youth aged 14-26 in Vancouver, Canada, and employed Cox regression analyses to examine whether employment was associated with injection initiation. Among 422 injecting naïve youth recruited between September 2005 and November 2011, 77 participants transitioned from non-injection to injection drug use, for an incidence density of 10.3 (95% confidence interval [CI]: 8.0-12.6) per 100 person years. Results demonstrating that employment was inversely associated with injection initiation (adjusted hazard ratio: 0.53; 95% CI: 0.33-0.85) were robust to adjustment for a range of potential confounders. A lack of employment among street-involved youth was associated with the initiation of injection drug use, a practice that predisposes individuals to serious long-term health consequences. Future research should examine if reducing barriers to labour market involvement among street-involved youth prevents transitions into high-risk drug use. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Reducing socioeconomic inequalities in COPD care in the hospital outpatient setting - A nationwide initiative

    DEFF Research Database (Denmark)

    Tøttenborg, Sandra Søgaard; Lange, Peter; Thomsen, Reimar W

    2017-01-01

    Objective: Socioeconomic differences in quality of care have been suggested to contribute to inequality in clinical prognosis of COPD. We examined socioeconomic differences in the quality of COPD outpatient care and the potential of a systematic quality improvement initiative in reducing potentia...

  10. Initial evaluation of a full breast digital system

    International Nuclear Information System (INIS)

    Vano, E.; Fernandez, J.M.; Chevalier, M.; Moran, P.; Cepeda, T.; Fabra, A.; Alvarez Pedrosa, C.S.

    2001-01-01

    Full-field digital mammography systems have been developed for overcoming the limitations of the screen-film mammography. This work is focused on the system from GE Medical Systems (Senographe 2000) which has been recently installed in our institution. The imager consists of a thin Ics:Tl scintillator which is in narrow contact with an array of amorphous silicon detectors mounted in a single panel. The flat-panel detector is integrated in a x-ray system with a high-frequency generator Senographe DM and dual track anode of Mo and Rh with Mo and Rh filtration. The aim of this work is to analyse the defaults exposure factors set at the installation of the x-ray unit. The image quality has been evaluated by using one of the two phantoms recommended in the ACR Accreditation Program. Phantom images were obtained at each of the three available imaging modes: contrast (CNT), standard (STD) and DOSE. While maintaining the defaults of kilovoltage and anode/filter combination, phantom images were obtained at lower dose vales. The contrast noise ratio (CNR) was calculated for each of the low contrast objects (masses) of the phantom images and the detail visibility was also evaluated. The results obtained for both parameters reveal that similar image quality can be obtained with significant reductions of the average glandular dose. (author)

  11. Assessing students in community settings: the role of peer evaluation

    NARCIS (Netherlands)

    H.G. Schmidt (Henk); D.H.J.M. Dolmans (Diana); A.A. Abdel-Hameed (Ahmed); M.E.M. Mohi Eldin (Magzoub)

    1998-01-01

    textabstractThe assessment of students in community settings faces unique difficulties. Since students are usually posted in small groups in different community settings and since the learning (largely) takes place outside the classroom, assessing student performance becomes an intrinsically complex

  12. Provider-initiated HIV testing in health care settings: Should it ...

    African Journals Online (AJOL)

    centered counselling? ... SAHARA-J: Journal of Social Aspects of HIV/AIDS ... To address the resource limitations of the PITC setting, WHO and CDC suggest that patient-provider interactions during PITC may need to focus on providing information ...

  13. The Evaluation of the Initial Shear Modulus of Selected Cohesive Soils

    Science.gov (United States)

    Gabryś, Katarzyna; Szymański, Alojzy

    2015-06-01

    The paper concerns the evaluation of the initial stiffness of selected cohesive soils based on laboratory tests. The research materials used in this study were clayey soils taken from the area of the road embankment No. WD-18, on the 464th km of the S2 express-way, Konotopa-Airport route, Warsaw. The initial stiffness is represented here by the shear modulus (Gmax) determined during resonant column tests. In the article, a number of literature empirical formulas for defining initial value of the shear modulus of soils being examined were adopted from the literature in order to analyze the data set. However, a large discrepancy between laboratory test results and the values of Gmax calculated from empirical relationships resulted in the rejection of these proposals. They are inaccurate and do not allow for an exact evaluation of soil stiffness for selected cohesive soils. Hence, the authors proposed their own empirical formula that enables the evaluation of the test soils' Gmax in an easy and uncomplicated way. This unique formula describes mathematically the effect of certain soil parameters, namely mean effective stress ( p') and void ratio (e), on the initial soil stiffness.

  14. An evaluation of safety culture initiatives at BNSF Railway

    Science.gov (United States)

    2015-04-01

    Major safety culture (SC) initiatives initiated in the FRA Office of Research, Technology and Development (RT&D), such as Clear Signal for Action (CSA), the Investigation of Safety Related Occurrences Protocol (ISROP), the Participative Safety Rules ...

  15. Practical Approaches to Evaluating Progress and Outcomes in Community-Wide Teen Pregnancy Prevention Initiatives.

    Science.gov (United States)

    Tevendale, Heather D; Condron, D Susanne; Garraza, Lucas Godoy; House, L Duane; Romero, Lisa M; Brooks, Megan A M; Walrath, Christine

    2017-03-01

    This paper presents an overview of the key evaluation components for a set of community-wide teen pregnancy prevention initiatives. We first describe the performance measures selected to assess progress toward meeting short-term objectives on the reach and quality of implementation of evidence-based teen pregnancy prevention interventions and adolescent reproductive health services. Next, we describe an evaluation that will compare teen birth rates in intervention communities relative to synthetic control communities. Synthetic controls are developed via a data-driven technique that constructs control communities by combining information from a pool of communities that are similar to the intervention community. Finally, we share lessons learned thus far in the evaluation of the project, with a focus on those lessons that may be valuable for local communities evaluating efforts to reduce teen pregnancy. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Initial ACTR retrieval technology evaluation test material recommendations

    International Nuclear Information System (INIS)

    Powell, M.R.

    1996-04-01

    Millions of gallons of radiaoctive waste are contained in underground storage tanks at Hanford (SE Washington). Techniques for retrieving much of this waste from the storage tanks have been developed. Current baseline approach is to use sluice jets for single-shell tanks and mixer pumps for double-shell tanks. The Acquire Commercial Technology for Retrieval (ACTR) effort was initiated to identify potential improvements in or alternatives to the baseline waste retrieval methods. Communications with a variety of vendors are underway to identify improved methods that can be implemented at Hanford with little or no additional development. Commercially available retrieval methods will be evaluated by a combination of testing and system-level cost estimation. Current progress toward developing waste simulants for testing ACTR candidate methods is reported; the simulants are designed to model 4 different types of tank waste. Simulant recipes are given for wet sludge, hardpan/dried sludge,hard saltcake, and soft saltcake. Comparisons of the waste and simulant properties are documented in this report

  17. Multi-Objective Evaluation of Target Sets for Logistics Networks

    National Research Council Canada - National Science Library

    Emslie, Paul

    2000-01-01

    .... In the presence of many objectives--such as reducing maximum flow, lengthening routes, avoiding collateral damage, all at minimal risk to our pilots--the problem of determining the best target set is complex...

  18. Evaluating nuclear power: voter choice on the California nuclear energy initiative. Executive summary

    International Nuclear Information System (INIS)

    Hensler, D.R.; Hensler, C.P.

    1979-07-01

    In 1976, under grants from the National Science Foundation and the Ford Foundation, The Rand Corporation conducted a set of surveys of Californians' attitudes toward nuclear power nd Proposition 15 that we hoped would illuminate the reasons for the voters' decision on the nuclear initiative. The study focused on the attitudes of the general public; it did not investigate the factors that motivate activists on both sides of the nuclear controversy. The study was limited to California, but because results indicate that attitudes of Californians are similar to attitudes reported in nationwide surveys, we believe that our findings have broader applicability. The objectives of the study were to: describe public knowledge, beliefs, and evaluation of nuclear energy development; analyze the relationship between beliefs and evaluation of nuclear energy; investigate the relationship between critical beliefs about nuclear energy and general political orientations, trust in government and other political and social institutions, and social background characteristics; describe public knowledge, beliefs, and evaluation of Proposition 15, the California nuclear energy initiative; and investigate the relationship between individuals' voting decisions on Proposition 15 and their evaluations of nuclear power and responses to the initiative campaign

  19. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    Science.gov (United States)

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts. Published by Elsevier Inc.

  20. Initial verification of an induction heating set-up for injection molding

    DEFF Research Database (Denmark)

    Menotti, Stefano; Hansen, Hans Nørgaard; Bissacco, Giuliano

    2013-01-01

    Molding of thin and long parts by injection molding leads to special requirements for the mold in order to ensure proper filling and acceptable cycle time. This paper investigates the applicability of embedded induction heating for the improvement of the filling of thin long parts. The object...... selected for the investigation is a thin spiral. For the complete molding of the component, elevated mold temperatures are required. For this propose a new injection molding set-up was developed, which allows rapid heating of the cavity wall by an induction heating system. The temperature was measured...

  1. Testing initiatives increase rates of HIV diagnosis in primary care and community settings: an observational single-centre cohort study.

    Directory of Open Access Journals (Sweden)

    Prini Mahendran

    Full Text Available The primary objective was to examine trends in new HIV diagnoses in a UK area of high HIV prevalence between 2000 and 2012 with respect to site of diagnosis and stage of HIV infection.Single-centre observational cohort study.An outpatient HIV department in a secondary care UK hospital.1359 HIV-infected adults.Demographic information (age, gender, ethnicity, and sexual orientation, site of initial HIV diagnosis (Routine settings such as HIV/GUM clinics versus Non-Routine settings such as primary care and community venues, stage of HIV infection, CD4 count and seroconversion symptoms were collated for each participant.There was a significant increase in the proportion of new HIV diagnoses made in Non-Routine settings (from 27.0% in 2000 to 58.8% in 2012; p<0.001. Overall there was a decrease in the rate of late diagnosis from 50.7% to 32.9% (p=0.001. Diagnosis of recent infection increased from 23.0% to 47.1% (p=0.001. Of those with recent infection, significantly more patients were likely to report symptoms consistent with a seroconversion illness over the 13 years (17.6% to 65.0%; p<0.001.This is the first study, we believe, to demonstrate significant improvements in HIV diagnosis and a shift in diagnosis of HIV from HIV/GUM settings to primary practice and community settings due to multiple initiatives.

  2. 38 CFR 21.376 - Travel expenses for initial evaluation and counseling.

    Science.gov (United States)

    2010-07-01

    ... initial evaluation and counseling. 21.376 Section 21.376 Pensions, Bonuses, and Veterans' Relief... Travel expenses for initial evaluation and counseling. When VA asks a disabled veteran to report to a designated place for an initial evaluation, reevaluation or counseling (including personal or vocational...

  3. The Neurodevelopmental Evaluation in a Private Pediatric Setting.

    Science.gov (United States)

    Fomalont, Robert

    1986-01-01

    A comprehensive neurodevelopment evaluation technique known as PEERAMID is recommended for pediatricians in the evaluation of learning disabilities. This multifaceted system assesses the learning process individually, analyzing: minor neurological indicators, fine and gross motor function, language ability, temporal-sequential organization,…

  4. Coded Statutory Data Sets for Evaluation of Public Health Law

    Science.gov (United States)

    Costich, Julia Field

    2012-01-01

    Background and objectives: The evaluation of public health law requires reliable accounts of underlying statutes and regulations. States often enact public health-related statutes with nonuniform provisions, and variation in the structure of state legal codes can foster inaccuracy in evaluating the impact of specific categories of law. The optimal…

  5. Performance Evaluation of Feature Sets of Minutiae Quadruplets ...

    African Journals Online (AJOL)

    The features proposed in this paper are derived from minutiae quadruplets and are applicable in matching and indexing ngerprint images. In this work nineteen different possibilities of features were explored for indexing and the performances of some of the feature sets were mixed: some giving good performances on ...

  6. Initial assessment of hearing loss using a mobile application for audiological evaluation.

    Science.gov (United States)

    Derin, S; Cam, O H; Beydilli, H; Acar, E; Elicora, S S; Sahan, M

    2016-03-01

    This study aimed to compare an Apple iOS mobile operating system application for audiological evaluation with conventional audiometry, and to determine its accuracy and reliability in the initial evaluation of hearing loss. The study comprised 32 patients (16 females) diagnosed with hearing loss. The patients were first evaluated with conventional audiometry and the degree of hearing loss was recorded. Then they underwent a smartphone-based hearing test and the data were compared using Cohen's kappa analysis. Patients' mean age was 53.59 ± 18.01 years (range, 19-85 years). The mobile phone audiometry results for 39 of the 64 ears were fully compatible with the conventional audiometry results. There was a statistically significant concordant relationship between the two sets of audiometry results (p Apple iPhone 5 that can measure hearing loss with reliable results.

  7. Facility to evaluate street lightning solutionsin a realistic urban setting

    DEFF Research Database (Denmark)

    Andersen, Jakob Munkgaard; Thorseth, Anders; Dam-Hansen, Carsten

    2015-01-01

    This paper describes a new large scale outdoor testing facility for street lighting solutions, that has been establish in Denmark for both research and demonstration purposes. The facility is fitted with lamp posts with an array of sensors and connections to allow for monitoring and control...... of lighting solutions under test. Initial data suggests a 75% reduction in energy usage from use of LED luminaries combined with traffic monitoring systems could be achievable....

  8. Climate Variability and Oceanographic Settings Associated with Interannual Variability in the Initiation of Dinophysis acuminata Blooms

    Directory of Open Access Journals (Sweden)

    Henrick Berger

    2013-08-01

    Full Text Available In 2012, there were exceptional blooms of D. acuminata in early spring in what appeared to be a mesoscale event affecting Western Iberia and the Bay of Biscay. The objective of this work was to identify common climatic patterns to explain the observed anomalies in two important aquaculture sites, the Galician Rías Baixas (NW Spain and Arcachon Bay (SW France. Here, we examine climate variability through physical-biological couplings, Sea Surface Temperature (SST anomalies and time of initiation of the upwelling season and its intensity over several decades. In 2012, the mesoscale features common to the two sites were positive anomalies in SST and unusual wind patterns. These led to an atypical predominance of upwelling in winter in the Galician Rías, and increased haline stratification associated with a southward advection of the Gironde plume in Arcachon Bay. Both scenarios promoted an early phytoplankton growth season and increased stability that enhanced D. acuminata growth. Therefore, a common climate anomaly caused exceptional blooms of D. acuminata in two distant regions through different triggering mechanisms. These results increase our capability to predict intense diarrhetic shellfish poisoning outbreaks in the early spring from observations in the preceding winter.

  9. Pre-capacity building in loosely-coupled collaborations: Setting the stage for future initiatives

    Directory of Open Access Journals (Sweden)

    Cheryl A. Hyde

    2012-08-01

    Full Text Available This article examines the benefits and limitations of ‘loosely-coupled’ research collaborations between university faculty and 12 grassroots community-based organisations (CBOs. The authors assert that community-based research projects that develop the knowledge base within CBOs, and can be described as ‘pre-capacity building’ work, can be an important stepping stone to the subsequent development of more formal and strategic capacity-building partnership ventures. However, such projects must be approached carefully with a clear understanding of the ‘threshold dimensions’ that must be met before proceeding with any collaboration. Written as a cautionary tale, the authors identify some of the problems that arise when the threshold stage is poorly executed, and more generally speak to the dangers of initiating even loosely-coupled collaborations in the absence of an explicit and well-established campus commitment to and support for community engagement and partnerships. Keywords: Community capacity-building, community-university partnerships, community research, collaboration

  10. Mathematical modeling of vibration processes in reinforced concrete structures for setting up crack initiation monitoring

    Science.gov (United States)

    Bykov, A. A.; Matveenko, B. P.; Serovaev, G. S.; Shardakov, I. N.; Shestakov, A. P.

    2015-03-01

    The contemporary construction industry is based on the use of reinforced concrete structures, but emergency situations resulting in fracture can arise in their exploitation. In a majority of cases, reinforced concrete fracture is realized as the process of crack formation and development. As a rule, the appearance of the first cracks does not lead to the complete loss of the carrying capacity but is a fracture precursor. One method for ensuring the safe operation of building structures is based on crack initiation monitoring. A vibration method for the monitoring of reinforced concrete structures is justified in this paper. An example of a reinforced concrete beam is used to consider all stages related to the analysis of the behavior of natural frequencies in the development of a crack-shaped defect and the use of the obtained numerical results for the vibration test method. The efficiency of the method is illustrated by the results of modeling of the physical part of the method related to the analysis of the natural frequency evolution as a response to the impact action in the crack development process.

  11. Do law enforcement interactions reduce the initiation of injection drug use? An investigation in three North American settings.

    Science.gov (United States)

    Melo, J S; Garfein, R S; Hayashi, K; Milloy, M J; DeBeck, K; Sun, S; Jain, S; Strathdee, S A; Werb, D

    2018-01-01

    The prevention of drug injecting is often cited as a justification for the deployment of law enforcement and for the continuation of drug criminalization policies. We sought to characterize the impact of law enforcement interactions on the risk that people who inject drugs (PWID) report assisting others with injection initiation in three North American countries. Cross-sectional data from PWID participating in cohort studies in three cities (San Diego, USA; Tijuana, Mexico; Vancouver, Canada) were pooled (August 2014-December 2016). The dependent variable was defined as recently (i.e., past six months) providing injection initiation assistance; the primary independent variable was the frequency of recent law enforcement interactions, defined categorically (0 vs. 1 vs. 2-5 vs. ≥6). We employed multivariable logistic regression analyses to assess this relationship while controlling for potential confounders. Among 2122 participants, 87 (4.1%) reported recently providing injection initiation assistance, and 802 (37.8%) reported recent law enforcement interactions. Reporting either one or more than five recent interactions with law enforcement was not significantly associated with injection initiation assistance. Reporting 2-5 law enforcement interactions was associated with initiation assistance (Adjusted Odds Ratio=1.74, 95% Confidence Interval: 1.01-3.02). Reporting interactions with law enforcement was not associated with a reduced likelihood that PWID reported initiating others into injection drug use. Instead, we identified a positive association between reporting law enforcement interactions and injection initiation assistance among PWID in multiple settings. These findings raise concerns regarding the effectiveness of drug law enforcement to deter injection drug use initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Using the Nine Common Themes of Good Practice checklist as a tool for evaluating the research priority setting process of a provincial research and program evaluation program.

    Science.gov (United States)

    Mador, Rebecca L; Kornas, Kathy; Simard, Anne; Haroun, Vinita

    2016-03-23

    Given the context-specific nature of health research prioritization and the obligation to effectively allocate resources to initiatives that will achieve the greatest impact, evaluation of priority setting processes can refine and strengthen such exercises and their outcomes. However, guidance is needed on evaluation tools that can be applied to research priority setting. This paper describes the adaption and application of a conceptual framework to evaluate a research priority setting exercise operating within the public health sector in Ontario, Canada. The Nine Common Themes of Good Practice checklist, described by Viergever et al. (Health Res Policy Syst 8:36, 2010) was used as the conceptual framework to evaluate the research priority setting process developed for the Locally Driven Collaborative Projects (LDCP) program in Ontario, Canada. Multiple data sources were used to inform the evaluation, including a review of selected priority setting approaches, surveys with priority setting participants, document review, and consultation with the program advisory committee. The evaluation assisted in identifying improvements to six elements of the LDCP priority setting process. The modifications were aimed at improving inclusiveness, information gathering practices, planning for project implementation, and evaluation. In addition, the findings identified that the timing of priority setting activities and level of control over the process were key factors that influenced the ability to effectively implement changes. The findings demonstrate the novel adaptation and application of the 'Nine Common Themes of Good Practice checklist' as a tool for evaluating a research priority setting exercise. The tool can guide the development of evaluation questions and enables the assessment of key constructs related to the design and delivery of a research priority setting process.

  13. Development and initial feasibility of an organizational measure of behavioral health integration in medical care settings.

    Science.gov (United States)

    McGovern, Mark P; Urada, Darren; Lambert-Harris, Chantal; Sullivan, Steven T; Mazade, Noel A

    2012-12-01

    In the advent of health care reform, models are sought to integrate behavioral health and routine medical care services. Historically, the behavioral health specialty has not itself been integrated, but instead bifurcated by substance use and mental health across treatment systems, care providers and even research. With the present opportunity to transform the health care delivery system, it is incumbent upon policymakers, researchers and clinicians to avoid repeating this historical error, and provide integrated behavioral health services in medical contexts. An organizational measure designed to assess this capacity is described: the Dual Diagnosis Capability in Health Care Settings (DDCHCS). The DDCHCS was used to assess a sample of federally-qualified health centers (N=13) on the degree of behavioral health integration. The measure was found to be feasible and sensitive to detecting variation in integrated behavioral health services capacity. Three of the 13 agencies were dual diagnosis capable, with significant variation in DDCHCS dimensions measuring staffing, treatment practices and program milieu. In general, mental health services were more integrated than substance use. Future research should consider a revised version of the measure, a larger and more representative sample, and linking organizational capacity with patient outcomes. Copyright © 2012. Published by Elsevier Inc.

  14. Analysis of Internet Usage Among Cancer Patients in a County Hospital Setting: A Quality Improvement Initiative

    Science.gov (United States)

    Lilley, Lisa; Lodrigues, William; Dreadin-Pulliam, Julie; Xie, Xian-Jin; Mathur, Sakshi; Rao, Madhu; Harvey, Valorie; Leitch, Ann Marilyn; Rao, Roshni

    2014-01-01

    Background Cancer is one of the most common diseases that patients research on the Internet. The Commission on Cancer (CoC) recommended that Parkland Memorial Hospital (PMH) improve the oncology services website. PMH is Dallas County’s public health care facility, serving a largely uninsured, minority population. Most research regarding patient Internet use has been conducted in insured, Caucasian populations, raising concerns that the needs of PMH patients may not be extrapolated from available data. The PMH Cancer Committee, therefore, adopted a quality improvement initiative to understand patients’ Internet usage. Objective The objective of the study was to obtain and analyze data regarding patients’ Internet usage in order to make targeted improvements to the oncology services section of the institutional website. Methods A task force developed an 11-question survey to ascertain what proportion of our patients have Internet access and use the Internet to obtain medical information as well as determine the specific information sought. Between April 2011 and August 2011, 300 surveys were administered to newly diagnosed cancer patients. Multivariate analyses were performed. Results Of 300 surveys, 291 were included. Minorities, primarily African-American and Hispanic, represented 78.0% (227/291) of patients. Only 37.1% (108/291) of patients had Internet access, most (256/291, 87.9%) having access at home. Younger patients more commonly had Internet access, with a mean age of 47 versus 58 years for those without (PInternet research was to develop questions for discussion with one’s physician. Patients most frequently sought information regarding cancer treatment options, outcomes, and side effects. Conclusions Less than one-half of PMH oncology patients have Internet access. This is influenced by age, educational level, and ethnicity. Those with access use it to obtain information related to their cancer diagnosis. The most effective way of addressing our

  15. Family planning in a rural setting in Uganda, the USHAPE initiative.

    Science.gov (United States)

    Clark, Emily; Goodhart, Clare

    2016-01-01

    The total fertility rate in Uganda is 5.9 children per woman, and women admit to having nearly two more children than they actually want. The maternal mortality rate remains stubbornly high. Family planning saves lives. It prevents maternal deaths by delaying motherhood, helping women limit their family size and avoid unwanted pregnancies. It also reduces infant mortality. USHAPE (Ugandan Sexual Health and Pastoral Education) is an initiative run in conjunction with the Royal College of General Practitioners in south-west Uganda. USHAPE aims to disseminate positive messages about modern contraception in an attempt to dispel fears and misconceptions and address the high rate of unmet need. The aim was to determine the rate of unmet need for family planning among women of reproductive age in the population local of Kisiizi hospital and to use the successful USHAPE model to train health workers to address this need. 100 patients were screened in the outpatient department to determine the level of unmet need by asking 2 questions. Level 1 training aims enhance every staff member's knowledge, so that the responsibility for family planning is adopted by the whole institution. Level 2 trains clinicians to become full family planning providers, with the necessary communication, educational and practical skills. The screening for unmet need for contraception revealed that 51% have an unmet need, which is higher than the national average of 38%. Sixty-eight members of staff at Kisiizi trained to a basic level and a further 32 staff have been trained to Level 2 higher level. The USHAPE approach has begun to tackle some of the barriers to accessing family planning, but there are further areas which need development. Our cascade model of training, involves training Ugandan USHAPE trainers with the aim of future scale up and long-term development.

  16. Comparative evaluation of different methods of setting hygienic standards

    International Nuclear Information System (INIS)

    Ramzaev, P.V.; Rodionova, L.F.; Mashneva, N.I.

    1978-01-01

    Long-term experiments were carried out on white mice and rats to study the relative importance of various procedures used in setting hygienic standards for exposure to adverse factors. A variety of radionuclides and chemical substances were tested and the sensitivities to them of various indices of the bodily state were determined. For each index, statistically significant minimal effective concentrations of substances were established

  17. Evaluation of the cooperative multi-carrier delivery initiatives.

    Science.gov (United States)

    2013-12-01

    In the last several years there has been a surge of interest in fostering more sustainable logistical operations in : urban areas. Under the umbrella of the generic term City Logistics, these initiatives try to take advantage of : the coordinating po...

  18. Symposium--The Safe Schools Healthy Students Initiative: The Evaluation Context in District Wide Initiatives.

    Science.gov (United States)

    Massey, Oliver T.; Armstrong, Kathleen; Lattimore, Pamela; Boroughs, Michael; Tucker, Joan; Santoro, Gina

    This report discusses the outcomes of two studies that investigated the effectiveness of the Safe Schools Healthy Students Initiative (SS/HSI), a federal grant program designed to promote healthy childhood development and prevent violence and substance abuse. The first study, titled "Results of a Longitudinal Study of Disciplinary Referrals…

  19. Evaluation of Knowledge Development in a Healthcare Setting

    Science.gov (United States)

    Schaffer, Scott P.

    Healthcare organizations worldwide have recently increased efforts to improve performance, quality, and knowledge transfer using information and communication technologies. Evaluation of the effectiveness and quality of such efforts is challenging. A macro and micro-level system evaluation conducted with a 14000 member US hospital administrative services organization examined the appropriateness of a blended face-to-face and technology-enabled performance improvement and knowledge development system. Furthermore, a successful team or microsystem in a high performing hospital was studied in-depth. Several types of data methods including interview, observation, and questionnaire were used to address evaluation questions within a knowledge development framework created for the study. Results of this preliminary study focus on how this organization attempted to organize clinical improvement efforts around quality and performance improvement processes supported by networked technologies.

  20. Clad vent set cup closure-weld-zone grinding evaluation

    International Nuclear Information System (INIS)

    Ulrich, G.B.; Woods, A.T.; Ohriner, E.K.

    1996-04-01

    Clad vent set (CVS) cups were ground in the closure-weld zone to reduce the wall-thickness variation created by the cup deep-drawing process. A significantly more uniform wall thickness would be beneficial for the CVS closure-weld operation. The goal was to reduce the average within-cup wall-thickness variation (defined as the range of wall thicknesses in the closure-weld zone) approximately 50% from the Cassini production value of 42 microm. This goal was shown to be achievable but, unfortunately, not with the existing blank and formed cup thicknesses

  1. Development of main steam safety valve set pressure evaluating system

    International Nuclear Information System (INIS)

    Oketani, Koichiro; Manabe, Yoshihisa.

    1991-01-01

    A main steam safety valve set pressure test is conducted for all valves during every refueling outage in Japan's PWRs. Almost all operations of the test are manually conducted by a skilled worker. In order to obtain further reliability and reduce the test time, an automatic test system using a personnel computer has been developed in accordance with system concept. Quality assurance was investigated to fix system specifications. The prototype of the system was manufactured to confirm the system reliability. The results revealed that this system had high accuracy measurement and no adverse influence on the safety valve. This system was concluded to be applicable for actual use. (author)

  2. Setting ART initiation targets in response to changing guidelines: The importance of addressing both steady-state and backlog.

    Science.gov (United States)

    Martin, Catherine; Naidoo, Nicolette P; Venter, W D Francois; Jaffer, Ambereen; Barker, Pierre M

    2014-05-12

    Target setting is useful in planning, assessing and improving antiretroviral treatment (ART) programmes. In the past 4 years, the ART initiation environment has been transformed due to the change in eligibility criteria (starting ART at a CD4+ count ART. To describe and illustrate the use of a target-setting model for estimating district-based targets in the era of an expanding ART programme and changing CD4+ count thresholds for ART initiation. Using previously described models and data for annual new HIV infections, we estimated both steady-state need for ART initiation and backlog in a North West Province district, accounting for the shift in eligibility. Comparison of actual v. targeted ART initiations was undertaken. The change in CD4+ count threshold adds a once-off group of newly eligible patients to the pool requiring ART - the backlog. The steady-state remains unchanged as it is determined by the annual rate of new HIV infections in previous years. The steady-state need for the district was 639 initiations/month, and the backlog was ~15,388 patients. After the shift in eligibility in September 2011, the steady-state target was exceeded over several months with some backlog addressed. Of the total backlog for this district, 72% remains to be cleared. South Africa has two pools of patients who need ART: the steady-state of HIV-infected patients entering the programme each year, determined by historical infection rates; and the backlog created by the shift in eligibility. The healthcare system needs to build long- term capacity to meet the steady-state need for ART and additional capacity to address the backlog.

  3. Evaluating the FRIENDS Programme in a Scottish Setting

    Science.gov (United States)

    Liddle, Ian; Macmillan, Susan

    2010-01-01

    This study used an "indicated prevention" approach to attempt to replicate very positive international evaluations of the FRIENDS for Life programme. Using standardised self-report measures of anxiety, low mood and self esteem with groups of children from four schools, the study found significant improvements in all of these measures…

  4. Effects of Inoculum Amount, Initial pH, and Nicotine Load on the Set-Up of Bioaugmented System with Pseudomonas Sp. HF-1 to Treat Tobacco Wastewater

    Directory of Open Access Journals (Sweden)

    Kun Zhang

    2014-01-01

    Full Text Available This study evaluated and optimized the influence of inoculum amount, initial pH, and nicotine load on the construction of Pseudomonas sp. HF-1 bioaugmented system for tobacco wastewater treatment. The results demonstrated that the optimum condition for the set-up of strain HF-1 bioaugmented system was 1.10 mg/g (dry weight of strain HF-1/dry weight of activated sludge of inoculum amount, initial pH 7.0, and 250–1000 mg/L nicotine load. Higher than 1.10 mg/g could lead to noncolonization of strain HF-1 in activated sludge and failure of set-up of this bioaugmented system. Higher than pH 8.0 could restrain the colonization of strain HF-1 in activated sludge. Even though strain HF-1 colonizes in the activated sludge when pH was above 8.0, the removal of nicotine and total organic carbon (TOC was suppressed due to low activities of bacteria in the activated sludge. Nicotine load did not show inhibition effect on set-up of bioaugmented system, but the ability of TOC removal was restrained when the nicotine load was above 1000 mg/L. This work could offer vital parameters for the set-up of bioaugmented system to treat tobacco wastewater in engineering.

  5. Initiatives in training program evaluation outside the nuclear utility industry

    International Nuclear Information System (INIS)

    Allen, C.J.

    1987-01-01

    Training literature is reviewed, and program evaluative practices outside the nuclear utility industry are reported. The findings indicate some innovations in philosophy and practice and program evaluation, although not necessarily in the context of evaluation as a route to assessing the impact of training. Program evaluation is described in the context of the impact of training, suggesting continued efforts to accept a multivariate concept of individual and organizational performance

  6. Building the field of population health intervention research: The development and use of an initial set of competencies.

    Science.gov (United States)

    Riley, Barbara; Harvey, Jean; Di Ruggiero, Erica; Potvin, Louise

    2015-01-01

    Population health intervention research (PHIR) is a relatively new research field that studies interventions that can improve health and health equity at a population level. Competencies are one way to give legitimacy and definition to a field. An initial set of PHIR competencies was developed with leadership from a multi-sector group in Canada. This paper describes the development process for these competencies and their possible uses. Methods to develop the competencies included key informant interviews; a targeted review of scientific and gray literature; a 2-round, online adapted Delphi study with a 24-member panel; and a focus group with 9 international PHIR experts. The resulting competencies consist of 25 items grouped into 6 categories. They include principles of good science applicable though not exclusive to PHIR, and more suitable for PHIR teams rather than individuals. This initial set of competencies, released in 2013, may be used to develop graduate student curriculum, recruit trainees and faculty to academic institutions, plan non-degree professional development, and develop job descriptions for PHIR-related research and professional positions. The competencies provide some initial guideposts for the field and will need to be adapted as the PHIR field matures and to meet unique needs of different jurisdictions.

  7. Evaluating the Outcomes of Transactional Analysis and Integrative Counselling Psychology within UK Primary Care Settings

    Directory of Open Access Journals (Sweden)

    Biljana van Rijn

    2011-07-01

    Full Text Available The paper reports on a naturalistic study that replicated the evaluative design associated with the UK National Health Service initiative IAPT − Improving Access to Psychological Therapies (CSIP 2008, NHS 2011, as previously used to assess Cognitive Behavioural Therapy (CBT, with the aim of evaluating 12-session treatments for anxiety and depression, applying Transactional Analysis and Integrative Counselling Psychology approaches within real clinical settings in primary care. Standard outcome measures were used in line with the IAPT model (CORE 10 and 34, GAD-7, PHQ-9, supplemented with measurement of the working alliance (WAI Horvath 1986 and an additional depression inventory BDI-II (Beck, 1996, and ad-herence to the therapeutic model using newly designed questionnaires. Results indicated that severity of problems was reduced using either approach, comparative to Cognitive Behavioural Therapy; that initial severity was predictive of outcome; and that working alliance increased as therapy progressed but was not directly related to outcomes. Adherence was high for both approaches. Several areas for enhance-ments to future research are suggested.

  8. Gigantic Jet Environments: A Meteorological Evaluation Using Reanalysis Data Sets

    Science.gov (United States)

    Splitt, M. E.; Lazarus, S. M.

    2017-12-01

    The meteorological conditions of gigantic jet (GJ) producing thunderstorms tend to be connected to maritime tropical environments. In particular, they have an affinity toward tropical disturbances including those with moderate values of upper tropospheric environmental wind shear. Wind shear related effects (including turbulence) in association with deep convection in these environments have been proposed as mechanisms for the arrangement of GJ favorable charge structures. This study focuses on a climatological evaluation in an effort to assess whether the proposed ingredients are consistent with observed GJ event regions. The Climate System Forecast System - Version 2 (CFSR V2) is used here to test for the proposed GJ conditions.

  9. Microindentation hardness evaluation of iridium alloy clad vent set cups

    International Nuclear Information System (INIS)

    Ulrich, G.B.; DeRoos, L.F.; Stinnette, S.E.

    1993-01-01

    An iridium alloy, DOP-26, is used as cladding for 238 PuO 2 fuel in radioisotope heat sources for space power systems. Presently, DOP-26 iridium alloy clad vent sets (CVS) are being manufactured at the Oak Ridge Y-12 Plant for potential use in the National Aeronautics and Space Administration's Cassini mission to Saturn. Wrought/ground/stress relieved blanks are warm formed into CVS cups. These cups are then annealed to recrystallize the material for subsequent fabrication/assembly operations as well as for final use. One of the cup manufacturing certification requirements is to test for Vickers microindentation hardness. New microindentation hardness specification limits, 210 to 310 HV, have been established for a test load of 1000 grams-force (gf). The original specification limits, 250 to 350 HV, were for 200 gf testing. The primary reason for switching to a higher test load was to reduce variability in the test data. The DOP-26 alloy exhibits microindentation hardness load dependence, therefore, new limits were needed for 1000 gf testing. The new limits were established by testing material from 15 CVS cups using 200 gf and 1000 gf loads and then statistically analyzing the data. Additional work using a Knoop indenter and a 10 gf load indicated that the DOP-26 alloy grain boundaries have higher hardnesses than the grain interiors

  10. Biomechanical evaluation of nursing tasks in a hospital setting.

    Science.gov (United States)

    Jang, R; Karwowski, W; Quesada, P M; Rodrick, D; Sherehiy, B; Cronin, S N; Layer, J K

    2007-11-01

    A field study was conducted to investigate spinal kinematics and loading in the nursing profession using objective and subjective measurements of selected nursing tasks observed in a hospital setting. Spinal loading was estimated using trunk motion dynamics measured by the lumbar motion monitor (LMM) and lower back compressive and shear forces were estimated using the three-dimensional (3D) Static Strength Prediction Program. Subjective measures included the rate of perceived physical effort and the perceived risk of low back pain. A multiple logistic regression model, reported in the literature for predicting low back injury based on defined risk groups, was tested. The study results concluded that the major risk factors for low back injury in nurses were the weight of patients handled, trunk moment, and trunk axial rotation. The activities that required long time exposure to awkward postures were perceived by nurses as a high physical effort. This study also concluded that self-reported perceived exertion could be used as a tool to identify nursing activities with a high risk of low-back injury.

  11. Microindentation hardness evaluation of iridium alloy clad vent set cups

    International Nuclear Information System (INIS)

    Ulrich, G.B.; DeRoos, L.F.; Stinnette, S.E.

    1992-01-01

    An iridium alloy, DOP-26, is used as cladding for 238 PuO 2 fuel in radioisotope heat sources for space power systems. Presently, DOP-26 iridium alloy clad vent sets (CVS) are being manufactured at the Oak Ridge Y-12 Plant for potential use in the National Aeronautics and Space Administration's Cassini mission to Saturn. Wrought/ground/stress relieved blanks are warm formed into CVS cups. These cups are then annealed to recrystallize the material for subsequent fabrication/assembly operations as well as for final use. One of the cup manufacturing certification requirements is to test for Vickers microindentation hardness. New microindentation hardness specification limits, 210 to 310 HV, have been established for a test load of 1000 grams-force (gf). The original specification limits, 250 to 350 HV, were for 200 gf testing. The primary reason for switching to a higher test load was to reduce variability in the test data. The DOP-26 alloy exhibits microindentation hardness load dependence, therefore, new limits were needed for 1000 gf testing. The new limits were established by testing material from 15 CVS cups using 200 gf and 1000 gf loads and then statistically analyzing the data. Additional work using a Knoop indenter and a 10 gf load indicated that the DOP-26 alloy grain boundaries have higher hardnesses than the grain interiors

  12. A simulator tool set for evaluating HEVC/SHVC streaming

    Science.gov (United States)

    Al Hadhrami, Tawfik; Nightingale, James; Wang, Qi; Grecos, Christos; Kehtarnavaz, Nasser

    2015-02-01

    Video streaming and other multimedia applications account for an ever increasing proportion of all network traffic. The recent adoption of High Efficiency Video Coding (HEVC) as the H.265 standard provides many opportunities for new and improved services multimedia services and applications in the consumer domain. Since the delivery of version one of H.265, the Joint Collaborative Team on Video Coding have been working towards standardisation of a scalable extension (SHVC) to the H.265 standard and a series of range extensions and new profiles. As these enhancements are added to the standard the range of potential applications and research opportunities will expend. For example the use of video is also growing rapidly in other sectors such as safety, security, defence and health with real-time high quality video transmission playing an important role in areas like critical infrastructure monitoring and disaster management. Each of which may benefit from the application of enhanced HEVC/H.265 and SHVC capabilities. The majority of existing research into HEVC/H.265 transmission has focussed on the consumer domain addressing issues such as broadcast transmission and delivery to mobile devices with the lack of freely available tools widely cited as an obstacle to conducting this type of research. In this paper we present a toolset which facilitates the transmission and evaluation of HEVC/H.265 and SHVC encoded video on the popular open source NCTUns simulator. Our toolset provides researchers with a modular, easy to use platform for evaluating video transmission and adaptation proposals on large scale wired, wireless and hybrid architectures. The toolset consists of pre-processing, transmission, SHVC adaptation and post-processing tools to gather and analyse statistics. It has been implemented using HM15 and SHM5, the latest versions of the HEVC and SHVC reference software implementations to ensure that currently adopted proposals for scalable and range extensions to

  13. Evaluating quality of patient care communication in integrated care settings: a mixed methods apporach

    NARCIS (Netherlands)

    Gulmans, J.; Gulmans, J.; Vollenbroek-Hutten, Miriam Marie Rosé; van Gemert-Pijnen, Julia E.W.C.; van Harten, Willem H.

    2007-01-01

    Background. Owing to the involvement of multiple professionals from various institutions, integrated care settings are prone to suboptimal patient care communication. To assure continuity, communication gaps should be identified for targeted improvement initiatives. However, available assessment

  14. Report to DOE on the evaluation of initial trapping studies

    International Nuclear Information System (INIS)

    Breun, R.A.; Kesner, J.; Nonn, P.; Pian, T.; Post, R.S.; Scharer, J.; Smatlak, D.; Smith, D.; Yugo, J.; Yujiri, L.

    1978-12-01

    This report summarizes work up to Dec. 1, 1978 on the single mirror plug of Phaedrus. The design, construction and initial experiments proceeded without major problems. The results on RF trapping and heating steadily improved during the months of October and November with our best results being obtained during the last two weeks of November. These positive results are encouraging for RF heating in mirrors. The experiments to date have concentrated on heating stream gun plasmas. This plasma source has been well suited for our initial studies as it produces a hot, dense plasma over a long duration (approx. 1 msec). This has made diagnostics particularly straight forward. Because of the time scale we have carried out most of our work with the 200 kW source which is capable of running for long pulses

  15. Acute upper gastrointestinal bleeding (UGIB) - initial evaluation and management.

    Science.gov (United States)

    Khamaysi, Iyad; Gralnek, Ian M

    2013-10-01

    Acute upper gastrointestinal bleeding (UGIB) is the most common reason that the 'on-call' gastroenterologist is consulted. Despite the diagnostic and therapeutic capabilities of upper endoscopy, there is still significant associated morbidity and mortality in patients experiencing acute UGIB, thus this is a true GI emergency. Acute UGIB is divided into non-variceal and variceal causes. The most common type of acute UGIB is 'non-variceal' and includes diagnoses such as peptic ulcer (gastric and duodenal), gastroduodenal erosions, Mallory-Weiss tears, erosive oesophagitis, arterio-venous malformations, Dieulafoy's lesion, and upper GI tract tumours and malignancies. This article focuses exclusively on initial management strategies for acute upper GI bleeding. We discuss up to date and evidence-based strategies for patient risk stratification, initial patient management prior to endoscopy, potential causes of UGIB, role of proton pump inhibitors, prokinetic agents, prophylactic antibiotics, vasoactive pharmacotherapies, and timing of endoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Improved diagnostic accuracy of Alzheimer's disease by combining regional cortical thickness and default mode network functional connectivity: Validated in the Alzheimer's disease neuroimaging initiative set

    International Nuclear Information System (INIS)

    Park, Ji Eun; Park, Bum Woo; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Jung; Oh, Joo Young; Shim, Woo Hyun; Lee, Jae Hong; Roh, Jee Hoon

    2017-01-01

    To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal (p < 0.001) and supramarginal gyrus (p = 0.007) of the left cerebral hemisphere. Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease

  17. [Evaluation of the Initial Stage Career Exploration Inventory (ISCEI)].

    Science.gov (United States)

    Adachi, Tomoko

    2010-06-01

    The Initial Stage Career Exploration Inventory (ISCEI) was designed to assess career exploration among students in the early stage of making career decisions. The reliability, validity, and applicability of the ISCEI were investigated. In Study 1, responses on the ISCEI from student participants (n = 294 : 69 men, 225 women) were factor analyzed. The results suggested a 3-factor structure consisting of "self-understanding," "information gathering" and "learning from others." Comparison between the ISCEI and self-improvement motive, vocational decisions, and career decision-making self-efficacy scales from the Career Exploration Survey (CES) indicated that the ISCEI had sufficient construct validity. Study 2 investigated the applicability of the ISCEI. The responses of student participants (n = 859 : 451 men, 408 women) on the ISCEI indicated high "self-understanding," neutral "information gathering," and comparatively low "learning from others" scores, which were similarly related to the CES as in Study 1. These findings indicate that the ISCEI can be used as a tool for understanding career exploration among students in the initial stage of making career decision.

  18. Ready for goal setting? Process evaluation of a patient-specific goal-setting method in physiotherapy.

    Science.gov (United States)

    Stevens, Anita; Köke, Albère; van der Weijden, Trudy; Beurskens, Anna

    2017-08-31

    Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method. We conducted a process evaluation within a non-controlled intervention study. Community-based physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals, planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by recording consultations and assessing patient files, questionnaires and written reflection reports. Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files were analysed. The PSG steps were performed as intended, but the 'setting goals' and 'planning treatment' steps were not performed in detail. The patients and physiotherapists were positive about the method, and the physiotherapists perceived increased patient participation. They became aware of the importance of engaging patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e. informing and involving patients, and client-centred competences had improved, this was not completely confirmed by the objectively observed behaviour. The PSG is a feasible method and tends to have impact on increasing patient participation in the goal-setting

  19. Evaluation of COSMO-ART in the Framework of the Air Quality Model Evaluation International Initiative (AQMEII)

    Science.gov (United States)

    Giordano, Lea; Brunner, Dominik; Im, Ulas; Galmarini, Stefano

    2014-05-01

    The Air Quality Model Evaluation International Initiative (AQMEII) coordinated by the EC-JRC and US-EPA, promotes since 2008 research on regional air quality model evaluation across the atmospheric modelling communities of Europe and North America. AQMEII has now reached its Phase 2 that is dedicated to the evaluation of on-line coupled chemistry-meteorology models as opposed to Phase 1 where only off-line models were considered. At European level, AQMEII collaborates with the COST Action "European framework for on-line integrated air quality and meteorology modelling" (EuMetChem). All European groups participating in AQMEII performed simulations over the same spatial domain (Europe at a resolution of about 20 km) and using the same simulation strategy (e.g. no nudging allowed) and the same input data as much as possible. The initial and boundary conditions (IC/BC) were shared between all groups. Emissions were provided by the TNO-MACC database for anthropogenic emissions and the FMI database for biomass burning emissions. Chemical IC/BC data were taken from IFS-MOZART output, and meteorological IC/BC from the ECWMF global model. Evaluation data sets were collected by the Joint Research Center (JRC) and include measurements from surface in situ networks (AirBase and EMEP), vertical profiles from ozone sondes and aircraft (MOZAIC), and remote sensing (AERONET, satellites). Since Phase 2 focuses on on-line coupled models, a special effort is devoted to the detailed speciation of particulate matter components, with the goal of studying feedback processes. For the AQMEII exercise, COSMO-ART has been run with 40 levels of vertical resolution, and a chemical scheme that includes the SCAV module of Knote and Brunner (ACP 2013) for wet-phase chemistry and the SOA treatment according to VBS (volatility basis set) approach (Athanasopoulou et al., ACP 2013). The COSMO-ART evaluation shows that, next to a good performance in the meteorology, the gas phase chemistry is well

  20. An Initial Evaluation of the NAG f90 Compiler

    Directory of Open Access Journals (Sweden)

    Michael Metcalf

    1992-01-01

    Full Text Available A few weeks before the formal publication of the ISO Fortran 90 Standard, NAG announced the world's first f90 compiler. We have evaluated the compiler by using it to assess the impact of Fortran 90 on the CERN Program Library.

  1. The Dynamic Evaluation of Enterprise's Strategy Based on Rough Set Theory

    Institute of Scientific and Technical Information of China (English)

    刘恒江; 陈继祥

    2003-01-01

    This paper presents dynamic evaluation of enterprise's strategy which is suitable for dealing with the complex and dynamic problems of strategic evaluation. Rough Set Theory is a powerful mathematical tool to handle vagueness and uncertainty of dynamic evaluation. By the application of Rough Set Theory, this paper computes the significance and weights of each evaluation criterion and helps to lay evaluation emphasis on the main and effective criteria. From the reduced decision table,evaluators can get decision rules Which direct them to give judgment or suggestion of strategy. The whole evaluation process is decided by data, so the results are certain and reasonable.

  2. Evaluation of the first fracture liaison service in the Greek healthcare setting.

    Science.gov (United States)

    Makras, Polyzois; Panagoulia, Maria; Mari, Andriana; Rizou, Stavroula; Lyritis, George P

    2017-12-01

    We evaluated the first implementation of FLS in the Greek healthcare setting, at the 251 Hellenic Air Force and VA General Hospital of Athens. Participation rate was moderate (54.5%) and needs improvement; osteoporosis medication was either suggested or reviewed in 74 out of the 116 patients recruited. The purpose of this study was to evaluate the first implementation of a fracture liaison service (FLS) in Greece, at the 251 Hellenic Air Force and VA General Hospital, Athens. Single-center, prospective study from May 1, 2013 to April 30, 2015 (first year-second year follow-up) was conducted. Patients of both genders aged 40-90 years old, with a history of a low trauma fracture and willing to participate, were included after identification by an FLS nurse. Following recruitment, osteoporosis risk factors were assessed, FRAX score was calculated for treatment-naïve patients, bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA), and osteoporosis treatment was suggested where applicable. The rate of participation, the indication of osteoporosis treatment, and the difficulties met were evaluated. Of the eligible 213 patients, 97 (45.5%) were reluctant to participate for personal reasons. From the 116 initially recruited patients (mean age 74.8 ± 12 years), 77 (66.4%) discontinued their participation at some point for various reasons and 39 patients concluded the study. All 116 patients were assessed for osteoporosis risk factors and given a tailor-made exercise and education program, while FRAX score was assessed in all treatment-naïve patients (74 patients, 63.8%). Osteoporosis medication was suggested or reviewed in 74 patients; however, an adherence rate of 100% is only available for the 24 who concluded the study. We report the first implementation of FLS in the Greek healthcare setting. The participation rate is moderate and definitely needs improvement.

  3. A Revalidation of the SET37 Questionnaire for Student Evaluations of Teaching

    Science.gov (United States)

    Mortelmans, Dimitri; Spooren, Pieter

    2009-01-01

    In this study, the authors report on the validity and reliability of a paper-and-pencil instrument called SET37 used for Student Evaluation of Teaching (SET) in higher education. Using confirmatory factor analysis on 2525 questionnaires, a revalidation of the SET37 shows construct and discriminant validity of the 12 dimensions included in the…

  4. Experiences from the anatomy track in the ontology alignment evaluation initiative.

    Science.gov (United States)

    Dragisic, Zlatan; Ivanova, Valentina; Li, Huanyu; Lambrix, Patrick

    2017-12-04

    One of the longest running tracks in the Ontology Alignment Evaluation Initiative is the Anatomy track which focuses on aligning two anatomy ontologies. The Anatomy track was started in 2005. In 2005 and 2006 the task in this track was to align the Foundational Model of Anatomy and the OpenGalen Anatomy Model. Since 2007 the ontologies used in the track are the Adult Mouse Anatomy and a part of the NCI Thesaurus. Since 2015 the data in the Anatomy track is also used in the Interactive track of the Ontology Alignment Evaluation Initiative. In this paper we focus on the Anatomy track in the years 2007-2016 and the Anatomy part of the Interactive track in 2015-2016. We describe the data set and the changes it went through during the years as well as the challenges it poses for ontology alignment systems. Further, we give an overview of all systems that participated in the track and the techniques they have used. We discuss the performance results of the systems and summarize the general trends. About 50 systems have participated in the Anatomy track. Many different techniques were used. The most popular matching techniques are string-based strategies and structure-based techniques. Many systems also use auxiliary information. The quality of the alignment has increased for the best performing systems since the beginning of the track and more and more systems check the coherence of the proposed alignment and implement a repair strategy. Further, interacting with an oracle is beneficial.

  5. Effect of Initiation Time of Hydrostatic Pressure Shock on Chromosome Set Doubling of Tetraploidization in Turbot Scophthalmus maximus.

    Science.gov (United States)

    Zhu, Xiangping; Lin, Zhengmei; Wu, Zhihao; Li, Jiandong; You, Feng

    2017-10-01

    The objective of the study was to clarify the effects of initiation time on chromosome set doubling induced by hydrostatic pressure shock through nuclear phase fluorescent microscopy in turbot Scophthalmus maximus. The ratio of developmentally delayed embryo and chromosome counting was used to assess induction efficiency. For the embryos subjected to a pressure of 67.5 MPa for 6 min at prometaphase (A group), chromosomes recovered to the pre-treatment condition after 11-min recovering. The first nuclear division and cytokinesis proceeded normally. During the second cell cycle, chromosomes did not enter into metaphase after prometaphase, but spread around for about 13 min, then assembled together and formed a large nucleus without anaphase separation; the second nuclear division and cytokinesis was inhibited. The ratio of developmentally delayed embryo showed that the second mitosis of 78% A group embryo was inhibited. The result of chromosome counting showed that the tetraploidization rate of A group was 72%. For the embryos subjected to a pressure of 67.5 MPa for 6 min at anaphase (B group), chromosomes recovered to the pre-treatment condition after about 31-min recovering. Afterwards, one telophase nucleus formed without anaphase separation; the first nuclear division was inhibited. The time of the first cleavage furrow occurrence of B group embryos delayed 27 min compared with that of A group embryos. With the first cytokinesis proceeding normally, 81.3% B group embryos were at two-cell stage around the middle of the second cell cycle after treatment. Those embryos were one of the two blastomeres containing DNA and the other without DNA. The first nuclear division of those embryos was inhibited. During the third cell cycle after treatment, 65.2% of those abovementioned embryos were at four-cell stage, cytokinesis occurred in both blastomeres, and nuclear division only occurred in the blastomere containing DNA. Of those abovementioned embryos, 14.0% were at

  6. Improving the Quality of Freeze Dried Rice: Initial Evaluations

    Science.gov (United States)

    2015-05-01

    a soft consistency and swells more during this period without disintegration of cell walls [10]. Evaluation of freshly cooked rice 4.1.2...synthetic/ plastic aroma and flavour. Comparison between Parboiled and Control-A 4.1.6. A more detailed series of rehydration tests with texture...the clumps rapidly and easily disintegrated into individual grains. Control-C and Parboiled differed in colour post- cooking due to the different

  7. Incidence of WHO stage 3 and 4 conditions following initiation of anti-retroviral therapy in resource limited settings.

    Directory of Open Access Journals (Sweden)

    Andrea J Curtis

    Full Text Available OBJECTIVES: To determine the incidence of WHO clinical stage 3 and 4 conditions during early anti-retroviral therapy (ART in resource limited settings (RLS. DESIGN/SETTING: A descriptive analysis of routine program data collected prospectively from 25 Médecins Sans Frontières supported HIV treatment programs in eight countries between 2002 and 2010. SUBJECTS/PARTICIPANTS: 35,349 study participants with median follow-up on ART of 1.33 years (IQR 0.51-2.41. OUTCOME MEASURES: Incidence in 100 person-years of WHO stage 3 or 4 conditions during 5 periods after ART initiation. Diagnoses of conditions were made according to WHO criteria and relied upon clinical assessments supported by basic laboratory investigations. RESULTS: The incidence of any WHO clinical stage 3 or 4 condition over 3 years was 40.02 per 100 person-years (31.77 for stage 3 and 8.25 for stage 4. The incidence of stage 3 and 4 conditions fell by over 97% between months 0-3 and months 25-36 (77.81 to 2.40 for stage 3 and 28.70 to 0.64 for stage 4. During months 0-3 pulmonary tuberculosis was the most common condition diagnosed in adults (incidence 22.24 per 100 person-years and children aged 5-14 years (25.76 and oral candidiasis was the most common in children <5 years (25.79. Overall incidences were higher in Africa compared with Asia (43.98 versus 12.97 for stage 3 and 8.98 versus 7.05 for stage 4 conditions, p<0.001. Pulmonary tuberculosis, weight loss, oral and oesophageal candidiasis, chronic diarrhoea, HIV wasting syndrome and severe bacterial infections were more common in Africa. Extra-pulmonary tuberculosis, non-tuberculous mycobacterial infection, cryptococcosis, penicilliosis and toxoplasmosis were more common in Asia. CONCLUSIONS: The incidence of WHO stage 3 and 4 conditions during the early period after ART initiation in RLS is high, but greatly reduces over time. This is likely due to both the benefits of ART and deaths of the sickest patients occurring shortly

  8. Setting standards and detecting intrajudge inconsistency using interdependent evaluation of response alternatives

    NARCIS (Netherlands)

    Chang, Lei; van der Linden, Willem J.; Vos, Hendrik J.

