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Sample records for sheet national primary

  1. Fact sheet: National primary drinking water regulations for lead and copper

    1991-05-01

    The Fact Sheet contains a summary of what the regulations will do, establish, and provide; regulatory impact in regards to benefits and costs; treatment technique requirements; tap water monitoring for lead and copper; water quality monitoring (other than lead and copper); monitoring schedules, regulatory schedules for large, medium-sized, and small systems

  2. Fact Sheets - The National Guard

    National Guard About Us By the Numbers Contact Us FAQ Federal Mission History Join Us Leaders Director of March Today in Guard History Leadership CNGB VCNGB SEA DANG DARNG Joint Staff J-1 J-2 J-3 J-4 J-5 J-6 J Marshal Office of the Joint Surgeon PARC Small Business Programs Chaplain Diversity NGB-GOMO Resources

  3. National Clean Fleets Partnership (Fact Sheet)

    2012-01-01

    Provides an overview of Clean Cities National Clean Fleets Partnership (NCFP). The NCFP is open to large private-sector companies that have fleet operations in multiple states. Companies that join the partnership receive customized assistance to reduce petroleum use through increased efficiency and use of alternative fuels. This initiative provides fleets with specialized resources, expertise, and support to successfully incorporate alternative fuels and fuel-saving measures into their operations. The National Clean Fleets Partnership builds on the established success of DOE's Clean Cities program, which reduces petroleum consumption at the community level through a nationwide network of coalitions that work with local stakeholders. Developed with input from fleet managers, industry representatives, and Clean Cities coordinators, the National Clean Fleets Partnership goes one step further by working with large private-sector fleets.

  4. National Clean Fleets Partnership (Fact Sheet)

    None, None

    2014-01-01

    Clean Cities' National Clean Fleets Partnership establishes strategic alliances with large fleets to help them explore and adopt alternative fuels and fuel economy measures to cut petroleum use. The initiative leverages the strength of nearly 100 Clean Cities coalitions, nearly 18,000 stakeholders, and more than 20 years of experience. It provides fleets with top-level support, technical assistance, robust tools and resources, and public acknowledgement to help meet and celebrate fleets' petroleum-use reductions.

  5. Development of the Brazilian national sheet scintillator converter of neutron

    Barbosa, Andre Luis Nunes

    2008-03-01

    Both the national domain of the technology for the separation of rare earth elements and the large reserves of these minerals in Brazilian territory, motivated the study of national sheets scintillators converter of neutrons, using a granular mixture Gd 2 O 3 -Zn S:Ag. Three methodologies were used for the manufacture of such sheets, namely: deposition done with a compressed-air gun on a sheet of cellulose type CG3460-3M; fusion of granular mixture with EVA in the mixing chamber and deposition of granular mixture on the substrate of EVA. It was used the flux of the order of 4,46 x 10 5 neutrons thermic/cm 2 .s, coming from the channel irradiation, J-9, of the reactor Argonauta/IEN/CNEN and the radiographic film AA-400 Kodak Industrex. The performances of national scintillator neutrons converter sheets were analyzed and the images obtained with the, demonstrated that the methodologies proposed are technically feasible and can contribute to the reduction of cost of this technique for NDA, but which lack optimization is aimed at increasing the number of photons of light to allow its use in neutrongraphies in Real Time (NRTR). (author)

  6. Sheet, ligament and droplet formation in swirling primary atomization

    Shao, Changxiao; Luo, Kun; Chai, Min; Fan, Jianren

    2018-04-01

    We report direct numerical simulations of swirling liquid atomization to understand the physical mechanism underlying the sheet breakup of a non-turbulent liquid swirling jet which lacks in-depth investigation. The volume-of-fluid (VOF) method coupled with adapted mesh refinement (AMR) technique in GERRIS code is employed in the present simulation. The mechanisms of sheet, ligament and droplet formation are investigated. It is observed that the olive-shape sheet structure is similar to the experimental result qualitatively. The numerical results show that surface tension, pressure difference and swirling effect contribute to the contraction and extension of liquid sheet. The ligament formation is partially at the sheet rim or attributed to the extension of liquid hole. Especially, the movement of hairpin vortex exerts by an anti-radial direction force to the sheet surface and leads to the sheet thinness. In addition, droplet formation is attributed to breakup of ligament and central sheet.

  7. Sheet, ligament and droplet formation in swirling primary atomization

    Changxiao Shao

    2018-04-01

    Full Text Available We report direct numerical simulations of swirling liquid atomization to understand the physical mechanism underlying the sheet breakup of a non-turbulent liquid swirling jet which lacks in-depth investigation. The volume-of-fluid (VOF method coupled with adapted mesh refinement (AMR technique in GERRIS code is employed in the present simulation. The mechanisms of sheet, ligament and droplet formation are investigated. It is observed that the olive-shape sheet structure is similar to the experimental result qualitatively. The numerical results show that surface tension, pressure difference and swirling effect contribute to the contraction and extension of liquid sheet. The ligament formation is partially at the sheet rim or attributed to the extension of liquid hole. Especially, the movement of hairpin vortex exerts by an anti-radial direction force to the sheet surface and leads to the sheet thinness. In addition, droplet formation is attributed to breakup of ligament and central sheet.

  8. Formation of sheeting joints in Yosemite National Park, California

    Martel, S. J.

    2009-04-01

    The formation of sheeting joints (i.e., "exfoliation joints"), opening mode fractures subparallel to the Earth's surface, has been a classic unresolved problem in geology. Diverse new observations and analyses support the hypothesis that sheeting joints develop in response to a near-surface tension induced by compressive stresses parallel to a convex slope (hypothesis 1) rather than the conventional explanation that the joints form as a result of removal of overburden by erosion (hypothesis 2). The opening mode displacements across the joints together with the absence of mineral precipitates within the joints mean that sheeting joints open in response to a near-surface tension normal to the surface (N) rather than a pressurized fluid. An absolute tension must arise in the shallow subsurface if a plot of N as a function of depth normal to the surface (z) has a positive slope at the surface (z=0). The differential equations of static equilibrium require that this slope (derivative) equals k2 P22 + k3 P33 - ?g cosβ, where k2 and k3 are the principal curvatures of the surface, P22 and P33 are the respective surface-parallel normal stresses along the principal curvatures, ? is the material density, g is gravitational acceleration, and β is the slope. This derivative will be positive and sheeting joints can open if the surface-parallel stress in at least one direction is sufficiently compressive (negative) and the curvature in that direction is sufficiently convex (negative). Hypotheses 1 and 2 are being tested using geologic mapping and aerial LIDAR data from Yosemite National Park, California. The abundance of sheeting joints on convex ridges there, where erosion is a local minimum, coupled with their scarcity in the adjacent concave valleys, where erosion is a local maximum, is consistent with hypothesis 1 but inconsistent with hypothesis 2. At several sites with sheeting joints, measurements of the current topographic curvatures and the current surface

  9. The National Agriculture Imagery Program (NAIP) Information Sheet

    Farm Service Agency, Department of Agriculture — This story map journal is an interactive version of the NAIP information sheet provided on the Aerial Photography Field Office web site. This map journal provides...

  10. Fact Sheet: National Space Policy. Appendix F-2

    1996-01-01

    For over three decades, the United States has led the world in the exploration and use of outer space. Our achievements in space have inspired a generation of Americans and people throughout the world. We will maintain this leadership role by supporting a strong, stable, and balanced national space program that serves our goals in national security, foreign policy, economic growth, environmental stewardship, and scientific and technical excellence. Access to and use of space are central for preserving peace and protecting US national security as well as civil and commercial interests. The United States will pursue greater levels of partnership and cooperation in national and international space activities and work with other nations to ensure the continued exploration and use of outer space for peaceful purposes. The goals of the US space program are to: (a) Enhance knowledge of the Earth, the solar system, and the universe through human and robotic exploration; (b) Strengthen and maintain the national security of the United States; (c) Enhance the economic competitiveness and scientific and technical capabilities of the United States; (d) Encourage State, local, and private sector investment in, and use of, space technologies; (e) Promote international cooperation to further US domestic, national security, and foreign policies. The United States is committed to the exploration and use of outer space by all nations for peaceful purposes and for the benefit of all humanity. "Peaceful purposes" allow defense and intelligence-related activities in pursuit of national security and other goals. The United States rejects any claims to sovereignty by any nation over outer space or celestial bodies, or any portion thereof, and rejects any limitations on the fundamental right of sovereign nations to acquire data from space. The United States considers the space systems of any nation to be national property with the right of passage through and operations in space without

  11. Career Planning: Developing the Nation's Primary Resource.

    Jarvis, Phillip S.

    Career planning is the most critical ingredient in developing a nation's primary resource, its workers. A 1988 Gallup Poll showed that 62 percent of U.S. workers had no career goal when they began their first job, and more than 50 percent felt they were in the wrong job. The same results probably could be applied to Canada. Career planning skills…

  12. National Contingency Plan (NCP) Subpart J Product Schedule Fact Sheet

    This section of the National Oil and Hazardous Substances Pollution Contingency Plan stipulates the criteria for listing and managing the use of dispersants and other chemical and biological agents used to mitigate oil spills.

  13. Development of the Brazilian national sheet scintillator converter of neutron; Desenvolvimento de uma tela cintiladora nacional conversora de neutrons

    Barbosa, Andre Luis Nunes

    2008-03-15

    Both the national domain of the technology for the separation of rare earth elements and the large reserves of these minerals in Brazilian territory, motivated the study of national sheets scintillators converter of neutrons, using a granular mixture Gd{sub 2}O{sub 3}-Zn S:Ag. Three methodologies were used for the manufacture of such sheets, namely: deposition done with a compressed-air gun on a sheet of cellulose type CG3460-3M; fusion of granular mixture with EVA in the mixing chamber and deposition of granular mixture on the substrate of EVA. It was used the flux of the order of 4,46 x 10{sup 5} neutrons thermic/cm{sup 2}.s, coming from the channel irradiation, J-9, of the reactor Argonauta/IEN/CNEN and the radiographic film AA-400 Kodak Industrex. The performances of national scintillator neutrons converter sheets were analyzed and the images obtained with the, demonstrated that the methodologies proposed are technically feasible and can contribute to the reduction of cost of this technique for NDA, but which lack optimization is aimed at increasing the number of photons of light to allow its use in neutrongraphies in Real Time (NRTR). (author)

  14. Oak Ridge National Laboratory Technology Logic Diagram. Volume 3, Technology evaluation data sheets: Part B, Dismantlement, Remedial action

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D&D), remedial action (RA), and WM activities. The TLD consists of three fundamentally separate volumes: Vol. 1, Technology Evaluation; Vol. 2, Technology Logic Diagram and Vol. 3, Technology EvaLuation Data Sheets. Part A of Vols. 1 and 2 focuses on RA. Part B of Vols. 1 and 2 focuses on the D&D of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TM, an explanation of the problems facing the volume-specific program, a review of identified technologies, and rankings of technologies applicable to the site. Volume 2 (Pts. A. B. and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A. B, and C) contains the TLD data sheets. This volume provides the technology evaluation data sheets (TEDS) for ER/WM activities (D&D, RA and WM) that are referenced by a TEDS code number in Vol. 2 of the TLD. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than is given for the technologies in Vol. 2.

  15. Oak Ridge National Laboratory Technology Logic Diagram. Volume 3, Technology evaluation data sheets: Part C, Robotics/automation, Waste management

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D&D), remedial action (RA), and WM activities. The TLD consists of three fundamentally separate volumes: Vol. 1, Technology Evaluation; Vol. 2, Technology Logic Diagram and Vol. 3, Technology EvaLuation Data Sheets. Part A of Vols. 1 and 2 focuses on RA. Part B of Vols. 1 and 2 focuses on the D&D of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TM, an explanation of the problems facing the volume-specific program, a review of identified technologies, and rankings of technologies applicable to the site. Volume 2 (Pts. A. B. and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A. B, and C) contains the TLD data sheets. This volume provides the technology evaluation data sheets (TEDS) for ER/WM activities (D&D, RA and WM) that are referenced by a TEDS code number in Vol. 2 of the TLD. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than is given for the technologies in Vol. 2.

  16. Formation of Sheeting Joints as a Result of Compression Parallel to Convex Surfaces, With Examples from Yosemite National Park, California

    Martel, S. J.

    2008-12-01

    The formation of sheeting joints has been an outstanding problem in geology. New observations and analyses indicate that sheeting joints develop in response to a near-surface tension induced by compressive stresses parallel to a convex slope (hypothesis 1) rather than by removal of overburden by erosion, as conventionally assumed (hypothesis 2). Opening mode displacements across the joints together with the absence of mineral precipitates within the joints mean that sheeting joints open in response to a near-surface tension normal to the surface rather than a pressurized fluid. Consideration of a plot of this tensile stress as a function of depth normal to the surface reveals that a true tension must arise in the shallow subsurface if the rate of that tensile stress change with depth is positive at the surface. Static equilibrium requires this rate (derivative) to equal P22 k2 + P33 k3 - ρ g cosβ, where k2 and k3 are the principal curvatures of the surface, P22 and P33 are the respective surface- parallel normal stresses along the principal curvatures, ρ is the material density, g is gravitational acceleration, and β is the slope. This derivative will be positive and sheeting joints can open if at least one principal curvature is sufficiently convex (negative) and the surface-parallel stresses are sufficiently compressive (negative). At several sites with sheeting joints (e.g., Yosemite National Park in California), the measured topographic curvatures and the measured surface-parallel stresses of about -10 MPa combine to meet this condition. In apparent violation of hypothesis 1, sheeting joints occur locally at the bottom of Tenaya Canyon, one of the deepest glaciated, U-shaped (concave) canyons in the park. The canyon-bottom sheeting joints only occur, however, where the canyon is convex downstream, a direction that nearly coincides with direction of the most compressive stress measured in the vicinity. The most compressive stress acting along the convex

  17. [Primary antisera before and after the expiration date. Comparative immunohistochemical observations and analysis of data sheets and labels].

    Vigliani, R; Babache, N

    2002-06-01

    By means of positive and negative controls, the immunostaining properties of a series (B) of 78 primary antibodies (PAB) that had expired 7-77 months previously (mean, 26.3 months) were evaluated in comparison those of the same non expired (functioning) PAB. Qualitatively, no significative difference was observed in the specificity and sensitivity. Among all of the PAB (with the exception of one), no immunonegativity was observed. With special reference to immunohistochemical methods, dilution and retrieval procedures, as suggested on data sheets, were additionally considered. Moreover the residual availability of the reagents was checked. In fact 58 PAB were still available for further examination with probable prolongation of the duration of validity. Other observations are analytically reported as far as polyclonal, monoclonal, concentrated and predilluted expired PAB are concerned. In the same way, duration of available validity before the expiration date was examined for the expired PAB and for an additional series of 90 nonexpired PAB. Finally textual information (including intended use) reported on data sheets and labels has been scrutinized in detail. In conclusion, for the diagnostically applied immunohistochemistry on the basis of these findings and the recent American and European rules, the following propositions should be considered: (1) surveillance on methodological technical approach and diagnostic evaluation, with emphasis on accurate standardization and primary responsibility of the pathologist; (2) opportunity of a continuous feed-back between laboratories-customers and producers-traders, in order to render more uniform the information and establish more realistic parameters of utilization; and (3) possibility of cost reduction according to limited financial support from the health care administration.

  18. Whiteness and National Identity: Teacher Discourses in Australian Primary Schools

    Walton, Jessica; Priest, Naomi; Kowal, Emma; White, Fiona; Fox, Brandi; Paradies, Yin

    2018-01-01

    The study examines how white teachers talked to children about national identity and cultural diversity by drawing on qualitative research with eight- to 12-year-old students and their teachers from four Australian primary schools with different racial, ethnic and cultural demographics. Despite a range of explicit and implicit approaches that…

  19. The Quest for Strategic Malaysian Quality National Primary School Leaders

    Ali, Hairuddin Mohd

    2012-01-01

    Purpose: The purpose of this paper is to investigate the nine-point strategic leadership characteristics of Malaysian Quality National Primary School Leaders (QNPSL) and to indicate the implications of these findings for the current educational management and leadership practices in their quest for Malaysian quality education.…

  20. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  1. Optimization of the National Ignition Facility primary shield design

    Annese, C.E.; Watkins, E.F.; Greenspan, E.; Miller, W.F.

    1993-10-01

    Minimum cost design concepts of the primary shield for the National Ignition laser fusion experimental Facility (NIF) are searched with the help of the optimization code SWAN. The computational method developed for this search involves incorporating the time dependence of the delayed photon field within effective delayed photon production cross sections. This method enables one to address the time-dependent problem using relatively simple, time-independent transport calculations, thus significantly simplifying the design process. A novel approach was used for the identification of the optimal combination of constituents that will minimize the shield cost; it involves the generation, with SWAN, of effectiveness functions for replacing materials on an equal cost basis. The minimum cost shield design concept was found to consist of a mixture of polyethylene and low cost, low activation materials such as SiC, with boron added near the shield boundaries

  2. Physics and national socialism an anthology of primary sources

    1996-01-01

    This anthology of primary sources is a collection of 121 documents in English translation portraying the role of physics, both perceived and actual, in the Nazi state. These texts were written predominantly by influential German scientists, particularly physicists, both inside and outside Germany in the period from 1933 to 1945. The semipopular articles, private correspondence, and official memoranda selected for the volume reflect the contemporary developments in science as well as the change in political climate and working conditions after the National Socialists' rise to power. The extensive annotation is clearly distinguished from the original text, and the appendix provides an aid to the reader with biographical information on the more important figures and brief outlines of frequently mentioned institutions, journals and companies. The introduction surveys the latest results in the secondary literature.   ------    (…) the envisaged audience includes not only scholars and students of science, hist...

  3. Implementing primary health care: some problems of creating national programmes.

    Vaughan, J P; Walt, G

    1984-07-01

    While there is a great deal of agreement about the principles underlying Primary Health Care (PHC), there exist many problems, political, planning and management, involved in putting the approach into effect. Some of these difficulties are discussed. It is clear that the PHC approach is essentially political; the way it is implemented in each country will reflect the political priorities and systems of that country. Moreover, ministries of health are not known for their strong position in the ministerial pecking order. Finance and planning ministeries would have to be won over to the importance of the concept of PHC to try to eexpand the health budget and to change the emphasis of existing resource allocation patterns. Costs incurred by a PHC approach ( e.g., expensive transport and communication systems), and resources needed to finance it may be available; however, they may not be channelled to the politically less articulate groups in rural areas. Political implications are not limited to national levels; considerable conflict may exist between different status groups and classes at the village level, thus sabotaging PHC plans. Professional politics will also be played at all levels. It is equally essential to recognize the historical context in which PHC is being introduced. Many countries have inherited colonial infrastructures. Changing the values, perceptions, expectations, administration and organization that accompany such systems is extremely hard, and to put PHC into effect demands radical changes. The planning difficulties which beset PHC are related to the still large private provision of social services like health, and to a flourishing traditional private sector in many developing countries. These may limit the implementation of a national health policy and PHC may thus result in a very patchy service throughout the country. The level of centralized planning will also affect resource allocation and therefore the policy, planning and implementation

  4. Radon in Irish primary and post-primary schools. The results of a national survey

    Synnott, H.; Fennell, S.; Pollard, D.; Colgan, P.A.; Hanley, O.; O'Colmain, M.; Maloney, L.

    2004-05-01

    This report presents the results of a survey of radon concentrations in schools in the Republic of Ireland. The survey was carried out by the Radiological Protection Institute of Ireland (RPII) on behalf of the Department of Education and Science. A workplace Reference Level of 400 Bq/m3 is set down in national legislation. However, in the case of schools the RPII has recommended that, wherever possible, radon concentrations should be reduced to below 200 Bq/m3. The objective of the survey was to assess the distribution of radon in Irish schools and to identify those requiring remedial work to reduce radon exposure to children and staff. The survey was carried out on a phased basis from 1998 to 2002. All schools in the Free Education System were invited to participate. Indoor radon concentrations were measured using passive alpha track-etch detectors with a measurement period of one academic year from September to the following June. Measurements were completed in the ground floor classrooms and offices of 3444 schools, representing over 85% of the approximate 4000 primary and post-primary schools in Ireland. Of these, 898 had radon concentrations greater than 200 Bq/m3 and 307 had radon concentrations in excess of the national Reference Level for workplaces of 400 Bq/m3 in one or more ground floor rooms. The average radon concentration in the schools surveyed was 93 Bq/m3. Different remediation strategies have been adopted for schools with maximum radon concentrations between 200 and 400 Bq/m3 and for schools with radon concentrations in excess of 400 Bq/m3. In schools with radon concentrations below 400 Bq/m3, passive remediation through increased background ventilation is, where practicable, being used to reduce the radon concentrations. Where the initial radon concentration exceeded 400 Bq/m3, a remediation consultant assessed the school and remedial measures specific to each school have been designed. In the majority of these cases active remediation in the

  5. 78 FR 10269 - National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule

    2013-02-13

    ... Illness CWS--Community Water System DBP--Disinfection Byproduct DWC--Drinking Water Committee EA--Economic... 141 and 142 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule; Final...-9684-8] RIN 2040-AD94 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule...

  6. Issue of Changes in Adhesion of Bitumen Sheet to Primary Layer over the Course of Time in Multilayer Waterproofing during Shear Testing

    Plachý, Jan; Vysoká, Jana; Vejmelka, Radek; Horský, Jan; Vacek, Vítězslav

    2017-10-01

    This paper is based on research dealing with defects that appear on concrete bridge decks with an insulating layer from asphalt strips on the interface between the asphalt strip and its basis. The durability and lifespan of the bearing structure of concrete bridge is determined by insulating layer that constitutes, together with the primary layer and a protective layer, the insulation system of the concrete bridge deck. Paints based on low viscosity epoxy resigns are one of the possibilities of primary layer implementation. These paints may be performed as anchoring-impregnation paints that usually represent single layer paint on the bridge deck surface. Sealing layer is another variant. Sealing layer is a multilayer consisting of anchoring- impregnation paint and sealing paint. The primary layers mainly provide vapour closing of the concrete surface, and partly, through roughening the surface, contribute to adhesion of bitumen (asphalt) insulation (waterproofing) layer. Application of the primary layer has been spreading in the Czech Republic since the 1990s. Now, after approximately 30 years of use defects in these epoxy based sealing layers at the interface between primary layer and waterproofing layer of reinforced bitumen sheets (RBS) are being solved in the Czech Republic. After performance of the first test focusing on breaking-strength, it was found that the strength between the asphalt and the primary belt layer in some types of low-viscosity resin-epoxy decreases and after a certain period of time again increases, depending on the time. Tensile strength test is carried out on a sample of asphalt strip, which is fused onto the substrate with a primer coat. It was therefore proceeded to test the shear adhesion. Testing of the shear adhesion is conducted on the entire concrete deck waterproofing system. It was supposed that the decrease of adhesion at this test become evident in higher extent. Adhesion tests in shear were performed on the primary layer

  7. Decontamination sheet

    Hirose, Emiko; Kanesaki, Ken.

    1995-01-01

    The decontamination sheet of the present invention is formed by applying an adhesive on one surface of a polymer sheet and releasably appending a plurality of curing sheets. In addition, perforated lines are formed on the sheet, and a decontaminating agent is incorporated in the adhesive. This can reduce the number of curing operation steps when a plurality steps of operations for radiation decontamination equipments are performed, and further, the amount of wastes of the cured sheets, and operator's exposure are reduced, as well as an efficiency of the curing operation can be improved, and propagation of contamination can be prevented. (T.M.)

  8. 76 FR 9409 - National Emission Standards for Hazardous Air Pollutants: Primary Lead Smelting

    2011-02-17

    ... National Emission Standards for Hazardous Air Pollutants: Primary Lead Smelting; Proposed Rule #0;#0... Emission Standards for Hazardous Air Pollutants: Primary Lead Smelting AGENCY: Environmental Protection... standards for hazardous air pollutants (NESHAP) for Primary Lead Smelting to address the results of the...

  9. Development of Quality Assurance System in Culture and Nation Character Education in Primary Education in Indonesia

    Susilana, Rudi; Asra

    2013-01-01

    The purpose of national education is to develop skills and build dignified national character and civilization in educating nation life (Act No. 20, 2003). The paper describes a system of quality assurance in culture and character education in primary education. This study employs the six sigma model which consists of the formula DMAIC (Define,…

  10. Energy information sheets

    NONE

    1995-07-01

    The National Energy Information Center (NEIC), as part of its mission, provides energy information and referral assistance to Federal, State, and local governments, the academic community, business and industrial organizations, and the public. The Energy Information Sheets was developed to provide general information on various aspects of fuel production, prices, consumption, and capability. Additional information on related subject matter can be found in other Energy Information Administration (EIA) publications as referenced at the end of each sheet.

  11. Clinical findings confirm national guidelines regarding primary gastroscopy for upper gastrointestinal symptoms

    Rolff, Hans Christian; Simonsen, Louise Rolighed; Rosenberg, Jacob

    2011-01-01

    This study describes unsedated transnasal oesophagogastroduodenoscopy (UT-OGD) in the office setting. Evaluation of national guidelines regarding primary endoscopy for the investigation of upper gastrointestinal (GI) symptoms was also a focus of this study....

  12. Primary Aluminum Reduction Industry - National Emission Standards for Hazardous Air Pollutants (NESHAP)

    National emission standards for each new or existing potline, paste production operation, and anode bake furnace associated with a primary aluminum reduction plant. Includes rule history, implementation information and additional resources.

  13. Using the Global Burden of Disease study to assist development of nation-specific fact sheets to promote prevention and control of hypertension and reduction in dietary salt: a resource from the World Hypertension League.

    Campbell, Norm R C; Lackland, Daniel T; Lisheng, Liu; Niebylski, Mark L; Nilsson, Peter M; Zhang, Xin-Hua

    2015-03-01

    Increased blood pressure and high dietary salt are leading risks for death and disability globally. Reducing the burden of both health risks are United Nations' targets for reducing noncommunicable disease. Nongovernmental organizations and individuals can assist by ensuring widespread dissemination of the best available facts and recommended interventions for both health risks. Simple but impactful fact sheets can be useful for informing the public, healthcare professionals, and policy makers. The World Hypertension League has developed fact sheets on dietary salt and hypertension but in many circumstances the greatest impact would be obtained from national-level fact sheets. This manuscript provides instructions and a template for developing fact sheets based on the Global Burden of Disease study and national survey data. ©2015 Wiley Periodicals, Inc.

  14. Constructing a Successful Cross-National Virtual Learning Environment in Primary and Secondary Education

    Ligorio, Maria Beatrice; van Veen, Klaas

    2006-01-01

    Virtual environments are more and more used in primary schools. One of the most interesting potentialities of these environments is to foster cross-national applications. Yet, this specific feature is not fully exploited. This paper presents a successful virtual learning environment for primary

  15. Expanding Global Language Education in Public Primary Schools: The National English Programme in Mexico

    Sayer, Peter

    2015-01-01

    The paper examines the recent national programme of English language instruction in the Mexican public primary schools, called the "Programa Nacional de Inglés en Educación Básica" (PNIEB). The programme, initiated in 2009 by the Ministry of Education as part of the national curriculum, represents the largest expansion of English…

  16. Comparing primary energy attributed to renewable energy with primary energy equivalent to determine carbon abatement in a national context.

    Gallachóir, Brian P O; O'Leary, Fergal; Bazilian, Morgan; Howley, Martin; McKeogh, Eamon J

    2006-01-01

    The current conventional approach to determining the primary energy associated with non-combustible renewable energy (RE) sources such as wind energy and hydro power is to equate the electricity generated from these sources with the primary energy supply. This paper compares this with an approach that was formerly used by the IEA, in which the primary energy equivalent attributed to renewable energy was equated with the fossil fuel energy it displaces. Difficulties with implementing this approach in a meaningful way for international comparisons lead to most international organisations abandoning the primary energy equivalent methodology. It has recently re-emerged in prominence however, as efforts grow to develop baseline procedures for quantifying the greenhouse gas (GHG) emissions avoided by renewable energy within the context of the Kyoto Protocol credit trading mechanisms. This paper discusses the primary energy equivalent approach and in particular the distinctions between displacing fossil fuel energy in existing plant or in new plant. The approach is then extended provide insight into future primary energy displacement by renewable energy and to quantify the amount of CO2 emissions avoided by renewable energy. The usefulness of this approach in quantifying the benefits of renewable energy is also discussed in an energy policy context, with regard to increasing security of energy supply as well as reducing energy-related GHG (and other) emissions. The approach is applied in a national context and Ireland is case study country selected for this research. The choice of Ireland is interesting in two respects. The first relates to the high proportion of electricity only fossil fuel plants in Ireland resulting in a significant variation between primary energy and primary energy equivalent. The second concerns Ireland's poor performance to date in limiting GHG emissions in line with its Kyoto target and points to the need for techniques to quantify the potential

  17. Energy information sheets

    1993-12-02

    The National Energy Information Center (NEIC), as part of its mission, provides energy information and referral assistance to Federal, State, and local governments, the academic community, business and industrial organizations, and the general public. Written for the general public, the EIA publication Energy Information Sheets was developed to provide information on various aspects of fuel production, prices, consumption and capability. The information contained herein pertains to energy data as of December 1991. Additional information on related subject matter can be found in other EIA publications as referenced at the end of each sheet.

  18. Findings from the 2013 NZCER Primary and Intermediate Schools National Survey

    New Zealand Council for Educational Research, 2014

    2014-01-01

    The New Zealand Council for Educational Research (NZCER) primary and intermediate schools national survey was carried out in July-August 2013. NZCER questioned principals, teachers and trustees at a representative sample of schools, and sought the views of a random sample of 1 in 4 parents in 36 of these schools. In all, the survey gathered data…

  19. Arts Shoved Aside: Changing Art Practices in Primary Schools since the Introduction of National Standards

    Irwin, Michael Ray

    2018-01-01

    This article reports on the understandings and practices of primary teachers in implementing the arts curriculum since the 2010 introduction of National Standards in Numeracy and Literacy within the New Zealand Education system. The ever-mounting pressure on schools to perform to these standards has resulted in a reduction of emphasis and time…

  20. The National Singing Programme for Primary Schools in England: An Initial Baseline Study

    Welch, G. F.; Himonides, E.; Papageorgi, I.; Saunders, J.; Rinta, T.; Stewart, C.; Preti, C.; Lani, J.; Vraka, M.; Hill, J.

    2009-01-01

    The "Sing Up" National Singing Programme for primary schools in England was launched in November 2007 under the UK government's "Music Manifesto". "Sing Up" is a four-year programme whose overall aim is to raise the status of singing and increase opportunities for children throughout the country to enjoy singing as…

  1. National Survey of Workplaces Handling and Manufacturing Nanomaterials, Exposure to and Health Effects of Nanomaterials, and Evaluation of Nanomaterial Safety Data Sheets

    2016-01-01

    A national survey on workplace environment nanomaterial handling and manufacturing was conducted in 2014. Workplaces relevant to nanomaterials were in the order of TiO2 (91), SiO2 (88), carbon black (84), Ag (35), Al2O3 (35), ZnO (34), Pb (33), and CeO2 (31). The survey results indicated that the number of workplaces handling or manufacturing nanomaterials was 340 (0.27% of total 126,846) workplaces. The number of nanomaterials used and products was 546 (1.60 per company) and 583 (1.71 per company), respectively. For most workplaces, the results on exposure to hazardous particulate materials, including nanomaterials, were below current OELs, yet a few workplaces were above the action level. As regards the health status of workers, 9 workers were diagnosed with a suspected respiratory occupational disease, where 7 were recommended for regular follow-up health monitoring. 125 safety data sheets (SDSs) were collected from the nanomaterial-relevant workplaces and evaluated for their completeness and reliability. Only 4 CNT SDSs (3.2%) included the term nanomaterial, while most nanomaterial SDSs were not regularly updated and lacked hazard information. When taken together, the current analysis provides valuable national-level information on the exposure and health status of workers that can guide the next policy steps for nanomaterial management in the workplace. PMID:27556041

  2. 78 FR 47191 - Air Quality Designations for the 2010 Sulfur Dioxide (SO2) Primary National Ambient Air Quality...

    2013-08-05

    ... Air Quality Designations for the 2010 Sulfur Dioxide (SO[bdi2]) Primary National Ambient Air Quality... air quality designations for certain areas in the United States for the 2010 primary Sulfur Dioxide (SO 2 ) National Ambient Air Quality Standard (NAAQS). The EPA is issuing this rule to identify areas...

  3. 40 CFR Appendix P to Part 50 - Interpretation of the Primary and Secondary National Ambient Air Quality Standards for Ozone

    2010-07-01

    ... the data handling procedures for the reported data). 2.3Comparisons with the Primary and Secondary... Secondary National Ambient Air Quality Standards for Ozone P Appendix P to Part 50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY...

  4. Estimating the global prevalence of inadequate zinc intake from national food balance sheets: effects of methodological assumptions.

    K Ryan Wessells

    Full Text Available The prevalence of inadequate zinc intake in a population can be estimated by comparing the zinc content of the food supply with the population's theoretical requirement for zinc. However, assumptions regarding the nutrient composition of foods, zinc requirements, and zinc absorption may affect prevalence estimates. These analyses were conducted to: (1 evaluate the effect of varying methodological assumptions on country-specific estimates of the prevalence of dietary zinc inadequacy and (2 generate a model considered to provide the best estimates.National food balance data were obtained from the Food and Agriculture Organization of the United Nations. Zinc and phytate contents of these foods were estimated from three nutrient composition databases. Zinc absorption was predicted using a mathematical model (Miller equation. Theoretical mean daily per capita physiological and dietary requirements for zinc were calculated using recommendations from the Food and Nutrition Board of the Institute of Medicine and the International Zinc Nutrition Consultative Group. The estimated global prevalence of inadequate zinc intake varied between 12-66%, depending on which methodological assumptions were applied. However, country-specific rank order of the estimated prevalence of inadequate intake was conserved across all models (r = 0.57-0.99, P<0.01. A "best-estimate" model, comprised of zinc and phytate data from a composite nutrient database and IZiNCG physiological requirements for absorbed zinc, estimated the global prevalence of inadequate zinc intake to be 17.3%.Given the multiple sources of uncertainty in this method, caution must be taken in the interpretation of the estimated prevalence figures. However, the results of all models indicate that inadequate zinc intake may be fairly common globally. Inferences regarding the relative likelihood of zinc deficiency as a public health problem in different countries can be drawn based on the country

  5. Energy information sheets, July 1998

    NONE

    1998-07-01

    The National Energy Information Center (NEIC), as part of its mission, provides energy information and referral assistance to Federal, State, and local governments, the academic community, business and industrial organizations, and the public. The Energy Information Sheets was developed to provide general information on various aspects of fuel production, prices, consumption, and capability. Additional information on related subject matter can be found in other Energy Information Administration (EIA) publications as referenced at the end of each sheet.

  6. Energy information sheets, September 1996

    NONE

    1996-09-01

    The National Energy Information Center (NEIC), as part of its mission, provides energy information and referral assistance to Federal, State, and local governments, the academic community, business and industrial organizations, and the public. The Energy Information Sheets was developed to provide general information on various aspects of fuel production, prices, consumption, and capability. Additional information on related subject matter can be found in other Energy Information Administration (EIA) publications as referenced at the end of each sheet.

  7. Episodic Late Holocene dune movements on the sand-sheet area, Great Sand Dunes National Park and Preserve, San Luis Valley, Colorado, USA

    Forman, S. L.; Spaeth, M.; Marín, L.; Pierson, J.; Gómez, J.; Bunch, F.; Valdez, A.

    2006-07-01

    The Great Sand Dunes National Park and Preserve (GSDNPP) in the San Luis Valley, Colorado, contains a variety of eolian landforms that reflect Holocene drought variability. The most spectacular is a dune mass banked against the Sangre de Cristo Mountains, which is fronted by an extensive sand sheet with stabilized parabolic dunes. Stratigraphic exposures of parabolic dunes and associated luminescence dating of quartz grains by single-aliquot regeneration (SAR) protocols indicate eolian deposition of unknown magnitude occurred ca. 1290-940, 715 ± 80, 320 ± 30, and 200-120 yr ago and in the 20th century. There are 11 drought intervals inferred from the tree-ring record in the past 1300 yr at GSDNPP potentially associated with dune movement, though only five eolian depositional events are currently recognized in the stratigraphic record. There is evidence for eolian transport associated with dune movement in the 13th century, which may coincide with the "Great Drought", a 26-yr-long dry interval identified in the tree ring record, and associated with migration of Anasazi people from the Four Corners areas to wetter areas in southern New Mexico. This nascent chronology indicates that the transport of eolian sand across San Luis Valley was episodic in the late Holocene with appreciable dune migration in the 8th, 10-13th, and 19th centuries, which ultimately nourished the dune mass against the Sangre de Cristo Mountains.

  8. 1970-1997 energy balance-sheets

    1998-01-01

    The aim of this document is to bring together a consistent and harmonized set of statistical data on energy economics in the French territory. The information is based on the global and structural approach of the different energy balance-sheets published between 1970 and 1997. The first chapter gives a general idea of the energy situation of the passed year and outlines the evolution of the main aggregates (production, primary and final consumption etc..) comparatively to those of the general economy. The second chapter is devoted to the history of energy economics. Time series of indicators and diagrams allow to precise the structural modifications that occurred during the last decades. The main transformations in the national energy production and the development of the different energy sources in the industry, the residential and tertiary sectors and in the transportation sector are described too. The third chapter gives numerical data on energy for the last 28 years using the common Mtpe unit (million of tons of petroleum equivalent). These balance sheets are based on new energy keeping methods and use identical equivalence coefficients. The last chapter presents the energy balance sheets for the last three years, using the proper units for coal, petroleum, gas and electricity. (J.S.)

  9. Access to primary energy sources - the basis of national energy security

    Szlązak, Jan; Szlązak, Rafał A.

    2017-11-01

    National energy security is of fundamental importance for economic development of a country. To ensure such safety energy raw material, also called primary energy sources, are necessary. Currently in Poland primary energy sources include mainly fossil fuels, such as hard coal, brown coal, natural gas and crude oil. Other sources, e.g. renewable energy sources account for c. 15% in the energy mix. Primary energy sources are used to produce mainly electricity, which is considered as the cleanest form of energy. Poland does not have, unfortunately, sufficient energy sources and is forced to import some of them, mainly natural gas and crude oil. The article presents an insightful analysis of energy raw material reserves possessed by Poland and their structure taking account of the requirements applicable in the European Union, in particular, those related to environmental protection. The article also describes demand for electricity now and in the perspective of 2030. Primary energy sources necessary for its production have also been given. The article also includes the possibilities for the use of renewable energy sources in Poland, however, climatic conditions there are not are not particularly favourable to it. All the issues addressed in the article are summed up and ended with conclusions.

  10. National Physical Education Standards: Level of Physical Fitness Male Student Primary School in Malaysia

    Ahmad Hashim; Mohd. Sani Madon; Nur Haziyanti Mohd Khalid; Nelfianty binti Mohd Rashid; Sadzali bin Hassan; Yusop bin Ahmad

    2014-01-01

    This study aims to analyze the level of physical fitness in the development of the National Standards of Physical Education. The study was conducted on 279 primary school boys age 10 years (n = 79), 11 years (n = 94) and 12 years (n = 106) in five randomly selected schools in the state of Perak. FITNESSGRAM was used to test the level of physical fitness among subjects. This includes trunk lift, 90 degree push-ups, modified pull-up, back saver sit and reach and PACER. ANOVA analysis showed a s...

  11. Chlamydia - CDC Fact Sheet

    ... Archive STDs Home Page Bacterial Vaginosis (BV) Chlamydia Gonorrhea Genital Herpes Hepatitis HIV/AIDS & STDs Human Papillomavirus ( ... sheet Pelvic Inflammatory Disease (PID) – CDC fact sheet Gonorrhea – CDC fact sheet STDs Home Page Bacterial Vaginosis ( ...

  12. National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

    Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

    2017-12-01

    To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  13. GASN sheets

    2013-12-01

    This document gathers around 50 detailed sheets which describe and present various aspects, data and information related to the nuclear sector or, more generally to energy. The following items are addressed: natural and artificial radioactive environment, evolution of energy needs in the world, radioactive wastes, which energy for France tomorrow, the consequences in France of the Chernobyl accident, ammunitions containing depleted uranium, processing and recycling of used nuclear fuel, transport of radioactive materials, seismic risk for the basic nuclear installations, radon, the precautionary principle, the issue of low doses, the EPR, the greenhouse effect, the Oklo nuclear reactors, ITER on the way towards fusion reactors, simulation and nuclear deterrence, crisis management in the nuclear field, does nuclear research put a break on the development of renewable energies by monopolizing funding, nuclear safety and security, the plutonium, generation IV reactors, comparison of different modes of electricity production, medical exposure to ionizing radiations, the control of nuclear activities, food preservation by ionization, photovoltaic solar collectors, the Polonium 210, the dismantling of nuclear installations, wind energy, desalination and nuclear reactors, from non-communication to transparency about nuclear safety, the Jules Horowitz reactor, CO 2 capture and storage, hydrogen, solar energy, the radium, the subcontractors of maintenance of the nuclear fleet, biomass, internal radio-contamination, epidemiological studies, submarine nuclear propulsion, sea energy, the Three Mile Island accident, the Chernobyl accident, the Fukushima accident, the nuclear after Fukushima

  14. Dental Procedures in Primary Health Care of the Brazilian National Health System

    Suellen R. Mendes

    2017-12-01

    Full Text Available The aim of this study was to examine the procedures of primary dental health care performed by oral health teams (OHTs adhering to the second cycle of the ‘National Programme for Improving Access and Quality of Primary Care’ (PMAQ-AB in Brazil. A cross-sectional descriptive analysis was performed, across 23 dental procedures comprising preventive, restorative/prosthetic, surgical, endodontic and oral cancer monitoring. Descriptive analysis shows that most of the oral health teams carry out basic dental procedures. However, most of the time, they do not keep adequate records of suspected cases of oral cancer, diagnosis tests or follow-ups, and do not perform dental prosthetic procedures. Data also showed disparities in the average number of procedures performed in each Brazilian geographical region in 2013–2014, ranging from 13.9 in the northern to 16.5 in the southern and south-eastern regions, reinforcing the great social disparities between them. Brazilian regions with the highest volume of dental need deliver the lowest number of dental procedures. The need to tackle inequalities and further shape the supply of appropriate primary health care (PHC is evident.