    2004-01-01

    This article introduces a new test-centered standard-setting method as well as a procedure to detect intrajudge inconsistency of the method. The standard-setting method that is based on interdependent evaluations of alternative responses has judges closely evaluate the process that examinees use to

  9. Development and initial evaluation of a treatment decision dashboard.

    Science.gov (United States)

    Dolan, James G; Veazie, Peter J; Russ, Ann J

    2013-04-21

    For many healthcare decisions, multiple alternatives are available with different combinations of advantages and disadvantages across several important dimensions. The complexity of current healthcare decisions thus presents a significant barrier to informed decision making, a key element of patient-centered care.Interactive decision dashboards were developed to facilitate decision making in Management, a field marked by similarly complicated choices. These dashboards utilize data visualization techniques to reduce the cognitive effort needed to evaluate decision alternatives and a non-linear flow of information that enables users to review information in a self-directed fashion. Theoretically, both of these features should facilitate informed decision making by increasing user engagement with and understanding of the decision at hand. We sought to determine if the interactive decision dashboard format can be successfully adapted to create a clinically realistic prototype patient decision aid suitable for further evaluation and refinement. We created a computerized, interactive clinical decision dashboard and performed a pilot test of its clinical feasibility and acceptability using a multi-method analysis. The dashboard summarized information about the effectiveness, risks of side effects and drug-drug interactions, out-of-pocket costs, and ease of use of nine analgesic treatment options for knee osteoarthritis. Outcome evaluations included observations of how study participants utilized the dashboard, questionnaires to assess usability, acceptability, and decisional conflict, and an open-ended qualitative analysis. The study sample consisted of 25 volunteers - 7 men and 18 women - with an average age of 51 years. The mean time spent interacting with the dashboard was 4.6 minutes. Mean evaluation scores on scales ranging from 1 (low) to 7 (high) were: mechanical ease of use 6.1, cognitive ease of use 6.2, emotional difficulty 2.7, decision-aiding effectiveness 5

  10. 2017 European guideline for the screening, prevention and initial management of hepatitis B and C infections in sexual health settings.

    Science.gov (United States)

    Brook, Gary; Brockmeyer, Norbert; van de Laar, Thijs; Schellberg, Sven; Winter, Andrew J

    2018-01-01

    This guideline updates the 2010 European guideline for the management of hepatitis B and C virus infections. It is primarily intended to provide advice on testing, prevention and initial management of viral hepatitis B and C for clinicians working in sexual health clinical settings in European countries. The guideline is in a new question and answer format based on clinical situations, from which population/intervention/comparison/outcome questions were formulated. Updates cover areas such as epidemiology, point-of-care tests for hepatitis B, hepatitis C risk and 'chemsex', and HIV pre-exposure prophylaxis and hepatitis B. We have also included a short paragraph on hepatitis E noting there is no evidence for sexual transmission. The guideline has been prepared in accordance with the Europe protocol for production available at http://www.iusti.org/regions/europe/pdf/2017/ProtocolForProduction2017.pdf.

  11. Mexico City Air Quality Research Initiative; Volume 5, Strategic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-03-01

    Members of the Task HI (Strategic Evaluation) team were responsible for the development of a methodology to evaluate policies designed to alleviate air pollution in Mexico City. This methodology utilizes information from various reports that examined ways to reduce pollutant emissions, results from models that calculate the improvement in air quality due to a reduction in pollutant emissions, and the opinions of experts as to the requirements and trade-offs that are involved in developing a program to address the air pollution problem in Mexico City. The methodology combines these data to produce comparisons between different approaches to improving Mexico City`s air quality. These comparisons take into account not only objective factors such as the air quality improvement or cost of the different approaches, but also subjective factors such as public acceptance or political attractiveness of the different approaches. The end result of the process is a ranking of the different approaches and, more importantly, the process provides insights into the implications of implementing a particular approach or policy.

  12. Initial evaluation of an interactive test of sentence gist recognition.

    Science.gov (United States)

    Tye-Murray, N; Witt, S; Castelloe, J

    1996-12-01

    The laser videodisc-based Sentence Gist Recognition (SGR) test consists of sets of topically related sentences that are cued by short film clips. Clients respond to test items by selecting picture illustrations and may interact with the talker by using repair strategies when they do not recognize a test item. The two experiments, involving 40 and 35 adult subjects, respectively, indicated that the SGR may better predict subjective measures of speechreading and listening performance than more traditional audiologic sentence and nonsense syllable tests. Data from cochlear implant users indicated that the SGR accounted for a greater percentage of the variance for selected items of the Communication Profile for the Hearing-Impaired and the Speechreading Questionnaire for Cochlear-Implant Users than two other audiologic tests. As in previous work, subjects were most apt to ask the talker to repeat an utterance that they did not recognize than to ask the talker to restructure it. It is suggested that the SGR may reflect the interactive nature of conversation and provide a simulated real-world listening and/or speechreading task. The principles underlaying this test are consistent with the development of other computer technologies and concepts, such as compact discinteractive and virtual reality.

  13. The Pediatric Obesity Initiative: development, implementation, and evaluation.

    Science.gov (United States)

    Sample, Denise A; Carroll, Heather L; Barksdale, Debra J; Jessup, Ann

    2013-09-01

    Pediatric obesity rates have nearly tripled over the past three decades contributing to increased morbidity and mortality in the United States and around the world. Pediatric obesity is most prevalent in developed countries and affects all races, ethnicities, cultures, and age groups. To combat this epidemic locally, a team of dedicated providers developed a comprehensive evidenced-based toolkit and training program for clinical practices providing primary care services to children in a North Carolina county. The toolkit and training program were developed using the most current treatment guidelines for pediatric obesity and included resources developed by Healthy Carolinians. One unique feature of the training was a demonstration of motivational interviewing with additional resources included in the toolkit. Staff and providers in three pediatric practices and the local Health Department received the training. In a 3 months follow-up survey after the training, the providers indicated that the toolkit and training program were useful but that they still did not consistently use the guidelines or tools. Ensuring the use of available guidelines and resources by providers remains a challenge. Further study is needed on how to improve implementation of guidelines in primary care settings. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  14. Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

    Directory of Open Access Journals (Sweden)

    Christopher R. Stark

    2017-06-01

    Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.

  15. An historical document analysis of the introduction of the Baby Friendly Hospital Initiative into the Australian setting.

    Science.gov (United States)

    Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

    2017-02-01

    Breastfeeding has many known benefits yet its support across Australian health systems was suboptimal throughout the 20th Century. The World Health Organization launched a global health promotion strategy to help create a 'breastfeeding culture'. Research on the programme has revealed multiple barriers since implementation. To analyse the sociopolitical challenges associated with implementing a global programme into a national setting via an examination of the influences on the early period of implementation of the Baby Friendly Hospital Initiative in Australia. A focused historical document analysis was attended as part of an instrumental case study. A purposeful sampling strategy obtained a comprehensive sample of public and private documents related to the introduction of the BFHI in Australia. Analysis was informed by a 'documents as commentary' approach to gain insight into individual and collective social practices not otherwise observable. Four major themes were identified: "a breastfeeding culture"; "resource implications"; "ambivalent support for breastfeeding and the BFHI" and "business versus advocacy". "A breastfeeding culture" included several subthemes. No tangible support for breastfeeding generally, or the Baby Friendly Hospital Initiative specifically, was identified. Australian policy did not follow international recommendations. There were no financial or policy incentives for BFHI implementation. Key stakeholders' decisions negatively impacted on the Baby Friendly Hospital Initiative at a crucial time in its implementation in Australia. The potential impact of the programme was not realised, representing a missed opportunity to establish and provide sustainable standardised breastfeeding support to Australian women and their families. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  16. Provider Training to Screen and Initiate Evidence-Based Pediatric Obesity Treatment in Routine Practice Settings: A Randomized Pilot Trial.

    Science.gov (United States)

    Kolko, Rachel P; Kass, Andrea E; Hayes, Jacqueline F; Levine, Michele D; Garbutt, Jane M; Proctor, Enola K; Wilfley, Denise E

    This randomized pilot trial evaluated two training modalities for first-line, evidence-based pediatric obesity services (screening and goal setting) among nursing students. Participants (N = 63) were randomized to live interactive training or Web-facilitated self-study training. Pretraining, post-training, and 1-month follow-up assessments evaluated training feasibility, acceptability, and impact (knowledge and skill via simulation). Moderator (previous experience) and predictor (content engagement) analyses were conducted. Nearly all participants (98%) completed assessments. Both types of training were acceptable, with higher ratings for live training and participants with previous experience (ps pediatric obesity services. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  17. Initial Clinical Evaluation of the Modular Prosthetic Limb

    Directory of Open Access Journals (Sweden)

    Briana N. Perry

    2018-03-01

    Full Text Available The Modular Prosthetic Limb (MPL was examined for its feasibility and usability as an advanced, dexterous upper extremity prosthesis with surface electromyography (sEMG control in with two individuals with below-elbow amputations. Compared to currently marketed prostheses, the MPL has a greater number of sequential and simultaneous degrees of motion, as well as wrist modularity, haptic feedback, and individual digit control. The MPL was successfully fit to a 33-year-old with a trans-radial amputation (TR01 and a 30-year-old with a wrist disarticulation amputation (TR02. To preserve anatomical limb length, we adjusted the powered degrees of freedom of wrist motion between users. Motor training began with practicing sEMG and pattern recognition control within the virtual integration environment (VIE. Prosthetic training sessions then allowed participants to complete a variety of activities of daily living with the MPL. Training and Motion Control Accuracy scores quantified their ability to consistently train and execute unique muscle-to-motion contraction patterns. Each user also completed one prosthetic functional metric—the Southampton Hand Assessment Procedure (SHAP for TR01 and the Jebsen-Taylor Hand Function Test (JHFT for TR02. Haptic feedback capabilities were integrated for TR01. TR01 achieved 95% accuracy at 84% of his VIE sessions. He demonstrated improved scores over a year of prosthetic training sessions, ultimately achieving simultaneous control of 13 of the 17 (76% attempted motions. His performance on the SHAP improved from baseline to final assessment with an increase in number of tasks achieved. TR01 also used vibrotactile sensors to successfully discriminate between hard and soft objects being grasped by the MPL hand. TR02 demonstrated 95% accuracy at 79% of his VIE sessions. He demonstrated improved scores over months of prosthetic training sessions, however there was a significant drop in scores initially following a mid

  18. Initial evaluation and management of the critical burn patient.

    Science.gov (United States)

    Vivó, C; Galeiras, R; del Caz, Ma D P

    2016-01-01

    The major improvement in burn therapy is likely to focus on the early management of hemodynamic and respiratory failures in combination with an aggressive and early surgical excision and skin grafting for full-thickness burns. Immediate burn care by first care providers is important and can vastly alter outcomes, and it can significantly limit burn progression and depth. The goal of prehospital care should be to cease the burning process as well as prevent future complications and secondary injuries for burn shock. Identifying burn patients appropriate for immediate or subacute transfer is an important step in reducing morbidity and mortality. Delays in transport to Burn Unit should be minimized. The emergency management follows the principles of the Advanced Trauma Life Support Guidelines for assessment and stabilization of airway, breathing, circulation, disability, exposure and environment control. All patients with suspected inhalation injury must be removed from the enclosure as soon as possible, and immediately administer high-flow oxygen. Any patient with stridor, shortness of breath, facial burns, singed nasal hairs, cough, soot in the oral cavity, and history of being in a fire in an enclosed space should be strongly considered for early intubation. Fibroscopy may also be useful if airway damage is suspected and to assess known lung damage. Secondary evaluation following admission to the Burn Unit of a burned patient suffering a severe thermal injury includes continuation of respiratory support and management and treatment of inhalation injury, fluid resuscitation and cardiovascular stabilization, pain control and management of burn wound. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  19. Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation.

    Science.gov (United States)

    Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

    2015-09-16

    Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1) Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a) Stakeholder satisfaction, (b) Stakeholder understanding, (c) Shifted priorities (reallocation of resources), and (d) Implementation of decisions. (2) Priority setting processes should also meet the procedural conditions of (a) Stakeholder engagement, (b) Stakeholder empowerment, (c) Transparency, (d) Use of evidence, (e) Revisions, (f) Enforcement, and (g) Being grounded on community values. Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from these complementary schools of thought. © 2015

  20. Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation

    Science.gov (United States)

    Barasa, Edwine W.; Molyneux, Sassy; English, Mike; Cleary, Susan

    2015-01-01

    Background: Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. Methods: We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. Results: Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1) Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a) Stakeholder satisfaction, (b) Stakeholder understanding, (c) Shifted priorities (reallocation of resources), and (d) Implementation of decisions. (2) Priority setting processes should also meet the procedural conditions of (a) Stakeholder engagement, (b) Stakeholder empowerment, (c) Transparency, (d) Use of evidence, (e) Revisions, (f) Enforcement, and (g) Being grounded on community values. Conclusion: Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from these

  1. Setting Healthcare Priorities at the Macro and Meso Levels: A Framework for Evaluation

    Directory of Open Access Journals (Sweden)

    Edwine W. Barasa

    2015-11-01

    Full Text Available Background Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. Methods We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers. A total of 31 papers on evaluation of priority setting were identified. These were supplemented by broader theoretical literature related to evaluation of priority setting. A conceptual review of selected papers was undertaken. Results Based on a synthesis of the selected literature, we propose an evaluative framework that requires that priority setting practices at the macro and meso levels of the health system meet the following conditions: (1 Priority setting decisions should incorporate both efficiency and equity considerations as well as the following outcomes; (a Stakeholder satisfaction, (b Stakeholder understanding, (c Shifted priorities (reallocation of resources, and (d Implementation of decisions. (2 Priority setting processes should also meet the procedural conditions of (a Stakeholder engagement, (b Stakeholder empowerment, (c Transparency, (d Use of evidence, (e Revisions, (f Enforcement, and (g Being grounded on community values. Conclusion Available frameworks for the evaluation of priority setting are mostly grounded on procedural requirements, while few have included outcome requirements. There is, however, increasing recognition of the need to incorporate both consequential and procedural considerations in priority setting practices. In this review, we adapt an integrative approach to develop and propose a framework for the evaluation of priority setting practices at the macro and meso levels that draws from

  2. Benchmarking Data Sets for the Evaluation of Virtual Ligand Screening Methods: Review and Perspectives.

    Science.gov (United States)

    Lagarde, Nathalie; Zagury, Jean-François; Montes, Matthieu

    2015-07-27

    Virtual screening methods are commonly used nowadays in drug discovery processes. However, to ensure their reliability, they have to be carefully evaluated. The evaluation of these methods is often realized in a retrospective way, notably by studying the enrichment of benchmarking data sets. To this purpose, numerous benchmarking data sets were developed over the years, and the resulting improvements led to the availability of high quality benchmarking data sets. However, some points still have to be considered in the selection of the active compounds, decoys, and protein structures to obtain optimal benchmarking data sets.

  3. Guidance document for setting an Acute Reference Dose in Dutch national pesticide evaluations

    NARCIS (Netherlands)

    Raaij MTM van; CSR

    2001-01-01

    This report describes a proposal for the procedures for setting an Acute Reference Dose (ARfD) for pesticides evaluated in the Netherlands. This deals with both evaluations on the national level (on behalf of the Dutch Board for the Authorisation of Pesticides (CTB)) and evaluations at the European

  4. Working together: a joint initiative between academics and clinicians to prepare undergraduate nursing students to work in mental health settings.

    Science.gov (United States)

    Curtis, Janette

    2007-08-01

    There is ongoing concern among mental health professionals regarding the recruitment of newly graduated nurses to this specialist nursing area. Many reasons for the problem have been identified, including the perceived inadequate preparation by the tertiary sector, students' prejudices and anxieties about mental illness, a perceived lack of support while undertaking clinical placement, and the quality of the clinical placement itself. This paper describes a collaborative response to these issues undertaken in the Illawarra region of New South Wales, Australia. The implementation of preclinical undergraduate workshops using problem-based learning and role plays were undertaken. Mental health nursing scenarios were developed in association with experienced clinicians to introduce core concepts in a supportive learning environment. Quantitative and qualitative evaluation data were collected immediately following the workshop and again after the students returned to the university following a mental health clinical placement. A further survey of one cohort was undertaken 12 months after initial state registration and the beginning of a career in mental health nursing. Results showed that both students' and clinicians' attitudes to the workshops were consistently positive and indicated that the workshops were beneficial in preparing students for their clinical placement. Importantly, since the implementation of the workshops and other collaborative initiatives, an increasing number of newly graduated nurses from the region are choosing to work in mental health.

  5. Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature

    Science.gov (United States)

    Waithaka, Dennis; Tsofa, Benjamin; Barasa, Edwine

    2018-01-01

    Background: Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso (sub-national) level of health systems. Methods: We systematically searched PubMed, ScienceDirect and Google scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers. We only included empirical studies that described and evaluated, or those that only evaluated priority setting practice at the meso-level. A total of 16 papers were identified from LMICs and HICs. We analyzed data from the selected papers by thematic review. Results: Few studies used systematic priority setting processes, and all but one were from HICs. Both formal and informal criteria are used in priority-setting, however, informal criteria appear to be more perverse in LMICs compared to HICs. The priority setting process at the meso-level is a top-down approach with minimal involvement of the community. Accountability for reasonableness was the most common evaluative framework as it was used in 12 of the 16 studies. Efficiency, reallocation of resources and options for service delivery redesign were the most common outcome measures used to evaluate priority setting. Limitations: Our study was limited by the fact that there are very few empirical studies that have evaluated priority setting at the meso-level and there is likelihood that we did not capture all the studies. Conclusions: Improving priority setting practices at the meso level is crucial to strengthening health systems. This can be achieved through incorporating and adapting systematic priority setting processes and frameworks to the context where used, and making considerations of both process

  6. Application of the theory of indistinct sets for evaluation scholarship quality of students

    Directory of Open Access Journals (Sweden)

    Вячеслав Порфирьевич Добрица

    2010-03-01

    Full Text Available An algorithm for evaluating of students quality education, which eliminates the disadvantages of the five point scale is discussed in the article. The theory of indistinct sets is the base of the constructed algorithm.

  7. Goal Setting in Principal Evaluation: Goal Quality and Predictors of Achievement

    Science.gov (United States)

    Sinnema, Claire E. L.; Robinson, Viviane M. J.

    2012-01-01

    This article draws on goal-setting theory to investigate the goals set by experienced principals during their performance evaluations. While most goals were about teaching and learning, they tended to be vaguely expressed and only partially achieved. Five predictors (commitment, challenge, learning, effort, and support) explained a significant…

  8. Atmospheric bromoform at Cape Point, South Africa: an initial fixed-point data set on the African continent

    Directory of Open Access Journals (Sweden)

    B. Kuyper

    2018-04-01

    Full Text Available Bromoform mixing ratios in marine air were measured at Cape Point Global Atmospheric Watch Station, South Africa. This represents the first such bromoform data set recorded at this location. Manual daily measurements were made during a month-long field campaign (austral spring 2011 using a gas chromatograph-electron capture detector (GC-ECD with a custom-built front end thermal desorption trap. The measured concentrations ranged between 4.4 and 64.6 (± 22.2 % ppt with a mean of 24.8 ± 14.8 ppt. The highest mixing ratios recorded here occurred at, or shortly after, low tide. The diurnal cycle exhibited a morning and evening maximum with lower concentrations throughout the rest of the day. Initial analysis of the data presented indicates that the local kelp beds were the dominant source of the bromoform reported. A concentration-weighted trajectory analysis of the bromoform measurements suggests that two offshore source areas may exist. These source areas appear to be centred on the Agulhas retroflection and extend from St Helena Bay to the southwest.

  9. Atmospheric bromoform at Cape Point, South Africa: an initial fixed-point data set on the African continent

    Science.gov (United States)

    Kuyper, Brett; Palmer, Carl J.; Labuschagne, Casper; Reason, Chris J. C.

    2018-04-01

    Bromoform mixing ratios in marine air were measured at Cape Point Global Atmospheric Watch Station, South Africa. This represents the first such bromoform data set recorded at this location. Manual daily measurements were made during a month-long field campaign (austral spring 2011) using a gas chromatograph-electron capture detector (GC-ECD) with a custom-built front end thermal desorption trap. The measured concentrations ranged between 4.4 and 64.6 (± 22.2 %) ppt with a mean of 24.8 ± 14.8 ppt. The highest mixing ratios recorded here occurred at, or shortly after, low tide. The diurnal cycle exhibited a morning and evening maximum with lower concentrations throughout the rest of the day. Initial analysis of the data presented indicates that the local kelp beds were the dominant source of the bromoform reported. A concentration-weighted trajectory analysis of the bromoform measurements suggests that two offshore source areas may exist. These source areas appear to be centred on the Agulhas retroflection and extend from St Helena Bay to the southwest.

  10. Evaluating the use of the Cleo 90 infusion set for patients on a palliative care unit.

    Science.gov (United States)

    Schneider, Michael; Hoffmann, Martin; Lorenzl, Stefan

    2009-08-01

    Although the use of subcutaneous infusion is common in palliative care, problems can occur. Normally, butterfly needles are used; however, there are occasional issues with patients being able to walk around or with restless patients who suffer from delirium. In these cases, needles often dislocate; therefore, a small observational study was undertaken to evaluate the use of the Cleo 90 infusion set. The use of this needle system has been well established in diabetic patients who require continuous subcutaneous infusion of insulin, but has never been tested in a wider range of patients with other medications. In this 6-month study, 45 patients were identified for subcutaneous infusion and a total of 112 needles were used for this study, since we initially changed each site after 2 days to control the local site for adverse reactions. We have not observed any complications with drug combinations delivered via the attached tube and the needle, and have used up to five different drugs mixed together in a single syringe. Needles could be used for a mean time of 5 +/- 2 days (range 2-12 days). Local site reactions have been observed only with sodium chloride infusions, which were not delivered via a pump system. Reddening and induration of the skin occurred, but they were reversible after removing the needle. As this was a small study in only one unit, without standardization the results can only be observational. However, it has shown, for the first time, that the Cleo 90 needle can be safe and comfortable.

  11. Enhanced evaluation data initiates a collaborative out-of-school time food sponsors work group.

    Science.gov (United States)

    Rifkin, Robin; Williams, Lauren A; Grode, Gabrielle M; Roberts-Johnson, Wendy-Anne

    2015-01-01

    Philadelphia's Healthy Kids, Healthy Communities Out-of-School Time (OST) Initiative led by the Health Promotion Council developed 10 Healthy Living Guidelines for Out-of-School Time Programs to support a healthy environment for Philadelphia youth in 200 OST programs. Health Promotion Council participated in an enhanced cross-site evaluation with the national Robert Wood Johnson Foundation evaluator during the final year of funding to learn more about food and nutrition in the OST setting, and to share data and engage the OST food providers. A plate waste study measured the quantity and nutrition composition of meals served to youth compared to food not eaten. Staff interviews measured program adherence to the Healthy Living Guidelines, along with other facets of the food environment in 7 Philadelphia OST programs. Online surveys were sent to OST programs. Food providers (sponsors) were interviewed using Appreciative Inquiry methodology to gain insight into systems, goals, and common interests. Aggregated plate waste data from 7 observations showed an average of 42% of the food uneaten after meal/snack consumption, and high sodium content of the meals. Twenty-nine staff at OST programs completed the online survey, and 3 food sponsors were interviewed. Recommendations to improve the food included increasing variety, offering more salads, fruits and vegetables, and culturally appropriate foods. Food sponsor interviews showed a variety of meal production, distribution, service and training systems, and an interest in working together. The food sponsors met to review the data and prioritized common goals. They continue to work together to improve systems and meals for food service. A food sponsors work group formed and continues as a result of sharing enhanced cross-site data about food in OST settings. Food sponsors continue to work together to improve systems and nutritional offerings for Philadelphia OST programs.

  12. A Plan for the Evaluation of California's Class Size Reduction Initiative.

    Science.gov (United States)

    Kirst, Michael; Bomstedt, George; Stecher, Brian

    In July 1996, California began its Class Size Reduction (CSR) Initiative. To gauge the effectiveness of this initiative, an analysis of its objectives and an overview of proposed strategies for evaluating CSR are presented here. An outline of the major challenges that stand between CSR and its mission are provided. These include logistical…

  13. Using low energy x-ray radiography to evaluate root initiation and growth of Populus

    Science.gov (United States)

    Ronald S., Jr. Zalesny; A. L. Friend; B. Kodrzycki; D.W. McDonald; R. Michaels; A.H. Wiese; J.W. Powers

    2007-01-01

    Populus roots have been studied less than aboveground tissues. However, there is an overwhelming need to evaluate root initiation and growth in order to understand the genetics and physiology of rooting, along with genotype x environment interactions.

  14. Integrated corridor management initiative : demonstration phase evaluation, San Diego air quality test plan.

    Science.gov (United States)

    2012-08-01

    This report presents the test plan for conducting the Air Quality Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM projects being...

  15. Integrated corridor management initiative : demonstration phase evaluation, Dallas air quality test plan.

    Science.gov (United States)

    2012-08-01

    This report presents the test plan for conducting the Air Quality Analysis for the United States : Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor : Management (ICM) Initiative Demonstration. The ICM proje...

  16. Integrated corridor management initiative : demonstration phase evaluation - Dallas technical capability analysis test plan.

    Science.gov (United States)

    This report presents the test plan for conducting the Technical Capability Analysis for the United States : Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor : Management (ICM) Initiative Demonstration. The ...

  17. Integrated corridor management initiative : demonstration phase evaluation, San Diego technical capability analysis test plan.

    Science.gov (United States)

    2012-08-01

    This report presents the test plan for conducting the Technical Capability Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM proje...

  18. An evaluation system of the setting up of predictive maintenance programmes

    International Nuclear Information System (INIS)

    Carnero, MaCarmen

    2006-01-01

    Predictive Maintenance can provide an increase in safety, quality and availability in industrial plants. However, the setting up of a Predictive Maintenance Programme is a strategic decision that until now has lacked analysis of questions related to its setting up, management and control. In this paper, an evaluation system is proposed that carries out the decision making in relation to the feasibility of the setting up. The evaluation system uses a combination of tools belonging to operational research such as: Analytic Hierarchy Process, decision rules and Bayesian tools. This system is a help tool available to the managers of Predictive Maintenance Programmes which can both increase the number of Predictive Maintenance Programmes set up and avoid the failure of these programmes. The Evaluation System has been tested in a petrochemical plant and in a food industry

  19. Using the Language of Sets to Describe Nested Systems in Emergy Evaluations

    Science.gov (United States)

    The language of set theory has been recently used to describe the emergy evaluation of a process. In this paper this mathematical language is used as a guide to evaluate the emergy of nested systems. We analyze a territorial system on multiple scales as an example of hierarchical...

  20. [Evaluation of the influence of humidity and temperature on the drug stability by initial average rate experiment].

    Science.gov (United States)

    He, Ning; Sun, Hechun; Dai, Miaomiao

    2014-05-01

    To evaluate the influence of temperature and humidity on the drug stability by initial average rate experiment, and to obtained the kinetic parameters. The effect of concentration error, drug degradation extent, humidity and temperature numbers, humidity and temperature range, and average humidity and temperature on the accuracy and precision of kinetic parameters in the initial average rate experiment was explored. The stability of vitamin C, as a solid state model, was investigated by an initial average rate experiment. Under the same experimental conditions, the kinetic parameters obtained from this proposed method were comparable to those from classical isothermal experiment at constant humidity. The estimates were more accurate and precise by controlling the extent of drug degradation, changing humidity and temperature range, or by setting the average temperature closer to room temperature. Compared with isothermal experiments at constant humidity, our proposed method saves time, labor, and materials.

  1. Effect of exposure to evening light on sleep initiation in the elderly: a longitudinal analysis for repeated measurements in home settings.

    Science.gov (United States)

    Obayashi, Kenji; Saeki, Keigo; Iwamoto, Junko; Okamoto, Nozomi; Tomioka, Kimiko; Nezu, Satoko; Ikada, Yoshito; Kurumatani, Norio

    2014-05-01

    Epidemiologic data have demonstrated associations of sleep-onset insomnia with a variety of diseases, including depression, dementia, diabetes and cardiovascular diseases. Sleep initiation is controlled by the suprachiasmatic nucleus of the hypothalamus and endogenous melatonin, both of which are influenced by environmental light. Exposure to evening light is hypothesized to cause circadian phase delay and melatonin suppression before bedtime, resulting in circadian misalignment and sleep-onset insomnia; however, whether exposure to evening light disturbs sleep initiation in home settings remains unclear. In this longitudinal analysis of 192 elderly individuals (mean age: 69.9 years), we measured evening light exposure and sleep-onset latency for 4 days using a wrist actigraph incorporating a light meter and an accelerometer. Mixed-effect linear regression analysis for repeated measurements was used to evaluate the effect of evening light exposure on subsequent sleep-onset latency. The median intensity of evening light exposure and the median sleep-onset latency were 27.3 lux (interquartile range, 17.9-43.4) and 17 min (interquartile range, 7-33), respectively. Univariate models showed significant associations between sleep-onset latency and age, gender, daytime physical activity, in-bed time, day length and average intensity of evening and nighttime light exposures. In a multivariate model, log-transformed average intensity of evening light exposure was significantly associated with log-transformed sleep-onset latency independent of the former potential confounding factors (regression coefficient, 0.133; 95% CI, 0.020-0.247; p = 0.021). Day length and nighttime light exposure were also significantly associated with log-transformed sleep-onset latency (p = 0.001 and p < 0.001, respectively). In conclusion, exposure to evening light in home setting prolongs subsequent sleep-onset latency in the elderly.

  2. Criteria for evaluating programme theory diagrams in quality improvement initiatives: a structured method for appraisal.

    Science.gov (United States)

    Issen, Laurel; Woodcock, Thomas; McNicholas, Christopher; Lennox, Laura; Reed, Julie E

    2018-04-09

    Despite criticisms that many quality improvement (QI) initiatives fail due to incomplete programme theory, there is no defined way to evaluate how programme theory has been articulated. The objective of this research was to develop, and assess the usability and reliability of scoring criteria to evaluate programme theory diagrams. Criteria development was informed by published literature and QI experts. Inter-rater reliability was tested between two evaluators. About 63 programme theory diagrams (42 driver diagrams and 21 action-effect diagrams) were reviewed to establish whether the criteria could support comparative analysis of different approaches to constructing diagrams. Components of the scoring criteria include: assessment of overall aim, logical overview, clarity of components, cause-effect relationships, evidence and measurement. Independent reviewers had 78% inter-rater reliability. Scoring enabled direct comparison of different approaches to developing programme theory; action-effect diagrams were found to have had a statistically significant but moderate improvement in programme theory quality over driver diagrams; no significant differences were observed based on the setting in which driver diagrams were developed. The scoring criteria summarise the necessary components of programme theory that are thought to contribute to successful QI projects. The viability of the scoring criteria for practical application was demonstrated. Future uses include assessment of individual programme theory diagrams and comparison of different approaches (e.g. methodological, teaching or other QI support) to produce programme theory. The criteria can be used as a tool to guide the production of better programme theory diagrams, and also highlights where additional support for QI teams could be needed.

  3. Evaluation of rotational set-up errors in patients with thoracic neoplasms

    International Nuclear Information System (INIS)

    Wang Yanyang; Fu Xiaolong; Xia Bing; Fan Min; Yang Huanjun; Ren Jun; Xu Zhiyong; Jiang Guoliang

    2010-01-01

    Objective: To assess the rotational set-up errors in patients with thoracic neoplasms. Methods: 224 kilovoltage cone-beam computed tomography (KVCBCT) scans from 20 thoracic tumor patients were evaluated retrospectively. All these patients were involved in the research of 'Evaluation of the residual set-up error for online kilovoltage cone-beam CT guided thoracic tumor radiation'. Rotational set-up errors, including pitch, roll and yaw, were calculated by 'aligning the KVCBCT with the planning CT, using the semi-automatic alignment method. Results: The average rotational set-up errors were -0.28 degree ±1.52 degree, 0.21 degree ± 0.91 degree and 0.27 degree ± 0.78 degree in the left-fight, superior-inferior and anterior-posterior axis, respectively. The maximal rotational errors of pitch, roll and yaw were 3.5 degree, 2.7 degree and 2.2 degree, respectively. After correction for translational set-up errors, no statistically significant changes in rotational error were observed. Conclusions: The rotational set-up errors in patients with thoracic neoplasms were all small in magnitude. Rotational errors may not change after the correction for translational set-up errors alone, which should be evaluated in a larger sample future. (authors)

  4. Singapore Cancer Network (SCAN) Guidelines for the Initial Evaluation, Diagnosis, and Management of Extremity Soft Tissue Sarcoma and Osteosarcoma.

    Science.gov (United States)

    2015-10-01

    The SCAN sarcoma workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for the initial evaluation, diagnosis, and management of extremity soft tissue sarcoma and osteosarcoma. The workgroup utilised a consensus approach to create high quality evidence-based clinical practice guidelines suited for our local setting. Various international guidelines from the fields of radiology, pathology, orthopaedic surgery, medical, radiation and paediatric oncology were reviewed, including those developed by von Mehren Metal (J Natl Compr Canc Netw 2014), the National Collaborating Centre for Cancer (2006), the European Sarcoma Network Working Group (2012) and Grimer RJ et al (Sarcoma 2008). Our clinical practice guidelines contextualised to the local patient will streamline care and improve clinical outcomes for patients with extremity soft tissue and osteosarcoma. These guidelines form the SCAN Guidelines 2015 for the initial evaluation, diagnosis, and management of extremity soft tissue sarcoma and osteosarcoma.

  5. A Porcine Model for Initial Surge Mechanical Ventilator Assessment and Evaluation of Two Limited Function Ventilators

    Science.gov (United States)

    Dickson, Robert P; Hotchkin, David L; Lamm, Wayne JE; Hinkson, Carl; Pierson, David J; Glenny, Robb W; Rubinson, Lewis

    2013-01-01

    Objective To adapt an animal model of acute lung injury for use as a standard protocol for a screening, initial evaluation of limited function, or “surge,” ventilators for use in mass casualty scenarios. Design Prospective, experimental animal study. Setting University research laboratory. Subjects 12 adult pigs. Interventions 12 spontaneously breathing pigs (6 in each group) were subjected to acute lung injury/acute respiratory distress syndrome (ALI/ARDS) via pulmonary artery infusion of oleic acid. Following development of respiratory failure, animals were mechanically ventilated with a limited function ventilator (Simplified Automatic Ventilator [SAVe] I or II; Automedx) for one hour or until the ventilator could not support the animal. The limited function ventilator was then exchanged for a full function ventilator (Servo 900C; Siemens). Measurements and Main Results Reliable and reproducible levels of ALI/ARDS were induced. The SAVe I was unable to adequately oxygenate 5 animals, with PaO2 (52.0 ± 11.1 torr) compared to the Servo (106.0 ± 25.6 torr; p=0.002). The SAVe II was able to oxygenate and ventilate all 6 animals for one hour with no difference in PaO2 (141.8 ± 169.3 torr) compared to the Servo (158.3 ± 167.7 torr). Conclusions We describe a novel in vivo model of ALI/ARDS that can be used to initially screen limited function ventilators considered for mass respiratory failure stockpiles, and is intended to be combined with additional studies to defintively assess appropriateness for mass respiratory failure. Specifically, during this study we demonstrate that the SAVe I ventilator is unable to provide sufficient gas exchange, while the SAVe II, with several more functions, was able to support the same level of hypoxemic respiratory failure secondary to ALI/ARDS for one hour. PMID:21187747

  6. Evaluation of the initial and final radiological status of a nuclear facility in sanitation status

    International Nuclear Information System (INIS)

    Granier, Guy; Aubonnet, Emilie; Courbet, Christele; Desnoyers, Yvon; Dubot, Didier; Fichet, Pascal; Nokhamzon, Jean-Guy; Ollivier Dehaye, Catherine; Pillette-Cousin, Lucien; Mahe, Charly

    2017-02-01

    This technical report is a guideline for radiological assessment of a nuclear facility in remediation stages. From initial state of remediation to final status survey it describes the best suited statistical or geostatistical approach for the characterization of sites contaminated by radionuclides. Prior to any characterization campaign an historical analysis coupled with a function analysis targeted investigations is fundamental to obtain a robust overview. The evaluation of the amount of radioactive material present in a defined area requires a sampling strategy correlated with characterization objective. On the other hand correlation between remediation objectives and characterization objectives also requires knowing acceptable level of risk. This give better inputs to allow available resources and take into account environmental constraints. In particular, radiological characterization of infrastructures is one of the key step to conduct industrial project of decommissioning nuclear facilities in remediation. It needs a reliable initial diagnosis to obtain an efficient waste management with a financial control Optimization of the production of nuclear waste. It is an important part of Setting the Off Final - Dismantling). This approach is compatible with French Regulation (Guide 14 ASN) for the first and second line of defence. Annexes provide feedback of experimentation of this methodology. This report supplements the methodological guide published by the GT10 CETAMA entitled 'Soil Radiological Characterisation Methodology' (CEA-R 6386). The latter is intended for project managers and covers all issues related to the characterization projects for soil. This guideline concern specifically design engineers in charge of implementation program at the different stages of investigation and data processing. Similarly, the proposed methodology can be broken for the characterization of chemical pollution and process equipment. (authors)

  7. Evaluation of a well-established task-shifting initiative: the lay counselor cadre in Botswana.

    Science.gov (United States)

    Ledikwe, Jenny H; Kejelepula, Mable; Maupo, Kabelo; Sebetso, Siwulani; Thekiso, Mothwana; Smith, Monica; Mbayi, Bagele; Houghton, Nankie; Thankane, Kabo; O'Malley, Gabrielle; Semo, Bazghina-Werq

    2013-01-01

    Evidence supports the implementation of task shifting to address health worker shortages that are common in resource-limited settings. However, there is need to learn from established programs to identify ways to achieve the strongest, most sustainable impact. This study examined the Botswana lay counselor cadre, a task shifting initiative, to explore effectiveness and contribution to the health workforce. This evaluation used multiple methods, including a desk review, a national lay counselor survey (n = 385; response = 94%), in-depth interviews (n = 79), lay counselors focus group discussions (n = 7), lay counselors observations (n = 25), and client exit interviews (n = 47). Interview and focus group data indicate that lay counselors contribute to essentially all HIV-related programs in Botswana and they conduct the majority of HIV tests and related counseling at public health facilities throughout the country. Interviews showed that the lay counselor cadre is making the workload of more skilled health workers more manageable and increasing HIV acceptance in communities. The average score on a work-related knowledge test was 74.5%. However for 3 questions, less than half answered correctly. During observations, lay counselors demonstrated average competence for most skills assessed and clients (97.9%) were satisfied with services received. From the survey, lay counselors generally reported being comfortable with their duties; however, some reported clinical duties that extended beyond their training and mandate. Multiple factors affecting the performance of the lay counselors were identified, including insufficient resources, such as private counseling space and HIV test kits; and technical, administrative, and supervisory support. Lay counselors are fulfilling an important role in Botswana's healthcare system, serving as the entry point into HIV care, support, and treatment services. For this and other similar task shifting initiatives

  8. Baseline Survey for an Impact Evaluation of the Greenbelt Transformation Initiative in South Sudan

    Data.gov (United States)

    US Agency for International Development — This data set is derived from a 2013 household baseline survey in the country's Greenbelt region as part of an impact evaluation of the Food, Agribusiness, and Rural...

  9. Efficiency of the kidney disease outcomes quality initiative guidelines for preemptive vascular access in an academic setting.

    Science.gov (United States)

    Kimball, Traci A; Barz, Ken; Dimond, Kelly R; Edwards, James M; Nehler, Mark R

    2011-09-01

    The National Kidney Foundation-Kidney Diseases Outcomes Quality Initiative (KDOQI) for vascular access guidelines state that patients with late-stage chronic kidney disease (CKD) should undergo native arteriovenous fistula (AVF) creation at least 6 months before anticipated start of hemodialysis (HD) treatments to obviate the need for other vascular access types, such as grafts or central catheters. The objective of this study was to determine the incidence of HD, the functional patency, and associated morbidity of AVFs in patients with late-stage CKD placed according to KDOQI. Consecutive patients with late-stage CKD who underwent AVF creation using KDOQI guidelines for anatomy between January 2003 and December 2007 at two tertiary academic centers were retrospectively evaluated. Baseline demographics, AVF type, and clinical comorbidities were recorded. Patients were stratified into one of four groups (groups A-D) over the follow-up course based on two end points: patency of their AVF and whether or not they began HD. The ideal primary outcome was AVF maturation and use for HD (group A; cumulative functional patency). Other outcomes included AVF patency but no HD (group B), HD with AVF failure (group C), or no HD and AVF abandonment (ie, death, refused hemodialysis, kidney transplant, or fistula failure; group D). Secondary outcomes were time to first cannulation, complications, and secondary interventions. AVFs were created (46% forearm and 54% upper arm) in 150 patients with CKD (85% men, median age 63 years old). At a median follow-up of 10 months, 74 patients (49%) were receiving HD and of these, 48 patients (65%) were using their AVF (group A), whereas 26 patients (35%) were not due to fistula failure (group C). Thirty-four patients (23%) never initiated HD treatments, but had a viable AVF (group B), and 42 patients (28%) never initiated HD and abandoned their AVF (group D). Overall, AVF abandonment was 51%. Mean maturation time of all AVFs successfully

  10. Containment performance evaluation for the GESSAR-II plant for seismic initiating events

    International Nuclear Information System (INIS)

    Shiu, K.K.; Chu, T.; Ludewig, H.; Pratt, W.T.

    1986-01-01

    As a part of the overall effort undertaken by Brookhaven National Laboratory (BNL) to review the GESSAR-II probabilistic risk assessment, an independent containment performance evaluation was performed using the containment event tree approach. This evaluation focused principally on those accident sequences which are initiated by seismic events. This paper reports the findings of this study. 1 ref

  11. Evaluating Speed Enforcement Field Set-Ups Used by Regional Police in Belgium: An Analysis of Speed Outcome Indicators

    Directory of Open Access Journals (Sweden)

    Brenda Wilmots

    2016-12-01

    Full Text Available In this paper the results from a field experiment (conducted in 2012 are presented, in which 3 regional police units in the Flemish region of Belgium each tested a particular combination of a speed control (with mobile radar in an anonymous car with communicative signage. The goal of this paper was to scientifically evaluate frequently used field set-ups. The following set-ups were tested in one week: (1 police unit 1: speed control with and without a static feedback sign placed after the control; (2 police unit 2: speed control with and without a digital feedback sign placed after the control; (3 police unit 3: speed display followed by a second speed display further along the road section. During certain time frames, speed control took place in between both signs. All tested field set-ups generated significant reductions in the speed level. Studying the effect of the different variations for each set-up reveals that the effect of the speed control is generally larger in combination with the signage alongside the road. After the period during which the police activities took place, speed levels again reached their initial level. Based on the before–after analysis, only in police area 2 was a small ‘time halo-effect’ found. To generalize results from this pilot study, repetition of tested set-ups in the field is recommended as well as testing on a larger scale.

  12. Initial Experience with "Honoring Choices Wisconsin": Implementation of an Advance Care Planning Pilot in a Tertiary Care Setting.

    Science.gov (United States)

    Peltier, Wendy L; Gani, Faiz; Blissitt, Jennifer; Walczak, Katherine; Opper, Kristi; Derse, Arthur R; Johnston, Fabian M

    2017-09-01

    Although previous research on advance care planning (ACP) has associated ACP with improved quality of care at the end of life, the appropriate use of ACP remains limited. To evaluate the impact of a pilot program using the "Honoring Choices Wisconsin" (HCW) model for ACP in a tertiary care setting, and to understand barriers to system-wide implementation. Retrospective review of prospectively collected data. Patients who received medical or surgical oncology care at Froedtert and the Medical College of Wisconsin. Patient demographics, disease characteristics, patient satisfaction, and clinical outcomes. Data from 69 patients who died following the implementation of the HCW program were reviewed; 24 patients were enrolled in the HCW program while 45 were not. Patients enrolled in HCW were proportionally less likely to be admitted to the ICU (12.5% vs. 17.8%) and were more likely to be "do not resuscitate" (87.5% vs. 80.0%), as well as have a completed ACP (83.3% vs. 79.1%). Furthermore, admission to a hospice was also higher among patients who were enrolled in the HCW program (79.2% vs. 25.6%), with patients enrolled in HCW more likely to die in hospice (70.8% vs. 53.3%). The HCW program was favorably viewed by patients, patient caregivers, and healthcare providers. Implementation of a facilitator-based ACP care model was associated with fewer ICU admissions, and a higher use of hospice care. System-level changes are required to overcome barriers to ACP that limit patients from receiving end-of-life care in accordance with their preferences.

  13. Evaluating the consistency of gene sets used in the analysis of bacterial gene expression data

    Directory of Open Access Journals (Sweden)

    Tintle Nathan L

    2012-08-01

    Full Text Available Abstract Background Statistical analyses of whole genome expression data require functional information about genes in order to yield meaningful biological conclusions. The Gene Ontology (GO and Kyoto Encyclopedia of Genes and Genomes (KEGG are common sources of functionally grouped gene sets. For bacteria, the SEED and MicrobesOnline provide alternative, complementary sources of gene sets. To date, no comprehensive evaluation of the data obtained from these resources has been performed. Results We define a series of gene set consistency metrics directly related to the most common classes of statistical analyses for gene expression data, and then perform a comprehensive analysis of 3581 Affymetrix® gene expression arrays across 17 diverse bacteria. We find that gene sets obtained from GO and KEGG demonstrate lower consistency than those obtained from the SEED and MicrobesOnline, regardless of gene set size. Conclusions Despite the widespread use of GO and KEGG gene sets in bacterial gene expression data analysis, the SEED and MicrobesOnline provide more consistent sets for a wide variety of statistical analyses. Increased use of the SEED and MicrobesOnline gene sets in the analysis of bacterial gene expression data may improve statistical power and utility of expression data.

  14. Time asymmetric spacetimes near null and spatial infinity: II. Expansions of developments of initial data sets with non-smooth conformal metrics

    International Nuclear Information System (INIS)

    Kroon, Juan Antonio Valiente

    2005-01-01

    This paper uses the conformal Einstein equations and the conformal representation of spatial infinity introduced by Friedrich to analyse the behaviour of the gravitational field near null and spatial infinity for the development of initial data which are, in principle, non-conformally flat and time asymmetric. The paper is the continuation of the investigation started in Class. Quantum Grav. 21 (2004) 5457-92, where only conformally flat initial data sets were considered. For the purposes of this investigation, the conformal metric of the initial hypersurface is assumed to have a very particular type of non-smoothness at infinity in order to allow for the presence of non-Schwarzschildean stationary initial data sets in the class under study. The calculation of asymptotic expansions of the development of these initial data sets reveals-as in the conformally flat case-the existence of a hierarchy of obstructions to the smoothness of null infinity which are expressible in terms of the initial data. This allows for the possibility of having spacetimes where future and past null infinity have different degrees of smoothness. A conjecture regarding the general structure of the hierarchy of obstructions is presented

  15. Leader performance evaluations and role congruity expectations in a community college setting

    OpenAIRE

    Trickey, Edward

    2011-01-01

    To investigate the relationships among evaluator attitudes, the role congruity biases many people consciously and unconsciously maintain, evaluation practices, perceptions of leader efficacy and success, and leader persistence in two community college settings, a mixed-methods study was conducted. Leaders are the products of their experiences, environments, the greater society within which they live, their personal attitudes and biases, and the attitudes and role biases of others. Over time, ...

  16. Rotavirus vaccine effectiveness in low-income settings: An evaluation of the test-negative design

    OpenAIRE

    Schwartz, Lauren M.; Halloran, M. Elizabeth; Rowhani-Rahbar, Ali; Neuzil, Kathleen M.; Victor, John C.

    2017-01-01

    Background The test-negative design (TND), an epidemiologic method currently used to measure rotavirus vaccine (RV) effectiveness, compares the vaccination status of rotavirus-positive cases and rotavirus-negative controls meeting a pre-defined case definition for acute gastroenteritis. Despite the use of this study design in low-income settings, the TND has not been evaluated to measure rotavirus vaccine effectiveness. Methods This study builds upon prior methods to evaluate the use of the T...

  17. Rough Set Theory Based Fuzzy TOPSIS on Serious Game Design Evaluation Framework

    Directory of Open Access Journals (Sweden)

    Chung-Ho Su

    2013-01-01

    Full Text Available This study presents a hybrid methodology for solving the serious game design evaluation in which evaluation criteria are based on meaningful learning, ARCS motivation, cognitive load, and flow theory (MACF by rough set theory (RST and experts’ selection. The purpose of this study tends to develop an evaluation model with RST based fuzzy Delphi-AHP-TOPSIS for MACF characteristics. Fuzzy Delphi method is utilized for selecting the evaluation criteria, Fuzzy AHP is used for analyzing the criteria structure and determining the evaluation weight of criteria, and Fuzzy TOPSIS is applied to determine the sequence of the evaluations. A real case is also used for evaluating the selection of MACF criteria design for four serious games, and both the practice and evaluation of the case could be explained. The results show that the playfulness (C24, skills (C22, attention (C11, and personalized (C35 are determined as the four most important criteria in the MACF selection process. And evaluation results of case study point out that Game 1 has the best score overall (Game 1 > Game 3 > Game 2 > Game 4. Finally, proposed evaluation framework tends to evaluate the effectiveness and the feasibility of the evaluation model and provide design criteria for relevant multimedia game design educators.

  18. Feature Set Evaluation for Offline Handwriting Recognition Systems: Application to the Recurrent Neural Network Model.

    Science.gov (United States)

    Chherawala, Youssouf; Roy, Partha Pratim; Cheriet, Mohamed

    2016-12-01

    The performance of handwriting recognition systems is dependent on the features extracted from the word image. A large body of features exists in the literature, but no method has yet been proposed to identify the most promising of these, other than a straightforward comparison based on the recognition rate. In this paper, we propose a framework for feature set evaluation based on a collaborative setting. We use a weighted vote combination of recurrent neural network (RNN) classifiers, each trained with a particular feature set. This combination is modeled in a probabilistic framework as a mixture model and two methods for weight estimation are described. The main contribution of this paper is to quantify the importance of feature sets through the combination weights, which reflect their strength and complementarity. We chose the RNN classifier because of its state-of-the-art performance. Also, we provide the first feature set benchmark for this classifier. We evaluated several feature sets on the IFN/ENIT and RIMES databases of Arabic and Latin script, respectively. The resulting combination model is competitive with state-of-the-art systems.

  19. Evaluation of farmed cod products by a trained sensory panel and consumers in different test settings

    NARCIS (Netherlands)

    Sveinsdottir, K.; Martinsdottir, E.; Thorsdottir, F.; Schelvis-Smit, A.A.M.; Kole, A.; Thorsdottir, I.

    2010-01-01

    Sensory characteristics of farmed cod exposed to low or conventional stress levels prior to slaughter were evaluated by a trained sensory panel. Consumers in two different settings, central location test (CLT) and home-use test (HUT), also tasted the products and rated them according to overall

  20. Cross-sectional evaluation of an internet-based hearing screening test in an occupational setting

    NARCIS (Netherlands)

    Sheikh Rashid, Marya; Leensen, Monique Cj; de Laat, Jan Apm; Dreschler, Wouter A.

    2017-01-01

    Objectives The Occupational Earcheck (OEC) is an online internet test to detect high-frequency hearing loss for the purposes of occupational hearing screening. In this study, we evaluated the OEC in an occupational setting in order to assess test sensitivity, specificity, and validity. Methods A

  1. Change in Vitamin D Levels Occurs Early after Antiretroviral Therapy Initiation and Depends on Treatment Regimen in Resource-Limited Settings

    Science.gov (United States)

    Havers, Fiona P.; Detrick, Barbara; Cardoso, Sandra W.; Berendes, Sima; Lama, Javier R.; Sugandhavesa, Patcharaphan; Mwelase, Noluthando H.; Campbell, Thomas B.; Gupta, Amita

    2014-01-01

    Study Background Vitamin D has wide-ranging effects on the immune system, and studies suggest that low serum vitamin D levels are associated with worse clinical outcomes in HIV. Recent studies have identified an interaction between antiretrovirals used to treat HIV and reduced serum vitamin D levels, but these studies have been done in North American and European populations. Methods Using a prospective cohort study design nested in a multinational clinical trial, we examined the effect of three combination antiretroviral (cART) regimens on serum vitamin D levels in 270 cART-naïve, HIV-infected adults in nine diverse countries, (Brazil, Haiti, Peru, Thailand, India, Malawi, South Africa, Zimbabwe and the United States). We evaluated the change between baseline serum vitamin D levels and vitamin D levels 24 and 48 weeks after cART initiation. Results Serum vitamin D levels decreased significantly from baseline to 24 weeks among those randomized to efavirenz/lamivudine/zidovudine (mean change: −7.94 [95% Confidence Interval (CI) −10.42, −5.54] ng/ml) and efavirenz/emtricitabine/tenofovir-DF (mean change: −6.66 [95% CI −9.40, −3.92] ng/ml) when compared to those randomized to atazanavir/emtricitabine/didanosine-EC (mean change: −2.29 [95% CI –4.83, 0.25] ng/ml). Vitamin D levels did not change significantly between week 24 and 48. Other factors that significantly affected serum vitamin D change included country (p<0.001), season (p<0.001) and baseline vitamin D level (p<0.001). Conclusion Efavirenz-containing cART regimens adversely affected vitamin D levels in patients from economically, geographically and racially diverse resource-limited settings. This effect was most pronounced early after cART initiation. Research is needed to define the role of Vitamin D supplementation in HIV care. PMID:24752177

  2. Geostatistical analysis of groundwater chemistry in Japan. Evaluation of the base case groundwater data set

    Energy Technology Data Exchange (ETDEWEB)

    Salter, P.F.; Apted, M.J. [Monitor Scientific LLC, Denver, CO (United States); Sasamoto, Hiroshi; Yui, Mikazu

    1999-05-01

    The groundwater chemistry is one of important geological environment for performance assessment of high level radioactive disposal system. This report describes the results of geostatistical analysis of groundwater chemistry in Japan. Over 15,000 separate groundwater analyses have been collected of deep Japanese groundwaters for the purpose of evaluating the range of geochemical conditions for geological radioactive waste repositories in Japan. The significance to issues such as radioelement solubility limits, sorption, corrosion of overpack, behavior of compacted clay buffers, and many other factors involved in safety assessment. It is important therefore, that a small, but representative set of groundwater types be identified so that defensible models and data for generic repository performance assessment can be established. Principal component analysis (PCA) is used to categorize representative deep groundwater types from this extensive data set. PCA is a multi-variate statistical analysis technique, similar to factor analysis or eigenvector analysis, designed to provide the best possible resolution of the variability within multi-variate data sets. PCA allows the graphical inspection of the most important similarities (clustering) and differences among samples, based on simultaneous consideration of all variables in the dataset, in a low dimensionality plot. It also allows the analyst to determine the reasons behind any pattern that is observed. In this study, PCA has been aided by hierarchical cluster analysis (HCA), in which statistical indices of similarity among multiple samples are used to distinguish distinct clusters of samples. HCA allows the natural, a priori, grouping of data into clusters showing similar attributes and is graphically represented in a dendrogram Pirouette is the multivariate statistical software package used to conduct the PCA and HCA for the Japanese groundwater dataset. An audit of the initial 15,000 sample dataset on the basis of

  3. How does additional diagnostic testing influence the initial diagnosis in patients with cognitive complaints in a memory clinic setting?

    Science.gov (United States)

    Meijs, Anouk P; Claassen, Jurgen A H R; Rikkert, Marcel G M Olde; Schalk, Bianca W M; Meulenbroek, Olga; Kessels, Roy P C; Melis, René J F

    2015-01-01

    patients suspected of dementia frequently undergo additional diagnostic testing (e.g. brain imaging or neuropsychological assessment) after standard clinical assessment at a memory clinic. This study investigates the use of additional testing in an academic outpatient memory clinic and how it influences the initial diagnosis. the initial diagnosis after standard clinical assessment (history, laboratory tests, cognitive screening and physical and neurological examination) and the final diagnosis after additional testing of 752 memory clinic patients were collected. We specifically registered if, and what type of, additional testing was requested. additional testing was performed in 518 patients (69%), 67% of whom underwent magnetic resonance imaging, 45% had neuropsychological assessment, 14% had cerebrospinal fluid analysis and 49% had (combinations of) other tests. This led to a modification of the initial diagnosis in 17% of the patients. The frequency of change was highest in patients with an initial non-Alzheimer's disease (AD) dementia diagnosis (54%, compared with 11 and 14% in patients with AD and 'no dementia'; P testing 44% was diagnosed with AD, 9% with non-AD dementia and 47% with 'no dementia'. additional testing should especially be considered in non-AD patients. In the large group of patients with an initial AD or 'no dementia' diagnosis, additional tests have little diagnostic impact and may perhaps be used with more restraint. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. MR imaging system evaluation and quality assurance using a new phantom set

    International Nuclear Information System (INIS)

    Tsui, B.M.W.; Jaszczak, R.J.; Todd-Pokropek, A.E.; Jaszczak, N.J.

    1986-01-01

    A phantom set with interchangeable modular inserts was used in the evaluation of a number of MR imaging systems. The system characteristics measured included uniformity, linearity and distortion of the image field, thickness and profile of an image section, spatial resolution, pixel calibration, signal-to-noise ratio, and variations of contiguous section thicknesses and section-to-section separations in multiple-section imaging. Also evaluated were the accuracy in quantitative measurement of MR imaging parameters and oblique angle measurement capability. Based on these measurements, protocols for MR imaging system evaluation, acceptance testing, and quality assurance were developed

  5. The development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): a large-scale data sharing initiative.

    Science.gov (United States)

    Lutomski, Jennifer E; Baars, Maria A E; Schalk, Bianca W M; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

    2013-01-01

    In 2008, the Ministry of Health, Welfare and Sport commissioned the National Care for the Elderly Programme. While numerous research projects in older persons' health care were to be conducted under this national agenda, the Programme further advocated the development of The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) which would be integrated into all funded research protocols. In this context, we describe TOPICS data sharing initiative (www.topics-mds.eu). A working group drafted TOPICS-MDS prototype, which was subsequently approved by a multidisciplinary panel. Using instruments validated for older populations, information was collected on demographics, morbidity, quality of life, functional limitations, mental health, social functioning and health service utilisation. For informal caregivers, information was collected on demographics, hours of informal care and quality of life (including subjective care-related burden). Between 2010 and 2013, a total of 41 research projects contributed data to TOPICS-MDS, resulting in preliminary data available for 32,310 older persons and 3,940 informal caregivers. The majority of studies sampled were from primary care settings and inclusion criteria differed across studies. TOPICS-MDS is a public data repository which contains essential data to better understand health challenges experienced by older persons and informal caregivers. Such findings are relevant for countries where increasing health-related expenditure has necessitated the evaluation of contemporary health care delivery. Although open sharing of data can be difficult to achieve in practice, proactively addressing issues of data protection, conflicting data analysis requests and funding limitations during TOPICS-MDS developmental phase has fostered a data sharing culture. To date, TOPICS-MDS has been successfully incorporated into 41 research projects, thus supporting the feasibility of constructing a large (>30,000 observations

  6. Development and Use of a Goal Setting/Attainment Process Designed To Measure a Teacher's Ability To Engage in Professional Growth and Leadership Initiatives.

    Science.gov (United States)

    Minix, Nancy; And Others

    The process used to evaluate progress in identifying the goals to be used in evaluating teacher performance under the Kentucky Career Ladder Program is described. The process pertains to two areas of teacher development: (1) professional growth and development, and (2) professional leadership and initiative. A total of 1,650 individuals were asked…

  7. Evaluation of a pilot training program in alcohol screening, brief intervention, and referral to treatment for nurses in inpatient settings.

    Science.gov (United States)

    Broyles, Lauren M; Gordon, Adam J; Rodriguez, Keri L; Hanusa, Barbara H; Kengor, Caroline; Kraemer, Kevin L

    2013-01-01

    Alcohol screening, brief intervention, and referral to treatment (SBIRT) is a set of clinical strategies for reducing the burden of alcohol-related injury, disease, and disability. SBIRT is typically considered a physician responsibility but calls for interdisciplinary involvement requiring basic SBIRT knowledge and skills training for all healthcare disciplines. The purpose of this pilot study was to design, implement, and evaluate a theory-driven SBIRT training program for nurses in inpatient settings (RN-SBIRT) that was developed through an interdisciplinary collaboration of nursing, medical, and public health professionals and tailored for registered nurses in the inpatient setting. In this three-phase study, we evaluated (1) RN-SBIRT's effectiveness for changing nurses' alcohol-related knowledge, clinical practice, and attitudes and (2) the feasibility of implementing the inpatient curriculum. In a quasi-experimental design, two general medical units at our facility were randomized to receive RN-SBIRT or a self-directed Web site on alcohol-related care. We performed a formative evaluation of RN-SBIRT, guided by the RE-AIM implementation framework. After training, nurses in the experimental condition had significant increases in Role Adequacy for working with drinkers and reported increased performance and increased competence for a greater number of SBIRT care tasks. Despite some scheduling challenges for the nurses to attend RN-SBIRT, nurse stakeholders were highly satisfied with RN-SBIRT. Results suggest that with adequate training and ongoing role support, nurses in inpatient settings could play active roles in interdisciplinary initiatives to address unhealthy alcohol use among hospitalized patients.

  8. Pharmaceutical priority setting and the use of health economic evaluations: a systematic literature review.

    Science.gov (United States)

    Erntoft, Sandra

    2011-06-01

    To investigate which factors and criteria are used in priority setting of pharmaceuticals, in what contexts health economic evaluations are used, and barriers to the use of health economic evaluations at micro, meso, and macro health-care levels. The search for empirical articles was based on the MeSH index (Medical Substance Heading), including the search terms "economic evaluation," "cost-effectiveness analysis," "cost-utility analysis," "cost-benefit analysis," "pharmacoeconomic," AND "drug cost(s)," AND "eligibility determination," AND "decision-making," AND "rationing," AND formulary. The following databases were searched: PubMed, EconLit, Cochrane, Web of Science, CINAHL, and PsycINFO. More than 3100 studies were identified, 31 of which were included in this review. The use of health economic evaluations at all three health-care levels was investigated in three countries (United States [US], United Kingdom [UK], and Sweden). Postal and telephone survey methods dominated (n = 17) followed by interviews (n = 13), document analysis (n = 10), and observations of group deliberations (n = 9). The cost-effectiveness criterion was most important at the macro level. A number of contextual uses of health economic evaluations were identified, including importantly the legitimizing of decisions, structuring the priority-setting process, and requesting additional budgets to finance expensive pharmaceuticals. Factors that seem to support the increased use of health economic evaluations are well-developed frameworks for evaluations, the presence of health economic skills, and an explicit priority-setting process. Differences in how economic evaluations are used at macro, meso, and micro levels are attributed to differences in the preconditions at each level. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. SARS and hospital priority setting: a qualitative case study and evaluation

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-12-01

    Full Text Available Abstract Background Priority setting is one of the most difficult issues facing hospitals because of funding restrictions and changing patient need. A deadly communicable disease outbreak, such as the Severe Acute Respiratory Syndrome (SARS in Toronto in 2003, amplifies the difficulties of hospital priority setting. The purpose of this study is to describe and evaluate priority setting in a hospital in response to SARS using the ethical framework 'accountability for reasonableness'. Methods This study was conducted at a large tertiary hospital in Toronto, Canada. There were two data sources: 1 over 200 key documents (e.g. emails, bulletins, and 2 35 interviews with key informants. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results Participants described the types of priority setting decisions, the decision making process and the reasoning used. Although the hospital leadership made an effort to meet the conditions of 'accountability for reasonableness', they acknowledged that the decision making was not ideal. We described good practices and opportunities for improvement. Conclusions 'Accountability for reasonableness' is a framework that can be used to guide fair priority setting in health care organizations, such as hospitals. In the midst of a crisis such as SARS where guidance is incomplete, consequences uncertain, and information constantly changing, where hour-by-hour decisions involve life and death, fairness is more important rather than less.

  10. SARS and hospital priority setting: a qualitative case study and evaluation.

    Science.gov (United States)

    Bell, Jennifer A H; Hyland, Sylvia; DePellegrin, Tania; Upshur, Ross E G; Bernstein, Mark; Martin, Douglas K

    2004-12-19

    Priority setting is one of the most difficult issues facing hospitals because of funding restrictions and changing patient need. A deadly communicable disease outbreak, such as the Severe Acute Respiratory Syndrome (SARS) in Toronto in 2003, amplifies the difficulties of hospital priority setting. The purpose of this study is to describe and evaluate priority setting in a hospital in response to SARS using the ethical framework 'accountability for reasonableness'. This study was conducted at a large tertiary hospital in Toronto, Canada. There were two data sources: 1) over 200 key documents (e.g. emails, bulletins), and 2) 35 interviews with key informants. Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Participants described the types of priority setting decisions, the decision making process and the reasoning used. Although the hospital leadership made an effort to meet the conditions of 'accountability for reasonableness', they acknowledged that the decision making was not ideal. We described good practices and opportunities for improvement. 'Accountability for reasonableness' is a framework that can be used to guide fair priority setting in health care organizations, such as hospitals. In the midst of a crisis such as SARS where guidance is incomplete, consequences uncertain, and information constantly changing, where hour-by-hour decisions involve life and death, fairness is more important rather than less.

  11. Undergraduate paramedic student psychomotor skills in an obstetric setting: An evaluation.

    Science.gov (United States)

    Lenson, Shane; Mills, Jason

    2018-01-01

    The clinical education of paramedic students is an international concern. In Australia, student placements are commonly undertaken with local district ambulance services, however these placements are increasingly limited. Clinical placements within inter-professional settings represent an innovative yet underdeveloped area of investigation. This paper addresses that gap by reporting a pilot evaluation of paramedic student clinical placements in a specialised obstetrics setting. Using a case study approach, the evaluation aimed to identify paramedic psychomotor skills that could be practised in this setting, and understand the nature of key learning events. A purposive sample of paramedic students was recruited following completion of the obstetrics placement. A combination of student reflection and assessed psychomotor skills data were collected from clinical placement logs. Content analysis of all data was conducted inductively and deductively, as appropriate. Findings indicated a comprehensive range of psychomotor skills can be practised in this setting, with over thirty psychomotor skills identified directly related to the paramedic curriculum; and seven psychomotor skills indirectly related. The themes finding confidence in maternity care, watching the experts, and putting theory into practice provide narrative insight into the clinical learning experience of paramedic students in this setting. Further research is recommended to build upon this pilot. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. RQ-21A Blackjack Small Tactical Unmanned Aircraft System (STUAS): Initial Operational Test and Evaluation Report

    Science.gov (United States)

    2015-06-29

    Evaluation Report June 2015 This report on the RQ-21A Blackjack Small Tactical Unmanned Aircraft System fulfills the provisions of Title 10...suitability of the RQ-21A Blackjack Small Tactical Unmanned Aircraft System (STUAS) during Initial Operational Test and Evaluation (IOT&E). The Navy’s...66.9 percent). The average service life of the propulsion modules was 48.9 hours, which does not meet the manufacturer’s stated 100-hour

  13. Participation in Risk Management Decisions: Theoretical, Practical, and Strategic Difficulties in the Evaluation of Public Participation Initiatives

    International Nuclear Information System (INIS)

    Rowe, Gene; Frewer, Lynn

    2003-01-01

    A current trend in risk management, and policy setting more generally, is the involvement of members of the public, or other significant stakeholders, in the decision-making process. Such involvement has been argued to have the advantage of increasing the democratic legitimacy of decisions, and allowing the incorporation of lay insight into problems that have a degree of scientific uncertainty (and hence that are based to some extent on value judgments). One significant issue is the quality or validity of such processes, namely, the issue of evaluation. Evaluation is important, not only from a quality control perspective, but because it may indicate potential improvements for the conduct of further exercises, and importantly, may help to assure participants (and the public more widely) that the exercise is more than just a public relations exercise. However, evaluation of public involvement initiatives is relatively rare, and little discussed in the academic literature. It is also beset with a large number of potential problems and uncertainties. In this paper, we will discuss a variety of problems with conducting evaluations of participation initiatives. These problems range from the theoretical (how one defines effectiveness, how one measures this, how one confirms the validity, reliability and utility of one's measures), to the practical (how one conducts evaluations given limitations in time, space, resources, and possible sources of data), to the strategic/political (how one deals with sponsor/organiser resistance to evaluation). These problems will be discussed from a theoretical point of view, and with reference to practical evaluations that we have conducted with a large variety of governmental and non-governmental organisations, predominantly in the UK. The paper will conclude with a number of recommendations regarding best practice in conducting evaluations

  14. The unfunded priorities: an evaluation of priority setting for noncommunicable disease control in Uganda.

    Science.gov (United States)

    Essue, Beverley M; Kapiriri, Lydia

    2018-02-20

    The double burden of infectious diseases coupled with noncommunicable diseases poses unique challenges for priority setting and for achieving equitable action to address the major causes of disease burden in health systems already impacted by limited resources. Noncommunicable disease control is an important global health and development priority. However, there are challenges for translating this global priority into local priorities and action. The aim of this study was to evaluate the influence of national, sub-national and global factors on priority setting for noncommunicable disease control in Uganda and examine the extent to which priority setting was successful. A mixed methods design that used the Kapiriri & Martin framework for evaluating priority setting in low income countries. The evaluation period was 2005-2015. Data collection included a document review (policy documents (n = 19); meeting minutes (n = 28)), media analysis (n = 114) and stakeholder interviews (n = 9). Data were analysed according to the Kapiriri & Martin (2010) framework. Priority setting for noncommunicable diseases was not entirely fair nor successful. While there were explicit processes that incorporated relevant criteria, evidence and wide stakeholder involvement, these criteria were not used systematically or consistently in the contemplation of noncommunicable diseases. There were insufficient resources for noncommunicable diseases, despite being a priority area. There were weaknesses in the priority setting institutions, and insufficient mechanisms to ensure accountability for decision-making. Priority setting was influenced by the priorities of major stakeholders (i.e. development assistance partners) which were not always aligned with national priorities. There were major delays in the implementation of noncommunicable disease-related priorities and in many cases, a failure to implement. This evaluation revealed the challenges that low income countries are

  15. 49 CFR 40.297 - Does anyone have the authority to change a SAP's initial evaluation?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Does anyone have the authority to change a SAP's... the Return-to-Duty Process § 40.297 Does anyone have the authority to change a SAP's initial... managed-care provider, any service agent) may change in any way the SAP's evaluation or recommendations...

  16. Housing Services for Child Welfare-Involved Families: An Initial Evaluation Using Observational Data

    Science.gov (United States)

    Fowler, Patrick J.; Taylor, Jeremy J.; Rufa, Anne K.

    2011-01-01

    This study evaluated the impact of housing services among child welfare-involved families using observational data. Propensity score matching with data from the National Survey of Child and Adolescent Well-Being compared intact families (n = 183) who received housing services 12 months after initial investigation to nontreated families balanced on…

  17. Using the Concept of "Population Dose" in Planning and Evaluating Community-Level Obesity Prevention Initiatives

    Science.gov (United States)

    Cheadle, Allen; Schwartz, Pamela M.; Rauzon, Suzanne; Bourcier, Emily; Senter, Sandra; Spring, Rebecca; Beery, William L.

    2013-01-01

    When planning and evaluating community-level initiatives focused on policy and environment change, it is useful to have estimates of the impact on behavioral outcomes of particular strategies (e.g., building a new walking trail to promote physical activity). We have created a measure of estimated strategy-level impact--"population dose"--based on…

  18. Social capital, agricultural innovation and the evaluation of agricultural development initiatives

    NARCIS (Netherlands)

    Rijn, van F.C.

    2014-01-01

    In this thesis, I show that social capital has an important role in the evaluation of development initiatives targeting agricultural innovation. Social capital and agricultural innovation are naturally linked from an innovation system perspective in which innovations result from the integration

  19. Association Between Student Loan Debt on Graduation, Demographic Characteristics and Initial Choice of Practice Setting of Pharmacists

    Directory of Open Access Journals (Sweden)

    Akeem A. Yusuf

    2011-01-01

    Full Text Available Objectives: (1 To examine trends in level of student loan indebtedness for groups of pharmacists that were first licensed between 1980 and 2006; (2 To examine if demographic variables are associated with level of student loan indebtedness; (3 To examine the association between student loan debt and choice of practice setting while controlling for demographic variables. Methods: Data for this study were collected from a national random sample of 3,000 pharmacists using a self administered survey. Descriptive statistics were used to examine trends in level of indebtedness. The relationships between level of indebtedness, demographic variables and practice setting choice were examined using Chi-square statistics. Multinomial logistic regression was used to determine the independent association of student loan debt and choice of practice setting while controlling for demographic variables. Results: The proportion of licensed pharmacists reporting student loan debt after graduation, and the mean amount of debt incurred increased between 1980 and 2006. Non-white pharmacists incurred debt at a higher proportion compared to white, and they also incurred significantly higher levels of debt. A lower level of indebtedness was associated with choosing independent practice over chain practice. Conclusions: Student loan indebtedness has been increasing over time, especially for non-white pharmacy students. Future research should be done to examine other factors that might influence student debt load, work contributions and choice of practice settings. The affordability of pharmacy education for students of color and how salaries may or may not help off-set these costs also should be examined closely.   Type: Original Research

  20. Evaluation of the Standard Setting on the 2005 Grade 12 National Assessment of Educational Progress Mathematics Test

    Science.gov (United States)

    Sireci, Stephen G.; Hauger, Jeffrey B.; Wells, Craig S.; Shea, Christine; Zenisky, April L.

    2009-01-01

    The National Assessment Governing Board used a new method to set achievement level standards on the 2005 Grade 12 NAEP Math test. In this article, we summarize our independent evaluation of the process used to set these standards. The evaluation data included observations of the standard-setting meeting, observations of advisory committee meetings…

  1. Evaluating financial education initiatives in South Africa: The importance of multiple evaluation approaches

    Directory of Open Access Journals (Sweden)

    Emily Massey

    2016-06-01

    Objectives: This study aims to show that, particularly in a South African context, where investment in financial education interventions is mandated by the Financial Sector Codes, impact should not be the only criterion assessed when evaluating financial education projects. Research method and design: This study was informed by a literature review, a synthesis of team experience on a range of financial education projects in South Africa and the development of case studies. Results: Describing the success or failure of a project needs to go beyond impact and explore factors such as project relevance, design and quality. In order to verify these other factors, different types of evaluations are necessary at the various stages of the project’s life-cycle. Conclusion: Expanding the learning objective beyond the exclusive identification of whether financial behaviour was achieved is particularly important where financial education projects, and the monitoring and evaluation thereof, is mandated. In the African context, where resources are scarce, money for monitoring and evaluation should be selectively channelled into determining project relevance, effectiveness, efficiency and then only impact.

  2. Use of simulated data sets to evaluate the fidelity of Metagenomicprocessing methods

    Energy Technology Data Exchange (ETDEWEB)

    Mavromatis, Konstantinos; Ivanova, Natalia; Barry, Kerri; Shapiro, Harris; Goltsman, Eugene; McHardy, Alice C.; Rigoutsos, Isidore; Salamov, Asaf; Korzeniewski, Frank; Land, Miriam; Lapidus, Alla; Grigoriev, Igor; Richardson, Paul; Hugenholtz, Philip; Kyrpides, Nikos C.

    2006-12-01

    Metagenomics is a rapidly emerging field of research for studying microbial communities. To evaluate methods presently used to process metagenomic sequences, we constructed three simulated data sets of varying complexity by combining sequencing reads randomly selected from 113 isolate genomes. These data sets were designed to model real metagenomes in terms of complexity and phylogenetic composition. We assembled sampled reads using three commonly used genome assemblers (Phrap, Arachne and JAZZ), and predicted genes using two popular gene finding pipelines (fgenesb and CRITICA/GLIMMER). The phylogenetic origins of the assembled contigs were predicted using one sequence similarity--based (blast hit distribution) and two sequence composition--based (PhyloPythia, oligonucleotide frequencies) binning methods. We explored the effects of the simulated community structure and method combinations on the fidelity of each processing step by comparison to the corresponding isolate genomes. The simulated data sets are available online to facilitate standardized benchmarking of tools for metagenomic analysis.

  3. Use of simulated data sets to evaluate the fidelity of metagenomic processing methods

    Energy Technology Data Exchange (ETDEWEB)

    Mavromatis, K [U.S. Department of Energy, Joint Genome Institute; Ivanova, N [U.S. Department of Energy, Joint Genome Institute; Barry, Kerrie [U.S. Department of Energy, Joint Genome Institute; Shapiro, Harris [U.S. Department of Energy, Joint Genome Institute; Goltsman, Eugene [U.S. Department of Energy, Joint Genome Institute; McHardy, Alice C. [IBM T. J. Watson Research Center; Rigoutsos, Isidore [IBM T. J. Watson Research Center; Salamov, Asaf [U.S. Department of Energy, Joint Genome Institute; Korzeniewski, Frank [U.S. Department of Energy, Joint Genome Institute; Land, Miriam L [ORNL; Lapidus, Alla L. [U.S. Department of Energy, Joint Genome Institute; Grigoriev, Igor [U.S. Department of Energy, Joint Genome Institute; Hugenholtz, Philip [U.S. Department of Energy, Joint Genome Institute; Kyrpides, Nikos C [U.S. Department of Energy, Joint Genome Institute

    2007-01-01

    Metagenomics is a rapidly emerging field of research for studying microbial communities. To evaluate methods presently used to process metagenomic sequences, we constructed three simulated data sets of varying complexity by combining sequencing reads randomly selected from 113 isolate genomes. These data sets were designed to model real metagenomes in terms of complexity and phylogenetic composition. We assembled sampled reads using three commonly used genome assemblers (Phrap, Arachne and JAZZ), and predicted genes using two popular gene-finding pipelines (fgenesb and CRITICA/GLIMMER). The phylogenetic origins of the assembled contigs were predicted using one sequence similarity-based ( blast hit distribution) and two sequence composition-based (PhyloPythia, oligonucleotide frequencies) binning methods. We explored the effects of the simulated community structure and method combinations on the fidelity of each processing step by comparison to the corresponding isolate genomes. The simulated data sets are available online to facilitate standardized benchmarking of tools for metagenomic analysis.

  4. Evaluation about the performance of E-government based on interval-valued intuitionistic fuzzy set.

    Science.gov (United States)

    Zhang, Shuai; Yu, Dejian; Wang, Yan; Zhang, Wenyu

    2014-01-01

    The evaluation is an important approach to promote the development of the E-Government. Since the rapid development of E-Government in the world, the E-Government performance evaluation has become a hot issue in the academia. In this paper, we develop a new evaluation method for the development of the E-Government based on the interval-valued intuitionistic fuzzy set which is a powerful technique in expressing the uncertainty of the real situation. First, we extend the geometric Heronian mean (GHM) operator to interval-valued intuitionistic fuzzy environment and proposed the interval-valued intuitionistic fuzzy GHM (IIFGHM) operator. Then, we investigate the relationships between the IIFGHM operator and some existing ones, such as generalized interval-valued intuitionistic fuzzy HM (GIIFHM) and interval-valued intuitionistic fuzzy weighted Bonferoni mean operator. Furthermore, we validate the effectiveness of the proposed method using a real case about the E-Government evaluation in Hangzhou City, China.

  5. Fuzzy sets as extension of probabilistic models for evaluating human reliability

    International Nuclear Information System (INIS)

    Przybylski, F.

    1996-11-01

    On the base of a survey of established quantification methodologies for evaluating human reliability, a new computerized methodology was developed in which a differential consideration of user uncertainties is made. In this quantification method FURTHER (FUzzy Sets Related To Human Error Rate Prediction), user uncertainties are quantified separately from model and data uncertainties. As tools fuzzy sets are applied which, however, stay hidden to the method's user. The user in the quantification process only chooses an action pattern, performance shaping factors and natural language expressions. The acknowledged method HEART (Human Error Assessment and Reduction Technique) serves as foundation of the fuzzy set approach FURTHER. By means of this method, the selection of a basic task in connection with its basic error probability, the decision how correct the basic task's selection is, the selection of a peformance shaping factor, and the decision how correct the selection and how important the performance shaping factor is, were identified as aspects of fuzzification. This fuzzification is made on the base of data collection and information from literature as well as of the estimation by competent persons. To verify the ammount of additional information to be received by the usage of fuzzy sets, a benchmark session was accomplished. In this benchmark twelve actions were assessed by five test-persons. In case of the same degree of detail in the action modelling process, the bandwidths of the interpersonal evaluations decrease in FURTHER in comparison with HEART. The uncertainties of the single results could not be reduced up to now. The benchmark sessions conducted so far showed plausible results. A further testing of the fuzzy set approach by using better confirmed fuzzy sets can only be achieved in future practical application. Adequate procedures, however, are provided. (orig.) [de

  6. Crop Evaluation System Optimization: Attribute Weights Determination Based on Rough Sets Theory

    Directory of Open Access Journals (Sweden)

    Ruihong Wang

    2017-01-01

    Full Text Available The present study is mainly a continuation of our previous study, which is about a crop evaluation system development that is based on grey relational analysis. In that system, the attribute weight determination affects the evaluation result directly. Attribute weight is usually ascertained by decision-makers experience knowledge. In this paper, we utilize rough sets theory to calculate attribute significance and then combine it with weight given by decision-maker. This method is a comprehensive consideration of subjective experience knowledge and objective situation; thus it can acquire much more ideal results. Finally, based on this method, we improve the system based on ASP.NET technology.

  7. ECONOMIC EVALUATION OF A BREEDING PROGRAMME FOR SETTING UP TWO HIGH PERFORMANCES BEE LINES

    OpenAIRE

    POPESCU, A.; RADOI, C.

    2003-01-01

    This study aimed to evaluate costs, incomes and financial results related to the creation of two Apis Mellifica Carpatica lines, based on a specific Breeding Programme within a closed population. The two beelines have been carefully selected for the bee populations living in two areas of Romania: North Moldavia and South Muntenia. A new selection technology is set up in order to produce high performance queen bees, well adapted to the environmental conditions mainly to picking. Genetic gain w...

  8. Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo

    Science.gov (United States)

    Hustache, Sarah; Moro, Marie-Rose; Roptin, Jacky; Souza, Renato; Gansou, Grégoire Magloire; Mbemba, Alain; Roederer, Thomas; Grais, Rebecca F; Gaboulaud, Valérie; Baubet, Thierry

    2009-01-01

    Background Little is known about the impact of psychological support in war and transcultural contexts and in particular, whether there are lasting benefits. Here, we present an evaluation of the late effect of post-rape psychological support provided to women in Brazzaville, Republic of Congo. Methods Women who attended the Médecins Sans Frontières program for sexual violence in Brazzaville during the conflict were selected to evaluate the psychological consequences of rape and the late effect of post-rape psychological support. A total of 178 patients met the eligibility criteria: 1) Women aged more than 15 years; 2) raped by unknown person(s) wearing military clothes; 3) admitted to the program between the 1/1/2002 and the 30/4/2003; and 4) living in Brazzaville. Results The initial diagnosis according to DSM criteria showed a predominance of anxious disorders (54.1%) and acute stress disorders (24.6%). One to two years after the initial psychological care, 64 women were evaluated using the Trauma Screening Questionnaire (TSQ), the Global Assessment of Functioning scale (GAF) and an assessment scale to address medico-psychological care in emergencies (EUMP). Two patients (3.1%) met the needed criteria for PTSD diagnosis from the TSQ. Among the 56 women evaluated using GAF both as pre and post-test, global functioning was significantly improved by initial post-rape support (50 women (89.3%) had extreme or medium impairment at first post-rape evaluation, and 16 (28.6%) after psychological care; p = 0.04). When interviewed one to two years later, the benefit was fully maintained (16 women (28.6%) presenting extreme or medium impairment). Conclusion We found the benefits of post-rape psychological support to be present and lasting in this conflict situation. However, we were unable to evaluate all women for the long-term impact, underscoring the difficulty of leading evaluation studies in unstable contexts. Future research is needed to validate these findings in

  9. Using the Hospital Nutrition Environment Scan to Evaluate Health Initiative in Hospital Cafeterias.

    Science.gov (United States)

    Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie

    2015-11-01

    Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  10. Evaluation of strength and failure of brittle rock containing initial cracks under lithospheric conditions

    Science.gov (United States)

    Li, Xiaozhao; Qi, Chengzhi; Shao, Zhushan; Ma, Chao

    2018-02-01

    Natural brittle rock contains numerous randomly distributed microcracks. Crack initiation, growth, and coalescence play a predominant role in evaluation for the strength and failure of brittle rocks. A new analytical method is proposed to predict the strength and failure of brittle rocks containing initial microcracks. The formulation of this method is based on an improved wing crack model and a suggested micro-macro relation. In this improved wing crack model, the parameter of crack angle is especially introduced as a variable, and the analytical stress-crack relation considering crack angle effect is obtained. Coupling the proposed stress-crack relation and the suggested micro-macro relation describing the relation between crack growth and axial strain, the stress-strain constitutive relation is obtained to predict the rock strength and failure. Considering different initial microcrack sizes, friction coefficients and confining pressures, effects of crack angle on tensile wedge force acting on initial crack interface are studied, and effects of crack angle on stress-strain constitutive relation of rocks are also analyzed. The strength and crack initiation stress under different crack angles are discussed, and the value of most disadvantaged angle triggering crack initiation and rock failure is founded. The analytical results are similar to the published study results. Rationality of this proposed analytical method is verified.

  11. Variations in thematic mapper spectra of soil related to tillage and crop residue management - Initial evaluation

    Science.gov (United States)

    Seeley, M. W.; Ruschy, D. L.; Linden, D. R.

    1983-01-01

    A cooperative research project was initiated in 1982 to study differences in thematic mapper spectral characteristics caused by variable tillage and crop residue practices. Initial evaluations of radiometric data suggest that spectral separability of variably tilled soils can be confounded by moisture and weathering effects. Separability of bare tilled soils from those with significant amounts of corn residue is enhanced by wet conditions, but still possible under dry conditions when recent tillage operations have occurred. In addition, thematic mapper data may provide an alternative method to study the radiant energy balance at the soil surface in conjunction with variable tillage systems.

  12. Initial validation of the prekindergarten Classroom Observation Tool and goal setting system for data-based coaching.

    Science.gov (United States)

    Crawford, April D; Zucker, Tricia A; Williams, Jeffrey M; Bhavsar, Vibhuti; Landry, Susan H

    2013-12-01

    Although coaching is a popular approach for enhancing the quality of Tier 1 instruction, limited research has addressed observational measures specifically designed to focus coaching on evidence-based practices. This study explains the development of the prekindergarten (pre-k) Classroom Observation Tool (COT) designed for use in a data-based coaching model. We examined psychometric characteristics of the COT and explored how coaches and teachers used the COT goal-setting system. The study included 193 coaches working with 3,909 pre-k teachers in a statewide professional development program. Classrooms served 3 and 4 year olds (n = 56,390) enrolled mostly in Title I, Head Start, and other need-based pre-k programs. Coaches used the COT during a 2-hr observation at the beginning of the academic year. Teachers collected progress-monitoring data on children's language, literacy, and math outcomes three times during the year. Results indicated a theoretically supported eight-factor structure of the COT across language, literacy, and math instructional domains. Overall interrater reliability among coaches was good (.75). Although correlations with an established teacher observation measure were small, significant positive relations between COT scores and children's literacy outcomes indicate promising predictive validity. Patterns of goal-setting behaviors indicate teachers and coaches set an average of 43.17 goals during the academic year, and coaches reported that 80.62% of goals were met. Both coaches and teachers reported the COT was a helpful measure for enhancing quality of Tier 1 instruction. Limitations of the current study and implications for research and data-based coaching efforts are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  13. Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation.

    Science.gov (United States)

    Scobbie, Lesley; McLean, Donald; Dixon, Diane; Duncan, Edward; Wyke, Sally

    2013-05-24

    aspects of the framework was inconsistent. The regulatory function of goal non-attainment and the importance of creating flexible partnerships with patients have been highlighted. Further development of the G-AP framework, training package and patient held record is required to address the specific issues highlighted by this process evaluation. Further evaluation of G-AP is required across diverse community rehabilitation settings.

  14. Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation

    Science.gov (United States)

    2013-01-01

    rehabilitation team; however, implementation of novel aspects of the framework was inconsistent. The regulatory function of goal non-attainment and the importance of creating flexible partnerships with patients have been highlighted. Further development of the G-AP framework, training package and patient held record is required to address the specific issues highlighted by this process evaluation. Further evaluation of G-AP is required across diverse community rehabilitation settings. PMID:23705824

  15. Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation.

    Science.gov (United States)

    Valentini, Raisa Bressan; Macedo, Bruno Mussoi de; Izquierdo, Rogério Friedrich; Meyer, Erika Laurini Souza

    2016-04-01

    Even though it is a rare event, most associations of thyroid carcinoma with subacute thyroiditis described in the literature are related to its granulomatous form (Quervain's thyroiditis). We present a patient with subacute lymphocytic thyroiditis (painless thyroiditis) and papillary thyroid cancer that was first suspected in an initial ultrasound evaluation. A 30-year old female patient who was referred to the emergency room due to hyperthyroidism symptoms was diagnosed with painless thyroiditis established by physical examination and laboratory findings. With the presence of a palpable painless thyroid nodule an ultrasound was prescribed and the images revealed a suspicious thyroid nodule, microcalcification focus in the heterogeneous thyroid parenquima and cervical lymphadenopathy. Fine needle aspiration biopsy was taken from this nodule; cytology was assessed for compatibility with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a multicentric papillary carcinoma and lymphocytic infiltration. Subacute thyroiditis, regardless of type, may produce transitory ultrasound changes that obscure the coexistence of papillary carcinoma. Due to this, initial thyroid ultrasound evaluation should be delayed until clinical recovery. We recommended a thyroid ultrasound exam for initial evaluation of painless thyroiditis, particularly in patients with palpable thyroid nodule. Further cytological examination is recommended in cases presenting with suspect thyroid nodule and/or non-nodular hypoechoic (> 1 cm) or heterogeneous areas with microcalcification focus.

  16. The gradient boosting algorithm and random boosting for genome-assisted evaluation in large data sets.

    Science.gov (United States)

    González-Recio, O; Jiménez-Montero, J A; Alenda, R

    2013-01-01

    In the next few years, with the advent of high-density single nucleotide polymorphism (SNP) arrays and genome sequencing, genomic evaluation methods will need to deal with a large number of genetic variants and an increasing sample size. The boosting algorithm is a machine-learning technique that may alleviate the drawbacks of dealing with such large data sets. This algorithm combines different predictors in a sequential manner with some shrinkage on them; each predictor is applied consecutively to the residuals from the committee formed by the previous ones to form a final prediction based on a subset of covariates. Here, a detailed description is provided and examples using a toy data set are included. A modification of the algorithm called "random boosting" was proposed to increase predictive ability and decrease computation time of genome-assisted evaluation in large data sets. Random boosting uses a random selection of markers to add a subsequent weak learner to the predictive model. These modifications were applied to a real data set composed of 1,797 bulls genotyped for 39,714 SNP. Deregressed proofs of 4 yield traits and 1 type trait from January 2009 routine evaluations were used as dependent variables. A 2-fold cross-validation scenario was implemented. Sires born before 2005 were used as a training sample (1,576 and 1,562 for production and type traits, respectively), whereas younger sires were used as a testing sample to evaluate predictive ability of the algorithm on yet-to-be-observed phenotypes. Comparison with the original algorithm was provided. The predictive ability of the algorithm was measured as Pearson correlations between observed and predicted responses. Further, estimated bias was computed as the average difference between observed and predicted phenotypes. The results showed that the modification of the original boosting algorithm could be run in 1% of the time used with the original algorithm and with negligible differences in accuracy

  17. Evaluating Diagnostic Point-of-Care Tests in Resource-Limited Settings

    Science.gov (United States)

    Drain, Paul K; Hyle, Emily P; Noubary, Farzad; Freedberg, Kenneth A; Wilson, Douglas; Bishai, William; Rodriguez, William; Bassett, Ingrid V

    2014-01-01

    Diagnostic point-of-care (POC) testing is intended to minimize the time to obtain a test result, thereby allowing clinicians and patients to make an expeditious clinical decision. As POC tests expand into resource-limited settings (RLS), the benefits must outweigh the costs. To optimize POC testing in RLS, diagnostic POC tests need rigorous evaluations focused on relevant clinical outcomes and operational costs, which differ from evaluations of conventional diagnostic tests. Here, we reviewed published studies on POC testing in RLS, and found no clearly defined metric for the clinical utility of POC testing. Therefore, we propose a framework for evaluating POC tests, and suggest and define the term “test efficacy” to describe a diagnostic test’s capacity to support a clinical decision within its operational context. We also proposed revised criteria for an ideal diagnostic POC test in resource-limited settings. Through systematic evaluations, comparisons between centralized diagnostic testing and novel POC technologies can be more formalized, and health officials can better determine which POC technologies represent valuable additions to their clinical programs. PMID:24332389

  18. Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

    Science.gov (United States)

    McKinnon-Howe, Leah; Dowdall, Jayme

    2018-05-01

    The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Provider Initiated Testing and Counseling (PITC for HIV in resource-limited clinical settings: important questions unanswered

    Directory of Open Access Journals (Sweden)

    Peter Twyman

    2009-09-01

    Full Text Available Testing is the gateway to HIV care and support services, and efforts to broaden treatment must include a proactive and inclusive approach to testing. Provider Initiated Testing and Counseling (PITC for HIV utilizes the opportunity afforded by the clinical encounter for the care provider to make a clinical recommendation that the patient have a voluntary HIV test. It is hoped that by broadening testing by such strategies as PITC more patients may be identified and linked to treatment and support. However, there exist multiple challenges and questions regarding the provision of routine HIV testing and counseling in clinical facilities. In order to support further PITC efforts and scale up of current testing programs, a research agenda that addresses the ethical, social and operational components of PITC programming in health facilities, is critically needed to further guide its expansion.

  20. Evaluating the Credibility of Transport Processes in Simulations of Ozone Recovery using the Global Modeling Initiative Three-dimensional Model

    Science.gov (United States)

    Strahan, Susan E.; Douglass, Anne R.

    2004-01-01

    The Global Modeling Initiative (GMI) has integrated two 36-year simulations of an ozone recovery scenario with an offline chemistry and tra nsport model using two different meteorological inputs. Physically ba sed diagnostics, derived from satellite and aircraft data sets, are d escribed and then used to evaluate the realism of temperature and transport processes in the simulations. Processes evaluated include barri er formation in the subtropics and polar regions, and extratropical w ave-driven transport. Some diagnostics are especially relevant to sim ulation of lower stratospheric ozone, but most are applicable to any stratospheric simulation. The global temperature evaluation, which is relevant to gas phase chemical reactions, showed that both sets of me teorological fields have near climatological values at all latitudes and seasons at 30 hPa and below. Both simulations showed weakness in upper stratospheric wave driving. The simulation using input from a g eneral circulation model (GMI(GCM)) showed a very good residual circulation in the tropics and Northern Hemisphere. The simulation with inp ut from a data assimilation system (GMI(DAS)) performed better in the midlatitudes than it did at high latitudes. Neither simulation forms a realistic barrier at the vortex edge, leading to uncertainty in the fate of ozone-depleted vortex air. Overall, tracer transport in the offline GML(GCM) has greater fidelity throughout the stratosphere tha n it does in the GMI(DAS)

  1. Evaluation of initial degradation in stress corrosion cracking by magnetic methods

    International Nuclear Information System (INIS)

    Takaya, Shigeru; Suzuki, Takayuki; Matsumoto, Yoshihiro; Demachi, Kazuyuki; Uesaka, Mitsuru

    2003-01-01

    Two magnetic methods are proposed for the evaluation of initial degradations of type 304 stainless steel in stress corrosion cracking (SCC). The first one is the measurement of the distribution of chromium depletion by means of a magnetic force microscope (MFM). MFM observations are performed for some samples sensitized in various conditions, and the obtained results coincide with the expected ones from the chromium behavior. Moreover, the phase distributions in the solution-annealed and sensitized states are observed by electron backscatter pattern technique. The observation results show that the phase transformation from the austenite phase to the martensite phase occurred along grain boundaries where the chromium was depleted. The second one is the detection of initial SCC cracks by measurement of magnetic flux densities. In-situ measurement of magnetic flux density during the SCC test and MFM observation reveal the relation of initial SCC cracks and magnetic properties. (author)

  2. Defects level evaluation of LiTiZn ferrite ceramics using temperature dependence of initial permeability

    Science.gov (United States)

    Malyshev, A. V.; Petrova, A. B.; Sokolovskiy, A. N.; Surzhikov, A. P.

    2018-06-01

    The method for evaluating the integral defects level and chemical homogeneity of ferrite ceramics based on temperature dependence analysis of initial permeability is suggested. A phenomenological expression for the description of such dependence was suggested and an interpretation of its main parameters was given. It was shown, that the main criterion of the integral defects level of ferrite ceramics is relation of two parameters correlating with elastic stress value in a material. An indicator of structural perfection can be a maximum value of initial permeability close to Curie point as well. The temperature dependences of initial permeability have analyzed for samples sintered in laboratory conditions and for the ferrite industrial product. The proposed method allows controlling integral defects level of the soft ferrite products and has high sensitivity compare to typical X-ray methods.

  3. Evaluation of the "Foundations in Knowledge Translation" training initiative: preparing end users to practice KT.

    Science.gov (United States)

    Park, Jamie S; Moore, Julia E; Sayal, Radha; Holmes, Bev J; Scarrow, Gayle; Graham, Ian D; Jeffs, Lianne; Timmings, Caitlyn; Rashid, Shusmita; Johnson, Alekhya Mascarenhas; Straus, Sharon E

    2018-04-25

    Current knowledge translation (KT) training initiatives are primarily focused on preparing researchers to conduct KT research rather than on teaching KT practice to end users. Furthermore, training initiatives that focus on KT practice have not been rigorously evaluated and have focused on assessing short-term outcomes and participant satisfaction only. Thus, there is a need for longitudinal training evaluations that assess the sustainability of training outcomes and contextual factors that may influence outcomes. We evaluated the KT training initiative "Foundations in KT" using a mixed-methods longitudinal design. "Foundations in KT" provided training in KT practice and included three tailored in-person workshops, coaching, and an online platform for training materials and knowledge exchange. Two cohorts were included in the study (62 participants, including 46 "Foundations in KT" participants from 16 project teams and 16 decision-maker partners). Participants completed self-report questionnaires, focus groups, and interviews at baseline and at 6, 12, 18, and 24 months after the first workshop. Participant-level outcomes include survey results which indicated that participants' self-efficacy in evidence-based practice (F(1,8.9) = 23.7, p = 0.001, n = 45), KT activities (F(1,23.9) = 43.2, p training initiative helped participants achieve their KT project objectives, plan their projects, and solve problems over time. Contextual factors include teams with high self-reported organizational capacity and commitment to implement at the start of their project had buy-in from upper management that resulted in secured funding and resources for their project. Training initiative outcomes include participants who applied the KT knowledge and skills they learned to other projects by sharing their knowledge informally with coworkers. Sustained spread of KT practice was observed with five teams at 24 months. We completed a longitudinal evaluation of a KT

  4. Substantial differences in initiation of oral anticoagulant therapy and clinical outcome among non-valvular atrial fibrillation patients treated in inpatient and outpatient settings

    DEFF Research Database (Denmark)

    Mikkelsen, Anders Pretzmann; Hansen, Morten Lock; Olesen, Jonas Bjerring

    2016-01-01

    with a CHADS2 ≥ 2 was 42.1, 63.0, and 32.4%, respectively. Initiation of OAC therapy was only modestly influenced by CHADS2 and HAS-BLED scores, regardless of the healthcare setting. The rate of TE was 4.30 [95% confidence interval (CI) 4.21-4.40] per 100 person-years for inpatients, 2.28 (95% CI 2...

  5. Assessing Patients’ Cognitive Therapy Skills: Initial Evaluation of the Competencies of Cognitive Therapy Scale

    Science.gov (United States)

    Strunk, Daniel R.; Hollars, Shannon N.; Adler, Abby D.; Goldstein, Lizabeth A.; Braun, Justin D.

    2014-01-01

    In Cognitive Therapy (CT), therapists work to help patients develop skills to cope with negative affect. Most current methods of assessing patients’ skills are cumbersome and impractical for clinical use. To address this issue, we developed and conducted an initial psychometric evaluation of self and therapist reported versions of a new measure of CT skills: the Competencies of Cognitive Therapy Scale (CCTS). We evaluated the CCTS at intake and post-treatment in a sample of 67 patients participating in CT. The CCTS correlated with a preexisting measure of CT skills (the Ways of Responding Questionnaire) and was also related to concurrent depressive symptoms. Across CT, self-reported improvements in CT competencies were associated with greater changes in depressive symptoms. These findings offer initial evidence for the validity of the CCTS. We discuss the CCTS in comparison with other measures of CT skills and suggest future research directions. PMID:25408560

  6. Preliminary safety evaluation, based on initial site investigation data. Planning document

    International Nuclear Information System (INIS)

    Hedin, Allan

    2002-12-01

    This report is a planning document for the preliminary safety evaluations (PSE) to be carried out at the end of the initial stage of SKBs ongoing site investigations for a deep repository for spent nuclear fuel. The main purposes of the evaluations are to determine whether earlier judgements of the suitability of the candidate area for a deep repository with respect to long-term safety holds up in the light of borehole data and to provide feed-back to continued site investigations and site specific repository design. The preliminary safety evaluations will be carried out by a safety assessment group, based on a site model, being part of a site description, provided by a site modelling group and a repository layout within that model suggested by a repository engineering group. The site model contains the geometric features of the site as well as properties of the host rock. Several alternative interpretations of the site data will likely be suggested. Also the biosphere is included in the site model. A first task for the PSE will be to compare the rock properties described in the site model to previously established criteria for a suitable host rock. This report gives an example of such a comparison. In order to provide more detailed feedback, a number of thermal, hydrological, mechanical and chemical analyses of the site will also be included in the evaluation. The selection of analyses is derived from the set of geosphere and biosphere analyses preliminarily planned for the comprehensive safety assessment named SR-SITE, which will be based on a complete site investigation. The selection is dictated primarily by the expected feedback to continued site investigations and by the availability of data after the PSE. The repository engineering group will consider several safety related factors in suggesting a repository layout: Thermal calculations will be made to determine a minimum distance between canisters avoiding canister surface temperatures above 100 deg C

  7. Evaluation of Color Settings in Aerial Images with the Use of Eye-Tracking User Study

    Science.gov (United States)

    Mirijovsky, J.; Popelka, S.

    2016-06-01

    The main aim of presented paper is to find the most realistic and preferred color settings for four different types of surfaces on the aerial images. This will be achieved through user study with the use of eye-movement recording. Aerial images taken by the unmanned aerial system were used as stimuli. From each image, squared crop area containing one of the studied types of surfaces (asphalt, concrete, water, soil, and grass) was selected. For each type of surface, the real value of reflectance was found with the use of precise spectroradiometer ASD HandHeld 2 which measures the reflectance. The device was used at the same time as aerial images were captured, so lighting conditions and state of vegetation were equal. The spectral resolution of the ASD device is better than 3.0 nm. For defining the RGB values of selected type of surface, the spectral reflectance values recorded by the device were merged into wider groups. Finally, we get three groups corresponding to RGB color system. Captured images were edited with the graphic editor Photoshop CS6. Contrast, clarity, and brightness were edited for all surface types on images. Finally, we get a set of 12 images of the same area with different color settings. These images were put into the grid and used as stimuli for the eye-tracking experiment. Eye-tracking is one of the methods of usability studies and it is considered as relatively objective. Eye-tracker SMI RED 250 with the sampling frequency 250 Hz was used in the study. As respondents, a group of 24 students of Geoinformatics and Geography was used. Their task was to select which image in the grid has the best color settings. The next task was to select which color settings they prefer. Respondents' answers were evaluated and the most realistic and most preferable color settings were found. The advantage of the eye-tracking evaluation was that also the process of the selection of the answers was analyzed. Areas of Interest were marked around each image in the

  8. Evaluating the late career nurse initiative: a cross-sectional survey of senior nurses in Ontario.

    Science.gov (United States)

    Doran, Diane; Jeffs, Lianne; Rizk, Paul; Laporte, Daniel R; Chilcote, Autumn Marie; Bai, Yu Qing

    2015-10-01

    This study evaluated the impact of the late career nurse initiative on nurse perceptions of their work environment, workplace burnout, job satisfaction, organisational commitment and intention to remain. The Ontario Ministry of Health and Long-Term Care introduced the late career nurse initiative with the goal of improving the retention of front-line nurses aged 55 and over by implementing a 0.20 full-time equivalent reduction of physically or psychologically demanding duties, enabling nurses to engage in special projects for the improvement of their organisations and patient care. A sample of 902 nurses aged 55 and over from acute and long-term care facilities were surveyed using valid and reliable questionnaires. Nurses who had participated in the initiative did not differ significantly from those who had not in terms of workplace burnout, job satisfaction, length of service or intention to remain within their current organisation. The late career nurse initiative participants reported significantly higher perceptions of managers' ability, leadership and support and their level of participation in hospital affairs. The late career nurse initiative was associated with perceived differences in nurses' work environment but not outcomes. Leaders need to pay attention to how late career nurses are selected and matched to organisational projects. © 2014 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

  9. Evaluation of auto region of interest settings for single photon emission computed tomography findings

    International Nuclear Information System (INIS)

    Mizuno, Takashi; Takahashi, Masaaki; Yoshioka, Katsunori

    2008-01-01

    It has been noted that the manual settings of region of interest (ROI) to the single-photon-emission-computed-tomography (SPECT) slice lacked objectivity when the fixed quantity value of regional cerebral blood flow (rCBF) was measured previously. Therefore, we jointly developed software Brain ROI' with Daiichi Radioisotope Laboratories, Ltd. (Present name: FUJIFILM RI Pharma Co., Ltd.) The software normalized an individual brain to a standard brain template by using Statistical Parametric Mapping 2 (SPM 2) of the easy Z-score Imaging System ver. 3.0 (eZIS Ver. 3.0), and the ROI template was set to a specific slice. In this study, we evaluated the accuracy of this software with an ROI template that we made of useful size and shape, in some clinical samples. The method of automatic setting of ROI was the objective. However, we felt that we should use the shape of the ROI template without the influence of brain atrophy. Moreover, we should see normalization of the individual brain and confirm the accuracy of normalization. When normalization failed, we should partially correct the ROI or set everything by manual operation for the operator. However, it was thought that this software was useful if the tendency was understood because examples of failure were few. (author)

  10. The evaluation of the automatic setting of ROI to SPECT measuring cerebral blood flow

    International Nuclear Information System (INIS)

    Mizuno, Hiroshi; Takahashi, Masaaki; Yoshioka, Katsunori

    2007-01-01

    It has been pointed out that the manual settings of region of interest (ROI) to the single-photon-emission-computed-tomography (SPECT) slice lacked objectivity when the fixed quantity value of regional cerebral blood flow (rCBF) was measured previously. Therefore, we jointly developed software Brain ROI'' with Daiichi Radioisotope Laboratories, Ltd. (DRL) that normalized an individual brain to a standard brain template by using Statistical Parametric Mapping 2 (SPM 2) of easy Z-score Imaging System ver. 3.0 (eZIS Ver. 3.0), and, ROI template was set to a specific slice. In this paper, we evaluated the accuracy of this software with ROI template that we made the useful size of the shape, in some clinical samples. As a result, the method of the automatic setting of ROI was the objectively. However, we thought that we should use the shape of ROI template without an influence of Brain atrophy. Moreover, we should see Normalizing individual brain and confirm the accuracy of normalization. When failing in normalization, we should partially correct ROI or set all by the manual operation of the operator. However, it was thought that this software was useful if the tendency was understood because the failure example was few. (author)

  11. Feasibility of using the International Classification of Functioning, Disability and Health Core Set for evaluation of fall-related risk factors in acute rehabilitation settings.

    Science.gov (United States)

    Huang, Shih W; Lin, Li F; Chou, Lin C; Wu, Mei J; Liao, Chun D; Liou, Tsan H

    2016-04-01

    Previously, we reported the use of an International Classification of Functioning (ICF) core set that can provide a holistic framework for evaluating the risk factors of falls; however, data on the feasibility of applying this core set are lacking. To investigate the feasibility of applying the fall-related ICF risk-factor core set in the case of patients in an acute-rehabilitation setting. A cross-sectional and descriptive correlational design. Acute-rehabilitation ward. A total of 273 patients who experienced fall at acute-rehabilitation ward. The data on falls were collected from the hospital's Nursing Information System (NIS) and the fall-reporting system (Adverse Event Reporting System, AERS) between 2010 and 2013. The relationship of both systems to the fall-related ICF core set was analyzed to assess the feasibility of their clinical application. We evaluated the feasibility of using the fall-related ICF risk-factor core set by using the frequency and the percentage of the fall patients in of the listed categories. The fall-related ICF risk-factor core set category b735 (muscle tone functions) exhibited a high feasibility (85.95%) for clinical application, and the category b730 (muscle power functions) covered 77.11% of the patients. The feasibility of application of the category d410 (change basic body position) was also high in the case of all fall patients (81.69%). In the acute-rehabilitation setting, the feasibility of application of the fall-related ICF risk-factor core set is high. The fall-related ICF risk-factor core set can help multidisciplinary teams develop fall-prevention strategies in acute rehabilitation wards.

  12. Evaluation of quality improvement initiative in pediatric oncology: implementation of aggressive hydration protocol.

    Science.gov (United States)

    Fratino, Lisa M; Daniel, Denise A; Cohen, Kenneth J; Chen, Allen R

    2009-01-01

    Our goal was to improve the efficiency of chemotherapy administration for pediatric oncology patients. We identified prechemotherapy hydration as the process that most often delayed chemotherapy administration. An aggressive hydration protocol, supported by fluid order sets, was developed for patients receiving planned chemotherapy. The mean interval from admission to achieving adequate hydration status was reduced significantly from 4.9 to 1.4 hours with a minor reduction in the time to initiate chemotherapy from 9.6 to 8.6 hours. Chemotherapy availability became the new rate-limiting process.

  13. Evaluation of a cross-sector community initiative partnership: delivering a local sport program.

    Science.gov (United States)

    Kihl, Lisa A; Tainsky, Scott; Babiak, Kathy; Bang, Hyejin

    2014-06-01

    Corporate community initiatives (CCI) are often established via cross-sector partnerships with nonprofit agencies to address critical social problems. While there is a growing body of literature exploring the effectiveness and social impact of these partnerships, there is a limited evaluative research on the implementation and execution processes of CCIs. In this paper, we examined the implementation and operational processes in the delivery of a professional sport organization's CCI initiative using program theory evaluation. The findings showed discrepancies between the associate organization and the implementers regarding understanding and fulfilling responsibilities with performing certain aspects (maintaining accurate records and program marketing) of the service delivery protocol. Despite program stakeholders being satisfied overall with the program delivery, contradictions between program stakeholders' satisfaction in the quality of program delivery was found in critical components (marketing and communications) of the service delivery. We conclude that ongoing evaluations are necessary to pinpoint the catalyst of the discrepancies along with all partners valuing process evaluation in addition to outcome evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Initial evaluation of children admitted on the Paediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Esperanza Arce Delgado

    2007-09-01

    Full Text Available The initial evaluation of the child, when admitted on the Paediatric Intensive Unit, is a essential tool and key piece as a starting point on the development of a specific Care Plan for each child. Therefore, it is necessary the existence of a protocol, according to a rigorous methodology, so that cares will have quality and thus, it will be avoided that each nursing professional will act in a different way, according to his intuition, beliefs or improvisation capacity.The initial evaluation of the child will allow us not only to coordinate the interventions, but also to give continuity to the cares.The initial evaluation of the child document is a nursing register that is part of the clinical register of the paediatric patient. Nursing registers turn to be the best approximation of what nowadays is our job’s practice, and they are, therefore, necessary for us to be judged by a professional perspective and to make it possible to classify the services we carry out to the society.