  15. Prayer for Health and Primary Care: Results From the 2002 National Health Interview Survey

    Wilkinson, Joanne E.; Saper, Robert B.; Rosen, Amy K.; Welles, Seth L.; Culpepper, Larry

    2009-01-01

    Background and Objectives Prayer for health (PFH) is common; in 2002, 35% of US adults prayed for their health. We examined the relationship of PFH and primary care visits, with a special focus on African American women, using data from the 2002 National Health Interview Survey (NHIS). Methods We used chi-square analyses to compare the demographic (age group, gender, race, region, marital status, educational level, ethnicity) and health-related covariates (alcohol use, smoking status, and selected medical conditions) between individuals who did and did not pray for their health in the past year. Univariate associations between PFH and visit to primary care provider (PCP), with Mantel-Haenszel adjustment for confounding, were determined. Multivariate regression was used to determine independent factors associated with PFH and PCP visit, with SUDAAN to adjust for the clustered survey design. Results Subjects who prayed were more likely to be female, older than 58, Black, Southern, separated, divorced or widowed, and nondrinkers. Subjects who prayed were also more likely to have seen a PCP within the past year. Black women who prayed were also more likely to see a PCP. Conclusions These findings suggest that people who pray for their health do so in addition to, not instead of, seeking primary care. This finding is maintained but with a smaller effect size, in Black women. PMID:18830839

  16. Primary care physician decision making regarding referral for bariatric surgery: a national survey.

    Stolberg, Charlotte Røn; Hepp, Nicola; Juhl, Anna Julie Aavild; B C, Deepti; Juhl, Claus B

    2017-05-01

    Bariatric surgery is the most effective treatment for severe obesity. It results in significant and sustained weight loss and reduces obesity-related co-morbidities. Despite an increasing prevalence of severe obesity, the number of bariatric operations performed in Denmark has decreased during the past years. This is only partly explained by changes in the national guidelines for bariatric surgery. The purpose of the cross-sectional study is to investigate referral patterns and possible reservations regarding bariatric surgery among Danish primary care physicians (PCPs). Primary care physicians in Denmark METHODS: A total of 300 Danish PCPs were invited to participate in a questionnaire survey regarding experiences with bariatric surgery, reservations about bariatric surgery, attitudes to specific patient cases, and the future treatment of severe obesity. Most questions required a response on a 5-point Likert scale (strongly disagree, disagree, neither agree nor disagree, agree, and strongly agree) and frequency distributions were calculated. 133 completed questionnaires (44%) were returned. Most physicians found that they had good knowledge about the national referral criteria for bariatric surgery. With respect to the specific patient cases, a remarkably smaller part of physicians would refer patients on their own initiative, compared with the patient's initiative. Fear of postoperative surgical complications and medical complications both influenced markedly the decision to refer patients for surgery. Only 9% of the respondents indicated that bariatric surgery should be the primary treatment option for severe obesity in the future. Danish PCPs express severe concerns about surgical and medical complications following bariatric surgery. This might, in part, result in a low rate of referral to bariatric surgery. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  17. 40 CFR 50.11 - National primary and secondary ambient air quality standards for oxides of nitrogen (with...

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient air quality standards for oxides of nitrogen (with nitrogen dioxide as the indicator). 50.11 Section 50.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL...

  18. A primary exploration to quasi-two-dimensional rare-earth ferromagnetic particles: holmium-doped MoS2 sheet as room-temperature magnetic semiconductor

    Chen, Xi; Lin, Zheng-Zhe

    2018-05-01

    Recently, two-dimensional materials and nanoparticles with robust ferromagnetism are even of great interest to explore basic physics in nanoscale spintronics. More importantly, room-temperature magnetic semiconducting materials with high Curie temperature is essential for developing next-generation spintronic and quantum computing devices. Here, we develop a theoretical model on the basis of density functional theory calculations and the Ruderman-Kittel-Kasuya-Yoshida theory to predict the thermal stability of two-dimensional magnetic materials. Compared with other rare-earth (dysprosium (Dy) and erbium (Er)) and 3 d (copper (Cu)) impurities, holmium-doped (Ho-doped) single-layer 1H-MoS2 is proposed as promising semiconductor with robust magnetism. The calculations at the level of hybrid HSE06 functional predict a Curie temperature much higher than room temperature. Ho-doped MoS2 sheet possesses fully spin-polarized valence and conduction bands, which is a prerequisite for flexible spintronic applications.

  19. A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol.

    Bello, Aminu K; Ronksley, Paul E; Tangri, Navdeep; Singer, Alexander; Grill, Allan; Nitsch, Dorothea; Queenan, John A; Lindeman, Cliff; Soos, Boglarka; Freiheit, Elizabeth; Tuot, Delphine; Mangin, Dee; Drummond, Neil

    2017-08-04

    Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery. The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods. The CPCSSN is committed to high ethical standards when dealing with

  20. Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit

    Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

    2018-01-01

    Background Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. Aim To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Design and setting Clinical audit of cancer diagnosis in general practices in England. Method Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Results Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15–86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0–27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. Conclusion The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. PMID:29255111

  1. Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit.

    Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

    2018-01-01

    Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Clinical audit of cancer diagnosis in general practices in England. Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15-86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0-27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. © British Journal of General Practice 2018.

  2. Trends in primary and revision anterior cruciate ligament reconstruction among National Basketball Association team physicians.

    Mall, Nathan A; Abrams, Geoffrey D; Azar, Frederick M; Traina, Steve M; Allen, Answorth A; Parker, Richard; Cole, Brian J

    2014-06-01

    Anterior cruciate ligament (ACL) tears are common in athletes. Techniques and methods of treatment for these injuries continue to vary among surgeons. Thirty National Basketball Association (NBA) team physicians were surveyed during the NBA Pre-Draft Combine. Survey questions involved current and previous practice methods of primary and revision ACL reconstruction, including technique, graft choice, rehabilitation, and treatment of combined ACL and medial collateral ligament injuries. Descriptive parametric statistics, Fisher exact test, and logistic regression were used, and significance was set at α = 0.05. All 30 team physicians completed the survey. Eighty-seven percent indicated they use autograft (81% bone-patellar tendon-bone) for primary ACL reconstruction in NBA athletes, and 43% indicated they use autograft for revision cases. Fourteen surgeons (47%) indicated they use an anteromedial portal (AMP) for femoral tunnel drilling, whereas 5 years earlier only 4 (13%) used this technique. There was a significant (P = .009) positive correlation between fewer years in practice and AMP use. NBA team physicians' use of an AMP for femoral tunnel drilling has increased over the past 5 years.

  3. National program for family planning and primary health care Pakistan: a SWOT analysis.

    Wazir, Mohammad Salim; Shaikh, Babar Tasneem; Ahmed, Ashfaq

    2013-11-22

    The National Program for Family Planning and Primary Healthcare was launched in 1994. It is one of the largest community based programs in the world, providing primary healthcare services to about 80 million people, most of which is rural poor. The program has been instrumental in improving health related indicators of maternal and child health in the last two decades. SWOT analysis was used by making recourse to the structure and dynamics of the program as well as searching the literature. Strengths of the program include: comprehensive design of planning, implementation and supervision mechanisms aided by an MIS, selection and recruitments processes and evidence created through improving health impact indicators. Weaknesses identified are slow progress, poor integration of the program with health services at local levels including MIS, and de-motivational factors such as job insecurity and non-payment of salaries in time. Opportunities include further widening the coverage of services, its potential contribution to health system research, and its use in areas other than health like women empowerment and poverty alleviation. Threats the program may face are: political interference, lack of funds, social threats and implications for professional malpractices. Strengthening of the program will necessitate a strong political commitment, sustained funding and a just remuneration to this bare foot doctor of Pakistan, the Lady Health Worker.

  4. Determinants of outpatient expenditure within primary care in the Brazilian National Health System

    Bruna Camilo Turi

    2017-04-01

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING: Cross-sectional study conducted in five primary care units in Bauru (SP, Brazil. METHODS: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests. Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01, hypertension (OR = 3.04; 95% CI: 1.91-4.82 and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81. Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47 and female sex (OR = 1.70; 95% CI: 1.14-2.55. CONCLUSIONS: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.

  5. A national day with near zero emissions and its effect on primary and secondary pollutants

    Levy, Ilan

    2013-10-01

    Traffic related air pollution is a major health concern in many countries. The potential costs and benefits of different abatement policies are usually estimated by either models, case studies or previously implemented intervention measures. Such estimations have, however, limited ability to predict the effect of a reduction in primary pollutants' emissions on secondary pollutants such as ozone, because of the nonlinear nature of the photochemical reactions. This study examines the short term effects of a drastic change in emissions on a national scale during the Jewish holiday of Day of Atonement (DA) in Israel. During the holiday nearly all anthropogenic emission sources are ceased for a period of 25 h, including all vehicles, commercial, industrial and recreational activities. DAs during the 15 years period of 1998-2012 are analyzed at three sites with respect to primary and secondary air pollutants, and in greater details for 2001. A dramatic decrease in primary pollutants emissions (83-98% in NO) causes an 8 ppbv increase in ozone at the urban core. Downwind (27 km), ozone decreases by only 5 ppbv. Nighttime O3 is shown to increase to 20 ppbv at the urban sites and 30 ppbv downwind. In spite of the striking reduction in emissions, changes in ozone are not greater than what is reported in the literature about less significant events like the ozone weekend effect. Changes in ambient pollution levels observed during DA provide some indication to the possible outcomes of a major change in anthropogenic emissions. These may be considered as the best case scenario for emissions reduction intervention measures and thus aid policy makers in evaluating potential benefits of such measures.

  6. Automobile sheet metal part production with incremental sheet forming

    İsmail DURGUN

    2016-02-01

    Full Text Available Nowadays, effect of global warming is increasing drastically so it leads to increased interest on energy efficiency and sustainable production methods. As a result of adverse conditions, national and international project platforms, OEMs (Original Equipment Manufacturers, SMEs (Small and Mid-size Manufacturers perform many studies or improve existing methodologies in scope of advanced manufacturing techniques. In this study, advanced manufacturing and sustainable production method "Incremental Sheet Metal Forming (ISF" was used for sheet metal forming process. A vehicle fender was manufactured with or without die by using different toolpath strategies and die sets. At the end of the study, Results have been investigated under the influence of method and parameters used.Keywords: Template incremental sheet metal, Metal forming

  7. The social balance sheet 2004

    Ph. Delhez; P. Heuse

    2005-01-01

    Each year, in the 4th quarter’s Economic Review, the National Bank examines the provisional results of the social balance sheets. As all the social balance sheets are not yet available for 2004, the study is based on a limited population of enterprises, compiled according to the principle of a constant sample. This population is made up of 38,530 enterprises employing around 1,331,000 workers in 2004. The main results of the analysis, in terms of employment, working hours, labour cost and tra...

  8. Aerial radiometric and magnetic survey; Brushy Basin detail survey: Price/Salina national topographic map sheets, Utah. Volume IV. Area III: graphic data. Final report

    1981-01-01

    This volume contains all the graphic data for Area III, which includes lines 3420 to 5320 and tie lines 6080, 6100, and 6140. Due to the large map scale of the data presented (1:62,500), this area was further subdivided into eleven 7-1/2 min quadrant sheets

  9. Advancing Concentrating Solar Power Research (Fact Sheet)

    None, None

    2014-02-01

    Researchers at the National Renewable Energy Laboratory (NREL) provide scientific, engineering, and analytical expertise to help advance innovation in concentrating solar power (CSP). This fact sheet summarizes how NREL is advancing CSP research.

  10. Greenland Radar Ice Sheet Thickness Measurements

    National Aeronautics and Space Administration — Two 150-MHz coherent radar depth sounders were developed and flown over the Greenland ice sheet to obtain ice thickness measurements in support of PARCA...

  11. Hydrologic Outlets of the Greenland Ice Sheet

    National Aeronautics and Space Administration — The Hydrologic Outlets of the Greenland Ice Sheet data set contains GIS point shapefiles that include 891 observed and potential hydrologic outlets of the Greenland...

  12. Partnership effectiveness in primary community care networks: A national empirical analysis of partners' coordination infrastructure designs.

    Lin, Blossom Yen-Ju; Lin, Yung-Kai; Lin, Cheng-Chieh

    2010-01-01

    Previous empirical and managerial studies have ignored the effectiveness of integrated health networks. It has been argued that the varying definitions and strategic imperatives of integrated organizations may have complicated the assessment of the outcomes/performance of varying models, particularly when their market structures and contexts differed. This study aimed to empirically verify a theoretical perspective on the coordination infrastructure designs and the effectiveness of the primary community care networks (PCCNs) formed and funded by the Bureau of National Health Insurance since March 2003. The PCCNs present a model to replace the traditional fragmented providers in Taiwan's health care. The study used a cross-sectional mailed survey designed to ascertain partnership coordination infrastructure and integration of governance, clinical care, bonding, finances, and information. The outcome indicators were PCCNs' perceived performance and willingness to remain within the network. Structural equation modeling examined the causal relationships, controlling for organizational and environmental factors. Primary data collection occurred from February through December 2005, via structured questionnaires sent to 172 PCCNs. Using the individual PCCN as the unit of analysis, the results found that a network's efforts regarding coordination infrastructures were positively related to the PCCN's perceived performance and willingness to remain within the network. In addition, PCCNs practicing in rural areas and in areas with higher density of medical resources had better perceived effectiveness and willingness to cooperate in the network.Practical Implication: The lack of both an operational definition and an information about system-wide integration may have obstructed understanding of integrated health networks' organizational dynamics. This study empirically examined individual PCCNs and offers new insights on how to improve networks' organizational design and

  13. Pregnancy Options Counseling and Abortion Referrals Among US Primary Care Physicians: Results From a National Survey.

    Holt, Kelsey; Janiak, Elizabeth; McCormick, Marie C; Lieberman, Ellice; Dehlendorf, Christine; Kajeepeta, Sandhya; Caglia, Jacquelyn M; Langer, Ana

    2017-07-01

    Primary care physicians (PCPs) can play a critical role in addressing unintended pregnancy through high-quality options counseling and referrals. We surveyed a nationally representative sample of 3,000 PCPs in general, family, and internal medicine on practices and opinions related to options counseling for unintended pregnancy. We assessed predictors of physician practices using multivariable logistic regression weighted for sampling design and differential non-response. Response rate was 29%. Seventy-one percent believed residency training in options counseling should be required, and 69% believed PCPs have an obligation to provide abortion referrals even in the presence of a personal objection to abortion. However, only 26% reported routine options counseling when caring for women with unintended pregnancy compared to 60% who routinely discuss prenatal care. Among physicians who see women seeking abortion, 62% routinely provide referrals, while 14% routinely attempt to dissuade women. Family physicians were more likely to provide routine options counseling when seeing patients with unintended pregnancy than internal medicine physicians (32% vs 21%, P=0.002). In multivariable analyses, factors associated with higher odds of routine abortion referrals were more years in practice (OR=1.03 for each additional year, 95% CI: 1.00-1.05), identifying as a woman vs a man (OR=2.11, 95% CI: 1.31-3.40), practicing in a hospital vs private primary care/multispecialty setting (OR=3.17, 95% CI: 1.10-9.15), and no religious affiliation of practice vs religious affiliation (OR for Catholic affiliation=0.27, 95% CI: 0.11-0.66; OR for other religious affiliation=0.36, 95% CI: 0.15-0.83). Personal Christian religious affiliation among physicians who regularly attend religious services vs no religious affiliation was associated with lower odds of counseling (OR=0.48, 95% CI: 0.26-0.90) and referrals (OR=0.31, 95% CI: 0.15-0.62), and higher odds of abortion dissuasion (OR=4.03, 95

  14. A national probability survey of American Medical Association gynecologists and primary care physicians concerning menopause.

    Singh, Betsy; Liu, Xiao-Dong; Der-Martirosian, Claudia; Hardy, Mary; Singh, Vijay; Shepard, Neil; Gandhi, Sonal; Khorsan, Raheleh

    2005-09-01

    This survey intended to clarify physicians' understanding of the issues surrounding women, menopause, alternative medicine, and drug therapy for the treatment of menopause. This study was designed as a national probability sample survey of primary care physicians and gynecologists nationwide. Its focus was to identify major concerns and issues identified by patients about menopause and perceived communication with effectiveness how to communicate with their patients. Physicians were also asked to rate their comfort level in recommending the use of herbal remedies and which herbal remedy they felt comfortable recommending to interested patients. Data indicated that a patient's complaint about menopausal symptoms was the most common factor leading to discussion of menopausal issues with physicians (91%) and that the primary concern to the patient was management of menopausal symptoms. Other factors were controversies about hormone replacement therapy, long-term health implications of menopause, and hormone replacement therapy. Eighty percent of the physician found confusing messages with regard to menopause to be the most challenging aspect in patient communication. The second most challenging issue is "inconclusive data about hormone replacement therapy" (56%). Seventy-six percent of the physicians found "showing sympathy" to be the most important factor for the physicians to communicate effectively with patients, whereas "being honest and open" was the most important patient attitude cited for the same purpose. When it comes to herbal therapy for menopause symptom control, only 4% of the physicians indicated that none of their patients take any remedies. Only 18% were not very comfortable in discussing or recommending herbal therapies, whereas the rest ranged from fairly comfortable to completely comfortable. This study has provided data with regard to physician understanding of menopause treatment options and their primary interaction with patients on this issue

  15. Stress sources and manifestations in a nation-wide sample of pre-primary, primary and secondary educators in Greece

    Nadia eKourmousi

    2016-04-01

    Full Text Available BackgroundTeachers experience high levels of stress as a result of their professional duties and research has shown a growing interest in this phenomenon during the recent years. Aim of this study was to explore the associations of stress sources and manifestations with individual and job-related characteristics in educators of all levels. MethodsIn a cross–sectional design, following an informative e-campaign on the study aims through the official and the main teachers’ portals in Greece, respondents completed online the Teachers Stress Inventory (TSI and the 14-item Perceived Stress Scale (PSS-14. 974 male and 2473 female pre-primary, primary and secondary educators with a mean age of 41.2 years responded. ResultsWomen and younger teachers reported significantly higher levels of stress, mainly due to lack of time and other work-related stressors, and also more emotional and gastronomic manifestations. Increased age and working experience were associated with lower levels of several stress sources. Teachers of administrative positions had increased time management stressors, but less professional distress, professional investment and discipline and motivation stressors. Additionally, working and residing far from family increased teachers’ stress levels associated to control, motivation and investment. Teachers of pre-primary education had reduced professional investment and motivation stress factors while vocational lyceum teachers of secondary education reported less work-related stressors and manifestations and more discipline and motivation related ones. Having students supported or in need of support from special educators and students with difficulties in speaking or comprehension was associated with most of the teachers' stress sources and manifestations (i.e. TSI subscales. Finally, colleagues’ and mainly supervisors' support seemed to provide a strong and consistent protection against both stress sources and manifestations

  16. Systematic review of the use of data from national childhood obesity surveillance programmes in primary care: a conceptual synthesis.

    Henderson, E J; Ells, L J; Rubin, G P; Hunter, D J

    2015-11-01

    This study reviewed the use in primary care of national surveillance data for children to determine the data's potential utility to inform policy and practice decisions on how to prevent and treat childhood obesity. We reviewed the 28 countries identified by the World Obesity Federation as having high-quality comparable body mass index data for children. Literature published from any period up to December 2013 was included. Peer review literature was searched using Web of Science (Core Collection, MEDLINE). Grey literature was searched using the Internet by country name, programme name and national health and government websites. We included studies that (i) use national surveillance obesity data in primary care, or (ii) explore practitioner or parent perspectives about the use of such data. The main uses of national surveillance data in primary care were to identify and recruit obese children and their parents to participate in school and general practice-based research and/or interventions, and to inform families of children's measurements. Findings indicate a need for school staff and practitioners to receive additional training and support to sensitively communicate with families. Translation of these findings into policy and practice could help to improve current uses of national child obesity surveillance data in primary care. © 2015 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

  17. Large Fleets Lead in Petroleum Reduction (Fact Sheet)

    Proc, H.

    2011-03-01

    Fact sheet describes Clean Cities' National Petroleum Reduction Partnership, an initiative through which large private fleets can receive support from Clean Cities to reduce petroleum consumption.

  18. Overview of the current National Primary Drinking Water Regulations and regulation development process

    Cotruvo, J.A.; Regelski, M.

    1989-01-01

    The promulgation of the National Primary Drinking Water Regulations (NPDWR) follows specific steps. First, the Advance Notice of Proposed Rule Making (ANPRM) is published. Second, the EPA, as mandated by the SDWA Amendments, proposes maximum contaminant levels (MCLs), (enforceable standards) and maximum contaminant level goals (MCLGs) simultaneously. The Office of Drinking Water developed a six-phase schedule that has attempted to parallel the SDWA-specified deadlines: Phase I - Voltile organic chemicals - July 8, 1987; Phase II - Synthetic organic chemicals and inorganic chemicals - June 1989, microbials and surface water treatment - June 1989, and Lead/copper - December 1988; Phase III - Radionuclides - December 1988; Phase IV - Disinfectants and disinfection by-products - June 1989; Phase V - Other inorganic chemicals, synthetic organic chemicals, and pesticides - June 1989; and Phase VI - 25 additional chemicals - January 199. In selecting contaminants for regulation, the most relevant criteria are (1) potential health risk; (2) ability to detect a contaminant in the drinking water; and (3) occurrence or potential occurrence in drinking water. The EPA uses a three category approach for setting maximum contaminant level goals for carcinogens: Category I, strong evidence of carcinogenicity-zero; Category II, equivocal evidence - reference dose (RfD) approach or 0.00001 to 0.000001 cancer risk range; and Category III, inadequate or no evidence from animal studies - RfD approach. 10 refs., 5 tabs

  19. Comparing MODIS Net Primary Production Estimates with Terrestrial National Forest Inventory Data in Austria

    Mathias Neumann

    2015-04-01

    Full Text Available The mission of this study is to compare Net Primary Productivity (NPP estimates using (i forest inventory data and (ii spatio-temporally continuous MODIS (MODerate resolution Imaging Spectroradiometer remote sensing data for Austria. While forest inventories assess the change in forest growth based on repeated individual tree measurements (DBH, height etc., the MODIS NPP estimates are based on ecophysiological processes such as photosynthesis, respiration and carbon allocation. We obtained repeated national forest inventory data from Austria, calculated a “ground-based” NPP estimate and compared the results with “space-based” MODIS NPP estimates using different daily climate data. The MODIS NPP estimates using local Austrian climate data exhibited better compliance with the forest inventory driven NPP estimates than the MODIS NPP predictions using global climate data sets. Stand density plays a key role in addressing the differences between MODIS driven NPP estimates versus terrestrial driven inventory NPP estimates. After addressing stand density, both results are comparable across different scales. As forest management changes stand density, these findings suggest that management issues are important in understanding the observed discrepancies between MODIS and terrestrial NPP.

  20. Perspectives on the value of advanced medical imaging: a national survey of primary care physicians.

    Hughes, Christine M; Kramer, Erich; Colamonico, Jennifer; Duszak, Richard

    2015-05-01

    To understand perceptions of primary care physicians (PCPs) about the value of advanced medical imaging. A national quantitative survey of 500 PCPs was conducted using an online self-administered questionnaire. Questions focused on advanced medical imaging (CT, MRI, and PET) and its perceived impact on the delivery of patient care. Responses were stratified by physician demographics. Large majorities of the PCPs indicated that advanced imaging increases their diagnostic confidence (441; 88%); provides data not otherwise available (451; 90%); permits better clinical decision making (440; 88%); increases confidence in treatment choices (438; 88%), and shortens time to definitive diagnosis (430; 86%]). Most (424; 85%) believe that patient care would be negatively affected without access to advanced imaging. PCPs whose clinical careers predated the proliferation of advanced imaging modalities (>20 years of practice) assigned higher value to advanced imaging on several dimensions compared with younger physicians whose training overlapped widespread technology availability. By a variety of metrics, large majorities of PCPs believe that advanced medical imaging provides considerable value to patient care. Those whose careers predated the widespread availability of advanced imaging tended to associate it with even higher value. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  1. Photovoltaics Fact Sheet

    None

    2016-02-01

    This fact sheet is an overview of the Photovoltaics (PV) subprogram at the U.S. Department of Energy SunShot Initiative. The U.S. Department of Energy (DOE)’s Solar Energy Technologies Office works with industry, academia, national laboratories, and other government agencies to advance solar PV, which is the direct conversion of sunlight into electricity by a semiconductor, in support of the goals of the SunShot Initiative. SunShot supports research and development to aggressively advance PV technology by improving efficiency and reliability and lowering manufacturing costs. SunShot’s PV portfolio spans work from early-stage solar cell research through technology commercialization, including work on materials, processes, and device structure and characterization techniques.

  2. Aesthetic Education of Primary School Pupils as an Integral Part of the National System of Continuous Art Education in Japan

    Kuchai, Tetiana

    2014-01-01

    The article examines aesthetic education of primary school pupils as an integral part of the national system of continuous art education in Japan. One of the most important traditional means of aesthetic education in Japan, according to L. Tsaryova is considered nature. Analysis of the scientific literature by domestic and foreign scientists…

  3. Primary Percutaneous Coronary Intervention as a National Reperfusion Strategy in Patients With ST-Segment Elevation Myocardial Infarction

    Terkelsen, Christian J; Jensen, Lisette O; Hansen, Hans-Henrik Tilsted

    2011-01-01

    In Denmark, primary percutaneous coronary intervention (PPCI) was chosen as a national reperfusion strategy for patients with ST-segment elevation myocardial infarction in 2003. This study describes the temporal implementation of PPCI in Western Denmark, the gradual introduction of field triage...

  4. English Language Teaching in Public Primary Schools in Mexico: The Practices and Challenges of Implementing a National Language Education Program

    Ramírez Romero, José Luis; Sayer, Peter; Pamplón Irigoyen, Elva Nora

    2014-01-01

    Over the past 15?years, many state governments in Mexico have initiated local programs to introduce English at the primary school level. In 2009, the Mexican Ministry of Education formalized the "Programa Nacional de Inglés en Educación Básica" (PNIEB) as part of the national curriculum, based on the argument that increasing the number…

  5. AIDS-related primary central nervous system lymphoma: a Norwegian national survey 1989–2003

    Haldorsen, Ingfrid S; Kråkenes, Jostein; Goplen, Anne K; Dunlop, Oona; Mella, Olav; Espeland, Ansgar

    2008-01-01

    Primary central nervous system lymphoma (PCNSL) is a frequent complication in acquired immunodeficiency syndrome (AIDS). The objective of this survey was to investigate incidence, clinical features, radiological findings, histologic diagnosis, treatment and outcome for all patients with histologically verified AIDS-related PCNSL diagnosed in Norway in 1989–2003. We identified the patients by chart review of all cases recorded as PCNSL in The Norwegian Cancer Registry (by law recording all cases of cancer in Norway) and all cases recorded as AIDS-related PCNSL in the autopsy registry at a hospital having 67% autopsy rate and treating 59% of AIDS patients in Norway, from 1989 to 2003. Histologic material and radiological images were reviewed. We used person-time techniques to calculate incidence rates of PCNSL among AIDS patients based on recordings on AIDS at the Norwegian Surveillance System for Communicable Diseases (by law recording all cases of AIDS in Norway). Twenty-nine patients had histologically confirmed, newly diagnosed AIDS-related PCNSL in Norway from 1989–2003. Only 2 patients had this diagnosis established while alive. AIDS patients had 5.5% lifetime risk of PCNSL. Their absolute incidence rate of PCNSL per 100 person-years was 1.7 (95%CI: 1.1–2.4) and decreased during the consecutive 5-year periods from 3.6, to 2.5, and to 0.4 (p < 0.001). Median survival from initial symptom of PCNSL was 2.3 months, but one patient was still alive 4 years after completed radiotherapy. This is the first national survey to confirm decreasing incidence of AIDS-related PCNSL. Despite dismal survival in most patients, the possibility of long term survival should prompt more aggressive diagnostics in suspected PCNSL

  6. US primary care physicians' opinions about conscientious refusal: a national vignette experiment.

    Brauer, Simon G; Yoon, John D; Curlin, Farr A

    2016-02-01

    Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate. We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements. Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86). This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. [Development of national neglect norm for urban primary school students of China].

    Pan, Jian-ping; Wang, Fei; Li, Min; Chen, Jing-qi; Zhang, Hui-ying; Wang, Gui-xiang; Gu, Gui-xiong; Guo, Wei-wei; Peng, Yu-lin; Shi, Shu-hua; Chen, Guang-hu; Yi, Hua-ni; Fu, Ping; Xia, Li; Yu, Hong; Lu, Biao; Duan, Zhi-xian; Wang, Ying-xiong; Zhong, Zhao-hui; Li, Jian; Wang, Lin; Cao, Chun-hong; Luo, Sha-sha; Zhang, Song-jie; Zhang, Hua

    2013-02-01

    To develop the national neglect norms for urban primary school students in China. According to multi-stage stratified cluster sampling principle, 24 cities of 13 provinces (municipalities) in China were selected during December 1 to 31, 2008. A total of 1491 students in grade 1 - 3 and 2236 students in grade 4 - 6 were selected. Questionnaire was designed by authors and the final norms were determined through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norms. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm was completed. The two questionnaires of grade 1 - 3 and grade 4 - 6 students consisted of 55 and 57 items, respectively, whose item loadings were ranged from 0.301 to 0.687 and 0.321 to 0.730, which met the statistical requirements. For grade 1 - 3 students, the scale's total Cronbach α coefficients was 0.914, the total split-half reliability coefficients was 0.896, the Cronbach α coefficients of four level was above 0.737 except medical and social neglect, split-half reliability was ranged from 0.461 to 0.757; for grade 4-6 students, the scale's total Cronbach α coefficients was 0.916, split-half reliability was 0.883, except social neglect, the Cronbach α coefficients of other level was ranged 0.457 to 0.856, split-half reliability was ranged from 0.500 to 0.798. The total neglect cut-off score of the two scales grade 1-3 and 4-6 were 125 and 155, respectively. The structure of two norms was reasonable. The scales have good stability and reliability.

  8. Population need for primary eye care in Rwanda: A national survey.

    Tess Bright

    Full Text Available Universal access to Primary Eye Care (PEC is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI. PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE and create a referral pathway for specialist eye care, thus offering a potential solution to a lack of eye health specialists in low-income countries. However, there is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa.A national survey was conducted of people aged 7 and over in Rwanda in September-December 2016. Participants were selected through two-stage probability proportional to size sampling and compact segment sampling. VI (visual acuity<6/12 was assessed using Portable Eye Examination Kit (PEEK; URE was detected using a pinhole and presbyopia using local near vision test. We also used validated questionnaires to collect socio-demographic and minor eye symptoms information. Prevalence estimates for VI, URE and need for PEC (URE, presbyopia with good distance vision, need for referrals and minor eye conditions were age and sex standardized to the Rwandan population. Associations between age, sex, socio-economic status and the key outcomes were examined using logistic regression.4618 participants were examined and interviewed out of 5361 enumerated (86% response rate. The adjusted population prevalence of VI was 3.7% (95%CI = 3.0-4.5%, URE was 2.2% (95%CI = 1.7-2.8% and overall need for PEC was 34.0% (95%CI = 31.8-36.4%. Women and older people were more likely to need PEC and require a referral.Nearly a third of the population in Rwanda has the potential to benefit from PEC, with greater need identified in older people and women. Universal access to PEC can address unmet eye health needs and public health planning needs to ensure equitable access to older people and women.

  9. The user with respiratory symptoms of tuberculosis in the primary care: assessment of actions according to national recommendations

    Luize Barbosa Antunes

    2016-06-01

    Full Text Available Objective: to investigate the evaluation of the user with respiratory symptoms of tuberculosis in Primary Health Care services according to the norms of the National Program for Tuberculosis Control. Methods: cross-sectional study with application of a form to 99 people with pulmonary tuberculosis. Results: a total of 87.9% participants reported cough as the symptom that motivated the search for Primary Care; from these, 27.3% sought Primary Care units, 96.3% received care in this service, of which 46.2% reported that sputum smear was requested by professionals in the units. Conclusion: more than half of participants sought secondary or tertiary services due to the symptoms of tuberculosis, and also less than half of patients assisted in Primary Care had diagnostic tests requested by professionals of that service.

  10. Quasi-Experimental Evaluation of a National Primary School HIV Intervention in Kenya

    Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

    2007-01-01

    This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant…

  11. Net primary productivity of subalpine meadows in Yosemite National Park in relation to climate variability

    Peggy E. Moore; Jan W. van Wagtendonk; Julie L. Yee; Mitchel P. McClaran; David N. Cole; Neil K. McDougald; Matthew L. Brooks

    2013-01-01

    Subalpine meadows are some of the most ecologically important components of mountain landscapes, and primary productivity is important to the maintenance of meadow functions. Understanding how changes in primary productivity are associated with variability in moisture and temperature will become increasingly important with current and anticipated changes in climate....

  12. Y-12 Groundwater Protection Program Extent Of The Primary Groundwater Contaminants At The Y-12 National Security Complex

    None, None

    2013-12-01

    This report presents data summary tables and maps used to define and illustrate the approximate lateral extent of groundwater contamination at the U.S. Department of Energy (DOE) Y-12 National Security Complex (Y-12) in Oak Ridge, Tennessee. The data tables and maps address the primary (i.e., most widespread and mobile) organic, inorganic, and radiological contaminants in the groundwater. The sampling locations, calculated contaminant concentrations, plume boundary values, and paired map format used to define, quantify, delineate, and illustrate the approximate extent of the primary organic, inorganic, and radiological contaminants in groundwater at Y-12 are described.

  13. Health promotion practices as perceived by primary healthcare professionals at the Ministry of National Guard Health Affairs, Saudi Arabia.

    Altamimi, Samar; Alshoshan, Feda; Al Shaman, Ghada; Tawfeeq, Nasser; Alasmary, May; Ahmed, Anwar E

    2016-01-01

    In recent years, several research studies have investigated health promotion practices in Saudi healthcare organizations, yet no published literature exists on health promotion practices of primary healthcare professionals working for the Ministry of National Guard Health Affairs (MNG-HA). A cross-sectional study was conducted in a convenience sample of 206 primary healthcare professionals at the MNG-HA. A self-reporting questionnaire was used to investigate the attitudes, awareness, satisfaction, and methods regarding health promotion practices of primary healthcare professionals. Of the 206 primary healthcare professionals surveyed, 58.1% reported awareness of health promotion programs conducted in the hospitals and 64.6% reported that the health promotion system in the hospitals needs to be improved. Language barriers and cultural beliefs were viewed as obstacles to carrying out effective health promotion by 65% and 64.6% of primary healthcare professionals, respectively. The majority (79.9%) of the primary healthcare professionals perceived themselves as having the necessary skills to promote health and 80.6% believed that printed educational materials are the most prevalent method of health promotion/education, whereas 55.8% reported that counseling was the most preferred method of health promotion. The awareness level of health promotion policies, strategies, and programs conducted in the hospitals was not found to be satisfactory. Therefore, widespread training programs are recommended to improve the health promotion system in the hospitals. These programs include facilitating behavioral change, introducing health promotion policies and strategies in hospitals, mandatory workshops, and systematic reminders.

  14. Tube sheet design for PFBR steam generator

    Chellapandi, P.; Chetal, S.C.; Bhoje, S.B.

    1991-01-01

    Top and bottom tube sheets of PFBR Steam Generators have been analysed with 3D and axisymmetric models using CASTEM Programs. Analysis indicates that the effects of piping reactions at the inlet/outlet nozzles on the primary stresses in the tube sheets are negligible and the asymmetricity of the deformation pattern introduced in the tube sheet by the presence of inlet/outlet and manhole nozzles is insignificant. The minimum tube sheet thicknesses for evaporator and reheater are 135 mm and 75 mm respectively. Further analysis has indicated the minimum fillet radius at the junction of tube sheet and dished end should be 20 mm. Simplified methodology has been developed to arrive at the number of thermal baffles required to protect the tube sheet against fatigue damage due to thermal transient. This method has been applied to PFBR steam generators to determine the required number of thermal baffles. For protecting the bottom tube sheet of evaporator against the thermal shock due to feed water and secondary pump trip, one thermal shield is found to be sufficient. Further analysis is required to decide upon the actual number to take care of the severe thermal transient, following the event of sudden dumping of water/steam, immediately after the sodium-water reaction. (author)

  15. The potential impact of the next influenza pandemic on a national primary care medical workforce

    Wilson, Nick; Baker, Michael; Crampton, Peter; Mansoor, Osman

    2005-01-01

    Abstract Background Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. Methods The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta) was applied to the New Zealand primary care medical workforce (i.e., general practitioners). Results At its peak (week 4) the pandemic would lead to...

  16. Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

    Ramona Fernanda Ceriotti Toassi

    2013-06-01

    Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

  17. Ice sheet in peril

    Hvidberg, Christine Schøtt

    2016-01-01

    Earth's large ice sheets in Greenland and Antarctica are major contributors to sea level change. At present, the Greenland Ice Sheet (see the photo) is losing mass in response to climate warming in Greenland (1), but the present changes also include a long-term response to past climate transitions...

  18. Mobility Balance Sheet 2009

    Jorritsma, P.; Derriks, H.; Francke, J.; Gordijn, H.; Groot, W.; Harms, L.; Van der Loop, H.; Peer, S.; Savelberg, F.; Wouters, P.

    2009-06-01

    The Mobility Balance Sheet provides an overview of the state of the art of mobility in the Netherlands. In addition to describing the development of mobility this report also provides explanations for the growth of passenger and freight transport. Moreover, the Mobility Balance Sheet also focuses on a topical theme: the effects of economic crises on mobility. [nl

  19. Variation in primary site resection practices for advanced colon cancer: a study using the National Cancer Data Base.

    Healy, Mark A; Pradarelli, Jason C; Krell, Robert W; Regenbogen, Scott E; Suwanabol, Pasithorn A

    2016-10-01

    Treatment of metastatic colon cancer may be driven as much by practice patterns as by features of disease. To optimize management, there is a need to better understand what is determining primary site resection use. We evaluated all patients with stage IV cancers in the National Cancer Data Base from 2002 to 2012 (50,791 patients, 1,230 hospitals). We first identified patient characteristics associated with primary tumor resection. Then, we assessed nationwide variation in hospital resection rates. Overall, 27,387 (53.9%) patients underwent primary site resection. Factors associated with resection included younger age, having less than 2 major comorbidities, and white race (P primary tumor resection rates ranged from 26.0% to 87.8% with broad differences across geographical areas and hospital accreditation types. There is statistically significant variation in hospital rates of primary site resection. This demonstrates inconsistent adherence to guidelines in the presence of conflicting evidence regarding resection benefit. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Perceived Barriers to Implementing Individual Choosing Wisely® Recommendations in Two National Surveys of Primary Care Providers.

    Zikmund-Fisher, Brian J; Kullgren, Jeffrey T; Fagerlin, Angela; Klamerus, Mandi L; Bernstein, Steven J; Kerr, Eve A

    2017-02-01

    While some research has examined general attitudes about efforts to reduce overutilization of services, such as the Choosing Wisely ® (CW) initiative, little data exists regarding primary care providers' attitudes regarding individual recommendations. We sought to identify whether particular CW recommendations were perceived by primary care providers as difficult to follow, difficult for patients to accept, or both. Two national surveys, one by mail to a random sample of 2000 U.S. primary care physicians in November 2013, and the second electronically to a random sample of 2500 VA primary care providers (PCPs) in October-December 2014. A total of 603 U.S. primary care physicians and 1173 VA primary care providers. Response rates were 34 and 48 %, respectively. PCP ratings of whether 12 CW recommendations for screening, testing and treatments applicable to adult primary care were difficult to follow and difficult for patients to accept; and ratings of potential barriers to reducing overutilization. For four recommendations regarding not screening or testing in asymptomatic patients, less than 20 % of PCPs found the CW recommendations difficult to accept (range 7.2-16.6 %) or difficult for patients to follow (12.2-19.3 %). For five recommendations regarding testing or treatment for symptomatic conditions, however, there was both variation in reported difficulty to follow (9.8-32 %) and a high level of reported difficulty for patients to accept (35.7-87.1 %). The most frequently reported barriers to reducing overuse included malpractice concern, patient requests for services, lack of time for shared decision making, and the number of tests recommended by specialists. While PCPs found many CW recommendations easy to follow, they felt that some, especially those for symptomatic conditions, would be difficult for patients to accept. Overcoming PCPs' perceptions of patient acceptability will require approaches beyond routine physician education, feedback and

  1. 76 FR 76259 - National Emissions Standards for Hazardous Air Pollutants: Primary Aluminum Reduction Plants

    2011-12-06

    ... Emissions From Maleic Anhydride Plants, Ethylbenzene/Styrene Plants, Benzene Storage Vessels, Benzene...). The rule is applicable to facilities with affected sources associated with the production of aluminum... are subject to the requirements of this NESHAP: 14 primary aluminum production plants and one carbon...

  2. PATTERNS OF DOMINANCE OF LANGUAGE VITALITIES AMONG MALAYSIAN STUDENTS IN PRIMARY NATIONAL-TYPE AND SECONDARY SCHOOLS

    Soo Ying How

    2017-01-01

    Full Text Available Multilingualism is embedded in the Malaysian Education Blueprint (2015-2025 as a stated goal towards nation building. The education system provides opportunity to learn Malay which is the national language, the mother tongue (Mandarin or Tamil and the English language as part of formal schooling. In fact, Malaysian primary schools are classified into two major divisions. Students can opt to study in national schools in which the medium of instruction is Malay with the provision for the learning of English and a mother tongue. The other option allows students to enrol in national-type schools of which the medium of instruction is either Mandarin or Tamil, with English and Malay taught as academic subjects. At secondary level, the medium of instruction in national schools is Malay and students are provided the opportunity to learn their mother tongue and English. Other than in school, other social milieus also allow the use and practice of these languages. Given this linguistic environment, there exists a myriad of language experiences within and outside formal learning which together would influence the totality of language vitality. This paper investigates language vitality featured in this multilingual environment. It focuses on the vitality of the English language among students that appears to co-exist with the learning and use of other languages as they progress through the primary and secondary levels. The vitality is measured by the following indicators: language preference, choice, dominance, use, attitude and motivation and proficiency which were used to develop a questionnaire to obtain data on strength evaluation of these languages. The methodology encompasses random and convenient sampling to obtain representative responses from students with different levels of education and language experiences. The study reveals relative vitalities of languages used and highlights values attached to languages at different points of language

  3. Absolute measurement of the DT primary neutron yield on the National Ignition Facility

    Leeper R.J.