  15. Variability in use of voiding cystourethrogram during initial evaluation of infants with congenital hydronephrosis.

    Science.gov (United States)

    Vemulakonda, Vijaya M; Chiang, George; Corbett, Sean T

    2014-05-01

    To identify geographic variability in the imaging of infants with congenital hydronephrosis at initial pediatric urologic evaluation. We performed a retrospective review of infants aged ≤ 12 months with congenital hydronephrosis seen as new patients from October 2010 to September 2011 at 3 regionally diverse pediatric urology practices: University of Virginia Hospital, Rady Children's Hospital, and Children's Hospital Colorado. Primary outcomes measured were the type and number of tests ordered at initial evaluation. Independent variables collected included the following: patient age, location, and initial ultrasound findings. Ultrasound findings were manually extracted from the attending pediatric urologist's clinic note. All other data were automatically extracted from the electronic medical record. Proportions were analyzed using Pearson's goodness of fit and Fisher exact tests. Medians were compared using the Kruskal-Wallis test. Two hundred forty-one patients met the study criteria. Median patient age was 2 months and did not differ across sites. Most patients (64.7%) had Society for Fetal Urology grade 0-2 hydronephrosis; prevalence of high-grade hydronephrosis varied across sites (P = .002). Use of voiding cystourethrography also varied across sites (17.6%-88.9%); this difference persisted when controlling for age and hydronephrosis grade (P hydronephrosis varies across practices. This variation persists when controlling for differences in age and ultrasound findings, suggesting that regional differences in patient demographics, provider/parental preferences, or referral patterns might contribute to practice variations in the evaluation of these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. A rough set-based association rule approach implemented on a brand trust evaluation model

    Science.gov (United States)

    Liao, Shu-Hsien; Chen, Yin-Ju

    2017-09-01

    In commerce, businesses use branding to differentiate their product and service offerings from those of their competitors. The brand incorporates a set of product or service features that are associated with that particular brand name and identifies the product/service segmentation in the market. This study proposes a new data mining approach, a rough set-based association rule induction, implemented on a brand trust evaluation model. In addition, it presents as one way to deal with data uncertainty to analyse ratio scale data, while creating predictive if-then rules that generalise data values to the retail region. As such, this study uses the analysis of algorithms to find alcoholic beverages brand trust recall. Finally, discussions and conclusion are presented for further managerial implications.

  17. Volumetric response classification in metastatic solid tumors on MSCT: Initial results in a whole-body setting

    International Nuclear Information System (INIS)

    Wulff, A.M.; Fabel, M.; Freitag-Wolf, S.; Tepper, M.; Knabe, H.M.; Schäfer, J.P.; Jansen, O.; Bolte, H.

    2013-01-01

    Purpose: To examine technical parameters of measurement accuracy and differences in tumor response classification using RECIST 1.1 and volumetric assessment in three common metastasis types (lung nodules, liver lesions, lymph node metastasis) simultaneously. Materials and methods: 56 consecutive patients (32 female) aged 41–82 years with a wide range of metastatic solid tumors were examined with MSCT for baseline and follow up. Images were evaluated by three experienced radiologists using manual measurements and semi-automatic lesion segmentation. Institutional ethics review was obtained and all patients gave written informed consent. Data analysis comprised interobserver variability operationalized as coefficient of variation and categorical response classification according to RECIST 1.1 for both manual and volumetric measures. Continuous data were assessed for statistical significance with Wilcoxon signed-rank test and categorical data with Fleiss kappa. Results: Interobserver variability was 6.3% (IQR 4.6%) for manual and 4.1% (IQR 4.4%) for volumetrically obtained sum of relevant diameters (p < 0.05, corrected). 4–8 patients’ response to therapy was classified differently across observers by using volumetry compared to standard manual measurements. Fleiss kappa revealed no significant difference in categorical agreement of response classification between manual (0.7558) and volumetric (0.7623) measurements. Conclusion: Under standard RECIST thresholds there was no advantage of volumetric compared to manual response evaluation. However volumetric assessment yielded significantly lower interobserver variability. This may allow narrower thresholds for volumetric response classification in the future

  18. Volumetric response classification in metastatic solid tumors on MSCT: Initial results in a whole-body setting

    Energy Technology Data Exchange (ETDEWEB)

    Wulff, A.M., E-mail: a.wulff@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Fabel, M. [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Freitag-Wolf, S., E-mail: freitag@medinfo.uni-kiel.de [Institut für Medizinische Informatik und Statistik, Brunswiker Str. 10, 24105 Kiel (Germany); Tepper, M., E-mail: m.tepper@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Knabe, H.M., E-mail: h.knabe@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Schäfer, J.P., E-mail: jp.schaefer@rad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Jansen, O., E-mail: o.jansen@neurorad.uni-kiel.de [Klinik für Diagnostische Radiologie, Arnold-Heller-Straße 3, Haus 23, 24105 Kiel (Germany); Bolte, H., E-mail: hendrik.bolte@ukmuenster.de [Klinik für Nuklearmedizin, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster (Germany)

    2013-10-01

    Purpose: To examine technical parameters of measurement accuracy and differences in tumor response classification using RECIST 1.1 and volumetric assessment in three common metastasis types (lung nodules, liver lesions, lymph node metastasis) simultaneously. Materials and methods: 56 consecutive patients (32 female) aged 41–82 years with a wide range of metastatic solid tumors were examined with MSCT for baseline and follow up. Images were evaluated by three experienced radiologists using manual measurements and semi-automatic lesion segmentation. Institutional ethics review was obtained and all patients gave written informed consent. Data analysis comprised interobserver variability operationalized as coefficient of variation and categorical response classification according to RECIST 1.1 for both manual and volumetric measures. Continuous data were assessed for statistical significance with Wilcoxon signed-rank test and categorical data with Fleiss kappa. Results: Interobserver variability was 6.3% (IQR 4.6%) for manual and 4.1% (IQR 4.4%) for volumetrically obtained sum of relevant diameters (p < 0.05, corrected). 4–8 patients’ response to therapy was classified differently across observers by using volumetry compared to standard manual measurements. Fleiss kappa revealed no significant difference in categorical agreement of response classification between manual (0.7558) and volumetric (0.7623) measurements. Conclusion: Under standard RECIST thresholds there was no advantage of volumetric compared to manual response evaluation. However volumetric assessment yielded significantly lower interobserver variability. This may allow narrower thresholds for volumetric response classification in the future.

  19. Evaluations of Sexual Assault Prevention Programs in Military Settings: A Synthesis of the Research Literature.

    Science.gov (United States)

    Orchowski, Lindsay M; Berry-Cabán, Cristóbal S; Prisock, Kara; Borsari, Brian; Kazemi, Donna M

    2018-03-01

    The prevention of sexual assault (SA) in the U.S. military is a significant priority. This study applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to a literature search that identified research evaluating SA prevention programs conducted within military settings. Only six studies published between 2005 and 2016 met criteria for inclusion in the review. Studies demonstrated high heterogeneity in the: (1) conceptual framework of the prevention approach; (2) target population and timing of administration; (3) study recruitment methods; (4) methodological design; (5) method of delivery, program dosage and theory of change; and (6) outcome administration and efficacy. Scientific rigor according to the Oxford Center for Evidence-based Medicine was also variable. Several gaps in the research base were identified. Specifically, research evaluating SA prevention programs have only been conducted among U.S. Army and U.S. Navy samples. Most studies did not examine whether program participation was associated with reductions in rates of sexual violence. Studies also lacked utilization of a long-term follow-up period. Additionally, studies did not reflect the types of SA prevention programs currently being implemented in military settings. Taken together, further research is needed to enhance the evidence base for SA prevention in the military, and to evaluate the effectiveness of the approaches currently being conducted with service members.

  20. Evaluation of students' perceptions on game based learning program using fuzzy set conjoint analysis

    Science.gov (United States)

    Sofian, Siti Siryani; Rambely, Azmin Sham

    2017-04-01

    An effectiveness of a game based learning (GBL) can be determined from an application of fuzzy set conjoint analysis. The analysis was used due to the fuzziness in determining individual perceptions. This study involved a survey collected from 36 students aged 16 years old of SMK Mersing, Johor who participated in a Mathematics Discovery Camp organized by UKM research group called PRISMatik. The aim of this research was to determine the effectiveness of the module delivered to cultivate interest in mathematics subject in the form of game based learning through different values. There were 11 games conducted for the participants and students' perceptions based on the evaluation of six criteria were measured. A seven-point Likert scale method was used to collect students' preferences and perceptions. This scale represented seven linguistic terms to indicate their perceptions on each module of GBLs. Score of perceptions were transformed into degree of similarity using fuzzy set conjoint analysis. It was found that Geometric Analysis Recreation (GEAR) module was able to increase participant preference corresponded to the six attributes generated. The computations were also made for the other 10 games conducted during the camp. Results found that interest, passion and team work were the strongest values obtained from GBL activities in this camp as participants stated very strongly agreed that these attributes fulfilled their preferences in every module. This was an indicator of efficiency for the program. The evaluation using fuzzy conjoint analysis implicated the successfulness of a fuzzy approach to evaluate students' perceptions toward GBL.

  1. A Set of Functional Brain Networks for the Comprehensive Evaluation of Human Characteristics

    Directory of Open Access Journals (Sweden)

    Yul-Wan Sung

    2018-03-01

    Full Text Available Many human characteristics must be evaluated to comprehensively understand an individual, and measurements of the corresponding cognition/behavior are required. Brain imaging by functional MRI (fMRI has been widely used to examine brain function related to human cognition/behavior. However, few aspects of cognition/behavior of individuals or experimental groups can be examined through task-based fMRI. Recently, resting state fMRI (rs-fMRI signals have been shown to represent functional infrastructure in the brain that is highly involved in processing information related to cognition/behavior. Using rs-fMRI may allow diverse information about the brain through a single MRI scan to be obtained, as rs-fMRI does not require stimulus tasks. In this study, we attempted to identify a set of functional networks representing cognition/behavior that are related to a wide variety of human characteristics and to evaluate these characteristics using rs-fMRI data. If possible, these findings would support the potential of rs-fMRI to provide diverse information about the brain. We used resting-state fMRI and a set of 130 psychometric parameters that cover most human characteristics, including those related to intelligence and emotional quotients and social ability/skill. We identified 163 brain regions by VBM analysis using regression analysis with 130 psychometric parameters. Next, using a 163 × 163 correlation matrix, we identified functional networks related to 111 of the 130 psychometric parameters. Finally, we made an 8-class support vector machine classifiers corresponding to these 111 functional networks. Our results demonstrate that rs-fMRI signals contain intrinsic information about brain function related to cognition/behaviors and that this set of 111 networks/classifiers can be used to comprehensively evaluate human characteristics.

  2. Integrating Soft Set Theory and Fuzzy Linguistic Model to Evaluate the Performance of Training Simulation Systems.

    Science.gov (United States)

    Chang, Kuei-Hu; Chang, Yung-Chia; Chain, Kai; Chung, Hsiang-Yu

    2016-01-01

    The advancement of high technologies and the arrival of the information age have caused changes to the modern warfare. The military forces of many countries have replaced partially real training drills with training simulation systems to achieve combat readiness. However, considerable types of training simulation systems are used in military settings. In addition, differences in system set up time, functions, the environment, and the competency of system operators, as well as incomplete information have made it difficult to evaluate the performance of training simulation systems. To address the aforementioned problems, this study integrated analytic hierarchy process, soft set theory, and the fuzzy linguistic representation model to evaluate the performance of various training simulation systems. Furthermore, importance-performance analysis was adopted to examine the influence of saving costs and training safety of training simulation systems. The findings of this study are expected to facilitate applying military training simulation systems, avoiding wasting of resources (e.g., low utility and idle time), and providing data for subsequent applications and analysis. To verify the method proposed in this study, the numerical examples of the performance evaluation of training simulation systems were adopted and compared with the numerical results of an AHP and a novel AHP-based ranking technique. The results verified that not only could expert-provided questionnaire information be fully considered to lower the repetition rate of performance ranking, but a two-dimensional graph could also be used to help administrators allocate limited resources, thereby enhancing the investment benefits and training effectiveness of a training simulation system.

  3. EVALUATION OF NEUTRON CROSS SECTIONS FOR A COMPLETE SET OF Nd ISOTOPES.

    Energy Technology Data Exchange (ETDEWEB)

    KIM,H.; HERMAN, M.; MUGHABGHAB, S.F.; OBLOZINSKY, P.; ROCHMAN, D.; LEE. Y.-O.

    2007-10-29

    Neutron cross sections for a complete set of Nd isotopes, {sup 142,143,144,145,146,147,148,150}Nd, were evaluated in the incident energy range from 10{sup -5} eV to 20 MeV. In the low energy region, including thermal and resolved resonances, our evaluations are based on the latest data published in the Atlas of Neutron Resonances. In the unresolved resonance region we performed additional evaluation by using the averages of the resolved resonances and adjusting them to the experimental data. In the fast neutron region, we used the nuclear reaction model code EMPIRE-2.19 validated against the experimental data. The results are compared to the existing nuclear data libraries, including ENDF/B-VI.8, JENDL-3.3 and JEFF-3.1, and to the available experimental data. The new evaluations are suitable for neutron transport calculations and they were adopted by the new evaluated nuclear data file of the United States, ENDF/B-VII.0, released in December 2006.

  4. Evaluation of neutron cross sections for a complete set of Dy isotopes

    International Nuclear Information System (INIS)

    Kim, Hyeong Il; Herman, M.; Mughabghab, S.F.; Oblozinsky, P.; Lee, Young-Ouk

    2008-01-01

    Neutron cross sections for a complete set of Dy isotopes, 156,158,160,161,162,163,164 Dy, were evaluated in the incident energy range from 10 -5 eV to 20 MeV. In the low energy region, including thermal and resolved resonances, our evaluations are based on the latest data published in the Atlas of Neutron Resonances. In the unresolved resonance region we performed additional evaluation by using the averages of the resolved resonances and adjusting them to the experimental data. In the fast neutron region, we used the nuclear reaction model code EMPIRE-2.19 with the model parameters adjusted to the experimental data. The results are compared with the available experimental data and with the existing nuclear data libraries, including ENDF/B-VI.8 and JEFF-3.1. The new evaluations are suitable for neutron transport calculations and they were adopted by the new US evaluated nuclear data library, ENDF/B-VII.0, released in December 2006

  5. ECONOMIC EVALUATION OF A BREEDING PROGRAMME FOR SETTING UP TWO HIGH PERFORMANCES BEE LINES

    Directory of Open Access Journals (Sweden)

    A POPESCU

    2003-10-01

    Full Text Available This study aimed to evaluate costs, incomes and financial results related to the creation of two Apis Mellifica Carpatica lines, based on a specific Breeding Programme within a closed population. The two beelines have been carefully selected for the bee populations living in two areas of Romania: North Moldavia and South Muntenia. A new selection technology is set up in order to produce high performance queen bees, well adapted to the environmental conditions mainly to picking. Genetic gain will be get by selling the mated selected queens belonging to the two lines to various beekeepers interested to obtain more and high quality bee products.

  6. Anterior prostate biopsy at initial and repeat evaluation: is it useful to detect significant prostate cancer?

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2015-10-01

    Full Text Available ABSTRACT Purpose: Detection rate for anterior prostate cancer (PCa in men who underwent initial and repeat biopsy has been prospectively evaluated. Materials and Methods: From January 2013 to March 2014, 400 patients all of Caucasian origin (median age 63.5 years underwent initial (285 cases and repeat (115 cases prostate biopsy; all the men had negative digital rectal examination and the indications to biopsy were: PSA values > 10 ng/mL, PSA between 4.1-10 or 2.6-4 ng/mL with free/total PSA≤25% and ≤20%, respectively. A median of 22 (initial biopsy and 31 cores (repeat biopsy were transperineally performed including 4 cores of the anterior zone (AZ and 4 cores of the AZ plus 2 cores of the transition zone (TZ, respectively. Results: Median PSA was 7.9 ng/mL; overall, a PCa was found in 180 (45% patients: in 135 (47.4% and 45 (36% of the men who underwent initial and repeat biopsy, respectively. An exclusive PCa of the anterior zone was found in the 8.9 (initial biopsy vs 13.3% (repeat biopsy of the men: a single microfocus of cancer was found in the 61.2% of the cases; moreover, in 7 out 18 AZ PCa the biopsy histology was predictive of significant cancer in 2 (28.5% and 5 (71.5% men who underwent initial and repeat biopsy, respectively. Conclusions: However AZ biopsies increased detection rate for PCa (10% of the cases, the majority of AZ PCa with histological findings predictive of clinically significant cancer were found at repeat biopsy (about 70% of the cases.

  7. Noninvasive evaluation of mental stress using by a refined rough set technique based on biomedical signals.

    Science.gov (United States)

    Liu, Tung-Kuan; Chen, Yeh-Peng; Hou, Zone-Yuan; Wang, Chao-Chih; Chou, Jyh-Horng

    2014-06-01

    Evaluating and treating of stress can substantially benefits to people with health problems. Currently, mental stress evaluated using medical questionnaires. However, the accuracy of this evaluation method is questionable because of variations caused by factors such as cultural differences and individual subjectivity. Measuring of biomedical signals is an effective method for estimating mental stress that enables this problem to be overcome. However, the relationship between the levels of mental stress and biomedical signals remain poorly understood. A refined rough set algorithm is proposed to determine the relationship between mental stress and biomedical signals, this algorithm combines rough set theory with a hybrid Taguchi-genetic algorithm, called RS-HTGA. Two parameters were used for evaluating the performance of the proposed RS-HTGA method. A dataset obtained from a practice clinic comprising 362 cases (196 male, 166 female) was adopted to evaluate the performance of the proposed approach. The empirical results indicate that the proposed method can achieve acceptable accuracy in medical practice. Furthermore, the proposed method was successfully used to identify the relationship between mental stress levels and bio-medical signals. In addition, the comparison between the RS-HTGA and a support vector machine (SVM) method indicated that both methods yield good results. The total averages for sensitivity, specificity, and precision were greater than 96%, the results indicated that both algorithms produced highly accurate results, but a substantial difference in discrimination existed among people with Phase 0 stress. The SVM algorithm shows 89% and the RS-HTGA shows 96%. Therefore, the RS-HTGA is superior to the SVM algorithm. The kappa test results for both algorithms were greater than 0.936, indicating high accuracy and consistency. The area under receiver operating characteristic curve for both the RS-HTGA and a SVM method were greater than 0.77, indicating

  8. Initial quantitative evaluation of computed radiography in an intensive care unit

    International Nuclear Information System (INIS)

    Hillis, D.J.; McDonald, I.G.; Kelly, W.J.

    1996-01-01

    The first computed radiography (CR) unit in Australia was installed at St Vincent's Hospital, Melbourne, in February 1994. An initial qualitative evaluation of the attitude of the intensive care unit (ICU) physicians to the CR unit was conducted by use of a survey. The results of the survey of ICU physicians indicated that images were available faster than under the previous system and that the use of the CR system was preferred to evaluate chest tubes and line placements. While it is recognized that a further detailed radiological evaluation of the CR system is required to establish the diagnostic performance of CR compared with conventional film, some comments on the implementation of the system and ICU physician attitudes to the CR system are put forward for consideration by other hospitals examining the possible use of CR systems. 11 refs., 1 tab

  9. Evaluating methamphetamine use and risks of injection initiation among street youth: the ARYS study

    Directory of Open Access Journals (Sweden)

    Montaner Julio SG

    2006-05-01

    Full Text Available Abstract Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDU. These health concerns have recently been exacerbated by the increasing availability and use of methamphetamine. The challenges of reducing health-related harms among IDU have led to an increased recognition that strategies to prevent initiation into injection drug use must receive renewed focus. In an effort to better explore the factors that may protect against or facilitate entry into injection drug use, the At Risk Youth Study (ARYS has recently been initiated in Vancouver, Canada. The local setting is unique due to the significant infrastructure that has been put in place to reduce HIV transmission among active IDU. The ARYS study will seek to examine the impact of these programs, if any, on non-injection drug users. In addition, Vancouver has been the site of widespread use of methamphetamine in general and has seen a substantial increase in the use of crystal methamphetamine among street youth. Hence, the ARYS cohort is well positioned to examine the harms associated with methamphetamine use, including its potential role in facilitating initiation into injection drug use. This paper provides some background on the epidemiology of illicit drug use among street youth in North America and outlines the methodology of ARYS, a prospective cohort study of street youth in Vancouver, Canada.

  10. The influence of contextual factors on healthcare quality improvement initiatives: what works, for whom and in what setting? Protocol for a realist review.

    Science.gov (United States)

    Coles, Emma; Wells, Mary; Maxwell, Margaret; Harris, Fiona M; Anderson, Julie; Gray, Nicola M; Milner, Gill; MacGillivray, Stephen

    2017-08-23

    Context shapes the effectiveness of knowledge implementation and influences health improvement. Successful healthcare quality improvement (QI) initiatives frequently fail to transfer to different settings, with local contextual factors often cited as the cause. Understanding and overcoming contextual barriers is therefore crucial to implementing effective improvement; yet context is still poorly understood. There is a paucity of information on the mechanisms underlying how and why QI projects succeed or fail in given settings. A realist review of empirical studies of healthcare QI initiatives will be undertaken to examine the influence and impact of contextual factors on quality improvement in healthcare settings and explore whether QI initiatives can work in all contexts. The review will explore which contextual factors are important, and how, why, when and for whom they are important, within varied settings. The dynamic nature of context and change over time will be explored by examining which aspects of context impact at key points in the improvement trajectory. The review will also consider the influence of context on improvement outcomes (provider- and patient-level), spread and sustainability. The review process will follow five iterative steps: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions and (5) disseminate findings. The reviewers will consult with experts and stakeholders in the early stages to focus the review and develop a programme theory consisting of explanatory 'context-mechanism-outcome' configurations. Searches for primary evidence will be conducted iteratively. Data will be extracted and tested against the programme theory. A review advisory group will oversee the review process. Review findings will follow RAMESES guidelines and will be disseminated via a report, presentations and peer-reviewed publications. The review will update and consolidate evidence

  11. Evaluation of stability of k-means cluster ensembles with respect to random initialization.

    Science.gov (United States)

    Kuncheva, Ludmila I; Vetrov, Dmitry P

    2006-11-01

    Many clustering algorithms, including cluster ensembles, rely on a random component. Stability of the results across different runs is considered to be an asset of the algorithm. The cluster ensembles considered here are based on k-means clusterers. Each clusterer is assigned a random target number of clusters, k and is started from a random initialization. Here, we use 10 artificial and 10 real data sets to study ensemble stability with respect to random k, and random initialization. The data sets were chosen to have a small number of clusters (two to seven) and a moderate number of data points (up to a few hundred). Pairwise stability is defined as the adjusted Rand index between pairs of clusterers in the ensemble, averaged across all pairs. Nonpairwise stability is defined as the entropy of the consensus matrix of the ensemble. An experimental comparison with the stability of the standard k-means algorithm was carried out for k from 2 to 20. The results revealed that ensembles are generally more stable, markedly so for larger k. To establish whether stability can serve as a cluster validity index, we first looked at the relationship between stability and accuracy with respect to the number of clusters, k. We found that such a relationship strongly depends on the data set, varying from almost perfect positive correlation (0.97, for the glass data) to almost perfect negative correlation (-0.93, for the crabs data). We propose a new combined stability index to be the sum of the pairwise individual and ensemble stabilities. This index was found to correlate better with the ensemble accuracy. Following the hypothesis that a point of stability of a clustering algorithm corresponds to a structure found in the data, we used the stability measures to pick the number of clusters. The combined stability index gave best results.

  12. Assessment set for evaluation of clinical outcomes in multiple sclerosis: psychometric properties

    Directory of Open Access Journals (Sweden)

    Rasova K

    2012-10-01

    Full Text Available Kamila Rasova,1 Patricia Martinkova,2 Jana Vyskotova,3 Michaela Sedova21Department of Rehabilitation, 3rd Faculty of Medicine, Charles University in Prague and Faculty Hospital Královské Vinohrady, Prague, Czech Republic; 2Center of Biomedical Informatics and Department of Medical Informatics and Biostatistics, Institute of Computer Science, AS CR, Prague, Czech Republic; 3Faculty of Medicine, Ostrava University, Ostrava, Czech RepublicPurpose: Multiple sclerosis (MS manifests itself in a wide range of symptoms. Physiotherapy plays an important role in the treatment of those symptoms connected with mobility. For this therapy to be at its most effective it should be based on a systematic examination that is able to describe and classify damaged clinical functions meaningfully. The purpose of this study was to develop and validate a battery of tests and composite tests that can be used to systematically evaluate clinical features of MS treatable by physiotherapy.Methods: The authors assembled a proposed battery of tests comprising known, standard, and validated assessments (low-contrast letter acuity testing; the Motricity Index; the Modified Ashworth Scale; the Berg Balance Scale; scales of postural reactions, tremor, dysdiadochokinesia, and dysmetria; the Nine-Hole Peg Test; the Timed 25-Foot Walk; and the 3-minute version of the Paced Auditory Serial Addition Test and one test (knee hyperextension of the authors’ own. Normalization was calculated and six composite assessments were measured. Seventeen ambulatory subjects with MS were tested twice with the assessment set before undergoing physiotherapy, and 12 were also tested with the assessment set after the physiotherapy. The test–retest reliability, stability, internal consistency of composite measurements, sensitivity to changes after therapy, and correlation between measurements and the Kurtzke Expanded Disability Status Scale score were evaluated for all tests in the assessment set

  13. Proceduralism and its role in economic evaluation and priority setting in health.

    Science.gov (United States)

    Jan, Stephen

    2014-05-01

    This paper provides a critical overview of Gavin Mooney's proceduralist approach to economic evaluation and priority setting in health. Proceduralism is the notion that the social value attached to alternative courses of action should be determined not only by outcomes, but also processes. Mooney's brand of proceduralism was unique and couched within a broader critique of 'neo-liberal' economics. It operated on a number of levels. At the micro level of the individual program, he pioneered the notion that 'process utility' could be valued and measured within economic evaluation. At a macro level, he developed a framework in which the social objective of equity was defined by procedural justice in which communitarian values were used as the basis for judging how resources should be allocated across the health system. Finally, he applied the notion of procedural justice to further our understanding of the political economy of resource allocation; highlighting how fairness in decision making processes can overcome the sometimes intractable zero-sum resource allocation problem. In summary, his contributions to this field have set the stage for innovative programs of research to help in developing health policies and programs that are both in alignment with community values and implementable. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Rotavirus vaccine effectiveness in low-income settings: An evaluation of the test-negative design.

    Science.gov (United States)

    Schwartz, Lauren M; Halloran, M Elizabeth; Rowhani-Rahbar, Ali; Neuzil, Kathleen M; Victor, John C

    2017-01-03

    The test-negative design (TND), an epidemiologic method currently used to measure rotavirus vaccine (RV) effectiveness, compares the vaccination status of rotavirus-positive cases and rotavirus-negative controls meeting a pre-defined case definition for acute gastroenteritis. Despite the use of this study design in low-income settings, the TND has not been evaluated to measure rotavirus vaccine effectiveness. This study builds upon prior methods to evaluate the use of the TND for influenza vaccine using a randomized controlled clinical trial database. Test-negative vaccine effectiveness (VE-TND) estimates were derived from three large randomized placebo-controlled trials (RCTs) of monovalent (RV1) and pentavalent (RV5) rotavirus vaccines in sub-Saharan Africa and Asia. Derived VE-TND estimates were compared to the original RCT vaccine efficacy estimates (VE-RCTs). The core assumption of the TND (i.e., rotavirus vaccine has no effect on rotavirus-negative diarrhea) was also assessed. TND vaccine effectiveness estimates were nearly equivalent to original RCT vaccine efficacy estimates. Neither RV had a substantial effect on rotavirus-negative diarrhea. This study supports the TND as an appropriate epidemiologic study design to measure rotavirus vaccine effectiveness in low-income settings. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  15. Hand Hygiene – Evaluation of Three Disinfectant Hand Sanitizers in a Community Setting

    Science.gov (United States)

    Babeluk, Rita; Jutz, Sabrina; Mertlitz, Sarah; Matiasek, Johannes; Klaus, Christoph

    2014-01-01

    Hand hygiene is acknowledged as the single most important measure to prevent nosocomial infections in the healthcare setting. Similarly, in non-clinical settings, hand hygiene is recognised as a key element in helping prevent the spread of infectious diseases. The aim of this study was to evaluate the efficacy of three different disinfectant hand sanitizers in reducing the burden of bacterial hand contamination in 60 healthy volunteers in a community setting, both before and after education about the correct use of hand sanitizers. The study is the first to evaluate the efficacy and ease of use of different formulations of hand rubs used by the general population. The products tested were: Sterillium (perfumed, liquid), desderman pure gel (odorless, gel) and Lavit (perfumed, spray). Sterillium and desderman are EN1500 (hygienic hand rub) certified products (available in pharmacy) and Lavit is non EN1500 certified and available in supermarkets. The two EN1500 certified products were found to be significantly superior in terms of reducing bacterial load. desderman pure gel, Sterillium and Lavit reduced the bacterial count to 6.4%, 8.2% and 28.0% respectively. After education in the correct use of each hand rub, the bacterial load was reduced even further, demonstrating the value of education in improving hand hygiene. Information about the testers' perceptions of the three sanitizers, together with their expectations of a hand sanitizer was obtained through a questionnaire. Efficacy, followed by skin compatibility were found to be the two most important attributes of a hand disinfectant in our target group. PMID:25379773

  16. Hand hygiene--evaluation of three disinfectant hand sanitizers in a community setting.

    Directory of Open Access Journals (Sweden)

    Rita Babeluk

    Full Text Available Hand hygiene is acknowledged as the single most important measure to prevent nosocomial infections in the healthcare setting. Similarly, in non-clinical settings, hand hygiene is recognised as a key element in helping prevent the spread of infectious diseases. The aim of this study was to evaluate the efficacy of three different disinfectant hand sanitizers in reducing the burden of bacterial hand contamination in 60 healthy volunteers in a community setting, both before and after education about the correct use of hand sanitizers. The study is the first to evaluate the efficacy and ease of use of different formulations of hand rubs used by the general population. The products tested were: Sterillium (perfumed, liquid, desderman pure gel (odorless, gel and Lavit (perfumed, spray. Sterillium and desderman are EN1500 (hygienic hand rub certified products (available in pharmacy and Lavit is non EN1500 certified and available in supermarkets. The two EN1500 certified products were found to be significantly superior in terms of reducing bacterial load. desderman pure gel, Sterillium and Lavit reduced the bacterial count to 6.4%, 8.2% and 28.0% respectively. After education in the correct use of each hand rub, the bacterial load was reduced even further, demonstrating the value of education in improving hand hygiene. Information about the testers' perceptions of the three sanitizers, together with their expectations of a hand sanitizer was obtained through a questionnaire. Efficacy, followed by skin compatibility were found to be the two most important attributes of a hand disinfectant in our target group.

  17. Evaluation of Fatigue Crack Initiation for Volumetric Flaw in Pressure Tube

    International Nuclear Information System (INIS)

    Choi, Sung Nam; Yoo, Hyun Joo

    2005-01-01

    CAN/CSA.N285.4-94 requires the periodic inservice inspection and surveillance of pressure tubes in operating CANDU nuclear power reactors. If the inspection results reveal a flaw exceeding the acceptance criteria of the Code, the flaw must be evaluated to determine if the pressure is acceptable for continued service. Currently, the flaw evaluation methodology and acceptance criteria specified in CSA-N285.05-2005, 'Technical requirements for in-service evaluation of zirconium alloy pressure tubes in CANDU reactors'. The Code is applicable to zirconium alloy pressure tubes. The evaluation methodology for a crack-like flaw is similar to that of ASME B and PV Sec. XI, 'Inservice Inspection of Nuclear Power Plant Components'. However, the evaluation methodology for a blunt volumetric flaw is described in CSA-N285.05-2005 code. The object of this paper is to address the fatigue crack initiation evaluation for the blunt volumetric flaw as it applies to the pressure tube at Wolsong NPP

  18. Evaluation of a Low-Cost Bubble CPAP System Designed for Resource-Limited Settings.

    Science.gov (United States)

    Bennett, Desmond J; Carroll, Ryan W; Kacmarek, Robert M

    2018-04-01

    Respiratory compromise is a leading contributor to global neonatal death. CPAP is a method of treatment that helps maintain lung volume during expiration, promotes comfortable breathing, and improves oxygenation. Bubble CPAP is an effective alternative to standard CPAP. We sought to determine the reliability and functionality of a low-cost bubble CPAP device designed for low-resource settings. The low-cost bubble CPAP device was compared to a commercially available bubble CPAP system. The devices were connected to a lung simulator that simulated neonates of 4 different weights with compromised respiratory mechanics (∼1, ∼3, ∼5, and ∼10 kg). The devices' abilities to establish and maintain pressure and flow under normal conditions as well as under conditions of leak were compared. Multiple combinations of pressure levels (5, 8, and 10 cm H 2 O) and flow levels (3, 6, and 10 L/min) were tested. The endurance of both devices was also tested by running the systems continuously for 8 h and measuring the changes in pressure and flow. Both devices performed equivalently during the no-leak and leak trials. While our testing revealed individual differences that were statistically significant and clinically important (>10% difference) within specific CPAP and flow-level settings, no overall comparisons of CPAP or flow were both statistically significant and clinically important. Each device delivered pressures similar to the desired pressures, although the flows delivered by both machines were lower than the set flows in most trials. During the endurance trials, the low-cost device was marginally better at maintaining pressure, while the commercially available device was better at maintaining flow. The low-cost bubble CPAP device evaluated in this study is comparable to a bubble CPAP system used in developed settings. Extensive clinical trials, however, are necessary to confirm its effectiveness. Copyright © 2018 by Daedalus Enterprises.

  19. Evaluation of the Healthy Lifestyles Initiative for Improving Community Capacity for Childhood Obesity Prevention.

    Science.gov (United States)

    Berman, Marcie; Bozsik, Frances; Shook, Robin P; Meissen-Sebelius, Emily; Markenson, Deborah; Summar, Shelly; DeWit, Emily; Carlson, Jordan A

    2018-02-22

    Policy, systems, and environmental approaches are recommended for preventing childhood obesity. The objective of our study was to evaluate the Healthy Lifestyles Initiative, which aimed to strengthen community capacity for policy, systems, and environmental approaches to healthy eating and active living among children and families. The Healthy Lifestyles Initiative was developed through a collaborative process and facilitated by community organizers at a local children's hospital. The initiative supported 218 partners from 170 community organizations through training, action planning, coalition support, one-on-one support, and the dissemination of materials and sharing of resources. Eighty initiative partners completed a brief online survey on implementation strategies engaged in, materials used, and policy, systems, and environmental activities implemented. In accordance with frameworks for implementation science, we assessed associations among the constructs by using linear regression to identify whether and which of the implementation strategies were associated with materials used and implementation of policy, systems, and environmental activities targeted by the initiative. Each implementation strategy was engaged in by 30% to 35% of the 80 survey respondents. The most frequently used materials were educational handouts (76.3%) and posters (66.3%). The most frequently implemented activities were developing or continuing partnerships (57.5%) and reviewing organizational wellness policies (46.3%). Completing an action plan and the number of implementation strategies engaged in were positively associated with implementation of targeted activities (action plan, effect size = 0.82; number of strategies, effect size = 0.51) and materials use (action plan, effect size = 0.59; number of strategies, effect size = 0.52). Materials use was positively associated with implementation of targeted activities (effect size = 0.35). Community-capacity-building efforts can be

  20. Process and impact evaluation of the Romp & Chomp obesity prevention intervention in early childhood settings: lessons learned from implementation in preschools and long day care settings.

    Science.gov (United States)

    de Silva-Sanigorski, Andrea M; Bell, Andrew C; Kremer, Peter; Park, Janet; Demajo, Lisa; Smith, Michael; Sharp, Sharon; Nichols, Melanie; Carpenter, Lauren; Boak, Rachel; Swinburn, Boyd

    2012-06-01

    The Romp & Chomp controlled trial, which aimed to prevent obesity in preschool Australian children, was recently found to reduce the prevalence of childhood overweight and obesity and improve children's dietary patterns. The intervention focused on capacity building and policy implementation within various early childhood settings. This paper reports on the process and impact evaluation of this trial and the lessons learned from this complex community intervention. Process data was collected throughout and audits capturing nutrition and physical activity-related environments and practices were completed postintervention by directors of Long Day Care (LDC) centers (n = 10) and preschools (n = 41) in intervention and comparison (n = 161 LDC and n = 347 preschool) groups. The environmental audits demonstrated positive impacts in both settings on policy, nutrition, physical activity opportunities, and staff capacity and practices, although results varied across settings and were more substantial in the preschool settings. Important lessons were learned in relation to implementation of such community-based interventions, including the significant barriers to implementing health-promotion interventions in early childhood settings, lack of engagement of for-profit LDC centers in the evaluation, and an inability to attribute direct intervention impacts when the intervention components were delivered as part of a health-promotion package integrated with other programs. These results provide confidence that obesity prevention interventions in children's settings can be effective; however, significant efforts must be directed toward developing context-specific strategies that invest in policies, capacity building, staff support, and parent engagement. Recognition by funders and reviewers of the difficulties involved in implementing and evaluating such complex interventions is also critical to strengthening the evidence base on the effectiveness of such public health

  1. Review and evaluation of performance measures for survival prediction models in external validation settings

    Directory of Open Access Journals (Sweden)

    M. Shafiqur Rahman

    2017-04-01

    Full Text Available Abstract Background When developing a prediction model for survival data it is essential to validate its performance in external validation settings using appropriate performance measures. Although a number of such measures have been proposed, there is only limited guidance regarding their use in the context of model validation. This paper reviewed and evaluated a wide range of performance measures to provide some guidelines for their use in practice. Methods An extensive simulation study based on two clinical datasets was conducted to investigate the performance of the measures in external validation settings. Measures were selected from categories that assess the overall performance, discrimination and calibration of a survival prediction model. Some of these have been modified to allow their use with validation data, and a case study is provided to describe how these measures can be estimated in practice. The measures were evaluated with respect to their robustness to censoring and ease of interpretation. All measures are implemented, or are straightforward to implement, in statistical software. Results Most of the performance measures were reasonably robust to moderate levels of censoring. One exception was Harrell’s concordance measure which tended to increase as censoring increased. Conclusions We recommend that Uno’s concordance measure is used to quantify concordance when there are moderate levels of censoring. Alternatively, Gönen and Heller’s measure could be considered, especially if censoring is very high, but we suggest that the prediction model is re-calibrated first. We also recommend that Royston’s D is routinely reported to assess discrimination since it has an appealing interpretation. The calibration slope is useful for both internal and external validation settings and recommended to report routinely. Our recommendation would be to use any of the predictive accuracy measures and provide the corresponding predictive

  2. Evaluation of set-of errors in pelvic irradiation with electronic portal imaging device

    International Nuclear Information System (INIS)

    Wu Xiaoying; Zhang Zhen; Wang Wenchao; Ren Jun; Guo Xiaomei; Lu Huizhong

    2007-01-01

    Objective: Evaluate the systematic and random set-up error in the pelvic irradiation u- sing electronic portal imaging device(EPID) to provide institution-specific margin for PTV design in pelvic cancer treatment planning with 3D conformal therapy and/or IMRT. Methods: From May to August 2005, twelve patients who received pelvic irradiation, were involved in this study. CT simulations were performed and DRRs were generated as the reference images. Ant-post and lateral portal images were taken daily, and total of 244 sets of EPID images were collected for the whole group. The translational shifts along right-left, superior-inferior and anterior-posterior directions were calculated with aligning the pelvic bony structures on the DRRs and electronic portal images. The systematic and random setup errors were evaluated based on the 244 sets of data. PTV margin was assessed assuming target rotation was negligible. Results: In the right- left (R-L), superior-inferior (S-I) and anterior-posterior (A-P) directions, the maximum shifts were 9.9, 14.0 and 21.1 mm and the systematic setup errors were 0.5, 0.2 and 2.3 mm respectively. For all 244 sets of data in this study, the frequency of the shift larger than 10 mm were 0% (R-L), 1% (S-I) and 3% (A -P); and in R-L and S-I direction, 92% and 91% of the times the shift was smaller than 5 mm. However, only 79% of the times the A-P shift was less than 5 mm. Conclusions: It is suggested in this study that in order to achieve a target coverage of better than 95% of the times throughout the pelvic irradiation in our institution, a 5 mm PTV margin in right-left and superior-inferior directions is required, however, the anterior-posterior margin needs to be increased to at least 10 mm. One needs to be cautious though when applying the PTV margin derived from small sample of patient population to individual patient. (authors)

  3. Prospective evaluation of the International Neuroblastoma Staging System (INSS) and the International Neuroblastoma Response Criteria (INRC) in a multicentre setting.

    Science.gov (United States)

    Castel, V; García-Miguel, P; Cañete, A; Melero, C; Navajas, A; Ruíz-Jiménez, J I; Navarro, S; Badal, M D

    1999-04-01

    The aim of this study was to classify prospectively a series of neuroblastoma tumours according to the International Neuroblastoma Staging System (INSS) and the International Neuroblastoma Response Criteria (INRC) and to evaluate the difficulties and pitfalls involved in a multicentre setting. Each hospital provided their data for central review. The surgical procedures and their complications were reported. Kaplan-Meier estimates of survival and event-free survival were calculated according to stage and response to therapy. From June 1992 to December 1996, 194 patients were included in the study, with a mean age of 2 years. Initial studies were performed according to INSS recommendations without major problems. INSS stage was correctly applied to all patients except for 9 (95%). Post-operative complications were observed in 15 patients (8.3%). Response to therapy (INRC) was studied in 63 stage 4 patients, 11 of whom were not classified correctly (17%). Differences in survival according to stage (INSS) and group of response to therapy (INRC) were statistically significant (P INSS was easy to use and separated different prognostic groups. Surgical complications and mortality did not increase in this series because of using the INSS. The feasibility of INRC was evaluated in a small series of stage 4 patients and the designation of response was problematic in a relatively high proportion of cases. The prognostic value of the different responses was highly significant, but less informative than had been hoped for.

  4. An evaluation of the process and initial impact of disseminating a nursing e-thesis.

    Science.gov (United States)

    Macduff, Colin

    2009-05-01

    This paper is a report of a study conducted to evaluate product, process and outcome aspects of the dissemination of a nursing PhD thesis via an open-access electronic institutional repository. Despite the growth of university institutional repositories which make theses easily accessible via the world wide web, nursing has been very slow to evaluate related processes and outcomes. Drawing on Stake's evaluation research methods, a case study design was adopted. The case is described using a four-phase structure within which key aspects of process and impact are reflexively analysed. In the conceptualization/re-conceptualization phase, fundamental questions about the purpose, format and imagined readership for a published nursing PhD were considered. In the preparation phase, seven key practical processes were identified that are likely to be relevant to most e-theses. In the dissemination phase email invitations were primarily used to invite engagement. The evaluation phase involved quantitative indicators of initial impact, such as page viewing and download statistics and qualitative feedback on processes and product. Analysis of process and impact elements of e-thesis dissemination is likely to have more than intrinsic value. The advent of e-theses housed in web-based institutional repositories has the potential to transform thesis access and use. It also offers potential to transform the nature and scope of thesis production and dissemination. Nursing scholars can exploit and evaluate such opportunities.

  5. High resolution tsunami modelling for the evaluation of potential risk areas in Setúbal (Portugal

    Directory of Open Access Journals (Sweden)

    J. Ribeiro

    2011-08-01

    Full Text Available The use of high resolution hydrodynamic modelling to simulate the potential effects of tsunami events can provide relevant information about the most probable inundation areas. Moreover, the consideration of complementary data such as the type of buildings, location of priority equipment, type of roads, enables mapping of the most vulnerable zones, computing of the expected damage on man-made structures, constrain of the definition of rescue areas and escape routes, adaptation of emergency plans and proper evaluation of the vulnerability associated with different areas and/or equipment.

    Such an approach was used to evaluate the specific risks associated with a potential occurrence of a tsunami event in the region of Setúbal (Portugal, which was one of the areas most seriously affected by the 1755 tsunami.

    In order to perform an evaluation of the hazard associated with the occurrence of a similar event, high resolution wave propagation simulations were performed considering different potential earthquake sources with different magnitudes. Based on these simulations, detailed inundation maps associated with the different events were produced. These results were combined with the available information on the vulnerability of the local infrastructures (building types, roads and streets characteristics, priority buildings in order to impose restrictions in the production of high-scale potential damage maps, escape routes and emergency routes maps.

  6. Links between causal effects and causal association for surrogacy evaluation in a gaussian setting.

    Science.gov (United States)

    Conlon, Anna; Taylor, Jeremy; Li, Yun; Diaz-Ordaz, Karla; Elliott, Michael

    2017-11-30

    Two paradigms for the evaluation of surrogate markers in randomized clinical trials have been proposed: the causal effects paradigm and the causal association paradigm. Each of these paradigms rely on assumptions that must be made to proceed with estimation and to validate a candidate surrogate marker (S) for the true outcome of interest (T). We consider the setting in which S and T are Gaussian and are generated from structural models that include an unobserved confounder. Under the assumed structural models, we relate the quantities used to evaluate surrogacy within both the causal effects and causal association frameworks. We review some of the common assumptions made to aid in estimating these quantities and show that assumptions made within one framework can imply strong assumptions within the alternative framework. We demonstrate that there is a similarity, but not exact correspondence between the quantities used to evaluate surrogacy within each framework, and show that the conditions for identifiability of the surrogacy parameters are different from the conditions, which lead to a correspondence of these quantities. Copyright © 2017 John Wiley & Sons, Ltd.

  7. The Sustainable Island Development Evaluation Model and Its Application Based on the Nonstructural Decision Fuzzy Set

    Directory of Open Access Journals (Sweden)

    Quanming Wang

    2013-01-01

    Full Text Available Due to the complexity and diversity of the issue of sustainable island development, no widely accepted and applicable evaluation system model regarding the issue currently exists. In this paper, we discuss and establish the sustainable development indicator system and the model approach from the perspective of resources, the island environment, the island development status, the island social development, and the island intelligence development. We reference the sustainable development theory and the sustainable development indicator system method concerning land region, combine the character of the sustainable island development, analyze and evaluate the extent of the sustainable island development, orient development, and identify the key and limited factors of sustainable island development capability. This research adopts the entropy method and the nonstructural decision fuzzy set theory model to determine the weight of the evaluating indicators. Changhai County was selected as the subject of the research, which consisted of a quantitative study of its sustainable development status from 2001 to 2008 to identify the key factors influencing its sustainability development, existing problems, and limited factors and to provide basic technical support for ocean development planning and economic development planning.

  8. Evaluating the Utility of Web-Based Consumer Support Tools Using Rough Sets

    Science.gov (United States)

    Maciag, Timothy; Hepting, Daryl H.; Slezak, Dominik; Hilderman, Robert J.

    On the Web, many popular e-commerce sites provide consumers with decision support tools to assist them in their commerce-related decision-making. Many consumers will rank the utility of these tools quite highly. Data obtained from web usage mining analyses, which may provide knowledge about a user's online experiences, could help indicate the utility of these tools. This type of analysis could provide insight into whether provided tools are adequately assisting consumers in conducting their online shopping activities or if new or additional enhancements need consideration. Although some research in this regard has been described in previous literature, there is still much that can be done. The authors of this paper hypothesize that a measurement of consumer decision accuracy, i.e. a measurement preferences, could help indicate the utility of these tools. This paper describes a procedure developed towards this goal using elements of rough set theory. The authors evaluated the procedure using two support tools, one based on a tool developed by the US-EPA and the other developed by one of the authors called cogito. Results from the evaluation did provide interesting insights on the utility of both support tools. Although it was shown that the cogito tool obtained slightly higher decision accuracy, both tools could be improved from additional enhancements. Details of the procedure developed and results obtained from the evaluation will be provided. Opportunities for future work are also discussed.

  9. Long-term Satellite NDVI Data Sets: Evaluating Their Ability to Detect Ecosystem Functional Changes in South America.

    Science.gov (United States)

    Baldi, Germán; Nosetto, Marcelo D; Aragón, Roxana; Aversa, Fernando; Paruelo, José M; Jobbágy, Esteban G

    2008-09-03

    In the last decades, South American ecosystems underwent important functional modifications due to climate alterations and direct human intervention on land use and land cover. Among remotely sensed data sets, NOAA-AVHRR "Normalized Difference Vegetation Index" (NDVI) represents one of the most powerful tools to evaluate these changes thanks to their extended temporal coverage. In this paper we explored the possibilities and limitations of three commonly used NOAA-AVHRR NDVI series (PAL, GIMMS and FASIR) to detect ecosystem functional changes in the South American continent. We performed pixel-based linear regressions for four NDVI variables (average annual, maximum annual, minimum annual and intra-annual coefficient of variation) for the 1982-1999 period and (1) analyzed the convergences and divergences of significant multi-annual trends identified across all series, (2) explored the degree of aggregation of the trends using the O-ring statistic, and (3) evaluated observed trends using independent information on ecosystem functional changes in five focal regions. Several differences arose in terms of the patterns of change (the sign, localization and total number of pixels with changes). FASIR presented the highest proportion of changing pixels (32.7%) and GIMMS the lowest (16.2%). PAL and FASIR data sets showed the highest agreement, with a convergence of detected trends on 71.2% of the pixels. Even though positive and negative changes showed substantial spatial aggregation, important differences in the scale of aggregation emerged among the series, with GIMMS showing the smaller scale (≤11 pixels). The independent evaluations suggest higher accuracy in the detection of ecosystem changes among PAL and FASIR series than with GIMMS, as they detected trends that match expected shifts. In fact, this last series eliminated most of the long term patterns over the continent. For example, in the "Eastern Paraguay" and "Uruguay River margins" focal regions, the

  10. Evaluation of leadership skills during the simulation education course for the initial management of blunt trauma.

    Science.gov (United States)

    Schott, Eric; Brautigam, Robert T; Smola, Jacqueline; Burns, Karyl J

    2012-04-01

    Leadership skills of senior residents, trauma fellows, and a nurse practitioner were assessed during simulation training for the initial management of blunt trauma. This was a pilot, observational study, that in addition to skill development and assessment also sought to determine the need for a dedicated leadership training course for surgical residents. The study evaluated the leadership skills and adherence to Advance Trauma Life Support (ATLS) guidelines of the team leaders during simulation training. The team leaders' performances on criteria regarding prearrival planning, critical actions based on ATLS, injury identification, patient management, and communication were evaluated for each of five blunt-trauma scenarios. Although there was a statistically significant increase in leadership skills for performing ATLS critical actions, P skills for team leadership willbe a worthwhile endeavor at our institution.

  11. Evaluation of a social skills program based on social learning theory, implemented in a school setting.

    Science.gov (United States)

    Sheridan, Beth A; MacDonald, Douglas A; Donlon, Mark; Kuhn, Beth; McGovern, Katie; Friedman, Harris

    2011-04-01

    Using a sample of 647 Canadian children in kindergarten to Grade 3 (325 boys, 322 girls), the present study evaluated the perceived effectiveness of Skillstreaming (McGinnis & Goldstein, 2003), a widely known social skills program implemented to target the development of four skill sets, i.e., listening, following directions, problem-solving, and knowing when to tell. Results indicated significant postprogram improvements in all skills as well as in ratings of overall prosociality obtained from both classroom teachers and mental health staff, with medium to large effect sizes obtained from teachers' and mental health professionals' ratings, respectively. Additional analyses yielded significant but weak moderator effects of grade and preprogram prosocial functioning for teacher ratings but no consistent moderator effects for children's sex or school location (i.e., urban versus rural) regardless of rater.

  12. Impact of electronic prescribing in a hospital setting: a process-focused evaluation.

    Science.gov (United States)

    Cunningham, Thomas R; Geller, E Scott; Clarke, Steven W

    2008-08-01

    To evaluate effects of a natural CPOE implementation in a hospital setting and inform the efficacy of using CPOE rather than traditional paper medication orders. A multiple-baseline, quasi-experimental study of a naturally occurring CPOE intervention, with a non-equivalent control site. Compliance with medication-ordering protocols and time to first dose of antibiotics. Medication orders placed using CPOE were significantly more compliant than paper-based medication orders, and first doses of antibiotics were delivered significantly faster when ordered with CPOE than when placed using the standard paper-based system (p<.01). Findings support the use of CPOE and justify the need for interventions to increase CPOE adoption and consistent use among physicians.

  13. Index-based groundwater vulnerability mapping models using hydrogeological settings: A critical evaluation

    International Nuclear Information System (INIS)

    Kumar, Prashant; Bansod, Baban K.S.; Debnath, Sanjit K.; Thakur, Praveen Kumar; Ghanshyam, C.

    2015-01-01

    Groundwater vulnerability maps are useful for decision making in land use planning and water resource management. This paper reviews the various groundwater vulnerability assessment models developed across the world. Each model has been evaluated in terms of its pros and cons and the environmental conditions of its application. The paper further discusses the validation techniques used for the generated vulnerability maps by various models. Implicit challenges associated with the development of the groundwater vulnerability assessment models have also been identified with scientific considerations to the parameter relations and their selections. - Highlights: • Various index-based groundwater vulnerability assessment models have been discussed. • A comparative analysis of the models and its applicability in different hydrogeological settings has been discussed. • Research problems of underlying vulnerability assessment models are also reported in this review paper

  14. Index-based groundwater vulnerability mapping models using hydrogeological settings: A critical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Prashant, E-mail: prashantkumar@csio.res.in [CSIR-Central Scientific Instruments Organisation, Chandigarh 160030 (India); Academy of Scientific and Innovative Research—CSIO, Chandigarh 160030 (India); Bansod, Baban K.S.; Debnath, Sanjit K. [CSIR-Central Scientific Instruments Organisation, Chandigarh 160030 (India); Academy of Scientific and Innovative Research—CSIO, Chandigarh 160030 (India); Thakur, Praveen Kumar [Indian Institute of Remote Sensing (ISRO), Dehradun 248001 (India); Ghanshyam, C. [CSIR-Central Scientific Instruments Organisation, Chandigarh 160030 (India); Academy of Scientific and Innovative Research—CSIO, Chandigarh 160030 (India)

    2015-02-15

    Groundwater vulnerability maps are useful for decision making in land use planning and water resource management. This paper reviews the various groundwater vulnerability assessment models developed across the world. Each model has been evaluated in terms of its pros and cons and the environmental conditions of its application. The paper further discusses the validation techniques used for the generated vulnerability maps by various models. Implicit challenges associated with the development of the groundwater vulnerability assessment models have also been identified with scientific considerations to the parameter relations and their selections. - Highlights: • Various index-based groundwater vulnerability assessment models have been discussed. • A comparative analysis of the models and its applicability in different hydrogeological settings has been discussed. • Research problems of underlying vulnerability assessment models are also reported in this review paper.

  15. 3D-CT vascular setting protocol using computer graphics for the evaluation of maxillofacial lesions

    Directory of Open Access Journals (Sweden)

    CAVALCANTI Marcelo de Gusmão Paraiso

    2001-01-01

    Full Text Available In this paper we present the aspect of a mandibular giant cell granuloma in spiral computed tomography-based three-dimensional (3D-CT reconstructed images using computer graphics, and demonstrate the importance of the vascular protocol in permitting better diagnosis, visualization and determination of the dimensions of the lesion. We analyzed 21 patients with maxillofacial lesions of neoplastic and proliferative origins. Two oral and maxillofacial radiologists analyzed the images. The usefulness of interactive 3D images reconstructed by means of computer graphics, especially using a vascular setting protocol for qualitative and quantitative analyses for the diagnosis, determination of the extent of lesions, treatment planning and follow-up, was demonstrated. The technique is an important adjunct to the evaluation of lesions in relation to axial CT slices and 3D-CT bone images.

  16. 3D-CT vascular setting protocol using computer graphics for the evaluation of maxillofacial lesions.