    2013-11-01

    Full Text Available The measurement of the absolute neutron yield produced in inertial confinement fusion target experiments conducted on the National Ignition Facility (NIF is essential in benchmarking progress towards the goal of achieving ignition on this facility. This paper describes three independent diagnostic techniques that have been developed to make accurate and precise DT neutron yield measurements on the NIF.

  4. [Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

    Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

    2017-01-23

    This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

  5. Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples

    McDermott Robyn

    2010-05-01

    Full Text Available Abstract Background Strengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE project has facilitated the implementation of modern Continuous Quality Improvement (CQI approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1 explore the factors associated with variation in clinical performance; 2 examine specific strategies that have been effective in improving primary care clinical performance; and 3 work with health service staff, management and policy makers to enhance the effective implementation of successful strategies. Methods/Design The study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management. Discussion By linking researchers directly to users of research (service providers, managers and policy makers, the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary

  6. Primary Cyst adenocarcinoma: exceptional etiology of a retroperitoneal cystic tumor.First National Communication

    Gonzalez, D.; Ruso, L.; Ettlin, A.

    2010-01-01

    This work is about the clinical case of a 29 year old patient who consulted for right lank pain, where a tumor was identified. Ultrasound confirmed the existence of a cystic process, and complete surgical abscission/exeresis was performed next to an area in the in the abdominal wall. Anatomopathological report confirmed a primary retroperitoneal cistoadenocarcinoma. No adjuvant treatment was applied, evolution was good 11 months after surgery, no evidence of the disease

  7. Fact Sheets: Air Toxics Rules for the Manufacture of Amino/Phenolic Resins

    This page contains a December 1999 fact sheet for the proposed National Emission Standards for Hazardous Air Pollutants (NESHAP): Manufacture of Amino/Phenolic Resins and a September 2014 fact sheet with information regarding the final NESHAP

  8. The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China.

    Guo, Zhigang; Guan, Xiaodong; Shi, Luwen

    2017-11-13

    In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010. A questionnaire survey developed by the study team was distributed to all of the primary healthcare institutions. Nine indicators from three dimensions as the outcome variables were used and calculated to evaluate the impacts of implementation of policies. All of the outcome variables were tested using independent-samples T test between the treatment group (with the NEMPs implemented) and the control group (without the NEMPs implemented). The ratio of drug sales and institution revenues at primary healthcare institutions was 42.99% in the treatment group, which was significantly lower than the control group (53.90%, p financial subsidies of the treatment group was shown to be higher (30.78% VS 20.82%, p institutions, the improvement of the mechanisms for government investment, and the healthcare pricing system. Meanwhile, the gaps between urban and rural areas need to be addressed. In conclusion, the NEMPs of China are instrumental to the aim of providing basic healthcare services to every citizen.

  9. Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Terminal Operations HITL 1B Primary Results

    Rorie, Conrad; Monk, Kevin; Roberts, Zach; Brandt, Summer

    2018-01-01

    This presentation provides an overview of the primary results from the Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project's second Terminal Operations human-in-the-loop simulation. This talk covers the background of this follow-on experiment, which includes an overview of the first Terminal Operations HITL performed by the project. The primary results include a look at the number and durations of detect and avoid (DAA) alerts issued by the two DAA systems under test. It also includes response time metrics and metrics on the ability of the pilot-in-command (PIC) to maintain sufficient separation. Additional interoperability metrics are included to illustrate how pilots interact with the tower controller. Implications and conclusions are covered at the end.

  10. Carbon sheet pumping

    Ohyabu, N.; Sagara, A.; Kawamura, T.; Motojima, O.; Ono, T.

    1993-07-01

    A new hydrogen pumping scheme has been proposed which controls recycling of the particles for significant improvement of the energy confinement in toroidal magnetic fusion devices. In this scheme, a part of the vacuum vessel surface near the divertor is covered with carbon sheets of a large surface area. Before discharge initiation, the sheets are baked up to 700 ∼ 1000degC to remove the previously trapped hydrogen atoms. After being cooled down to below ∼ 200degC, the unsaturated carbon sheets trap high energy charge exchange hydrogen atoms effectively during a discharge and overall pumping efficiency can be as high as ∼ 50 %. (author)

  11. Communication between secondary and primary care following self-harm: are National Institute of Clinical Excellence (NICE guidelines being met?

    Jordan Rita

    2008-10-01

    Full Text Available Abstract Background Most patients contact their general practitioner (GP following presentation to an Emergency Department (ED after a self-harm incident, and strategies to help GPs manage these patients include efficient communication between services. The aim of this study was to assess the standard of documentation and communication to primary care from secondary care as recommended by the National Institute of Clinical Excellence (NICE guidelines on the short-term management of people who self-harm. Methods An audit of medical records (ED and Psychiatric on people aged 16 years and over who had presented to the ED following self-harm, benchmarked according to government guidelines, was performed. Data were collected over a 4-week period at a general teaching hospital. Results We collected data on 93 consecutive episodes of self-harm; 62% of episodes were communicated to primary care, 58% of these communications were within 24 h and most within 3 days. Patient identifying details and follow-up arrangements were specified in most cases. Communication via psychiatric staff was most detailed. ED clinicians provided few communications and were of limited content. Communication with the patient's GP was not made in half of those cases seen by a mental health specialist. Conclusion Government guidelines are only partially being met. Reliance on communication by ED staff would leave a substantial proportion of patients discharged from the ED with no or minimal communication to primary care. Psychiatric services need to improve the rate of communication to the patient's GP following assessment A national sample of National Health Service (NHS trusts would establish if this is a problem elsewhere.

  12. TSCA Chemical Data Reporting Fact Sheet: Articles

    This fact sheet provides guidance on classifying articles under the Toxic Substances Control Act (TSCA) and determining the applicability of EPA’s articles exclusion policy for purposes of the Chemical Data Reporting (CDR) rule. The primary goal of this document is to help the regulated community comply with the requirements of the CDR rule.

  13. Radiology standards for primary dental care: report by the Royal College of Radiologists and the National Radiological Protection Board

    Hudson, Tony

    1994-01-01

    In 1992 a joint venture between the Royal College of Radiologists (RCR) and the National Radiological Protection Board (NRPB) resulted in the formation of a Working Party (WP) to consider dental radiology. Although individual doses to patients are low, WP identified considerable scope for reducing the collective dose to patients and for improving the diagnostic quality of radiographs. The report published in the Documents of the NRPB series presents the WP conclusions in the form of guidelines that deal with all aspects of dental radiology in primary dental care. (Author)

  14. A national cohort study of long-course preoperative radiotherapy in primary fixed rectal cancer in Denmark

    Bulow, S.; Jensen, L.H.; Altaf, R.

    2010-01-01

    OBJECTIVE: Preoperative radiotherapy has been shown to enable a fixed rectal cancer to become resectable which in turn may result in long-time survival. In this study, we analysed the outcome of long-course preoperative radiotherapy in fixed rectal cancer in a national cohort including all Danish...... patients registered with primary inoperable rectal cancer and treated in the period May 2001 to December 2005. METHOD: The study was based on surgical and demographic data from a continuously updated and validated national database. In addition, retrospective data were retrieved from all departments...... of radiotherapy concerning technique of radiotherapy, dose and fractionation and use of concomitant chemotherapy. Outcome was determined by actuarial analysis of local control, disease-free survival and overall survival. RESULTS: A total of 258 patients with fixed rectal cancer received long-course radiotherapy...

  15. Anesthesia Fact Sheet

    ... Education About NIGMS NIGMS Home > Science Education > Anesthesia Anesthesia Tagline (Optional) Middle/Main Content Area En español ... Version (464 KB) Other Fact Sheets What is anesthesia? Anesthesia is a medical treatment that prevents patients ...

  16. Structural Biology Fact Sheet

    ... NIGMS NIGMS Home > Science Education > Structural Biology Structural Biology Tagline (Optional) Middle/Main Content Area PDF Version (688 KB) Other Fact Sheets What is structural biology? Structural biology is the study of how biological ...

  17. Radiation protecting sheet

    Makiguchi, Hiroshi.

    1989-01-01

    As protection sheets used in radioactivity administration areas, a thermoplastic polyurethane composition sheet with a thickness of less 0.5 mm, solid content (ash) of less than 5% and a shore D hardness of less than 60 is used. A composite sheet with thickness of less than 0.5 mm laminated or coated with such a thermoplastic polyurethane composition as a surface layer and the thermoplastic polyurethane composition sheet applied with secondary fabrication are used. This can satisfy all of the required properties, such as draping property, abrasion resistance, high breaking strength, necking resistance, endurance strength, as well as chemical resistance and easy burnability in burning furnace. Further, by forming uneveness on the surface by means of embossing, etc. safety problems such as slippage during operation and walking can be overcome. (T.M.)

  18. Global ice sheet modeling

    Hughes, T.J.; Fastook, J.L.

    1994-05-01

    The University of Maine conducted this study for Pacific Northwest Laboratory (PNL) as part of a global climate modeling task for site characterization of the potential nuclear waste respository site at Yucca Mountain, NV. The purpose of the study was to develop a global ice sheet dynamics model that will forecast the three-dimensional configuration of global ice sheets for specific climate change scenarios. The objective of the third (final) year of the work was to produce ice sheet data for glaciation scenarios covering the next 100,000 years. This was accomplished using both the map-plane and flowband solutions of our time-dependent, finite-element gridpoint model. The theory and equations used to develop the ice sheet models are presented. Three future scenarios were simulated by the model and results are discussed

  19. Placebo use in the United kingdom: results from a national survey of primary care practitioners.

    Jeremy Howick

    Full Text Available OBJECTIVES: Surveys in various countries suggest 17% to 80% of doctors prescribe 'placebos' in routine practice, but prevalence of placebo use in UK primary care is unknown. METHODS: We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into 'pure' and 'impure'. 'Impure' placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections. 'Pure' placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks. RESULTS: We surveyed 1715 general practitioners and 783 (46% completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15 of respondents used pure placebos while 97% (95% CI 96 to 98 used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79 used impure placebos at least once per week. Most (66% for pure, 84% for impure respondents stated placebos were ethical in some circumstances. CONCLUSION AND IMPLICATIONS: Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions.

  20. The potential impact of the next influenza pandemic on a national primary care medical workforce

    Crampton Peter

    2005-08-01

    Full Text Available Abstract Background Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. Methods The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta was applied to the New Zealand primary care medical workforce (i.e., general practitioners. Results At its peak (week 4 the pandemic would lead to 1.2% to 2.7% loss of medical work time, using conservative baseline assumptions. Most workdays (88% would be lost due to illness, followed by hospitalisation (8%, and then premature death (4%. Inputs for a "more severe" scenario included greater health effects and time spent caring for sick relatives. For this scenario, 9% of medical workdays would be lost in the peak week, and 3% over a more compressed six-week period of the first pandemic wave. As with the base case, most (64% of lost workdays would be due to illness, followed by caring for others (31%, hospitalisation (4%, and then premature death (1%. Conclusion Preparedness planning for future influenza pandemics must consider the impact on this medical workforce and incorporate strategies to minimise this impact, including infection control measures, well-designed protocols, and improved health sector surge capacity.

  1. The potential impact of the next influenza pandemic on a national primary care medical workforce.

    Wilson, Nick; Baker, Michael; Crampton, Peter; Mansoor, Osman

    2005-08-11

    Another influenza pandemic is all but inevitable. We estimated its potential impact on the primary care medical workforce in New Zealand, so that planning could mitigate the disruption from the pandemic and similar challenges. The model in the "FluAid" software (Centers for Disease Control and Prevention, CDC, Atlanta) was applied to the New Zealand primary care medical workforce (i.e., general practitioners). At its peak (week 4) the pandemic would lead to 1.2% to 2.7% loss of medical work time, using conservative baseline assumptions. Most workdays (88%) would be lost due to illness, followed by hospitalisation (8%), and then premature death (4%). Inputs for a "more severe" scenario included greater health effects and time spent caring for sick relatives. For this scenario, 9% of medical workdays would be lost in the peak week, and 3% over a more compressed six-week period of the first pandemic wave. As with the base case, most (64%) of lost workdays would be due to illness, followed by caring for others (31%), hospitalisation (4%), and then premature death (1%). Preparedness planning for future influenza pandemics must consider the impact on this medical workforce and incorporate strategies to minimise this impact, including infection control measures, well-designed protocols, and improved health sector surge capacity.

  2. Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider.

    Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna

    2014-01-01

    Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

  3. Patient experience of access to primary care: identification of predictors in a national patient survey.

    Kontopantelis, Evangelos; Roland, Martin; Reeves, David

    2010-08-28

    The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. 8,307 English general practices were included in the survey (of 8,403 identified). 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given the increasing tendency for small practices to combine into larger

  4. Patient experience of access to primary care: identification of predictors in a national patient survey

    Kontopantelis Evangelos

    2010-08-01

    Full Text Available Abstract Background The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. Methods 8,307 English general practices were included in the survey (of 8,403 identified. 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. Results After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. Conclusions This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given

  5. Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study.

    Whitford, David L

    2009-01-01

    BACKGROUND: Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. METHODS: Postal survey of random sample of general practitioners undertaken (N = 204; 46% response). Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. RESULTS: Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. CONCLUSION: General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.

  6. Is primary care a neglected piece of the jigsaw in ensuring optimal stroke care? Results of a national study

    O'Sullivan Bernadette

    2009-04-01

    Full Text Available Abstract Background Stroke is a major cause of mortality and morbidity with potential for improved care and prevention through general practice. A national survey was undertaken to determine current resources and needs for optimal stroke prevention and care. Methods Postal survey of random sample of general practitioners undertaken (N = 204; 46% response. Topics included practice organisation, primary prevention, acute management, secondary prevention, long-term care and rehabilitation. Results Service organisation for both primary and secondary prevention was poor. Home management of acute stroke patients was used at some stage by 50% of responders, accounting for 7.3% of all stroke patients. Being in a structured cardiovascular management scheme, a training practice, a larger practice, or a practice employing a practice nurse were associated with structures and processes likely to support stroke prevention and care. Conclusion General practices were not fulfilling their potential to provide stroke prevention and long-term management. Systems of structured stroke management in general practice are essential to comprehensive national programmes of stroke care.

  7. Risk of subsequent primary malignancies after dermatofibrosarcoma protuberans diagnosis: a national study.

    Kurlander, David E; Martires, Kathryn J; Chen, Yanwen; Barnholtz-Sloan, Jill S; Bordeaux, Jeremy S

    2013-05-01

    Patients frequently live many years after diagnosis of dermatofibrosarcoma protuberans (DFSP). We sought to determine the risk of subsequent primary malignancy (SPM) after DFSP diagnosis. Using the Surveillance, Epidemiology, and End Results database (1973-2008) for 3734 patients with DFSP, we compared the risk of developing 14 SPMs (12 most prevalent cancers in the United States plus other nonepithelial and soft tissue) relative to risk in the general population of same sex, race, and age and year of diagnosis. Patients given the diagnosis of DFSP had an overall increased risk of SPM (observed:expected [O:E], 1.20; 95% confidence intervals [CI], 1.04-1.39), with much of the overall increased risk attributable to increased risk of nonepithelial skin cancer (O:E, 9.94; 95% CI, 3.38-22.30). Specifically, female patients with DFSP were at increased risk of other nonepithelial skin cancer (O:E, 14.50; 95% CI, 3.46-38.98), melanoma (O:E, 2.59; 95% CI, 1.02-5.35), and breast cancer (O:E, 1.44; 95% CI, 1.00-2.00). Male patients were not at increased overall risk (O:E, 1.18; 95% CI, 0.96-1.44) of SPM or at increased risk of any specific malignancy (P > .05) adjusted for multiplicity of t tests. Surveillance bias may have led to increased rates and earlier detection of primary malignances in patients with DFSP compared with the general population. Individual data that may reveal shared environmental causes of DFSP and SPM were unavailable. Patients with DFSP are at increased risk of a number of SPMs. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  8. A comparison of gas geochemistry of fumaroles in the 1912 ash-flow sheet and on active stratovolcanoes, Katmai National Park, Alaska

    Sheppard, D.S.; Janik, C.J.; Keith, T.E.C.

    1992-01-01

    Fumarolic gas samples collected in 1978 and 1979 from the stratovolcanoes Mount Griggs, Mount Mageik, and the 1953-68 SW Trident cone in Katmai National Park, Alaska, have been analysed and the results presented here. Comparison with recalculated analyses of samples collected from the Valley of Ten Thousand Smokes (VTTS) in 1917 and 1919 demonstrates differences between gases from the short-lived VTTS fumaroles, which were not directly magma related, and the fumaroles on the volcanic peaks. Fumarolic gases of Mount Griggs have an elevated total He content, suggesting a more direct deep crustal or mantle source for these gases than those from the other volcanoes. ?? 1992.

  9. A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol

    Cohen, Deborah J.; Balasubramanian, Bijal A.; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I.; Crabtree, Benjamin F.; Stange, Kurt C.; Davis, Melinda; Miller, William L.; Damschroder, Laura J.; McConnell, K. John; Creswell, John

    2016-01-01

    Background The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to...

  10. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care

    Darko Gvozdanovi_

    2007-09-01

    Full Text Available In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1 to provide efficient healthcare-related data management in support of decision-making processes; (2 to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

  11. The Danish National Health Service Register (NHSR) as a Source for Research on Primary Care

    Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan

    . The data is easy accessible from the Danish National Board of Health. Conclusion: The register's strengths include completeness, size and long follow-up period. It is useful for research purposes especially when linked with other registers. However, grave reservations must be made regarding the validity...... of the register as no studies of this point have been made. Knowledge of the working conditions in general practice is necessary in order to use the NHSR for research purposes.......Aim: To describe NHSR in relation to research. Content: The data in the register from general practice is generated through the GPs’ electronic invoices to the Regional Health Administration. Data from 1990 onwards is available covering more than 600 million patient contacts. For each service...

  12. The Impacts of Retention, Expenditures, and Class Size on Primary School Completion in Sub-Saharan Africa: A Cross-National Analysis

    Ruff, Ryan Richard

    2016-01-01

    Education in Sub-Saharan Africa is increasingly viewed as a means of emancipation and a transformative project for social mobility. Developing nations have pursued policies such as universal or free primary education to increase access to education and improve student outcomes. In this study, direct and indirect precursors to primary school…

  13. Social franchising primary healthcare clinics--a model for South African National Health Insurance?

    Robinson, Andrew Ken Lacey

    2015-09-21

    This article describes the first government social franchise initiative in the world to deliver a 'brand' of quality primary healthcare (PHC) clinic services. Quality and standards of care are not uniformly and reliably delivered across government PHC clinics in North West Province, South Africa, despite government support, numerous policies, guidelines and in-service training sessions provided to staff. Currently the strongest predictor of good-quality service is the skill and dedication of the facility manager. A project utilising the social franchising business model, harvesting best practices, has been implemented with the aim of developing a system to ensure reliably excellent healthcare service provision in every facility in North West. The services of social franchising consultants have been procured to develop the business model to drive this initiative. Best practices have been benchmarked, and policies, guidelines and clinic support systems have been reviewed, evaluated and assessed, and incorporated into the business plan. A pilot clinic has been selected to refine and develop a working social franchise model. This will then be replicated in one clinic to confirm proof of concept before further scale-up. The social franchise business model can provide solutions to a reliable and recognisable 'brand' of quality universal coverage of healthcare services.

  14. PRIMARY HEALTH CARE IN THE VILLAGES AROUND LORE LINDU NATIONAL PARK, CENTRAL SULAWESI

    M. Sudomo

    2012-10-01

    Full Text Available The general pattern of service provision provides specialist and maternity hospitals at the tertiary care level, general hospitals as secondary level care, while the PUSKESMAS, PUSKESTU, POSYANDU and Village Delivery Units (POLINDES make up the primary care facilities. A PUSKESMAS is staffed by a medical doctor (general physician, a dental surgeon, nurses, midwives, assistant pharmacist and sanitarians, alongside the necessary administrative staff. Usually the facilities of a PUSKESMAS will include a minor operations surgery, a delivery room, a dental surgery and a small inpatient ward. The PUSKESMAS may also have minor laboratory facilities, such as the capacity to diagnose malaria, helminth infection or tuberculosis. The PUSKESTU has nurses only. The Village Delivery Unit is used by both the Village Midwife (Bidem Desa, usually a newly qualified midwife, and the traditional midwife (Dukun who may or may not be trained. Facilities are open Monday to Friday during normal office hours, with emergency cover only outside these times. Care is generally provided on a fee-for-service basis.

  15. Assessing mixed anxiety-depressive disorder. A national primary care survey.

    Balestrieri, Matteo; Isola, Miriam; Quartaroli, Mauro; Roncolato, Maurizio; Bellantuono, Cesario

    2010-04-30

    Prevalence and risk factors associated with mixed anxiety-depressive disorder (MAD) have yet to be established. Using MINI 5.0.1 and HADS, a two-week survey involving 21,644 primary care patients was carried out. We found 1.8% of subjects with MAD and 20% of subjects with a co-morbid anxiety and depression (CAD) disorder. MAD patients without a past history of anxiety/affective episodes were defined as "pure MAD" (pMAD: 0.9% of the sample). While MAD patients showed a number of differences vs. the other groups of patients in the socio-demographic statistics, pMAD patients were not different, apart from a higher proportion of males vs. CAD patients. Nearly in all the comparisons, MAD and pMAD patients showed lower association with life events and with a familial predisposition than the other patients. On HADS assessment, MAD showed a higher risk of anxiety and depressive symptoms than anxiety diagnoses, a lower risk of depressive symptoms than depressive diagnoses and a lower risk of both anxiety and depressive symptoms than CAD. Since more than a half of MAD patients were classified as pMAD, the hypothesis that MAD should be viewed as a partial remission of a major depression is not entirely confirmed in our study. Copyright (c) 2008 Elsevier Ltd. All rights reserved.

  16. [Primary immune thrombocytopenia in adults in Mexico: national characteristics and the relation to international literature].

    Meillón-García, Luis Antonio; García-Chávez, Jaime; Gómez-Almaguer, David; Gutiérrez-Espíndola, Guillermo R; Martínez-Murillo, Carlos

    2014-01-01

    In order to identify the clinical approach of a sample of Mexican hematologists for primary immune thrombocytopenia (ITP) in adults in Mexico, we applied an electronic survey via the internet to identify common practices for the diagnosis and treatment of ITP and draw a comparison between the information from these hematologists with international guidelines or the international literature. The results were analyzed using measures of central tendency. The sample was 21 medical hematologists, predominantly from Mexico City (average age: 51.4 years). A total of 66.7% of the surveyed physicians use international guidelines to make therapeutic decisions, and 43% defined ITP including the numerical concept (< 100 x 10(9)/l). We found some differences between requested clinical exams and tests indicated by the guidelines. In first-line treatment (except emergency), 91% of the participants start with prednisone and 24% use dexamethasone. Danazol is used in persistent ITP by most (41%) of the specialists. In second-line treatment, 67% would indicate splenectomy. Some differences were found between clinical practice of the hematologists in Mexico versus guidelines recommendations.

  17. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

    Bordonaba-Bosque Daniel

    2011-06-01

    Full Text Available Abstract Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain. Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®. Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.

  18. Primary Maternity Units in rural and remote Australia: Results of a national survey.

    Kruske, Sue; Kildea, Sue; Jenkinson, Bec; Pilcher, Jennifer; Robin, Sarah; Rolfe, Margaret; Kornelsen, Jude; Barclay, Lesley

    2016-09-01

    Primary Maternity Units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. a descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia. Data were subjected to simple descriptive statistics and thematic analysis for free text answers. Only 17 PMUs were identified in rural and remote areas of Australia. All 17 completed the survey. the PMUs were, on average, 56km or 49minutes from their referral service and provided care to an average of 59 birthing women per year. Periodic closures or downgrading of services was common. Low-risk eligibility criteria were universally used, but with some variability. Medically-led care was the most widely available model of care. In most PMUs midwives worked shift work involving both nursing and midwifery duties, with minimal uptake of recent midwifery workforce innovations. Perceived enablers of, and threats to, sustainability were reported. a small number of PMUs operate in rural Australia, and none in remote areas. Continuing overreliance on local medical support, and under-utilisation of the midwifery workforce constrain the restoration of maternity services to rural and remote Australia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. The Security Education Concepts in the Textbooks of the National and Civic Education of the Primary Stage in Jordan--An Analytical Study

    Al-Edwan, Zaid Suleiman

    2016-01-01

    The present study aimed at exploring the concepts of the security education in the textbooks of the national and civic education of the higher primary stage in Jordan. It adopted the descriptive analytical method. The study sample consisted of the textbooks of the national and civic education for the basic eighth, ninth and tenth grades. To…

  20. 40 CFR Appendix I to Part 50 - Interpretation of the 8-Hour Primary and Secondary National Ambient Air Quality Standards for Ozone

    2010-07-01

    ... Secondary National Ambient Air Quality Standards for Ozone 1. General. This appendix explains the data.... Primary and Secondary Ambient Air Quality Standards for Ozone. 2.1 Data Reporting and Handling Conventions... and Secondary National Ambient Air Quality Standards for Ozone I Appendix I to Part 50 Protection of...

  1. 1998 energy balance sheet of France

    Anon.

    1999-01-01

    This paper summarizes the results of the energy balance sheet of France for the year 1998 according to the data published by the energy observatory from the general direction of energy and raw materials (DGEMP) and according to the press communication given by C. Pierret, French state secretary of the industry. The following points are commented: the energy balance sheet (national production and energy independence, the energy shares in the consumption), the decay of the energy bill, and the details of the bill by energy type. (J.S.)

  2. Decennial scheme of grid development 2016: National component + synthesis, Regional component, Regional sheets. Version 1 submitted to public consultation - December 2016, final version after public consultation - January 2017

    2016-12-01

    Two versions of the same decennial scheme are gathered. The first one has been published before public consultation, and the second one after, and thus contains some evolutions. This decennial scheme presents an overview of the main electric power transport infrastructures envisaged for the ten years to come. It notably highlights the different orientations of the planned development: to streamline transits and to ease mutual supports between neighbouring countries, to streamline transits between French regions, to support consumption evolution in territories, to integrate electric power production means, and to ensure a safe operation of the power system. Main projects are more precisely presented while maps and synthetic tables propose a general overview. After this national approach, the report proposes syntheses for the different French regions. These syntheses address the present grid situation, and propose a list and a map of works which have been commissioned in 2016, a recall of regional ambitions regarding climate and energy (Climate-air-energy regional scheme, SRCAE) and renewable energies (regional scheme for the connection of renewable energies to the grid, S3REnR), a list and a map of planned projects, and a presentation of perspectives of grid development beyond a 10 year horizon

  3. Internet Gaming Disorder Among Slovenian Primary Schoolchildren: Findings From a Nationally Representative Sample of Adolescents

    Pontes, Halley M.; Macur, Mirna; Griffiths, Mark D.

    2016-01-01

    Background and aims Since the inclusion of Internet Gaming Disorder (IGD) in the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a tentative disorder, a few psychometric screening instruments have been developed to assess IGD, including the 9-item Internet Gaming Disorder Scale – Short-Form (IGDS9-SF) – a short, valid, and reliable instrument. Methods Due to the lack of research on IGD in Slovenia, this study aimed to examine the psychometric properties of the IGDS9-SF in addition to investigating the prevalence rates of IGD in a nationally representative sample of eighth graders from Slovenia (N = 1,071). Results The IGDS9-SF underwent rigorous psychometric scrutiny in terms of validity and reliability. Construct validation was investigated with confirmatory factor analysis to examine the factorial structure of the IGDS9-SF and a unidimensional structure appeared to fit the data well. Concurrent and criterion validation were also investigated by examining the association between IGD and relevant psychosocial and game-related measures, which warranted these forms of validity. In terms of reliability, the Slovenian version IGDS9-SF obtained excellent results regarding its internal consistency at different levels, and the test appears to be a valid and reliable instrument to assess IGD among Slovenian youth. Finally, the prevalence rates of IGD were found to be around 2.5% in the whole sample and 3.1% among gamers. Discussion and conclusion Taken together, these results illustrate the suitability of the IGDS9-SF and warrants further research on IGD in Slovenia. PMID:27363464

  4. The retention of health human resources in primary healthcare centers in Lebanon: a national survey.

    Alameddine, Mohamad; Saleh, Shadi; El-Jardali, Fadi; Dimassi, Hani; Mourad, Yara

    2012-11-22

    Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Two out of five respondents indicated likelihood to quit their jobs within the next 1-3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health professionals. Particular attention should

  5. The retention of health human resources in primary healthcare centers in Lebanon: a national survey

    Alameddine Mohamad

    2012-11-01

    Full Text Available Abstract Background Critical shortages of health human resources (HHR, associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. Methods A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory. A total of 755 providers completed the questionnaire (60.5% response rate. Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Results Two out of five respondents indicated likelihood to quit their jobs within the next 1–3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%, better job opportunities outside the country (35.1% and lack of professional development (33.7%. A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. Conclusions The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits

  6. Disintegration of liquid sheets

    Mansour, Adel; Chigier, Norman

    1990-01-01

    The development, stability, and disintegration of liquid sheets issuing from a two-dimensional air-assisted nozzle is studied. Detailed measurements of mean drop size and velocity are made using a phase Doppler particle analyzer. Without air flow the liquid sheet converges toward the axis as a result of surface tension forces. With airflow a quasi-two-dimensional expanding spray is formed. The air flow causes small variations in sheet thickness to develop into major disturbances with the result that disruption starts before the formation of the main break-up region. In the two-dimensional variable geometry air-blast atomizer, it is shown that the air flow is responsible for the formation of large, ordered, and small chaotic 'cell' structures.

  7. Safety advice sheets

    HSE Unit

    2013-01-01

    You never know when you might be faced with questions such as: when/how should I dispose of a gas canister? Where can I find an inspection report? How should I handle/store/dispose of a chemical substance…?   The SI section of the DGS/SEE Group is primarily responsible for safety inspections, evaluating the safety conditions of equipment items, premises and facilities. On top of this core task, it also regularly issues “Safety Advice Sheets” on various topics, designed to be of assistance to users but also to recall and reinforce safety rules and procedures. These clear and concise sheets, complete with illustrations, are easy to display in the appropriate areas. The following safety advice sheets have been issued so far: Other sheets will be published shortly. Suggestions are welcome and should be sent to the SI section of the DGS/SEE Group. Please send enquiries to general-safety-visits.service@cern.ch.

  8. How to use The National Gallery as a cross curricular approach to weather and climate studies at primary level.

    Hansen, P. J. K.

    2009-09-01

    How to use The National Gallery as a cross curricular approach to weather and climate studies at primary level. Pål J. Kirkeby Hansen Faculty of Education and International Studies, Oslo University College (PalKirkeby.Hansen@lui.hio.no) Weather and climate are topics in natural science and geography in primary and secondary education in most countries. The pupils are often doing own weather observations and measurements and are presenting the results oral, by posters or with digital aids. They also use the Internet with all its relevant resources in their studies to develop vocabulary, practical and conceptual knowledge. Knowledge about weather and climate is parts of liberal education and could be projected to other topics in science and to topics in other subjects, for instance: history, social geography, literature and arts. This article reports from a case study in grade 3 classes (age 9 year) during their Weather Week. Their science teacher was, quite untypical, also educated in art history. She arranged a visited to The National Gallery with the double agenda: 1. To introduce the pupils to Norwegian canon paintings from the national romantic period, our so-called "golden age”. 2. To look for and discuss weather elements in this paintings. For one hour the museum curator guided the pupils around the water cycle by using the paintings. While the pupils' own observations of weather, clouds and wind and measurements of temperature and precipitation during the Weather Week only are point checks, the guided tour in The National Gallery gave literally "the whole picture” of the Norwegian weather and climate and of the water cycle. During the tour, the curator constantly invited the pupils to tell about and discuss what weather and water elements they were looking at when standing in front of a painting. The pupils were responsive and interested all the time. Back at school, they demonstrated that they had learned much about both weather elements, the water

  9. Greenland Ice Sheet Melt Characteristics Derived from Passive Microwave Data

    National Aeronautics and Space Administration — The Greenland ice sheet melt extent data, acquired as part of the NASA Program for Arctic Regional Climate Assessment (PARCA), is a daily (or every other day, prior...

  10. Hydrologic Outlets of the Greenland Ice Sheet, Version 1

    National Aeronautics and Space Administration — The Hydrologic Outlets of the Greenland Ice Sheet data set contains GIS point shapefiles that include 891 observed and potential hydrologic outlets of the Greenland...

  11. Ice Sheets & Ice Cores

    Mikkelsen, Troels Bøgeholm

    Since the discovery of the Ice Ages it has been evident that Earth’s climate is liable to undergo dramatic changes. The previous climatic period known as the Last Glacial saw large oscillations in the extent of ice sheets covering the Northern hemisphere. Understanding these oscillations known....... The first part concerns time series analysis of ice core data obtained from the Greenland Ice Sheet. We analyze parts of the time series where DO-events occur using the so-called transfer operator and compare the results with time series from a simple model capable of switching by either undergoing...

  12. Factors Influencing Academic Performance Of Standard Eight Girls In National Examinations In Public Primary Schools A Case Of Matungu Division.

    Oparanya Wamukoya Windrick

    2015-06-01

    Full Text Available ABSTARCT This study is designed to establish the factors influencing academic of standard eight girls in public primary schools in National exams in Matungu division. The researcher aimed at finding out why there is increased low performance of girls in public schools despite the fact that they are assessed through periodic performance tests do continuous assessment tests CATS midterm carry out tuition and the provision of free primary education which is aimed at improving academic performance. This study adapted a descriptive survey design as a major method of research where data was collected by the researcher members of a population under study. The target population comprised of Head teachers teachers pupils parents and parent schools representatives. Purposive sampling and simple random technique were used. Data was collected by use of questionnaires and interview guides. Data was analyzed by use of descriptive statistics constituting frequencies and percentages.The study established that girls were exposed to harsh school environmental conditions they walked long distances to school schools lacked facilities like toilets libraries and were exposed to male pest teachers. There were also teacher factors like training teacher shortage and motivation that affected girls performance.The study came up with recommendations for improvement of girls academic performance. More public schools should be build to reduce on distance and also overpopulation. The ministry of Education should monitor and evaluate the academic performance of girls in rural areas. The government should put up strict rules on pest teachers. The ministry should hire more teachers.

  13. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data.

    Atun, Rifat; Gurol-Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-12-01

    Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Using routinely collected health billing records for 2005-2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co-morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply-side variables, and PHC use. Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow-up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

  14. Antidepressant medication use for primary care patients with and without medical comorbidities: a national electronic health record (EHR) network study.

    Gill, James M; Klinkman, Michael S; Chen, Ying Xia

    2010-01-01

    Because comorbid depression can complicate medical conditions (eg, diabetes), physicians may treat depression more aggressively in patients who have these conditions. This study examined whether primary care physicians prescribe antidepressant medications more often and in higher doses for persons with medical comorbidities. This secondary data analysis of electronic health record data was conducted in the Centricity Health Care User Research Network (CHURN), a national network of ambulatory practices that use a common outpatient electronic health record. Participants included 209 family medicine and general internal medicine providers in 40 primary care CHURN offices in 17 US states. Patients included adults with a new episode of depression that had been diagnosed during the period October 2006 through July 2007 (n = 1513). Prescription of antidepressant medication and doses of antidepressant medication were compared for patients with and without 6 comorbid conditions: diabetes, coronary heart disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, and cancer. 20.7% of patients had at least one medical comorbidity whereas 5.8% had multiple comorbidities. Overall, 77% of depressed patients were prescribed antidepressant medication. After controlling for age and sex, patients with multiple comorbidities were less likely to be prescribed medication (adjusted odds ratio, 0.58; 95% CI, 0.35-0.96), but there was no significant difference by individual comorbidities. Patients with cerebrovascular disease were less likely to be prescribed a full dose of medication (adjusted odds ratio, 0.26; 95% CI, 0.08-0.88), but there were no differences for other comorbidities or for multiple comorbidities, and there was no difference for any comorbidities in the prescription of minimally effective doses. Patients with new episodes of depression who present to a primary care practice are not treated more aggressively if they have medical

  15. Magma transport in sheet intrusions of the Alnö carbonatite complex, central Sweden.

    Andersson, Magnus; Almqvist, Bjarne S G; Burchardt, Steffi; Troll, Valentin R; Malehmir, Alireza; Snowball, Ian; Kübler, Lutz

    2016-06-10

    Magma transport through the Earth's crust occurs dominantly via sheet intrusions, such as dykes and cone-sheets, and is fundamental to crustal evolution, volcanic eruptions and geochemical element cycling. However, reliable methods to reconstruct flow direction in solidified sheet intrusions have proved elusive. Anisotropy of magnetic susceptibility (AMS) in magmatic sheets is often interpreted as primary magma flow, but magnetic fabrics can be modified by post-emplacement processes, making interpretation of AMS data ambiguous. Here we present AMS data from cone-sheets in the Alnö carbonatite complex, central Sweden. We discuss six scenarios of syn- and post-emplacement processes that can modify AMS fabrics and offer a conceptual framework for systematic interpretation of magma movements in sheet intrusions. The AMS fabrics in the Alnö cone-sheets are dominantly oblate with magnetic foliations parallel to sheet orientations. These fabrics may result from primary lateral flow or from sheet closure at the terminal stage of magma transport. As the cone-sheets are discontinuous along their strike direction, sheet closure is the most probable process to explain the observed AMS fabrics. We argue that these fabrics may be common to cone-sheets and an integrated geology, petrology and AMS approach can be used to distinguish them from primary flow fabrics.

  16. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data.

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-06-01

    The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. To determine whether primary care access is associated with the route of emergency admission-via a GP versus via an A and E department. Retrospective analysis of national administrative data from English hospitals for 2011-2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access-the percentage of patients able to get a general practice appointment on their last attempt-was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Among hospital inpatients admitted as an emergency, patients registered to more accessible general practices were more

  17. The distribution of lung cancer across sectors of society in the United Kingdom: a study using national primary care data

    Iyen-Omofoman Barbara

    2011-11-01

    Full Text Available Abstract Background There is pressing need to diagnose lung cancer earlier in the United Kingdom (UK and it is likely that research using computerised general practice records will help this process. Linkage of these records to area-level geo-demographic classifications may also facilitate case ascertainment for public health programmes, however, there have as yet been no extensive studies of data validity for such purposes. Methods To first address the need for validation, we assessed the completeness and representativeness of lung cancer data from The Health Improvement Network (THIN national primary care database by comparing incidence and survival between 2000 and 2009 with the UK National Cancer Registry and the National Lung Cancer Audit Database. Secondly, we explored the potential of a geo-demographic social marketing tool to facilitate disease ascertainment by using Experian's Mosaic Public Sector ™ classification, to identify detailed profiles of the sectors of society where lung cancer incidence was highest. Results Overall incidence of lung cancer (41.4/100, 000 person-years, 95% confidence interval 40.6-42.1 and median survival (232 days were similar to other national data; The incidence rate in THIN from 2003-2006 was found to be just over 93% of the national cancer registry rate. Incidence increased considerably with area-level deprivation measured by the Townsend Index and was highest in the North-West of England (65.1/100, 000 person-years. Wider variations in incidence were however identified using Mosaic classifications with the highest incidence in Mosaic Public Sector ™types 'Cared-for pensioners, ' 'Old people in flats' and 'Dignified dependency' (191.7, 174.2 and 117.1 per 100, 000 person-years respectively. Conclusions Routine electronic data in THIN are a valid source of lung cancer information. Mosaic ™ identified greater incidence differentials than standard area-level measures and as such could be used as a tool

  18. Collisionless current sheet equilibria

    Neukirch, T.; Wilson, F.; Allanson, O.

    2018-01-01

    Current sheets are important for the structure and dynamics of many plasma systems. In space and astrophysical plasmas they play a crucial role in activity processes, for example by facilitating the release of magnetic energy via processes such as magnetic reconnection. In this contribution we will focus on collisionless plasma systems. A sensible first step in any investigation of physical processes involving current sheets is to find appropriate equilibrium solutions. The theory of collisionless plasma equilibria is well established, but over the past few years there has been a renewed interest in finding equilibrium distribution functions for collisionless current sheets with particular properties, for example for cases where the current density is parallel to the magnetic field (force-free current sheets). This interest is due to a combination of scientific curiosity and potential applications to space and astrophysical plasmas. In this paper we will give an overview of some of the recent developments, discuss their potential applications and address a number of open questions.

  19. Cholera Fact Sheet

    ... news-room/fact-sheets/detail/cholera","@context":"http://schema.org","@type":"Article"}; العربية 中文 français русский español ... that includes feedback at the local level and information-sharing at the global level. Cholera cases are ...

  20. Pseudomonas - Fact Sheet

    Public Health Agency

    2012-01-01

    Fact sheet on Pseudomonas, including:What is Pseudomonas?What infections does it cause?Who is susceptible to pseudomonas infection?How will I know if I have pseudomonas infection?How can Pseudomonas be prevented from spreading?How can I protect myself from Pseudomonas?How is Pseudomonas infection treated?

  1. NTPR Fact Sheets

    History Documents US Underground Nuclear Test History Reports NTPR Radiation Exposure Reports Enewetak Atoll Cleanup Documents TRAC About Who We Are Our Values History Locations Our Leadership Director Support Center Contact Us FAQ Sheet Links Success Stories Contracts Business Opportunities Current

  2. Production (information sheets)

    2007-01-01

    Documentation sheets: Geo energy 2 Integrated System Approach Petroleum Production (ISAPP) The value of smartness 4 Reservoir permeability estimation from production data 6 Coupled modeling for reservoir application 8 Toward an integrated near-wellbore model 10 TNO conceptual framework for "E&P

  3. Hibernia fact sheet

    Anon.

    1994-01-01

    This fact sheet gives details of the Hibernia oil field including its location, discovery date, oil company's interests in the project, the recoverable reserves of the two reservoirs, the production system used, capital costs of the project, and overall targets for Canadian benefit. Significant dates for the Hibernia project are listed. (UK)

  4. Ethanol Basics (Fact Sheet)

    2015-01-01

    Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.

  5. State Arts Agency Fact Sheet: Support for Arts Education

    Online Submission, 2015

    2015-01-01

    This national overview of state arts agency grants and services for arts education includes summary statistics and geographic distribution. The fact sheet uses data from Final Descriptive Reports of state arts agency grant-making activities submitted annually to the National Assembly of State Arts Agencies (NASAA) and the National Endowment for…

  6. Rubella - Fact Sheet for Parents

    ... and 4 through 6 years Fact Sheet for Parents Color [2 pages] Español: Rubéola The best way ... according to the recommended schedule. Fact Sheets for Parents Diseases and the Vaccines that Prevent Them Chickenpox ...

  7. Sandia National Laboratories: News: Publications: Fact Sheets

    Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for

  8. An online photographic catalog of primary types of Platygastroidea (Hymenoptera in the National Museum of Natural History, Smithsonian Institution

    Elijah J. Talamas

    2017-06-01

    Full Text Available A photographic catalog of primary types of Platygastroidea housed in the National Insect Collection, National Museum of Natural History, is here made available online at the image database at The Ohio State University (specimage.osu.edu. Following examination of this collection we enact the following taxonomic changes: Leptacis piniella MacGown syn. n. is treated as a junior synonym of Leptacis pinicola MacGown; Sacespalus indicus Mani is transferred to Platygaster Latreille; Platygaster indica Mukerjee is given the replacement name Platygaster chaos Talamas, n. n.; Synopeas rugiceps (Ashmead, comb. n. is transferred from Leptacis Förster; Axea atriclava (Kieffer, comb. n. is transferred from Psilanteris Kieffer; Chakra pachmarhica (Sharma, comb. n. is transferred from Paridris Kieffer; Paridris dubeyi Sharma, syn. n. is treated as a junior synonym of Chakra pachmarhica; Holoteleia indica (Mani is transferred to Opisthacantha Ashmead and given a replacement name, Opisthacantha nomados Talamas, n. n.; Psilanteris nigriclavata (Ashmead, comb. n. is transferred from Anteris Förster; Probaryconus grenadensis (Ashmead, comb. n. is transferred from Monoteleia Kieffer; Monoteleia syn.n. is treated as a junior synonym of Probaryconus Kieffer; Paridris karnatakensis Sharma, syn. n is treated as a junior synonym of Probaryconus cauverycus Saraswat; Probaryconus punctatus (Ashmead, comb. n. is transferred from Oxyteleia Kieffer; Triteleia bengalensis (Saraswat, comb. n. is transferred from Alloteleia Kieffer; Trimorus varius Fouts, syn. n. and Trimorus pulchricornis Fouts, syn. n. are treated as junior synonyms of Trimorus annulicornis (Ashmead; Neotypes are designated for Gryon leptocorisae (Howard, Idris seminiger (Ashmead, Telenomus graptae Howard, Telenomus persimilis Ashmead, and Telenomus rileyi Howard; lectotypes are designated for Cremastobaeus bicolor Ashmead, Oethecoctonus insularis (Ashmead, Oethecoctonus laticinctus (Ashmead and Probaryconus

  9. Film sheet cassette

    1981-01-01

    A novel film sheet cassette is described for handling CAT photographic films under daylight conditions and facilitating their imaging. A detailed description of the design and operation of the cassette is given together with appropriate illustrations. The resulting cassette is a low-cost unit which is easily constructed and yet provides a sure light-tight seal for the interior contents of the cassette. The individual resilient fingers on the light-trap permit the ready removal of the slide plate for taking pictures. The stippled, non-electrostatic surface of the pressure plate ensures an air layer and free slidability of the film for removal and withdrawal of the film sheet. The advantage of the daylight system is that a darkroom need not be used for inserting and removing the film in and out of the cassette resulting in a considerable time saving. (U.K.)

  10. Clean Cities Fact Sheet

    2004-01-01

    This fact sheet explains the Clean Cities Program and provides contact information for all coalitions and regional offices. It answers key questions such as: What is the Clean Cities Program? What are alternative fuels? How does the Clean Cities Program work? What sort of assistance does Clean Cities offer? What has Clean Cities accomplished? What is Clean Cities International? and Where can I find more information?

  11. Information sheets on energy

    2004-01-01

    These sheets, presented by the Cea, bring some information, in the energy domain, on the following topics: the world energy demand and the energy policy in France and in Europe, the part of the nuclear power in the energy of the future, the greenhouse gases emissions and the fight against the greenhouse effect, the carbon dioxide storage cost and the hydrogen economy. (A.L.B.)

  12. Biomolecular Science (Fact Sheet)

    2012-04-01

    A brief fact sheet about NREL Photobiology and Biomolecular Science. The research goal of NREL's Biomolecular Science is to enable cost-competitive advanced lignocellulosic biofuels production by understanding the science critical for overcoming biomass recalcitrance and developing new product and product intermediate pathways. NREL's Photobiology focuses on understanding the capture of solar energy in photosynthetic systems and its use in converting carbon dioxide and water directly into hydrogen and advanced biofuels.

  13. Sheet pinch devices

    Anderson, O.A.; Baker, W.R.; Ise, J. Jr.; Kunkel, W.B.; Pyle, R.V.; Stone, J.M.

    1958-01-01

    Three types of sheet-like discharges are being studied at Berkeley. The first of these, which has been given the name 'Triax', consists of a cylindrical plasma sleeve contained between two coaxial conducting cylinders A theoretical analysis of the stability of the cylindrical sheet plasma predicts the existence of a 'sausage-mode' instability which is, however, expected to grow more slowly than in the case of the unstabilized linear pinch (by the ratio of the radial dimensions). The second pinch device employs a disk shaped discharge with radial current guided between flat metal plates, this configuration being identical to that of the flat hydromagnetic capacitor without external magnetic field. A significant feature of these configurations is the absence of a plasma edge, i.e., there are no regions of sharply curved magnetic field lines anywhere in these discharges. The importance of this fact for stability is not yet fully investigated theoretically. As a third configuration a rectangular, flat pinch tube has been constructed, and the behaviour of a flat plasma sheet with edges is being studied experimentally

  14. Fatigue analysis of a PWR steam generator tube sheet

    Billon, F.; Buchalet, C.; Poudroux, G.

    1985-01-01

    The fatigue analysis of a PWR steam generator (S.G) tube sheet is threefold. First, the flow, pressure and temperature variations during the design transients are defined for both the primary fluid and the normal and auxiliary feedwater. Second, the flow, velocities, pressure and temperature variations of the secondary fluid at the bottom of the downcomer and above the tube sheet are determined for the transients considered. Finally, the corresponding temperatures and stresses in the tube sheet are calculated and the usage factors determined at various locations in the tube sheet. The currently available standard design transients for the primary fluid and the feedwater are too conservative to be utilized as such in the fatigue analysis of the S.G. tube sheets. Thus, a detailed examination and reappraisal of each operating transient was performed. The revised design conditions are used as inputs to the calculation model TEMPTRON. TEMPTRON determines the mixing conditions between the feedwater and the recirculation fluid from the S.G. feedwater nozzles to the center of the tube sheet via the downcomer. The fluid parameters, flow rate and velocity, temperature and pressure variations, as a function of the time during the transients are obtained. Finally, the usage factors at various locations on the tube sheet are derived using the standard ASME section III method

  15. Thermal Transport Properties of Dry Spun Carbon Nanotube Sheets

    Heath E. Misak

    2016-01-01

    Full Text Available The thermal properties of carbon nanotube- (CNT- sheet were explored and compared to copper in this study. The CNT-sheet was made from dry spinning CNTs into a nonwoven sheet. This nonwoven CNT-sheet has anisotropic properties in in-plane and out-of-plane directions. The in-plane direction has much higher thermal conductivity than the out-of-plane direction. The in-plane thermal conductivity was found by thermal flash analysis, and the out-of-plane thermal conductivity was found by a hot disk method. The thermal irradiative properties were examined and compared to thermal transport theory. The CNT-sheet was heated in the vacuum and the temperature was measured with an IR Camera. The heat flux of CNT-sheet was compared to that of copper, and it was found that the CNT-sheet has significantly higher specific heat transfer properties compared to those of copper. CNT-sheet is a potential candidate to replace copper in thermal transport applications where weight is a primary concern such as in the automobile, aircraft, and space industries.

  16. Prescribing tamoxifen in primary care for the prevention of breast cancer: a national online survey of GPs' attitudes.

    Smith, Samuel G; Foy, Robbie; McGowan, Jennifer A; Kobayashi, Lindsay C; DeCensi, Andrea; Brown, Karen; Side, Lucy; Cuzick, Jack

    2017-06-01

    The cancer strategy for England (2015-2020) recommends GPs prescribe tamoxifen for breast cancer primary prevention among women at increased risk. To investigate GPs' attitudes towards prescribing tamoxifen. In an online survey, GPs in England, Northern Ireland, and Wales ( n = 928) were randomised using a 2 × 2 between-subjects design to read one of four vignettes describing a healthy patient seeking a tamoxifen prescription. In the vignette, the hypothetical patient's breast cancer risk (moderate versus high) and the clinician initiating the prescription (GP prescriber versus secondary care clinician [SCC] prescriber) were manipulated in a 1:1:1:1 ratio. Outcomes were willingness to prescribe, comfort discussing harms and benefits, comfort managing the patient, factors affecting the prescribing decision, and awareness of tamoxifen and the National Institute for Health and Care Excellence (NICE) guideline CG164. Half (51.7%) of the GPs knew tamoxifen can reduce breast cancer risk, and one-quarter (24.1%) were aware of NICE guideline CG164. Responders asked to initiate prescribing (GP prescriber) were less willing to prescribe tamoxifen than those continuing a prescription initiated in secondary care (SCC prescriber) (68.9% versus 84.6%, P preventive therapy in secondary care before asking GPs to continue the patient's care may overcome some prescribing barriers. © British Journal of General Practice 2017.

  17. Nation

    Østergaard, Uffe

    2014-01-01

    Nation er et gammelt begreb, som kommer af det latinske ord for fødsel, natio. Nationalisme bygger på forestillingen om, at mennesker har én og kun én national identitet og har ret til deres egen nationalstat. Ordet og forestillingen er kun godt 200 år gammel, og i 1900-tallet har ideologien bredt...

  18. Sense and readability: participant information sheets for research studies.

    Ennis, Liam; Wykes, Til

    2016-02-01

    Informed consent in research is partly achieved through the use of information sheets. There is a perception however that these information sheets are long and complex. The recommended reading level for patient information is grade 6, or 11-12 years old. To investigate whether the readability of participant information sheets has changed over time, whether particular study characteristics are related to poorer readability and whether readability and other study characteristics are related to successful study recruitment. Method: We obtained 522 information sheets from the UK National Institute for Health Research Clinical Research Network: Mental Health portfolio database and study principal investigators. Readability was assessed with the Flesch reading index and the Grade level test. Information sheets increased in length over the study period. The mean grade level across all information sheets was 9.8, or 15-16 years old. A high level of patient involvement was associated with more recruitment success and studies involving pharmaceutical or device interventions were the least successful. The complexity of information sheets had little bearing on successful recruitment. Information sheets are far more complex than the recommended reading level of grade 6 for patient information. The disparity may be exacerbated by an increasing focus on legal content. Researchers would benefit from clear guidance from ethics committees on writing succinctly and accessibly and how to balance the competing legal issues with the ability of participants to understand what a study entails. © The Royal College of Psychiatrists 2016.

  19. Dense sheet Z-pinches

    Tetsu, Miyamoto

    1999-01-01

    The steady state and quasi-steady processes of infinite- and finite-width sheet z-pinches are studied. The relations corresponding to the Bennett relation and Pease-Braginskii current of cylindrical fiber z-pinches depend on a geometrical factor in the sheet z-pinches. The finite-width sheet z-pinch is approximated by a segment of infinite-width sheet z-pinch, if it is wide enough, and corresponds to a number of (width/thickness) times fiber z-pinch plasmas of the diameter that equals the sheet thickness. If the sheet current equals this number times the fiber current, the plasma created in the sheet z-pinches is as dense as in the fiber z-pinches. The total energy of plasma and magnetic field per unit mass is approximately equal in both pinches. Quasi-static transient processes are different in several aspects from the fiber z-pinch. No radiation collapse occurs in the sheet z-pinch. The stability is improved in the sheet z-pinches. The fusion criterions and the experimental arrangements to produce the sheet z-pinches are also discussed. (author)

  20. Perforation of metal sheets

    Steenstrup, Jens Erik

    simulation is focused on the sheet deformation. However, the effect on the tool and press is included. The process model is based on the upper bound analysis in order to predict the force progress and hole characteristics etc. Parameter analyses are divided into two groups, simulation and experimental tests......The main purposes of this project are:1. Development of a dynamic model for the piercing and performation process2. Analyses of the main parameters3. Establishing demands for process improvements4. Expansion of the existing parameter limitsThe literature survey describes the process influence...

  1. Primary non-Hodgkin's lymphomas of the breast: 23 years of experience at the Colombian national cancer institute

    Rodriguez, Myriam; Grajales, Marco; Londono, Sonia; Ortiz, Natascha

    2004-01-01

    Primary non- Hodgkin's lymphomas of the breast (PNHLB) are an infrequent malignancy. In a review of the literature, in which six Latin American journals are included, approximately 450 cases have been reported during the past two decades. in this paper we present the experience of the national cancer institute of Colombia during the last 23 years. Objective: to carry out a retrospective analysis of the characteristics, natural history, prognostic factors, and outcome of patients with PNHLB at the NCI of Colombia. Methods: the medical histories of patients diagnosed with PNHLB between 1980 and 2003 were reviewed; likewise, the clinical characteristics, treatment protocols, and final outcomes were analyzed. Results: 25 patients were identified as PNHLB. The average follow-up was 57 months. The medium age was 58, ranging from 26 to 83. 84% had diffused large cell lymphoma. The Karnofsky index was over 80 in 92% of the patients. 72% received chop chemotherapy. Two patients received a combination without doxorubicin. 68% received combined chemo- and radiation therapy. Two patients refused therapy. Two patients died before receiving any type of treatment. CNS compromise was observed in 20% of patients during the evolution of their disease. The youngest patient, whose case deserves special comment, obtained a second complete remission with simple mastectomy, after having relapsed after conventional chemotherapy, radiotherapy, and autologous bone marrow transplant. No significant prognostic variables were found using the univariate analysis. Conclusions: a high rate of complete remission can be achieved by using combined treatment in patients with PNHLB. The medium overall survival was not reached after 71 months of follow-up. The most frequent relapse site was the CNS

  2. SunShot Initiative Fact Sheet

    DOE Solar Energy Technologies Office

    2015-04-01

    The U.S. Department of Energy (DOE) SunShot Initiative is a collaborative national effort launched in 2011 that aggressively drives innovation to make solar energy fully cost competitive with traditional energy sources before the end of the decade. The SunShot fact sheet outlines goals and successes of the program as it works with private companies, universities, non-profit organizations, state and local governments, and national laboratories to drive down the cost of solar electricity to $0.06 per kilowatt-hour, without incentives, by the year 2020.

  3. Predicting Hot Deformation of AA5182 Sheet

    Lee, John T.; Carpenter, Alexander J.; Jodlowski, Jakub P.; Taleff, Eric M.

    Aluminum 5000-series alloy sheet materials exhibit substantial ductilities at hot and warm temperatures, even when grain size is not particularly fine. The relatively high strain-rate sensitivity exhibited by these non-superplastic materials, when deforming under solute-drag creep, is a primary contributor to large tensile ductilities. This active deformation mechanism influences both plastic flow and microstructure evolution across conditions of interest for hot- and warm-forming. Data are presented from uniaxial tensile and biaxial bulge tests of AA5182 sheet material at elevated temperatures. These data are used to construct a material constitutive model for plastic flow, which is applied in finite-element-method (FEM) simulations of plastic deformation under multiaxial stress states. Simulation results are directly compared against experimental data to explore the usefulness of this constitutive model. The effects of temperature and stress state on plastic response and microstructure evolution are discussed.

  4. Experiments on sheet metal shearing

    Gustafsson, Emil

    2013-01-01

    Within the sheet metal industry, different shear cutting technologies are commonly used in several processing steps, e.g. in cut to length lines, slitting lines, end cropping etc. Shearing has speed and cost advantages over competing cutting methods like laser and plasma cutting, but involves large forces on the equipment and large strains in the sheet material.Numerical models to predict forces and sheared edge geometry for different sheet metal grades and different shear parameter set-ups a...

  5. Primary Hyperparathyroidism

    ... Neoplasia Type 1 Thyroid Disease & Pregnancy Primary Hyperparathyroidism Prolactinoma National Hormone and Pituitary Program (NHPP): Information for ... qualified health care provider nearby. Eating, Diet, and Nutrition Eating, diet, and nutrition have not been shown ...

  6. Availability of herbal medicines and medicinal plants in the primary health facilities of the state of São Paulo, Southeast Brazil: results from the National Program for Access and Quality Improvement in Primary Care.

    Caccia-Bava, Maria do Carmo Gullaci Guimarães; Bertoni, Bianca Waléria; Pereira, Ana Maria Soares; Martinez, Edson Zangiacomi

    2017-05-01

    This study aims to describe the availability of herbal medicines and medicinal plants in the primary care facilities in the state of São Paulo, Southeast Brazil, from the results of the first cycle of the National Program for Access and Quality Improvement in Primary Care (PMAQ). The PMAQ uses a national cross-sectional multicenter design, with data from 4,249 health facilities distributed among 645 municipalities of the state of São Paulo. Of these facilities, 467 (11%) had herbal medicines and/or medicinal plants. Among the 645 municipalities, 104 (16.1%) had at least one health facility that provided these drugs. We observed that the availability of herbal medicines is greater in larger cities with better social and economic conditions. Furthermore, we found that use of industrialized herbal medicines prevailed over that of vegetal drugs or compounded herbal medicines.

  7. Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data.

    Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

    2015-02-17

    For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of

  8. Aerial radiometric and magnetic survey; Brushy Basin detail survey: Price/Salina national topographic map sheets, Utah. Volume III. Area II: graphic data, Section I-II. Final report

    1981-01-01

    This volume contains all of the graphic data for Area II which consists of map lines 1660 to 3400 and 5360 to 5780, and tie lines 6100, 6120, and 6160. Due to the large map scale of the presented data (1:62,500), this sub-section was divided into eleven 7-1/2 min quadrant sheets

  9. Annual Energy Balance Sheets 2001-2002

    2004-01-01

    During the year 2002 the primary supply of energy reached 629 TWh, which is 7.7 TWh less than 2001. The decrease originates mainly from the reduced electricity production from water power. Also the electricity production in nuclear power plants decreased by 4.5 TWh. If we were to look at the supplied energy for final consumption we will find a slightly rise by 1.8 TWh. The year 2002 was warmer than a 'normal' year and that consequently brings lower energy needs. Compared with 2001, 2002 was not warmer and a net electricity import of 5.4 TWh covered the energy needs. The energy use increased by 3.3 TWh between 2002 and 2001. The industry sector shows the largest rise by 2.9 TWh, nearly 2 per cent. Within that sector, energy from biomass fuel had a rise by 6.7 per cent. The household sector decreases its energy use by 2.7 per cent, and oil and electricity show the largest decrease. The proportionately high electricity price probably had a slowing down effect on the electricity use. The balance sheets of energy sources are showing the total supply and consumption of energy sources expressed in original units, i.e. units recorded in the primary statistics - mainly commercial units. The production of derived energy commodities is recorded on the supply - side of the balance sheets of energy sources, which is not the case in the energy balance sheets. The balance sheets of energy sources also include specifications of input--output and energy consumption in energy conversion industries. The energy balance sheets are based on primary data recorded in the balance sheets of energy sources, here expressed in a common energy unit, TJ. The production of derived energy is recorded in a second flow-step comprising energy turnover in energy conversion and is also specified in complementary input - output tables for energy conversion industries. The following items are shown in the energy balance sheets. 1.1 Inland supply of primary energy; 1.3 Import; 1.4 Export; 1.5 Changes in

  10. Flat-plate solar array project. Volume 3: Silicon sheet: Wafers and ribbons

    Briglio, A.; Dumas, K.; Leipold, M.; Morrison, A.

    1986-01-01

    The primary objective of the Silicon Sheet Task of the Flat-Plate Solar Array (FSA) Project was the development of one or more low cost technologies for producing silicon sheet suitable for processing into cost-competitive solar cells. Silicon sheet refers to high purity crystalline silicon of size and thickness for fabrication into solar cells. Areas covered in the project were ingot growth and casting, wafering, ribbon growth, and other sheet technologies. The task made and fostered significant improvements in silicon sheet including processing of both ingot and ribbon technologies. An additional important outcome was the vastly improved understanding of the characteristics associated with high quality sheet, and the control of the parameters required for higher efficiency solar cells. Although significant sheet cost reductions were made, the technology advancements required to meet the task cost goals were not achieved.

  11. Primary Care Provider-Delivered Smoking Cessation Interventions and Smoking Cessation Among Participants in the National Lung Screening Trial.

    Park, Elyse R; Gareen, Ilana F; Japuntich, Sandra; Lennes, Inga; Hyland, Kelly; DeMello, Sarah; Sicks, JoRean D; Rigotti, Nancy A

    2015-09-01

    The National Lung Screening Trial (NLST) found a reduction in lung cancer mortality among participants screened with low-dose computed tomography vs chest radiography. In February 2015, Medicare announced its decision to cover annual lung screening for patients with a significant smoking history. These guidelines promote smoking cessation treatment as an adjunct to screening, but the frequency and effectiveness of clinician-delivered smoking cessation interventions delivered after lung screening are unknown. To determine the association between the reported clinician-delivered 5As (ask, advise, assess, assist [talk about quitting or recommend stop-smoking medications or recommend counseling], and arrange follow-up) after lung screening and smoking behavior changes. A matched case-control study (cases were quitters and controls were continued smokers) of 3336 NLST participants who were smokers at enrollment examined participants' rates and patterns of 5A delivery after a lung screen and reported smoking cessation behaviors. Prevalence of the clinician-delivered 5As and associated smoking cessation after lung screening. Delivery of the 5As 1 year after screening were as follows: ask, 77.2%; advise, 75.6%; assess, 63.4%; assist, 56.4%; and arrange follow-up, 10.4%. Receipt of ask, advise, and assess was not significantly associated with quitting in multivariate models that adjusted for sociodemographic characteristics, medical history, screening results, nicotine dependence, and motivation to quit. Assist was associated with a 40% increase in the odds of quitting (odds ratio, 1.40; 95% CI, 1.21-1.63), and arrange was associated with a 46% increase in the odds of quitting (odds ratio, 1.46; 95% CI, 1.19-1.79). Assist and arrange follow-up delivered by primary care providers to smokers who were participating in the NLST were associated with increased quitting; less intensive interventions (ask, advise, and assess) were not. However, rates of assist and arrange

  12. Aboveground Net Primary Production of tree cover at the post-disturbance area in the Tatra National Park, Slovakia

    Konôpka Bohdan

    2015-09-01

    Full Text Available Large-scale disturbances under the conditions of Slovakia, caused especially by storm and bark beetle, bring dramatic decline in carbon budget of the country, besides other negative consequences. The largest disturbance in modern history of the Slovak forestry was the storm damage that occurred in November 2004. The Tatra National Park (TNP was one of the most affected regions. Thus, in this territory, two transects (T1 – the Danielov dom site and T2 – near the Horný Smokovec village were established to survey basic dendrometric properties of trees in young stands established after the disaster. The standing stock of aboveground biomass in tree cover for the spring and autumn 2014 was calculated using the recorded variables, i.e. tree height and diameter measured at the stem base, together with the region-specific allometric relations. Then, the Aboveground Net Primary Production (ANPP in tree cover was estimated with respect to its components (stem, branches and foliage. ANPP was 315 g m−2 per year (Transect T1, and 391 g m−2 per year (Transect T2. The differences in the structure of ANPP, i.e. contribution of tree components, were found between transects T1 and T2. They were caused by the contrasting tree species composition, specifically the ratios between Norway spruce and broadleaved species. Broadleaves allocated more biomass production to foliage than spruce. This phenomenon together with higher turnover (once a year of foliage caused that broadleaves manifest higher share of fast-cycling carbon in comparison to the amount of carbon sequestrated in woody parts (stem and branches. High variability of ANPP was found within the transects, i.e. among the plots (microsites. As for the representative estimation of the standing stock of aboveground part of tree cover as well as ANPP at the post-disturbance area in the TNP territory, the survey should be performed on a net of research plots. Only this approach enables reliable estimates

  13. Soft Costs Fact Sheet

    None

    2016-05-01

    This fact sheet is an overview of the systems integration subprogram at the U.S. Department of Energy SunShot Initiative. Soft costs can vary significantly as a result of a fragmented energy marketplace. In the U.S., there are 18,000 jurisdictions and 3,000 utilities with different rules and regulations for how to go solar. The same solar equipment may vary widely in its final installation price due to process and market variations across jurisdictions, creating barriers to rapid industry growth. SunShot supports the development of innovative solutions that enable communities to build their local economies and establish clean energy initiatives that meet their needs, while at the same time creating sustainable solar market conditions.

  14. Systems Integration Fact Sheet

    None

    2016-06-01

    This fact sheet is an overview of the Systems Integration subprogram at the U.S. Department of Energy SunShot Initiative. The Systems Integration subprogram enables the widespread deployment of safe, reliable, and cost-effective solar energy technologies by addressing the associated technical and non-technical challenges. These include timely and cost-effective interconnection procedures, optimal system planning, accurate prediction of solar resources, monitoring and control of solar power, maintaining grid reliability and stability, and many more. To address the challenges associated with interconnecting and integrating hundreds of gigawatts of solar power onto the electricity grid, the Systems Integration program funds research, development, and demonstration projects in four broad, interrelated focus areas: grid performance and reliability, dispatchability, power electronics, and communications.

  15. Hyperspectral light sheet microscopy

    Jahr, Wiebke; Schmid, Benjamin; Schmied, Christopher; Fahrbach, Florian O.; Huisken, Jan

    2015-09-01

    To study the development and interactions of cells and tissues, multiple fluorescent markers need to be imaged efficiently in a single living organism. Instead of acquiring individual colours sequentially with filters, we created a platform based on line-scanning light sheet microscopy to record the entire spectrum for each pixel in a three-dimensional volume. We evaluated data sets with varying spectral sampling and determined the optimal channel width to be around 5 nm. With the help of these data sets, we show that our setup outperforms filter-based approaches with regard to image quality and discrimination of fluorophores. By spectral unmixing we resolved overlapping fluorophores with up to nanometre resolution and removed autofluorescence in zebrafish and fruit fly embryos.

  16. Settlement during vibratory sheet piling

    Meijers, P.

    2007-01-01

    During vibratory sheet piling quite often the soil near the sheet pile wall will settle. In many cases this is not a problem. For situations with houses, pipelines, roads or railroads at relative short distance these settlements may not be acceptable. The purpose of the research described in this

  17. Plasma dynamics in current sheets

    Bogdanov, S.Yu.; Drejden, G.V.; Kirij, N.P.; AN SSSR, Leningrad

    1992-01-01

    Plasma dynamics in successive stages of current sheet evolution is investigated on the base of analysis of time-spatial variations of electron density and electrodynamic force fields. Current sheet formation is realized in a two-dimensional magnetic field with zero line under the action of relatively small initial disturbances (linear regimes). It is established that in the limits of the formed sheet is concentrated dense (N e ∼= 10 16 cm -3 ) (T i ≥ 100 eV, bar-Z i ≥ 2) hot pressure of which is balanced by the magnetic action of electrodynamic forces is carried out both plasma compression in the sheet limits and the acceleration along the sheet surface from a middle to narrow side edges

  18. Final Rule to Reduce Toxic Air Emissions from Asphalt Processing and Asphalt Roofing Manufacturing Facilities Fact Sheet

    This page contains a February 2003 fact sheet with information regarding the National Emissions Standards for Hazardous Air Pollutants (NESHAP) for Asphalt Processing and Asphalt Roofing Manufacturing.

  19. Flash flip book applications to measure the level of nationalism with quasi experiment on primary school students

    Asri, Yessy; Fitriani, Yessy

    2017-08-01

    Great nation is a nation that respects the the sacrifice of the heroes and the history of his people. This young generation is the root of a nation who need to know and respect the values of which has been laid the founding fathers. The history continues to be written by people, in all civilizations and in all times,History in writing or documentation becomes an important tool in studying the progress and setbacks of a nation that is contained in various events in the past. Indonesia is a pluralistic nation consisting of various tribes, culture and history are scattered throughout the country. Interactive flash flip book application built to pack the local stories and history of the nation which is widespread in the thirty-three provinces to to elementary school children through teachers, especially elementary school teachers Islam Bani Saleh 5 and SDN Setiadarma 04 Bekasi in the subjects of Citizenship Education (PKn). The main problem in this research is "Whether a flash flip book can give effect to increase the spirit of nationalism elementary school students ? ". The method used is the One group pretest posttest design. Population in this research is class student V SD Islam Bani Saleh and SDN Setiadarma 04 Bekasi. Results of this study was to measure the influence of media flash flip book to foster a sense of nationalism graders V SD in the subjects of Citizenship Education (PKn) in SD Islam Bani Saleh 5 and SDN Setiadarma 04 Bekasi Bekasi.

  20. 40 CFR Appendix S to Part 50 - Interpretation of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen...

    2010-07-01

    ... Ambient Air Quality Standards for Oxides of Nitrogen (Nitrogen Dioxide) S Appendix S to Part 50 Protection... National Ambient Air Quality Standards for Oxides of Nitrogen (Nitrogen Dioxide) 1. General (a) This... national ambient air quality standards for oxides of nitrogen as measured by nitrogen dioxide (“NO2 NAAQS...

  1. Dietary Supplement Fact Sheets

    ... Primary Mitochondrial Disorders Weight Loss A Acai Aloe Vera Anabolic Steroids Antioxidants (see Exercise and Athletic Performance ) ... Pills (see Weight Loss ) Dietary Supplements Vitamin D E Echinacea Ephedra Essiac/Flor-Essence European Elder Evening ...

  2. Characterization of Tensile Mechanical Behavior of MSCs/PLCL Hybrid Layered Sheet

    Azizah Intan Pangesty

    2016-06-01

    Full Text Available A layered construct was developed by combining a porous polymer sheet and a cell sheet as a tissue engineered vascular patch. The primary objective of this study is to investigate the influence of mesenchymal stem cells (MSCs sheet on the tensile mechanical properties of porous poly-(l-lactide-co-ε-caprolactone (PLCL sheet. The porous PLCL sheet was fabricated by the solid-liquid phase separation method and the following freeze-drying method. The MSCs sheet, prepared by the temperature-responsive dish, was then layered on the top of the PLCL sheet and cultured for 2 weeks. During the in vitro study, cellular properties such as cell infiltration, spreading and proliferation were evaluated. Tensile test of the layered construct was performed periodically to characterize the tensile mechanical behavior. The tensile properties were then correlated with the cellular properties to understand the effect of MSCs sheet on the variation of the mechanical behavior during the in vitro study. It was found that MSCs from the cell sheet were able to migrate into the PLCL sheet and actively proliferated into the porous structure then formed a new layer of MSCs on the opposite surface of the PLCL sheet. Mechanical evaluation revealed that the PLCL sheet with MSCs showed enhancement of tensile strength and strain energy density at the first week of culture which is characterized as the effect of MSCs proliferation and its infiltration into the porous structure of the PLCL sheet. New technique was presented to develop tissue engineered patch by combining MSCs sheet and porous PLCL sheet, and it is expected that the layered patch may prolong biomechanical stability when implanted in vivo.

  3. Vitamin and Mineral Supplement Fact Sheets

    ... website Submit Search NIH Office of Dietary Supplements Vitamin and Mineral Supplement Fact Sheets Search the list ... Supplements: Background Information Botanical Dietary Supplements: Background Information Vitamin and Mineral Fact Sheets Botanical Supplement Fact Sheets ...

  4. European recommendations for primary prevention of congenital anomalies: a joined effort of EUROCAT and EUROPLAN projects to facilitate inclusion of this topic in the National Rare Disease Plans.

    Taruscio, Domenica; Arriola, Larraitz; Baldi, Francesca; Barisic, Ingeborg; Bermejo-Sánchez, Eva; Bianchi, Fabrizio; Calzolari, Elisa; Carbone, Pietro; Curran, Rhonda; Garne, Ester; Gatt, Miriam; Latos-Bieleńska, Anna; Khoshnood, Babak; Irgens, Lorentz; Mantovani, Alberto; Martínez-Frías, Maria Luisa; Neville, Amanda; Rißmann, Anke; Ruggeri, Stefania; Wellesley, Diana; Dolk, Helen

    2014-01-01

    Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention to an integrated preventive strategy has led to the prevalence of CA remaining relatively stable in recent decades. The 2 European projects, EUROCAT and EUROPLAN, have joined efforts to provide the first science-based and comprehensive set of recommendations for the primary prevention of CA in the European Union. The resulting EUROCAT-EUROPLAN 'Recommendations on Policies to Be Considered for the Primary Prevention of Congenital Anomalies in National Plans and Strategies on Rare Diseases' were issued in 2012 and endorsed by EUCERD (European Union Committee of Experts on Rare Diseases) in 2013. The recommendations exploit interdisciplinary expertise encompassing drugs, diet, lifestyles, maternal health status, and the environment. The recommendations include evidence-based actions aimed at reducing risk factors and at increasing protective factors and behaviors at both individual and population level. Moreover, consideration is given to topics specifically related to CA (e.g. folate status, teratogens) as well as of broad public health impact (e.g. obesity, smoking) which call for specific attention to their relevance in the pre- and periconceptional period. The recommendations, reported entirely in this paper, are a comprehensive tool to implement primary prevention into national policies on rare diseases in Europe. © 2014 S. Karger AG, Basel.

  5. A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.

    Cohen, Deborah J; Balasubramanian, Bijal A; Gordon, Leah; Marino, Miguel; Ono, Sarah; Solberg, Leif I; Crabtree, Benjamin F; Stange, Kurt C; Davis, Melinda; Miller, William L; Damschroder, Laura J; McConnell, K John; Creswell, John

    2016-06-29

    The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic). Examples of external support include practice facilitation, expert consultation, performance feedback, and educational materials and activities. This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). This prospective observational study will examine the portfolio of EvidenceNOW Cooperatives using both qualitative and quantitative data. Qualitative data include: online implementation diaries, observation and interviews at Cooperatives and practices, and systematic assessment of context from the perspective of Cooperative team members. Quantitative data include: practice-level performance on clinical quality measures (aspirin prescribing, blood pressure and cholesterol control, and smoking cessation; ABCS) collected by Cooperatives from electronic health records (EHRs); practice and practice member surveys to assess practice capacity and other organizational and structural characteristics; and systematic tracking of intervention delivery. Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness. ESCALATES is

  6. Using Large-Scale Linkage Data to Evaluate the Effectiveness of a National Educational Program on Antithrombotic Prescribing and Associated Stroke Prevention in Primary Care.

    Liu, Zhixin; Moorin, Rachael; Worthington, John; Tofler, Geoffrey; Bartlett, Mark; Khan, Rabia; Zuo, Yeqin

    2016-10-13

    The National Prescribing Service (NPS) MedicineWise Stroke Prevention Program, which was implemented nationally in 2009-2010 in Australia, sought to improve antithrombotic prescribing in stroke prevention using dedicated interventions that target general practitioners. This study evaluated the impact of the NPS MedicineWise Stroke Prevention Program on antithrombotic prescribing and primary stroke hospitalizations. This population-based time series study used administrative health data linked to 45 and Up Study participants with a high risk of cardiovascular disease (CVD) to assess the possible impact of the NPS MedicineWise program on first-time aspirin prescriptions and primary stroke-related hospitalizations. Time series analysis showed that the NPS MedicineWise program was significantly associated with increased first-time prescribing of aspirin (P=0.03) and decreased hospitalizations for primary ischemic stroke (P=0.03) in the at-risk study population (n=90 023). First-time aspirin prescription was correlated with a reduction in the rate of hospitalization for primary stroke (P=0.02). Following intervention, the number of first-time aspirin prescriptions increased by 19.8% (95% confidence interval, 1.6-38.0), while the number of first-time stroke hospitalizations decreased by 17.3% (95% confidence interval, 1.8-30.0). Consistent with NPS MedicineWise program messages for the high-risk CVD population, the NPS MedicineWise Stroke Prevention Program (2009) was associated with increased initiation of aspirin and a reduced rate of hospitalization for primary stroke. The findings suggest that the provision of evidence-based multifaceted large-scale educational programs in primary care can be effective in changing prescriber behavior and positively impacting patient health outcomes. © 2016 The Authors and NPS MedicineWise. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  7. Global ice sheet/RSL simulations using the higher-order Ice Sheet System Model.

    Larour, E. Y.; Ivins, E. R.; Adhikari, S.; Schlegel, N.; Seroussi, H. L.; Morlighem, M.

    2017-12-01

    Relative sea-level rise is driven by processes that are intimately linked to the evolution ofglacial areas and ice sheets in particular. So far, most Earth System models capable of projecting theevolution of RSL on decadal to centennial time scales have relied on offline interactions between RSL andice sheets. In particular, grounding line and calving front dynamics have not been modeled in a way that istightly coupled with Elasto-Static Adjustment (ESA) and/or Glacial-Isostatic Adjustment (GIA). Here, we presenta new simulation of the entire Earth System in which both Greenland and Antarctica ice sheets are tightly coupledto an RSL model that includes both ESA and GIA at resolutions and time scales compatible with processes suchas grounding line dynamics for Antarctica ice shelves and calving front dynamics for Greenland marine-terminatingglaciers. The simulations rely on the Ice Sheet System Model (ISSM) and show the impact of higher-orderice flow dynamics and coupling feedbacks between ice flow and RSL. We quantify the exact impact of ESA andGIA inclusion on grounding line evolution for large ice shelves such as the Ronne and Ross ice shelves, as well asthe Agasea Embayment ice streams, and demonstate how offline vs online RSL simulations diverge in the long run,and the consequences for predictions of sea-level rise.This work was performed at the California Institute of Technology's Jet Propulsion Laboratory undera contract with the National Aeronautics and Space Administration's Cryosphere Science Program.

  8. Ice Sheet Model Intercomparison Project (ISMIP6) contribution to CMIP6

    Nowicki, Sophie M J; Payne, Anthony; Larour, Eric; Seroussi, Helene; Goelzer, Heiko|info:eu-repo/dai/nl/412549123; Lipscomb, William; Gregory, Jonathan; Abe-Ouchi, Ayako; Shepherd, Andrew

    2016-01-01

    Reducing the uncertainty in the past, present, and future contribution of ice sheets to sea-level change requires a coordinated effort between the climate and glaciology communities. The Ice Sheet Model Intercomparison Project for CMIP6 (ISMIP6) is the primary activity within the Coupled Model

  9. Selectively reflective transparent sheets

    Waché, Rémi; Florescu, Marian; Sweeney, Stephen J.; Clowes, Steven K.

    2015-08-01

    We investigate the possibility to selectively reflect certain wavelengths while maintaining the optical properties on other spectral ranges. This is of particular interest for transparent materials, which for specific applications may require high reflectivity at pre-determined frequencies. Although there exist currently techniques such as coatings to produce selective reflection, this work focuses on new approaches for mass production of polyethylene sheets which incorporate either additives or surface patterning for selective reflection between 8 to 13 μ m. Typical additives used to produce a greenhouse effect in plastics include particles such as clays, silica or hydroxide materials. However, the absorption of thermal radiation is less efficient than the decrease of emissivity as it can be compared with the inclusion of Lambertian materials. Photonic band gap engineering by the periodic structuring of metamaterials is known in nature for producing the vivid bright colors in certain organisms via strong wavelength-selective reflection. Research to artificially engineer such structures has mainly focused on wavelengths in the visible and near infrared. However few studies to date have been carried out to investigate the properties of metastructures in the mid infrared range even though the patterning of microstructure is easier to achieve. We present preliminary results on the diffuse reflectivity using FDTD simulations and analyze the technical feasibility of these approaches.

  10. Superfund fact sheet: The remedial program. Fact sheet

    1992-09-01

    The fact sheet describes what various actions the EPA can take to clean up hazardous wastes sites. Explanations of how the criteria for environmental and public health risk assessment are determined and the role of state and local governments in site remediation are given. The fact sheet is one in a series providing reference information about Superfund issues and is intended for readers with no formal scientific training

  11. Tribo-systems for Sheet Metal Forming

    Bay, Niels

    2009-01-01

    The present paper gives an overview of more than 10 years work by the author’s research group through participation in national as well as international framework programmes on developing and testing environmentally friendly lubricants and tool materials and coatings inhibiting galling. Partners ......’s research group has especially been involved in the development of a system of tribo-tests for sheet metal forming and in testing and modelling of friction and limits of lubrication of new, environmentally friendly lubricants and tool materials....

  12. A comparison of UK primary care data with other national data sources for monitoring the prevalence of smoking during pregnancy.

    Dhalwani, Nafeesa N; Tata, Laila J; Coleman, Tim; Fiaschi, Linda; Szatkowski, Lisa

    2015-09-01

    We aimed to assess the potential usefulness of primary care data in the UK for estimating smoking prevalence in pregnancy by comparing the primary care data estimates with those obtained from other data sources. In The Health Improvement Network (THIN) primary care database, we identified pregnant smokers using smoking information recorded during pregnancy. Where this information was missing, we used smoking information recorded prior to pregnancy. We compared annual smoking prevalence from 2000 to 2012 in THIN with measures from the Infant Feeding Survey (IFS), Smoking At Time of Delivery (SATOD), Child Health Systems Programme (CHSP) and Scottish Morbidity Record (SMR). Smoking estimates from THIN data converged with estimates from other sources after 2004, though still do not agree completely. For example, in 2012 smoking prevalence at booking was 11.6% in THIN using data recorded only during pregnancy, compared with 19.6% in SMR data. However, the use of smoking data recorded up to 27 months before conception increased the THIN prevalence to 20.3%, improving the comparability. Under-recording of smoking status during pregnancy results in unreliable prevalence estimates from primary care data and needs improvement. However, in the absence of gestational smoking data, the inclusion of pre-conception smoking records may increase the utility of primary care data. One strategy to improve gestational smoking status recording in primary care could be the inclusion of pregnancy in the Quality and Outcome's Framework as a condition for which smoking status and smoking cessation advice must be recorded electronically in patient records. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

  13. Association between expansion of primary healthcare and racial inequalities in mortality amenable to primary care in Brazil: A national longitudinal analysis.