    Science.gov (United States)

    Cavalcanti, M G; Ruprecht, A; Vannier, M W

    2001-01-01

    In this paper we present the aspect of a mandibular giant cell granuloma in spiral computed tomography-based three-dimensional (3D-CT) reconstructed images using computer graphics, and demonstrate the importance of the vascular protocol in permitting better diagnosis, visualization and determination of the dimensions of the lesion. We analyzed 21 patients with maxillofacial lesions of neoplastic and proliferative origins. Two oral and maxillofacial radiologists analyzed the images. The usefulness of interactive 3D images reconstructed by means of computer graphics, especially using a vascular setting protocol for qualitative and quantitative analyses for the diagnosis, determination of the extent of lesions, treatment planning and follow-up, was demonstrated. The technique is an important adjunct to the evaluation of lesions in relation to axial CT slices and 3D-CT bone images.

  17. Structural changes in the German pharmaceutical market: price setting mechanisms based on the early benefit evaluation.

    Science.gov (United States)

    Henschke, Cornelia; Sundmacher, Leonie; Busse, Reinhard

    2013-03-01

    In the past, free price setting mechanisms in Germany led to high prices of patented pharmaceuticals and to increasing expenditures in the pharmaceutical sector. In order to control patented pharmaceutical prices and to curb increasing pharmaceutical spending, the Act for Restructuring the Pharmaceutical Market in Statutory Health Insurance (AMNOG) came into effect on 1st January 2011. In a structured dossier, pharmaceutical manufacturers have to demonstrate the additional therapeutic benefit of the newly approved pharmaceutical compared to its appropriate comparator. According to the level of additional benefit, pharmaceuticals will be subject to price negotiations between the Federal Association of Statutory Health Insurance Funds and the pharmaceutical company concerned (or assigned to a reference price group in case of no additional benefit). Therefore, the health care reform is a first step to decision making based on "value for money". The process of price setting based on early benefit evaluation has an impact on the German as well as the European pharmaceutical markets. Therefore, these structural changes in Germany are of importance for pricing decisions in many European countries both from a political point of view and for strategic planning for pharmaceutical manufacturers, which may have an effect on insured patients' access to pharmaceuticals. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Overall strategy for risk evaluation and priority setting of risk regulations

    International Nuclear Information System (INIS)

    Hokstad, Per; Steiro, Trygve

    2006-01-01

    This paper presents the framework of an approach to support planning and priority setting for risk control. Such an approach could assist government/regulatory authorities in their allocation of resources among different sectors. The term risk will here be used in a very wide sense, and it will include, but not restrict to, the traditional HES (Health, Environment and Safety) concept. An overall classification of risk ('loss categories'), to be used across sectors and directorates is suggested. The risk evaluation includes a number of factors not accounted for in a standard risk assessment, but should be taken into account when authorities set priorities regarding risk control. Sociological, psychological and ethical perspectives are included, and the need for a discourse during the decision process is pinpointed. The paper also discusses the potential inclusion of cost benefit analyses in such an approach. The indicated approach is denoted Risk Across Sectors (RAS), and suggestions regarding the process to implement it are given. Such an implementation process will by itself increase the knowledge and competence of the involved parties

  19. Set up of analytical methods for evaluation of specifications of recombinant Hepatitis-B vaccine

    Directory of Open Access Journals (Sweden)

    Daram M

    2009-06-01

    Full Text Available "nBackground: Hepatitis B vaccination has been included in routine immunization of all individuals according to WHO recommendations since 1991. Despite successful coverage, 3-5% of recipients fail to mount a desirable protection level of Ab. Vaccine failure results from: emergence of mutation, immune failure of individuals, decrease in vaccine potency, and etc. The quality of Hepatitis B vaccine should be evaluated by a reliable method. "n"nMethods: The amount of vaccine antigen was measured through the in vitro assay of Hepatitis B vaccines which consists of multiple dilutions of the reference material and samples. The preparations were evaluated by Elisa to determine the amount of HBsAg. The data were analyzed by parallel-line analysis software. The in vivo assay was performed by inoculating multiple doses of the reference and sample preparations in Balb/c mice. A control group was also inoculated with vaccine matrix. Four weeks later, the mice sera were evaluated to determine the presence of antibodies against Hepatitis B by Elisa method. The data were analyzed by Probit analysis software. "n"nResults: Both methods were set up in our laboratory by which different batches of Hepatitis B vaccine were evaluated. It was observed that In vivo and In vitro methods provide comparable results. Therefore we can use the in vitro method for routine testing of HB vaccine quality control. "n"nConclusion: In vitro method can be used in place of In vivo method because of its time and cost-effectiveness. Moreover, since no animals are used in in vitro method, it complies well with the 3R concept (Reduction, Refinement, and Replacement of animal testing and the current tendency to use alternative method.

  20. Evaluating Fast Maximum Likelihood-Based Phylogenetic Programs Using Empirical Phylogenomic Data Sets

    Science.gov (United States)

    Zhou, Xiaofan; Shen, Xing-Xing; Hittinger, Chris Todd

    2018-01-01

    Abstract The sizes of the data matrices assembled to resolve branches of the tree of life have increased dramatically, motivating the development of programs for fast, yet accurate, inference. For example, several different fast programs have been developed in the very popular maximum likelihood framework, including RAxML/ExaML, PhyML, IQ-TREE, and FastTree. Although these programs are widely used, a systematic evaluation and comparison of their performance using empirical genome-scale data matrices has so far been lacking. To address this question, we evaluated these four programs on 19 empirical phylogenomic data sets with hundreds to thousands of genes and up to 200 taxa with respect to likelihood maximization, tree topology, and computational speed. For single-gene tree inference, we found that the more exhaustive and slower strategies (ten searches per alignment) outperformed faster strategies (one tree search per alignment) using RAxML, PhyML, or IQ-TREE. Interestingly, single-gene trees inferred by the three programs yielded comparable coalescent-based species tree estimations. For concatenation-based species tree inference, IQ-TREE consistently achieved the best-observed likelihoods for all data sets, and RAxML/ExaML was a close second. In contrast, PhyML often failed to complete concatenation-based analyses, whereas FastTree was the fastest but generated lower likelihood values and more dissimilar tree topologies in both types of analyses. Finally, data matrix properties, such as the number of taxa and the strength of phylogenetic signal, sometimes substantially influenced the programs’ relative performance. Our results provide real-world gene and species tree phylogenetic inference benchmarks to inform the design and execution of large-scale phylogenomic data analyses. PMID:29177474

  1. Improved diagnostic accuracy of Alzheimer's disease by combining regional cortical thickness and default mode network functional connectivity: Validated in the Alzheimer's disease neuroimaging initiative set

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Eun; Park, Bum Woo; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Jung; Oh, Joo Young; Shim, Woo Hyun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, Jae Hong; Roh, Jee Hoon [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-11-15

    To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal (p < 0.001) and supramarginal gyrus (p = 0.007) of the left cerebral hemisphere. Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease.

  2. Participatory Planning, Monitoring and Evaluation of Multi-Stakeholder Platforms in Integrated Landscape Initiatives.

    Science.gov (United States)

    Kusters, Koen; Buck, Louise; de Graaf, Maartje; Minang, Peter; van Oosten, Cora; Zagt, Roderick

    2017-03-21

    Integrated landscape initiatives typically aim to strengthen landscape governance by developing and facilitating multi-stakeholder platforms. These are institutional coordination mechanisms that enable discussions, negotiations, and joint planning between stakeholders from various sectors in a given landscape. Multi-stakeholder platforms tend to involve complex processes with diverse actors, whose objectives and focus may be subjected to periodic re-evaluation, revision or reform. In this article we propose a participatory method to aid planning, monitoring, and evaluation of such platforms, and we report on experiences from piloting the method in Ghana and Indonesia. The method is comprised of three components. The first can be used to look ahead, identifying priorities for future multi-stakeholder collaboration in the landscape. It is based on the identification of four aspirations that are common across multi-stakeholder platforms in integrated landscape initiatives. The second can be used to look inward. It focuses on the processes within an existing multi-stakeholder platform in order to identify areas for possible improvement. The third can be used to look back, identifying the main outcomes of an existing platform and comparing them to the original objectives. The three components can be implemented together or separately. They can be used to inform planning and adaptive management of the platform, as well as to demonstrate performance and inform the design of new interventions.

  3. Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.

    Science.gov (United States)

    Gros, Daniel F

    2014-12-15

    Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n=15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n=29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders. Published by Elsevier Ireland Ltd.

  4. Online support and education for dementia caregivers: overview, utilization, and initial program evaluation.

    Science.gov (United States)

    Glueckauf, Robert L; Ketterson, Timothy U; Loomis, Jeffrey S; Dages, Pat

    2004-01-01

    Family caregivers of older adults with progressive dementia (e.g., Alzheimer's disease) are confronted with a variety of challenges in providing assistance to their loved ones, such as dealing with persistent, repetitive questions, managing episodes of agitation and aggressive responding, as well as monitoring hygiene and self-care activities. Although professional and governmental organizations have called for the creation of community-based education and support programs, a significant proportion of dementia caregivers in the United States continue to receive little or no formal instruction in responding effectively to these anxiety-provoking situations. This paper describes the development and implementation of Alzheimer's Caregiver Support Online (also known as AlzOnline), an Internet- and telephone-based education and support network for caregivers of individuals with progressive dementia. An outcome analysis of a Robert Wood Johnson Foundation-funded strategic marketing initiative to promote the use of AlzOnline is reviewed, followed by a presentation of the findings of an initial program evaluation. Finally, future directions for online caregiver evaluation research are proposed.

  5. Psychometric evaluation and design of patient-centered communication measures for cancer care settings.

    Science.gov (United States)

    Reeve, Bryce B; Thissen, David M; Bann, Carla M; Mack, Nicole; Treiman, Katherine; Sanoff, Hanna K; Roach, Nancy; Magnus, Brooke E; He, Jason; Wagner, Laura K; Moultrie, Rebecca; Jackson, Kathryn D; Mann, Courtney; McCormack, Lauren A

    2017-07-01

    To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC). Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty. For each Function we conducted factor analyses, item response theory modeling, and tests for differential item functioning, and assessed reliability and construct validity. Participants included 501 respondents; 46% had a high school education or less. Reliability within each Function ranged from 0.90 to 0.96. The PCC-Ca-36 (36-question survey; reliability=0.94) and PCC-Ca-6 (6-question survey; reliability=0.92) measures differentiated between individuals with poor and good health (i.e., known-groups validity) and were highly correlated with the HINTS communication scale (i.e., convergent validity). This study provides theory-grounded PCC measures found to be reliable and valid in colorectal cancer patients in North Carolina. Future work should evaluate measure validity over time and in other cancer populations. The PCC-Ca-36 and PCC-Ca-6 measures may be used for surveillance, intervention research, and quality improvement initiatives. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Setting priorities for zinc-related health research to reduce children's disease burden worldwide: an application of the Child Health and Nutrition Research Initiative's research priority-setting method.

    Science.gov (United States)

    Brown, Kenneth H; Hess, Sonja Y; Boy, Erick; Gibson, Rosalind S; Horton, Susan; Osendarp, Saskia J; Sempertegui, Fernando; Shrimpton, Roger; Rudan, Igor

    2009-03-01

    To make the best use of limited resources for supporting health-related research to reduce child mortality, it is necessary to apply a suitable method to rank competing research options. The Child Health and Nutrition Research Initiative (CHNRI) developed a new methodology for setting health research priorities. To broaden experience with this priority-setting technique, we applied the method to rank possible research priorities concerning the control of Zn deficiency. Although Zn deficiency is not generally recognized as a direct cause of child mortality, recent research indicates that it predisposes children to an increased incidence and severity of several of the major direct causes of morbidity and mortality. Leading experts in the field of Zn research in child health were identified and invited to participate in a technical working group (TWG) to establish research priorities. The individuals were chosen to represent a wide range of expertise in Zn nutrition. The seven TWG members submitted a total of ninety research options, which were then consolidated into a final list of thirty-one research options categorized by the type of resulting intervention. The identified priorities were dominated by research investment options targeting Zn supplementation, and were followed by research on Zn fortification, general aspects of Zn nutrition, dietary modification and other new interventions. In general, research options that aim to improve the efficiency of an already existing intervention strategy received higher priority scores. Challenges identified during the implementation of the methodology and suggestions to modify the priority-setting procedures are discussed.

  7. How to evaluate network initiatives in urban planning - studying area based initiatives (Kvarterløft) in Denmark"

    DEFF Research Database (Denmark)

    Agger, Annika

    This article presents a theoretical and empirical contribution to the discussions of more inclusive and participatory modes of governing that are taking place in many western countries. It develops a critical evaluation framework for assessing the qualities and outcomes of citizens participating ...... planning process in a urban environment in Denmark that focus on improving deprived urban neighbourhoods by mobilising networks....... in collaborative planning processes. This is done by introducing the concepts of institutional capacity and empowerment that derives from different fields of literature, but that covers different perspectives when assessing citizen participation. Some of the central questions raised in the article are: What...

  8. The challenges and opportunities of conducting a clinical trial in a low resource setting: The case of the Cameroon mobile phone SMS (CAMPS trial, an investigator initiated trial

    Directory of Open Access Journals (Sweden)

    Ongolo-Zogo Pierre

    2011-06-01

    Full Text Available Abstract Conducting clinical trials in developing countries often presents significant ethical, organisational, cultural and infrastructural challenges to researchers, pharmaceutical companies, sponsors and regulatory bodies. Globally, these regions are under-represented in research, yet this population stands to gain more from research in these settings as the burdens on health are greater than those in developed resourceful countries. However, developing countries also offer an attractive setting for clinical trials because they often have larger treatment naive populations with higher incidence rates of disease and more advanced stages. These factors can present a reduction in costs and time required to recruit patients. So, balance needs to be found where research can be encouraged and supported in order to bring maximum public health benefits to these communities. The difficulties with such trials arise from problems with obtaining valid informed consent, ethical compensation mechanisms for extremely poor populations, poor health infrastructure and considerable socio-economic and cultural divides. Ethical concerns with trials in developing countries have received attention, even though many other non-ethical issues may arise. Local investigator initiated trials also face a variety of difficulties that have not been adequately reported in literature. This paper uses the example of the Cameroon Mobile Phone SMS trial to describe in detail, the specific difficulties encountered in an investigator-initiated trial in a developing country. It highlights administrative, ethical, financial and staff related issues, proposes solutions and gives a list of additional documentation to ease the organisational process.

  9. The challenges and opportunities of conducting a clinical trial in a low resource setting: the case of the Cameroon mobile phone SMS (CAMPS) trial, an investigator initiated trial.

    Science.gov (United States)

    Mbuagbaw, Lawrence; Thabane, Lehana; Ongolo-Zogo, Pierre; Lang, Trudie

    2011-06-09

    Conducting clinical trials in developing countries often presents significant ethical, organisational, cultural and infrastructural challenges to researchers, pharmaceutical companies, sponsors and regulatory bodies. Globally, these regions are under-represented in research, yet this population stands to gain more from research in these settings as the burdens on health are greater than those in developed resourceful countries. However, developing countries also offer an attractive setting for clinical trials because they often have larger treatment naive populations with higher incidence rates of disease and more advanced stages. These factors can present a reduction in costs and time required to recruit patients. So, balance needs to be found where research can be encouraged and supported in order to bring maximum public health benefits to these communities. The difficulties with such trials arise from problems with obtaining valid informed consent, ethical compensation mechanisms for extremely poor populations, poor health infrastructure and considerable socio-economic and cultural divides. Ethical concerns with trials in developing countries have received attention, even though many other non-ethical issues may arise. Local investigator initiated trials also face a variety of difficulties that have not been adequately reported in literature. This paper uses the example of the Cameroon Mobile Phone SMS trial to describe in detail, the specific difficulties encountered in an investigator-initiated trial in a developing country. It highlights administrative, ethical, financial and staff related issues, proposes solutions and gives a list of additional documentation to ease the organisational process.

  10. The accuracy of SST retrievals from AATSR: An initial assessment through geophysical validation against in situ radiometers, buoys and other SST data sets

    Science.gov (United States)

    Corlett, G. K.; Barton, I. J.; Donlon, C. J.; Edwards, M. C.; Good, S. A.; Horrocks, L. A.; Llewellyn-Jones, D. T.; Merchant, C. J.; Minnett, P. J.; Nightingale, T. J.; Noyes, E. J.; O'Carroll, A. G.; Remedios, J. J.; Robinson, I. S.; Saunders, R. W.; Watts, J. G.

    The Advanced Along-Track Scanning Radiometer (AATSR) was launched on Envisat in March 2002. The AATSR instrument is designed to retrieve precise and accurate global sea surface temperature (SST) that, combined with the large data set collected from its predecessors, ATSR and ATSR-2, will provide a long term record of SST data that is greater than 15 years. This record can be used for independent monitoring and detection of climate change. The AATSR validation programme has successfully completed its initial phase. The programme involves validation of the AATSR derived SST values using in situ radiometers, in situ buoys and global SST fields from other data sets. The results of the initial programme presented here will demonstrate that the AATSR instrument is currently close to meeting its scientific objectives of determining global SST to an accuracy of 0.3 K (one sigma). For night time data, the analysis gives a warm bias of between +0.04 K (0.28 K) for buoys to +0.06 K (0.20 K) for radiometers, with slightly higher errors observed for day time data, showing warm biases of between +0.02 (0.39 K) for buoys to +0.11 K (0.33 K) for radiometers. They show that the ATSR series of instruments continues to be the world leader in delivering accurate space-based observations of SST, which is a key climate parameter.

  11. The WACMOS-ET project – Part 2: Evaluation of global terrestrial evaporation data sets

    KAUST Repository

    Miralles, D. G.; Jimé nez, C.; Jung, M.; Michel, D.; Ershadi, Ali; McCabe, Matthew; Hirschi, M.; Martens, B.; Dolman, A. J.; Fisher, J. B.; Mu, Q.; Seneviratne, S. I.; Wood, E. F.; Fernaì ndez-Prieto, D.

    2015-01-01

    The WAter Cycle Multi-mission Observation Strategy – EvapoTranspiration (WACMOS-ET) project aims to advance the development of land evaporation estimates on global and regional scales. Its main objective is the derivation, validation, and intercomparison of a group of existing evaporation retrieval algorithms driven by a common forcing data set. Three commonly used process-based evaporation methodologies are evaluated: the Penman–Monteith algorithm behind the official Moderate Resolution Imaging Spectroradiometer (MODIS) evaporation product (PM-MOD), the Global Land Evaporation Amsterdam Model (GLEAM), and the Priestley–Taylor Jet Propulsion Laboratory model (PT-JPL). The resulting global spatiotemporal variability of evaporation, the closure of regional water budgets, and the discrete estimation of land evaporation components or sources (i.e. transpiration, interception loss, and direct soil evaporation) are investigated using river discharge data, independent global evaporation data sets and results from previous studies. In a companion article (Part 1), Michel et al. (2016) inspect the performance of these three models at local scales using measurements from eddy-covariance towers and include in the assessment the Surface Energy Balance System (SEBS) model. In agreement with Part 1, our results indicate that the Priestley and Taylor products (PT-JPL and GLEAM) perform best overall for most ecosystems and climate regimes. While all three evaporation products adequately represent the expected average geographical patterns and seasonality, there is a tendency in PM-MOD to underestimate the flux in the tropics and subtropics. Overall, results from GLEAM and PT-JPL appear more realistic when compared to surface water balances from 837 globally distributed catchments and to separate evaporation estimates from ERAInterim and the model tree ensemble (MTE). Nonetheless, all products show large dissimilarities during conditions of water stress and drought and

  12. The WACMOS-ET project – Part 2: Evaluation of global terrestrial evaporation data sets

    KAUST Repository

    Miralles, D. G.

    2015-10-19

    The WAter Cycle Multi-mission Observation Strategy – EvapoTranspiration (WACMOS-ET) project aims to advance the development of land evaporation estimates on global and regional scales. Its main objective is the derivation, validation, and intercomparison of a group of existing evaporation retrieval algorithms driven by a common forcing data set. Three commonly used process-based evaporation methodologies are evaluated: the Penman–Monteith algorithm behind the official Moderate Resolution Imaging Spectroradiometer (MODIS) evaporation product (PM-MOD), the Global Land Evaporation Amsterdam Model (GLEAM), and the Priestley–Taylor Jet Propulsion Laboratory model (PT-JPL). The resulting global spatiotemporal variability of evaporation, the closure of regional water budgets, and the discrete estimation of land evaporation components or sources (i.e. transpiration, interception loss, and direct soil evaporation) are investigated using river discharge data, independent global evaporation data sets and results from previous studies. In a companion article (Part 1), Michel et al. (2016) inspect the performance of these three models at local scales using measurements from eddy-covariance towers and include in the assessment the Surface Energy Balance System (SEBS) model. In agreement with Part 1, our results indicate that the Priestley and Taylor products (PT-JPL and GLEAM) perform best overall for most ecosystems and climate regimes. While all three evaporation products adequately represent the expected average geographical patterns and seasonality, there is a tendency in PM-MOD to underestimate the flux in the tropics and subtropics. Overall, results from GLEAM and PT-JPL appear more realistic when compared to surface water balances from 837 globally distributed catchments and to separate evaporation estimates from ERAInterim and the model tree ensemble (MTE). Nonetheless, all products show large dissimilarities during conditions of water stress and drought and

  13. Ingroup/Outgroup Attitudes and Group Evaluations: The Role of Competition in British Classroom Settings

    Directory of Open Access Journals (Sweden)

    Virginia L. Lam

    2016-01-01

    Full Text Available Children’s intergroup bias is one of the consequences of their readiness to categorise people into ingroups and outgroups, even when groups are assigned arbitrarily. The present study examined the influence of intergroup competition on children’s ingroup and outgroup attitudes developed within the minimal-group setting in British classrooms. One hundred and twelve children in two age groups (6-7- and 9-10-year-olds were assessed on classification skills and self-esteem before being allocated to one of two colour “teams.” In the experimental condition, children were told that the teams would have a competition after two weeks and teachers made regular use of these teams to organise activities. In the control condition, where no competition ensued, teachers did not refer to “teams.” Then children completed trait attributions to their own-team (ingroup and other-team (outgroup members and group evaluations. It was found that children developed positive ingroup bias across conditions, but outgroup negative bias was shown only by 6-7-year-olds in the experimental condition, particularly if they lost the competition, where they evaluated their team more critically. Better classification skills were associated with less negativity towards the outgroup in the experimental condition. Findings are discussed in relation to relevant theoretical premises and particulars of the intergroup context.

  14. An evaluation of patient safety culture in a secondary care setting in Kuwait

    Directory of Open Access Journals (Sweden)

    Hamad Alqattan, MPH

    2018-06-01

    لمرضى. الاستنتاجات: أظهرت هذه الدراسة أن سلامة المرضى ينظر إليها بشكل مختلف بين الطاقم الطبي من مختلف بلدان المنشأ، والمجموعات المهنية، والفئات العمرية. يجب الإقرار بهذه المتغيرات ومعالجتها عند تخطيط وتقييم مبادرات سلامة المرضى. Abstract: Objectives: To improve patient safety outcomes, it is considered essential to create a positive culture of patient safety. This study carried out an initial evaluation of the patient safety culture in a secondary care setting in Kuwait. Methods: This cross-sectional questionnaire study was conducted in a general hospital medical department in Kuwait, using the Hospital Survey on Patient Safety Culture (HSPSC. Multiple linear regression analyses were used to identify patient safety culture predictors. Both an ANOVA and a Kruskal Wallis test were carried out to assess the differences between participants' total scores and the scores they achieved in each dimension, categorized by nationality. Results: A total of 1008 completed questionnaires were received, yielding a response rate of 75.2%. Three dimensions of patient safety culture were found to be priority areas for improvement: non-punitive responses to errors, staffing, and communication openness. Teamwork within units and organizational learning with continuous improvement were identified as areas of strength. Respondents from Kuwait and the Gulf State countries had a less positive perception of the hospital's patient safety culture than did Asian respondents. A regression analysis showed that the respondents' countries of origin, professions, age, and patient safety course/lecture attendance were significantly correlated with their perceptions of the hospital's patient safety culture. Conclusion: This study demonstrates that patient safety is perceived differently by medical staff members from

  15. Initial evaluation of the radioecological situation at the Semipalatinsk Test Site in the Republic of Kazakhstan

    Energy Technology Data Exchange (ETDEWEB)

    Voigt, G.; Semiochkina, N. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany). Inst. fuer Strahlenschutz

    1998-12-31

    The Semipalatinsk Test Site (STS) located in the Republic of Kazakhstan (Figure 1.1) was one of the major nuclear weapon test sites of the former Soviet Union. At the site, four hundred fifty six nuclear explosions took place between 1949 and 1989 within the STS (Mikhailov et al. 1996; Dubasov et al. 1994a), resulting in radioactive contamination both within and around the STS. Incidences of radiation related illnesses in such areas may be higher than normal levels (Burkhart 1996). Published estimates of the resulting dose to the public vary according to the source, but an independent study (Grosche 1996) indicated that as many as 30,000-40,000 people could have been exposed to an average dose of 1.6 Sv (160 rem) or more (mainly due to short-lived radionuclides such as {sup 131}I). A detailed international assessment of the impact of these tests on the local population has not yet been undertaken. A current investigation under the acronym, RADTEST, includes an evaluation of Semipalatinsk as part of a broad review of internal and external doses to people arising from nuclear tests at many different sites in the world. In the context of the European Commission funded project RESTORE (Restoration Strategy for Radioactive Contaminated Ecosystems) an attempt is being made to assess the present radiolecological situation in the STS. This initial report collates currently available data published in Russian-language literature and internal CIS reports, reports from Europe and the USA, and other international literature. In this initial evaluation, only an overview of published data made available to the RESTORE project is provided and briefly discussed. In addition, further assessments including experimental work are suggested. Additional sources of data will be pursued and will be integrated with experimental results in the final evaluation report. (orig.)

  16. Initial evaluation of the radioecological situation at the Semipalatinsk Test Site in the Republic of Kazakhstan

    International Nuclear Information System (INIS)

    Voigt, G.; Semiochkina, N.

    1998-01-01

    The Semipalatinsk Test Site (STS) located in the Republic of Kazakhstan (Figure 1.1) was one of the major nuclear weapon test sites of the former Soviet Union. At the site, four hundred fifty six nuclear explosions took place between 1949 and 1989 within the STS (Mikhailov et al. 1996; Dubasov et al. 1994a), resulting in radioactive contamination both within and around the STS. Incidences of radiation related illnesses in such areas may be higher than normal levels (Burkhart 1996). Published estimates of the resulting dose to the public vary according to the source, but an independent study (Grosche 1996) indicated that as many as 30,000-40,000 people could have been exposed to an average dose of 1.6 Sv (160 rem) or more (mainly due to short-lived radionuclides such as 131 I). A detailed international assessment of the impact of these tests on the local population has not yet been undertaken. A current investigation under the acronym, RADTEST, includes an evaluation of Semipalatinsk as part of a broad review of internal and external doses to people arising from nuclear tests at many different sites in the world. In the context of the European Commission funded project RESTORE (Restoration Strategy for Radioactive Contaminated Ecosystems) an attempt is being made to assess the present radiolecological situation in the STS. This initial report collates currently available data published in Russian-language literature and internal CIS reports, reports from Europe and the USA, and other international literature. In this initial evaluation, only an overview of published data made available to the RESTORE project is provided and briefly discussed. In addition, further assessments including experimental work are suggested. Additional sources of data will be pursued and will be integrated with experimental results in the final evaluation report. (orig.)

  17. African Swine Fever in Uganda: Qualitative Evaluation of Three Surveillance Methods with Implications for Other Resource-Poor Settings.

    Science.gov (United States)

    Chenais, Erika; Sternberg-Lewerin, Susanna; Boqvist, Sofia; Emanuelson, Ulf; Aliro, Tonny; Tejler, Emma; Cocca, Giampaolo; Masembe, Charles; Ståhl, Karl

    2015-01-01

    Animal diseases impact negatively on households and on national economies. In low-income countries, this pertains especially to socio-economic effects on household level. To control animal diseases and mitigate their impact, it is necessary to understand the epidemiology of the disease in its local context. Such understanding, gained through disease surveillance, is often lacking in resource-poor settings. Alternative surveillance methods have been developed to overcome some of the hurdles obstructing surveillance. The objective of this study was to evaluate and qualitatively compare three methods for surveillance of acute infectious diseases using African swine fever in northern Uganda as an example. Report-driven outbreak investigations, participatory rural appraisals (PRAs), and a household survey using a smartphone application were evaluated. All three methods had good disease-detecting capacity, and each of them detected many more outbreaks compared to those reported to the World Organization for Animal Health during the same time period. Apparent mortality rates were similar for the three methods although highest for the report-driven outbreak investigations, followed by the PRAs, and then the household survey. The three methods have different characteristics and the method of choice will depend on the surveillance objective. The optimal situation might be achieved by a combination of the methods: outbreak detection via smartphone-based real-time surveillance, outbreak investigation for collection of biological samples, and a PRA for a better understanding of the epidemiology of the specific outbreak. All three methods require initial investments and continuous efforts. The sustainability of the surveillance system should, therefore, be carefully evaluated before making such investments.

  18. African swine fever in Uganda: qualitative evaluation of three surveillance methods with implications for other resource-poor settings

    Directory of Open Access Journals (Sweden)

    Erika eChenais

    2015-10-01

    Full Text Available Animal diseases impact negatively on households and on national economies. In low-income countries this pertains especially to socio-economic effects on household level. To control animal diseases and mitigate their impact, it is necessary to understand the epidemiology of the disease in its local context. Such understanding, gained through disease surveillance, is often lacking in resource-poor settings. Alternative surveillance methods have been developed to overcome some of the hurdles obstructing surveillance. The objective of this study was to evaluate and qualitatively compare three methods for surveillance of acute infectious diseases using African swine fever (ASF in northern Uganda as an example. Report-driven outbreak investigations, participatory rural appraisals (PRA, and a household survey using a smartphone application were evaluated. All three methods had good disease-detecting capacity, each of them detected many more outbreaks compared to those reported to the World Organization for Animal Health (OIE during the same time period. Apparent mortality rates were similar for the three methods although highest for the report-driven outbreak investigations, followed by the PRAs, and then the household survey. The three methods have different characteristics and the method of choice will depend on the surveillance objective. The optimal situation might be achieved by a combination of the methods: outbreak detection via smartphone-based real-time surveillance, outbreak investigation for collection of biological samples, and a PRA for a better understanding of the epidemiology of the specific outbreak. All three methods require initial investments and continuous efforts. The sustainability of the surveillance system should therefore be carefully evaluated before making such investments.

  19. Validation and evaluation of common large-area display set (CLADS) performance specification

    Science.gov (United States)

    Hermann, David J.; Gorenflo, Ronald L.

    1998-09-01

    Battelle is under contract with Warner Robins Air Logistics Center to design a Common Large Area Display Set (CLADS) for use in multiple Command, Control, Communications, Computers, and Intelligence (C4I) applications that currently use 19- inch Cathode Ray Tubes (CRTs). Battelle engineers have built and fully tested pre-production prototypes of the CLADS design for AWACS, and are completing pre-production prototype displays for three other platforms simultaneously. With the CLADS design, any display technology that can be packaged to meet the form, fit, and function requirements defined by the Common Large Area Display Head Assembly (CLADHA) performance specification is a candidate for CLADS applications. This technology independent feature reduced the risk of CLADS development, permits life long technology insertion upgrades without unnecessary redesign, and addresses many of the obsolescence problems associated with COTS technology-based acquisition. Performance and environmental testing were performed on the AWACS CLADS and continues on other platforms as a part of the performance specification validation process. A simulator assessment and flight assessment were successfully completed for the AWACS CLADS, and lessons learned from these assessments are being incorporated into the performance specifications. Draft CLADS specifications were released to potential display integrators and manufacturers for review in 1997, and the final version of the performance specifications are scheduled to be released to display integrators and manufacturers in May, 1998. Initial USAF applications include replacements for the E-3 AWACS color monitor assembly, E-8 Joint STARS graphics display unit, and ABCCC airborne color display. Initial U.S. Navy applications include the E-2C ACIS display. For these applications, reliability and maintainability are key objectives. The common design will reduce the cost of operation and maintenance by an estimated 3.3M per year on E-3 AWACS

  20. Evaluation of errors set-up and setting margins calculation in treatments 3-D conformal radiotherapy; Evaluacion de errores de set-up y calculo de margenes de configuracion en tratamientos de radioterapia CONFORMADA 3-D

    Energy Technology Data Exchange (ETDEWEB)

    Donis, S.; Robayna, B.; Gonzalez, A.; Hernandez Armas, J.

    2011-07-01

    The use of IGRT techniques provide knowledge of the mistakes made in the positioning of a patient, to population studies and estimate the margins for each population.In this paper we evaluate the errors of set-up in 3 different locations and from these margins are calculated configuration (SM).

  1. Development and initial psychometric evaluation of patient-reported outcome questionnaires to evaluate the symptoms and impact of hidradenitis suppurativa.

    Science.gov (United States)

    Kimball, Alexa B; Sundaram, Murali; Banderas, Benjamin; Foley, Catherine; Shields, Alan L

    2018-03-01

    Two patient-reported outcome (PRO) questionnaires, the Hidradenitis Suppurativa Symptom Assessment (HSSA) and Hidradenitis Suppurativa Impact Assessment (HSIA), were developed to measure signs, symptoms and impacts of HS in treatment efficacy studies. In accordance with FDA guidelines and published best practices, four stages of research were conducted to create the questionnaires: concept elicitation, questionnaire construction, content evaluation and psychometric evaluation. Subjects (N = 20) who participated in the concept elicitation stage reported 15 unique HS-related signs and symptoms and 51 impacts. Following this, eight sign and symptom concepts and 21 impacts were selected for construction of the HSSA and HSIA, respectively. During content evaluation, cognitive debriefing interviews with HS subjects (N = 20) confirmed subjects could read, comprehend and meaningfully respond to both questionnaires. Modifications made after this stage of work resulted in a nine-item HSSA and a 17-item HSIA. The HSSA and HSIA were subsequently entered into a US-based observational study (N = 40), and the scores produced by each were found to be reliable, construct valid, and able to distinguish among clinically distinct groups. The HSSA and HSIA are content-valid, HS-specific, PRO questionnaires with demonstrated ability to generate reliable, valid scores when administered to patients with HS in a research setting.

  2. A core outcome set for studies evaluating the effectiveness of prepregnancy care for women with pregestational diabetes.

    LENUS (Irish Health Repository)

    Egan, Aoife M

    2017-04-01

    The aim of this study was to develop a core outcome set (COS) for trials and other studies evaluating the effectiveness of prepregnancy care for women with pregestational (pre-existing) diabetes mellitus.

  3. Quantitative evaluation of ozone and selected climate parameters in a set of EMAC simulations

    Directory of Open Access Journals (Sweden)

    M. Righi

    2015-03-01

    Full Text Available Four simulations with the ECHAM/MESSy Atmospheric Chemistry (EMAC model have been evaluated with the Earth System Model Validation Tool (ESMValTool to identify differences in simulated ozone and selected climate parameters that resulted from (i different setups of the EMAC model (nudged vs. free-running and (ii different boundary conditions (emissions, sea surface temperatures (SSTs and sea ice concentrations (SICs. To assess the relative performance of the simulations, quantitative performance metrics are calculated consistently for the climate parameters and ozone. This is important for the interpretation of the evaluation results since biases in climate can impact on biases in chemistry and vice versa. The observational data sets used for the evaluation include ozonesonde and aircraft data, meteorological reanalyses and satellite measurements. The results from a previous EMAC evaluation of a model simulation with nudging towards realistic meteorology in the troposphere have been compared to new simulations with different model setups and updated emission data sets in free-running time slice and nudged quasi chemistry-transport model (QCTM mode. The latter two configurations are particularly important for chemistry-climate projections and for the quantification of individual sources (e.g., the transport sector that lead to small chemical perturbations of the climate system, respectively. With the exception of some specific features which are detailed in this study, no large differences that could be related to the different setups (nudged vs. free-running of the EMAC simulations were found, which offers the possibility to evaluate and improve the overall model with the help of shorter nudged simulations. The main differences between the two setups is a better representation of the tropospheric and stratospheric temperature in the nudged simulations, which also better reproduce stratospheric water vapor concentrations, due to the improved

  4. Decreased health care utilization and health care costs in the inpatient and emergency department setting following initiation of ketogenic diet in pediatric patients: The experience in Ontario, Canada.

    Science.gov (United States)

    Whiting, Sharon; Donner, Elizabeth; RamachandranNair, Rajesh; Grabowski, Jennifer; Jetté, Nathalie; Duque, Daniel Rodriguez

    2017-03-01

    To assess the change in inpatient and emergency department utilization and health care costs in children on the ketogenic diet for treatment of epilepsy. Data on children with epilepsy initiated on the ketogenic diet (KD) Jan 1, 2000 and Dec 31, 2010 at Ontario pediatric hospitals were linked to province wide inpatient, emergency department (ED) data at the Institute for Clinical Evaluative Sciences. ED and inpatient visits and costs for this cohort were compared for a maximum of 2 years (730days) prior to diet initiation and for a maximum of 2 years (730days) following diet initiation. KD patient were compared to matched group of children with epilepsy who did not receive the ketogenic diet (no KD). Children on the KD experienced a mean decrease in ED visits of 2.5 visits per person per year [95% CI (1.5-3.4)], and a mean decrease of 0.8 inpatient visits per person per year [95% CI (0.3-1.3)], following diet initiation. They had a mean decrease in ED costs of $630 [95% CI (249-1012)] per person per year and a median decrease in inpatient costs of $1059 [IQR: 7890; pdiet experienced a mean reduction of 2.1 ED visits per child per year [95% CI (1.0-3.2)] and a mean decrease of 0.6 [95% CI (0.1-1.1)] inpatient visits per child per year. Patients on the KD experienced a reduction of $442 [95% CI (34.4-850)] per child per year more in ED costs than the matched group. The ketogenic diet group had greater median decrease in inpatient costs per child per year than the matched group [pketogenic diet, experienced decreased ED and inpatient visits as well as costs following diet initiation in Ontario, Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Development and Evaluation of an Educational Initiative to Improve Hospital Personnel Preparedness to Care for Children with Autism Spectrum Disorder.

    Science.gov (United States)

    Lucarelli, Jennifer; Welchons, Leah; Sideridis, Georgios; Sullivan, Nancy R; Chan, Eugenia; Weissman, Laura

    2018-06-01

    To evaluate the effectiveness of a multimodal educational curriculum on increasing hospital personnel's awareness of successful strategies and comfort in caring for children with autism spectrum disorder (ASD). We developed a 3-part training for front-line staff (i.e., front desk, clinical assistants, and phlebotomists) in 8 outpatient hospital departments frequented by patients with ASD. Following a needs assessment, participants completed an online educational module and then attended an in-person seminar tailored to each department. To evaluate training effectiveness, we administered pre-, immediate post-, and 1 month post-training surveys assessing personnel attitudes, comfort, perceived knowledge, and behaviors around caring for patients with ASD. We trained 168 staff members from 8 departments. On the needs assessment, participants (N = 129) reported a mean 2.5 behavioral incidents involving patients with ASD over the previous 3 months; 92% believed that the training would be helpful for their work. Across pre-, immediate- and 1-month post-training surveys, scores improved on all questions related to personnel attitudes about the importance of ASD-friendly care, comfort interacting with patients with ASD, perceived knowledge about ASD, and self-reported frequency of behaviors intended to help children with ASD adjust to the hospital setting (p initiative led to improvement in attitudes, comfort level, perceived knowledge, and self-reported behaviors of hospital personnel working with patients with ASD, which was maintained over 1 month.

  6. The Veteran-Initiated Electronic Care Coordination: A Multisite Initiative to Promote and Evaluate Consumer-Mediated Health Information Exchange.

    Science.gov (United States)

    Klein, Dawn M; Pham, Kassi; Samy, Leila; Bluth, Adam; Nazi, Kim M; Witry, Matthew; Klutts, J Stacey; Grant, Kathleen M; Gundlapalli, Adi V; Kochersberger, Gary; Pfeiffer, Laurie; Romero, Sergio; Vetter, Brian; Turvey, Carolyn L

    2017-04-01

    Information continuity is critical to person-centered care when patients receive care from multiple healthcare systems. Patients can access their electronic health record data through patient portals to facilitate information exchange. This pilot was developed to improve care continuity for rural Veterans by (1) promoting the use of the Department of Veterans Affairs (VA) patient portal to share health information with non-VA providers, and (2) evaluating the impact of health information sharing at a community appointment. Veterans from nine VA healthcare systems were trained to access and share their VA Continuity of Care Document (CCD) with their non-VA providers. Patients and non-VA providers completed surveys on their experiences. Participants (n = 620) were primarily older, white, and Vietnam era Veterans. After training, 78% reported the CCD would help them be more involved in their healthcare and 86% planned to share it regularly with non-VA providers. Veterans (n = 256) then attended 277 community appointments. Provider responses from these appointments (n = 133) indicated they were confident in the accuracy of the information (97%) and wanted to continue to receive the CCD (96%). Ninety percent of providers reported the CCD improved their ability to have an accurate medication list and helped them make medication treatment decisions. Fifty percent reported they did not order a laboratory test or another procedure because of information available in the CCD. This pilot demonstrates feasibility and value of patient access to a CCD to facilitate information sharing between VA and non-VA providers. Outreach and targeted education are needed to promote consumer-mediated health information exchange.

  7. Evaluation of three methods for hemoglobin measurement in a blood donor setting

    Directory of Open Access Journals (Sweden)

    Jacob Rosenblit

    1999-05-01

    Full Text Available CONTEXT: The hemoglobin (Hb level is the most-used parameter for screening blood donors for the presence of anemia, one of the most-used methods for measuring Hb levels is based on photometric detection of cyanmetahemoglobin, as an alternative to this technology, HemoCue has developed a photometric method based on the determination of azide metahemoglobin. OBJECTIVE: To evaluate the performance of three methods for hemoglobin (Hb determination in a blood bank setting. DESIGN: Prospective study utilizing blood samples to compare methods for Hb determination. SETTING: Hemotherapy Service of the Hospital Israelita Albert Einstein, a private institution in the tertiary health care system. SAMPLE: Serial blood samples were collected from 259 individuals during the period from March to June 1996. MAIN MEASUREMENTS: Test performances and their comparisons were assessed by the analysis of coefficients of variation (CV, linear regression and mean differences. RESULTS: The CV for the three methods were: Coulter 0.68%, Cobas 0.82% and HemoCue 0.69%. There was no difference between the mean Hb determination for the three methods (p>0.05. The Coulter and Cobas methods showed the best agreement and the HemoCue method gave a lower Hb determination when compared to both the Coulter and Cobas methods. However, pairs of methods involving the HemoCue seem to have narrower limits of agreement (± 0.78 and ± 1.02 than the Coulter and Cobas combination (± 1.13. CONCLUSION: The three methods provide good agreement for hemoglobin determination.

  8. Developing an objective evaluation method to estimate diabetes risk in community-based settings.

    Science.gov (United States)

    Kenya, Sonjia; He, Qing; Fullilove, Robert; Kotler, Donald P

    2011-05-01

    Exercise interventions often aim to affect abdominal obesity and glucose tolerance, two significant risk factors for type 2 diabetes. Because of limited financial and clinical resources in community and university-based environments, intervention effects are often measured with interviews or questionnaires and correlated with weight loss or body fat indicated by body bioimpedence analysis (BIA). However, self-reported assessments are subject to high levels of bias and low levels of reliability. Because obesity and body fat are correlated with diabetes at different levels in various ethnic groups, data reflecting changes in weight or fat do not necessarily indicate changes in diabetes risk. To determine how exercise interventions affect diabetes risk in community and university-based settings, improved evaluation methods are warranted. We compared a noninvasive, objective measurement technique--regional BIA--with whole-body BIA for its ability to assess abdominal obesity and predict glucose tolerance in 39 women. To determine regional BIA's utility in predicting glucose, we tested the association between the regional BIA method and blood glucose levels. Regional BIA estimates of abdominal fat area were significantly correlated (r = 0.554, P < 0.003) with fasting glucose. When waist circumference and family history of diabetes were added to abdominal fat in multiple regression models, the association with glucose increased further (r = 0.701, P < 0.001). Regional BIA estimates of abdominal fat may predict fasting glucose better than whole-body BIA as well as provide an objective assessment of changes in diabetes risk achieved through physical activity interventions in community settings.

  9. Evaluation of pharmacists' educational and counselling impact on patients' clinical outcomes in a diabetic setting

    Directory of Open Access Journals (Sweden)

    Winifred Aitalegbe Ojieabu

    2017-01-01

    Full Text Available Background: Nigeria had the highest number of people living with diabetes mellitus in the African region in year 2013. Previous researchers have found that patients with knowledge of their diseases including their treatment methods have a high likelihood to succeed in managing the disease conditions. Many pharmaceutical care programmes which have been successfully applied in various countries to enhance clinical outcomes and health-related quality of life are not very common in Nigeria. Objective: This study was to evaluate pharmacist's educational and counselling impact on diabetic patients' outcomes in a diabetic setting. Materials and Methods: The 4-month randomised controlled study involved 150 elderly Type 2 diabetic patients. Sociodemographic and clinical parameters were measured. We educated and counselled the 75 patients in our intervention group at least four times during the study period, but the control group was deprived of the pharmacist's intervention. Results: Female to male participants was in the ratio of 9:6 and 9:5 in both control and intervention groups, respectively. Majority (>40% of the patients in both groups had primary education. Baseline and 4-month mean fasting blood sugar in the control group was 162.2 ± 69.1 and 159.9 ± 57.2, respectively (P = 0.825, whereas the intervention group had 156.7 ± 30.5 and 131.8 ± 40.4, respectively (P < 0.001. Mean systolic blood pressure in both groups was 146.4 ± 13.9 and 133.8 ± 18.5 (P < 0.001, respectively. Adherence levels to medication taking in both groups were 42.7%:94.7%, respectively (P = 0.001. Conclusion: This study encourages the inclusion of clinical pharmacists into multidisciplinary healthcare groups in hospital and clinic settings as well as incorporation of this type of intervention into diabetic management programmes for optimal patients' outcomes.

  10. Which Triple Aim related measures are being used to evaluate population management initiatives? An international comparative analysis.

    Science.gov (United States)

    Hendrikx, Roy J P; Drewes, Hanneke W; Spreeuwenberg, Marieke; Ruwaard, Dirk; Struijs, Jeroen N; Baan, Caroline A

    2016-05-01

    Population management (PM) initiatives are introduced in order to create sustainable health care systems. These initiatives should focus on the continuum of health and well-being of a population by introducing interventions that integrate various services. To be successful they should pursue the Triple Aim, i.e. simultaneously improve population health and quality of care while reducing costs per capita. This study explores how PM initiatives measure the Triple Aim in practice. An exploratory search was combined with expert consultations to identify relevant PM initiatives. These were analyzed based on general characteristics, utilized measures and related selection criteria. In total 865 measures were used by 20 PM initiatives. All quality of care domains were included by at least 11 PM initiatives, while most domains of population health and costs were included by less than 7 PM initiatives. Although their goals showed substantial overlap, the measures applied showed few similarities between PM initiatives and were predominantly selected based on local priority areas and data availability. Most PM initiatives do not measure the full scope of the Triple Aim. Additionally, variety between measures limits comparability between PM initiatives. Consensus on the coverage of Triple Aim domains and a set of standardized measures could further both the inclusion of the various domains as well as the comparability between PM initiatives. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Accuracy evaluation of initialization-free registration for intraoperative 3D-navigation

    International Nuclear Information System (INIS)

    Diakov, Georgi; Freysinger, Wolfgang

    2007-01-01

    Purpose An initialization-free approach for perioperative registration in functional endoscopic sinus surgery (FESS) is sought. The quality of surgical navigation relies on registration accuracy of preoperative images to the patient. Although landmark-based registration is fast, it is prone to human operator errors. This study evaluates the accuracy of two well-known methods for segmentation of the occipital bone from CT-images for use in surgical 3D-navigation. Method The occipital bone was segmented for registration without pre-defined correspondences, with the iterative closest point algorithm (ICP). The thresholding plus marching cubes segmentation (TMCS), and the deformable model segmentation (DMS) were compared quantitatively by overlaying the areas of the segmentations in cross-sectional slices, and visually by displaying the pointwise distances between the segmentations in a three-dimensional distance map relative to an expert manual segmentation, taken as a ''ground truth''. Results Excellent correspondence between the two methods was achieved; the results showed, however, that the TMCS is closer to the ''ground truth''. This is due to the sub-voxel accuracy of the marching cubes algorithm by definition, and the sensitivity of the DMS method to the choice of parameters. The DMS approach, as a gradient-based method, is insensitive to the thresholding initialization. For noisy images and soft tissue delineation a gradient-based method, like the deformable model, performs better. Both methods correspond within minute differences less than 4%. Conclusion These results will allow further minimization of human interaction in the planning phase for intraoperative 3D-navigation, by allowing to automatically create surface patches for registration purposes, ultimately allowing to build an initialization-free, fully automatic registration procedure for navigated Ear-, Nose-, Throat- (ENT) surgery. (orig.)

  12. Design and methods for evaluating an early childhood obesity prevention program in the childcare center setting

    Directory of Open Access Journals (Sweden)

    Natale Ruby

    2013-01-01

    Full Text Available Abstract Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. Methods/design A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present. The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US. The purpose is to test the efficacy of a parent and teacher role-modeling intervention on children’s nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2 intervention arm schools received a combination of (1 implementing a daily curricula for teachers/parents (the nutritional gatekeepers; (2 implementing a daily curricula for children; (3 technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4 creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment

  13. Design and methods for evaluating an early childhood obesity prevention program in the childcare center setting.

    Science.gov (United States)

    Natale, Ruby; Scott, Stephanie Hapeman; Messiah, Sarah E; Schrack, Maria Mesa; Uhlhorn, Susan B; Delamater, Alan

    2013-01-28

    Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present). The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US). The purpose is to test the efficacy of a parent and teacher role-modeling intervention on children's nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2) intervention arm schools received a combination of (1) implementing a daily curricula for teachers/parents (the nutritional gatekeepers); (2) implementing a daily curricula for children; (3) technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4) creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment. Although few attempts have been made to prevent obesity

  14. Evaluation of digital soil mapping approaches with large sets of environmental covariates

    Science.gov (United States)

    Nussbaum, Madlene; Spiess, Kay; Baltensweiler, Andri; Grob, Urs; Keller, Armin; Greiner, Lucie; Schaepman, Michael E.; Papritz, Andreas

    2018-01-01

    The spatial assessment of soil functions requires maps of basic soil properties. Unfortunately, these are either missing for many regions or are not available at the desired spatial resolution or down to the required soil depth. The field-based generation of large soil datasets and conventional soil maps remains costly. Meanwhile, legacy soil data and comprehensive sets of spatial environmental data are available for many regions. Digital soil mapping (DSM) approaches relating soil data (responses) to environmental data (covariates) face the challenge of building statistical models from large sets of covariates originating, for example, from airborne imaging spectroscopy or multi-scale terrain analysis. We evaluated six approaches for DSM in three study regions in Switzerland (Berne, Greifensee, ZH forest) by mapping the effective soil depth available to plants (SD), pH, soil organic matter (SOM), effective cation exchange capacity (ECEC), clay, silt, gravel content and fine fraction bulk density for four soil depths (totalling 48 responses). Models were built from 300-500 environmental covariates by selecting linear models through (1) grouped lasso and (2) an ad hoc stepwise procedure for robust external-drift kriging (georob). For (3) geoadditive models we selected penalized smoothing spline terms by component-wise gradient boosting (geoGAM). We further used two tree-based methods: (4) boosted regression trees (BRTs) and (5) random forest (RF). Lastly, we computed (6) weighted model averages (MAs) from the predictions obtained from methods 1-5. Lasso, georob and geoGAM successfully selected strongly reduced sets of covariates (subsets of 3-6 % of all covariates). Differences in predictive performance, tested on independent validation data, were mostly small and did not reveal a single best method for 48 responses. Nevertheless, RF was often the best among methods 1-5 (28 of 48 responses), but was outcompeted by MA for 14 of these 28 responses. RF tended to over

  15. Road safety risk evaluation and target setting using data envelopment analysis and its extensions.

    Science.gov (United States)

    Shen, Yongjun; Hermans, Elke; Brijs, Tom; Wets, Geert; Vanhoof, Koen

    2012-09-01

    Currently, comparison between countries in terms of their road safety performance is widely conducted in order to better understand one's own safety situation and to learn from those best-performing countries by indicating practical targets and formulating action programmes. In this respect, crash data such as the number of road fatalities and casualties are mostly investigated. However, the absolute numbers are not directly comparable between countries. Therefore, the concept of risk, which is defined as the ratio of road safety outcomes and some measure of exposure (e.g., the population size, the number of registered vehicles, or distance travelled), is often used in the context of benchmarking. Nevertheless, these risk indicators are not consistent in most cases. In other words, countries may have different evaluation results or ranking positions using different exposure information. In this study, data envelopment analysis (DEA) as a performance measurement technique is investigated to provide an overall perspective on a country's road safety situation, and further assess whether the road safety outcomes registered in a country correspond to the numbers that can be expected based on the level of exposure. In doing so, three model extensions are considered, which are the DEA based road safety model (DEA-RS), the cross-efficiency method, and the categorical DEA model. Using the measures of exposure to risk as the model's input and the number of road fatalities as output, an overall road safety efficiency score is computed for the 27 European Union (EU) countries based on the DEA-RS model, and the ranking of countries in accordance with their cross-efficiency scores is evaluated. Furthermore, after applying clustering analysis to group countries with inherent similarity in their practices, the categorical DEA-RS model is adopted to identify best-performing and underperforming countries in each cluster, as well as the reference sets or benchmarks for those

  16. Description and evaluation of an initiative to develop advanced practice nurses in mainland China.

    Science.gov (United States)

    Wong, Frances Kam Yuet; Peng, Gangyi; Kan, Eva C; Li, Yajie; Lau, Ada T; Zhang, Liying; Leung, Annie F; Liu, Xueqin; Leung, Vilna O; Chen, Weiju; Li, Ming

    2010-05-01

    This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004-2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs. Copyright 2009 Elsevier Ltd. All rights reserved.

  17. Accuracy of 16-detector Multislice Spiral Computed Tomography in the initial evaluation of dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Cornily, Jean-Christophe; Gilard, Martine; Le Gal, Gregoire; Pennec, Pierre-Yves; Vinsonneau, Ulric; Blanc, Jean-Jacques; Mansourati, Jacques; Boschat, Jacques

    2007-01-01

    Background: Multislice Computed Tomography (MSCT) recently proved its accuracy in the detection of coronary artery disease (CAD). It can also give information about left ventricular function and venous network anatomy. We here sought to validate a MSCT-based strategy in the initial evaluation of patients with dilated cardiomyopathy (DCM). Methods: 36 patients with DCM underwent cardiac MSCT before conventional coronary angiography with ventriculography. We analysed arterial calcium score (Agatston score equivalent: ASE), coronary stenosis, left ventricular parameters and venous network. Results: The sensitivity of a MSCT-based strategy in detecting significant CAD was 100% and the specificity 80%. The positive and negative predictive values were respectively 67% and 100%. For ASE 1.000, conventional coronary angiography is mandatory due to MSCT's poor interest in such cases; when ASE <1.000, a contrast-enhanced MSCT may, when normal, replace coronary angiography

  18. Hesitant Trapezoidal Fuzzy QUALIFLEX Method and Its Application in the Evaluation of Green Supply Chain Initiatives

    Directory of Open Access Journals (Sweden)

    Xiaolu Zhang

    2016-09-01

    Full Text Available This paper explores how to handle multiple criteria decision-making (MCDM problems in which the criteria values of alternatives take the form of comparative linguistic expressions. Firstly, the new concept of hesitant trapezoidal fuzzy numbers (HTrFNs is provided to model the semantics of the comparative linguistic expressions. Then, the operational laws and the distance measures of HTrFNs are presented. Afterwards, a useful outranking method, the hesitant trapezoidal fuzzy QUALIFLEX method, is developed to handle the MCDM problems with hierarchical structure in the environment of HTrFN. At length, the proposed method is applied to evaluating green supply chain initiatives in order to achieve sustainable economic and environmental performance, and a case study concerned with a fashion retail chain is presented to demonstrate its feasibility and applicability, also, a comparative analysis with other relevant approaches is conducted to validate the effectiveness of the proposed method.