    Thomas Hone

    2017-05-01

    Full Text Available Universal health coverage (UHC can play an important role in achieving Sustainable Development Goal (SDG 10, which addresses reducing inequalities, but little supporting evidence is available from low- and middle-income countries. Brazil's Estratégia de Saúde da Família (ESF (family health strategy is a community-based primary healthcare (PHC programme that has been expanding since the 1990s and is the main platform for delivering UHC in the country. We evaluated whether expansion of the ESF was associated with differential reductions in mortality amenable to PHC between racial groups.Municipality-level longitudinal fixed-effects panel regressions were used to examine associations between ESF coverage and mortality from ambulatory-care-sensitive conditions (ACSCs in black/pardo (mixed race and white individuals over the period 2000-2013. Models were adjusted for socio-economic development and wider health system variables. Over the period 2000-2013, there were 281,877 and 318,030 ACSC deaths (after age standardisation in the black/pardo and white groups, respectively, in the 1,622 municipalities studied. Age-standardised ACSC mortality fell from 93.3 to 57.9 per 100,000 population in the black/pardo group and from 75.7 to 49.2 per 100,000 population in the white group. ESF expansion (from 0% to 100% was associated with a 15.4% (rate ratio [RR]: 0.846; 95% CI: 0.796-0.899 reduction in ACSC mortality in the black/pardo group compared with a 6.8% (RR: 0.932; 95% CI: 0.892-0.974 reduction in the white group (coefficients significantly different, p = 0.012. These differential benefits were driven by greater reductions in mortality from infectious diseases, nutritional deficiencies and anaemia, diabetes, and cardiovascular disease in the black/pardo group. Although the analysis is ecological, sensitivity analyses suggest that over 30% of black/pardo deaths would have to be incorrectly coded for the results to be invalid. This study is limited by

  14. Historicizing Teaching in Awgni as a Mother Tongue Language at Primary Schools of Awi Nationality Administrative Zone: Challenges and Implementation

    Engida, Alemayehu Erkihun

    2015-01-01

    This study examined the challenges facing the teaching as well as the implementation of Awgni as a mother tongue language in primary schools of Awi administrative zone. The need to teach through mother tongue in Ethiopia was widely discussed following the change of the politics in 1991. To this end, the government issued new education and training…

  15. Cross-National Comparisons of Background and Confidence in Visual Arts and Music Education of Pre-Service Primary Teachers

    Russell-Bowie, Deirdre

    2010-01-01

    This paper reports the findings of a study on pre-service teachers' background and confidence in music and visual arts education. The study involved 939 non-specialist pre-service primary teachers from five countries. Initially the paper identifies the students' perceptions of their background and confidence in relation to music and visual arts…

  16. 2012 Swimming Season Fact Sheets

    To help beachgoers make informed decisions about swimming at U.S. beaches, EPA annually publishes state-by-state data about beach closings and advisories for the previous year's swimming season. These fact sheets summarize that information by state.

  17. State Fact Sheets on COPD

    ... Submit Search The CDC Chronic Obstructive Pulmonary Disease (COPD) Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . COPD Homepage Data and Statistics Fact Sheets Publications Publications ...

  18. Annual Energy Balance Sheets 2003-2004

    2005-01-01

    During the year 2004 the supply of primary energy reached 657.6 TWh. That is an increased supply by 16 TWh compared with 2003, The electricity production in hydropower and wind power stations increased by 7 TWh, to 61 TWh during the year 2004. The electricity generated in nuclear power plants was 77.5 TWh, an increase by 10 TWh. During the year 2004 Sweden net exported 2.1 TWh electricity. But in year 2003 we net imported 12.8 TWh electricity. The energy use increased from 406 TWh to 409 TWh between year 2003 and year 2004. The use of coal and coke in manufacturing increased by 22 per cent, and the use of oil products in transport sector increased by 4 per cent. The energy balance sheets are based on data primary recorded in the balance sheets of energy sources, here expressed in a common energy unit, TJ. The production of derived energy is here recorded in a second flow-step comprising energy turnover in energy conversion and is also specified in complementary input-output tables for energy conversion industries

  19. Australian Government Balance Sheet Management

    Wilson Au-Yeung; Jason McDonald; Amanda Sayegh

    2006-01-01

    Since almost eliminating net debt, the Australian Government%u2019s attention has turned to the financing of broader balance sheet liabilities, such as public sector superannuation. Australia will be developing a significant financial asset portfolio in the %u2018Future Fund%u2019 to smooth the financing of expenses through time. This raises the significant policy question of how best to manage the government balance sheet to reduce risk. This paper provides a framework for optimal balance sh...

  20. Impact of the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention on adherence to national obesity clinical practice guidelines in a primary care centre.

    Barnes, Emily R; Theeke, Laurie A; Mallow, Jennifer

    2015-04-01

    Obesity is significantly underdiagnosed and undertreated in primary care settings. The purpose of this clinical practice change project was to increase provider adherence to national clinical practice guidelines for the diagnosis and treatment of obesity in adults. Based upon the National Institutes of Health guidelines for the diagnosis and treatment of obesity, a clinical change project was implemented. Guided by the theory of planned behaviour, the Provider and Healthcare team Adherence to Treatment Guidelines (PHAT-G) intervention includes education sessions, additional provider resources for patient education, a provider reminder system and provider feedback. Primary care providers did not significantly increase on documentation of diagnosis and planned management of obesity for patients with body mass index (BMI) greater than or equal to 30. Medical assistants increased recording of height, weight and BMI in the patient record by 13%, which was significant. Documentation of accurate BMI should lead to diagnosis of appropriate weight category and subsequent care planning. Future studies will examine barriers to adherence to clinical practice guidelines for obesity. Interventions are needed that include inter-professional team members and may be more successful if delivered separately from routine primary care visits. © 2015 John Wiley & Sons, Ltd.

  1. Aerial radiometric and magnetic survey; Brushy Basin detail survey: Price/Salina national topographic map sheets, Utah. Volume III. Area II: graphic data, Section III-IX Final report

    1981-01-01

    This volume contains all of the graphic data for Area II, which include map lines 1660 to 3400 and 5360 to 5780 and tie lines 6100, 6120, and 6160. Due to the large map scale of the data presented (1:62,500), this area was further subdivided into eleven 7-1/2 min quadrant sheets. It should be noted that TL6100 resides in both Areas II and III. The graphic data for TL6100 are presented in Volume IV - Area III - Graphic Data of this report

  2. Potential Teaching Model for Applying Novel Approaches of Renewed Estonian National Curriculum into Visual Art Classes in Primary School

    Vahter, Edna

    2015-01-01

    In 2010, the renewed national curriculum was legislated in Estonia. Major changes include a new list of cross-curricular topics, increased importance of integration and specification of the components of the art learning process. In this situation, the question arises--how to fully implement the challenges of the renewed curriculum in primary…

  3. The relative influence of secondary versus primary prevention using the national cholesterol education program adult treatment panel II guidelines

    Goldman, L; Coxson, P; Hunink, MGM; Goldman, PA; Tosteson, ANA; Mittleman, M; Williams, L; Weinstein, MC

    OBJECTIVES This study was undertaken to project the population-wide effect of full implementation of the Adult Treatment Panel (ATP) II guidelines of the National Cholesterol Education Program (NCEP). BACKGROUND The ATP II has proposed guidelines for cholesterol reduction, but the long-term

  4. Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Akazili, James; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F.

    2015-01-01

    Background: Despite improvements in a number of health outcome indicators partly due to the National Health Insurance Scheme (NHIS), Ghana is unlikely to attain all its health-related millennium development goals before the end of 2015. Inefficient use of available limited resources has been cited

  5. Adolescent Literacy. Fact Sheet

    Alliance for Excellent Education, 2011

    2011-01-01

    The nation's workforce is demanding ever more literate workers and citizens. As technology advances and the American economy grows increasingly knowledge based, individuals must be able to read, write, and communicate at higher levels in order to remain economic and social contributors. A student's level of literacy is a critical determinant of…

  6. Respirator Fact Sheet

    ... 6, 2014 Content source: National Institute for Occupational Safety and Health Education and Information Division Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO ( ...

  7. Fact Sheet: Trigeminal Neuralgia

    ... Health, is the federal government’s leading supporter of biomedical research on disorders of the brain and nervous system. ... by the National Institute of Dental and Craniofacial Research. One ... mucosa). Current drug therapy is absorbed through the body, which may lead ...

  8. Environmental Management Fact Sheets.

    Department of Energy, Washington, DC.

    In recent years, the need for nuclear materials has decreased and the Department of Energy (DOE) has focused greater attention on cleaning up contamination left from past activities. The Office of Environmental Management (EM) within DOE is responsible for managing waste and cleaning up contamination at DOE sites across the nation. This collection…

  9. The GP Patient Survey for use in primary care in the National Health Service in the UK--development and psychometric characteristics.

    Campbell, John; Smith, Patten; Nissen, Sonja; Bower, Peter; Elliott, Marc; Roland, Martin

    2009-08-22

    The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9) involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3%) was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%). Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care) accounting for 68.3% of the variance in the sample. The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of pound sterling 65 million ($107 million) of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  10. The GP Patient Survey for use in primary care in the National Health Service in the UK – development and psychometric characteristics

    Bower Peter

    2009-08-01

    Full Text Available Abstract Background The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9 involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. Methods The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. Results The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3% was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%. Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care accounting for 68.3% of the variance in the sample. Conclusion The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of £65 million ($107 million of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  11. Frequency and distribution of primary site among gender minority cancer patients: An analysis of U.S. national surveillance data.

    Nash, Rebecca; Ward, Kevin C; Jemal, Ahmedin; Sandberg, David E; Tangpricha, Vin; Goodman, Michael

    2018-03-09

    Transgender people and persons with disorders of sex development (DSD) are two separate categories of gender minorities, each characterized by unique cancer risk factors. Although cancer registry data typically include only two categories of sex, registrars have the option of indicating that a patient is transgender or has a DSD. Data for primary cancer cases in 46 states and the District of Columbia were obtained from the North American Association of Central Cancer Registries (NAACCR) database for the period 1995-2013. The distributions of primary sites and categories of cancers with shared risk factors were examined separately for transgender and DSD patients and compared to the corresponding distributions in male and female cancer patients. Proportional incidence ratios were calculated by dividing the number of observed cases by the number of expected cases. Expected cases were calculated based on the age- and year of diagnosis-specific proportions of cases in each cancer category observed among male and female patients. Transgender patients have significantly elevated proportional incidence ratios (95% confidence intervals) for viral infection induced cancers compared to either males (2.3; 2.0-2.7) or females (3.3; 2.8-3.7). Adult DSD cancer patients have a similar distribution of primary sites compared to male or female patients but DSD children with cancer have ten times more cases of testicular malignancies than expected (95% confidence interval: 4.7-20). The proportions of certain primary sites and categories of malignancies among transgender and DSD cancer patients are different from the proportions observed for male or female patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. National Headache Foundation

    ... Headache Topic Sheets (Spanish) Headache FAQ NHF Webinars Education Modules MigrainePro™ Children’s Headache Disorders New Perspectives on Caffeine and Headache War Veterans Health Resource Initiative National Headache Foundation Brochures ...

  13. Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

    Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

    2017-12-01

    Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly

  14. FDTD modeling of thin impedance sheets

    Luebbers, Raymond J.; Kunz, Karl S.

    1991-01-01

    Thin sheets of resistive or dielectric material are commonly encountered in radar cross section calculations. Analysis of such sheets is simplified by using sheet impedances. In this paper it is shown that sheet impedances can be modeled easily and accurately using Finite Difference Time Domain (FDTD) methods.

  15. Spread-sheet application to classify radioactive material for shipment

    Brown, A.N.

    1998-01-01

    A spread-sheet application has been developed at the Idaho National Engineering and Environmental Laboratory to aid the shipper when classifying nuclide mixtures of normal form, radioactive materials. The results generated by this spread-sheet are used to confirm the proper US DOT classification when offering radioactive material packages for transport. The user must input to the spread-sheet the mass of the material being classified, the physical form (liquid or not) and the activity of each regulated nuclide. The spread-sheet uses these inputs to calculate two general values: 1)the specific activity of the material and a summation calculation of the nuclide content. The specific activity is used to determine if the material exceeds the DOT minimal threshold for a radioactive material. If the material is calculated to be radioactive, the specific activity is also used to determine if the material meets the activity requirement for one of the three low specific activity designations (LSA-I, LSA-II, LSA-III, or not LSA). Again, if the material is calculated to be radioactive, the summation calculation is then used to determine which activity category the material will meet (Limited Quantity, Type A, Type B, or Highway Route Controlled Quantity). This spread-sheet has proven to be an invaluable aid for shippers of radioactive materials at the Idaho National Engineering and Environmental Laboratory. (authors)

  16. Participation in Sports and Civic Engagement. Fact Sheet

    Lopez, Mark Hugo; Moore, Kimberlee

    2006-01-01

    One reason to offer sports in school is to teach youth the values, skills, and habits that will make them more active, engaged, and responsible citizens. Past evidence on the civic effects of sports is mixed, but points to some potential positive civic effects. This fact sheet uses recent data from the 2002 National Youth Survey of Civic…

  17. Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: a retrospective chart review.

    Waldorf, Barbara; Gill, Christopher; Crosby, Sondra S

    2014-10-01

    In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines.

  18. Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry.

    Kaiser, Daniel W; Tsai, Vivian; Heidenreich, Paul A; Goldstein, Mary K; Wang, Yongfei; Curtis, Jeptha; Turakhia, Mintu P

    2015-10-01

    Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs. Using data from the National Cardiovascular Data Registry's ICD Registry, we identified patients who received ICDs for primary prevention from January 2006 to December 2008. We determined whether patients met the inclusion criteria of at least 1 of the 4 ICD primary prevention trials: Multicenter Automatic Defibrillator Implantation Trial (MADIT), MADIT-II, Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), and the Multicenter Unsustained Tachycardia Trial (MUSTT). Among 150,264 patients, 86% met criteria for an ICD implantation based on trial data. The proportion of patients who did not meet trial-based criteria increased as age decreased. In multivariate analysis, the significant predictors for not meeting trial criteria included prior cardiac transplantation (odds ratio [OR] 2.1), pediatric electrophysiology operator (OR 2.0), and high-grade atrioventricular conduction disease (OR 1.4). Among National Cardiovascular Data Registry registrants receiving first-time ICDs for primary prevention, the majority met trial-based criteria. Multivariate analyses suggested that many patients who did not meet the trial-based criteria may have had clinical circumstances that warranted ICD implantation. These findings caution against the use of trial-based indications to determine site quality metrics that could penalize sites that care for younger patients. The planned incorporation of appropriate use criteria into the ICD registry may better characterize patient- and site-level quality and performance. Published by Elsevier Inc.

  19. On Jovian plasma sheet structure

    Khurana, K.K.; Kivelson, M.G.

    1989-01-01

    The authors evaluate several models of Jovian plasma sheet structure by determining how well they organize several aspects of the observed Voyager 2 magnetic field characteristics as a function of Jovicentric radial distance. It is shown that in the local time sector of the Voyager 2 outbound pass (near 0300 LT) the published hinged-magnetodisc models with wave (i.e., models corrected for finite wave velocity effects) are more successful than the published magnetic anomaly model in predicting locations of current sheet crossings. They also consider the boundary between the plasma sheet and the magnetotail lobe which is expected to vary slowly with radial distance. They use this boundary location as a further test of the models of the magnetotail. They show that the compressional MHD waves have much smaller amplitude in the lobes than in the plasma sheet and use this criterion to refine the identification of the plasma-sheet-lobe boundary. When the locations of crossings into and out of the lobes are examined, it becomes evident that the magnetic-anomaly model yields a flaring plasma sheet with a halfwidth of ∼ 3 R J at a radial distance of 20 R J and ∼ 12 R J at a radial distance of 100 R J . The hinged-magnetodisc models with wave, on the other hand, predict a halfwidth of ∼ 3.5 R J independent of distance beyond 20 R J . New optimized versions of the two models locate both the current sheet crossings and lobe encounters equally successfully. The optimized hinged-magnetodisc model suggests that the wave velocity decreases with increasing radial distance. The optimized magnetic anomaly model yields lower velocity contrast than the model of Vasyliunas and Dessler (1981)

  20. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

    Brennan Sharon L

    2012-04-01

    Full Text Available Abstract Background The utilization of total hip replacement (THR surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years. Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  1. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

    Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

    2012-04-30

    The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  2. Uranium mining sites - Thematic sheets

    2009-01-01

    A first sheet proposes comments, data and key numbers about uranium extraction in France: general overview of uranium mining sites, status of waste rock and tailings after exploitation, site rehabilitation. The second sheet addresses the sources of exposure to ionizing radiations due to ancient uranium mining sites: discussion on the identification of these sources associated with these sites, properly due to mining activities or to tailings, or due to the transfer of radioactive substances towards water and to the contamination of sediments, description of the practice and assessment of radiological control of mining sites. A third sheet addresses the radiological exposure of public to waste rocks, and the dose assessment according to exposure scenarios: main exposure ways to be considered, studied exposure scenarios (passage on backfilled path and grounds, stay in buildings built on waste rocks, keeping mineralogical samples at home). The fourth sheet addresses research programmes of the IRSN on uranium and radon: epidemiological studies (performed on mine workers; on French and on European cohorts, French and European studies on the risk of lung cancer associated with radon in housing), study of the biological effects of chronic exposures. The last sheet addresses studies and expertises performed by the IRSN on ancient uranium mining sites in France: studies commissioned by public authorities, radioactivity control studies performed by the IRSN about mining sites, participation of the IRSN to actions to promote openness to civil society

  3. ICESat's First Year of Measurements Over the Polar Ice Sheets

    Shuman, C. A.

    2004-05-01

    NASA's Ice, Cloud and Land Elevation Satellite (ICESat) mission was developed to measure changes in elevation of the Greenland and Antarctic ice sheets. Its primary mission goal is to significantly refine estimates of polar ice sheet mass balance. Obtaining precise, spatially dense, ice sheet elevations through time is the first step towards this goal. ICESat data will then enable study of associations between observed ice changes and dynamic or climatic forcing factors, and thus enable improved estimation of the present and future contributions of the ice sheets to global sea level rise. ICESat was launched on January 12, 2003 and acquired science data from February 20th to March 29th with the first of the three lasers of the Geoscience Laser Altimeter System (GLAS). Data acquisition with the second laser began on September 25th and continued until November 18th, 2003. For one-year change detection, the second laser is scheduled for operation from approximately February 17th to March 20th, 2004. Additional operational periods will be selected to 1) enable periodic measurements through the year, and 2) to support of other NASA Earth Science Enterprise missions and activities. To obtain these precise ice sheet elevations, GLAS has a 1064 nm wavelength laser operating at 40 Hz with a designed range precision of about 10 cm. The laser footprints are about 70 m in diameter on the Earth's surface and are spaced every 172 m along-track. The on-board GPS receiver enables radial orbit determinations to an accuracy better than 5 cm. The star-tracking attitude-determination system will enable laser footprints to be located to 6 m horizontally when attitude calibration is completed. The orbital altitude averages 600 km at an inclination of 94 degrees with coverage extending from 86 degrees N and S latitude. The spacecraft attitude can be controlled to point the laser beam to within 50 m of surface reference tracks over the ice sheets and to point off-nadir up to 5 degrees to

  4. The impact of family planning on primary school enrolment in sub-national areas within 25 African countries.

    Longwe, Abiba; Smits, Jeroen

    2013-06-01

    We study how the availability and use of family planning services in African countries influences the family planning situation of households and through this the educational participation of young children. A district panel dataset is used for 441 urban and rural areas within 233 districts of 25 countries. Path analysis shows that a decrease in the number of births is associated with an increase in educational participation in the area. The number of births is negatively associated with acceptance, knowledge and actual use of contraceptives in the area. As reversed causality and selection bias seem unlikely, the identified relationship probably is at least partially causal. Hence, investments in family planning services in poor areas are not only important because they allow women to plan their births better, but also because they may lead to higher primary enrolment rates and thus contribute to the region's future economic growth.

  5. Malaysia Shape of the Nation (MySoN): a primary care based study of abdominal obesity in Malaysia.

    Zaki, M; Robaayah, Z; Chan, S P; Vadivale, M; Lim, T O

    2010-06-01

    Abdominal obesity (AO), measured by waist circumference (WC), is a stronger predictor of subsequent development of cardiovascular disease (CVD) than generalised obesity, which is measured by body mass index (BMI). This study aimed to measure WC and prevalence of AO in Malaysians visiting primary care physicians. 1893 patients between the ages of 18 and 80 attending primary care clinics in Malaysia were recruited over two days for this multi-centre cross-sectional study. Pregnant women were excluded, their medical history, weight, height and WC were examined. The prevalence of co-morbidities were as follows: (1) CVD-4%, lipid disorder-17%, hypertension-26%, diabetes-14% and any of the clinical characteristics of CVD/lipid disorder/hypertension/diabetes-38%. The mean BMI for men and women was 25.62 +/- 4.73 kg/m2 and 26.63 +/- 5.72 kg/m2, respectively. Based on WHO criteria for BMI (overweight, 25-29.9 kg/m2; obese, > 30 kg/m2), 34.2% were overweight and 20.4% were obese. The mean WC for men and women was 89.03 +/- 13.45 cm and 84.26 +/- 12.78 cm, respectively. Overall, 55.6% had AO and there was higher prevalence among women (based on International Diabetes Federation criteria: WC > or = 90 cm for men and > or = 80 cm for women). AO was present in approximately 71% patients with lipid disorder, in 76% with hypertension and in 75% with diabetes. Patients with AO were also at a higher risk of developing co-morbidities. Malaysia has a high prevalence of AO and associated cardiovascular risk factors. This needs to be addressed by public health programs, which should also include routine measurement of WC.

  6. Root-growth-inhibiting sheet

    Burton, F.G.; Cataldo, D.A.; Cline, J.F.; Skiens, W.E.; Van Voris, P.

    1993-01-26

    In accordance with this invention, a porous sheet material is provided at intervals with bodies of a polymer which contain a 2,6-dinitroaniline. The sheet material is made porous to permit free passage of water. It may be either a perforated sheet or a woven or non-woven textile material. A particularly desirable embodiment is a non-woven fabric of non-biodegradable material. This type of material is known as a geotextile'' and is used for weed control, prevention of erosion on slopes, and other landscaping purposes. In order to obtain a root repelling property, a dinitroaniline is blended with a polymer which is attached to the geotextile or other porous material.

  7. Optimal swimming of a sheet.

    Montenegro-Johnson, Thomas D; Lauga, Eric

    2014-06-01

    Propulsion at microscopic scales is often achieved through propagating traveling waves along hairlike organelles called flagella. Taylor's two-dimensional swimming sheet model is frequently used to provide insight into problems of flagellar propulsion. We derive numerically the large-amplitude wave form of the two-dimensional swimming sheet that yields optimum hydrodynamic efficiency: the ratio of the squared swimming speed to the rate-of-working of the sheet against the fluid. Using the boundary element method, we show that the optimal wave form is a front-back symmetric regularized cusp that is 25% more efficient than the optimal sine wave. This optimal two-dimensional shape is smooth, qualitatively different from the kinked form of Lighthill's optimal three-dimensional flagellum, not predicted by small-amplitude theory, and different from the smooth circular-arc-like shape of active elastic filaments.

  8. Root-growth-inhibiting sheet

    Burton, Frederick G.; Cataldo, Dominic A.; Cline, John F.; Skiens, W. Eugene; Van Voris, Peter

    1993-01-01

    In accordance with this invention, a porous sheet material is provided at intervals with bodies of a polymer which contain a 2,6-dinitroaniline. The sheet material is made porous to permit free passage of water. It may be either a perforated sheet or a woven or non-woven textile material. A particularly desirable embodiment is a non-woven fabric of non-biodegradable material. This type of material is known as a "geotextile" and is used for weed control, prevention of erosion on slopes, and other landscaping purposes. In order to obtain a root repelling property, a dinitroaniline is blended with a polymer which is attached to the geotextile or other porous material.

  9. UWBRAD: Ultra Wideband Software Defined Microwave Radiometer for Ice Sheet Subsurface Temperature Sensing

    National Aeronautics and Space Administration — Existing space and airborne remote sensing instruments have pushed the state-of-the-art in the characterization of ice sheet behaviors with the exception of one key...

  10. Fact Sheet - Final Air Toxics Rule for Gold Mine Ore Processing and Production

    Fact sheet summarizing main points of National Emissions Standards for Hazardous Air Pollutants for gold ore processing and production facilities, the seventh largest source of mercury air emission in the United States.

  11. Ionospheric Values (Daily Work Sheets), F-Plots, Tabulations, Booklets, Catalogs, and Log Books

    National Oceanic and Atmospheric Administration, Department of Commerce — These ionospheric data consist of scaling notes, equipment usage logs, and ionospheric values in the form of daily work sheets, F-Plots, tabulations, and booklets....

  12. Final Rule to Reduce Hazardous Air Emissions from Newly Built Stationary Combustion Turbines: Fact Sheet

    This page contains an August 2003 fact sheet with information regarding the National Emissions Standards for Hazardous Air Pollutants (NESHAP) for Stationary Combustion Turbines. This document provides a summary of the information for this NESHAP.

  13. Universal Style Sheet Language Environment Modification for the Business Use

    Jiří Brázdil

    2014-01-01

    Full Text Available This paper deals with the description of USSL – Universal Style Sheet Language environment. USSL style sheet language is platform-independent and its primary focus is the declarative notation of the appearance of GUI libraries used by imperative programming languages. The implementation of the software support for wxWidgets library is made, because this library has no support for the separate declarative notation of the appearance via style sheet language. The separation of the appearance enables us to reuse and standardize the appearance notation and the independent development of the appearance. In this way it is possible to achieve consistent appearance of applications of specific set or even all of company software products. However, the first proposal of the USSL has several disadvantages which restrict the possibilities for practical use in business or other environment. These disadvantages are: the lack of @import rule for importing other style sheets, USSL only supports basic set of selectors compared with selectors of other style sheet languages for desktop environment such as Qt QSS and GTK+ GtkCssProvider, the lack of styling of the cursors, it is impossible to put down URL. The placement of widgets and its borders are not solved either. This paper contains suggestions for solving these issues.

  14. Audit of HIV counselling and testing services among primary healthcare facilities in Cameroon: a protocol for a multicentre national cross-sectional study.

    Tianyi, Frank-Leonel; Tochie, Joel Noutakdie; Agbor, Valirie Ndip; Kadia, Benjamin Momo

    2018-03-01

    HIV testing is an invaluable entry point to prevention, care and treatment services for people living with HIV and AIDS. Poor adherence to recommended protocols and guidelines reduces the performance of rapid diagnostic tests, leading to misdiagnosis and poor estimation of HIV seroprevalence. This study seeks to evaluate the adherence of primary healthcare facilities in Cameroon to recommended HIV counselling and testing (HCT) procedures and the impact this may have on the reliability of HIV test results. This will be an analytical cross-sectional study involving primary healthcare facilities from all the 10 regions of Cameroon, selected by a multistaged random sampling of primary care facilities in each region. The study will last for 9 months. A structured questionnaire will be used to collect general information concerning the health facility, laboratory and other departments involved in the HCT process. The investigators will directly observe at least 10 HIV testing processes in each facility and fill out the checklist accordingly. Clearance has been obtained from the National Ethical Committee to carry out the study. Informed consent will be sought from the patients to observe the HIV testing process. The final study will be published in a peer-reviewed journal and the findings presented to health policy-makers and the general public. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Ice sheet hydrology - a review

    Jansson, Peter; Naeslund, Jens-Ove [Dept. of Physical Geography and Quaternary Geology, Stockholm Univ., Stockholm (Sweden); Rodhe, Lars [Geological Survey of Sweden, Uppsala (Sweden)

    2007-03-15

    This report summarizes the theoretical knowledge on water flow in and beneath glaciers and ice sheets and how these theories are applied in models to simulate the hydrology of ice sheets. The purpose is to present the state of knowledge and, perhaps more importantly, identify the gaps in our understanding of ice sheet hydrology. Many general concepts in hydrology and hydraulics are applicable to water flow in glaciers. However, the unique situation of having the liquid phase flowing in conduits of the solid phase of the same material, water, is not a commonly occurring phenomena. This situation means that the heat exchange between the phases and the resulting phase changes also have to be accounted for in the analysis. The fact that the solidus in the pressure-temperature dependent phase diagram of water has a negative slope provides further complications. Ice can thus melt or freeze from both temperature and pressure variations or variations in both. In order to provide details of the current understanding of water flow in conjunction with deforming ice and to provide understanding for the development of ideas and models, emphasis has been put on the mathematical treatments, which are reproduced in detail. Qualitative results corroborating theory or, perhaps more often, questioning the simplifications made in theory, are also given. The overarching problem with our knowledge of glacier hydrology is the gap between the local theories of processes and the general flow of water in glaciers and ice sheets. Water is often channelized in non-stationary conduits through the ice, features which due to their minute size relative to the size of glaciers and ice sheets are difficult to incorporate in spatially larger models. Since the dynamic response of ice sheets to global warming is becoming a key issue in, e.g. sea-level change studies, the problems of the coupling between the hydrology of an ice sheet and its dynamics is steadily gaining interest. New work is emerging

  16. Modelling the Antarctic Ice Sheet

    Pedersen, Jens Olaf Pepke; Holm, A.

    2015-01-01

    to sea level high stands during past interglacial periods. A number of AIS models have been developed and applied to try to understand the workings of the AIS and to form a robust basis for future projections of the AIS contribution to sea level change. The recent DCESS (Danish Center for Earth System......The Antarctic ice sheet is a major player in the Earth’s climate system and is by far the largest depository of fresh water on the planet. Ice stored in the Antarctic ice sheet (AIS) contains enough water to raise sea level by about 58 m, and ice loss from Antarctica contributed significantly...

  17. Ice sheet hydrology - a review

    Jansson, Peter; Naeslund, Jens-Ove; Rodhe, Lars

    2007-03-01

    This report summarizes the theoretical knowledge on water flow in and beneath glaciers and ice sheets and how these theories are applied in models to simulate the hydrology of ice sheets. The purpose is to present the state of knowledge and, perhaps more importantly, identify the gaps in our understanding of ice sheet hydrology. Many general concepts in hydrology and hydraulics are applicable to water flow in glaciers. However, the unique situation of having the liquid phase flowing in conduits of the solid phase of the same material, water, is not a commonly occurring phenomena. This situation means that the heat exchange between the phases and the resulting phase changes also have to be accounted for in the analysis. The fact that the solidus in the pressure-temperature dependent phase diagram of water has a negative slope provides further complications. Ice can thus melt or freeze from both temperature and pressure variations or variations in both. In order to provide details of the current understanding of water flow in conjunction with deforming ice and to provide understanding for the development of ideas and models, emphasis has been put on the mathematical treatments, which are reproduced in detail. Qualitative results corroborating theory or, perhaps more often, questioning the simplifications made in theory, are also given. The overarching problem with our knowledge of glacier hydrology is the gap between the local theories of processes and the general flow of water in glaciers and ice sheets. Water is often channelized in non-stationary conduits through the ice, features which due to their minute size relative to the size of glaciers and ice sheets are difficult to incorporate in spatially larger models. Since the dynamic response of ice sheets to global warming is becoming a key issue in, e.g. sea-level change studies, the problems of the coupling between the hydrology of an ice sheet and its dynamics is steadily gaining interest. New work is emerging

  18. Sheet Beam Klystron Instability Analysis

    Bane, K.

    2009-01-01

    Using the principle of energy balance we develop a 2D theory for calculating growth rates of instability in a two-cavity model of a sheet beam klystron. An important ingredient is a TE-like mode in the gap that also gives a longitudinal kick to the beam. When compared with a self-consistent particle-in-cell calculation, with sheet beam klystron-type parameters, agreement is quite good up to half the design current, 65 A; at full current, however, other, current-dependent effects come in and the results deviate significantly

  19. NREL Showcases Hydrogen Internal Combustion Engine Bus, Helps DOE Set Standards for Outreach (Fact Sheet)

    2010-11-01

    This fact sheet describes the National Renewable Energy Laboratory's (NREL's) accomplishments in showcasing a Ford hydrogen-powered internal combustion engine (H2ICE) bus at The Taste of Colorado festival in Denver. NREL started using its U.S. Department of Energy-funded H2ICE bus in May 2010 as the primary shuttle vehicle for VIP visitors, members of the media, and new employees. In September 2010, NREL featured the bus at The Taste of Colorado. This was the first major outreach event for the bus. NREL's educational brochure, vehicle wrap designs, and outreach efforts serve as a model for other organizations with DOE-funded H2ICE buses. Work was performed by the Hydrogen Education Group and Market Transformation Group in the Hydrogen Technologies and Systems Center.

  20. Variations in GP-patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey.

    Burt, Jenni; Lloyd, Cathy; Campbell, John; Roland, Martin; Abel, Gary

    2016-01-01

    Doctor-patient communication is a key driver of overall satisfaction with primary care. Patients from minority ethnic backgrounds consistently report more negative experiences of doctor-patient communication. However, it is currently unknown whether these ethnic differences are concentrated in one gender or in particular age groups. To determine how reported GP-patient communication varies between patients from different ethnic groups, stratified by age and gender. Analysis of data from the English GP Patient Survey from 2012-2013 and 2013-2014, including 1,599,801 responders. A composite score was created for doctor-patient communication from five survey items concerned with interpersonal aspects of care. Mixed-effect linear regression models were used to estimate age- and gender-specific differences between white British patients and patients of the same age and gender from each other ethnic group. There was strong evidence (Pcommunication varied by both age and gender. The difference in scores between white British and other responders on doctor-patient communication items was largest for older, female Pakistani and Bangladeshi responders, and for younger responders who described their ethnicity as 'Any other white'. The identification of groups with particularly marked differences in experience of GP-patient communication--older, female, Asian patients and younger 'Any other white' patients--underlines the need for a renewed focus on quality of care for these groups. © British Journal of General Practice 2016.

  1. National survey addressing the information needs of primary care physicians: Side effect management of patients on androgen deprivation therapy.

    Soeyonggo, Tony; Locke, Jennifer; Giudice, Maria Elizabeth Del; Alibhai, Shabbir; Fleshner, Neil Eric; Warde, Padraig

    2014-03-01

    Androgen deprivation therapy (ADT) is a common treatment for prostate cancer with numerous side effects. We assess primary care physicians' (PCPs) knowledge of ADT side effects and their interest in increasing their knowledge in this area. A list of active Canadian PCPs was obtained using the Canadian Medical Directory. A cross-sectional survey was distributed to 600 randomly selected physicians. We collected PCPs' demographic information, experience with ADT management, knowledge regarding ADT side effects and desired sources for obtaining knowledge on ADT management. In total, we received 103 completed questionnaires. Of these, 89% of PCPs had patients on ADT. One-third of respondents prescribed ADT and over half of them administered ADT annually. Thirty-eight percent felt their knowledge of ADT side effects was inadequate and 50% felt uncomfortable counselling patients on ADT. Many PCPs were less familiar with the incidence of functional side effects of ADT (i.e., hot flashes, fatigue and erectile dysfunction) compared to life-threatening side effects (i.e., cardiovascular events, metabolic syndrome, fractures). In terms of increasing their knowledge of ADT side effects, 82% of PCPs would use educational resources if they were available (52% and 32% preferred continued medical education [CME] events and educational pamphlets, respectively). PCPs play an important role in managing ADT side effects. There is poor awareness of the prevalence of ADT side effects, and many are uncomfortable in managing these side effects. These areas may be addressed through CME programs and educational pamphlets.

  2. Ice Sheet Model Intercomparison Project (ISMIP6) contribution to CMIP6

    Nowicki, Sophie M.J.; Payne, Tony; Larour, Eric; Seroussi, Helene; Goelzer, Heiko; Lipscomb, William; Gregory, Jonathan; Abe-Ouchi, Ayako; Shepherd, Andrew

    2018-01-01

    Reducing the uncertainty in the past, present and future contribution of ice sheets to sea-level change requires a coordinated effort between the climate and glaciology communities. The Ice Sheet Model Intercomparison Project for CMIP6 (ISMIP6) is the primary activity within the Coupled Model Intercomparison Project – phase 6 (CMIP6) focusing on the Greenland and Antarctic Ice Sheets. In this paper, we describe the framework for ISMIP6 and its relationship to other activities within CMIP6. The ISMIP6 experimental design relies on CMIP6 climate models and includes, for the first time within CMIP, coupled ice sheet – climate models as well as standalone ice sheet models. To facilitate analysis of the multi-model ensemble and to generate a set of standard climate inputs for standalone ice sheet models, ISMIP6 defines a protocol for all variables related to ice sheets. ISMIP6 will provide a basis for investigating the feedbacks, impacts, and sea-level changes associated with dynamic ice sheets and for quantifying the uncertainty in ice-sheet-sourced global sea-level change. PMID:29697697

  3. The association between socioeconomic status and visual impairments among primary glaucoma: the results from Nationwide Korean National Health Insurance Cohort from 2004 to 2013.

    Sung, Haejune; Shin, Hyun Ho; Baek, Yunseng; Kim, Gyu Ah; Koh, Jae Sang; Park, Eun-Cheol; Shin, Jaeyong

    2017-08-23

    Glaucoma is one of the most leading causes of permanent visual impairments in Korea, and social expenses spent for the glaucoma are increasing. This study is to identify association between socioeconomic status and the visual impairments caused by primary glaucoma in Korea. This study is based on a cohort study using stratified representative samples in the National Health Insurance claim data from 2002 to 2013 with 1,025,340 representative subjects. Target subjects were patients who are newly diagnosed with primary glaucoma from 2004 to 2013. We conducted a multiple logistic regression analysis depending on the occurrence of visual impairment and its temporal order compared to the glaucoma diagnosis. Among 1728 patients with primary glaucoma, those with low and middle income shows higher odds ratio (OR) of the visual impairments than those with high income group (low income; OR = 3.42, 95% Confidential Interval (CI):2.06-5.66, middle income; OR = 2.13, 95% CI: 1.28-3.55), in case of the occurrence of the visual impairments preceded the diagnosis of glaucoma. Glaucoma patients without pre-existing glaucoma history before visual impairment have higher association between socioeconomic status and the occurrence of visual impairments by primary glaucoma. Since glaucoma had not been diagnosed and recognized yet, the differences may have been derived from the disparities of the awareness of the glaucoma. These findings call attention to the correlation between socioeconomic factors and the visual impairments by glaucoma, and raise public health needs over the importance of glaucoma awareness and eye screening for glaucoma, especially for low socioeconomic status.

  4. Does providing more services increase the primary hospitals' revenue? An assessment of national essential medicine policy based on 2,675 counties in China.

    Fei Chen

    Full Text Available To understand whether the increased outpatient service provision (OSP brings in enough additional income (excluding income from essential medicine for primary hospitals (INCOME to compensate for reduced costs of medicine.The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province. We fitted bivariate five-level random effects regression models to examine correlations between OSP and INCOME in terms of their mean values and dose-response effects of the essential medicine policy (EMP. We adjusted for the effects of time period and selected hospital resources.The estimated correlation coefficients between the two outcomes' mean values were strongly positive among provinces (r = 0.910, moderately positive among counties (r = 0.380, and none among hospitals (r = 0.002 and time (r = 0.007. The correlation between their policy effects was weakly positive among provinces (r = 0.234, but none at the county and hospital levels. However, there were markedly negative correlation coefficients between the mean and policy effects at -0.328 for OSP and -0.541 for INCOME at the hospital level.There was no evidence to suggest an association between the two outcomes in terms of their mean values and dose-response effects of EMP at the hospital level. This indicated that increased OSP did not bring enough additional INCOME. Sustainable mechanisms to compensate primary hospitals are needed.

  5. Determinants of use of the bronchodilator test in primary and secondary care: results of a national survey in Spain.

    Lopez-Campos, Jose Luis; Soriano, Joan B; Calle, Myriam

    2016-03-01

    A recent study evaluated the use of spirometry in primary (PC) and secondary care (SC) in Spain. In the present study, we aimed to analyze the determinants of use of the bronchodilator test (BDT) with a special emphasis in the type of drugs used, waiting times and positive test criteria followed. Cross-sectional trial surveying 605 PC and 200 SC centers in Spain. Regarding the BDT, variables collected were: name of the drugs available for the BDT, name of the drug normally used, number of inhalations, waiting time for the second spirometry, staff involved and criteria used for a positive test. Adherence to actual guidelines according to five quality criteria was evaluated. Although a range of short-acting bronchodilators were used, only 25.9% of centers used a correct dose. The waiting time was correct in 63.7% and 72.8% of PC and SC, respectively (P = 0.023). A threshold higher than 12% and 200 mL to consider a positive test was fulfilled in 55.8% and 52.8% of PC and SC, respectively. Altogether, only 7.6% of PC and 6.0% of SC fulfilled all five quality criteria. Factors identified to be associated with this fulfillment were the number of spirometries per week, not being conducted by a nurse, periodical retraining, training for interpreting and daily calibration. The present study identifies determinants of the performance of the BDT in Spain identifying strengths and weaknesses. Health managers should use this information to improve the quality of spirometries in chronic respiratory patients. © 2014 John Wiley & Sons Ltd.

  6. Standard cardiovascular disease risk algorithms underestimate the risk of cardiovascular disease in schizophrenia: evidence from a national primary care database.

    McLean, Gary; Martin, Julie Langan; Martin, Daniel J; Guthrie, Bruce; Mercer, Stewart W; Smith, Daniel J

    2014-10-01

    Schizophrenia is associated with increased cardiovascular mortality. Although cardiovascular disease (CVD) risk prediction algorithms are widely in the general population, their utility for patients with schizophrenia is unknown. A primary care dataset was used to compare CVD risk scores (Joint British Societies (JBS) score), cardiovascular risk factors, rates of pre-existing CVD and age of first diagnosis of CVD for schizophrenia (n=1997) relative to population controls (n=215,165). Pre-existing rates of CVD and the recording of risk factors for those without CVD were higher in the schizophrenia cohort in the younger age groups, for both genders. Those with schizophrenia were more likely to have a first diagnosis of CVD at a younger age, with nearly half of men with schizophrenia plus CVD diagnosed under the age of 55 (schizophrenia men 46.1% vs. control men 34.8%, pschizophrenia women 28.9% vs. control women 23.8%, prisk factors within the schizophrenia group, only a very small percentage (3.2% of men and 7.5% of women) of those with schizophrenia under age 55 were correctly identified as high risk for CVD according to the JBS risk algorithm. The JBS2 risk score identified only a small proportion of individuals with schizophrenia under the age of 55 as being at high risk of CVD, despite high rates of risk factors and high rates of first diagnosis of CVD within this age group. The validity of CVD risk prediction algorithms for schizophrenia needs further research. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Learning from Balance Sheet Visualization

    Tanlamai, Uthai; Soongswang, Oranuj

    2011-01-01

    This exploratory study examines alternative visuals and their effect on the level of learning of balance sheet users. Executive and regular classes of graduate students majoring in information technology in business were asked to evaluate the extent of acceptance and enhanced capability of these alternative visuals toward their learning…

  8. Off-Balance Sheet Financing.

    Adams, Matthew C.