  19. Evaluation of abdominal CT in the initial treatment of abdominal trauma

    International Nuclear Information System (INIS)

    Watanabe, Shinsuke; Ishii, Takashi; Kuwata, Katsuya; Yoneyama, Chihiro; Kitamura, Kazuya; Sasaki, Yoshifumi; Kamachi, Masahiro; Nishiguchi, Hiroyasu.

    1986-01-01

    During the last four years 102 patients with abdominal trauma were examined by CT for preoperative evaluation in our hospital. In 35 patients (34 %), the CT scans revealed no abnormal findings. They were all managed conservatively except for one case of perforated small bowel. In 67 patients (66 %) CT revealed evidences of substantial abdominal or retroperitoneal trauma. In 30 of them CT findings were confirmed by surgery. Hepatic injury is usually easily recognized by CT. CT is also useful for the detection of renal or splenic injuries. The majority of those parenchymatous organ injuries were successfully managed with conservative therapy, despite apparent traumatic lesions revealed by CT. Repeat CT scans is proved to be very useful to follow the changes of these traumatic lesions. In conclusion, application of abdominal CT is extremely useful for the initial decision making in treatment of patients with abdominal trauma and for the follow-up observation of injured lesions. (author)

  20. The International Decision Support Initiative Reference Case for Economic Evaluation: An Aid to Thought.

    Science.gov (United States)

    Wilkinson, Thomas; Sculpher, Mark J; Claxton, Karl; Revill, Paul; Briggs, Andrew; Cairns, John A; Teerawattananon, Yot; Asfaw, Elias; Lopert, Ruth; Culyer, Anthony J; Walker, Damian G

    2016-12-01

    Policymakers in high-, low-, and middle-income countries alike face challenging choices about resource allocation in health. Economic evaluation can be useful in providing decision makers with the best evidence of the anticipated benefits of new investments, as well as their expected opportunity costs-the benefits forgone of the options not chosen. To guide the decisions of health systems effectively, it is important that the methods of economic evaluation are founded on clear principles, are applied systematically, and are appropriate to the decision problems they seek to inform. The Bill and Melinda Gates Foundation, a major funder of economic evaluations of health technologies in low- and middle-income countries (LMICs), commissioned a "reference case" through the International Decision Support Initiative (iDSI) to guide future evaluations, and improve both the consistency and usefulness to decision makers. The iDSI Reference Case draws on previous insights from the World Health Organization, the US Panel on Cost-Effectiveness in Health Care, and the UK National Institute for Health and Care Excellence. Comprising 11 key principles, each accompanied by methodological specifications and reporting standards, the iDSI Reference Case also serves as a means of identifying priorities for methods research, and can be used as a framework for capacity building and technical assistance in LMICs. The iDSI Reference Case is an aid to thought, not a substitute for it, and should not be followed slavishly without regard to context, culture, or history. This article presents the iDSI Reference Case and discusses the rationale, approach, components, and application in LMICs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Evaluation of a rapid diagnostic test for yaws infection in a community surveillance setting.

    Directory of Open Access Journals (Sweden)

    Michael Marks

    2014-09-01

    Full Text Available Yaws is a non-venereal treponemal infection caused by Treponema pallidum ssp. pertenue. The WHO has launched a worldwide control programme, which aims to eradicate yaws by 2020. The development of a rapid diagnostic test (RDT for serological diagnosis in the isolated communities affected by yaws is a key requirement for the successful implementation of the WHO strategy. We conducted a study to evaluate the utility of the DPP test in screening for yaws, utilizing samples collected as part of a community prevalence survey conducted in the Solomon Islands. 415 serum samples were tested using both traditional syphilis serology (TPPA and quantitative RPR and the Chembio DPP Syphilis Screen and Confirm RDT. We calculated the sensitivity and specificity of the RDT as compared to gold standard serology. The sensitivity of the RDT against TPPA was 58.5% and the specificity was 97.6%. The sensitivity of the RDT against RPR was 41.7% and the specificity was 95.2%. The sensitivity of the DPP was strongly related to the RPR titre with a sensitivity of 92.0% for an RPR titre of >1/16. Wider access to DPP testing would improve our understanding of worldwide yaws case reporting and the test may play a key role in assessing patients presenting with yaws like lesions in a post-mass drug administration (MDA setting.

  2. Evaluation of Safety in a Radiation Oncology Setting Using Failure Mode and Effects Analysis

    International Nuclear Information System (INIS)

    Ford, Eric C.; Gaudette, Ray; Myers, Lee; Vanderver, Bruce; Engineer, Lilly; Zellars, Richard; Song, Danny Y.; Wong, John; DeWeese, Theodore L.

    2009-01-01

    Purpose: Failure mode and effects analysis (FMEA) is a widely used tool for prospectively evaluating safety and reliability. We report our experiences in applying FMEA in the setting of radiation oncology. Methods and Materials: We performed an FMEA analysis for our external beam radiation therapy service, which consisted of the following tasks: (1) create a visual map of the process, (2) identify possible failure modes; assign risk probability numbers (RPN) to each failure mode based on tabulated scores for the severity, frequency of occurrence, and detectability, each on a scale of 1 to 10; and (3) identify improvements that are both feasible and effective. The RPN scores can span a range of 1 to 1000, with higher scores indicating the relative importance of a given failure mode. Results: Our process map consisted of 269 different nodes. We identified 127 possible failure modes with RPN scores ranging from 2 to 160. Fifteen of the top-ranked failure modes were considered for process improvements, representing RPN scores of 75 and more. These specific improvement suggestions were incorporated into our practice with a review and implementation by each department team responsible for the process. Conclusions: The FMEA technique provides a systematic method for finding vulnerabilities in a process before they result in an error. The FMEA framework can naturally incorporate further quantification and monitoring. A general-use system for incident and near miss reporting would be useful in this regard.

  3. Development and evaluation of probability density functions for a set of human exposure factors

    Energy Technology Data Exchange (ETDEWEB)

    Maddalena, R.L.; McKone, T.E.; Bodnar, A.; Jacobson, J.

    1999-06-01

    The purpose of this report is to describe efforts carried out during 1998 and 1999 at the Lawrence Berkeley National Laboratory to assist the U.S. EPA in developing and ranking the robustness of a set of default probability distributions for exposure assessment factors. Among the current needs of the exposure-assessment community is the need to provide data for linking exposure, dose, and health information in ways that improve environmental surveillance, improve predictive models, and enhance risk assessment and risk management (NAS, 1994). The U.S. Environmental Protection Agency (EPA) Office of Emergency and Remedial Response (OERR) plays a lead role in developing national guidance and planning future activities that support the EPA Superfund Program. OERR is in the process of updating its 1989 Risk Assessment Guidance for Superfund (RAGS) as part of the EPA Superfund reform activities. Volume III of RAGS, when completed in 1999 will provide guidance for conducting probabilistic risk assessments. This revised document will contain technical information including probability density functions (PDFs) and methods used to develop and evaluate these PDFs. The PDFs provided in this EPA document are limited to those relating to exposure factors.

  4. Development and evaluation of probability density functions for a set of human exposure factors

    International Nuclear Information System (INIS)

    Maddalena, R.L.; McKone, T.E.; Bodnar, A.; Jacobson, J.

    1999-01-01

    The purpose of this report is to describe efforts carried out during 1998 and 1999 at the Lawrence Berkeley National Laboratory to assist the U.S. EPA in developing and ranking the robustness of a set of default probability distributions for exposure assessment factors. Among the current needs of the exposure-assessment community is the need to provide data for linking exposure, dose, and health information in ways that improve environmental surveillance, improve predictive models, and enhance risk assessment and risk management (NAS, 1994). The U.S. Environmental Protection Agency (EPA) Office of Emergency and Remedial Response (OERR) plays a lead role in developing national guidance and planning future activities that support the EPA Superfund Program. OERR is in the process of updating its 1989 Risk Assessment Guidance for Superfund (RAGS) as part of the EPA Superfund reform activities. Volume III of RAGS, when completed in 1999 will provide guidance for conducting probabilistic risk assessments. This revised document will contain technical information including probability density functions (PDFs) and methods used to develop and evaluate these PDFs. The PDFs provided in this EPA document are limited to those relating to exposure factors

  5. Documentation of preventive care for pressure ulcers initiated during annual evaluations in SCI.

    Science.gov (United States)

    Guihan, Marylou; Murphy, Deidre; Rogers, Thea J; Parachuri, Ramadevi; Sae Richardson, Michael; Lee, Kenneth K; Bates-Jensen, Barbara M

    2016-05-01

    Community-acquired pressure ulcers (PrUs) are a frequent cause of hospitalization of Veterans with spinal cord injury (SCI). The Veterans Health Administration (VHA) recommends that SCI annual evaluations include assessment of PrU risk factors, a thorough skin inspection and sharing of recommendations for PrU prevention strategies. We characterized consistency of preventive skin care during annual evaluations for Veterans with SCI as a first step in identifying strategies to more actively promote PrU prevention care in other healthcare encounters. Retrospective cross-sectional observational design, including review of electronic medical records for 206 Veterans with SCI admitted to 2 VA SCI centers from January-December, 2011. Proportion of applicable skin health elements documented (number of applicable elements/skin health elements documented). Our sample was primarily white (78%) male (96.1%), and mean age = 61 years. 40% of participants' were hospitalized for PrU treatment, with a mean of 294 days (median = 345 days) from annual evaluation to the index admission. On average, Veterans received an average of 75.5% (IQR 68-86%) of applicable skin health elements. Documentation of applicable skin health elements was significantly higher during inpatient vs. outpatient annual evaluations (mean elements received = 80.3% and 64.3%, respectively, P > 0.001). No significant differences were observed in documentation of skin health elements by Veterans at high vs. low PrU risk. Additional PrU preventive care in the VHA outpatient setting may increase identification and detection of PrU risk factors and early PrU damage for Veterans with SCI in the community, allowing for earlier intervention.

  6. Initial experience in hybrid PET-MRI for evaluation of refractory focal onset epilepsy.

    Science.gov (United States)

    Shin, Hae W; Jewells, Valerie; Sheikh, Arif; Zhang, Jingwen; Zhu, Hongtu; An, Hongyu; Gao, Wei; Shen, Dinggang; Hadar, Eldad; Lin, Weili

    2015-09-01

    We aim to evaluate the utility/improved accuracy of hybrid PET/MR compared to current practice separate 3T MRI and PET-CT imaging for localization of seizure foci. In a pilot study, twenty-nine patients undergoing epilepsy surgery evaluation were imaged using PET/MR. This subject group had 29 previous clinical 3T MRI as well as 12 PET-CT studies. Prior clinical PET and MR images were read sequentially while the hybrid PET/MR was concurrently read. The median interval between hybrid PET/MR and prior imaging studies was 5 months (range 1-77 months). In 24 patients, there was no change in the read between the clinical exams and hybrid PET/MR while new anatomical or functional lesions were identified by hybrid PET/MR in 5 patients without significant clinical change. Four new anatomical MR lesions were seen with concordant PET findings. The remaining patient revealed a new abnormal PET lesion without an MR abnormality. All new PET/MR lesions were clinically significant with concordant EEG and/or SPECT results as potential epileptic foci. Our initial hybrid PET-MRI experience increased diagnostic yields for detection of potential epileptic lesions. This may be due to the unique advantage of improved co-registration and simultaneous review of both structural and functional data. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  7. Initial constructs for patient-centered outcome measures to evaluate brain-computer interfaces.

    Science.gov (United States)

    Andresen, Elena M; Fried-Oken, Melanie; Peters, Betts; Patrick, Donald L

    2016-10-01

    The authors describe preliminary work toward the creation of patient-centered outcome (PCO) measures to evaluate brain-computer interface (BCI) as an assistive technology (AT) for individuals with severe speech and physical impairments (SSPI). In Phase 1, 591 items from 15 existing measures were mapped to the International Classification of Functioning, Disability and Health (ICF). In Phase 2, qualitative interviews were conducted with eight people with SSPI and seven caregivers. Resulting text data were coded in an iterative analysis. Most items (79%) were mapped to the ICF environmental domain; over half (53%) were mapped to more than one domain. The ICF framework was well suited for mapping items related to body functions and structures, but less so for items in other areas, including personal factors. Two constructs emerged from qualitative data: quality of life (QOL) and AT. Component domains and themes were identified for each. Preliminary constructs, domains and themes were generated for future PCO measures relevant to BCI. Existing instruments are sufficient for initial items but do not adequately match the values of people with SSPI and their caregivers. Field methods for interviewing people with SSPI were successful, and support the inclusion of these individuals in PCO research. Implications for Rehabilitation Adapted interview methods allow people with severe speech and physical impairments to participate in patient-centered outcomes research. Patient-centered outcome measures are needed to evaluate the clinical implementation of brain-computer interface as an assistive technology.

  8. Economic evaluation of 'Return to Country': A remote Australian initiative to address indigenous homelessness.

    Science.gov (United States)

    Kinchin, Irina; Jacups, Susan; Hunter, Gary; Rogerson, Bernadette

    2016-06-01

    An increase in the number of Indigenous homeless persons in Cairns, Northern Australia, prompted the Queensland Police Service (QPS) to commence a pilot 'Return to Country' (R2C) program. The program was designed to assist homeless people who were voluntarily seeking to return to their home communities. This study assesses the costs of running the program and evaluates its net economic impact. Retrospective uncontrolled cost, cost-effectiveness and cost-offset analyses were undertaken from a societal perspective. All costs were expressed in 2014 AU$. The R2C program successfully assisted 140 participants to return home, reducing the prevalence of homelessness in the regional center by 9.6%. The total program cost was estimated as AU$ 135,831 or AU$ 970 per participant. The economic analysis indicated that R2C was value for money, potentially saving AU$ 2,714,460. Limitations of the study included retrospective data collection and no established alternative comparison group. R2C is a relatively simple, minimal cost program, which can be utilized by policy makers to offer one solution to homelessness. This economic evaluation informs the QPS of the effects of the R2C program in order to guide further program initiatives. The R2C model may be applied to assist temporarily stranded Indigenous people in other locations within Australia or internationally to return home. No funding was obtained for conducting this study. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Role of skull radiography in the initial evaluation of minor head injury: a retrospective study

    International Nuclear Information System (INIS)

    Murshid, W.R.

    1994-01-01

    The use of skull radiography in the initial evaluation of minor head injured patients is controversial. In an attempt to evaluate its benefits, a retrospective study of 566 cases subjected to skull radiography following close minor head trauma (Glasgow Coma Scale 13-15), is presented. A skull fracture (linear vault, depressed or base of skull) was present in 64 (11%) cases. Only three (5%) who were found to have a skull fracture on skull radiography developed an intracranial injury which required surgery. Intracranial injuries developed in 19 (3%) cases and were followed by surgery in six (32%). All, except for one case, had a decreased level of consciousness and a Glasgow Coma Scale less than 15, few had focal neurological deficits. Management had not been altered by the results of skull radiography in any of the cases. We concluded that skull radiographs are unnecessary for the decision process in closed minor head injury because management decisions are based primarily on a careful neurological examination. When intracranial injuries are a concern, a CT scan should be obtained. (author)

  10. A web-based application for initial screening of living kidney donors: development, implementation and evaluation.

    Science.gov (United States)

    Moore, D R; Feurer, I D; Zavala, E Y; Shaffer, D; Karp, S; Hoy, H; Moore, D E

    2013-02-01

    Most centers utilize phone or written surveys to screen candidates who self-refer to be living kidney donors. To increase efficiency and reduce resource utilization, we developed a web-based application to screen kidney donor candidates. The aim of this study was to evaluate the use of this web-based application. Method and time of referral were tabulated and descriptive statistics summarized demographic characteristics. Time series analyses evaluated use over time. Between January 1, 2011 and March 31, 2012, 1200 candidates self-referred to be living kidney donors at our center. Eight hundred one candidates (67%) completed the web-based survey and 399 (33%) completed a phone survey. Thirty-nine percent of donors accessed the application on nights and weekends. Postimplementation of the web-based application, there was a statistically significant increase (p web-based application as opposed to telephone contact. Also, there was a significant increase (p = 0.025) in the total number of self-referrals post-implementation from 61 to 116 per month. An interactive web-based application is an effective strategy for the initial screening of donor candidates. The web-based application increased the ability to interface with donors, process them efficiently and ultimately increased donor self-referral at our center. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. The development and initial assessment of the strategy and leadership systems capability evaluation survey.

    Science.gov (United States)

    Coon, Cheryl D; Bokowy, Kay L; Horblyuk, Ruslan; Zisman, Robert S; McLeod, Lori D; Brown, T Michelle

    2012-01-01

    Hospital management and leadership systems are associated with organizational success and quality care. The Strategy and Leadership Systems Capability Evaluation (CE) survey was developed by GE Healthcare to assess management and leadership systems at health care institutions, serve as a benchmark for improvement, and measure progress. To assess the psychometric properties of the 29-item CE survey, including the factor structure, scoring algorithm, reliability, and discriminant validity, an online survey was completed by 3450 employees at 15 US hospitals. Of these employees, 609 worked at a hospital where a leadership and management intervention occurred after the initial survey administration. Data were also collected on job level, number of hospital beds, hospital ownership, location, community type, and the implementation of hospital interventions. Item response frequencies showed no floor or ceiling effects and limited missing data. Interitem correlations were strong without obvious redundancies, and factor analysis suggested a unidimensional scale. The resulting scale had strong internal consistency and was able to discriminate among known groups. The CE survey was developed to evaluate management and leadership systems at health care institutions. This study provides psychometric evidence in support of the reliability, validity, and scoring structure of this survey.

  12. A Validated Set of MIDAS V5 Task Network Model Scenarios to Evaluate Nextgen Closely Spaced Parallel Operations Concepts

    Science.gov (United States)

    Gore, Brian Francis; Hooey, Becky Lee; Haan, Nancy; Socash, Connie; Mahlstedt, Eric; Foyle, David C.

    2013-01-01

    The Closely Spaced Parallel Operations (CSPO) scenario is a complex, human performance model scenario that tested alternate operator roles and responsibilities to a series of off-nominal operations on approach and landing (see Gore, Hooey, Mahlstedt, Foyle, 2013). The model links together the procedures, equipment, crewstation, and external environment to produce predictions of operator performance in response to Next Generation system designs, like those expected in the National Airspaces NextGen concepts. The task analysis that is contained in the present report comes from the task analysis window in the MIDAS software. These tasks link definitions and states for equipment components, environmental features as well as operational contexts. The current task analysis culminated in 3300 tasks that included over 1000 Subject Matter Expert (SME)-vetted, re-usable procedural sets for three critical phases of flight; the Descent, Approach, and Land procedural sets (see Gore et al., 2011 for a description of the development of the tasks included in the model; Gore, Hooey, Mahlstedt, Foyle, 2013 for a description of the model, and its results; Hooey, Gore, Mahlstedt, Foyle, 2013 for a description of the guidelines that were generated from the models results; Gore, Hooey, Foyle, 2012 for a description of the models implementation and its settings). The rollout, after landing checks, taxi to gate and arrive at gate illustrated in Figure 1 were not used in the approach and divert scenarios exercised. The other networks in Figure 1 set up appropriate context settings for the flight deck.The current report presents the models task decomposition from the tophighest level and decomposes it to finer-grained levels. The first task that is completed by the model is to set all of the initial settings for the scenario runs included in the model (network 75 in Figure 1). This initialization process also resets the CAD graphic files contained with MIDAS, as well as the embedded

  13. A head-mounted display system for augmented reality: Initial evaluation for interventional MRI

    International Nuclear Information System (INIS)

    Wendt, M.; Wacker, F.K.

    2003-01-01

    Purpose: To discuss the technical details of a head mounted display with an augmented reality (AR) system and to describe a first pre-clinical evaluation in interventional MRI. Method: The AR system consists of a video-see-through head mounted display (HMD), mounted with a mini video camera for tracking and a stereo pair of mini cameras that capture live images of the scene. The live video view of the phantom/patient is augmented with graphical representations of anatomical structures from MRI image data and is displayed on the HMD. The application of the AR system with interventional MRI was tested using a MRI data set of the head and a head phantom. Results: The HMD enables the user to move around and observe the scene dynamically from various viewpoints. Within a short time the natural hand-eye coordination can easily be adapted to the slightly different view. The 3D perception is based on stereo and kinetic depth cues. A circular target with a diameter of 0.5 square centimeter was hit in 19 of 20 attempts. In a first evaluation the MRI image data augmented reality scene of a head phantom allowed good planning and precise simulation of a puncture. Conclusion: The HMD in combination with AR provides a direct, intuitive guidance for interventional MR procedures. (orig.) [de

  14. Matching disease and phenotype ontologies in the ontology alignment evaluation initiative.

    Science.gov (United States)

    Harrow, Ian; Jiménez-Ruiz, Ernesto; Splendiani, Andrea; Romacker, Martin; Woollard, Peter; Markel, Scott; Alam-Faruque, Yasmin; Koch, Martin; Malone, James; Waaler, Arild

    2017-12-02

    The disease and phenotype track was designed to evaluate the relative performance of ontology matching systems that generate mappings between source ontologies. Disease and phenotype ontologies are important for applications such as data mining, data integration and knowledge management to support translational science in drug discovery and understanding the genetics of disease. Eleven systems (out of 21 OAEI participating systems) were able to cope with at least one of the tasks in the Disease and Phenotype track. AML, FCA-Map, LogMap(Bio) and PhenoMF systems produced the top results for ontology matching in comparison to consensus alignments. The results against manually curated mappings proved to be more difficult most likely because these mapping sets comprised mostly subsumption relationships rather than equivalence. Manual assessment of unique equivalence mappings showed that AML, LogMap(Bio) and PhenoMF systems have the highest precision results. Four systems gave the highest performance for matching disease and phenotype ontologies. These systems coped well with the detection of equivalence matches, but struggled to detect semantic similarity. This deserves more attention in the future development of ontology matching systems. The findings of this evaluation show that such systems could help to automate equivalence matching in the workflow of curators, who maintain ontology mapping services in numerous domains such as disease and phenotype.

  15. Lessons learned from the application of a participatory evaluation methodology to healthy municipalities, cities and communities initiatives in selected countries of the Americas.

    Science.gov (United States)

    Rice, Marilyn; Franceschini, Maria Cristina

    2007-01-01

    Health promotion has made significant strides in the past few decades in the Americas. Creating a healthy and supportive setting, also known as the settings approach, continues to be one of the most widely used health promotion strategies. Interest in evaluating the effectiveness of these strategies has been increasing greatly in the past few years. Participatory evaluation holds great promise for helping to generate this evidence and promote understanding of the factors that affect, positively or negatively, the advances of health promotion in the Region. During 2004-2006, a Participatory Evaluation methodology was introduced into several countries in the Americas through formal trainings conducted by the Pan American Health Organization (PAHO) in collaboration with country partners. This article summarizes the main lessons learned from the application of the participatory evaluation methodology in various countries in Latin America and the Caribbean. Factors affecting the evaluation of the initiatives were identified at multiple levels (individual, community, organizational, political, economic, etc.). Specific issues that were addressed included the political context, turnover of personnel in key institutions, concerns related to the effectiveness of participatory processes, and the existence of strong and sustained leadership at the country level. These factors are intertwined and affect each other in very complex ways, a fact that was reflected in the municipalities' experiences with participatory evaluation. Challenges included the ability to secure resources for the evaluation, the time needed to conclude the process, and working in an intersectoral manner. However, participating municipalities reported that the process of implementing a participatory evaluation and working with various stakeholders had an empowering effect: communities and stakeholders were more willing and interested in participating in health promotion initiatives in a sustained manner

  16. A new approach for evaluating water hammer including the initial state of pressurization of the installation and fluid

    Directory of Open Access Journals (Sweden)

    G. Kaless

    2016-04-01

    Full Text Available The water hammer phenomenon is well known since the 19th century, while its mathematical formulation, by means of differential equations, is due to works of researchers such us Allievi (1903 and others from the beginning of the 20th century. The equations found in the technical publications produce a strange water hammer when the initial condition is defined assuming an incompressible fluid and a rigid pipe. The correct solution requires solving the water hammer equations for the initial state. When the finite difference method is applied, the initial state is solved by means of a set of non-linear equations. A novel approach is proposed including the initial state of pressurization into the governing equations and hence simplifying the calculus of the initial conditions. Furthermore, a critical reading of the deduction of the equations is done pointing out conceptual inconsistencies and proposing corrections.

  17. BACHSCORE. A tool for evaluating efficiently and reliably the quality of large sets of protein structures

    Science.gov (United States)

    Sarti, E.; Zamuner, S.; Cossio, P.; Laio, A.; Seno, F.; Trovato, A.

    2013-12-01

    In protein structure prediction it is of crucial importance, especially at the refinement stage, to score efficiently large sets of models by selecting the ones that are closest to the native state. We here present a new computational tool, BACHSCORE, that allows its users to rank different structural models of the same protein according to their quality, evaluated by using the BACH++ (Bayesian Analysis Conformation Hunt) scoring function. The original BACH statistical potential was already shown to discriminate with very good reliability the protein native state in large sets of misfolded models of the same protein. BACH++ features a novel upgrade in the solvation potential of the scoring function, now computed by adapting the LCPO (Linear Combination of Pairwise Orbitals) algorithm. This change further enhances the already good performance of the scoring function. BACHSCORE can be accessed directly through the web server: bachserver.pd.infn.it. Catalogue identifier: AEQD_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEQD_v1_0.html Program obtainable from: CPC Program Library, Queen’s University, Belfast, N. Ireland Licensing provisions: GNU General Public License version 3 No. of lines in distributed program, including test data, etc.: 130159 No. of bytes in distributed program, including test data, etc.: 24 687 455 Distribution format: tar.gz Programming language: C++. Computer: Any computer capable of running an executable produced by a g++ compiler (4.6.3 version). Operating system: Linux, Unix OS-es. RAM: 1 073 741 824 bytes Classification: 3. Nature of problem: Evaluate the quality of a protein structural model, taking into account the possible “a priori” knowledge of a reference primary sequence that may be different from the amino-acid sequence of the model; the native protein structure should be recognized as the best model. Solution method: The contact potential scores the occurrence of any given type of residue pair in 5 possible

  18. The utility of plain radiographs in the initial evaluation of knee pain amongst sports medicine patients.

    Science.gov (United States)

    Alaia, Michael J; Khatib, Omar; Shah, Mehul; A Bosco, Joseph; M Jazrawi, Laith; Strauss, Eric J

    2015-08-01

    To evaluate whether screening radiographs as part of the initial workup of knee pain impacts clinical decision-making in a sports medicine practice. A questionnaire was completed by the attending orthopaedic surgeon following the initial office visit for 499 consecutive patients presenting to the sports medicine centre with a chief complaint of knee pain. The questionnaire documented patient age, duration of symptoms, location of knee pain, associated mechanical symptoms, history of trauma within the past 2 weeks, positive findings on plain radiographs, whether magnetic resonance imaging was ordered, and whether plain radiographs impacted the management decisions for the patient. Patients were excluded if they had prior X-rays, history of malignancy, ongoing pregnancy, constitutional symptoms as well as those patients with prior knee surgery or intra-articular infections. Statistical analyses were then performed to determine which factors were more likely do correspond with diagnostic radiographs. Overall, initial screening radiographs did not change management in 72 % of the patients assessed in the office. The mean age of patients in whom radiographs did change management was 57.9 years compared to 37.1 years in those patients where plain radiograph did not change management (p < 0.0001). Plain radiographs had no impact on clinical management in 97.3 % of patients younger than 40. In patients whom radiographs did change management, radiographs were more likely to influence management if patients were over age forty, had pain for over 6 months, had medial or diffuse pain, or had mechanical symptoms. A basic cost analysis revealed that the cost of a clinically useful radiographic series in a patient under 40 years of age was $7,600, in contrast to $413 for a useful series in patients above the age of 40. Data from the current study support the hypothesis that for the younger patient population, routine radiographic imaging as a screening tool may be of

  19. Integrating hypermedia into the environmental education setting: Developing a program and evaluating its effect

    Science.gov (United States)

    Parker, Tehri Davenport

    1997-09-01

    This study designed, implemented, and evaluated an environmental education hypermedia program for use in a residential environmental education facility. The purpose of the study was to ascertain whether a hypermedia program could increase student knowledge and positive attitudes toward the environment and environmental education. A student/computer interface, based on the theory of social cognition, was developed to direct student interactions with the computer. A quasi-experimental research design was used. Students were randomly assigned to either the experimental or control group. The experimental group used the hypermedia program to learn about the topic of energy. The control group received the same conceptual information from a teacher/naturalist. An Environmental Awareness Quiz was administered to measure differences in the students' cognitive understanding of energy issues. Students participated in one on one interviews to discuss their attitudes toward the lesson and the overall environmental education experience. Additionally, members of the experimental group were tape recorded while they used the hypermedia program. These tapes were analyzed to identify aspects of the hypermedia program that promoted student learning. The findings of this study suggest that computers, and hypermedia programs, can be integrated into residential environmental education facilities, and can assist environmental educators in meeting their goals for students. The study found that the hypermedia program was as effective as the teacher/naturalist for teaching about environmental education material. Students who used the computer reported more positive attitudes toward the lesson on energy, and thought that they had learned more than the control group. Students in the control group stated that they did not learn as much as the computer group. The majority of students had positive attitudes toward the inclusion of computers in the camp setting, and stated that they were a good

  20. Goal-setting to Promote a Healthier Lifestyle in Later Life: Qualitative Evaluation of the AgeWell Trial.

    Science.gov (United States)

    Nelis, Sharon M; Thom, Jeanette M; Jones, Ian Rees; Hindle, John V; Clare, Linda

    2017-12-15

    We report a mixed method evaluation of the feasibility and implementation of the AgeWell goal-setting intervention to promote healthy ageing later life. Researcher field notes, goal-setting interview content, and semi-structured interviews with participants were content analysed to review trial implementation and participants' perspective on the goal-setting and mentoring intervention. 75 people were recruited: 21 in the goal-setting and 22 in the goal-setting with mentoring arms of the intervention. Goal-setting was feasible in the main domains of interest. Adherence to the protocol was good and the mentoring schedule was adhered to. Participants reported satisfaction with their goal attainment, but barriers for non-achievement were also identified. Recommendations for small changes to the intervention included reducing the number of goals. Participants understood the goal-setting process, and were able to set realistic and achievable lifestyle goals. The intervention and the procedures were acceptable but changes in how goal-setting is both introduced and monitored are needed for wider implementation. Goal-setting can be a useful process to help people alter their lifestyle to allow them to age more successfully and reduce risk factors associated with dementia.

  1. A systematic review of structured versus non-structured breastfeeding programmes to support the initiation and duration of exclusive breastfeeding in acute and primary healthcare settings.

    Science.gov (United States)

    Beake, Sarah; Pellowe, Carol; Dykes, Fiona; Schmied, Virginia; Bick, Debra

    2011-01-01

    Background: Breastfeeding has many important health benefits for the woman and her baby. Despite evidence of benefit from a large number of well conducted studies, breastfeeding uptake and the duration of exclusive breastfeeding remain low in many countries. In order to improve breastfeeding rates, policy and guidelines at global, individual country level and in local healthcare settings have recommended that structured programmes to support breastfeeding should be introduced. The objective of this review was to consider the evidence of outcomes of structured compared with non-structured breastfeeding programmes in acute maternity care settings to support initiation and duration of exclusive breastfeeding. The definition of structured programme used included a multi-faceted or single intervention approach to support breastfeeding; definition of non-structured included support offered within standard care. The review considered quantitative and qualitative studies which addressed outcomes following the introduction of a structured programme in acute healthcare settings to support breastfeeding compared with no programme. The primary outcomes of interest were uptake of breastfeeding and duration of exclusive breastfeeding (only breast milk, including milk expressed). Studies which only considered community based interventions were not included. A search of the literature published between 1992 and 2010 was conducted, which followed a four step process. After a limited search of MEDLINE and CINAHL to identify key words contained in the title or abstract and index terms to describe relevant interventions, a second extensive search was undertaken using identified key words and index terms. The third step included a search of reference lists and bibliographies of relevant articles and the fourth step included a search of grey and unpublished literature and national databasesMethodological quality: Methodological quality was assessed using checklists developed by the

  2. Diagnostic Accuracy of Ultrasonography in the Initial Evaluation of Patients with Penetrating Chest Trauma

    Directory of Open Access Journals (Sweden)

    Farhad Heydari

    2014-03-01

    Full Text Available Introduction: Traumatic chest injuries (TCI are one of the most common causes of referring to the emergency departments, with high mortality and disability. This study was designed to evaluate the diagnostic accuracy of ultrasonography versus chest X ray (CXR in detection of hemo-pneumothorax for patients suffering penetrating TCI. Methods: The present cross-sectional study was performed to evaluate the diagnostic accuracy of ultrasonography in penetrating TCI victims referred to the emergency department of Shahid Kashani and Alzahra hospitals of Isfahan, Iran, from July 2012 to June 2013. Bedside ultrasonography and plain CXR was done on arrival and three hours after admission. The results of ultrasonography and radiography were separately evaluated by an emergency medicine specialist and a radiologist, who were blind to the aims of the study. Then, sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV, and kappa coefficient was considered to evaluate the accuracy of ultrasonography. Results: In this research 64 patients with penetrating chest trauma were assessed (98.4% male. The mean age of them was 25.6±8.5 years (rang: 13-65. The plain radiography revealed the eight (12.5 % cases of pneumothorax and one (1.6% hemothorax. The findings of primary ultrasonography also showed the same number of hemo-pneumothorax. Sensitivity and specificity of primary ultrasound in diagnosis of pneumothorax were 100% (95% Cl: 60.7- 100 and 100.0% (95% Cl, 92.0% to 100.0% and in detection of hemothorax were 100% (95% Cl: 50.5-100 and 100% (95% Cl: 92.8-100, respectively. Sensitivity and specificity of ultrasound in the third hour were 100% (95% Cl: 31.3-100 and 100% (95% Cl: 91.4-100, respectively. Conclusion: Findings of the present study have shown that ultrasonography has an acceptable diagnostic accuracy in the initial assessment of patients with penetrating chest trauma. However, because of its dependency on operator

  3. Bottom-up priority setting revised. A second evaluation of an institutional intervention in a Swedish health care organisation.

    Science.gov (United States)

    Waldau, Susanne

    2015-09-01

    Transparent priority setting in health care based on specific ethical principles is requested by the Swedish Parliament since 1997. Implementation has been limited. In this case, transparent priority setting was performed for a second time round and engaged an entire health care organisation. Objectives were to refine a bottom-up priority setting process, reach a political decision on service limits to make reallocation towards higher prioritised services possible, and raise systems knowledge. An action research approach was chosen. The national model for priority setting was used with addition of dimensions costs, volumes, gender distribution and feasibility. The intervention included a three step process and specific procedures for each step which were created, revised and evaluated regarding factual and functional aspects. Evaluations methods included analyses of documents, recordings and surveys. Vertical and horizontal priority setting occurred and resources were reallocated. Participants' attitudes remained positive, however less so than in the first priority setting round. Identifying low-priority services was perceived difficult, causing resentment and strategic behaviour. The horizontal stage served to raise quality of the knowledge base, level out differences in ranking of services and raise systems knowledge. Existing health care management systems do not meet institutional requirements for transparent priority setting. Introducing transparent priority setting constitutes a complex institutional reform, which needs to be driven by management/administration. Strong managerial commitment is required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. The Effects of a Statewide Evaluation Initiative in Gifted Education on Practitioner Knowledge, Concerns, and Program Documentation

    Science.gov (United States)

    Robinson, Ann; Cotabish, Alicia; Wood, Betty K.; O'Tuel, Fran S.

    2014-01-01

    When well-considered and grounded in current knowledge, program evaluations of services to gifted learners can be a powerful tool for increasing practitioners' knowledge and self-efficacy, and for effecting positive programmatic changes. The Arkansas Evaluation Initiative (AEI) in Gifted Education, a Jacob K. Javits-funded project, was implemented…

  5. An evaluation of four crop:weed competition models using a common data set

    NARCIS (Netherlands)

    Deen, W.; Cousens, R.; Warringa, J.; Bastiaans, L.; Carberry, P.; Rebel, K.; Riha, S.; Murphy, C.; Benjamin, L.R.; Cloughley, C.; Cussans, J.; Forcella, F.

    2003-01-01

    To date, several crop : weed competition models have been developed. Developers of the various models were invited to compare model performance using a common data set. The data set consisted of wheat and Lolium rigidum grown in monoculture and mixtures under dryland and irrigated conditions.

  6. VITEX 2016 : Evaluation of learning objectives and exercise set-up

    NARCIS (Netherlands)

    Rijk, R. van; Stubbé-Alberts, H.E.

    2016-01-01

    To strengthen awareness of the need for cooperation, between public and private partners, and between countries, a new exercise set-up was developed. The VITEX exercise set-up is a table top exercise that aims to bring relevant networks together, and supports cooperation and collaboration between

  7. Evaluating restoration in urban green spaces: Does setting type make a difference?

    NARCIS (Netherlands)

    Berg, van den A.; Jorgensen, A.; Wilson, E.R.

    2014-01-01

    A growing body of research suggests that natural settings are more effective in providing restoration from depleted emotional and cognitive resources than built settings. However, there is a lack of evidencebased guidelines on which options for urban green space design and management are most

  8. Evaluating restoration in urban green spaces : Does setting type make a difference?

    NARCIS (Netherlands)

    Van den Berg, Agnes E.; Jorgensen, Anna; Wilson, Edward R.

    A growing body of research suggests that natural settings are more effective in providing restoration from depleted emotional and cognitive resources than built settings. However, there is a lack of evidence-based guidelines on which options for urban green space design and management are most

  9. Initial evaluation of the Robert Wood Johnson Foundation Nurse Faculty Scholars program.

    Science.gov (United States)

    Hickey, Kathleen T; Hodges, Eric A; Thomas, Tami L; Coffman, Maren J; Taylor-Piliae, Ruth E; Johnson-Mallard, Versie M; Goodman, Janice H; Jones, Randy A; Kuntz, Sandra; Galik, Elizabeth; Gates, Michael G; Casida, Jesus M

    2014-01-01

    The Robert Wood Johnson Foundation Nurse Faculty Scholars (RWJF NFS) program was developed to enhance the career trajectory of young nursing faculty and to train the next generation of nurse scholars. Although there are publications that describe the RWJF NFS, no evaluative reports have been published. The purpose of this study was to evaluate the first three cohorts (n = 42 scholars) of the RWJF NFS program. A descriptive research design was used. Data were derived from quarterly and annual reports, and a questionnaire (seven open-ended questions) was administered via Survey Monkey Inc. (Palo Alto, CA, USA). During their tenure, scholars had on average six to seven articles published, were teaching/mentoring at the graduate level (93%), and holding leadership positions at their academic institutions (100%). Eleven scholars (26%) achieved fellowship in the American Academy of Nursing, one of the highest nursing honors. The average ratings on a Likert scale of 1 (not at all supportive) to 10 (extremely supportive) of whether or not RWJF had helped scholars achieve their goals in teaching, service, research, and leadership were 7.7, 8.0, 9.4, and 9.5, respectively. The majority of scholars reported a positive, supportive relationship with their primary nursing and research mentors; although, several scholars noted challenges in connecting for meetings or telephone calls with their national nursing mentors. These initial results of the RWJF NFS program highlight the success of the program in meeting its overall goal-preparing the next generation of nursing academic scholars for leadership in the profession. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. An Initial evaluation of law enforcement overdose training in Rhode Island.

    Science.gov (United States)

    Saucier, Cory D; Zaller, Nickolas; Macmadu, Alexandria; Green, Traci C

    2016-05-01

    To assess initial change in knowledge, self-efficacy, and anticipated behaviors among Rhode Island law enforcement officers on drug overdose response and prevention. Law enforcement officers (N=316) voluntarily completed a pre-post evaluation immediately before and after taking part in overdose prevention and response trainings. Assessment items included measures of knowledge (Brief Overdose Recognition and Response Assessment (BORRA)), self-efficacy, attitudes toward drugs and overdose prevention, awareness of the Good Samaritan Law, and open-ended items pertaining to overdose knowledge and response behaviors. Non-parametric tests measured within-group and between-group differences. Wilcoxon Signed Rank tests and Kruskal-Wallis tests evaluated changes in BORRA scores and self-efficacy items. McNemar's tests assessed changes regarding the Good Samaritan law and open-ended items. Wilcoxon Signed Rank tests measured post-training change in attitudes. Law enforcement officers demonstrated statistically significant improvements in self-efficacy (identifying signs of opioid overdose, naloxone indication, counseling witnesses in overdose prevention, and referring witnesses for more information), overdose identification knowledge (BORRA mean increased from 7.00 to 10.39), naloxone administration knowledge (BORRA mean increased from 10.15 to 12.59), Good Samaritan Law awareness (17.9% increase after training), and anticipated behaviors in response to future observed overdose (65.7% changed from passive to active response post training). Harm reduction programs can provide law enforcement officers with the knowledge and skills necessary to intervene and reduce overdose mortality. Given the statistically significant improvements in self-efficacy, attitudinal changes, and Good Samaritan law awareness, law enforcement officers are more prepared to actively interact with drug users during a drug-involved emergency. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. Initial Evaluation of a Titration Appliance for Temporary Treatment of Obstructive Sleep Apnea.

    Science.gov (United States)

    Levendowski, Daniel J; Morgan, Todd; Westbrook, Philip

    2012-01-01

    Custom oral appliances that adjustably advance the mandible provide superior outcomes when treating patients with moderate or severe sleep apnea. Custom appliances, however, are expensive, must be fitted by a dentist, and the likelihood of successful outcomes are difficult to predict. An inexpensive trial appliance, if proven efficacious, might be used to predict custom appliance outcomes or to provide temporary therapeutic benefit. The aim of this initial study was to assess the treatment efficacy of a novel titration oral appliance with that of an optimized custom appliance. Seventeen patients, treated with a custom oral appliance for at least one year, successfully completed a three-night home sleep test. The baseline obstructive sleep apnea severity was established on Night 1 with seven patients exhibiting severe, six moderate and four mild apnea/hypopnea indexes. Patients were randomly assigned to wear their custom appliance or the titration appliance on Nights 2 and 3. Significant reductions in the mean overall and supine apnea indexes (p titration and custom appliances. The proportion of patients who exhibited at least a 50% reduction in the overall apnea index and supine apnea/hypopnea were similar for the titration and custom appliance (~60%). The custom appliance reduced the overall apnea/hypopnea index by 50% in a greater proportion of the patients compared to the titration appliance (77% vs. 53%). The titration appliance significantly reduced the degree of hypoxic exposure across sleep disordered breathing events overall (p titration appliance, but preferred the titration appliance to no therapy. The titration appliance may be useful in assessing oral appliance treatment efficacy. When set to 70% of maximum protrusion, the titration appliance may provide immediate, temporary therapeutic benefit.

  12. Performance Evaluation of Orbit Determination System during Initial Phase of INSAT-3 Mission

    Science.gov (United States)

    Subramanian, B.; Vighnesam, N. V.

    INSAT-3C is the second in the third generation of ISRO's INSAT series of satellites that was launched by ARIANE-SPACE on 23 January 2002 at 23 h 46 m 57 s (lift off time in U.T). The ARIANE-4 Flight Nr.147 took off from Kourou in French Guyana and injected the 2750-kg communications satellite in a geostationary transfer orbit of (571 X 35935) km with an inclination of 4.007 deg at 00 h 07 m 48 s U.T on 24 January 2002 (1252 s after lift off). The satellite was successfully guided into its intended geostationary position of 74 deg E longitude by 09 February 2002 after a series of four firings of its Liquid Apogee Motor (LAM) and four station acquisition (STAQ) maneuvers. Six distinct phases of the mission were categorized based on the orbit characteristics of the INSAT- 3C mission, namely, the pre-launch phase, the launch phase, transfer orbit phase, intermediate orbit phase, drift orbit phase and synchronous orbit phase. The orbit with a perigee height of 571 km at injection of the satellite, was gradually raised to higher orbits with perigee height increasing to 9346 km after Apogee Motor Firing #1 (AMF #1), 18335 km after AMF #2, 32448 km after AMF #3 and 35493 km after AMF #4. The North and South solar panels and the reflectors were deployed at this stage of the mission and the attitude of the satellite with respect to the three axes was stabilized. The Orbit Determination System (ODS) that was used in the initial phase of the mission played a crucial role in realizing the objectives of the mission. This system which consisted of Tracking Data Pre-Processing (TDPP) software, Ephemeris Generation (EPHGEN) software and the Orbit Determination (OD) software, performed rigorously and its results were used for planning the AMF and STAQ strategies with a greater degree of accuracy. This paper reports the results of evaluation of the performance of the apogee-motor firings employed to place the satellite in its intended position where it is collocated with INSAT-1D

  13. Evaluation of local stress for stress corrosion crack initiation by three-dimensional polycrystal model

    International Nuclear Information System (INIS)

    Kamaya, Masayuki; Kitamura, Takayuki

    2006-01-01

    In order to understand the initiation behavior of microstructurally small cracks in a stress corrosion cracking condition, it is important to know the tensile normal stress acting on the grain boundary (normal G.B. stress). The local stress in a polycrystalline body is greatly influenced by deformation constraint which is caused by anisotropic and/or inhomogeneous property of each grain. In present study, the local normal G.B. stress on bi- and tri-crystal bodies and a three-dimensional polycrystalline body consisting of 100 grains were evaluated by the finite element method under a remote uniform tensile stress condition. The polycrystalline body was generated by using a Monte Carlo procedure and random orientations were assigned to each grain. It was revealed that the local normal G.B. stress on the polycrystalline body is inhomogeneous under uniform applied stress. The stress tends to be large near the triple points due to the deformation constraint caused by adjacent grains, even though the grain boundary inclination to the load axis has large influence. It was also shown that particular high stress was not observed at corners of the polycrystalline body. (author)

  14. Evaluation of wireless sensor networks (WSNs) for remote wetland monitoring: design and initial results.

    Science.gov (United States)

    Watras, Carl J; Morrow, Michael; Morrison, Ken; Scannell, Sean; Yaziciaglu, Steve; Read, Jordan S; Hu, Yu-Hen; Hanson, Paul C; Kratz, Tim

    2014-02-01

    Here, we describe and evaluate two low-power wireless sensor networks (WSNs) designed to remotely monitor wetland hydrochemical dynamics over time scales ranging from minutes to decades. Each WSN (one student-built and one commercial) has multiple nodes to monitor water level, precipitation, evapotranspiration, temperature, and major solutes at user-defined time intervals. Both WSNs can be configured to report data in near real time via the internet. Based on deployments in two isolated wetlands, we report highly resolved water budgets, transient reversals of flow path, rates of transpiration from peatlands and the dynamics of chromophoric-dissolved organic matter and bulk ionic solutes (specific conductivity)-all on daily or subdaily time scales. Initial results indicate that direct precipitation and evapotranspiration dominate the hydrologic budget of both study wetlands, despite their relatively flat geomorphology and proximity to elevated uplands. Rates of transpiration from peatland sites were typically greater than evaporation from open waters but were more challenging to integrate spatially. Due to the high specific yield of peat, the hydrologic gradient between peatland and open water varied with precipitation events and intervening periods of dry out. The resultant flow path reversals implied that the flux of solutes across the riparian boundary varied over daily time scales. We conclude that WSNs can be deployed in remote wetland-dominated ecosystems at relatively low cost to assess the hydrochemical impacts of weather, climate, and other perturbations.

  15. Baby-Friendly Hospital Initiative: evaluation of the Ten Steps to Successful Breastfeeding

    Directory of Open Access Journals (Sweden)

    Soraia da Silva Lopes

    2013-12-01

    Full Text Available OBJECTIVE: To asses the performance of the Ten Steps to Successful Breastfeeding in an university hospital. METHODS: Descriptive and quantitative research, in which 103 people were interviewed in the outpatient prenatal clinic, in the maternity-ward and in the Neonatal Intensive Care Unit of a university hospital in Vitória, Southeast Brazil. The "Institutional Self-Evaluation Questionnaire" of the Baby Friendly Hospital Initiative was applied. Using this tool, the outcome was measured by the concordance index (CI proposed by the World Health Organization and by the United Nations Children's Fund. RESULTS: Although the hospital does not have a policy that addresses promotion, protection and support for breastfeeding, 93.3% of the mothers had contact with their babies immediately after birth (step 4, 83.3% of the professionals guided mothers how to breastfeed (step 5, 86.6% of the neonates did not receive any food or drink other than breast milk (step 6, 100% of babies were housed together with their mothers (step 7, 83.3% of the women were encouraged for breastfeeding on demand (step 8 and 100% of the infants did not use bottles or pacifiers (step 9. CONCLUSIONS: 60% of the steps were completed by the hospital. The greatest difficulty was to inform pregnant women about the importance and the management of breastfeeding (step 3. Therefore, visits to pregnant women are recommended, in order to prepare them for breastfeeding and to explain about the infants' healthy feeding habits.

  16. Extended Plate and Beam Wall System: Concept Investigation and Initial Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Kochkin, V. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2015-08-01

    A new and innovative High-R wall design, referred to as the Extended Plate & Beam (EP&B), is under development. The EP&B system uniquely integrates foam sheathing insulation with wall framing such that wood structural panels are installed exterior of the foam sheathing, enabling the use of standard practices for installation of drainage plane, windows and doors, claddings, cavity insulation, and the standard exterior foam sheathing installation approach prone to damage of the foam during transportation of prefabricated wall panels. As part of the ongoing work, the EP&B wall system concept has undergone structural verification testing and has been positively vetted by a group of industry stakeholders. Having passed these initial milestone markers, the advanced wall system design has been analyzed to assess cost implications relative to other advanced wall systems, undergone design assessment to develop construction details, and has been evaluated to develop representative prescriptive requirements for the building code. This report summarizes the assessment steps conducted to-date and provides details of the concept development.

  17. The Tribal Tobacco Education and Policy Initiative: Findings From a Collaborative, Participatory Evaluation.

    Science.gov (United States)

    Scott, Sheryl; D'Silva, Joanne; Hernandez, Carol; Villaluz, Nicole Toves; Martinez, Jaime; Matter, Chris

    2017-07-01

    While the reduction in the overall U.S. smoking prevalence has been declared one of the top 10 public health achievements of the past century, the growing disparity in smoking between American Indians and the general population is one of the biggest challenges of the 21st century. Minnesota in particular has very high smoking rates among American Indians (59%). Tribal Nations in Minnesota share a past of attempted cultural genocide and a present of restoring the strength of their cultural teachings, including the prominence of traditional tobacco as a sacred "first medicine." The Tribal Tobacco Education and Policy initiative works to address this complex and challenging context. This article describes results of a participatory evaluation from 2010 to 2013 in four Minnesota Tribal Nations-three Ojibwe and one Dakota. Tribal Tobacco Education and Policy coordinators used their cultural knowledge to develop community-level strategies, identifying appropriate strategies from best practices on tobacco advocacy, while drawing on the strengths of their own sovereignty and sacred tobacco traditions. Tribal coordinators generated support for policy change by conducting culturally relevant education, engaging tribal members, and nurturing relationships. This approach resulted in norm changes, practices toward restoring traditional tobacco, informal policies, and tribal resolutions to advance smoke-free policies.

  18. Initial site characterization and evaluation of radionuclide contaminated soil waste burial grounds

    International Nuclear Information System (INIS)

    Phillips, S.J.; Reisenauer, A.E.; Rickard, W.H.; Sandness, G.A.

    1977-02-01

    A survey of historical records and literature containing information on the contents of 300 Area and North Burial Grounds was completed. Existing records of radioactive waste location, type, and quantity within each burial ground facility were obtained and distributed to cooperating investigators. A study was then initiated to evaluate geophysical exploration techniques for mapping buried waste materials, waste containers, and trench boundaries. Results indicate that a combination of ground penetrating radar, magnetometer, metal detector, and acoustic measurements will be effective but will require further study, hardware development, and field testing. Drilling techniques for recovering radionuclide-contaminated materials and sediment cores were developed and tested. Laboratory sediment characterization and fluid transport and monitoring analyses were begun by installation of in situ transducers at the 300 North Burial Ground site. Biological transport mechanisms that control radionuclide movement at contaminated sites were also studied. Flora and fauna presently inhabiting specific burial ground areas were identified and analyzed. Future monitoring of specific mammal populations will permit determination of dose rate and pathways of contaminated materials contained in and adjacent to burial ground sites

  19. Evaluation of occupational factors on continuation of breastfeeding and formula initiation in employed mothers.

    Science.gov (United States)

    Ahmadi, Mahshid; Moosavi, Seyyed Mohammad

    2013-09-25

    During recent decades, women have been increasingly involved in social activities. Despite the fact that mothers prefer to breastfeed, their return to work is associated with a reduction in breastfeeding frequency and duration. The present study evaluates the impact of occupational factors on continuation of breastfeeding and formula initiation in employed mothers with infants aged 6-12 months in Bandar-Abbas, Iran in 2010. This is a descriptive-analytic study on employed mothers with infants aged 6-12 months referring to healthcare centers of Bandar-Abbas in 2010. Data were collected through a questionnaire dealing with work-related factors in mothers' workplace. Out of 212 mothers who responded, 52.38% used formula to feed their children, and 27.36% had discontinued breastfeeding. The rate of formula use was significantly higher in mothers who had less than 6 months of maternity leave, those who did not have a suitable nursery or place to milk themselves and preserve the milk in their workplace, those working more than 6 hours per day, and those who could not take a breastfeeding break. It is essential to identify and support breastfeeding employed women. The employers should provide facilities such as nurseries, a suitable physical space for milking, as well as the equipment necessary for milk preservation. Also, such mothers should be granted breastfeeding breaks to feed their child or milk their breasts.

  20. Initial counselling for cleft lip and palate: parents' evaluation, needs and expectations.

    Science.gov (United States)

    Kuttenberger, J; Ohmer, J N; Polska, E

    2010-03-01

    During the first counselling after the birth of a child with cleft lip and palate (CLP) information about the malformation should be delivered and a long-standing relationship between the cleft team and the affected family must be established. The present study was conducted to evaluate the parents' experiences, needs and expectations with this first consultation. A questionnaire was sent to 105 parents at the cleft clinic, which could be answered anonymously. It collected demographic data, data on the parents' pre-existing level of information and the parents' assessment of the counselling at the cleft centre. Seventy percent of the questionnaires were returned. In 16% the clefts were diagnosed prenatally, in 32% there were relatives with clefts. Seventy-one percent of the parents received detailed counselling, 89% of which occurred in the first week. The parents requested that information about surgery (80%), feeding the child (63%) and the aetiology of clefts (44%) should be given. The quality of the consultation was rated very good or good by 87% of families. This study confirms the importance of initial counselling for CLP. The exceptional psychological situation of the family has to be considered and a close collaboration between cleft centre and maternity hospitals is mandatory.

  1. "helix Nebula - the Science Cloud", a European Science Driven Cross-Domain Initiative Implemented in via AN Active Ppp Set-Up

    Science.gov (United States)

    Lengert, W.; Mondon, E.; Bégin, M. E.; Ferrer, M.; Vallois, F.; DelaMar, J.

    2015-12-01

    Helix Nebula, a European science cross-domain initiative building on an active PPP, is aiming to implement the concept of an open science commons[1] while using a cloud hybrid model[2] as the proposed implementation solution. This approach allows leveraging and merging of complementary data intensive Earth Science disciplines (e.g. instrumentation[3] and modeling), without introducing significant changes in the contributors' operational set-up. Considering the seamless integration with life-science (e.g. EMBL), scientific exploitation of meteorological, climate, and Earth Observation data and models open an enormous potential for new big data science. The work of Helix Nebula has shown that is it feasible to interoperate publicly funded infrastructures, such as EGI [5] and GEANT [6], with commercial cloud services. Such hybrid systems are in the interest of the existing users of publicly funded infrastructures and funding agencies because they will provide "freedom and choice" over the type of computing resources to be consumed and the manner in which they can be obtained. But to offer such freedom and choice across a spectrum of suppliers, various issues such as intellectual property, legal responsibility, service quality agreements and related issues need to be addressed. Finding solutions to these issues is one of the goals of the Helix Nebula initiative. [1] http://www.egi.eu/news-and-media/publications/OpenScienceCommons_v3.pdf [2] http://www.helix-nebula.eu/events/towards-the-european-open-science-cloud [3] e.g. https://sentinel.esa.int/web/sentinel/sentinel-data-access [5] http://www.egi.eu/ [6] http://www.geant.net/

  2. Evaluation of setting time and flow properties of self-synthesize alginate impressions

    Science.gov (United States)

    Halim, Calista; Cahyanto, Arief; Sriwidodo, Harsatiningsih, Zulia

    2018-02-01

    Alginate is an elastic hydrocolloid dental impression materials to obtain negative reproduction of oral mucosa such as to record soft-tissue and occlusal relationships. The aim of the present study was to synthesize alginate and to determine the setting time and flow properties. There were five groups of alginate consisted of fifty samples self-synthesize alginate and commercial alginate impression product. Fifty samples were divided according to two tests, each twenty-five samples for setting time and flow test. Setting time test was recorded in the s unit, meanwhile, flow test was recorded in the mm2 unit. The fastest setting time result was in the group three (148.8 s) and the latest was group fours). The highest flow test result was in the group three (69.70 mm2) and the lowest was group one (58.34 mm2). Results were analyzed statistically by one way ANOVA (α= 0.05), showed that there was a statistical significance of setting time while no statistical significance of flow properties between self-synthesize alginate and alginate impression product. In conclusion, the alginate impression was successfully self-synthesized and variation composition gives influence toward setting time and flow properties. The most resemble setting time of control group is group three. The most resemble flow of control group is group four.