    1998-01-01

    Examines off-balance sheet financing, the facilities use of outsourcing for selected needs, as a means of saving operational costs and using facility assets efficiently. Examples of using outside sources for energy supply and food services, as well as partnering with business for facility expansion are provided. Concluding comments address tax…

  9. Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis

    David A Ellis, PhD

    2017-12-01

    Full Text Available Summary: Background: Addressing the causes of low engagement in health care is a prerequisite for reducing health inequalities. People who miss multiple appointments are an under-researched group who might have substantial unmet health needs. Individual-level patterns of missed general practice appointments might thus provide a risk marker for vulnerability and poor health outcomes. We sought to ascertain the contributions of patient and practice factors to the likelihood of missing general practice appointments. Methods: For this national retrospective cohort analysis, we extracted UK National Health Service general practice data that were routinely collected across Scotland between Sept 5, 2013, and Sept 5, 2016. We calculated the per-patient number of missed appointments from individual appointments and investigated the risk of missing a general practice appointment using a negative binomial model offset by number of appointments made. We then analysed the effect of patient-level factors (including age, sex, and socioeconomic status and practice-level factors (including appointment availability and geographical location on the risk of missing appointments. Findings: The full dataset included information from 909 073 patients, of whom 550 083 were included in the analysis after processing. We observed that 104 461 (19·0% patients missed more than two appointments in the 3 year study period. After controlling for the number of appointments made, patterns of non-attendance could be differentiated, with patients who were aged 16–30 years (relative risk ratio [RRR] 1·21, 95% CI 1·19–1·23 or older than 90 years (2·20, 2·09–2·29, and of low socioeconomic status (Scottish Index of Multiple Deprivation decile 1: RRR 2·27, 2·22–2·31 significantly more likely to miss multiple appointments. Men missed fewer appointments overall than women, but were somewhat more likely to miss appointments

  10. Whooping Cough (Pertussis) - Fact Sheet for Parents

    ... months 4 through 6 years Fact Sheet for Parents Color [2 pages] Español: Tosferina (pertussis) The best ... according to the recommended schedule. Fact Sheets for Parents Diseases and the Vaccines that Prevent Them Chickenpox ...

  11. Ethnic variations in incidence of asthma episodes in England & Wales: national study of 502,482 patients in primary care.

    Netuveli, Gopalakrishnan; Hurwitz, Brian; Sheikh, Aziz

    2005-10-21

    Recent studies have demonstrated marked international variations in the prevalence of asthma, but less is known about ethnic variations in asthma epidemiology within individual countries and in particular the impact of migration on risk of developing asthma. Recent within country comparisons have however revealed that despite originating from areas of the world with a low risk for developing asthma, South Asian and Afro-Caribbean people in the UK are significantly (3x and 2x respectively) more likely to be admitted to hospital for asthma related problems than Whites. Using data from the Fourth National Study of Morbidity Statistics in General Practice, a one-percent broadly representative prospective cohort study of consultations in general practice, we investigated ethnic variations in incident asthma consultations (defined as new or first consultations), and compared consultation rates between those born inside and outside the UK (migrant status). Logistic regression models were used to examine the combined effects of ethnicity and migration on asthma incident consultations. Results showed significantly lower new/first asthma consultation rates for Whites than for each of the ethnic minority groups studied (mean age-adjusted consultation rates per 1000 patient-years: Whites 26.4 (95%CI 26.4, 26.4); South Asians 30.4 (95%CI 30.3, 30.5); Afro-Caribbeans 35.1 (95%CI 34.9, 35.3); and Others 27.8 (27.7, 28.0). Within each of these ethnic groups, those born outside of the UK showed consistently lower rates of incident asthma consultations. Modelling the combined effects of ethnic and migrant status revealed that UK-born South Asians and Afro-Caribbeans experienced comparable risks for incident GP consultations for asthma to UK-born Whites. Non-UK born Whites however experienced reduced risks (adjusted OR 0.82, 95%CI 0.69, 0.97) whilst non-UK born South Asians experienced increased risks (adjusted OR 1.33, 95%CI 1.04, 1.70) compared to UK-born Whites. These findings

  12. Estimating primary care attendance rates for fever in infants after meningococcal B vaccination in England using national syndromic surveillance data.

    Harcourt, Sally; Morbey, Roger A; Bates, Chris; Carter, Helen; Ladhani, Shamez N; de Lusignan, Simon; Smith, Gillian E; Elliot, Alex J

    2018-01-25

    In September 2015, the United Kingdom became the first country to introduce the multicomponent group B meningococcal vaccine (4CMenB) into a national infant immunisation programme. In early clinical trials 51-61% of infants developed a fever when 4CMenB was administered with other routine vaccines. Whilst administration of prophylactic paracetamol is advised, up to 3% of parents may seek medical advice for fever following vaccination. We used research-level general practitioner consultations to identify any increase in attendances for all-cause fever in vaccine-eligible infants following 4CMenB introduction in England. Consultations for infant all-cause fever in the year following the vaccine introduction were identified from The Phoenix Partnership (TPP) ResearchOne general practice database using Read (CTV3) codes. Average daily consultation rates and incidence rate ratios (IRRs) were calculated for vaccine-eligible age groups and compared to the two years preceding vaccine introduction. The difference between pre- and post-vaccine all-cause fever consultations was estimated. All-cause fever consultations in vaccine-eligible 7-10 week olds were 1.6-fold higher (IRR, 1.58; 95% CI, 1.22-2.05) compared to the two previous years and 1.5-fold higher (IRR 1.47; 95% CI, 1.17-1.86) in 15-18 week-olds. There were no significant differences in 0-6 or 11-14 week-olds. Applying the difference between pre- and post-vaccine consultation rates to the 4CMenB vaccine-eligible age groups across England estimated 1825 additional fever consultations in the year following 4CMenB introduction. We found a small but significant difference in all-cause fever consultation rates in vaccine-eligible infants who would have received 4CMenB with other vaccines. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  13. Second primary cancers after adjuvant radiotherapy in early breast cancer patients: A national population based study under the Danish Breast Cancer Cooperative Group (DBCG)

    Grantzau, Trine; Mellemkjær, Lene; Overgaard, Jens

    2013-01-01

    Background and purpose: To analyze the long-term risk of second primary solid non-breast cancer in a national population-based cohort of 46,176 patients treated for early breast cancer between 1982 and 2007. Patients and methods: All patients studied were treated according to the national guidelines of the Danish Breast Cancer Cooperative Group. The risk of second primary cancers was estimated by Standardised incidence ratios (SIRs) and multivariate Cox regression models were used to estimate adjusted hazard ratios (HR) among irradiated women compared to non-irradiated. All irradiated patients were treated on linear accelerators. Second cancers were a priori categorized into two groups; radiotherapy-associated- (oesophagus, lung, heart/mediastinum, pleura, bones, and connective tissue) and non-radiotherapy-associated sites (all other cancers). Results: 2358 second cancers had occurred during the follow-up. For the radiotherapy-associated sites the HR among irradiated women was 1.34 (95% CI 1.11–1.61) with significantly increased HRs for the time periods of 10–14 years (HR 1.55; 95% CI 1.08–2.24) and ⩾15 years after treatment (HR 1.79; 95% CI 1.14–2.81). There was no increased risk for the non-radiotherapy-associated sites (HR 1.04; 95% CI 0.94–1.1). The estimated attributable risk related to radiotherapy for the radiotherapy-associated sites translates into one radiation-induced second cancer in every 200 women treated with radiotherapy. Conclusions: Radiotherapy treated breast cancer patients have a small but significantly excess risk of second cancers

  14. The Impact of the National Essential Medicines Policy on Rational Drug Use in Primary Care Institutions in Jiangsu Province of China.

    Chao, Jianqian; Gu, Jiangyi; Zhang, Hua; Chen, Huanghui; Wu, Zhenchun

    2018-01-01

    Essential medicine policy is a successful global health policy to promote rational drug use. The aim of this study was to evaluate the impact of the National Essential Medicines Policy (NEMP) on the rational drug use in primary care institutions in Jiangsu Province of China. In this exploratory study, a multistage, stratified, random sampling was used to select 3400 prescriptions from 17 primary care institutions who implemented the NEMP before (Jan 2010) and after the implementation of the NEMP (Jan 2014). The analyses were performed in SPSS 18.0 and SPSS Clementine client. After the implementation of the NEMP, the percentage of prescribed EML (Essential Medicines List) drugs rose significantly, the average number of drugs per prescription and average cost per prescription were declined significantly, while the differences of the prescription proportion of antibiotics and injection were not statistically significant. BP (Back Propagation) neural network analysis showed that the average number of drugs per prescription, the number of using antibiotics and hormone, regional differences, size of institutions, sponsorship, financial income of institutions, doctor degree, outpatient and emergency visits person times were important factors affecting the prescription costs, among these the average number of drugs per prescription has the greatest effect. The NEMP can promote the rational use of drugs in some degree, but its role is limited. We should not focus only on the EML but also make comprehensive NEMP.

  15. Genetics in primary health care and the National Policy on Comprehensive Care for People with Rare Diseases in Brazil: opportunities and challenges for professional education.

    Melo, Débora Gusmão; de Paula, Pamela Karen; de Araujo Rodrigues, Stephania; da Silva de Avó, Lucimar Retto; Germano, Carla Maria Ramos; Demarzo, Marcelo Marcos Piva

    2015-07-01

    As discoveries regarding the genetic contribution to disease have grown rapidly, health care professionals are expected to incorporate genetic and genomic perspectives into health education and practice. Genetic competencies common to all health professionals have been identified by the US National Coalition for Health Professional Education in Genetics (NCHPEG), which defined the knowledge, skills, and attitudes required to achieve these competencies. The aim of this study is to analyze genetic competencies of primary health care professionals in Brazil. It is a descriptive survey study, whereby doctors, nurses, and dentists were invited to participate by answering a questionnaire including 11 issues based on competencies established by the NCHPEG. Data were presented as percentages. Differences between groups of participants were assessed by the Fisher exact test, with the level of significance set at p < 0.05. Results showed that concerning knowledge, about 80 % of the participants recognized basic genetics terminology, but practitioners had difficulty in identifying patterns of inheritance. Regarding clinical skills, practitioners were able to recognize facial dysmorphias and identify situations where referral of patients to specialists was necessary. Nevertheless, there were challenges in the process of valuing and gathering information about family history. Regarding attitudes, 68.9 % of the participants thought about the comprehensiveness of care but faced challenges in counselling parents. The results of this study may contribute to developing an ongoing education program for primary health care professionals, leading to a strategy to overcome the challenges of including genetics in the Brazilian Unified Health System.

  16. 21 CFR 880.5180 - Burn sheet.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Burn sheet. 880.5180 Section 880.5180 Food and... Burn sheet. (a) Identification. A burn sheet is a device made of a porous material that is wrapped aroung a burn victim to retain body heat, to absorb wound exudate, and to serve as a barrier against...

  17. Manifold free multiple sheet superplastic forming

    Elmer, John W.; Bridges, Robert L.

    2004-01-13

    Fluid-forming compositions in a container attached to enclosed adjacent sheets are heated to relatively high temperatures to generate fluids (gases) that effect inflation of the sheets. Fluid rates to the enclosed space between the sheets can be regulated by the canal from the container. Inflated articles can be produced by a continuous, rather than batch-type, process.

  18. On the possible eigenoscillations of neutral sheets

    Almeida, W.A.; Costa, J.M. da; Aruquipa, E.G.; Sudano, J.P.

    1974-12-01

    A neutral sheet model with hyperbolic tangent equilibrium magnetic field and hyperbolic square secant density profiles is considered. It is shown that the equation for small oscillations takes the form of an eigenvalue oscillation problem. Computed eigenfrequencies of the geomagnetic neutral sheet were found to be in the range of the resonant frequencies of the geomagnetic plasma sheet computed by other authors

  19. Formation and interpretation of eskers beneath retreating ice sheets

    Creyts, T. T.; Hewitt, I.

    2017-12-01

    The retreat of the ice sheets during the Pleistocene left large and spectacular subglacial features exposed. Understanding these features gives us insight into how the ice sheets retreated, how meltwater influenced retreat, and can help inform our understanding of potential future rates of ice sheet retreat. Among these features, eskers, long sinuous ridges primarily composed of clastic sediments, lack a detailed explanation of how surface melt rates and ice sheet retreat rates influence their growth and spatial distribution. Here, we develop a theory for esker formation based on the initial work of Rothlisberger modified for sediment transport and inclusion of surface meltwater forcing. The primary subglacial ingredients include water flow through subglacial tunnels with the addition of mass balances for sediment transport. We show how eskers when water flow slows below a critical stress for sediment motion. This implies that eskers are deposited in a localized region near the snout of the ice sheet. Our findings suggest that very long eskers form sequentially as the ice front retreats. The position of the esker follows the path of the channel mouth through time, which does not necessarily coincide with the instantaneous route of the feeding channel. However, in most cases, we expect those locations to be similar. The role of surface meltwater and the climatology associated with the forcing is crucial to the lateral spacing of the eskers. We predict that high surface melt rates lead to narrower catchments but that the greater extent of the ablation area means that channels are likely larger. At the same time, for a given channel size (and hence sediment flux), the size of a deposited esker depends on a margin retreat rate. Hence, the size of the eskers is related delicately to the balance between surface melt rates and margin retreat rates. We discuss how our theory can be combined with observed esker distributions to infer the relationship between these two rates

  20. Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

    Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

    2018-04-10

    In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or

  1. Geometry of thin liquid sheet flows

    Chubb, Donald L.; Calfo, Frederick D.; Mcconley, Marc W.; Mcmaster, Matthew S.; Afjeh, Abdollah A.

    1994-01-01

    Incompresible, thin sheet flows have been of research interest for many years. Those studies were mainly concerned with the stability of the flow in a surrounding gas. Squire was the first to carry out a linear, invicid stability analysis of sheet flow in air and compare the results with experiment. Dombrowski and Fraser did an experimental study of the disintegration of sheet flows using several viscous liquids. They also detected the formulation of holes in their sheet flows. Hagerty and Shea carried out an inviscid stability analysis and calculated growth rates with experimental values. They compared their calculated growth rates with experimental values. Taylor studied extensively the stability of thin liquid sheets both theoretically and experimentally. He showed that thin sheets in a vacuum are stable. Brown experimentally investigated thin liquid sheet flows as a method of application of thin films. Clark and Dumbrowski carried out second-order stability analysis for invicid sheet flows. Lin introduced viscosity into the linear stability analysis of thin sheet flows in a vacuum. Mansour and Chigier conducted an experimental study of the breakup of a sheet flow surrounded by high-speed air. Lin et al. did a linear stability analysis that included viscosity and a surrounding gas. Rangel and Sirignano carried out both a linear and nonlinear invisid stability analysis that applies for any density ratio between the sheet liquid and the surrounding gas. Now there is renewed interest in sheet flows because of their possible application as low mass radiating surfaces. The objective of this study is to investigate the fluid dynamics of sheet flows that are of interest for a space radiator system. Analytical expressions that govern the sheet geometry are compared with experimental results. Since a space radiator will operate in a vacuum, the analysis does not include any drag force on the sheet flow.

  2. Ice sheet hydrology from observations

    Jansson, Peter [Dept. of Physical Geography and Quaternary Geology, Stockholm Univ-, Stockholm (Sweden)

    2010-11-15

    The hydrological systems of ice sheets are complex. Our view of the system is split, largely due to the complexity of observing the systems. Our basic knowledge of processes have been obtained from smaller glaciers and although applicable in general to the larger scales of the ice sheets, ice sheets contain features not observable on smaller glaciers due to their size. The generation of water on the ice sheet surface is well understood and can be satisfactorily modeled. The routing of water from the surface down through the ice is not complicated in terms of procat has been problematic is the way in which the couplings between surface and bed has been accomplished through a kilometer of cold ice, but with the studies on crack propagation and lake drainage on Greenland we are beginning to understand also this process and we know water can be routed through thick cold ice. Water generation at the bed is also well understood but the main problem preventing realistic estimates of water generation is lack of detailed information about geothermal heat fluxes and their geographical distribution beneath the ice. Although some average value for geothermal heat flux may suffice, for many purposes it is important that such values are not applied to sub-regions of significantly higher fluxes. Water generated by geothermal heat constitutes a constant supply and will likely maintain a steady system beneath the ice sheet. Such a system may include subglacial lakes as steady features and reconfiguration of the system is tied to time scales on which the ice sheet geometry changes so as to change pressure gradients in the basal system itself. Large scale re-organization of subglacial drainage systems have been observed beneath ice streams. The stability of an entirely subglacially fed drainage system may hence be perturbed by rapid ice flow. In the case of Antarctic ice streams where such behavior has been observed, the ice streams are underlain by deformable sediments. It is

  3. Periodic folding of viscous sheets

    Ribe, Neil M.

    2003-09-01

    The periodic folding of a sheet of viscous fluid falling upon a rigid surface is a common fluid mechanical instability that occurs in contexts ranging from food processing to geophysics. Asymptotic thin-layer equations for the combined stretching-bending deformation of a two-dimensional sheet are solved numerically to determine the folding frequency as a function of the sheet’s initial thickness, the pouring speed, the height of fall, and the fluid properties. As the buoyancy increases, the system bifurcates from “forced” folding driven kinematically by fluid extrusion to “free” folding in which viscous resistance to bending is balanced by buoyancy. The systematics of the numerically predicted folding frequency are in good agreement with laboratory experiments.

  4. Ice sheet hydrology from observations

    Jansson, Peter

    2010-11-01

    The hydrological systems of ice sheets are complex. Our view of the system is split, largely due to the complexity of observing the systems. Our basic knowledge of processes have been obtained from smaller glaciers and although applicable in general to the larger scales of the ice sheets, ice sheets contain features not observable on smaller glaciers due to their size. The generation of water on the ice sheet surface is well understood and can be satisfactorily modeled. The routing of water from the surface down through the ice is not complicated in terms of procat has been problematic is the way in which the couplings between surface and bed has been accomplished through a kilometer of cold ice, but with the studies on crack propagation and lake drainage on Greenland we are beginning to understand also this process and we know water can be routed through thick cold ice. Water generation at the bed is also well understood but the main problem preventing realistic estimates of water generation is lack of detailed information about geothermal heat fluxes and their geographical distribution beneath the ice. Although some average value for geothermal heat flux may suffice, for many purposes it is important that such values are not applied to sub-regions of significantly higher fluxes. Water generated by geothermal heat constitutes a constant supply and will likely maintain a steady system beneath the ice sheet. Such a system may include subglacial lakes as steady features and reconfiguration of the system is tied to time scales on which the ice sheet geometry changes so as to change pressure gradients in the basal system itself. Large scale re-organization of subglacial drainage systems have been observed beneath ice streams. The stability of an entirely subglacially fed drainage system may hence be perturbed by rapid ice flow. In the case of Antarctic ice streams where such behavior has been observed, the ice streams are underlain by deformable sediments. It is

  5. Load Test in Sheet Pile

    Luis Orlando Ibanez

    2016-01-01

    In this work, are discussed experiences in the use of mathematical modeling and testing in hydraulic engineering structures. For this purpose the results of load tests in sheet pile, evaluating horizontal and vertical deformations that occur in the same exposed. Comparisons between theoretical methods for calculating deformations and mathematical models based on the Finite Element Method are established. Finally, the coincidence between the numerical model and the results of the load test ful...

  6. Ohm's law for a current sheet

    Lyons, L. R.; Speiser, T. W.

    1985-01-01

    The paper derives an Ohm's law for single-particle motion in a current sheet, where the magnetic field reverses in direction across the sheet. The result is considerably different from the resistive Ohm's law often used in MHD studies of the geomagnetic tail. Single-particle analysis is extended to obtain a self-consistency relation for a current sheet which agrees with previous results. The results are applicable to the concept of reconnection in that the electric field parallel to the current is obtained for a one-dimensional current sheet with constant normal magnetic field. Dissipated energy goes directly into accelerating particles within the current sheet.

  7. Ice Sheet Model Intercomparison Project (ISMIP6) Contribution to CMIP6

    Nowicki, Sophie M. J.; Payne, Tony; Larour, Eric; Seroussi, Helene; Goelzer, Heiko; Lipscomb, William; Gregory, Jonathan; Abe-Ouchi, Ayako; Shepherd, Andrew

    2016-01-01

    Reducing the uncertainty in the past, present, and future contribution of ice sheets to sea-level change requires a coordinated effort between the climate and glaciology communities. The Ice Sheet Model Intercomparison Project for CMIP6 (ISMIP6) is the primary activity within the Coupled Model Intercomparison Project phase 6 (CMIP6) focusing on the Greenland and Antarctic ice sheets. In this paper, we describe the framework for ISMIP6 and its relationship with other activities within CMIP6. The ISMIP6 experimental design relies on CMIP6 climate models and includes, for the first time within CMIP, coupled ice-sheetclimate models as well as standalone ice-sheet models. To facilitate analysis of the multi-model ensemble and to generate a set of standard climate inputs for standalone ice-sheet models, ISMIP6 defines a protocol for all variables related to ice sheets. ISMIP6 will provide a basis for investigating the feedbacks, impacts, and sea-level changes associated with dynamic ice sheets and for quantifying the uncertainty in ice-sheet-sourced global sea-level change.

  8. Experimental formability analysis of bondal sandwich sheet

    Kami, Abdolvahed; Banabic, Dorel

    2018-05-01

    Metal/polymer/metal sandwich sheets have recently attracted the interests of industries like automotive industry. These sandwich sheets have superior properties over single-layer metallic sheets including good sound and vibration damping and light weight. However, the formability of these sandwich sheets should be enhanced which requires more research. In this paper, the formability of Bondal sheet (DC06/viscoelastic polymer/DC06 sandwich sheet) was studied through different types of experiments. The mechanical properties of Bondal were determined by uniaxial tensile tests. Hemispherical punch stretching and hydraulic bulge tests were carried out to determine the forming limit diagram (FLD) of Bondal. Furthermore, cylindrical and square cup drawing tests were performed in dry and oil lubricated conditions. These tests were conducted at different blank holding forces (BHFs). An interesting observation about Bondal sheet deep drawing was obtaining of higher drawing depths at dry condition in comparison with oil-lubricated condition.

  9. Buckling and stretching of thin viscous sheets

    O'Kiely, Doireann; Breward, Chris; Griffiths, Ian; Howell, Peter; Lange, Ulrich

    2016-11-01

    Thin glass sheets are used in smartphone, battery and semiconductor technology, and may be manufactured by producing a relatively thick glass slab and subsequently redrawing it to a required thickness. The resulting sheets commonly possess undesired centerline ripples and thick edges. We present a mathematical model in which a viscous sheet undergoes redraw in the direction of gravity, and show that, in a sufficiently strong gravitational field, buckling is driven by compression in a region near the bottom of the sheet, and limited by viscous resistance to stretching of the sheet. We use asymptotic analysis in the thin-sheet, low-Reynolds-number limit to determine the centerline profile and growth rate of such a viscous sheet.

  10. Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

    Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

    2016-09-05

    In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among

  11. Catalog of CERCLA applicable or relevant and appropriate requirements (ARARs) - fact sheets

    1990-07-01

    Section 121(d) of the Comprehensive Environmental Response Compensation and Liability Act (CERCLA) as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA), requires attainment of federal and state applicable or relevant and appropriate requirements (ARARs). Subpart E, Section 300.400(g) {open_quotes}Identification of applicable or relevant and appropriate requirements{close_quotes} of the National Oil and Hazardous Substances Pollution Contingency Plan (NCP)(55 FR 8666, March 8, 1990) describes the process for attaining ARARs. The purpose of this catalog is to provide DOE Program Offices and Field Organizations with all of the {open_quotes}Quick Reference Fact Sheets{close_quotes} on attaining ARARS. These fact sheets provide overviews of ARARs for CERCLA cleanup actions pertinent to DOE environmental restoration activities. All of the fact sheets in this catalog were prepared by the Environmental Protection Agency`s Office of Solid Waste and Emergency Response. Fact sheets 1-7 discuss land disposal restrictions (LDRs) and their applicability. LDRs may pertain to a number of CERCLA response actions at DOE facilities. Fact Sheets 8-13 are based on the CERCLA Compliance with Other Laws Manual: Parts I and II and provide an overview of many other CERCLA ARARs. Overview of ARARs-Focus on ARAR Waivers (fact sheet 11), provides a good introduction to ARARS. The last two fact sheets, 14 and 15, are periodic reports that describe additional fact sheets and clarify issues.

  12. Fact Sheets and Questions and Answers for the Final Air Toxics Rules for the Aerospace Manufacturing and Rework Industry

    This page contains the July 1995 final rule fact sheet and the January 2015 proposed rule fact sheet that contains information on the National Emission Standards for Aerospace Manufacturing and Rework Facilities, as well as a 2001 Q&A document on the rule

  13. Inquiry-Based Science Education Competencies of Primary School Teachers: A literature study and critical review of the American National Science Education Standards

    Alake-Tuenter, Ester; Biemans, Harm J. A.; Tobi, Hilde; Wals, Arjen E. J.; Oosterheert, Ida; Mulder, Martin

    2012-11-01

    Inquiry-based science education is an important innovation. Researchers and teachers consider it to be stimulating for pupils' application of research skills, construction of meaning and acquiring scientific knowledge. However, there is ambiguity as to what competencies are required to teach inquiry-based science. Our purpose is to develop a profile of professional competence, required for effective inquiry-based science teaching in primary schools in the Netherlands. This article reviews literature and compares the outcomes to the American National Science Education Standards (NSES). In so doing, it seeks to answer the following research questions: What elements of competencies required by primary school teachers who teach inquiry-based science are mentioned, discussed and researched in recent literature? To what extent are the American NSES (introduced 15 years ago) consistent with elements of competencies found in recent literature? A comprehensive literature review was conducted using Educational Resources Information Centre and Google Scholar databases. Fifty-seven peer-reviewed scientific journal articles from 2004 to 2011 were found using keyword combinations. Analysis of these articles resulted in the identification and classification of 22 elements of competencies. This outcome was compared to the American NSES, revealing gaps in the standards with respect to a lack of focus on how teachers view science teaching and themselves as teachers. We also found that elements of competencies are connected and poor mastery of one may affect a teacher's mastery of another. Therefore, we propose that standards for the Netherlands should be presented in a non-linear, holistic, competence-based model.

  14. Urban-rural inequality regarding drug prescriptions in primary care facilities - a pre-post comparison of the National Essential Medicines Scheme of China.

    Yao, Qiang; Liu, Chaojie; Ferrier, J Adamm; Liu, Zhiyong; Sun, Ju

    2015-07-30

    To assess the impact of the National Essential Medicines Scheme (NEMS) with respect to urban-rural inequalities regarding drug prescriptions in primary care facilities. A stratified two-stage random sampling strategy was used to sample 23,040 prescriptions from 192 primary care facilities from 2009 to 2010. Difference-in-Difference (DID) analyses were performed to test the association between NEMS and urban-rural gaps in prescription patterns. Between-Group Variance and Theil Index were calculated to measure urban-rural absolute and relative disparities in drug prescriptions. The use of the Essential Medicines List (EML) achieved a compliance rate of up to 90% in both urban and rural facilities. An overall reduction of average prescription cost improved economic access to drugs for patients in both areas. However, we observed an increased urban-rural disparity in average expenditure per prescription. The rate of antibiotics and glucocorticoids prescription remained high, despite a reduced disparity between urban and rural facilities. The average incidence of antibiotic prescription increased slightly in urban facilities (62 to 63%) and reduced in rural facilities (67% to 66%). The urban-rural disparity in the use of parenteral administration (injections and infusions) increased, albeit at a high level in both areas (44%-52%). NEMS interventions are effective in reducing the overall average prescription costs. Despite the increased use of the EML, indicator performances with respect to rational drug prescribing and use remain poor and exceed the WHO/INRUD recommended cutoff values and worldwide benchmarks. There is an increased gap between urban and rural areas in the use of parenteral administration and expenditure per prescription.

  15. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Alhassan, Robert Kaba; Duku, Stephen Opoku; Janssens, Wendy; Nketiah-Amponsah, Edward; Spieker, Nicole; van Ostenberg, Paul; Arhinful, Daniel Kojo; Pradhan, Menno; Rinke de Wit, Tobias F

    2015-01-01

    Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, pquality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in NHIS-accredited health facilities. There is the need to intensify client education and balanced

  16. Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: A national cross-sectional study.

    Alameddine, Mohamad; Baroud, Maysa; Kharroubi, Samer; Hamadeh, Randa; Ammar, Walid; Shoaib, Hikma; Khodr, Hiba

    2017-11-01

    Low job satisfaction is linked to higher staff turnover and intensified shortages in healthcare providers (HCP). This study investigates the level of, and factors associated with, HCP job satisfaction in the national primary healthcare (PHC) network in Lebanon. The study adopts a cross-sectional design to survey HCP at 99 PHC centres distributed across the country between October 2013 and May 2014. The study questionnaire consisted of four sections: socio-demographics/professional background, employment characteristics, level of job satisfaction (Measure of Job Satisfaction scale) and level of professional burnout (Maslach Burnout Inventory-HSS scale). A total of 1,000 providers completed the questionnaire (75.8% response rate). Bivariate and multivariate regression analyses were used to identify factors significantly associated with job satisfaction. Findings of the study highlight an overall mean job satisfaction score of 3.59 (SD 0.54) indicating that HCP are partially satisfied. Upon further examination, HCP were least satisfied with pay, training and job prospects. Gender, age, career plans, salary, exposure to violence, and level of burnout were significantly associated with the overall level of job satisfaction which was also associated with increased likelihood to quit. Overall, the study highlights how compensation, development and protection of PHC HCP can influence their job satisfaction. Recommendations include the necessity of developing a nationally representative committee, led by the Ministry of Public Health, to examine the policies and remuneration scales within the PHC sector and suggest mechanisms to bridge the pay differential with other sectors. The effective engagement of key stakeholders with the development, organisation and evaluation of professional development programmes offered to HCP in the PHC sector remains crucial. Concerned stakeholders should assess and formulate initiatives and programmes that enrich the physical, psychological

  17. Strontium-90 fluoride data sheet

    Fullam, H.T.

    1981-06-01

    This report is a compilation of available data and appropriate literature references on the properties of strontium-90 fluoride and nonradioactive strontium fluoride. The objective of the document is to compile in a single source pertinent data to assist potential users in the development, licensing, and use of /sup 90/SrF/sub 2/-fueled radioisotope heat sources for terrestrial power conversion and thermal applications. The report is an update of the Strontium-90 Fluoride Data Sheet (BNWL-2284) originally issued in April 1977.

  18. Vietnamese Hurricane Response Fact Sheets

    Các tờ dữ kiện được cung cấp nơi đây mô tả vai trò của EPA trong việc đáp ứng với bão và cách các chương trình cụ thể cung cấp sự hỗ trợ. The Vietnamese fact sheets provided here describe EPA's role in a hurricane response.

  19. Associations between socioeconomic status and primary total knee joint replacements performed for osteoarthritis across Australia 2003-10: data from the Australian Orthopaedic Association National Joint Replacement Registry.

    Brennan, Sharon L; Lane, Stephen E; Lorimer, Michelle; Buchbinder, Rachelle; Wluka, Anita E; Page, Richard S; Osborne, Richard H; Pasco, Julie A; Sanders, Kerrie M; Cashman, Kara; Ebeling, Peter R; Graves, Stephen E

    2014-10-28

    Relatively little is known about the social distribution of total knee joint replacement (TKR) uptake in Australia. We examine associations between socioeconomic status (SES) and TKR performed for diagnosed osteoarthritis 2003-10 for all Australian males and females aged ≥ 30 yr. Data of primary TKR (n=213,018, 57.4% female) were ascertained from a comprehensive national joint replacement registry. Residential addresses were matched to Australian Census data to identify area-level social disadvantage, and categorised into deciles. Estimated TKR rates were calculated. Poisson regression was used to model the relative risk (RR) of age-adjusted TKR per 1,000py, stratified by sex and SES. A negative relationship was observed between TKR rates and SES deciles. Females had a greater rate of TKR than males. Surgery utilisation was greatest for all adults aged 70-79 yr. In that age group differences in estimated TKR per 1,000py between deciles were greater for 2010 than 2003 (females: 2010 RR 4.32 and 2003 RR 3.67; males: 2010 RR 2.04 and 2003 RR 1.78). Identifying factors associated with TKR utilisation and SES may enhance resource planning and promote surgery utilisation for end-stage osteoarthritis.

  20. Cryosphere Science Outreach using the Ice Sheet System Model and a Virtual Ice Sheet Laboratory

    Cheng, D. L. C.; Halkides, D. J.; Larour, E. Y.

    2015-12-01

    Understanding the role of Cryosphere Science within the larger context of Sea Level Rise is both a technical and educational challenge that needs to be addressed if the public at large is to trulyunderstand the implications and consequences of Climate Change. Within this context, we propose a new approach in which scientific tools are used directly inside a mobile/website platform geared towards Education/Outreach. Here, we apply this approach by using the Ice Sheet System Model, a state of the art Cryosphere model developed at NASA, and integrated within a Virtual Ice Sheet Laboratory, with the goal is to outreach Cryospherescience to K-12 and College level students. The approach mixes laboratory experiments, interactive classes/lessons on a website, and a simplified interface to a full-fledged instance of ISSM to validate the classes/lessons. This novel approach leverages new insights from the Outreach/Educational community and the interest of new generations in web based technologies and simulation tools, all of it delivered in a seamlessly integrated web platform. This work was performed at the California Institute of Technology's Jet Propulsion Laboratory undera contract with the National Aeronautics and Space Administration's Cryosphere Science Program.

  1. AI applications in sheet metal forming

    Hussein, Hussein

    2017-01-01

    This book comprises chapters on research work done around the globe in the area of artificial intelligence (AI) applications in sheet metal forming. The first chapter offers an introduction to various AI techniques and sheet metal forming, while subsequent chapters describe traditional procedures/methods used in various sheet metal forming processes, and focus on the automation of those processes by means of AI techniques, such as KBS, ANN, GA, CBR, etc. Feature recognition and the manufacturability assessment of sheet metal parts, process planning, strip-layout design, selecting the type and size of die components, die modeling, and predicting die life are some of the most important aspects of sheet metal work. Traditionally, these activities are highly experience-based, tedious and time consuming. In response, researchers in several countries have applied various AI techniques to automate these activities, which are covered in this book. This book will be useful for engineers working in sheet metal industri...

  2. Dynamics of Radially Expanding Liquid Sheets

    Majumdar, Nayanika; Tirumkudulu, Mahesh S.

    2018-04-01

    The process of atomization often involves ejecting thin liquid sheets at high speeds from a nozzle that causes the sheet to flap violently and break up into fine droplets. The flapping of the liquid sheet has long been attributed to the sheet's interaction with the surrounding gas phase. Here, we present experimental evidence to the contrary and show that the flapping is caused by the thinning of the liquid sheet as it spreads out from the nozzle exit. The measured growth rates of the waves agree remarkably well with the predictions of a recent theory that accounts for the sheet's thinning but ignores aerodynamic interactions. We anticipate these results to not only lead to more accurate predictions of the final drop-size distribution but also enable more efficient designs of atomizers.

  3. Shape Optimization of Swimming Sheets

    Wilkening, J.; Hosoi, A.E.

    2005-03-01

    The swimming behavior of a flexible sheet which moves by propagating deformation waves along its body was first studied by G. I. Taylor in 1951. In addition to being of theoretical interest, this problem serves as a useful model of the locomotion of gastropods and various micro-organisms. Although the mechanics of swimming via wave propagation has been studied extensively, relatively little work has been done to define or describe optimal swimming by this mechanism.We carry out this objective for a sheet that is separated from a rigid substrate by a thin film of viscous Newtonian fluid. Using a lubrication approximation to model the dynamics, we derive the relevant Euler-Lagrange equations to optimize swimming speed and efficiency. The optimization equations are solved numerically using two different schemes: a limited memory BFGS method that uses cubic splines to represent the wave profile, and a multi-shooting Runge-Kutta approach that uses the Levenberg-Marquardt method to vary the parameters of the equations until the constraints are satisfied. The former approach is less efficient but generalizes nicely to the non-lubrication setting. For each optimization problem we obtain a one parameter family of solutions that becomes singular in a self-similar fashion as the parameter approaches a critical value. We explore the validity of the lubrication approximation near this singular limit by monitoring higher order corrections to the zeroth order theory and by comparing the results with finite element solutions of the full Stokes equations.

  4. Magnetic properties of sheet silicates

    Ballet, O.; Coey, J.M.D.

    1982-01-01

    Susceptibility, magnetisation and Moessbauer measurements are reported for a representative selection of 2:1 layer phyllosilicates. Eight samples from the mica, vermiculite and smectite groups include examples diluted in iron which are paramagnetic at all temperatures, as well as iron-rich silicates which order magnetically below 10 K. Anisotropic susceptibility of crystals of muscovite, biotite and vermiculite is quantitatively explained with a model where the Fe 2+ ions lie in sites of effective trigonal symmetry, the trigonal axis lying normal to the sheets. The ferrous ground state is an orbital singlet. Ferric iron gives an isotropic contribution to the susceptibility. Fe 2+ -Fe 2+ exchange interactions are ferromagnetic with Gapprox. equal to2 K, whereas Fe 3+ -Fe 3+ coupling is antiferromagnetic in the purely ferric minerals. A positive paramagnetic Curie temperature for glauconite may be attributable to Fe 2+ → Fe 3+ charge transfer. Magnetic order was found to set in inhomogeneously for glauconite at 1-7 K. One biotite sample showed an antiferromagnetic transition at Tsub(N) = 7 K marked by a well-defined susceptibility maximum. Its magnetic structure, consisting of ferromagnetic sheets with moments in their planes coupled antiferromagnetically by other, weak interactions, resembles that found earlier for the 1:1 mineral greenalite. (orig.)

  5. Weld Repair of Thin Aluminum Sheet

    Beuyukian, C. S.; Mitchell, M. J.

    1986-01-01

    Weld repairing of thin aluminum sheets now possible, using niobium shield and copper heat sinks. Refractory niobium shield protects aluminum adjacent to hole, while copper heat sinks help conduct heat away from repair site. Technique limits tungsten/inert-gas (TIG) welding bombardment zone to melt area, leaving surrounding areas around weld unaffected. Used successfully to repair aluminum cold plates on Space Shuttle, Commercial applications, especially in sealing fractures, dents, and holes in thin aluminum face sheets or clad brazing sheet in cold plates, heat exchangers, coolers, and Solar panels. While particularly suited to thin aluminum sheet, this process also used in thicker aluminum material to prevent surface damage near weld area.

  6. Predicting Pulsar Scintillation from Refractive Plasma Sheets

    Simard, Dana; Pen, Ue-Li

    2018-05-01

    The dynamic and secondary spectra of many pulsars show evidence for long-lived, aligned images of the pulsar that are stationary on a thin scattering sheet. One explanation for this phenomenon considers the effects of wave crests along sheets in the ionized interstellar medium, such as those due to Alfvén waves propagating along current sheets. If these sheets are closely aligned to our line-of-sight to the pulsar, high bending angles arise at the wave crests and a selection effect causes alignment of images produced at different crests, similar to grazing reflection off of a lake. Using geometric optics, we develop a simple parameterized model of these corrugated sheets that can be constrained with a single observation and that makes observable predictions for variations in the scintillation of the pulsar over time and frequency. This model reveals qualitative differences between lensing from overdense and underdense corrugated sheets: Only if the sheet is overdense compared to the surrounding interstellar medium can the lensed images be brighter than the line-of-sight image to the pulsar, and the faint lensed images are closer to the pulsar at higher frequencies if the sheet is underdense, but at lower frequencies if the sheet is overdense.

  7. Uncertainty Quantification for Ice Sheet Science and Sea Level Projections

    Boening, C.; Schlegel, N.; Limonadi, D.; Schodlok, M.; Seroussi, H. L.; Larour, E. Y.; Watkins, M. M.

    2017-12-01

    In order to better quantify uncertainties in global mean sea level rise projections and in particular upper bounds, we aim at systematically evaluating the contributions from ice sheets and potential for extreme sea level rise due to sudden ice mass loss. Here, we take advantage of established uncertainty quantification tools embedded within the Ice Sheet System Model (ISSM) as well as sensitivities to ice/ocean interactions using melt rates and melt potential derived from MITgcm/ECCO2. With the use of these tools, we conduct Monte-Carlo style sampling experiments on forward simulations of the Antarctic ice sheet, by varying internal parameters and boundary conditions of the system over both extreme and credible worst-case ranges. Uncertainty bounds for climate forcing are informed by CMIP5 ensemble precipitation and ice melt estimates for year 2100, and uncertainty bounds for ocean melt rates are derived from a suite of regional sensitivity experiments using MITgcm. Resulting statistics allow us to assess how regional uncertainty in various parameters affect model estimates of century-scale sea level rise projections. The results inform efforts to a) isolate the processes and inputs that are most responsible for determining ice sheet contribution to sea level; b) redefine uncertainty brackets for century-scale projections; and c) provide a prioritized list of measurements, along with quantitative information on spatial and temporal resolution, required for reducing uncertainty in future sea level rise projections. Results indicate that ice sheet mass loss is dependent on the spatial resolution of key boundary conditions - such as bedrock topography and melt rates at the ice-ocean interface. This work is performed at and supported by the California Institute of Technology's Jet Propulsion Laboratory. Supercomputing time is also supported through a contract with the National Aeronautics and Space Administration's Cryosphere program.

  8. Weatherization and Intergovernmental Programs Office Fact Sheet

    None

    2018-02-01

    One of the Department of Energy’s (DOE) primary forums for helping state and local governments implement costeffective and productive energy systems for American homes, communities, businesses, and industries is the Weatherization and Intergovernmental Programs Office (WIP). WIP is part of DOE’s Office of Energy Efficiency and Renewable Energy’s “all of the above” national energy strategy to create greater energy affordability, security and resiliency.

  9. Final Air Toxics Standards for Clay Ceramics Manufacturing, Glass Manufacturing, and Secondary Nonferrous Metals Processing Area Sources Fact Sheet

    This page contains a December 2007 fact sheet with information regarding the National Emissions Standards for Hazardous Air Pollutants (NESHAP) for Clay Ceramics Manufacturing, Glass Manufacturing, and Secondary Nonferrous Metals Processing Area Sources

  10. Accuracy of national key performance indicator reporting from two Aboriginal medical services: potential to underestimate the performance of primary health care.