  3. Renal impairment in HIV-infected patients initiating tenofovir-containing antiretroviral therapy regimens in a Primary Healthcare Setting in South Africa.

    Science.gov (United States)

    Kamkuemah, Monika; Kaplan, Richard; Bekker, Linda-Gail; Little, Francesca; Myer, Landon

    2015-04-01

    Long-term use of tenofovir disoproxil fumarate is associated with declines in glomerular function and chronic kidney disease in HIV-infected patients. We aimed to assess the prevalence and incidence of renal impairment in a primary care setting in sub-Saharan Africa. We analysed data from 1092 HIV-infected patients initiating tenofovir at a primary care clinic in Cape Town, South Africa. Renal function was assessed for the first 12 months on ART by estimating glomerular filtration rate (eGFR) calculated using the Cockroft-Gault equation categorised into normal, mild, moderate and severe reduction in renal function based on values >90, 60-89, 30-59 and <30 ml/min/1.73 m(2) , respectively. Associations were assessed using logistic regression, and average GFR trajectory over time was modelled using linear mixed-effects models. The cohort consisted of 62% women; median age was 34 years (IQR 29; 41 years). The majority had normal renal function pre-ART (79%), 19% had mildly reduced GFR, and 2% had moderate renal impairment. Older age, more advanced WHO stage and anaemia were independently associated with prevalent renal impairment. On average, estimated glomerular function improved over the first year on tenofovir [1.10 ml/min/1.73 m(2) average increase over 12 months (95% CI: 0.80; 1.40)]. Male gender, anaemia and immunosuppression (WHO Stage III/IV and CD4 cell counts <100 cells/mm(3) ) were associated with lower average eGFR levels over time. Overall, 3% developed eGFR <50 ml/min/1.73 m(2) during this period. Serum creatinine tests conducted before 4 months on ART had low predictive value for predicting change in eGFR after a year on ART. Generally, renal function improved in HIV-infected adults initiating ART in this primary healthcare setting during the first year on ART. While monitoring of renal function is recommended in the first 4 months on ART, renal impairment appears uncommon during the first 12 months of tenofovir-containing ART in primary

  4. Evaluation of the appropriate use of a CIWA-Ar alcohol withdrawal protocol in the general hospital setting.

    Science.gov (United States)

    Eloma, Amanda S; Tucciarone, Jason M; Hayes, Edmund M; Bronson, Brian D

    2018-01-01

    The Clinical Institute Withdrawal Assessment-Alcohol, Revised (CIWA-Ar) is an assessment tool used to quantify alcohol withdrawal syndrome (AWS) severity and inform benzodiazepine treatment for alcohol withdrawal. To evaluate the prescribing patterns and appropriate use of the CIWA-Ar protocol in a general hospital setting, as determined by the presence or absence of documented AWS risk factors, patients' ability to communicate, and provider awareness of the CIWA-Ar order. This retrospective chart review included 118 encounters of hospitalized patients placed on a CIWA-Ar protocol during one year. The following data were collected for each encounter: patient demographics, admitting diagnosis, ability to communicate, and admission blood alcohol level; and medical specialty of the clinician ordering CIWA-Ar, documentation of the presence or absence of established AWS risk factors, specific parameters of the protocol ordered, service admitted to, provider documentation of awareness of the active protocol within 48 h of initial order, total benzodiazepine dose equivalents administered and associated adverse events. 57% of patients who started on a CIWA-Ar protocol had either zero or one documented risk factor for AWS (19% and 38% respectively). 20% had no documentation of recent alcohol use. 14% were unable to communicate. 19% of medical records lacked documentation of provider awareness of the ordered protocol. Benzodiazepine associated adverse events were documented in 15% of encounters. The judicious use of CIWA-Ar protocols in general hospitals requires mechanisms to ensure assessment of validated alcohol withdrawal risk factors, exclusion of patients who cannot communicate, and continuity of care during transitions.

  5. Evaluation of the Palutop+4 malaria rapid diagnostic test in a non-endemic setting

    Directory of Open Access Journals (Sweden)

    van Esbroeck Marjan

    2009-12-01

    Full Text Available Abstract Background Palutop+4 (All. Diag, Strasbourg, France, a four-band malaria rapid diagnostic test (malaria RDT targeting the histidine-rich protein 2 (HRP-2, Plasmodium vivax-specific parasite lactate dehydrogenase (Pv-pLDH and pan Plasmodium-specific pLDH (pan-pLDH was evaluated in a non-endemic setting on stored whole blood samples from international travellers suspected of malaria. Methods Microscopy corrected by PCR was the reference method. Samples include those infected by Plasmodium falciparum (n = 323, Plasmodium vivax (n = 97, Plasmodium ovale (n = 73 and Plasmodium malariae (n = 25 and 95 malaria negative samples. Results The sensitivities for the diagnosis of P. falciparum, P. vivax, P. malariae and P. ovale were 85.1%, 66.0%, 32.0% and 5.5%. Sensitivities increased at higher parasite densities and reached 90.0% for P. falciparum >100/μl and 83.8% for P. vivax > 500/μl. Fourteen P. falciparum samples reacted with the Pv-pLDH line, one P. vivax sample with the HRP-2 line, and respectively two and four P. ovale and P. malariae samples reacted with the HRP-2 line. Two negative samples gave a signal with the HRP-2 line. Faint and weak line intensities were observed for 129/289 (44.6% HRP-2 lines in P. falciparum samples, for 50/64 (78.1% Pv-pLDH lines in P. vivax samples and for 9/13 (69.2% pan-pLDH lines in P. ovale and P. malariae samples combined. Inter-observer reliabilities for positive and negative readings were excellent for the HRP-2 and Pv-pLDH lines (overall agreement > 92.0% and kappa-values for each pair of readers ≥ 0.88, and good for the pan-pLDH line (85.5% overall agreement and kappa-values ≥ 0.74. Conclusions Palutop+4 performed moderately for the detection of P. falciparum and P. vivax, but sensitivities were lower than those of three-band malaria RDTs.

  6. A framework for the monitoring and evaluation of international surgical initiatives in low- and middle-income countries.

    Science.gov (United States)

    Ibrahim, George M; Cadotte, David W; Bernstein, Mark

    2015-01-01

    An estimated two billion people worldwide lack adequate access to surgical care. To address this humanitarian emergency, an increasing number of international surgical partnerships are emerging between developed and low- and middle-income countries (LMICs). At present, there are no clear indicators that may be used to assess the effectiveness of such initiatives. We conducted an international qualitative study of 31 surgeons from developed and LMICs involved in international partnerships across a variety of subspecialties. Thematic analysis and grounded theory were applied in order to develop a practical framework that may be applied to monitor and evaluate global surgical initiatives. Several themes emerged from the study: (i) there is a large unmet need to establish and maintain prospective databases in LMICs to inform the monitoring and evaluation of international surgical partnerships; (ii) assessment of initiatives must occur longitudinally over the span of several years; (ii) the domains of assessment are contextual and encompass cultural, institutional and regional factors; and (iv) evaluation strategies should explore broader impact within the community and country. Based on thematic analysis within the domains of inputs, outputs and outcomes, a framework for the monitoring and evaluation of international surgical initiatives, the Framework for the Assessment of InteRNational Surgical Success (FAIRNeSS) is proposed. In response to the increasing number of surgical partnerships between developed and LMICs, we propose a framework to monitor and evaluate international surgical initiatives.

  7. Evaluation of Melt Behavior with initial Melt Velocity under SFR Severe Accidents

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Hyo; Bang, In Cheol [UNIST, Ulsan (Korea, Republic of); Jerng, Dong Wook [Chung-Ang Univ, Seoul (Korea, Republic of)

    2015-10-15

    In the current Korean sodium-cooled fast reactor (SFR) program, early dispersion of the molten metallic fuel within a subchannel is suggested as one of the inherent safety strategies for the initiating phase of hypothetical core disruptive accident (HCDA). The safety strategy provides negative reactivity driven by the melt dispersal, so it could reduce the possibility of the recriticality event under a severe triple or more fault scenario for SFR. Since the behavior of the melt dispersion is unpredictable, it depends on the accident condition, particularly core region. While the voided coolant channel region is usually developed in the inner core, the unvoided coolant channel region is formed in the outer core. It is important to confirm the fuel dispersion with the core region, but there are not sufficient existing studies for them. From the existing studies, the coolant vapor pressure is considered as one of driving force to move the melt towards outside of the core. There is a complexity of the phenomena during intermixing of the melt with the coolant after the horizontal melt injections. It is too difficult to understand the several combined mechanisms related to the melt dispersion and the fragmentation. Thus, it could be worthwhile to study the horizontal melt injections at lower temperature as a preliminary study in order to identify the melt dispersion phenomena. For this reason, it is required to clarify whether the coolant vapor pressure is the driving force of the melt dispersion with the core region. The specific conditions to be well dispersed for the molten metallic fuel were discussed in the experiments with the simulant materials. The each melt behavior was compared to evaluate the melt dispersion under the coolant void condition and the boiling condition. As the results, the following results are remarked: 1. The upward melt dispersion did not occur for a given melt and coolant temperature in the nonboiling range. Over current range of conditions

  8. Evaluation of Melt Behavior with initial Melt Velocity under SFR Severe Accidents

    International Nuclear Information System (INIS)

    Heo, Hyo; Bang, In Cheol; Jerng, Dong Wook

    2015-01-01

    In the current Korean sodium-cooled fast reactor (SFR) program, early dispersion of the molten metallic fuel within a subchannel is suggested as one of the inherent safety strategies for the initiating phase of hypothetical core disruptive accident (HCDA). The safety strategy provides negative reactivity driven by the melt dispersal, so it could reduce the possibility of the recriticality event under a severe triple or more fault scenario for SFR. Since the behavior of the melt dispersion is unpredictable, it depends on the accident condition, particularly core region. While the voided coolant channel region is usually developed in the inner core, the unvoided coolant channel region is formed in the outer core. It is important to confirm the fuel dispersion with the core region, but there are not sufficient existing studies for them. From the existing studies, the coolant vapor pressure is considered as one of driving force to move the melt towards outside of the core. There is a complexity of the phenomena during intermixing of the melt with the coolant after the horizontal melt injections. It is too difficult to understand the several combined mechanisms related to the melt dispersion and the fragmentation. Thus, it could be worthwhile to study the horizontal melt injections at lower temperature as a preliminary study in order to identify the melt dispersion phenomena. For this reason, it is required to clarify whether the coolant vapor pressure is the driving force of the melt dispersion with the core region. The specific conditions to be well dispersed for the molten metallic fuel were discussed in the experiments with the simulant materials. The each melt behavior was compared to evaluate the melt dispersion under the coolant void condition and the boiling condition. As the results, the following results are remarked: 1. The upward melt dispersion did not occur for a given melt and coolant temperature in the nonboiling range. Over current range of conditions

  9. Beyond fun runs and fruit bowls: an evaluation of the meso-level processes that shaped the Australian Healthy Workers Initiative.

    Science.gov (United States)

    Grunseit, Anne C; Rowbotham, Samantha; Pescud, Melanie; Indig, Devon; Wutzke, Sonia

    2016-02-01

    Issue addressed The Australian National Partnership Agreement on Preventive Health (NPAPH) charged states and territories with the development and implementation of the Healthy Workers Initiative (HWI) to improve workplace health promotion. Most evaluation efforts focus on the setting (micro) level. In the present study the HWI at the meso-level (state program development) was examined to understand how jurisdictions navigated theoretical, practical, and political priorities to develop their programs, and the programmatic choices that support or hinder perceived success. Methods Interviews with HWI program coordinators and managers across seven Australian jurisdictions explored decision-making processes related to developing and implementing the HWI and the impact of defunding. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Results Despite taking a variety of approaches to the HWI, jurisdictions had common goals, namely achieving sustainability and capacity for meaningful change. These goals transcended the performance indicators set out by the NPAPH, which were considered unachievable in the given timeframe. Four ways jurisdictions sought to achieve their goals were identified, these were: 1) taking an embedded approach to workplace health promotion; 2) ensuring relevance of the HWI to businesses; 3) engaging in collaborative partnerships with agencies responsible for implementation; and 4) cultivating evolution of the HWI. Conclusions This meso-level evaluation has provided valuable insights into how health promotion program coordinators translate broad, national-level initiatives into state-specific programs and how they define program success. The study findings also highlight how broader, contextual factors, such as jurisdiction size, political imperatives and funding decisions impact on the implementation and success of a national health promotion initiative. So what? When evaluating the translation of complex initiatives, a

  10. Mechanisms of masked evaluative priming: task sets modulate behavioral and electrophysiological priming for picture and words differentially.

    Science.gov (United States)

    Kiefer, Markus; Liegel, Nathalie; Zovko, Monika; Wentura, Dirk

    2017-04-01

    Research with the evaluative priming paradigm has shown that affective evaluation processes reliably influence cognition and behavior, even when triggered outside awareness. However, the precise mechanisms underlying such subliminal evaluative priming effects, response activation vs semantic processing, are matter of a debate. In this study, we determined the relative contribution of semantic processing and response activation to masked evaluative priming with pictures and words. To this end, we investigated the modulation of masked pictorial vs verbal priming by previously activated perceptual vs semantic task sets and assessed the electrophysiological correlates of priming using event-related potential (ERP) recordings. Behavioral and electrophysiological effects showed a differential modulation of pictorial and verbal subliminal priming by previously activated task sets: Pictorial priming was only observed during the perceptual but not during the semantic task set. Verbal priming, in contrast, was found when either task set was activated. Furthermore, only verbal priming was associated with a modulation of the N400 ERP component, an index of semantic processing, whereas a priming-related modulation of earlier ERPs, indexing visuo-motor S-R activation, was found for both picture and words. The results thus demonstrate that different neuro-cognitive processes contribute to unconscious evaluative priming depending on the stimulus format. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  11. Evaluation of initiation behavior of stress corrosion cracking for type 316L stainless steel in high temperature water. Behavior of crack initiation and effects of distribution of plastic strain on crack initiation

    International Nuclear Information System (INIS)

    Miura, Yasufumi; Miyahara, Yuichi; Kako, Kenji; Sato, Masaru

    2011-01-01

    It is known that the initiation of stress corrosion cracking (SCC) in components such as the reactor core shroud and primary loop re-circulation piping made of L-grade stainless steel is affected by the properties of surface work hardened layer. Therefore, it is important to clarify the effect of the hardened layer on SCC initiation behavior. In this study, creviced bent beam (CBB) test using specimens made of Type 316L stainless steel with controlled distribution of surface work hardened layer was conducted in a simulated BWR environment in order to evaluate the effect of the controlled layer on SCC initiation behavior. The results obtained are as follows; (1) Micro intergranular SCC of low carbon stainless steel was initiated in 50 hours. (2) In this SCC test, it was found that only micro cracks whose depths were smaller than 50 μm were observed until 250 hours and cracks whose depths were larger than 50 μm were observed after 500 hours. (3) SCC was initiated preferentially on the region with high plastic strain gradient in the specimen with controlled distribution of work hardened layer. (author)

  12. Evaluation of a health system strengthening initiative in the Zambian prison system

    Science.gov (United States)

    Sharma, Anjali; Moonga, Clement N; Chileshe, Chisele; Magwende, George; Henostroza, German

    2018-01-01

    Introduction In 2013, the Zambian Correctional Service (ZCS) partnered with the Centre for Infectious Disease Research in Zambia on the Zambian Prisons Health System Strengthening project, seeking to tackle structural, organisational and cultural weaknesses within the prison health system. We present findings from a nested evaluation of the project impact on high, mid-level and facility-level health governance and health service arrangements in the Zambian Correctional Service. Methods Mixed methods were used, including document review, indepth interviews with ministry (11) and prison facility (6) officials, focus group discussions (12) with male and female inmates in six of the eleven intervention prisons, and participant observation during project workshops and meetings. Ethical clearance and verbal informed consent were obtained for all activities. Analysis incorporated deductive and iterative inductive coding. Results Outcomes: Improved knowledge of the prison health system strengthened political and bureaucratic will to materially address prison health needs. This found expression in a tripartite Memorandum of Understanding between the Ministry of Home Affairs, Ministry of Health (MOH) and Ministry of Community Development, and in the appointment of a permanent liaison between MOH and ZCS. Capacity-building workshops for ZCS Command resulted in strengthened health planning and management outcomes, including doubling ZCS health professional workforce (from 37 to78 between 2014 and 2016), new preservice basic health training for incoming ZCS officers and formation of facility-based prison health committees with a mandate for health promotion and protection. Mechanisms: continuous and facilitated communication among major stakeholders and the emergence of interorganisational trust were critical. Enabling contextual factors included a permissive political environment, a shift within ZCS from a ‘punitive’ to ‘correctional’ organisational culture, and

  13. Human versus Computer Controlled Selection of Ventilator Settings: An Evaluation of Adaptive Support Ventilation and Mid-Frequency Ventilation

    Directory of Open Access Journals (Sweden)

    Eduardo Mireles-Cabodevila

    2012-01-01

    Full Text Available Background. There are modes of mechanical ventilation that can select ventilator settings with computer controlled algorithms (targeting schemes. Two examples are adaptive support ventilation (ASV and mid-frequency ventilation (MFV. We studied how different clinician-chosen ventilator settings are from these computer algorithms under different scenarios. Methods. A survey of critical care clinicians provided reference ventilator settings for a 70 kg paralyzed patient in five clinical/physiological scenarios. The survey-derived values for minute ventilation and minute alveolar ventilation were used as goals for ASV and MFV, respectively. A lung simulator programmed with each scenario’s respiratory system characteristics was ventilated using the clinician, ASV, and MFV settings. Results. Tidal volumes ranged from 6.1 to 8.3 mL/kg for the clinician, 6.7 to 11.9 mL/kg for ASV, and 3.5 to 9.9 mL/kg for MFV. Inspiratory pressures were lower for ASV and MFV. Clinician-selected tidal volumes were similar to the ASV settings for all scenarios except for asthma, in which the tidal volumes were larger for ASV and MFV. MFV delivered the same alveolar minute ventilation with higher end expiratory and lower end inspiratory volumes. Conclusions. There are differences and similarities among initial ventilator settings selected by humans and computers for various clinical scenarios. The ventilation outcomes are the result of the lung physiological characteristics and their interaction with the targeting scheme.

  14. A simplified ingestion procedure for esophageal capsule endoscopy: initial evaluation in healthy volunteers.

    Science.gov (United States)

    Gralnek, I M; Rabinovitz, R; Afik, D; Eliakim, R

    2006-09-01

    Initial studies on esophageal capsule endoscopy (PillCam ESO) reported excellent sensitivity and specificity, but these were followed by mixed results in several subsequent studies, probably due to deviations from the recommended ingestion protocol and the inconvenience of capsule ingestion in the supine position. The aim of this study was therefore to test a simplified ingestion procedure (SIP) for PillCam ESO. Using a cross-over study design, the SIP was prospectively compared with the original ingestion procedure for PillCam ESO in 24 healthy volunteers (15 men, nine women; mean age 44, range 27 - 70) and evaluated for: bubbles/saliva interference at the Z-line, Z-line circumferential visualization (quadrants), and convenience and ease of the ingestion procedure. All Rapid 4 videos were reviewed in a randomized manner and read by an experienced PillCam ESO reader blinded to the ingestion procedure used. It was found that the SIP significantly improved visualization in comparison with the original ingestion procedure, with less interference due to bubbles/saliva observed at the gastroesophageal junction ( P = 0.002) and improved visualization of the Z-line ( P = 0.025). Although the esophageal transit time was significantly faster with the SIP (3 : 45 min vs. 0 : 38 min; P = 0.0001), there were no differences in the number of Z-line frames/images captured. This new, simplified ingestion procedure for PillCam ESO provides significantly improved visualization of the Z-line in healthy volunteers. The overall test characteristics of PillCam ESO using SIP should be tested in patients with esophageal disease.

  15. Evaluation of chondrocalcinosis and associated knee joint degeneration using MR imaging: Data from the osteoarthritis initiative

    Energy Technology Data Exchange (ETDEWEB)

    Gersing, Alexandra S.; Schwaiger, Benedikt J.; Heilmeier, Ursula; Joseph, Gabby B.; Facchetti, Luca; Kretzschmar, Martin; Steinbach, Lynne S.; Link, Thomas M. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Lynch, John A.; McCulloch, Charles E.; Nevitt, Michael C. [University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

    2017-06-15

    To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC. Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (r{sub T1GE} = 0.73, P < 0.001; r{sub DESS} = 0.68, P < 0.001) compared to other sequences (P > 0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017). Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage. (orig.)

  16. The Use of the Data Assimilation Research Testbed for Initializing and Evaluating IPCC Decadal Forecasts

    Science.gov (United States)

    Raeder, K.; Anderson, J. L.; Lauritzen, P. H.; Hoar, T. J.; Collins, N.

    2010-12-01

    DART (www.image.ucar.edu/DAReS/DART) is a general purpose, freely available, ensemble Kalman filter, data assimilation system, which is being used to generate state-of-the-art, partially coupled, ocean-atmosphere re-analyses in support of the decadal predictions planned for the next IPCC report. The resulting gridded product is directly comparable to the state variables output by POP and CAM (oceanic and atmospheric components of NCAR's Community Earth System Model climate model) because those are the assimilating models. Other models could also benefit from comparison against these reanalyses, since the ocean analyses are at the leading edge of ocean state estimation, and the atmospheric analyses are competitive with operational centers'. Such comparisons can reveal model biases and predictability characteristics, and do so in a quantitative way, since the ensemble nature of the analyses provides an objective estimate of the analysis error. The analyses will also be used as initial conditions for the decadal forecasts because they are the most realistic available. The generation of such analyses has revealed errors in model formulation for several versions of the finite volume core CAM, which has led to model improvements in each case. New models can be incorporated into DART in a matter of weeks, allowing them to be compared directly against available observations. The observations currently used in the assimilations include, for the ocean; temperature and salinity from the World Ocean Database (floats, drifters, moorings, autonomous pinipeds, and others), and for the atmosphere; temperature and winds from radiosondes, satellite drift winds, ACARS and aircraft. Observations of ocean currents and atmospheric moisture and pressure are also available. Global Positioning System profiles of atmospheric temperature and moisture are available for recent years. All that is required to add new observations to the suite is the forward operator, which generates an estimate

  17. Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Gersing, Alexandra S; Schwaiger, Benedikt J; Heilmeier, Ursula; Joseph, Gabby B; Facchetti, Luca; Kretzschmar, Martin; Lynch, John A; McCulloch, Charles E; Nevitt, Michael C; Steinbach, Lynne S; Link, Thomas M

    2017-06-01

    To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC. Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (r T1GE  = 0.73, P  0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017). Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage. • Magnetic resonance imaging is useful for assessing burden of calcium-containing crystals (CaC). • Gradient-echo sequences are superior to fast spin echo sequences for CaC imaging. • Presence of CaC is associated with meniscus and cartilage degradation.

  18. Initial evaluation and referral guidelines for management of pelvic/ovarian masses.

    Science.gov (United States)

    Le, Tien; Giede, Christopher; Salem, Shia; Lefebvre, Guylaine; Rosen, Barry; Bentley, James; Kupets, Rachel; Power, Patti; Renaud, Marie-Claude; Bryson, Peter; Davis, Donald B; Lau, Susie; Lotocki, Robert; Senikas, Vyta; Morin, Lucie; Bly, Stephen; Butt, Kimberly; Cargill, Yvonne M; Denis, Nanette; Gagnon, Robert; Hietala-Coyle, Marja Anne; Lim, Kenneth Ian; Ouellet, Annie; Raciot, Maria-Hélène

    2009-07-01

    To optimize the management of adnexal masses and to assist primary care physicians and gynaecologists determine which patients presenting with an ovarian mass with a significant risk of malignancy should be considered for gynaecologic oncology referral and management. Laparoscopic evaluation, comprehensive surgical staging for early ovarian cancer, or tumour debulking for advanced stage ovarian cancer. To optimize conservative versus operative management of women with possible ovarian malignancy and to optimize the involvement of gynaecologic oncologists in planning and delivery of treatment. Published literature was retrieved through searches of PubMed or MEDLINE, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary and key words. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Grey (unpublished) literature was identified by searching the web sites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. 1. Primary care physicians and gynaecologists should always consider the possibility of an underlying ovarian cancer in patients in any age group who present with an adnexal or ovarian mass. (II-2B) 2. Appropriate workup of a perimenopausal or postmenopausal woman presenting with an adnexal mass should include evaluation of symptoms and signs suggestive of malignancy, such as persistent pelvic/abdominal pain, urinary urgency/frequency, increased abdominal size/bloating, and difficulty eating. In addition, CA125 measurement should be considered. (II-2B) 3. Transvaginal or transabdominal ultrasound examination is recommended as part of the initial workup of a complex adnexal/ovarian mass. (II-2B) 4. Ultrasound reports should be standardized to include size and unilateral/bilateral location of the adnexal mass and

  19. Human Laboratory Settings for Assessing Drug Craving; Implications for the Evaluation of Treatment Efficacy

    Directory of Open Access Journals (Sweden)

    Zahra Alam Mehrjerdi

    2011-04-01

    Full Text Available Research on assessing craving in laboratory settings often involves inducing and then measuring craving in subjects. Cue-induced craving is studied in laboratory settings using the cue reactivity paradigm, in which drug-related photos, videos, evocative scripts, olfactory cues, and paraphernalia may induce craving. Cue-induced craving evoked by drug-related stimuli could be associated with relapse and recurrence of drug addiction. In this article, the authors review different methods of assessing craving in laboratory settings and explain how human laboratory settings can bridge the gap between randomized clinical trials (RCTs and animal models on pharmacological treatments for drug dependence. The brief reviewed literature provides strong evidence that laboratory-based studies of craving may improve our understanding of how subjective reports of drug craving are related to objective measures of drug abuse and laboratory settings provide an opportunity to measure the degree to which they co-vary during pharmacological interventions. This issue has important implications inclinical studies.

  20. Human Laboratory Settings for Assessing Drug Craving Implications for the Evaluation of Treatment Efficacy

    Directory of Open Access Journals (Sweden)

    Zahra Alam Mehrjerdi

    2011-04-01

    Full Text Available Research on assessing craving in laboratory settings often involves inducing and then measuring craving in subjects. Cue-induced craving is studied in laboratory settings using the cue reactivity paradigm, in which drug-related photos, videos, evocative scripts, olfactory cues, and paraphernalia may induce craving. Cue-induced craving evoked by drug-related stimuli could be associated with relapse and recurrence of drug addiction. In this article, the authors review different methods of assessing craving in laboratory settings and explain how human laboratory settings can bridge the gap between randomized clinical trials (RCTs and animal models on pharmacological treatments for drug dependence. The brief reviewed literature provides strong evidence that laboratory-based studies of craving may improve our understanding of how subjective reports of drug craving are related to objective measures of drug abuse and laboratory settings provide an opportunity to measure the degree to which they co-vary during pharmacological interventions. This issue has important implications inclinical studies.

  1. Focusing on the Whole Student: An Evaluation of Massachusetts's Wraparound Zone Initiative

    Science.gov (United States)

    Gandhi, Allison Gruner; Slama, Rachel; Park, So Jung; Russo, Patrick; Winner, Kendra; Bzura, Robin; Jones, Wehmah; Williamson, Sandra

    2018-01-01

    We used a comparative interrupted time series design to examine the impact of the Massachusetts' Wraparound Zone Initiative on student achievement, attendance, retention, and suspension. This initiative was designed to create coordinated district systems that allow schools to proactively and systematically address students' nonacademic needs. The…

  2. The Early College High School Initiative: An Overview of Five Evaluation Years

    Science.gov (United States)

    Berger, Andrea; Adelman, Nancy; Cole, Susan

    2010-01-01

    In 2002, the Bill & Melinda Gates Foundation started the Early College High School Initiative (ECHSI). Through this initiative, more than 200 Early College Schools (ECSs) opened by fall 2009. All of the schools aim to provide underserved students access to college classes while in high school. This article will provide an overview of the first 6…

  3. Development and Psychometric Evaluation of the Personal Growth Initiative Scale-II

    Science.gov (United States)

    Robitschek, Christine; Ashton, Matthew W.; Spering, Cynthia C.; Geiger, Nathaniel; Byers, Danielle; Schotts, G. Christian; Thoen, Megan A.

    2012-01-01

    The original Personal Growth Initiative Scale (PGIS; Robitschek, 1998) was unidimensional, despite theory identifying multiple components (e.g., cognition and behavior) of personal growth initiative (PGI). The present research developed a multidimensional measure of the complex process of PGI, while retaining the brief and psychometrically sound…

  4. Evaluation of the effect of initial texture on the development of deformation texture

    DEFF Research Database (Denmark)

    Leffers, Torben; Juul Jensen, Dorte

    1986-01-01

    The authors describe a computer procedure which allows them to introduce experimental initial textures as starting conditions for texture simulation (instead of a theoretical random texture). They apply the procedure on two batches of copper with weak initial textures and on fine-grained and coarse......-grained aluminium with moderately strong initial textures. In copper the initial texture turns out to be too weak to have any significant effect. In aluminium the initial texture has a very significant effect on the simulated textures-similar to the effect it has on the experimental textures. However......, there are differences between the simulated and the experimental aluminium textures that can only be explained as a grain-size effect. Possible future applications of the procedure are discussed...

  5. Evaluation of the Risk of Drug Addiction with the Help of Fuzzy Sets

    Directory of Open Access Journals (Sweden)

    L. Rakesh

    2010-01-01

    Full Text Available The primary focus of this paper is to present a general view of the current applications of fuzzy logic in medical analogy of consumption of drugs. The paper also deals with the origin, structure and composition of fuzzy sets. We particularly review the medical literature using fuzzy logic. Fuzzy set theory can be considered as a suitable formalism to deal with the imprecision intrinsic to many real world problems. Fuzzy set theory provides an appropriate framework for the representation of vague medical concepts and imprecise modes of reasoning. We present two concrete illustrations to investigate the impact of the risk related to drug addictions, like smoking and alcohol drinking and thereby highlighting the social problem related to health.

  6. Difficulties experienced in setting and achieving goals by participants of a falls prevention programme: a mixed-methods evaluation.

    Science.gov (United States)

    Haas, Romi; Mason, Wendy; Haines, Terry P

    2014-01-01

    To evaluate the ability of participants of a falls prevention programme to set and achieve goals. The study used a prospective longitudinal design and a mixed-methods approach to data collection. Study participants were (1) 220 older adults participating in a 15-week combined exercise and education falls prevention programme and (2) 9 practitioners (3 home-care nurses, 5 community workers, and an exercise physiologist) involved in delivering the programme. Data from goal-setting forms were analyzed, and descriptive statistics were used to determine the number of appropriate goals set and achieved. Data were analyzed according to programme setting (home- or group-based) and whether or not participants were classified as being from a Culturally and Linguistically Diverse (CALD) background in the Australian context. Semi-structured interviews with programme practitioners were thematically analyzed. A total of 144 respondents (n=75 CALD group, n=41 non-CALD group, n=6 CALD home, n=22 non-CALD home) set 178 goals. Only 101 (57%) goals could be evaluated according to achievement, because participants set goals that focused on health state instead of behaviour, set goals not relevant to falls prevention, used inappropriate constructs to measure goal achievement, and either did not review their goals or dropped out of the programme before goal review. Of these 101 goals, 64 were achieved. Practitioners described their own difficulties in understanding the process of setting health behaviour goals along with communication, cultural, and logistic difficulties. Both CALD and non-CALD participants and those participating in both group- and home-based programmes experienced difficulty in setting and achieving goals to facilitate behaviour change for falls prevention. Data suggest that home-based participants had more difficulty in setting goals than their group-based counterparts and, to a lesser extent, that CALD participants experienced more difficulty in setting goals than

  7. Evaluating patient care communication in integrated care settings: application of a mixed method approach in cerebral palsy programs

    NARCIS (Netherlands)

    Gulmans, J.; Gulmans, J.; Vollenbroek-Hutten, Miriam Marie Rosé; van Gemert-Pijnen, Julia E.W.C.; van Harten, Willem H.

    2009-01-01

    Objective. In this study, we evaluated patient care communication in the integrated care setting of children with cerebral palsy in three Dutch regions in order to identify relevant communication gaps experienced by both parents and involved professionals. - Design. A three-step mixed method

  8. Imagining oneself: Narrative evaluations of the professional identities of learners in a transnational higher-educational setting

    NARCIS (Netherlands)

    Haines, Kevin

    2015-01-01

    This article uses a narrative approach to investigate the learning experiences of third-year medical students in a transnational higher educational setting, specifically during an elective period abroad. The students evaluate their learning experiences in an unfamiliar environment both in relation

  9. A Novel Evaluation Model for Hybrid Power System Based on Vague Set and Dempster-Shafer Evidence Theory

    Directory of Open Access Journals (Sweden)

    Dongxiao Niu

    2012-01-01

    Full Text Available Because clean energy and traditional energy have different advantages and disadvantages, it is of great significance to evaluate comprehensive benefits for hybrid power systems. Based on thorough analysis of important characters on hybrid power systems, an index system including security, economic benefit, environmental benefit, and social benefit is established in this paper. Due to advantages of processing abundant uncertain and fuzzy information, vague set is used to determine the decision matrix. Convert vague decision matrix to real one by vague combination ruleand determine uncertain degrees of different indexes by grey incidence analysis, then the mass functions of different comment set in different indexes are obtained. Information can be fused in accordance with Dempster-Shafer (D-S combination rule and the evaluation result is got by vague set and D-S evidence theory. A simulation of hybrid power system including thermal power, wind power, and photovoltaic power in China is provided to demonstrate the effectiveness and potential of the proposed design scheme. It can be clearly seen that the uncertainties in decision making can be dramatically decreased compared with existing methods in the literature. The actual implementation results illustrate that the proposed index system and evaluation model based on vague set and D-S evidence theory are effective and practical to evaluate comprehensive benefit of hybrid power system.

  10. Evaluating Question, Persuade, Refer (QPR) Suicide Prevention Training in a College Setting

    Science.gov (United States)

    Mitchell, Sharon L.; Kader, Mahrin; Darrow, Sherri A.; Haggerty, Melinda Z.; Keating, Niki L.

    2013-01-01

    This study assesses short-term and long-term learning outcomes of Question, Persuade, Refer (QPR) suicide prevention training in a college setting. Two hundred seventy-three participants completed pretest, posttest, and follow-up surveys regarding suicide prevention knowledge, attitudes, and skills. Results indicated: (a) increases in suicide…

  11. A novel method of evaluation of three heat-moisture exchangers in six different ventilator settings

    NARCIS (Netherlands)

    Unal, N.; Kanhai, J. K.; Buijk, S. L.; Pompe, J. C.; Holland, W. P.; Gültuna, I.; Ince, C.; Saygin, B.; Bruining, H. A.

    1998-01-01

    The purpose of this study was to assess and compare the humidification, heating, and resistance properties of three commercially available heat-moisture exchangers (HMEs). To mimic clinical conditions, a previously validated, new, realistic experimental set-up and measurement protocol was used.

  12. Efficacy and Safety of Three Antiretroviral Regimens for Initial Treatment of HIV-1: A Randomized Clinical Trial in Diverse Multinational Settings

    Science.gov (United States)

    Campbell, Thomas B.; Smeaton, Laura M.; Kumarasamy, N.; Flanigan, Timothy; Klingman, Karin L.; Firnhaber, Cynthia; Grinsztejn, Beatriz; Hosseinipour, Mina C.; Kumwenda, Johnstone; Lalloo, Umesh; Riviere, Cynthia; Sanchez, Jorge; Melo, Marineide; Supparatpinyo, Khuanchai; Tripathy, Srikanth; Martinez, Ana I.; Nair, Apsara; Walawander, Ann; Moran, Laura; Chen, Yun; Snowden, Wendy; Rooney, James F.; Uy, Jonathan; Schooley, Robert T.; De Gruttola, Victor; Hakim, James Gita; Swann, Edith; Barnett, Ronald L.; Brizz, Barbara; Delph, Yvette; Gettinger, Nikki; Mitsuyasu, Ronald T.; Eshleman, Susan; Safren, Steven; Fiscus, Susan A.; Andrade, Adriana; Haas, David W.; Amod, Farida; Berthaud, Vladimir; Bollinger, Robert C.; Bryson, Yvonne; Celentano, David; Chilongozi, David; Cohen, Myron; Collier, Ann C.; Currier, Judith Silverstein; Cu-Uvin, Susan; Eron, Joseph; Flexner, Charles; Gallant, Joel E.; Gulick, Roy M.; Hammer, Scott M.; Hoffman, Irving; Kazembe, Peter; Kumwenda, Newton; Lama, Javier R.; Lawrence, Jody; Maponga, Chiedza; Martinson, Francis; Mayer, Kenneth; Nielsen, Karin; Pendame, Richard B.; Ramratnam, Bharat; Sanne, Ian; Severe, Patrice; Sirisanthana, Thira; Solomon, Suniti; Tabet, Steve; Taha, Taha; van der Horst, Charles; Wanke, Christine; Gormley, Joan; Marcus, Cheryl J.; Putnam, Beverly; Loeliger, Edde; Pappa, Keith A.; Webb, Nancy; Shugarts, David L.; Winters, Mark A.; Descallar, Renard S.; Steele, Joseph; Wulfsohn, Michael; Said, Farideh; Chen, Yue; Martin, John C; Bischofberger, Norbert; Cheng, Andrew; Jaffe, Howard; Sharma, Jabin; Poongulali, S.; Cardoso, Sandra Wagner; Faria, Deise Lucia; Berendes, Sima; Burke, Kelly; Mngqibisa, Rosie; Kanyama, Cecelia; Kayoyo, Virginia; Samaneka, Wadzanai P.; Chisada, Anthony; Faesen, Sharla; Chariyalertsak, Suwat; Santos, Breno; Lira, Rita Alves; Joglekar, Anjali A.; Rosa, Alberto La; Infante, Rosa; Jain, Mamta; Petersen, Tianna; Godbole, Sheela; Dhayarkar, Sampada; Feinberg, Judith; Baer, Jenifer; Pollard, Richard B.; Asmuth, David; Gangakhedkar, Raman R; Gaikwad, Asmita; Ray, M. Graham; Basler, Cathi; Para, Michael F.; Watson, Kathy J.; Taiwo, Babafemi; McGregor, Donna; Balfour, Henry H.; Mullan, Beth; Kim, Ge-Youl; Klebert, Michael K.; Cox, Gary Matthew; Silberman, Martha; Mildvan, Donna; Revuelta, Manuel; Tashima, Karen T.; Patterson, Helen; Geiseler, P. Jan; Santos, Bartolo; Daar, Eric S; Lopez, Ruben; Frarey, Laurie; Currin, David; Haas, David H.; Bailey, Vicki L.; Tebas, Pablo; Zifchak, Larisa; Noel-Connor, Jolene; Torres, Madeline; Sha, Beverly E.; Fritsche, Janice M.; Cespedes, Michelle; Forcht, Janet; O'Brien, William A.; Mogridge, Cheryl; Hurley, Christine; Corales, Roberto; Palmer, Maria; Adams, Mary; Luque, Amneris; Lopez-Detres, Luis; Stroberg, Todd

    2012-01-01

    Background Antiretroviral regimens with simplified dosing and better safety are needed to maximize the efficiency of antiretroviral delivery in resource-limited settings. We investigated the efficacy and safety of antiretroviral regimens with once-daily compared to twice-daily dosing in diverse areas of the world. Methods and Findings 1,571 HIV-1-infected persons (47% women) from nine countries in four continents were assigned with equal probability to open-label antiretroviral therapy with efavirenz plus lamivudine-zidovudine (EFV+3TC-ZDV), atazanavir plus didanosine-EC plus emtricitabine (ATV+DDI+FTC), or efavirenz plus emtricitabine-tenofovir-disoproxil fumarate (DF) (EFV+FTC-TDF). ATV+DDI+FTC and EFV+FTC-TDF were hypothesized to be non-inferior to EFV+3TC-ZDV if the upper one-sided 95% confidence bound for the hazard ratio (HR) was ≤1.35 when 30% of participants had treatment failure. An independent monitoring board recommended stopping study follow-up prior to accumulation of 472 treatment failures. Comparing EFV+FTC-TDF to EFV+3TC-ZDV, during a median 184 wk of follow-up there were 95 treatment failures (18%) among 526 participants versus 98 failures among 519 participants (19%; HR 0.95, 95% CI 0.72–1.27; p = 0.74). Safety endpoints occurred in 243 (46%) participants assigned to EFV+FTC-TDF versus 313 (60%) assigned to EFV+3TC-ZDV (HR 0.64, CI 0.54–0.76; p<0.001) and there was a significant interaction between sex and regimen safety (HR 0.50, CI 0.39–0.64 for women; HR 0.79, CI 0.62–1.00 for men; p = 0.01). Comparing ATV+DDI+FTC to EFV+3TC-ZDV, during a median follow-up of 81 wk there were 108 failures (21%) among 526 participants assigned to ATV+DDI+FTC and 76 (15%) among 519 participants assigned to EFV+3TC-ZDV (HR 1.51, CI 1.12–2.04; p = 0.007). Conclusion EFV+FTC-TDF had similar high efficacy compared to EFV+3TC-ZDV in this trial population, recruited in diverse multinational settings. Superior safety, especially in HIV-1-infected

  13. Efficacy and safety of three antiretroviral regimens for initial treatment of HIV-1: a randomized clinical trial in diverse multinational settings.

    Directory of Open Access Journals (Sweden)

    Thomas B Campbell

    Full Text Available Antiretroviral regimens with simplified dosing and better safety are needed to maximize the efficiency of antiretroviral delivery in resource-limited settings. We investigated the efficacy and safety of antiretroviral regimens with once-daily compared to twice-daily dosing in diverse areas of the world.1,571 HIV-1-infected persons (47% women from nine countries in four continents were assigned with equal probability to open-label antiretroviral therapy with efavirenz plus lamivudine-zidovudine (EFV+3TC-ZDV, atazanavir plus didanosine-EC plus emtricitabine (ATV+DDI+FTC, or efavirenz plus emtricitabine-tenofovir-disoproxil fumarate (DF (EFV+FTC-TDF. ATV+DDI+FTC and EFV+FTC-TDF were hypothesized to be non-inferior to EFV+3TC-ZDV if the upper one-sided 95% confidence bound for the hazard ratio (HR was ≤1.35 when 30% of participants had treatment failure. An independent monitoring board recommended stopping study follow-up prior to accumulation of 472 treatment failures. Comparing EFV+FTC-TDF to EFV+3TC-ZDV, during a median 184 wk of follow-up there were 95 treatment failures (18% among 526 participants versus 98 failures among 519 participants (19%; HR 0.95, 95% CI 0.72-1.27; p = 0.74. Safety endpoints occurred in 243 (46% participants assigned to EFV+FTC-TDF versus 313 (60% assigned to EFV+3TC-ZDV (HR 0.64, CI 0.54-0.76; p<0.001 and there was a significant interaction between sex and regimen safety (HR 0.50, CI 0.39-0.64 for women; HR 0.79, CI 0.62-1.00 for men; p = 0.01. Comparing ATV+DDI+FTC to EFV+3TC-ZDV, during a median follow-up of 81 wk there were 108 failures (21% among 526 participants assigned to ATV+DDI+FTC and 76 (15% among 519 participants assigned to EFV+3TC-ZDV (HR 1.51, CI 1.12-2.04; p = 0.007.EFV+FTC-TDF had similar high efficacy compared to EFV+3TC-ZDV in this trial population, recruited in diverse multinational settings. Superior safety, especially in HIV-1-infected women, and once-daily dosing of EFV+FTC-TDF are

  14. Development, implementation and evaluation of a peer review of teaching (PRoT) initiative in nursing education.

    Science.gov (United States)

    Mager, Diana R; Kazer, Meredith W; Conelius, Jaclyn; Shea, Joyce; Lippman, Doris T; Torosyan, Roben; Nantz, Kathryn

    2014-06-03

    For many years, an area of research in higher education has been emerging around the development and implementation of fair and effective peer evaluation programs. Recently, a new body of knowledge has developed regarding the development and implementation of fair and effective peer evaluation programs resulting in formative and summative evaluations. The purpose of this article is to describe the development, implementation, and evaluation of a peer review of teaching (PRoT) program for nursing faculty, initiated at one small comprehensive university in the northeastern United States. Pairs of nursing faculty evaluated each other's teaching, syllabi, and course materials after collaborating in a pre-evaluation conference to discuss goals of the classroom visit. Qualitative data gathered in post project focus groups revealed that faculty found their modified PRoT process to be a mutually beneficial experience that was more useful, flexible and collegial, and less stressful than their previous evaluation process.

  15. Initializing numerical weather prediction models with satellite-derived surface soil moisture: Data assimilation experiments with ECMWF's Integrated Forecast System and the TMI soil moisture data set

    Science.gov (United States)

    Drusch, M.

    2007-02-01

    Satellite-derived surface soil moisture data sets are readily available and have been used successfully in hydrological applications. In many operational numerical weather prediction systems the initial soil moisture conditions are analyzed from the modeled background and 2 m temperature and relative humidity. This approach has proven its efficiency to improve surface latent and sensible heat fluxes and consequently the forecast on large geographical domains. However, since soil moisture is not always related to screen level variables, model errors and uncertainties in the forcing data can accumulate in root zone soil moisture. Remotely sensed surface soil moisture is directly linked to the model's uppermost soil layer and therefore is a stronger constraint for the soil moisture analysis. For this study, three data assimilation experiments with the Integrated Forecast System (IFS) of the European Centre for Medium-Range Weather Forecasts (ECMWF) have been performed for the 2-month period of June and July 2002: a control run based on the operational soil moisture analysis, an open loop run with freely evolving soil moisture, and an experimental run incorporating TMI (TRMM Microwave Imager) derived soil moisture over the southern United States. In this experimental run the satellite-derived soil moisture product is introduced through a nudging scheme using 6-hourly increments. Apart from the soil moisture analysis, the system setup reflects the operational forecast configuration including the atmospheric 4D-Var analysis. Soil moisture analyzed in the nudging experiment is the most accurate estimate when compared against in situ observations from the Oklahoma Mesonet. The corresponding forecast for 2 m temperature and relative humidity is almost as accurate as in the control experiment. Furthermore, it is shown that the soil moisture analysis influences local weather parameters including the planetary boundary layer height and cloud coverage.

  16. EVALUATED NUCLEAR STRUCTURE DATA FILE. A MANUAL FOR PREPARATION OF DATA SETS

    International Nuclear Information System (INIS)

    TULI, J.K.

    2001-01-01

    This manual describes the organization and structure of the Evaluated Nuclear Structure Data File (ENSDF). This computer-based file is maintained by the National Nuclear Data Center (NNDC) at Brookhaven National Laboratory for the international Nuclear Structure and Decay Data Network. For every mass number (presently, A ≤ 293), the Evaluated Nuclear Structure Data File (ENSDF) contains evaluated structure information. For masses A ≥ 44, this information is published in the Nuclear Data Sheets; for A < 44, ENSDF is based on compilations published in the journal Nuclear Physics. The information in ENSDF is updated by mass chain or by nuclide with a varying cycle time dependent on the availability of new information

  17. Radical Initiated Hydrosilylation on Silicon Nanocrystal Surfaces: An Evaluation of Functional Group Tolerance and Mechanistic Study.

    Science.gov (United States)

    Yang, Zhenyu; Gonzalez, Christina M; Purkait, Tapas K; Iqbal, Muhammad; Meldrum, Al; Veinot, Jonathan G C

    2015-09-29

    Hydrosilylation is among the most common methods used for modifying silicon surface chemistry. It provides a wide range of surface functionalities and effective passivation of surface sites. Herein, we report a systematic study of radical initiated hydrosilylation of silicon nanocrystal (SiNC) surfaces using two common radical initiators (i.e., 2,2'-azobis(2-methylpropionitrile) and benzoyl peroxide). Compared to other widely applied hydrosilylation methods (e.g., thermal, photochemical, and catalytic), the radical initiator based approach is particle size independent, requires comparatively low reaction temperatures, and yields monolayer surface passivation after short reaction times. The effects of differing functional groups (i.e., alkene, alkyne, carboxylic acid, and ester) on the radical initiated hydrosilylation are also explored. The results indicate functionalization occurs and results in the formation of monolayer passivated surfaces.

  18. Evaluations of environmental effect on micro crack initiation and propagation by surface observations of fatigue specimens

    International Nuclear Information System (INIS)

    Fujikawa, Ryosuke; Abe, Shigeki; Nakamura, Takao; Kamaya, Masayuki

    2014-01-01

    Fatigue life of nuclear facilities tends to be decreased by the influence of reactor coolant, which is called environmental effect. The effect accelerates crack growth rate but the influence for crack initiation is not clarified. This study intends to discuss the environmental effect in crack initiation. The crack length and the number of cracks are measured from the investigation of fatigue test specimens in reactor coolant and air. The behavior of crack initiation is revealed from the measurement of number of cracks, crack sizes and fatigue life. From this study, environmental effect of reactor coolant is considered to influence crack initiation and increase the number of micro crack. It is also estimated that the coalescence of cracks influences the acceleration of crack growth. (author)

  19. Evaluating the impact of the Extractive Industries Transparency Initiative (EITI) on corruption in Zambia

    NARCIS (Netherlands)

    P. Fenton Villar (Paul); E. Papyrakis (Elissaios)

    2016-01-01

    textabstractThe Extractive Industries Transparency Initiative (EITI) is internationally recognised as a leading anti-corruption scheme, which promotes transparency, accountability and good governance of public oil, gas, and mining revenues. This article provides the first rigorous quantitative

  20. [A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

    Science.gov (United States)

    Petrini, Carlo

    2015-01-01

    The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

  1. Characterisation of flattening filter free (FFF) beam properties for initial beam set-up and routine QA, independent of flattened beams

    Science.gov (United States)

    Paynter, D.; Weston, S. J.; Cosgrove, V. P.; Thwaites, D. I.

    2018-01-01

    Flattening filter free (FFF) beams have reached widespread use for clinical treatment deliveries. The usual methods for FFF beam characterisation for their quality assurance (QA) require the use of associated conventional flattened beams (cFF). Methods for QA of FFF without the need to use associated cFF beams are presented and evaluated against current methods for both FFF and cFF beams. Inflection point normalisation is evaluated against conventional methods for the determination of field size and penumbra for field sizes from 3 cm  ×  3 cm to 40 cm  ×  40cm at depths from dmax to 20 cm in water for matched and unmatched FFF beams and for cFF beams. A method for measuring symmetry in the cross plane direction is suggested and evaluated as FFF beams are insensitive to symmetry changes in this direction. Methods for characterising beam energy are evaluated and the impact of beam energy on profile shape compared to that of cFF beams. In-plane symmetry can be measured, as can cFF beams, using observed changes in profile, whereas cross-plane symmetry can be measured by acquiring profiles at collimator angles 0 and 180. Beam energy and ‘unflatness’ can be measured as with cFF beams from observed shifts in profile with changing beam energy. Normalising the inflection points of FFF beams to 55% results in an equivalent penumbra and field size measurement within 0.5 mm of conventional methods with the exception of 40 cm  ×  40 cm fields at a depth of 20 cm. New proposed methods are presented that make it possible to independently carry out set up and QA measurements on beam energy, flatness, symmetry and field size of an FFF beam without the need to reference to an equivalent flattened beam of the same energy. The methods proposed can also be used to carry out this QA for flattened beams, resulting in universal definitions and methods for MV beams. This is presented for beams produced by an Elekta linear accelerator, but is

  2. Initial psychometric evaluation of the Moral Injury Questionnaire--Military version.

    Science.gov (United States)

    Currier, Joseph M; Holland, Jason M; Drescher, Kent; Foy, David

    2015-01-01

    Moral injury is an emerging construct related to negative consequences associated with war-zone stressors that transgress military veterans' deeply held values/beliefs. Given the newness of the construct, there is a need for instrumentation that might assess morally injurious experiences (MIEs) in this population. Drawing on a community sample of 131 Iraq and/or Afghanistan Veterans and clinical sample of 82 returning Veterans, we conducted an initial psychometric evaluation of the newly developed Moral Injury Questionnaire-Military version (MIQ-M)-a 20-item self-report measure for assessing MIEs. Possibly due to low rates of reporting, an item assessing sexual trauma did not yield favourable psychometric properties and was excluded from analyses. Veterans in the clinical sample endorsed significantly higher scores across MIQ-M items. Factor analytic results for the final 19 items supported a unidimensional structure, and convergent validity analyses revealed that higher scores (indicative of more MIEs) were correlated with greater general combat exposure, impairments in work/social functioning, posttraumatic stress and depression in the community sample. In addition, when controlling for demographics, deployment-related factors and exposure to life threat stressors associated with combat, tests of incremental validity indicated that MIQ-M scores were also uniquely linked with suicide risk and other mental health outcomes. These findings provide preliminary evidence for the validity of the MIQ-M and support the applicability of this measure for further research and clinical work with Veterans. Military service can confront service members with experiences that undermine their core sense of humanity and violate global values and beliefs. These types of experiences increase the risk for posttraumatic maladjustment in this population, even when accounting for rates of exposure to life threat traumas. Moral injury is an emerging construct to more fully capture the many

  3. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients.

    Science.gov (United States)

    Vafaei, Ali; Hatamabadi, Hamid Reza; Heidary, Kamran; Alimohammadi, Hosein; Tarbiyat, Mohammad

    2016-01-01

    Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT) scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67), were enrolled (77.6% male). Chest CT scan showed pulmonary contusion in 48 (31.6%) patients, hemothorax in 29 (19.1%), and pneumothorax in 55 (36.2%) cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96), 0.86 (95% CI: 0.78‒0.94), and 0.80 (95% CI: 0.736‒0.88), respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87) for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86) for hemothorax, and 0.58 (95% CI: 0.5‒0.67) for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02) and pulmonary contusion (p < 0.001). However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08). The results of the present study showed that ultrasonography is preferable to radiography in the initial evaluation of patients with traumatic injuries to the

  4. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients

    Directory of Open Access Journals (Sweden)

    Ali Vafaei

    2016-01-01

    Full Text Available Introduction: Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. Methods: In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. Results: 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67, were enrolled (77.6% male. Chest CT scan showed pulmonary contusion in 48 (31.6% patients, hemothorax in 29 (19.1%, and pneumothorax in 55 (36.2% cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96, 0.86 (95% CI: 0.78‒0.94, and 0.80 (95% CI: 0.736‒0.88, respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87 for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86 for hemothorax, and 0.58 (95% CI: 0.5‒0.67 for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02 and pulmonary contusion (p < 0.001. However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08. Conclusion: The results of the present study showed that ultrasonography is preferable to radiography in the initial

  5. EVALUATION OF SERVICE QUALITY OF AIRWAY COMPANIES GIVING DOMESTIC SERVICES IN TURKEY WITH FUZZY SET APPROACH

    Directory of Open Access Journals (Sweden)

    H. Handan DEMIR

    2013-01-01

    Full Text Available Today, service quality has become a major phenomenon with the requirement of meeting consumer demands in the best way brought along with the rising competition between companies. Airway transportation is preferred more and more during the recent years. Many qualitative and quantitative criteria are considered while evaluating service criteria in airway transportation. In this context, evaluation of service quality is a decisionmaking problem with many criteria. The purpose of this study is to evaluate service quality of domestic airway companies in Turkey. In this study; fuzzy TOPSIS method which is one of the most preferred fuzzy MCDM methods, extension of multi criteria decision making methods in fuzzy environments, considering qualitative and quantitative criteria together and giving opportunity to make group decisions in fuzzy environments. As a result, evaluation was made based on service quality criteria for the most preferred airways companies in Turkey and these companies were ranked according to their levels of service quality.

  6. Recall and Consumer Consideration Sets: Influencing Choice without Altering Brand Evaluations.

    OpenAIRE

    Nedungadi, Prakash

    1990-01-01

    This article focuses on memory-based choice situations where changes in a brand's accessibility may affect the probability that it is retrieved and considered for choice. In such instances, factors other than evaluation may affect which brands are brought to mind at purchase. Two experiments are described that manipulate the determinants of brand accessibility and measure consequent effects on retrieval, consideration, choice, and evaluation. Results provide evidence for the influence of memo...

  7. Prospective Evaluation of Dual-Energy Imaging in Patients Undergoing Image Guided Radiation Therapy for Lung Cancer: Initial Clinical Results

    International Nuclear Information System (INIS)

    Sherertz, Tracy; Hoggarth, Mark; Luce, Jason; Block, Alec M.; Nagda, Suneel; Harkenrider, Matthew M.; Emami, Bahman; Roeske, John C.

    2014-01-01

    Purpose: A prospective feasibility study was conducted to investigate the utility of dual-energy (DE) imaging compared to conventional x-ray imaging for patients undergoing kV-based image guided radiation therapy (IGRT) for lung cancer. Methods and Materials: An institutional review board-approved feasibility study enrolled patients with lung cancer undergoing IGRT and was initiated in September 2011. During daily setup, 2 sequential respiration-gated x-ray images were obtained using an on-board imager. Imaging was composed of 1 standard x-ray image at 120 kVp (1 mAs) and a second image obtained at 60 kVp (4 mAs). Weighted logarithmic subtraction of the 2 images was performed offline to create a soft tissue-selective DE image. Conventional and DE images were evaluated by measuring relative contrast and contrast-to-noise ratios (CNR) and also by comparing spatial localization, using both approaches. Imaging dose was assessed using a calibrated ion chamber. Results: To date, 10 patients with stage IA to IIIA lung cancer were enrolled and 57 DE images were analyzed. DE subtraction resulted in complete suppression of overlying bone in all 57 DE images, with an average improvement in relative contrast of 4.7 ± 3.3 over that of 120 kVp x-ray images (P<.0002). The improvement in relative contrast with DE imaging was seen for both smaller (gross tumor volume [GTV] ≤5 cc) and larger tumors (GTV >5 cc), with average relative contrast improvement ratios of 3.4 ± 4.1 and 5.4 ± 3.6, respectively. Moreover, the GTV was reliably localized in 95% of the DE images versus 74% of the single energy (SE images, (P=.004). Mean skin dose per DE image set was 0.44 ± 0.03 mGy versus 0.43 ± 0.03 mGy, using conventional kV imaging parameters. Conclusions: Initial results of this feasibility study suggest that DE thoracic imaging may enhance tumor localization in lung cancer patients receiving kV-based IGRT without increasing imaging dose

  8. Evaluation of the causal framework used for setting national ambient air quality standards.

    Science.gov (United States)

    Goodman, Julie E; Prueitt, Robyn L; Sax, Sonja N; Bailey, Lisa A; Rhomberg, Lorenz R

    2013-11-01

    Abstract A scientifically sound assessment of the potential hazards associated with a substance requires a systematic, objective and transparent evaluation of the weight of evidence (WoE) for causality of health effects. We critically evaluated the current WoE framework for causal determination used in the United States Environmental Protection Agency's (EPA's) assessments of the scientific data on air pollutants for the National Ambient Air Quality Standards (NAAQS) review process, including its methods for literature searches; study selection, evaluation and integration; and causal judgments. The causal framework used in recent NAAQS evaluations has many valuable features, but it could be more explicit in some cases, and some features are missing that should be included in every WoE evaluation. Because of this, it has not always been applied consistently in evaluations of causality, leading to conclusions that are not always supported by the overall WoE, as we demonstrate using EPA's ozone Integrated Science Assessment as a case study. We propose additions to the NAAQS causal framework based on best practices gleaned from a previously conducted survey of available WoE frameworks. A revision of the NAAQS causal framework so that it more closely aligns with these best practices and the full and consistent application of the framework will improve future assessments of the potential health effects of criteria air pollutants by making the assessments more thorough, transparent, and scientifically sound.

  9. New Integrated Quality Function Deployment Approach Based on Interval Neutrosophic Set for Green Supplier Evaluation and Selection

    Directory of Open Access Journals (Sweden)

    Luu Huu Van

    2018-03-01

    Full Text Available Green supplier evaluation and selection plays a crucial role in the green supply chain management of any organization to reduce the purchasing cost of materials and increase the flexibility and quality of products. An interval neutrosophic set (INS—which is a generalization of fuzzy sets, intuitionistic fuzzy sets (IFS and neutrosophic sets (NS—can better handle the incomplete, indeterminate and inconsistent information than the other sets. This paper proposes a new integrated Quality Function Deployment (QFD in support of the green supplier evaluation and selection process. In the proposed approach, INS is used to assess the relative importance of the characteristics that the purchased product should have (internal variables “WHATs” in order to satisfy the company’s needs, the relevant supplier assessment criteria (external variables “HOWs”, the “HOWs”-“WHATs” correlation scores, the resulting weights of the “HOWs” and the impact of each potential supplier. The normalized weighted rating is then defined and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS method is developed to obtain a final ranking of green suppliers. A case study is applied to demonstrate the efficiency and computational procedure of the proposed method.

  10. Impact and Process Evaluation of the U.S. Department of Energy's Wind Powering America Initiative

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-05-01

    This report presents an evaluation of the impacts and processes of the former Wind Powering America(WPA) initiative sponsored by the U.S. Department of Energy (DOE). WPA has an underlying goal of dramatically increasing the use of wind energy in the U.S.

  11. 49 CFR 40.293 - What is the SAP's function in conducting the initial evaluation of an employee?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What is the SAP's function in conducting the... Professionals and the Return-to-Duty Process § 40.293 What is the SAP's function in conducting the initial evaluation of an employee? As a SAP, for every employee who comes to you following a DOT drug and alcohol...

  12. Protective Effect of Forced Hydration with Isotonic Saline, Potassium Chloride and Magnesium Sulfate on Cisplatin Nephrotoxicity: An Initial Evaluation

    Directory of Open Access Journals (Sweden)

    Seyed Seifollah Beladi Mousavi

    2013-12-01

    How to cite this article: Beladi Mousavi SS, Hossainzadeh M, Khanzadeh A, Hayati F, Beladi Mousavi M, Zeraati AA, et al. Protective Effect of Forced Hydration with Isotonic Saline, Potassium Chloride and Magnesium Sulfate on Cisplatin Nephrotoxicity: An Initial Evaluation. Asia Pac J Med Toxicol 2013;2:136-9.

  13. Evaluation of the LiveWell@School Food Initiative Shows Increases in Scratch Cooking and Improvement in Nutritional Content

    Science.gov (United States)

    Schober, Daniel J.; Carpenter, Leah; Currie, Venita; Yaroch, Amy L.

    2016-01-01

    Background: The purpose of this evaluation was to examine the effects of the LiveWell@School Food Initiative (LW@SFI), a Colorado-based childhood obesity prevention program that partners with school districts to enable them to serve more scratch cooked foods through culinary training, action planning, and equipment grants. Methods: This evaluation…

  14. Preparation of data relevant to ''Equivalent Uniform Burnup'' and Equivalent Initial Enrichment'' for burnup credit evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Yasushi; Okuno, Hiroshi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Murazaki, Minoru [Tokyo Nuclear Service Inc., Tokyo (Japan)

    2001-11-01

    Based on the PWR spent fuel composition data measured at JAERI, two kinds of simplified methods such as ''Equivalent Uniform Burnup'' and ''Equivalent Initial Enrichment'' have been introduced. And relevant evaluation curves have been prepared for criticality safety evaluation of spent fuel storage pool and transport casks, taking burnup of spent fuel into consideration. These simplified methods can be used to obtain an effective neutron multiplication factor for a spent fuel storage/transportation system by using the ORIGEN2.1 burnup code and the KENO-Va criticality code without considering axial burnup profile in spent fuel and other various factors introducing calculated errors. ''Equivalent Uniform Burnup'' is set up for its criticality analysis to be reactivity equivalent with the detailed analysis, in which the experimentally obtained isotopic composition together with a typical axial burnup profile and various factors such as irradiation history are considered on the conservative side. On the other hand, Equivalent Initial Enrichment'' is set up for its criticality analysis to be reactivity equivalent with the detailed analysis such as above when it is used in the so called fresh fuel assumption. (author)

  15. Videoconferencing for site initiations in clinical studies: Mixed methods evaluation of usability, acceptability, and impact on recruitment.

    Science.gov (United States)

    Randell, Rebecca; Backhouse, Michael R; Nelson, E Andrea

    2016-12-01

    A critical issue for multicentre clinical studies is conducting site initiations, ensuring sites are trained in study procedures and comply with relevant governance requirements before they begin recruiting patients. How technology can support site initiations has not previously been explored. This study sought to evaluate use of off-the-shelf web-based videoconferencing to deliver site initiations for a large national multicentre study. Participants in the initiations, including podiatrists, diabetologists, trial coordinators, and research nurses, completed an online questionnaire based on the System Usability Scale (SUS) (N = 15). This was followed by semi-structured interviews, with a consultant diabetologist, a trial coordinator, and three research nurses, exploring perceived benefits and limitations of videoconferencing. The mean SUS score for the videoconferencing platform was 87.2 (SD = 13.7), suggesting a good level of usability. Interview participants perceived initiations delivered by videoconferencing as being more interactive and easier to follow than those delivered by teleconference. In comparison to face-to-face initiations, videoconferencing takes less time, easily fitting in with the work of staff at the local sites. Perceptions of impact on communication varied according to the hardware used. Off-the-shelf videoconferencing is a viable alternative to face-to-face site initiations and confers advantages over teleconferencing.

  16. Preoperative short hookwire placement for small pulmonary lesions: evaluation of technical success and risk factors for initial placement failure.

    Science.gov (United States)

    Iguchi, Toshihiro; Hiraki, Takao; Matsui, Yusuke; Fujiwara, Hiroyasu; Masaoka, Yoshihisa; Tanaka, Takashi; Sato, Takuya; Gobara, Hideo; Toyooka, Shinichi; Kanazawa, Susumu

    2018-05-01

    To retrospectively evaluate the technical success of computed tomography fluoroscopy-guided short hookwire placement before video-assisted thoracoscopic surgery and to identify the risk factors for initial placement failure. In total, 401 short hookwire placements for 401 lesions (mean diameter 9.3 mm) were reviewed. Technical success was defined as correct positioning of the hookwire. Possible risk factors for initial placement failure (i.e., requirement for placement of an additional hookwire or to abort the attempt) were evaluated using logistic regression analysis for all procedures, and for procedures performed via the conventional route separately. Of the 401 initial placements, 383 were successful and 18 failed. Short hookwires were finally placed for 399 of 401 lesions (99.5%). Univariate logistic regression analyses revealed that in all 401 procedures only the transfissural approach was a significant independent predictor of initial placement failure (odds ratio, OR, 15.326; 95% confidence interval, CI, 5.429-43.267; p < 0.001) and for the 374 procedures performed via the conventional route only lesion size was a significant independent predictor of failure (OR 0.793, 95% CI 0.631-0.996; p = 0.046). The technical success of preoperative short hookwire placement was extremely high. The transfissural approach was a predictor initial placement failure for all procedures and small lesion size was a predictor of initial placement failure for procedures performed via the conventional route. • Technical success of preoperative short hookwire placement was extremely high. • The transfissural approach was a significant independent predictor of initial placement failure for all procedures. • Small lesion size was a significant independent predictor of initial placement failure for procedures performed via the conventional route.

  17. FOND-2.2-evaluated nuclear data library for constants sets generation at ABBN constants providing system

    International Nuclear Information System (INIS)

    Koscheev, V.N.; Nikolaev, M.N.; Tsiboulia, A.M.

    2002-01-01

    The library FOND-2.2 of evaluated nuclear data files, which was created at the ABBN laboratory of IPPE, is described. FOND-2 library is the basic nuclear data source used for the preparation of group data sets with different energy structures. ABBN-93.1 group data set was retrieved from the FOND-2 data library and nowadays it is widely used in different applications, in neutronics calculations of different nuclear energetic installations with different kinds of neutron spectra, in radiation shielding calculation, and so on. (author)

  18. An Initial Evaluation of Tablet Devices & What Are the Next Steps?

    Science.gov (United States)

    McKillen, Tracey

    2016-01-01

    This paper describes an evaluation of tablet devices for a Graduate Entry Medical School (GEMS). The purpose of this evaluation is to assess what type of tablet device could meet the needs of a GEMS student. GEMS requirements for the evaluation include; using the tablet device to replace paper teaching resources in lectures and tutorials and…

  19. Evaluating Open Source Software for Use in Library Initiatives: A Case Study Involving Electronic Publishing

    Science.gov (United States)

    Samuels, Ruth Gallegos; Griffy, Henry

    2012-01-01

    This article discusses best practices for evaluating open source software for use in library projects, based on the authors' experience evaluating electronic publishing solutions. First, it presents a brief review of the literature, emphasizing the need to evaluate open source solutions carefully in order to minimize Total Cost of Ownership. Next,…

  20. Evaluation Model of Plate Waste to Monitor Food Consumption in Two Different Catering Settings.

    Science.gov (United States)

    Saccares, Stefano; Scognamiglio, Umberto; Moroni, Catia; Marani, Alessandra; Calcaterra, Veronica; Amendola, Mariano; Civitelli, Giulia; Cattaruzza, Maria Sofia; Ermenegildi, Arianna; Morena, Valeria

    2014-04-17

    An increasing number of people regularly eats lunch away from home, using catering services. In this context, therefore, it is extremely important to improve the meals' quality, remaining faithful to the principles of hygiene, nutritional and organoleptic quality and proper food handling. At the same time, it is necessary to promote food choices, nutritionally correct, by evaluations of appropriateness of menus. The study of food waste allows an evaluation of the nutritional habits of consumers and an important economic consideration of the costs incurred for the implementation of the service. This becomes even more important in some particularly sensitive groups, such as children and elderly. The purpose of this work is to test a model of semi-quantitative evaluation of waste to monitor food consumption in two different catering contexts (educational and business), in order to improve the service for school students and other consumers.

  1. Selection of an evaluation index for water ecological civilizations of water-shortage cities based on the grey rough set

    Science.gov (United States)

    Zhang, X. Y.; Zhu, J. W.; Xie, J. C.; Liu, J. L.; Jiang, R. G.

    2017-08-01

    According to the characteristics and existing problems of water ecological civilization of water-shortage cities, the evaluation index system of water ecological civilization was established using a grey rough set. From six aspects of water resources, water security, water environment, water ecology, water culture and water management, this study established the prime frame of the evaluation system, including 28 items, and used rough set theory to undertake optimal selection of the index system. Grey correlation theory then was used for weightings in order that the integrated evaluation index system for water ecology civilization of water-shortage cities could be constituted. Xi’an City was taken as an example, for which the results showed that 20 evaluation indexes could be obtained after optimal selection of the preliminary framework of evaluation index. The most influential indices were the water-resource category index and water environment category index. The leakage rate of the public water supply pipe network, as well as the disposal, treatment and usage rate of polluted water, urban water surface area ratio, the water quality of the main rivers, and so on also are important. It was demonstrated that the evaluation index could provide an objectively reflection of regional features and key points for the development of water ecology civilization for cities with scarce water resources. It is considered that the application example has universal applicability.

  2. A reconstructed melanoma data set for evaluating differential treatment benefit according to biomarker subgroups

    Directory of Open Access Journals (Sweden)

    Jaya M. Satagopan

    2017-06-01

    Full Text Available The data presented in this article are related to the research article entitled “Measuring differential treatment benefit across marker specific subgroups: the choice of outcome scale” (Satagopan and Iasonos, 2015 [1]. These data were digitally reconstructed from figures published in Larkin et al. (2015 [2]. This article describes the steps to digitally reconstruct patient-level data on time-to-event outcome and treatment and biomarker groups using published Kaplan-Meier survival curves. The reconstructed data set and the corresponding computer programs are made publicly available to enable further statistical methodology research.

  3. Evaluating climate model performance with various parameter sets using observations over the recent past

    Directory of Open Access Journals (Sweden)

    M. F. Loutre

    2011-05-01

    Full Text Available Many sources of uncertainty limit the accuracy of climate projections. Among them, we focus here on the parameter uncertainty, i.e. the imperfect knowledge of the values of many physical parameters in a climate model. Therefore, we use LOVECLIM, a global three-dimensional Earth system model of intermediate complexity and vary several parameters within a range based on the expert judgement of model developers. Nine climatic parameter sets and three carbon cycle parameter sets are selected because they yield present-day climate simulations coherent with observations and they cover a wide range of climate responses to doubled atmospheric CO2 concentration and freshwater flux perturbation in the North Atlantic. Moreover, they also lead to a large range of atmospheric CO2 concentrations in response to prescribed emissions. Consequently, we have at our disposal 27 alternative versions of LOVECLIM (each corresponding to one parameter set that provide very different responses to some climate forcings. The 27 model versions are then used to illustrate the range of responses provided over the recent past, to compare the time evolution of climate variables over the time interval for which they are available (the last few decades up to more than one century and to identify the outliers and the "best" versions over that particular time span. For example, between 1979 and 2005, the simulated global annual mean surface temperature increase ranges from 0.24 °C to 0.64 °C, while the simulated increase in atmospheric CO2 concentration varies between 40 and 50 ppmv. Measurements over the same period indicate an increase in global annual mean surface temperature of 0.45 °C (Brohan et al., 2006 and an increase in atmospheric CO2 concentration of 44 ppmv (Enting et al., 1994; GLOBALVIEW-CO2, 2006. Only a few parameter sets yield simulations that reproduce the observed key variables of the climate system over the last

  4. An evaluation of sampling and full enumeration strategies for Fisher Jenks classification in big data settings

    Science.gov (United States)

    Rey, Sergio J.; Stephens, Philip A.; Laura, Jason R.

    2017-01-01

    Large data contexts present a number of challenges to optimal choropleth map classifiers. Application of optimal classifiers to a sample of the attribute space is one proposed solution. The properties of alternative sampling-based classification methods are examined through a series of Monte Carlo simulations. The impacts of spatial autocorrelation, number of desired classes, and form of sampling are shown to have significant impacts on the accuracy of map classifications. Tradeoffs between improved speed of the sampling approaches and loss of accuracy are also considered. The results suggest the possibility of guiding the choice of classification scheme as a function of the properties of large data sets.

  5. Evaluation of a neurodevelopmental model of schizophrenia - Early postnatal PCP treatment in attentional set-shifting

    DEFF Research Database (Denmark)

    Broberg, B.V.; Dias, R.; Olsen, C.K.

    2008-01-01

    Phencyclidine (PCP) was administered to male and female Lister hooded rats on postnatal days (PND) 7, 9 and 11. All PCP animals tested in adulthood (PND 53-93) showed deficits in cognitive flexibility, specifically in their ability to shift attentional set, compared to controls. This novel finding...... is reminiscent of the impairment observed in schizophrenia patients, and supports the validity of the early postnatal PCP regimen as a disease-like model. (c) 2008 Elsevier B.V. All rights reserved Udgivelsesdato: 2008...

  6. Evaluating the relationship between evolutionary divergence and phylogenetic accuracy in AFLP data sets.

    Science.gov (United States)

    García-Pereira, María Jesús; Caballero, Armando; Quesada, Humberto

    2010-05-01

    Using in silico amplified fragment length polymorphism (AFLP) fingerprints, we explore the relationship between sequence similarity and phylogeny accuracy to test when, in terms of genetic divergence, the quality of AFLP data becomes too low to be informative for a reliable phylogenetic reconstruction. We generated DNA sequences with known phylogenies using balanced and unbalanced trees with recent, uniform and ancient radiations, and average branch lengths (from the most internal node to the tip) ranging from 0.02 to 0.4 substitutions per site. The resulting sequences were used to emulate the AFLP procedure. Trees were estimated by maximum parsimony (MP), neighbor-joining (NJ), and minimum evolution (ME) methods from both DNA sequences and virtual AFLP fingerprints. The estimated trees were compared with the reference trees using a score that measures overall differences in both topology and relative branch length. As expected, the accuracy of AFLP-based phylogenies decreased dramatically in the more divergent data sets. Above a divergence of approximately 0.05, AFLP-based phylogenies were largely inaccurate irrespective of the distinct topology, radiation model, or phylogenetic method used. This value represents an upper bound of expected tree accuracy for data sets with a simple divergence history; AFLP data sets with a similar divergence but with unbalanced topologies and short ancestral branches produced much less accurate trees. The lack of homology of AFLP bands quickly increases with divergence and reaches its maximum value (100%) at a divergence of only 0.4. Low guanine-cytosine (GC) contents increase the number of nonhomologous bands in AFLP data sets and lead to less reliable trees. However, the effect of the lack of band homology on tree accuracy is surprisingly small relative to the negative impact due to the low information content of AFLP characters. Tree-building methods based on genetic distance displayed similar trends and outperformed parsimony

  7. Evaluation results of the optimal estimation based, multi-sensor cloud property data sets derived from AVHRR heritage measurements in the Cloud_cci project.

    Science.gov (United States)

    Stapelberg, S.; Jerg, M.; Stengel, M.; Hollmann, R.

    2014-12-01

    In 2010 the ESA Climate Change Initiative (CCI) Cloud project was started with the objectives of generating a long-term coherent data set of cloud properties. The cloud properties considered are cloud mask, cloud top estimates, cloud optical thickness, cloud effective radius and post processed parameters such as cloud liquid and ice water path. During the first phase of the project 3 years of data spanning 2007 to 2009 have been produced on a global gridded daily and monthly mean basis. Next to the processing an extended evaluation study was started in order to gain a first understanding of the quality of the retrieved data. The critical discussion of the results of the evaluation holds a key role for the further development and improvement of the dataset's quality. The presentation will give a short overview of the evaluation study undertaken in the Cloud_cci project. The focus will be on the evaluation of gridded, monthly mean cloud fraction and cloud top data from the Cloud_cci AVHRR-heritage dataset with CLARA-A1, MODIS-Coll5, PATMOS-X and ISCCP data. Exemplary results will be shown. Strengths and shortcomings of the retrieval scheme as well as possible impacts of averaging approaches on the evaluation will be discussed. An Overview of Cloud_cci Phase 2 will be given.

  8. The FOND-2.2 evaluated neutron data library (Russian library of evaluated neutron data files for generating sets of constants in the ABBN constants system)

    International Nuclear Information System (INIS)

    Koshcheev, V.N.; Nikolaev, M.N.; Korchagina, Zh.A.; Savoskina, G.V.

    2001-01-01

    A short description is given of the Russian evaluated neutron data library FOND-2.2. The main purpose of FOND-2.2 is to provide sets of constants for the ABBN constants system. A history of its compilation and the sources of the neutron data are given. The contents of FOND-2.2 are presented with brief comments. (author)

  9. An Empirical Evaluation of Distance Learning's Effectiveness in the K-12 Setting

    Science.gov (United States)

    Harris-Packer, Jerilyn D.; Ségol, Geneviève

    2015-01-01

    This study evaluated the effect of online instruction on the academic achievement of K--12 students in ten states as measured by the percentage of proficient students in reading and mathematics at the school level. We used publicly available data provided by the Department of Education in Florida, Michigan, Minnesota, Nevada, Ohio, Pennsylvania,…

  10. Evaluation of regional climate simulations over the Great Lakes region driven by three global data sets

    Science.gov (United States)

    Shiyuan Zhong; Xiuping Li; Xindi Bian; Warren E. Heilman; L. Ruby Leung; William I. Jr. Gustafson

    2012-01-01

    The performance of regional climate simulations is evaluated for the Great Lakes region. Three 10-year (1990-1999) current-climate simulations are performed using the MM5 regional climate model (RCM) with 36-km horizontal resolution. The simulations employed identical configuration and physical parameterizations, but different lateral boundary conditions and sea-...

  11. Development of Children's Moral Evaluations of Modesty and Self-Promotion in Diverse Cultural Settings

    Science.gov (United States)

    Cameron, Catherine Ann; Lau, Cindy; Fu, Genyue; Lee, Kang

    2012-01-01

    This cross-cultural study of the moral judgements of Mainland Han-Chinese, Chinese-Canadian, and Euro-Canadian children aged seven to 11 examined the evaluations of narrative protagonists' modest lies and self-promoting truthful statements in situations where they had done a good deed. The story characters had thus either lied or told the truth…

  12. Further Classification and Methodological Considerations of Evaluations for Online Discussion in Instructional Settings

    Science.gov (United States)

    Spatariu, Alexandru; Winsor, Denise L.; Simpson, Cynthia; Hosman, Eric

    2016-01-01

    With the rapid advancements of technology, online communication in both K-12 and post-secondary instruction has been widely implemented. Instructors as well as researchers have used various frameworks to evaluate different aspects of online discussions' quality. The online discussions take place synchronously or asynchronously in chat rooms,…

  13. A method to evaluate performance reliability of individual subjects in laboratory research applied to work settings.

    Science.gov (United States)

    1978-10-01

    This report presents a method that may be used to evaluate the reliability of performance of individual subjects, particularly in applied laboratory research. The method is based on analysis of variance of a tasks-by-subjects data matrix, with all sc...

  14. Evaluation of safety at work in a psychiatric setting: the "Workplace Safety Assessment".

    Science.gov (United States)

    Palumbo, Claudia; Di Sciascio, Guido; Di Staso, Salvatore; Carabellese, Felice; Valerio, Antonella; Catanesi, Roberto

    2016-07-26

    Workplace violence is a common risk for mental health professionals, and psychiatrists often encounter it in a variety of settings. The aim of this study was to estimate the prevalence and features of violent episodes toward psychiatrists in various mental healthcare system settings. All psychiatrists from the Region of Puglia (Apulia) were contacted (N=285) via email and were administered an on-line standardized questionnaire. The response rate by psychiatrists was 57%. The main types of violence revealed were "threats" and "verbal aggression" and, of particular importance, "stalking". Female psychiatrists seemed to be at a higher risk of becoming victims of workplace violence, especially as regards verbal abuse (OR: 2.7, 95% CI: 1.2-6.5, c2 6.7, p=0.0095) and reported more serious psychological consequences with need for rest after the episode of aggression. Our data confirm that mental health workers, particularly psychiatrists, are healthcare professionals at high risk for workplace violence. Future implementation of preventive strategies with the aim of reducing aggressive episodes towards psychiatrists should be a high priority for managers and policy-makers operating in the Italian healthcare sector.

  15. Evaluation of the efficacy of antibacterial medical gloves in the ICU setting.

    Science.gov (United States)

    Kahar Bador, M; Rai, V; Yusof, M Y; Kwong, W K; Assadian, O

    2015-07-01

    Inappropriate use of medical gloves may support microbial transmission. New strategies could increase the safety of medical gloves without the risk of patient and surface contamination. To compare the efficacy of synthetic antibacterial nitrile medical gloves coated with polyhexamethylen-biguanid hydrochloride (PHMB) on the external surface with identical non-antibacterial medical gloves in reducing glove contamination after common patient care measures in an intensive care unit (ICU) setting. ICU staff wore either standard or antibacterial gloves during patient care activities. The number of bacteria on gloves was measured semi-quantitatively immediately after the performance of four clinical activities. There was a significant difference in mean bacterial growth [colony-forming units (cfu)] between control gloves and antibacterial gloves {60 [standard deviation (SD) 23] vs 16 (SD 23) cfu/glove imprint, P gloves had significantly less bacterial contamination compared with the control gloves (P = 0.011 and gloves showed lower bacterial contamination after changing linen compared with control gloves, the difference was not significant (P = 0.311). This study showed that use of antibacterial medical gloves significantly reduced bacterial contamination after typical patient care activities in 57% of the investigated clinical activities (P gloves may support reduction of cross-contamination in the ICU setting. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  16. [Positron emission tomography combined with computed tomography in the initial evaluation and response assessment in primary central nervous system lymphoma].

    Science.gov (United States)

    Mercadal, Santiago; Cortés-Romera, Montserrat; Vélez, Patricia; Climent, Fina; Gámez, Cristina; González-Barca, Eva

    2015-06-08

    To evaluate the role of positron emission tomography combined with computed tomography (PET-CT) in the initial evaluation and response assessment in primary central nervous system lymphoma (PCNSL). Fourteen patients (8 males) with a median age 59.5 years diagnosed of PCNSL. A brain PET-CT and magnetic resonance imaging (MRI) were performed in the initial evaluation. In 7 patients a PET-CT after treatment was performed. PET-CT showed at diagnosis 31 hypermetabolic focuses and MRI showed 47 lesions, with a good grade of concordance between both (k = 0.61; P = .005). In the response assessment, correlation between both techniques was good, and PET-CT was helpful in the appreciation of residual MRI lesions. Overall survival at 2 years of negative vs. positive PET-CT at the end of treatment was 100 vs. 37.5%, respectively (P = .045). PET-CT can be useful in the initial evaluation of PCNSL, and especially in the assessment of response. Despite the fact that PET-CT detects less small lesions than MRI, a good correlation between MRI and PET-CT was observed. It is effective in the evaluation of residual lesions. Prospective studies are needed to confirm their possible prognostic value. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. Setting global research priorities for integrated community case management (iCCM: Results from a CHNRI (Child Health and Nutrition Research Initiative exercise

    Directory of Open Access Journals (Sweden)

    Kerri Wazny

    2014-11-01

    Full Text Available Aims: to systematically identify global research gaps and resource priorities for integrated community case management (iCCM. Methods: an iCCM Child Health and Nutrition Research Initiative (CHNRI Advisory Group, in collaboration with the Community Case Management Operational Research Group (CCM ORG identified experts to participate in a CHNRI research priority setting exercise. These experts generated and systematically ranked research questions for iCCM. Research questions were ranked using a “Research Priority Score” (RPS and the “Average Expert Agreement” (AEA was calculated for every question. Our groups of experts were comprised of both individuals working in Ministries of Health or Non Governmental Organizations (NGOs in low– and middle–income countries (LMICs and individuals working in high–income countries (HICs in academia or NGO headquarters. A Spearman's Rho was calculated to determine the correlation between the two groups' research questions' ranks. Results: The overall RPS ranged from 64.58 to 89.31, with a median score of 81.43. AEA scores ranged from 0.54 to 0.86. Research questions involving increasing the uptake of iCCM services, research questions concerning the motivation, retention, training and supervision of Community Health Workers (CHWs and concerning adding additional responsibilities including counselling for infant and young child feeding (IYCF and treatment of severe acute malnutrition (SAM ranked highly. There was weak to moderate, statistically significant, correlation between scores by representatives of high–income countries and those working in–country or regionally (Spearman's ρ = 0.35034, P < 0.01. Conclusions: Operational research to determine optimal training, supervision and modes of motivation and retention for the CHW is vital for improving iCCM, globally, as is research to motivate caregivers to take advantage of iCCM services. Experts working in–country or regionally in

  18. Approaches to evaluating climate change impacts on species: A guide to initiating the adaptation planning process

    Science.gov (United States)

    Erika L. Rowland; Jennifer E. Davison; Lisa J. Graumlich

    2011-01-01

    Assessing the impact of climate change on species and associated management objectives is a critical initial step for engaging in the adaptation planning process. Multiple approaches are available. While all possess limitations to their application associated with the uncertainties inherent in the data and models that inform their results, conducting and incorporating...

  19. An evaluation of insulin therapy initiation among patients with type 2 ...

    African Journals Online (AJOL)

    Background: Clinically effective interventions that could reduce diabetic patients' risk of long-term complications are needed to contain the rising cost of diabetes care associated with the increasing prevalence of this condition. Good glycaemic control needs to be rapidly attained and maintained by the appropriate initiation ...

  20. "Doing Geography": Evaluating an Independent Geographic Inquiry Assessment Task in an Initial Teacher Education Program

    Science.gov (United States)

    Harte, Wendy; Reitano, Paul

    2016-01-01

    The assessment task of the final course in a bachelor of secondary education program is examined for opportunities for preservice geography teachers to achieve the course aims of integrating, consolidating, applying, and reflecting on the knowledge and skills they have learned during their initial teacher education program. The results show that…

  1. From Workshops to Walkshops: Evaluating Mobile Locastion-Based Applications in Realistic Settings

    DEFF Research Database (Denmark)

    Korn, Matthias; Zander, Pär-Ola

    2010-01-01

    Many open questions on how to best observe the mobile user experience remain - at the stage of design time as well as use time. In this paper, we are focusing on the stage of design time and describe our experiences from evaluating a mobile application for citizen involvement in municipal land use...... planning. Due to the problems and issues identified after conducting several user workshops in our exemplary case process, we propose "walkshops" as a complement to traditional workshops and prototype field studies specifically to evaluate mobile location-based applications (and similar context......-aware systems). We report some problems with workshops and outline how a walkshop may be carried out. The first trials of the new method are promising and have generated valuable feedback, insights and discussions about using the mobile application within the intended contexts. Many open questions on how...

  2. Evaluation of a Short Message Service diary methodology in a nonclinical, naturalistic setting.

    Science.gov (United States)

    Walsh, Erin I; Brinker, Jay K

    2012-11-01

    Particularly suited to repeated measures in naturalistic settings, Short Message Service (SMS) is garnering increasing attention as a viable method of data collection. The current study explored issues of practical importance for the development of this methodology, including factors impacting on attrition and compliance, and participant perception of SMS. Using a business-card-sized questionnaire key, 98 university students were sent prompt SMS messages nightly for a week. Completion and compliance were very high in all participants who responded to at least one prompt SMS; those who responded at least once (n=63) responded to 83 percent of all seven prompts, with 95 percent of responses containing appropriate alphanumeric answers to all questions. However, a time lag between recruitment and participation was associated with a failure to commence the diary study. Participants reported positive perceptions of SMS privacy and convenience.

  3. Diagnostic Evaluation of the Knee in the Office Setting Using Small-Bore Needle Arthroscopy.

    Science.gov (United States)

    Patel, Karan A; Hartigan, David E; Makovicka, Justin L; Dulle, Donald L; Chhabra, Anikar

    2018-01-01

    Arthroscopy is currently the gold standard for diagnosing intra-articular knee pathology. Magnetic resonance imaging (MRI) can be a clinical adjunct for diagnosis; however, it is not without its shortcomings. Although highly accurate, even advanced imaging misdiagnoses the condition in 1 in 14 patients with regard to anterior cruciate ligament pathology. Previous studies have indicated that MRI fails to identify meniscal pathology when one exists in 1 of every 10 cases, and diagnoses pathology when pathology truly does not exist in 1 of every 5 patients. In-office arthroscopy offers an alternative to formal diagnostic arthroscopy, with reduced cost and risk of complications. This is a technique article that discusses the use of small-bore needle arthroscopy in the office setting.

  4. Evaluation and Referral of Diabetic Eye Disease in the Endocrinology and Primary Care Office Settings.

    Science.gov (United States)

    Silva, Fabiana Q; Adhi, Mehreen; Wai, Karen M; Olansky, Leann; Lansang, M Cecilia; Singh, Rishi P

    2016-10-01

    The purpose of this study was to identify whether endocrinologists and primary care physicians (PCP) adequately screen for ophthalmic symptoms/signs within office visits and provide timely ophthalmology referrals in patients with diabetes. Patients between the ages of 18 years and 80 years with diabetes who underwent an office visit with an endocrinologist or a PCP between January 1, 2014, and December 31, 2014, were identified. Demographics, ophthalmic assessments, and referral information were collected. A total of 1,250 patient records were reviewed. Providers asked about ophthalmic symptoms/signs in 95.5% and 71% of endocrinology and primary care office encounters, respectively (P endocrinology and PCP visits, respectively (P < .0001). Ophthalmic complications from diabetes are not adequately screened, especially within the primary care setting, and further quality improvement measures may improve adherence to recommended screening protocols. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:930-934.]. Copyright 2016, SLACK Incorporated.

  5. Electronic data capture in a rural African setting: evaluating experiences with different systems in Malawi.

    Science.gov (United States)

    King, Carina; Hall, Jenny; Banda, Masford; Beard, James; Bird, Jon; Kazembe, Peter; Fottrell, Ed

    2014-01-01

    As hardware for electronic data capture (EDC), such as smartphones or tablets, becomes cheaper and more widely available, the potential for using such hardware as data capture tools in routine healthcare and research is increasing. We aim to highlight the advantages and disadvantages of four EDC systems being used simultaneously in rural Malawi: two for Android devices (CommCare and ODK Collect), one for PALM and Windows OS (Pendragon), and a custom-built application for Android (Mobile InterVA--MIVA). We report on the personal field and development experience of fieldworkers, project managers, and EDC system developers. Fieldworkers preferred using EDC to paper-based systems, although some struggled with the technology at first. Highlighted features include in-built skip patterns for all systems, and specifically the 'case' function that CommCare offers. MIVA as a standalone app required considerably more time and expertise than the other systems to create and could not be customised for our specific research needs; however, it facilitates standardised routine data collection. CommCare and ODK Collect both have user-friendly web-interfaces for form development and good technical support. CommCare requires Internet to build an application and download it to a device, whereas all steps can be done offline with ODK Collect, a desirable feature in low connectivity settings. Pendragon required more complex programming of logic, using a Microsoft Access application, and generally had less technical support. Start-up costs varied between systems, and all were considered more expensive than setting up a paper-based system; however running costs were generally low and therefore thought to be cost-effective over the course of our projects. EDC offers many opportunities for efficient data collection, but brings some issues requiring consideration when designing a study; the decision of which hardware and software to use should be informed by the aim of data collection

  6. Cognitive functioning and adjudicative competence: defendants referred for neuropsychological evaluation in a psychiatric inpatient setting.

    Science.gov (United States)

    Arredondo, Beth C; Marcopulos, Bernice A; Brand, Jesse G; Campbell, Kristen T; Kent, Julie-Ann

    2017-11-01

    A paucity of peer-reviewed research exists regarding the relation between cognitive functioning and adjudicative competence, despite increasing awareness of cognitive deficits associated with serious mental illness. This retrospective study sought to add to and expand upon existing research by considering performance validity and court determinations of competence, when available. We compared demographic and cognitive variables of a group of defendants with presumed valid testing admitted to an inpatient psychiatric facility for evaluation of adjudicative competence and referred for neuropsychological evaluation (n = 45) and compared individuals determined by the evaluator and/or the court to be competent (n = 30) and incompetent (n = 15). Defendants who were incompetent were more likely to be diagnosed with a cognitive disorder, with a medium effect size. There was a difference in tests of immediate and delayed memory as measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), with medium to large effects, and high delayed memory scores were helpful in ruling out incompetence (Negative predictive power = 85.71%). These results provide support for the relationship between cognitive functioning and trial competence, particularly at high and low levels of performance.

  7. Evaluation of vaginal flora and antibiogram analysis in reproductive-age women with or without vaginitis in primary care settings

    OpenAIRE

    Alim, Ahmet; Çetin, Ali; Yıldız, Çağlar

    2009-01-01

    Aims: The treatment modalities of patients with vaginal discharge are generally related to their symptoms. The aim of this study was to evaluate vaginal flora and antibiogram analysis in reproductive-age women with or without vaginitis in primary care settings. Methods: Vaginal swabs were taken from 311 women who have vaginitis, and tested for the causative agents of vaginal discharge. The control group was 89 healthy women without vaginal discharge. Vaginal swaps were used in a commercial te...

  8. Lambda based control O{sub 2} set point optimisation and evaluation; Lambdabaserad reglering. Boervaerdesoptimering av O{sub 2} och utvaerdering

    Energy Technology Data Exchange (ETDEWEB)

    Svensson, Mikael; Brodin, Peter [Vattenfall Utveckling, Aelvkarleby (Sweden)

    2004-10-01

    During winter and spring 2003, the project 'Lambda based control' was carried out at Vattenfall Utveckling AB in Aelvkarleby, Sweden. The main purpose of the project was to explore if conventional lambda sensors could be used to control the fuel/air-ratio in small boilers. The conclusion was that this is possible. To be able to make use of the result, the question of what the numerical set value for O{sub 2} should be, has to be answered. Several parameters have impact on the oxygen level in combustion gas. The main purpose of this project is to explore if there is a cost efficient way of controlling fuel/air-ratio by using lambda sensors. The scope of the project is achieve the following, by using the experience from project P4-209: find out which parameters that correlate most strongly with lambda; develop a method to decide which and how many parameters to use, in order to optimize cost efficiency; calculate optimal set value for O{sub 2} in one of the boilers used for experiments in the project; and evaluate the method and compare important parameters of operation, such as efficiency and emissions. The method developed in the project uses initial measurements to find out the relation between O{sub 2} and emissions at different power levels. Then a set point curve is calculated where set point for O{sub 2} is expressed as a function of power level in the current boiler. The method has been implemented and evaluated at a 400 kW boiler in Aelvkarleby, Sweden. The results are improvements in efficiency (6 %) and emissions, CO decreased 40 %, NO decreased by 20 %. The conclusion is that lambda based control according to this method could be a profitable investment under the right circumstances, where stability in characteristics is the most important property. What makes the method uncertain is its inability to handle changes in characteristics of a boiler.

  9. Priority setting in HIV/AIDS control in West Java Indonesia: an evaluation based on the accountability for reasonableness framework.

    Science.gov (United States)

    Tromp, Noor; Prawiranegara, Rozar; Subhan Riparev, Harris; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-04-01

    Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four conditions of the accountability for reasonableness (A4R) framework: relevance, publicity, appeals and revision, and enforcement. We reviewed government documents and conducted semi-structured qualitative interviews based on the A4R framework with 22 participants of the 5-year HIV/AIDS strategy development for 2008-13 (West Java province) and 2007-11 (Bandung). We found that criteria for priority setting were used implicitly and that the strategies included a wide range of programmes. Many stakeholders were involved in the process but their contribution could be improved and particularly the public and people living with HIV/AIDS could be better engaged. The use of appeal and publicity mechanisms could be more transparent and formally stated. Public regulations are not yet installed to ensure fair priority setting. To increase fairness in HIV/AIDS priority setting, West Java should make improvements on all four conditions of the A4R framework. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  10. Timing of initiation of macronuclear DNA synthesis is set during the preceding cell cycle in Paramecium tetraurelia: analysis of the effects of abrupt changes in nutrient level

    International Nuclear Information System (INIS)

    Ching, A.S.L.; Berger, J.D.

    1986-01-01

    In many eukaryotic organisms, initiation of DNA synthesis is associated with a major control point within the cell cycle and reflects the commitment of the cell to the DNA replication-division portion of the cell cycle. In paramecium, the timing of DNA synthesis initiation is established prior to fission during the preceding cell cycle. DNA synthesis normally starts at 0.25 in the cell cycle. When dividing cells are subjected to abrupt nutrient shift-up by transfer from a chemostat culture to medium with excess food, or shift-down from a well-fed culture to exhausted medium, DNA synthesis initiation in the post-shift cell cycle occurs at 0.25 of the parental cell cycle and not at either 0.25 in the post-shift cell cycle or at 0.25 in the equilibrium cell cycle produced under the post-shift conditions. The long delay prior to initiation of DNA synthesis following nutritional shift-up is not a consequence of continued slow growth because the rate of protein synthesis increases rapidly to the normal level after shift-up. Analysis of the relation between increase in cell mass and initiation of DNA synthesis following nutritional shifts indicates that increase in cell mass, per se, is neither a necessary nor a sufficient condition for initiation of DNA synthesis, in spite of the strong association between accumulation of cell mass and initiation of DNA synthesis in cells growing under steady-state conditions

  11. Evaluation of different set-up error corrections on dose-volume metrics in prostate IMRT using CBCT images

    International Nuclear Information System (INIS)

    Hirose, Yoshinori; Tomita, Tsuneyuki; Kitsuda, Kenji; Notogawa, Takuya; Miki, Katsuhito; Nakamura, Mitsuhiro; Nakamura, Kiyonao; Ishigaki, Takashi

    2014-01-01

    We investigated the effect of different set-up error corrections on dose-volume metrics in intensity-modulated radiotherapy (IMRT) for prostate cancer under different planning target volume (PTV) margin settings using cone-beam computed tomography (CBCT) images. A total of 30 consecutive patients who underwent IMRT for prostate cancer were retrospectively analysed, and 7-14 CBCT datasets were acquired per patient. Interfractional variations in dose-volume metrics were evaluated under six different set-up error corrections, including tattoo, bony anatomy, and four different target matching groups. Set-up errors were incorporated into planning the isocenter position, and dose distributions were recalculated on CBCT images. These processes were repeated under two different PTV margin settings. In the on-line bony anatomy matching groups, systematic error (Σ) was 0.3 mm, 1.4 mm, and 0.3 mm in the left-right, anterior-posterior (AP), and superior-inferior directions, respectively. Σ in three successive off-line target matchings was finally comparable with that in the on-line bony anatomy matching in the AP direction. Although doses to the rectum and bladder wall were reduced for a small PTV margin, averaged reductions in the volume receiving 100% of the prescription dose from planning were within 2.5% under all PTV margin settings for all correction groups, with the exception of the tattoo set-up error correction only (≥ 5.0%). Analysis of variance showed no significant difference between on-line bony anatomy matching and target matching. While variations between the planned and delivered doses were smallest when target matching was applied, the use of bony anatomy matching still ensured the planned doses. (author)

  12. Evaluating the influence of goal setting on intravenous catheterization skill acquisition and transfer in a hybrid simulation training context.

    Science.gov (United States)

    Brydges, Ryan; Mallette, Claire; Pollex, Heather; Carnahan, Heather; Dubrowski, Adam

    2012-08-01

    Educators often simplify complex tasks by setting learning objectives that focus trainees on isolated skills rather than the holistic task. We designed 2 sets of learning objectives for intravenous catheterization using goal setting theory. We hypothesized that setting holistic goals related to technical, cognitive, and communication skills would result in superior holistic performance, whereas setting isolated goals related to technical skills would result in superior technical performance. We randomly assigned practicing health care professionals to set holistic (n = 14) or isolated (n = 15) goals. All watched an instructional video and studied a list of 9 goals specific to their group. Participants practiced independently in a hybrid simulation (standardized patient combined with an arm simulator). The first and the last practice trials were videotaped for analysis. One-week later, participants completed a transfer test in another hybrid simulation scenario. Blinded experts evaluated performance on all 3 trials using the Direct Observation of Procedural Skills tool. The holistic group scored higher than the isolated group on the holistic Direct Observation of Procedural Skills score for all 3 trials [mean (SD), 45.0 (9.16) vs. 38.4 (9.17); P = 0.01]. The isolated group did not perform better than the holistic group on the technical skills score [10.3 (2.73) vs. 11.6 (3.01); P = 0.11]. Our results suggest that asking learners to set holistic goals did not interfere with their attaining competent holistic and technical skills during hybrid simulation training. This exploratory trial provides preliminary evidence for how to consider integrating hybrid simulation into medical curricula and for the design of learning goals in simulation-based education.

  13. Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting.

    Science.gov (United States)

    Goldenberg, Shira M; Chettiar, Jill; Simo, Annick; Silverman, Jay G; Strathdee, Steffanie A; Montaner, Julio S G; Shannon, Kate

    2014-01-01

    To explore factors associated with early sex work initiation and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs). Baseline data (2010-2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old. SWs completed a questionnaire and HIV/sexually transmitted infection testing. Using multivariate logistic regression, we identified associations with early sex work initiation (prostitution arrests among adult SWs. Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian born [adjusted odds ratio (AOR): 6.8, 95% confidence interval (CI): 2.42 to 19.02], inject drugs (AOR: 1.6, 95% CI: 1.0 to 2.5), and to have worked for a manager (AOR: 2.22, 95% CI: 1.3 to 3.6) or been coerced into sex work (AOR: 2.3, 95% CI: 1.14 to 4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3 to 3.2) and prostitution arrests (AOR: 2.0, 95% CI: 1.3 to 3.2). Adolescent sex work initiation is concentrated among marginalized, drug, and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs.

  14. Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting

    Science.gov (United States)

    GOLDENBERG, Shira M.; CHETTIAR, Jill; SIMO, Annick; SILVERMAN, Jay G.; STRATHDEE, Steffanie A.; MONTANER, Julio; SHANNON, Kate

    2014-01-01

    Objectives To explore factors associated with early sex work initiation, and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs). Design Baseline data (2010–2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time-location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old. Methods SWs completed a questionnaire and HIV/STI testing. Using multivariate logistic regression, we identified associations with early sex work initiation (prostitution arrests among adult SWs. Results Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian-born (Adjusted Odds Ratio (AOR): 6.8, 95% Confidence Interval (CI): 2.42–19.02), inject drugs (AOR: 1.6, 95%CI: 1.0–2.5), and to have worked for a manager (AOR: 2.22, 95%CI: 1.3–3.6) or been coerced into sex work (AOR: 2.3, 95%CI: 1.14–4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3–3.2) and prostitution arrests (AOR: 2.0, 95%CI: 1.3–3.2). Conclusions Adolescent sex work initiation is concentrated among marginalized, drug and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs. PMID:23982660

  15. Electronic data capture in a rural African setting: evaluating experiences with different systems in Malawi

    Directory of Open Access Journals (Sweden)

    Carina King

    2014-10-01

    Full Text Available Background: As hardware for electronic data capture (EDC, such as smartphones or tablets, becomes cheaper and more widely available, the potential for using such hardware as data capture tools in routine healthcare and research is increasing. Objective: We aim to highlight the advantages and disadvantages of four EDC systems being used simultaneously in rural Malawi: two for Android devices (CommCare and ODK Collect, one for PALM and Windows OS (Pendragon, and a custom-built application for Android (Mobile InterVA – MIVA. Design: We report on the personal field and development experience of fieldworkers, project managers, and EDC system developers. Results: Fieldworkers preferred using EDC to paper-based systems, although some struggled with the technology at first. Highlighted features include in-built skip patterns for all systems, and specifically the ‘case’ function that CommCare offers. MIVA as a standalone app required considerably more time and expertise than the other systems to create and could not be customised for our specific research needs; however, it facilitates standardised routine data collection. CommCare and ODK Collect both have user-friendly web-interfaces for form development and good technical support. CommCare requires Internet to build an application and download it to a device, whereas all steps can be done offline with ODK Collect, a desirable feature in low connectivity settings. Pendragon required more complex programming of logic, using a Microsoft Access application, and generally had less technical support. Start-up costs varied between systems, and all were considered more expensive than setting up a paper-based system; however running costs were generally low and therefore thought to be cost-effective over the course of our projects. Conclusions: EDC offers many opportunities for efficient data collection, but brings some issues requiring consideration when designing a study; the decision of which hardware

  16. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

    Science.gov (United States)

    Peter, W F; Jansen, M J; Hurkmans, E J; Bloo, H; Dekker, J; Dilling, R G; Hilberdink, W; Kersten-Smit, C; de Rooij, M; Veenhof, C; Vermeulen, H M; de Vos, R J; Schoones, J W; Vliet Vlieland, T P

    2011-01-01

    An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 17 experts from different professional backgrounds. A second draft was field-tested by 45 physiotherapists. In total 11 topics were selected. For the initial assessment, three recommendations were formulated, pertaining to history taking, red flags, and formulating treatment goals. Concerning treatment, 7 recommendations were formulated; (supervised) exercise therapy, education and self management interventions, a combination of exercise and manual therapy, postoperative exercise therapy and taping of the patella were recommended. Balneotherapy and hydrotherapy in HKOA, and thermotherapy, TENS, and Continuous Passive Motion in knee OA were neither recommended nor discouraged. Massage therapy, ultrasound, electrotherapy, electromagnetic field, Low Level Laser Therapy, preoperative physiotherapy and education could not be recommended. For the evaluation of treatment goals the following measurement instruments were recommended: Lequesne index, Western Ontario and McMaster Universities osteoarthritis index, Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score, 6-minute walktest, Timed Up and Go test, Patient Specific Complaint list, Visual Analoge Scale for pain, Intermittent and Constant OsteoArthritis Pain Questionnaire, goniometry, Medical Research Council for strength, handheld

  17. Initial evaluation of ultrasonic attenuation measurements for estimating fracture toughness of RPV steels

    Energy Technology Data Exchange (ETDEWEB)

    Hiser, A.L. Jr.; Green, R.E. Jr. [Johns Hopkins Univ., Baltimore, MD (United States). Center for Nondestructive Evaluation

    1999-08-01

    Neutron bombardment of reactor pressure vessel (RPV) steels causes reductions in fracture toughness in these steels, termed neutron irradiation embrittlement. Currently, there are no accepted methods for nondestructive determination of the extent of the irradiation embrittlement nor the actual fracture toughness of the reactor pressure vessel. This paper provides initial results of an effort addressing the use of ultrasonic attenuation as a suitable parameter for nondestructive determination of irradiation embrittlement in RPV steels. (orig.)

  18. Evaluation of a setting reaction pathway in the novel composite TiHA-CSD bone cement by FT-Raman and FT-IR spectroscopy

    Science.gov (United States)

    Paluszkiewicz, Czesława; Czechowska, Joanna; Ślósarczyk, Anna; Paszkiewicz, Zofia

    2013-02-01

    The aim of this study was to determine a setting reaction pathway in a novel, surgically handy implant material, based on calcium sulfate hemihydrate (CSH) and titanium doped hydroxyapatite (TiHA). The previous studies confirmed superior biological properties of TiHA in comparison to the undoped hydroxyapatite (HA) what makes it highly attractive for future medical applications. In this study the three types of titanium modified HA powders: untreated, calcined at 800 °C, sintered at 1250 °C and CSH were used to produce bone cements. The Fourier Transform-InfraRed (FT-IR) spectroscopy and Raman spectroscopy were applied to evaluate processes taking place during the setting of the studied materials. Our results undoubtedly confirmed that the reaction pathways and the phase compositions differed significantly for set cements and were dependent on the initial heat treatment of TiHA powder. Final materials were multiphase composites consisting of calcium sulfate dihydrate, bassanite, tricalcium phosphate, hydroxyapatite and calcium titanate (perovskite). The FT-IR and Scanning Electron Microscopy (SEM) measurements performed after the incubation of the cement samples in the simulated body fluid (SBF), indicate on high bioactive potential of the obtained bone cements.

  19. Retaining clients in an outcome monitoring evaluation study: HIV prevention efforts in community settings.

    Science.gov (United States)

    Smith, Bryce D; Kalayil, Elizabeth J; Patel-Larson, Alpa; Chen, Brenda; Vaughan, Marla

    2012-02-01

    The Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP) conducted outcome monitoring studies on evidence-based interventions (EBIs) provided by CDC-funded community-based organizations (CBOs). Critical to the success of outcome monitoring was the ability of CBOs to recruit and retain clients in evaluation studies. Two EBIs, Video Opportunities for Innovative Condom Education and Safer Sex (VOICES/VOCES) and Healthy Relationships, were evaluated using repeated measure studies, which require robust follow-up retention rates to increase the validity and usefulness of the findings. The retention rates were high for both VOICES/VOCES CBOs (95.8% at 30 days and 91.1% at 120 days), and Healthy Relationships CBOs (89.5% at 90 days and 83.5% at 180 days). This paper presents an overview of the retention of clients, challenges to follow-up, and strategies developed by CBOs to achieve high retention rates. These strategies and rates are discussed within the context of the CBOs' target populations and communities. Published by Elsevier Ltd.

  20. Evaluation of ceiling lifts in health care settings: patient outcome and perceptions.

    Science.gov (United States)

    Alamgir, Hasanat; Li, Olivia Wei; Gorman, Erin; Fast, Catherine; Yu, Shicheng; Kidd, Catherine

    2009-09-01

    Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the "year" variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation. Copyright (c) 2009, SLACK Incorporated.