    2017-05-09

    Objective The aim of the present study was to assess the accuracy of extracting national key performance indicator (nKPI) data for the Online Community Health Reporting Environment for Health Services (OCHREStreams) program using the Pen Computer Systems (Leichhardt, NSW, Australia) Clinical Audit Tool (CAT) from Communicare (Telstra Health Communicare Systems, Perth, WA, Australia), a commonly used patient information management system (PIMS) in Aboriginal primary care. Methods Two Aboriginal Community-Controlled Health Services (ACCHSs) were recruited to the present study. A sample of regular clients aged ≥55 years from each ACCHS was selected and a subset of 13 nKPIs was examined. A manual case note audit of the nKPI subset within Communicare was undertaken by a clinician at each participating ACCHS and acted as a 'gold standard' comparator for three query methods: (1) internal Communicare nKPI reports; (2) PenCS CAT nKPI manual filtering (a third-party data-extraction tool); and (3) nKPI data submitted to the Improvement Foundation qiConnect portal. Results No errors were found in nKPI data extraction from Communicare using the CAT and subsequent submission to the qiConnect portal. However, the Communicare internal nKPI report included deceased clients and past patients, and we can be very confident that deceased clients and past patients are also included in the qiConnect portal data. This resulted in inflation of client denominators and an underestimation of health service performance, particularly for nKPIs recording activity in the past 6 months. Several minor errors were also detected in Communicare internal nKPI reports. Conclusions CAT accurately extracts a subset of nKPI data from Communicare. However, given the widespread use of Communicare in ACCHSs, the inclusion of deceased clients and past patients in the OCHREStreams nKPI data program is likely to have resulted in systematic under-reporting of health service performance nationally. What is known

  11. The Role of National Adult Education Centre in Curriculum Development in Somalia in Selected Government Primary Adult Schools of Mogadisho. African Studies in Curriculum Development and Evaluation, No. 109.

    Bahar, Ismail F. S.

    A study of curriculum development in Somalia focused on the role of the National Adult Education Centre (NAEC) and involvement of teachers and inspectors. The sample consisted of 80 Mogadisho primary adult school teachers. Information sources were related literature, teacher questionnaires, and unstructured interviews with school inspectors,…

  12. Integration in primary community care networks (PCCNs: examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

    Lin Blossom Yen-Ju

    2007-06-01

    Full Text Available Abstract Background Taiwan's primary community care network (PCCN demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at

  13. Cost-effectiveness of a national exercise referral programme for primary care patients in Wales: results of a randomised controlled trial

    2013-01-01

    Background A recent HTA review concluded that there was a need for RCTs of exercise referral schemes (ERS) for people with a medical diagnosis who might benefit from exercise. Overall, there is still uncertainty as to the cost-effectiveness of ERS. Evaluation of public health interventions places challenges on conventional health economics approaches. This economic evaluation of a national public health intervention addresses this issue of where ERS may be most cost effective through subgroup analysis, particularly important at a time of financial constraint. Method This economic analysis included 798 individuals aged 16 and over (55% of the randomised controlled trial (RCT) sample) with coronary heart disease risk factors and/or mild to moderate anxiety, depression or stress. Individuals were referred by health professionals in a primary care setting to a 16 week national exercise referral scheme (NERS) delivered by qualified exercise professionals in local leisure centres in Wales, UK. Health-related quality of life, health care services use, costs per participant in NERS, and willingness to pay for NERS were measured at 6 and 12 months. Results The base case analysis assumed a participation cost of £385 per person per year, with a mean difference in QALYs between the two groups of 0.027. The incremental cost-effectiveness ratio was £12,111 per QALY gained. Probabilistic sensitivity analysis demonstrated an 89% probability of NERS being cost-effective at a payer threshold of £30,000 per QALY. When participant payments of £1 and £2 per session were considered, the cost per QALY fell from £12,111 (base case) to £10,926 and £9,741, respectively. Participants with a mental health risk factor alone or in combination with a risk of chronic heart disease generated a lower ICER (£10,276) compared to participants at risk of chronic heart disease only (£13,060). Conclusions Results of cost-effectiveness analyses suggest that NERS is cost saving in fully

  14. Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana.

    Robert Kaba Alhassan

    Full Text Available Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients' decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge.To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS in Ghana are also discussed.This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman's rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare.Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p<0.0001. Significant staff-client perception differences were found in all healthcare quality proxies, suggesting some level of unbalanced commitment to quality improvement and potential information asymmetry between clients and service providers. Overall, the findings suggest that increased efforts towards technical quality care alone will not necessarily translate into better client-perceived quality care and willingness to utilize health services in

  15. Tube sheet structural analysis of intermediate heat exchanger for fast breeder reactor 'Monju'

    Nakagawa, Y.; Ueno, T.; Fukuda, Y.; Ichimiya, M.

    1983-01-01

    The Prototype Fast Breeder Reactor 'Monju' is the first power generating fast breeder reactor in Japan. We have been designing the components of the plant for manufacturing. Among these is the intermediate heat exchanger (IHX) which exchanges heat between primary and secondary sodium loop. The tube sheet of IHX (shell to ligament junction) is a difficult area from the view point of structural strength design under elevated temperature. To validate the structural integrity of tube sheet we performed the series of inelastic analysis and tube sheet thermal shock test using test pieces and half scale model of actual design. The results of inelastic analyses showed there is little progressive deformation around shell to ligament structural discontinuous junction. Furthermore, thermal shock tests showed no increase of an accumulative deformation. By these analyses and experiments, structural reliability of tube sheet could be shown. (author)

  16. Knowledge and implementation of the National Malaria Control Programme among health-care workers in primary health-care centers in Ogun State, Nigeria

    Temitope Wunmi Ladi-Akinyemi

    2018-01-01

    Full Text Available Background: Lack of capacity to implement programs effectively and low public education about malaria is some of the factors that Nigeria governments must address to effectively combat malaria. Methods: This descriptive cross-sectional study assessed the knowledge and implementation of the National Malaria Control Programme (NMCP among health-care workers in the primary health-care centers in Ogun state. Three hundred and twenty-five respondents were recruited into the study using cluster sampling method. A pretested self-administered questionnaire was used to collect necessary information. Analysis and statistical calculation was done using SPSS version 20.0. Relationships between categorical variables were tested using Chi-square test with P value at 0.05. Results: One hundred and twenty-five (38.5% of the respondents were from Ado-odo/Ota local government areas (LGAs, 120 (36.9% of the respondents were from Ijebu-ode LGA and 80 (24.6% were from Ewekoro LGA. About 37.8% of the respondents were within age range of 45–54 years, with mean of 41.7 ± 8.5. Over 90% of the respondents knew the mode of transmission of malaria, <50% of them could identified case definition of simple and complicated malaria. Large percentage of the respondents knew the signs and symptoms of simple malaria. The respondents who were older (P = 0.004 with more than 15-year work experience (P = 0.006 had good knowledge score of the NMCP. Conclusion: Knowledge and implementation of NMCP by health-care workers in some of the LGAs in this study was inadequate. Regular visit to the health facilities, especially those in the remote areas by the staff of malaria control unit were recommended.

  17. Gender Differences in the Prevalence of Overweight and Obesity, Associated Behaviors, and Weight-related Perceptions in a National Survey of Primary School Children in China.

    Zhang, Juan; Zhai, Yi; Feng, Xiao Qi; Li, Wei Rong; Lyu, Yue Bin; Astell-Burt, Thomas; Zhao, Peng Yu; Shi, Xiao Ming

    2018-01-01

    To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio (OR) 2.30, 95% CI 2.00 to 2.65] and rural areas (OR = 1.85, 95% CI 1.55 to 2.20). Girls reported healthier diets (e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85) whereas boys consumed fried food (OR = 1.21, 95% CI 1.06 to 1.38) and sugar-sweetened drinks more often (OR = 1.49, 95% CI 1.34 to 1.65). Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers (OR = 1.35, 95% CI 1.09 to 1.68), less educated fathers (OR = 0.79, 95% CI 0.63 to 0.99), and if they frequently consumed carbonated drinks (OR = 1.48, 95% CI 1.07 to 2.05). Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls. Copyright © 2018 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  18. Use of Fibrates Monotherapy in People with Diabetes and High Cardiovascular Risk in Primary Care: A French Nationwide Cohort Study Based on National Administrative Databases.

    Ronan Roussel

    Full Text Available According to guidelines, diabetic patients with high cardiovascular risk should receive a statin. Despite this consensus, fibrate monotherapy is commonly used in this population. We assessed the frequency and clinical consequences of the use of fibrates for primary prevention in patients with diabetes and high cardiovascular risk.Retrospective cohort study based on nationwide data from the medical and administrative databases of French national health insurance systems (07/01/08-12/31/09 with a follow-up of up to 30 months.Lipid-lowering drug-naive diabetic patients initiating fibrate or statin monotherapy were identified. Patients at high cardiovascular risk were then selected: patients with a diagnosis of diabetes and hypertension, and > 50 (men or 60 (women, but with no history of cardiovascular events. The composite endpoint comprised myocardial infarction, stroke, amputation, or death.Of the 31,652 patients enrolled, 4,058 (12.8% received a fibrate. Age- and gender-adjusted annual event rates were 2.42% (fibrates and 2.21% (statins. The proportionality assumption required for the Cox model was not met for the fibrate/statin variable. A multivariate model including all predictors was therefore calculated by dividing data into two time periods, allowing Hazard Ratios to be calculated before (HR 540 of follow-up. Multivariate analyses showed that fibrates were associated with an increased risk for the endpoint after 540 days: HR 540 = 1.73 (1.28-2.32.Fibrate monotherapy is commonly prescribed in diabetic patients with high cardiovascular risk and is associated with poorer outcomes compared to statin therapy.

  19. Buckling of Aluminium Sheet Components

    Hegadekatte, Vishwanath; Shi, Yihai; Nardini, Dubravko

    Wrinkling is one of the major defects in sheet metal forming processes. It may become a serious obstacle to implementing the forming process and assembling the parts, and may also play a significant role in the wear of the tool. Wrinkling is essentially a local buckling phenomenon that results from compressive stresses (compressive instability) e.g., in the hoop direction for axi-symmetric systems such as beverage cans. Modern beverage can is a highly engineered product with a complex geometry. Therefore in order to understand wrinkling in such a complex system, we have started by studying wrinkling with the Yoshida buckling test. Further, we have studied the buckling of ideal and dented beverage cans under axial loading by laboratory testing. We have modelled the laboratory tests and also the imperfection sensitivity of the two systems using finite element method and the predictions are in qualitative agreement with experimental data.

  20. Non-specific low back pain in primary care in the Spanish National Health Service: a prospective study on clinical outcomes and determinants of management

    Muriel Alfonso

    2006-05-01

    Full Text Available Abstract Background The Spanish National Health Service is a universal and free health care system. Non-specific low back pain (LBP is a prevalent disorder, generating large health and social costs. The objectives of this study were to describe its management in primary care, to assess patient characteristics that influence physicians' decisions, and to describe clinical outcome at 2 months. Methods A cross-sectional sample of 648 patients with non-specific low back pain was recruited by 75 physicians (out of 361 – 20.8% working in 40 primary care centers in 10 of the 17 administrative regions in Spain, covering 693,026 out of the 40,499,792 inhabitants. Patients were assessed on the day they were recruited, and prospectively followed-up 14 and 60 days later. The principal patient characteristics that were analyzed were: sex, duration of the episode, history of LBP, working status, severity of LBP, leg pain and disability, and results of straight leg raising test. Descriptors of management were: performance of the straight leg raising test, ordering of diagnostic procedures, prescription of drug treatment, referral to physical therapy, rehabilitation or surgery, and granting of sick leave. Regression analysis was used to analyze the relationship between patients' baseline characteristics and physicians' management decisions. Only workers were included in the models on sick leave. Results Mean age (SD of included patients was 46.5 (15.5 years, 367 (56.6% were workers, and 338 (52.5% were females. Median (25th–75th interquartile range duration of pain when entering the study was 4 (2–10 days and only 28 patients (4.3% had chronic low back pain. Diagnostic studies included plain radiographs in 43.1% of patients and CT or MRI scans in 18.8%. Drug medication was prescribed to 91.7% of patients, 19.1% were sent to physical therapy or rehabilitation, and 9.6% were referred to surgery. The main determinants of the clinical management were duration

  1. 46 CFR 232.4 - Balance sheet accounts.

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Balance sheet accounts. 232.4 Section 232.4 Shipping... ACTIVITIES UNIFORM FINANCIAL REPORTING REQUIREMENTS Balance Sheet § 232.4 Balance sheet accounts. (a.... (b) Purpose of balance sheet accounts. The balance sheet accounts are intended to disclose the...

  2. Photocatalytic perfermance of sandwich-like BiVO{sub 4} sheets by microwave assisted synthesis

    Liu, Suqin, E-mail: liusuqin888@126.com [Department of Chemical engineering and Food Science, Hubei University of arts and science, Xiangyang 441053 (China); Hubei Key Laboratory of Low Dimensional Optoelectronic Materials and Devices, Xiangyang 441053 (China); Tang, Huiling; Zhou, Huan [Department of Chemical engineering and Food Science, Hubei University of arts and science, Xiangyang 441053 (China); Dai, Gaopeng, E-mail: dgp2000@126.com [Department of Chemical engineering and Food Science, Hubei University of arts and science, Xiangyang 441053 (China); Wang, Wanqiang [Department of Chemical engineering and Food Science, Hubei University of arts and science, Xiangyang 441053 (China)

    2017-01-01

    Graphical abstract: Sandwich-like BiVO{sub 4} sheets were successfully synthesized via a facile microwave-assisted method. The as-prepared samples exhibit a high activity for the degradation of methyl orange under visible light irradiation. - Highlights: • Sandwich-like BiVO{sub 4} sheets were synthesized by a facile microwave-assisted method. • The presence of PEG-10000 plays a critical role in the formation of BiVO{sub 4} sheets. • Ostwald ripening is the primary driving force for the formation of sandwich-like BiVO{sub 4}. • The sandwich-like BiVO{sub 4} sheets exhibit a high visible-light photocatalytic activity. - Abstract: Sandwich-like BiVO{sub 4} sheets were successfully synthesized in an aqueous solution containing bismuth nitrate, ammonium metavanadate and polyethylene glycol with a molecular weight of 10,000 (PEG-10000) using a facile microwave-assisted method. The as-prepared samples were characterized by scanning electron microscopy, N{sub 2} adsorption-desorption, X-ray diffraction, X-ray photoelectron spectroscopy (XPS), and UV–vis diffuse reflectance spectroscopy. The results show that the presence of PEG-10000 plays a critical role in the formation of BiVO{sub 4} sheets, and Ostwald ripening is the primary driving force for the formation of sandwich-like structures. The sandwich-like BiVO{sub 4} sheets exhibit a high activity for the degradation of methyl orange under visible light irradiation (λ ≥ 420 nm). The enhancement of photocatalytic activity of sandwich-like BiVO{sub 4} sheets can be attributed to its large surface area over the irregular BiVO{sub 4} particles.

  3. Photocatalytic perfermance of sandwich-like BiVO_4 sheets by microwave assisted synthesis

    Liu, Suqin; Tang, Huiling; Zhou, Huan; Dai, Gaopeng; Wang, Wanqiang

    2017-01-01

    Graphical abstract: Sandwich-like BiVO_4 sheets were successfully synthesized via a facile microwave-assisted method. The as-prepared samples exhibit a high activity for the degradation of methyl orange under visible light irradiation. - Highlights: • Sandwich-like BiVO_4 sheets were synthesized by a facile microwave-assisted method. • The presence of PEG-10000 plays a critical role in the formation of BiVO_4 sheets. • Ostwald ripening is the primary driving force for the formation of sandwich-like BiVO_4. • The sandwich-like BiVO_4 sheets exhibit a high visible-light photocatalytic activity. - Abstract: Sandwich-like BiVO_4 sheets were successfully synthesized in an aqueous solution containing bismuth nitrate, ammonium metavanadate and polyethylene glycol with a molecular weight of 10,000 (PEG-10000) using a facile microwave-assisted method. The as-prepared samples were characterized by scanning electron microscopy, N_2 adsorption-desorption, X-ray diffraction, X-ray photoelectron spectroscopy (XPS), and UV–vis diffuse reflectance spectroscopy. The results show that the presence of PEG-10000 plays a critical role in the formation of BiVO_4 sheets, and Ostwald ripening is the primary driving force for the formation of sandwich-like structures. The sandwich-like BiVO_4 sheets exhibit a high activity for the degradation of methyl orange under visible light irradiation (λ ≥ 420 nm). The enhancement of photocatalytic activity of sandwich-like BiVO_4 sheets can be attributed to its large surface area over the irregular BiVO_4 particles.

  4. Fact Sheets on Pesticides in Schools.

    National Coalition against the Misuse of Pesticides, Washington, DC.

    This document consists of a collection of fact sheets about the use of pesticides in schools and how to reduce it. The sheets are: (1) "Alternatives to Using Pesticides in Schools: What Is Integrated Pest Management?"; (2) "Health Effects of 48 Commonly Used Pesticides in Schools"; (3) "The Schooling of State Pesticide…

  5. Balance velocities of the Greenland ice sheet

    Joughin, I.; Fahnestock, M.; Ekholm, Simon

    1997-01-01

    We present a map of balance velocities for the Greenland ice sheet. The resolution of the underlying DEM, which was derived primarily from radar altimetery data, yields far greater detail than earlier balance velocity estimates for Greenland. The velocity contours reveal in striking detail......, the balance map is useful for ice-sheet modelling, mass balance studies, and field planning....

  6. Advanced friction modeling for sheet metal forming

    Hol, J.; Cid Alfaro, M.V.; de Rooij, Matthias B.; Meinders, Vincent T.

    2012-01-01

    The Coulomb friction model is frequently used for sheet metal forming simulations. This model incorporates a constant coefficient of friction and does not take the influence of important parameters such as contact pressure or deformation of the sheet material into account. This article presents a

  7. Advanced friction modeling in sheet metal forming

    Hol, J.; Cid Alfaro, M.V.; Meinders, Vincent T.; Huetink, Han

    2011-01-01

    The Coulomb friction model is frequently used for sheet metal forming simulations. This model incorporates a constant coefficient of friction and does not take the influence of important parameters such as contact pressure or deformation of the sheet material into account. This article presents a

  8. Antibubbles and fine cylindrical sheets of air

    Beilharz, D.; Guyon, A.; Li, E.Q.; Thoraval, Marie-Jean; Thoroddsen, S.T.

    2015-01-01

    Drops impacting at low velocities onto a pool surface can stretch out thin hemispherical sheets of air between the drop and the pool. These air sheets can remain intact until they reach submicron thicknesses, at which point they rupture to form a myriad of microbubbles. By impacting a

  9. Molding cork sheets to complex shapes

    Sharpe, M. H.; Simpson, W. G.; Walker, H. M.

    1977-01-01

    Partially cured cork sheet is easily formed to complex shapes and then final-cured. Temperature and pressure levels required for process depend upon resin system used and final density and strength desired. Sheet can be bonded to surface during final cure, or can be first-formed in mold and bonded to surface in separate step.

  10. Pressure balance between lobe and plasma sheet

    Baumjohann, W.; Paschmann, G.; Luehr, H.

    1990-01-01

    Using eight months of AMPTE/IRM plasma and magnetic field data, the authors have done a statistical survey on the balance of total (thermal and magnetic) pressure in the Earth's plasma sheet and tail lobe. About 300,000 measurements obtained in the plasma sheet and the lobe were compared for different levels of magnetic activity as well as different distances from the Earth. The data show that lobe and plasma sheet pressure balance very well. Even in the worst case they do not deviate by more than half of the variance in the data itself. Approximately constant total pressure was also seen during a quiet time pass when IRM traversed nearly the whole magnetotail in the vertical direction, from the southern hemisphere lobe through the neutral sheet and into the northern plasma sheet boundary layer

  11. Microwave conductance properties of aligned multiwall carbon nanotube textile sheets

    Brown, Brian L. [Univ. of Texas, Dallas, TX (United States); Martinez, Patricia [Univ. of Texas, Dallas, TX (United States); Zakhidov, Anvar A. [Univ. of Texas, Dallas, TX (United States); Shaner, Eric A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lee, Mark [Univ. of Texas, Dallas, TX (United States)

    2015-07-06

    Understanding the conductance properties of multi-walled carbon nanotube (MWNT) textile sheets in the microwave regime is essential for their potential use in high-speed and high-frequency applications. To expand current knowledge, complex high-frequency conductance measurements from 0.01 to 50 GHz and across temperatures from 4.2 K to 300 K and magnetic fields up to 2 T were made on textile sheets of highly aligned MWNTs with strand alignment oriented both parallel and perpendicular to the microwave electric field polarization. Sheets were drawn from 329 and 520 μm high MWNT forests that resulted in different DC resistance anisotropy. For all samples, the microwave conductance can be modeled approximately by a shunt capacitance in parallel with a frequency-independent conductance, but with no inductive contribution. Finally, this is consistent with diffusive Drude conduction as the primary transport mechanism up to 50 GHz. Further, it is found that the microwave conductance is essentially independent of both temperature and magnetic field.

  12. Bayesian Inversion for Large Scale Antarctic Ice Sheet Flow

    Ghattas, Omar

    2015-01-07

    The flow of ice from the interior of polar ice sheets is the primary contributor to projected sea level rise. One of the main difficulties faced in modeling ice sheet flow is the uncertain spatially-varying Robin boundary condition that describes the resistance to sliding at the base of the ice. Satellite observations of the surface ice flow velocity, along with a model of ice as a creeping incompressible shear-thinning fluid, can be used to infer this uncertain basal boundary condition. We cast this ill-posed inverse problem in the framework of Bayesian inference, which allows us to infer not only the basal sliding parameters, but also the associated uncertainty. To overcome the prohibitive nature of Bayesian methods for large-scale inverse problems, we exploit the fact that, despite the large size of observational data, they typically provide only sparse information on model parameters. We show results for Bayesian inversion of the basal sliding parameter field for the full Antarctic continent, and demonstrate that the work required to solve the inverse problem, measured in number of forward (and adjoint) ice sheet model solves, is independent of the parameter and data dimensions

  13. Bayesian Inversion for Large Scale Antarctic Ice Sheet Flow

    Ghattas, Omar

    2015-01-01

    The flow of ice from the interior of polar ice sheets is the primary contributor to projected sea level rise. One of the main difficulties faced in modeling ice sheet flow is the uncertain spatially-varying Robin boundary condition that describes the resistance to sliding at the base of the ice. Satellite observations of the surface ice flow velocity, along with a model of ice as a creeping incompressible shear-thinning fluid, can be used to infer this uncertain basal boundary condition. We cast this ill-posed inverse problem in the framework of Bayesian inference, which allows us to infer not only the basal sliding parameters, but also the associated uncertainty. To overcome the prohibitive nature of Bayesian methods for large-scale inverse problems, we exploit the fact that, despite the large size of observational data, they typically provide only sparse information on model parameters. We show results for Bayesian inversion of the basal sliding parameter field for the full Antarctic continent, and demonstrate that the work required to solve the inverse problem, measured in number of forward (and adjoint) ice sheet model solves, is independent of the parameter and data dimensions

  14. Folded Sheet Versus Transparent Sheet Models for Human Symmetry Judgments

    Jacques Ninio

    2011-07-01

    Full Text Available As a contribution to the mysteries of human symmetry perception, reaction time data were collected on the detection of symmetry or repetition violations, in the context of short term visual memory studies. The histograms for reaction time distributions are rather narrow in the case of symmetry judgments. Their analysis was performed in terms of a simple kinetic model of a mental process in two steps, a slow one for the construction of the representation of the images to be compared, and a fast one, in the 50 ms range, for the decision. There was no need for an additional ‘mental rotation’ step. Symmetry seems to facilitate the construction step. I also present here original stimuli showing a color equalization effect across a symmetry axis, and its counterpart in periodic patterns. According to a “folded sheet model”, when a shape is perceived, the brain automatically constructs a mirror-image representation of the shape. Based in part on the reaction time analysis, I present here an alternative “transparent sheet” model in which the brain constructs a single representation, which can be accessed from two sides, thus generating simultaneously a pattern and its mirror-symmetric partner. Filtering processes, implied by current models of symmetry perception could intervene at an early stage, by nucleating the propagation of similar perceptual groupings in the two symmetric images.

  15. Prevention of Glucocorticoid-Induced Osteoporosis: Clinical audit to evaluate the implementation of National Osteoporosis Guideline Group 2017 guidelines in a primary care setting.

    Carter, Matthew

    2018-04-12

    Treatment with glucocorticoids is the leading cause of drug-induced osteoporosis. National Osteoporosis Guideline Group (NOGG) 2017 guidelines advise a case-finding strategy for patients at risk. The aims of the audit were to evaluate the implementation of the NOGG 2017 guidelines for patients receiving long-term glucocorticoid therapy in a suburban general practice, to instigate changes to ensure 90% of patients are investigated and treated appropriately, and to evaluate impact at a 6-mo re-audit. Reporting Analysis and Intelligence Delivering Results (RAIDR) is a health-care intelligence tool accessing primary care clinical data. Using RAIDR, data on relevant osteoporotic risk factors were combined to produce FRAX scores for patients who had been prescribed glucocorticoids 3 or more times in the past 12 months. FRAX data were displayed in a NOGG guidance graph for major osteoporotic fracture probability. Patients were assessed as high, intermediate, or low risk. High- and intermediate-risk patients above the NOGG threshold were recommended to start bisphosphonates; these patients were sent a prescription for alendronate and a letter of explanation. There were no intermediate patients below the NOGG threshold. Low-risk patients were recommended to have lifestyle advice; a leaflet was produced and sent to these patients. Initial results showed that only 25% of patients recommended to be on bisphosphonates were taking them. Steps were taken to educate the general practitioners in the FRAX tool and NOGG guidelines; the chronic obstructive pulmonary disease annual template was amended to aid adherence by alerting the nurse to the number of glucocorticoid courses prescribed, with additional boxes for prescribing alendronate and printing the lifestyle leaflet; and 2-monthly RAIDR searches by the practice pharmacist were started. A re-audit 6 mo later showed improvement to 92%. This audit showed that education, reminders, and simple computer prompts can greatly improve

  16. Dissemination of the Project's Findings. National Seminar (14th, Zagreb, Yugoslavia, July 5-7, 1989). The CDCC's Project No. 8: "Innovation in Primary Education."

    Galton, Maurice

    A 3-day conference was convened in Zagreb, Yugoslavia for the purpose of disseminating results of the Council of Europe's Council for Cultural Cooperation's (CDCC) Project 8, Innovation in Primary Education (IPE). Changes in theoretical approaches to and organizational practices of primary education in Yugoslavia were discussed. A total of 61…

  17. Cervical lymph node metastases from unknown primary tumours. Results from a national survey by the Danish Society for Head and Neck Oncology

    Grau, Cai; Johansen, L V; Jakobsen, J

    2000-01-01

    The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark.......The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark....

  18. Thermomechanical processing of plasma sprayed intermetallic sheets

    Hajaligol, Mohammad R.; Scorey, Clive; Sikka, Vinod K.; Deevi, Seetharama C.; Fleischhauer, Grier; Lilly, Jr., A. Clifton; German, Randall M.

    2001-01-01

    A powder metallurgical process of preparing a sheet from a powder having an intermetallic alloy composition such as an iron, nickel or titanium aluminide. The sheet can be manufactured into electrical resistance heating elements having improved room temperature ductility, electrical resistivity, cyclic fatigue resistance, high temperature oxidation resistance, low and high temperature strength, and/or resistance to high temperature sagging. The iron aluminide has an entirely ferritic microstructure which is free of austenite and can include, in weight %, 4 to 32% Al, and optional additions such as .ltoreq.1% Cr, .gtoreq.0.05% Zr .ltoreq.2% Ti, .ltoreq.2% Mo, .ltoreq.1% Ni, .ltoreq.0.75% C, .ltoreq.0.1% B, .ltoreq.1% submicron oxide particles and/or electrically insulating or electrically conductive covalent ceramic particles, .ltoreq.1% rare earth metal, and/or .ltoreq.3% Cu. The process includes forming a non-densified metal sheet by consolidating a powder having an intermetallic alloy composition such as by roll compaction, tape casting or plasma spraying, forming a cold rolled sheet by cold rolling the non-densified metal sheet so as to increase the density and reduce the thickness thereof and annealing the cold rolled sheet. The powder can be a water, polymer or gas atomized powder which is subjecting to sieving and/or blending with a binder prior to the consolidation step. After the consolidation step, the sheet can be partially sintered. The cold rolling and/or annealing steps can be repeated to achieve the desired sheet thickness and properties. The annealing can be carried out in a vacuum furnace with a vacuum or inert atmosphere. During final annealing, the cold rolled sheet recrystallizes to an average grain size of about 10 to 30 .mu.m. Final stress relief annealing can be carried out in the B2 phase temperature range.

  19. National Pesticide Information Center

    ... How can I protect my pets when using pesticides around them? More FAQs FAQ Comics Video FAQs From NPIC: Fact Sheets Videos Web Apps Podcasts Outreach Materials NPIC Professional Resources Social Media: National Pesticide Information Center Tweets by NPICatOSU Please read our ...

  20. Plasma sheet behavior during substorms

    Hones, E.W. Jr.

    1983-01-01

    Auroral or magnetic substorms are periods of enhanced auroral and geomagnetic activity lasting one to a few hours that signify increased dissipation of energy from the magnetosphere to the earth. Data acquired during the past decade from satellites in the near-earth sector of the magnetotail have suggested that during a substorm part of the plasma sheet is severed from earth by magnetic reconnection, forming a plasmoid, i.e., a body of plasma and closed magnetic loops, that flows out of the tail into the solar wind, thus returning plasma and energy that have earlier been accumulated from the solar wind. Very recently this picture has been dramatically confirmed by observations, with the ISEE 3 spacecraft in the magnetotail 220 R/sub E/ from earth, of plasmoids passing that location in clear delayed response to substorms. It now appears that plasmoid release is a fundamental process whereby the magnetosphere gives up excess stored energy and plasma, much like comets are seen to do, and that the phenomena of the substorm seen at earth are a by-product of that fundamental process

  1. Radiation dominated relativistic current sheets

    Jaroschek, C.H.

    2008-01-01

    Relativistic Current Sheets (RCS) feature plasma instabilities considered as potential key to magnetic energy dissipation and non-thermal particle generation in Poynting flux dominated plasma flows. We show in a series of kinetic plasma simulations that the physical nature of non-linear RCS evolution changes in the presence of incoherent radiation losses: In the ultra-relativistic regime (i.e. magnetization parameter sigma = 104 defined as the ratio of magnetic to plasma rest frame energy density) the combination of non-linear RCS dynamics and synchrotron emission introduces a temperature anisotropy triggering the growth of the Relativistic Tearing Mode (RTM). As direct consequence the RTM prevails over the Relativistic Drift Kink (RDK) Mode as competitive RCS instability. This is in contrast to the previously studied situation of weakly relativistic RCS (sigma ∼ 1) where the RDK is dominant and most of the plasma is thermalized. The simulations witness the typical life cycle of ultra-relativistic RCS evolving from a violent radiation induced collapse towards a radiation quiescent state in rather classical Sweet-Parker topology. Such a transition towards Sweet-Parker configuration in the late non-linear evolution has immediate consequences for the efficiency of magnetic energy dissipation and non-thermal particle generation. Ceasing dissipation rates directly affect our present understanding of non-linear RCS evolution in conventional striped wind scenarios. (author)

  2. World-sheet gauge fields in superstrings

    Porrati, M.; Tomboulis, E.T.

    1989-01-01

    We investigate the introduction of world-sheet 2-dimensional gauge fields in a manner consistent with world-sheet supersymmetry. We obtain the effective string action resulting from the exact integration over the world-sheet gauge fields to show that it generally describes string models with spontaneous breaking of gauge symmetries with continuous breaking parameters. We examine the question of spacetime supersymmetry spontaneous breaking, and show that breaking with continuous, in particular arbitrarily small breaking parameters does not occur; only breaking for discrete values of parameters is possible. (orig.)

  3. Bifurcation of Jovian magnetotail current sheet

    P. L. Israelevich

    2006-07-01

    Full Text Available Multiple crossings of the magnetotail current sheet by a single spacecraft give the possibility to distinguish between two types of electric current density distribution: single-peaked (Harris type current layer and double-peaked (bifurcated current sheet. Magnetic field measurements in the Jovian magnetic tail by Voyager-2 reveal bifurcation of the tail current sheet. The electric current density possesses a minimum at the point of the Bx-component reversal and two maxima at the distance where the magnetic field strength reaches 50% of its value in the tail lobe.

  4. Bifurcation of Jovian magnetotail current sheet

    P. L. Israelevich

    2006-07-01

    Full Text Available Multiple crossings of the magnetotail current sheet by a single spacecraft give the possibility to distinguish between two types of electric current density distribution: single-peaked (Harris type current layer and double-peaked (bifurcated current sheet. Magnetic field measurements in the Jovian magnetic tail by Voyager-2 reveal bifurcation of the tail current sheet. The electric current density possesses a minimum at the point of the Bx-component reversal and two maxima at the distance where the magnetic field strength reaches 50% of its value in the tail lobe.

  5. Testing of Lubricant Performance in Sheet Metal Forming

    Bay, Niels; Olsson, David Dam; Friis, Kasper Leth

    2008-01-01

    Increasing focus on environmental issues in industrial production has urged a number of sheet metal forming companies to look for new tribo-systems in order to substitute hazardous lubricants such as chlorinated paraffin oils. The problems are especially pronounced, when forming tribologically...... of the lubricant film causing pick-up of work piece material on the tool surface and scoring of subsequent work piece surfaces. The present paper gives an overview of more than 10 years work by the authors’ research group through participation in national as well as international framework programmes on developing...

  6. Health risk among asbestos cement sheet manufacturing workers in Thailand.

    Phanprasit, Wantanee; Sujirarat, Dusit; Chaikittiporn, Chalermchai

    2009-12-01

    To assess asbestos exposure and calculate the relative risks of lung cancer among asbestos cement roof sheet workers and to predict the incidence rate of lung cancer caused by asbestos in Thailand. A cross-sectional study was conducted in four asbestos cement roof factories. Both area and personal air samples were collected and analyzed employing NIOSH method # 7400 and counting rule A for all procesess and activities. The time weight average exposures were calculated for each studied task using average area concentrations of the mill and personal concentrations. Then, cumulative exposures were estimated based on the past nation-wide air sampling concentrations and those from the present study. The relative risk (RR) of lung cancer among asbestos cement sheet workers was calculated and the number of asbestos related lung cancer case was estimated. The roof fitting polishers had the highest exposure to airborne asbestos fiber (0.73 fiber/ml). The highest average area concentration was at the conveyor to the de-bagger areas (0.02 fiber/ml). The estimated cumulative exposure for the workers performed studied-tasks ranged in between 90.13-115.65 fiber-years/ml while the relative risk of lung cancer calculated using US. EPA's model were 5.37-5.96. Based on the obtained RR, lung cancer among AC sheet in Thailand would be 2 case/year. In case that AC sheet will not be prohibited from being manufactured, even though only chrysotile is allowed, the surveillance system should be further developed and more seriously implemented. The better control measures for all processes must be implemented. Furthermore, due to the environmental persistence of asbestos fiber, its life cycle analysis should be conducted in order to control environmental exposure of general population.

  7. 2016 National Algal Biofuels Technology Review Fact Sheet

    None

    2016-06-01

    Algae-based biofuels and bioproducts offer great promise in contributing to the U.S. Department of Energy (DOE) Bioenergy Technologies Office’s (BETO’s) vision of a thriving and sustainable bioeconomy fueled by innovative technologies. The state of technology for producing algal biofuels continues to mature with ongoing investment by DOE and the private sector, but additional research, development, and demonstration (RD&D) is needed to achieve widespread deployment of affordable, scalable, and sustainable algal biofuels.

  8. Design and results of the ice sheet model initialisation initMIP-Greenland: an ISMIP6 intercomparison

    H. Goelzer

    2018-04-01

    Full Text Available Earlier large-scale Greenland ice sheet sea-level projections (e.g. those run during the ice2sea and SeaRISE initiatives have shown that ice sheet initial conditions have a large effect on the projections and give rise to important uncertainties. The goal of this initMIP-Greenland intercomparison exercise is to compare, evaluate, and improve the initialisation techniques used in the ice sheet modelling community and to estimate the associated uncertainties in modelled mass changes. initMIP-Greenland is the first in a series of ice sheet model intercomparison activities within ISMIP6 (the Ice Sheet Model Intercomparison Project for CMIP6, which is the primary activity within the Coupled Model Intercomparison Project Phase 6 (CMIP6 focusing on the ice sheets. Two experiments for the large-scale Greenland ice sheet have been designed to allow intercomparison between participating models of (1 the initial present-day state of the ice sheet and (2 the response in two idealised forward experiments. The forward experiments serve to evaluate the initialisation in terms of model drift (forward run without additional forcing and in response to a large perturbation (prescribed surface mass balance anomaly; they should not be interpreted as sea-level projections. We present and discuss results that highlight the diversity of data sets, boundary conditions, and initialisation techniques used in the community to generate initial states of the Greenland ice sheet. We find good agreement across the ensemble for the dynamic response to surface mass balance changes in areas where the simulated ice sheets overlap but differences arising from the initial size of the ice sheet. The model drift in the control experiment is reduced for models that participated in earlier intercomparison exercises.

  9. Design and results of the ice sheet model initialisation experiments initMIP-Greenland: an ISMIP6 intercomparison

    Goelzer, Heiko; Nowicki, Sophie; Edwards, Tamsin; Beckley, Matthew; Abe-Ouchi, Ayako; Aschwanden, Andy; Calov, Reinhard; Gagliardini, Olivier; Gillet-Chaulet, Fabien; Golledge, Nicholas R.; Gregory, Jonathan; Greve, Ralf; Humbert, Angelika; Huybrechts, Philippe; Kennedy, Joseph H.; Larour, Eric; Lipscomb, William H.; Le clec'h, Sébastien; Lee, Victoria; Morlighem, Mathieu; Pattyn, Frank; Payne, Antony J.; Rodehacke, Christian; Rückamp, Martin; Saito, Fuyuki; Schlegel, Nicole; Seroussi, Helene; Shepherd, Andrew; Sun, Sainan; van de Wal, Roderik; Ziemen, Florian A.

    2018-04-01

    Earlier large-scale Greenland ice sheet sea-level projections (e.g. those run during the ice2sea and SeaRISE initiatives) have shown that ice sheet initial conditions have a large effect on the projections and give rise to important uncertainties. The goal of this initMIP-Greenland intercomparison exercise is to compare, evaluate, and improve the initialisation techniques used in the ice sheet modelling community and to estimate the associated uncertainties in modelled mass changes. initMIP-Greenland is the first in a series of ice sheet model intercomparison activities within ISMIP6 (the Ice Sheet Model Intercomparison Project for CMIP6), which is the primary activity within the Coupled Model Intercomparison Project Phase 6 (CMIP6) focusing on the ice sheets. Two experiments for the large-scale Greenland ice sheet have been designed to allow intercomparison between participating models of (1) the initial present-day state of the ice sheet and (2) the response in two idealised forward experiments. The forward experiments serve to evaluate the initialisation in terms of model drift (forward run without additional forcing) and in response to a large perturbation (prescribed surface mass balance anomaly); they should not be interpreted as sea-level projections. We present and discuss results that highlight the diversity of data sets, boundary conditions, and initialisation techniques used in the community to generate initial states of the Greenland ice sheet. We find good agreement across the ensemble for the dynamic response to surface mass balance changes in areas where the simulated ice sheets overlap but differences arising from the initial size of the ice sheet. The model drift in the control experiment is reduced for models that participated in earlier intercomparison exercises.

  10. Validity of estimated prevalence of decreased kidney function and renal replacement therapy from primary care electronic health records compared with national survey and registry data in the United Kingdom.

    Iwagami, Masao; Tomlinson, Laurie A; Mansfield, Kathryn E; Casula, Anna; Caskey, Fergus J; Aitken, Grant; Fraser, Simon D S; Roderick, Paul J; Nitsch, Dorothea

    2017-04-01

    Anonymous primary care records are an important resource for observational studies. However, their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We thus compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry. Among all people ≥25 years of age registered in the CPRD for ≥1 year on 31 March 2014, we identified patients with an estimated glomerular filtration rate (eGFR) primary care data have good external validity for the prevalence of decreased kidney function and RRT. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

  11. Collected Engineering Data Sheets (Air Force Data Sheet Program)

    1978-12-01

    I12 HP 9-4-25 The HP 9-4-25 alloy is a nickel-cobalt quenched and tempered martensitic steel possessing excellent toughness at yield strength levels up...temperatures ranging from subzero to 1100 F. Below a tempering temperature of 900 F, the primary strengthening mechanism depends on precipitation reactions...properties at elevated temper - atures, and good creep properties and corrosion resistance . Because of the current interest in titanium castings, the material

  12. The Association between Working Memory and Educational Attainment as Measured in Different Mathematical Subtopics in the Swedish National Assessment: Primary Education

    Nyroos, Mikaela; Wiklund-Hornqvist, Carola

    2012-01-01

    The aim of this study was to examine the relationship between working memory capacity and mathematical performance measured by the national curriculum assessment in third-grade children (n = 40). The national tests concerned six subareas within mathematics. One-way ANOVA, two-tailed Pearson correlation and multiple regression analyses were…

  13. Do difficulties in accessing in-hours primary care predict higher use of out-of-hours GP services? Evidence from an English National Patient Survey.

    Zhou, Yin; Abel, Gary; Warren, Fiona; Roland, Martin; Campbell, John; Lyratzopoulos, Georgios

    2015-05-01

    It is believed that some patients are more likely to use out-of-hours primary care services because of difficulties in accessing in-hours care, but substantial evidence about any such association is missing. We analysed data from 567,049 respondents to the 2011/2012 English General Practice Patient Survey who reported at least one in-hours primary care consultation in the preceding 6 months. Of those respondents, 7% also reported using out-of-hours primary care. We used logistic regression to explore associations between use of out-of-hours primary care and five measures of in-hours access (ease of getting through on the telephone, ability to see a preferred general practitioner, ability to get an urgent or routine appointment and convenience of opening hours). We illustrated the potential for reduction in use of out-of-hours primary care in a model where access to in-hours care was made optimal. Worse in-hours access was associated with greater use of out-of-hours primary care for each access factor. In multivariable analysis adjusting for access and patient characteristic variables, worse access was independently associated with increased out-of-hours use for all measures except ease of telephone access. Assuming these associations were causal, we estimated that an 11% relative reduction in use of out-of-hours primary care services in England could be achievable if access to in-hours care were optimal. This secondary quantitative analysis provides evidence for an association between difficulty in accessing in-hours care and use of out-of-hours primary care services. The findings can motivate the development of interventions to improve in-hour access. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. fibrin–chitosan–sodium alginate composite sheet

    sodium alginate composite (F–C–SA) in sheet form. F–C–SA composite was prepared and characterized for its physicochemical properties like water absorption capacity, surface morphology, FTIR spectra and mechanical properties.

  15. Single clay sheets inside electrospun polymer nanofibers

    Sun, Zhaohui

    2005-03-01

    Nanofibers were prepared from polymer solution with clay sheets by electrospinning. Plasma etching, as a well controlled process, was used to supply electrically excited gas molecules from a glow discharge. To reveal the structure and arrangement of clay layers in the polymer matrix, plasma etching was used to remove the polymer by controlled gasification to expose the clay sheets due to the difference in reactivity. The shape, flexibility, and orientation of clay sheets were studied by transmission and scanning electron microscopy. Additional quantitative information on size distribution and degree of exfoliation of clay sheets were obtained by analyzing electron micrograph of sample after plasma etching. Samples in various forms including fiber, film and bulk, were thinned by plasma etching. Morphology and dispersion of inorganic fillers were studied by electron microscopy.

  16. HIV/AIDS Clinical Trials Fact Sheet

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Overview Home Understanding HIV/AIDS Fact Sheets HIV/ ... 4 p.m. ET) Send us an email HIV/AIDS Clinical Trials Last Reviewed: August 25, 2017 ...

  17. Nanotechnology for Site Remediation: Fact Sheet

    This fact sheet presents a snapshot of nanotechnology and its current uses in remediation. It presents information to help site project managers understand the potential applications of this group of technologies at their sites.

  18. Fact sheet: Ethanol from corn

    NONE

    1999-05-31

    This fact sheet is intended to provide an overview of the advantages of ethanol from corn, emphasizing ethanol`s contribution to environmental protection and sustainable agriculture. Ethanol, an alternative fuel used as an octane enhancer is produced through the conversion of starch to sugars by enzymes, and fermentation of these sugars to ethanol by yeast. The production process may involve wet milling or dry milling. Both these processes produce valuable by-products, in addition to ethanol and carbon dioxide. Ethanol contains about 32,000 BTU per litre. It is commonly believed that using state-of-the-art corn farming and corn processing processes, the amount of energy contained in ethanol and its by-products would be more than twice the energy required to grow and process corn into ethanol. Ethanol represents the third largest market for Ontario corn, after direct use as animal feed and wet milling for starch, corn sweetener and corn oil. The environmental consequences of using ethanol are very significant. It is estimated that a 10 per cent ethanol blend in gasoline would result in a 25 to 30 per cent decrease in carbon monoxide emissions, a 6 to 10 per cent decrease in net carbon dioxide, a slight increase in nitrous oxide emissions which, however, would still result in an overall decrease in ozone formation, since the significant reduction in carbon monoxide emissions would compensate for any slight increase in nitrous oxide. Volatile organic compounds emission would also decrease by about 7 per cent with a 10 per cent ethanol blend. High level blends could reduce VOCs production by as much as 30 per cent. 7 refs.

  19. Energized Oxygen : Speiser Current Sheet Bifurcation

    George, D. E.; Jahn, J. M.

    2017-12-01

    A single population of energized Oxygen (O+) is shown to produce a cross-tail bifurcated current sheet in 2.5D PIC simulations of the magnetotail without the influence of magnetic reconnection. Treatment of oxygen in simulations of space plasmas, specifically a magnetotail current sheet, has been limited to thermal energies despite observations of and mechanisms which explain energized ions. We performed simulations of a homogeneous oxygen background, that has been energized in a physically appropriate manner, to study the behavior of current sheets and magnetic reconnection, specifically their bifurcation. This work uses a 2.5D explicit Particle-In-a-Cell (PIC) code to investigate the dynamics of energized heavy ions as they stream Dawn-to-Dusk in the magnetotail current sheet. We present a simulation study dealing with the response of a current sheet system to energized oxygen ions. We establish a, well known and studied, 2-species GEM Challenge Harris current sheet as a starting point. This system is known to eventually evolve and produce magnetic reconnection upon thinning of the current sheet. We added a uniform distribution of thermal O+ to the background. This 3-species system is also known to eventually evolve and produce magnetic reconnection. We add one additional variable to the system by providing an initial duskward velocity to energize the O+. We also traced individual particle motion within the PIC simulation. Three main results are shown. First, energized dawn- dusk streaming ions are clearly seen to exhibit sustained Speiser motion. Second, a single population of heavy ions clearly produces a stable bifurcated current sheet. Third, magnetic reconnection is not required to produce the bifurcated current sheet. Finally a bifurcated current sheet is compatible with the Harris current sheet model. This work is the first step in a series of investigations aimed at studying the effects of energized heavy ions on magnetic reconnection. This work differs

  20. Copper contamination in thin stainless steel sheet

    Holbert, R.K. Jr.; Dobbins, A.G.; Bennett, R.K. Jr.

    1986-01-01

    The standard welding technique used at Oak Ridge Y-12 Plant for joining thin stainless sheet is the gas tungsten arc (GTA) welding process. One of the reoccurring problems with the sheet welds is surface cracking in the heat-affected zone (HAZ). Metallography shows that the cracks are only about 0.05 mm (0.002 in.) deep which is significant in a 0.25 mm (0.01 in.) thick sheet. Thus, welding requirements do not permit any surfacing cracking as detected by a fluorescent dye penetrant test conducted on every part after welding. Surface cracks have been found in both of the two most common weld designs in the thin sheet fabricated at the Oak Ridge Y-12 Plant. These butt joints are welded between two 0.25 mm thick stainless steel sheets and a tube with eyelet welded to a 25 mm (0.98 in.) thick sheet. The weld between the two sheets is made on a semiautomatic seam welding unit, whereas the tube-to-eyelet-to-sheet welds are done manually. The quality of both welds is very dependent on the welding procedure and the way the parts are placed in the weld fixturing. Metallographic examination has indicated that some welded parts with surface cracking in the weld region had copper particles on the surface, and the question of copper contamination has been raised. With the aid of a scanning electron microscope and an electron microprobe, the existence of copper in an around the surface cracks has been verified. The copper is on the surface of the parts prior to welding in the form of small dust particles

  1. Greenland Regional and Ice Sheet-wide Geometry Sensitivity to Boundary and Initial conditions

    Logan, L. C.; Narayanan, S. H. K.; Greve, R.; Heimbach, P.

    2017-12-01

    Ice sheet and glacier model outputs require inputs from uncertainly known initial and boundary conditions, and other parameters. Conservation and constitutive equations formalize the relationship between model inputs and outputs, and the sensitivity of model-derived quantities of interest (e.g., ice sheet volume above floatation) to model variables can be obtained via the adjoint model of an ice sheet. We show how one particular ice sheet model, SICOPOLIS (SImulation COde for POLythermal Ice Sheets), depends on these inputs through comprehensive adjoint-based sensitivity analyses. SICOPOLIS discretizes the shallow-ice and shallow-shelf approximations for ice flow, and is well-suited for paleo-studies of Greenland and Antarctica, among other computational domains. The adjoint model of SICOPOLIS was developed via algorithmic differentiation, facilitated by the source transformation tool OpenAD (developed at Argonne National Lab). While model sensitivity to various inputs can be computed by costly methods involving input perturbation simulations, the time-dependent adjoint model of SICOPOLIS delivers model sensitivities to initial and boundary conditions throughout time at lower cost. Here, we explore both the sensitivities of the Greenland Ice Sheet's entire and regional volumes to: initial ice thickness, precipitation, basal sliding, and geothermal flux over the Holocene epoch. Sensitivity studies such as described here are now accessible to the modeling community, based on the latest version of SICOPOLIS that has been adapted for OpenAD to generate correct and efficient adjoint code.

  2. Balance of the West Antarctic Ice Sheet

    2002-01-01

    For several decades, measurements of the West Antarctic Ice Sheet showed it to be retreating rapidly. But new data derived from satellite-borne radar sensors show the ice sheet to be growing. Changing Antarctic ice sheets remains an area of high scientific interest, particularly in light of recent global warming concerns. These new findings are significant because scientists estimate that sea level would rise 5-6 meters (16-20 feet) if the ice sheet collapsed into the sea. Do these new measurements signal the end of the ice sheet's 10,000-year retreat? Or, are these new satellite data simply much more accurate than the sparse ice core and surface measurements that produced the previous estimates? Another possibility is that the ice accumulation may simply indicate that the ice sheet naturally expands and retreats in regular cycles. Cryologists will grapple with these questions, and many others, as they examine the new data. The image above depicts the region of West Antarctica where scientists measured ice speed. The fast-moving central ice streams are shown in red. Slower tributaries feeding the ice streams are shown in blue. Green areas depict slow-moving, stable areas. Thick black lines depict the areas that collect snowfall to feed their respective ice streams. Reference: Ian Joughin and Slawek Tulaczyk Science Jan 18 2002: 476-480. Image courtesy RADARSAT Antarctic Mapping Project

  3. Antibubbles and fine cylindrical sheets of air

    Beilharz, D.

    2015-08-14

    Drops impacting at low velocities onto a pool surface can stretch out thin hemispherical sheets of air between the drop and the pool. These air sheets can remain intact until they reach submicron thicknesses, at which point they rupture to form a myriad of microbubbles. By impacting a higher-viscosity drop onto a lower-viscosity pool, we have explored new geometries of such air films. In this way we are able to maintain stable air layers which can wrap around the entire drop to form repeatable antibubbles, i.e. spherical air layers bounded by inner and outer liquid masses. Furthermore, for the most viscous drops they enter the pool trailing a viscous thread reaching all the way to the pinch-off nozzle. The air sheet can also wrap around this thread and remain stable over an extended period of time to form a cylindrical air sheet. We study the parameter regime where these structures appear and their subsequent breakup. The stability of these thin cylindrical air sheets is inconsistent with inviscid stability theory, suggesting stabilization by lubrication forces within the submicron air layer. We use interferometry to measure the air-layer thickness versus depth along the cylindrical air sheet and around the drop. The air film is thickest above the equator of the drop, but thinner below the drop and up along the air cylinder. Based on microbubble volumes, the thickness of the cylindrical air layer becomes less than 100 nm before it ruptures.

  4. Buckling Behavior of Substrate Supported Graphene Sheets

    Kuijian Yang

    2016-01-01

    Full Text Available The buckling of graphene sheets on substrates can significantly degrade their performance in materials and devices. Therefore, a systematic investigation on the buckling behavior of monolayer graphene sheet/substrate systems is carried out in this paper by both molecular mechanics simulations and theoretical analysis. From 70 simulation cases of simple-supported graphene sheets with different sizes under uniaxial compression, two different buckling modes are investigated and revealed to be dominated by the graphene size. Especially, for graphene sheets with length larger than 3 nm and width larger than 1.1 nm, the buckling mode depends only on the length/width ratio. Besides, it is revealed that the existence of graphene substrate can increase the critical buckling stress and strain to 4.39 N/m and 1.58%, respectively, which are about 10 times those for free-standing graphene sheets. Moreover, for graphene sheets with common size (longer than 20 nm, both theoretical and simulation results show that the critical buckling stress and strain are dominated only by the adhesive interactions with substrate and independent of the graphene size. Results in this work provide valuable insight and guidelines for the design and application of graphene-derived materials and nano-electromechanical systems.

  5. Antibubbles and fine cylindrical sheets of air

    Beilharz, D.; Guyon, A.; Li, E.  Q.; Thoraval, M.-J.; Thoroddsen, Sigurdur T

    2015-01-01

    Drops impacting at low velocities onto a pool surface can stretch out thin hemispherical sheets of air between the drop and the pool. These air sheets can remain intact until they reach submicron thicknesses, at which point they rupture to form a myriad of microbubbles. By impacting a higher-viscosity drop onto a lower-viscosity pool, we have explored new geometries of such air films. In this way we are able to maintain stable air layers which can wrap around the entire drop to form repeatable antibubbles, i.e. spherical air layers bounded by inner and outer liquid masses. Furthermore, for the most viscous drops they enter the pool trailing a viscous thread reaching all the way to the pinch-off nozzle. The air sheet can also wrap around this thread and remain stable over an extended period of time to form a cylindrical air sheet. We study the parameter regime where these structures appear and their subsequent breakup. The stability of these thin cylindrical air sheets is inconsistent with inviscid stability theory, suggesting stabilization by lubrication forces within the submicron air layer. We use interferometry to measure the air-layer thickness versus depth along the cylindrical air sheet and around the drop. The air film is thickest above the equator of the drop, but thinner below the drop and up along the air cylinder. Based on microbubble volumes, the thickness of the cylindrical air layer becomes less than 100 nm before it ruptures.

  6. 17 CFR 210.6-04 - Balance sheets.

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Balance sheets. 210.6-04... sheets. This rule is applicable to balance sheets filed by registered investment companies except for... of this part. Balance sheets filed under this rule shall comply with the following provisions: Assets...

  7. African American Students and U.S. High Schools. Fact Sheet

    Alliance for Excellent Education, 2008

    2008-01-01

    This fact sheet highlights the statistics of the status of the African American students living in the continental United States in terms of: population; graduation, dropouts, and preparedness; schools, segregation, and teacher quality; and special, gifted, and college preparatory education. According to the National Center for Education…

  8. Fuels planning: science synthesis and integration; economic uses fact sheet 05: NEPA and economics

    Rocky Mountain Research Station USDA Forest Service

    2004-01-01

    The National Environmental Policy Act (NEPA) is the law that requires Federal agencies to consider the environmental impacts of their actions, involve the public in the decisionmaking process, and disclose information, starting at the initial stages of planning. This fact sheet discusses when you should consider economics in the NEPA process, when to do an analysis,...

  9. Accelerating Geothermal Research (Fact Sheet)

    2014-05-01

    Geothermal research at the National Renewable Energy Laboratory (NREL) is advancing geothermal technologies to increase renewable power production. Continuous and not dependent on weather, the geothermal resource has the potential to jump to more than 500 gigawatts in electricity production, which is equivalent to roughly half of the current U.S. capacity. Enhanced geothermal systems have a broad regional distribution in the United States, allowing the potential for development in many locations across the country.

  10. Amenorrhea - primary

    ... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  11. European recommendations for primary prevention of congenital anomalies: A joined effort of EUROCAT and EUROPLAN projects to facilitate inclusion of this topic in the National Rare Disease Plans

    Taruscio, Domenica; Arriola, Larraitz; Baldi, Francesca

    2014-01-01

    Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention t...

  12. Best Management Practice, Fact Sheet 2. Sheet Flow to Open Space

    Sample, David; Doumar, Lia

    2013-01-01

    This publication explains what sheet flow to open space is, where and how it is used, their limitations, routine and nonroutine maintenance, expected costs, and a glossary of terms. This fact sheet is one of a 15-part series on urban stormwater management practices.

  13. Bessel light sheet structured illumination microscopy

    Noshirvani Allahabadi, Golchehr

    Biomedical study researchers using animals to model disease and treatment need fast, deep, noninvasive, and inexpensive multi-channel imaging methods. Traditional fluorescence microscopy meets those criteria to an extent. Specifically, two-photon and confocal microscopy, the two most commonly used methods, are limited in penetration depth, cost, resolution, and field of view. In addition, two-photon microscopy has limited ability in multi-channel imaging. Light sheet microscopy, a fast developing 3D fluorescence imaging method, offers attractive advantages over traditional two-photon and confocal microscopy. Light sheet microscopy is much more applicable for in vivo 3D time-lapsed imaging, owing to its selective illumination of tissue layer, superior speed, low light exposure, high penetration depth, and low levels of photobleaching. However, standard light sheet microscopy using Gaussian beam excitation has two main disadvantages: 1) the field of view (FOV) of light sheet microscopy is limited by the depth of focus of the Gaussian beam. 2) Light-sheet images can be degraded by scattering, which limits the penetration of the excitation beam and blurs emission images in deep tissue layers. While two-sided sheet illumination, which doubles the field of view by illuminating the sample from opposite sides, offers a potential solution, the technique adds complexity and cost to the imaging system. We investigate a new technique to address these limitations: Bessel light sheet microscopy in combination with incoherent nonlinear Structured Illumination Microscopy (SIM). Results demonstrate that, at visible wavelengths, Bessel excitation penetrates up to 250 microns deep in the scattering media with single-side illumination. Bessel light sheet microscope achieves confocal level resolution at a lateral resolution of 0.3 micron and an axial resolution of 1 micron. Incoherent nonlinear SIM further reduces the diffused background in Bessel light sheet images, resulting in

  14. The transposition of the balance sheet to financial and functional balance sheet. Research and development

    Liana GĂDĂU

    2015-09-01

    Full Text Available As the title suggests, through this paper we want to highlight the necessity of treating again the content and the form of the balance sheet in order to adapt it to a more efficient analysis, this way surpassing the informational valences of the classic balance sheet. The functional and the financial balance sheet will be taken into account. These models of balance sheet permit the complex analyses regarding the solvability or the bankruptcy risk of an enterprise to take place, and also other analyses, like the analysis of the structure and the financial/ functional equilibrium, the analysis of the company on operating cycles and their role in the functioning of the company. Through the particularities offered by each of these two models of balance sheet, we want to present the advantages of a superior informing. This content of this material is based on a vast investigation of the specialized literature.

  15. Three-Sheet Spot Welding of Advanced High-Strength Steels

    Nielsen, Chris Valentin; Friis, Kasper Storgaard; Zhang, W.

    2011-01-01

    The automotive industry has introduced the three-layer weld configuration, which represents new challenges compared to normal two-sheet lap welds. The process is further complicated by introducing high-strength steels in the joint. The present article investigates the weldability of thin, low....... The weld mechanisms are analyzed numerically and compared with metallographic analyses showing how the primary bonding mechanism between the thin, low-carbon steel sheet and the thicker sheet of high-strength steel is solid-state bonding, whereas the two high-strength steels are joined by melting, forming...... a weld nugget at their mutual interface. Despite the absence of the typical fusion nugget through the interface between the low-carbon steel and high-strength steel, the weld strengths obtained are acceptable. The failure mechanism in destructive testing is ductile fracture with plug failure....

  16. Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey.

    Bintabara, Deogratius; Mpondo, Bonaventura C T

    2018-01-01

    Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50%) of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension. The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary

  17. Preparedness of lower-level health facilities and the associated factors for the outpatient primary care of hypertension: Evidence from Tanzanian national survey.

    Deogratius Bintabara

    Full Text Available Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania.This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50% of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value < 0.2 were fitted into the multiple logistic regression models using a 5% significance level.Out of 725 health facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension.The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership

  18. Japan's Colonial Policies--From National Assimilation to the Kominka Movement: A Comparative Study of Primary Education in Taiwan and Korea (1937-1945)

    Peng, Huan-Sheng; Chu, Jo-Ying

    2017-01-01

    The eight-year-long period from Japan's initiation of the Second Sino-Japanese War in 1937 to its unconditional surrender in 1945 forced Japan to invest its national economy and industrial and scientific technologies in the war. In addition, in the name of the Greater East Asia Co-Prosperity Sphere, Japan initiated its assimilation and Kominka…

  19. School performance from primary education in the adolescent offspring of parents with schizophrenia and bipolar disorder- a national, register-based study.

    Ranning, Anne; Laursen, Thomas; Agerbo, Esben; Thorup, Anne; Hjorthøj, Carsten; Jepsen, Jens Richardt Møllegaard; Nordentoft, Merete

    2017-12-14

    Schizophrenia (SZ) and bipolar disorder (BP) are causes of severe disability worldwide and parents' severe mental illness (SMI) is associated with childhood adversity, and socio-emotional and cognitive problems in children. Yet, how parental BP and SZ affect educational attainment in offspring is still unclear. We included all children (N = 684.248) born and living in Denmark between 1986 and 1996 and their parents. Our follow-up lasted from 1986 until children's graduation in 2014. The main outcome variable was their school grades following their primary education. School outcomes were divided into four categories: not graduated, low-grade point average (GPA), medium GPA and high GPA. We then performed a multiple logistic regression with medium GPA as the reference category, with the children of parents without SZ or BP as the reference group. Children of parents with SZ faced higher odds than their peers of not graduating primary education (OR 2.6), along with low GPA (odds ratios (OR) 1.6) and lower odds for a high GPA (OR 0.7). Moreover, it was the children of mothers rather than fathers with BP who had higher odds of not graduating primary education (OR 1.6). Lastly, child placement was associated with lower grades and lower graduation rates, and outcomes for children of parents with SMI were favorable compared with other children placed in care. For children, parental SZ is associated with lower grades and lower chances for graduating primary education. In contrast, the children of parents with BP were indistinguishable from the reference group regarding school grades. This signifies that specificity of parental severe mental illness is important in relation to educational achievement of children.

  20. The boundary layers as the primary transport regions of the earth's magnetotail

    Eastman, T. E.; Frank, L. A.; Huang, C. Y.

    1985-01-01

    A comprehensive survey of ISEE and IMP LEPEDEA plasma measurements in the earth's magnetotail reveals that the magnetospheric boundary layer and the plasma sheet boundary layer are the primary transport regions there. These plasma measurements also reveal various components of the plasma sheet, including the central plasma sheet and plasma sheet boundary layer. A significant new result reported here is that of cold- and hot-plasma components that are spatially co-present within the central plasma sheet. Such plasma components cannot be explained merely by temporal variations in spectra involving the entire plasma sheet. Contributions to a low temperature component of the plasma sheet enter directly from the boundary layer located along the magnetotail flanks. Field-aligned flows predominate within the plasma sheet boundary layer which is almost always present and is located near the high- and low-latitude border of the plasma sheet. The plasma sheet boundary layer comprises highly anisotropic ion distributions, including counter-streaming ion beams, that evolve into the hot, isotropic component of the plasma sheet. Tailward acceleration regions generate these ion beams with plasma input from the magnetospheric boundary layer. Antisunward-flowing ion beams, at E/q less than 1 kV and of ionospheric composition, are frequently observed in the plasma sheet boundary layer and in tail lobes. These ion beams are likely accelerated at low altitude over the polar cap and especially along auroral field lines.

  1. Flapping dynamics of a thin liquid sheet

    Vadivukkarasan, M.; Kumaran, Dhivyaraja; Panchagnula, Mahesh; Multi-phase flow physics Group Team

    2017-11-01

    We attempt to delineate and describe the complete evolution of a thin soap film when air is blown through a nozzle in the normal direction. The sequence of events and its intrinsic dynamics are captured using high speed imaging. By careful observation, it was observed that multiple mechanisms occur in the same system and each event is triggered by an independent mechanism. The events include (a) flapping of a liquid sheet and pinching of the bubble, (b) onset of rupture on the liquid sheet, (c) formation of ligaments and (d) ejection of drops. From this study, it is shown that these events are predominantly governed by Kelvin-Helmholtz instability, Taylor - Culick law, Rayleigh-Taylor instability and capillary instability, respectively. The present experiments can be considered as an extension to the previous studies on soap films as well as thin flapping sheets which has direct relevance to coaxial atomizers used in aircraft applications.

  2. Symmetry breaking bifurcations of a current sheet

    Parker, R.D.; Dewar, R.L.; Johnson, J.L.

    1990-01-01

    Using a time evolution code with periodic boundary conditions, the viscoresistive hydromagnetic equations describing an initially static, planar current sheet with large Lundquist number have been evolved for times long enough to reach a steady state. A cosh 2 x resistivity model was used. For long periodicity lengths L p , the resistivity gradient drives flows that cause forced reconnection at X point current sheets. Using L p as a bifurcation parameter, two new symmetry breaking bifurcations were found: a transition to an asymmetric island chain with nonzero, positive, or negative phase velocity, and a transition to a static state with alternating large and small islands. These states are reached after a complex transient behavior, which involves a competition between secondary current sheet instability and coalescence

  3. Evolution of the MHD sheet pinch

    Matthaeus, W.H.; Montgomery, D.

    1979-01-01

    A magnetohydrodynamic (MHD) problem of recurrent interest for both astrophysical and laboratory plasmas is the evolution of the unstable sheet pinch, a current sheet across which a dc magnetic field reverses sign. The evolution of such a sheet pinch is followed with a spectral-method, incompressible, two-dimensional, MHD turbulence code. Spectral diagnostics are employed, as are contour plots of vector potential (magnetic field lines), electric current density, and velocity stream function (velocity streamlines). The nonlinear effect which seems most important is seen to be current filamentation: the concentration of the current density onto sets of small measure near a mgnetic X point. A great deal of turbulence is apparent in the current distribution, which, for high Reynolds numbers, requires large spatial grids (greater than or equal to (64) 2 ). 11 figures, 1 table

  4. Dipole-sheet multipole magnets for accelerators

    Walstrom, P.L.

    1993-01-01

    The dipole-sheet formalism can be used to describe both cylindrical current-sheet multipole magnets and cylindrical-bore magnets made up of permanent magnet blocks. For current sheets, the formalism provides a natural way of finding a finite set of turns that approximate a continuous distribution. The formalism is especially useful In accelerator applications where large-bore, short, high-field-quality magnets that are dominated by fringe fields are needed. A further advantage of the approach is that in systems with either open or cylindrically symmetric magnetic boundaries, analytical expressions for the three-dimensional fields that are suitable for rapid numerical evaluation can be derived. This development is described in some detail. Also, recent developments in higher-order particle-beam optics codes based on the formalism are described briefly

  5. Symmetry breaking bifurcations of a current sheet

    Parker, R.D.; Dewar, R.L.; Johnson, J.L.

    1988-08-01

    Using a time evolution code with periodic boundary conditions, the viscoresistive hydromagnetic equations describing an initially static, planar current sheet with large Lundquist number have been evolved for times long enough to reach a steady state. A cosh 2 x resistivity model was used. For long periodicity lengths, L p , the resistivity gradient drives flows which cause forced reconnection at X point current sheets. Using L p as a bifurcation parameter, two new symmetry breaking bifurcations were found - a transition to an asymmetric island chain with nonzero, positive or negative phase velocity, and a transition to a static state with alternating large and small islands. These states are reached after a complex transient behavior which involves a competition between secondary current sheet instability and coalescence. 31 refs., 6 figs

  6. Continuous liquid sheet generator for ion stripping

    Gavin, B.; Batson, P.; Leemann, B.; Rude, B.

    1984-10-01

    Many of the technical problems of generating a large thin liquid sheet from 0.02 to 0.20 μm thick (3 to 40 μgm/cm 2 ) have been solved. It is shown that this perennial sheet is stable and consonant in dimension. Several ion beam species from the SuperHILAC have been used for evaluation; at 0.11 MeV/n. In one of three modes this sheet serves as an equivalent substitute for a carbon foil. The second mode is characterized by a solid-like charge state distribution but with a varying fraction of unstripped ions. The third mode gives stripping performance akin to a vapor stripping medium. 9 references, 7 figures

  7. Balance Velocities of the Greenland Ice Sheet

    Joughin, Ian; Fahnestock, Mark; Ekholm, Simon; Kwok, Ron

    1997-01-01

    We present a map of balance velocities for the Greenland ice sheet. The resolution of the underlying DEM, which was derived primarily from radar altimetry data, yields far greater detail than earlier balance velocity estimates for Greenland. The velocity contours reveal in striking detail the location of an ice stream in northeastern Greenland, which was only recently discovered using satellite imagery. Enhanced flow associated with all of the major outlets is clearly visible, although small errors in the source data result in less accurate estimates of the absolute flow speeds. Nevertheless, the balance map is useful for ice-sheet modelling, mass balance studies, and field planning.

  8. Physics of the magnetotail current sheet

    Chen, J.

    1993-01-01

    The Earth's magnetotail plays an important role in the solar-wind--magnetosphere coupling. At the midplane of the magnetotail is a current sheet where the dominant magnetic field component reverses sign. The charged particle motion in and near the current sheet is collisionless and nonintegrable, exhibiting chaotic scattering. The current understanding of the dynamical properties of the charged particle motion is discussed. In particular, the relationships between particle dynamics and global attributes of the system are elucidated. Geometrical properties of the phase space determine important physical observables on both micro- and macroscales

  9. W-Band Sheet Beam Klystron Design

    Scheitrum, G.; Caryotakis, G.; Burke, A.; Jensen, A.; Jongewaard, E.; Krasnykh, A.; Neubauer, M.; Phillips, R.; Rauenbuehler, K.

    2011-01-01

    Sheet beam devices provide important advantages for very high power, narrow bandwidth RF sources like accelerator klystrons (1). Reduced current density and increased surface area result in increased power capabi1ity, reduced magnetic fields for focusing and reduced cathode loading. These advantages are offset by increased complexity, beam formation and transport issues and potential for mode competition in the ovennoded cavities and drift tube. This paper will describe the design issues encountered in developing a 100 kW peak and 2 kW average power sheet beam k1ystron at W-band including beam formation, beam transport, circuit design, circuit fabrication and mode competition.

  10. Balance sheet capacity and endogenous risk

    Jon Danielsson; Hyun Song Shin; Jean-Pierre Zigrand

    2011-01-01

    Banks operating under Value-at-Risk constraints give rise to a well-defined aggregate balance sheet capacity for the banking sector as a whole that depends on total bank capital. Equilibrium risk and market risk premiums can be solved in closed form as functions of aggregate bank capital. We explore the empirical properties of the model in light of recent experience in the financial crisis and highlight the importance of balance sheet capacity as the driver of the financial cycle and market r...

  11. Final Report. Coupled simulations of Antarctic Ice-sheet/ocean interactions using POP and CISM

    Asay-Davis, Xylar Storm [Potsdam Institute for Climate Impact Research, Potdam (Germany)

    2015-12-30

    The project performed under this award, referred to from here on as CLARION (CoupLed simulations of Antarctic Ice-sheet/Ocean iNteractions), included important advances in two models of ice sheet and ocean interactions. Despite its short duration (one year), the project made significant progress on its three major foci. First, together with collaborator Daniel Martin at Lawrence Berkeley National Laboratory (LBNL), I developed the POPSICLES coupled ice sheet-ocean model to the point where it could perform a number of pan-Antarctic simulations under various forcing conditions. The results were presented at a number of major conferences and workshops worldwide, and are currently being incorporated into two manuscripts in preparation.

  12. Outreach/education interface for Cryosphere models using the Virtual Ice Sheet Laboratory

    Larour, E. Y.; Halkides, D. J.; Romero, V.; Cheng, D. L.; Perez, G.

    2014-12-01

    In the past decade, great strides have been made in the development of models capable of projecting the future evolution of glaciers and the polar ice sheets in a changing climate. These models are now capable of replicating some of the trends apparent in satellite observations. However, because this field is just now maturing, very few efforts have been dedicated to adapting these capabilities to education. Technologies that have been used in outreach efforts in Atmospheric and Oceanic sciences still have not been extended to Cryospheric Science. We present a cutting-edge, technologically driven virtual laboratory, geared towards outreach and k-12 education, dedicated to the polar ice sheets on Antarctica and Greenland, and their role as major contributors to sea level rise in coming decades. VISL (Virtual Ice Sheet Laboratory) relies on state-of-the art Web GL rendering of polar ice sheets, Android/iPhone and web portability using Javascript, as well as C++ simulations (back-end) based on the Ice Sheet System Model, the NASA model for simulating the evolution of polar ice sheets. Using VISL, educators and students can have an immersive experience into the world of polar ice sheets, while at the same exercising the capabilities of a state-of-the-art climate model, all of it embedded into an education experience that follows the new STEM standards for education.This work was performed at the California Institute of Technology's Jet Propulsion Laboratory under a contract with the National Aeronautics and Space Administration's Cryosphere Science Program.

  13. Application of GRACE to the Evaluation of an Ice Flow Model of the Greenland Ice Sheet

    Schlegel, N.; Wiese, D. N.; Watkins, M. M.; Larour, E. Y.; Box, J. E.; Fettweis, X.; van den Broeke, M. R.; Morlighem, M.; Boening, C.; Seroussi, H. L.

    2014-12-01

    Quantifying Greenland's future contribution to sea level rise is a challenging task and requires accurate estimates of ice flow sensitivity to climate change. Transient ice flow models are promising tools for estimating future ice sheet behavior. However, confidence in these types of future projections is low, especially because evaluation of model historical runs is so challenging due to the scarcity of continental-wide data for validation. For more than a decade, NASA's GRACE has continuously acquired time-variable measurements of the Earth's gravity field and has provided unprecedented surveillance of mass balance of the ice sheets, offering an opportunity for ice sheet model evaluation. Here, we take advantage of a new high-resolution (~300 km) monthly mascon solution for the purpose of mass balance comparison with an independent, historical ice flow model simulation using the Ice Sheet System Model (ISSM). The comparison highlights which regions of the ice sheet differ most from GRACE. Investigation of regional differences in trends and seasonal amplitudes between simulations forced with three different Regional Climate Model (RCM)-based estimates of surface mass balance (SMB) allows us to make conclusions about the relative contributions of various error sources in the model hindcast. This study constitutes the first regional comparison of GRACE data and an ice sheet model. Conclusions will aid in the improvement of RCM SMB estimates as well as ice sheet simulation estimates of present and future rates of sea level rise. This work was performed at the California Institute of Technology's Jet Propulsion Laboratory under a contract with the National Aeronautics and Space Administration's Cryosphere Program and President's and Director's Fund Program.

  14. Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana

    Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

    2016-01-01

    Background In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universa...

  15. Efficacy and safety of human papillomavirus vaccine for primary prevention of cervical cancer: A review of evidence from phase III trials and national programs

    Partha Basu

    2013-01-01

    Full Text Available The Human Papillomavirus (HPV vaccines have been widely introduced in the national immunization programs in most of the medium and high income countries following endorsement from national and international advisory bodies. HPV vaccine is unique and its introduction is challenging in many ways - it is the first vaccine developed to prevent any cancer, the vaccine is gender specific, it targets adolescent females who are difficult to reach by any health intervention programs. It is not unusual for such a vaccine to face scepticism and reservations not only from lay public but also from professionals in spite of the clinical trial results convincingly and consistently proving their efficacy and safety. Over the last few years millions of doses of the HPV vaccine have been administered round the world and the efficacy and safety data have started coming from the real life programs. A comprehensive cervical cancer control program involving HPV vaccination of the adolescent girls and screening of the adult women has been proved to be the most cost-effective approach to reduce the burden of cervical cancer. The present article discusses the justification of HPV vaccination in the backdrop of natural history of cervical cancer, the mechanism of action of the vaccines, efficacy and safety data from phase III randomized controlled trials as well as from the national immunization programs of various countries.

  16. Relation between current sheets and vortex sheets in stationary incompressible MHD

    D. H. Nickeler

    2012-03-01

    Full Text Available Magnetohydrodynamic configurations with strong localized current concentrations and vortices play an important role in the dissipation of energy in space and astrophysical plasma. Within this work we investigate the relation between current sheets and vortex sheets in incompressible, stationary equilibria. For this approach it is helpful that the similar mathematical structure of magnetohydrostatics and stationary incompressible hydrodynamics allows us to transform static equilibria into stationary ones. The main control function for such a transformation is the profile of the Alfvén-Mach number MA, which is always constant along magnetic field lines, but can change from one field line to another. In the case of a global constant MA, vortices and electric current concentrations are parallel. More interesting is the nonlinear case, where MA varies perpendicular to the field lines. This is a typical situation at boundary layers like the magnetopause, heliopause, the solar wind flowing around helmet streamers and at the boundary of solar coronal holes. The corresponding current and vortex sheets show in some cases also an alignment, but not in every case. For special density distributions in 2-D, it is possible to have current but no vortex sheets. In 2-D, vortex sheets of field aligned-flows can also exist without strong current sheets, taking the limit of small Alfvén Mach numbers into account. The current sheet can vanish if the Alfvén Mach number is (almost constant and the density gradient is large across some boundary layer. It should be emphasized that the used theory is not only valid for small Alfvén Mach numbers MA MA ≲ 1. Connection to other theoretical approaches and observations and physical effects in space plasmas are presented. Differences in the various aspects of theoretical investigations of current sheets and vortex sheets are given.

  17. Clustering of unhealthy lifestyle behaviours and associations with perceived and actual weight status among primary school children in China: A nationally representative cross-sectional study.

    Zhang, Juan; Feng, Xiaoqi; Zhai, Yi; Li, Weirong; Lv, Yue-Bin; Astell-Burt, Thomas; Shi, Xiaoming

    2018-07-01

    Few studies have focused on clustering of unhealthy lifestyle behaviours among primary school children and potential associations with perceived and actual weight status. An index was constructed from adding up 13 unhealthy behaviours measured by survey responses. Multilevel linear regressions were used to analyse associations between child personal characteristics, perceived and actual weight status with the unhealthy lifestyle index among 11,157 children in primary schools across China. Parental and area factors were also taken into account, including education, weight status, physical activity, urban/rural and area socioeconomic circumstances. The unhealthy lifestyle index normally distributed, with 84.5% of children reporting between 2 and 6 unhealthy behaviours. Boys reported more unhealthy behaviours compared with girls (coefficient 0.32, 95%CI 0.26 to 0.37) and children in urban areas had fewer unhealthy behaviours than their rural counterparts (-0.29, 95%CI -0.56 to -0.03). An interaction revealed stronger 'protective' effects of living in cities for girls than boys, which were not explained by differences in child overweight/obesity. More unhealthy behaviours were characteristic of children in more affluent areas, and of those born to mothers and/or fathers with lower educational attainment. Children who perceived themselves as overweight or underweight both scored higher on the unhealthy lifestyle index. Unhealthy behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. There was no effect of actual weight status on number of unhealthy behaviours. Perceived, but not actual weight status, was also a significant correlate of unhealthy behaviours. Clustering of unhealthy lifestyle behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly

  18. Laminin-521 Promotes Rat Bone Marrow Mesenchymal Stem Cell Sheet Formation on Light-Induced Cell Sheet Technology

    Zhiwei Jiang

    2017-01-01

    Full Text Available Rat bone marrow mesenchymal stem cell sheets (rBMSC sheets are attractive for cell-based tissue engineering. However, methods of culturing rBMSC sheets are critically limited. In order to obtain intact rBMSC sheets, a light-induced cell sheet method was used in this study. TiO2 nanodot films were coated with (TL or without (TN laminin-521. We investigated the effects of laminin-521 on rBMSCs during cell sheet culturing. The fabricated rBMSC sheets were subsequently assessed to study cell sheet viability, reattachment ability, cell sheet thickness, collagen type I deposition, and multilineage potential. The results showed that laminin-521 could promote the formation of rBMSC sheets with good viability under hyperconfluent conditions. Cell sheet thickness increased from an initial 26.7 ± 1.5 μm (day 5 up to 47.7 ± 3.0 μm (day 10. Moreover, rBMSC sheets maintained their potential of osteogenic, adipogenic, and chondrogenic differentiation. This study provides a new strategy to obtain rBMSC sheets using light-induced cell sheet technology.

  19. The management of lactose intolerance among primary care physicians and its correlation with management by gastroenterologists: the SEPD-SEMG national survey

    Federico Argüelles-Arias

    2015-09-01

    Full Text Available Introduction and aims: The understanding of lactose intolerance (LI is limited in some professional settings. Sociedad Española de Patología Digestiva (SEPD and Sociedad Española de Medicina General (SEMG have developed a survey in order to: a Analyze primary care physicians (PCPs knowledge and clinical management; and b to compare results with those of a previous survey of Spanish gastroenterologists (GEs. Material and methods: An online questionnaire was sent to SEMG members with 27 items on various issues: Demographics, occupational characteristics, outlook on LI, diagnostic tests, treatment, and follow-up. Results were compared to those from a survey of GEs. Results: A total of 456 PCPs responded, versus 477 GEs. PCPs had an older mean age and longer professional experience. Level of understanding of LI was similar, albeit a higher proportion of PCPs lacked epidemiological awareness (p 0.001, and LI symptoms as overlapping those of irritable bowel syndrome (93.5 vs. 88.2%; p = 0.005, although symptoms perceived as suspicious of LI were similar in both groups. Dietary recommendations were recognized as the primary therapeutic approach. Conclusion: This study reveals the outlook of PCPs on LI, and allows comparison with that of GEs, as a basis for the development of strategies aimed at improving LI understanding, approach and management in our setting.

  20. Management of the clinical issue of constipation with abdominal complaints in adults: a national survey of Primary Care physicians and gastroenterologists

    Enrique Rey

    Full Text Available Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort with variable frequency. The goal of the present study was to obtain information on the workload entailed by patients with constipation and associated abdominal complaints, predominant clinical behaviors, education needs, and potential daily practice aids both in Primary Care and gastroenterology settings. The clinical behavior of doctors is generally similar at both levels, despite differences in healthcare approach: use of empiric therapies and clinically guided diagnostic tests, with some differences in colonoscopy use (not always directly accessible from Primary Care. Regarding perceptions, general support and osmotic laxatives are most valued by PC doctors, whereas osmotic laxatives, combined laxatives, and linaclotide are most valued by GE specialists. Furthermore, over half of respondents considered differentiating both diagnoses as challenging. Finally, considerable education needs are self-acknowledged at both levels, as is a demand for guidelines and protocols to help in managing this issue in clinical practice. A strength of this study is its providing a joint photograph of the medical approach and the perceptions of constipation with abdominal discomfort from a medical standpoint. Weaknesses include self-declaration (no formal validation and a response rate potentially biased by professional motivation.

  1. Bio-artificial pleura using an autologous dermal fibroblast sheet

    Kanzaki, Masato; Takagi, Ryo; Washio, Kaoru; Kokubo, Mami; Yamato, Masayuki

    2017-10-01

    Air leaks (ALs) are observed after pulmonary resections, and without proper treatment, can produce severe complications. AL prevention is a critical objective for managing patients after pulmonary resection. This study applied autologous dermal fibroblast sheets (DFS) to close ALs. For sealing ALs in a 44-year-old male human patient with multiple bullae, a 5 × 15-mm section of skin was surgically excised. From this skin specimen, primary dermal fibroblasts were isolated and cultured for 4 weeks to produce DFSs that were harvested after a 10-day culture. ALs were completely sealed using surgical placement of these autologous DFSs. DFS were found to be a durable long-term AL sealant, exhibiting requisite flexibility, elasticity, durability, biocompatibility, and usability, resulting reliable AL closure. DFS should prove to be an extremely useful tissue-engineered pleura substitute.

  2. LSA Large Area Silicon Sheet Task Continuous Czochralski Process Development

    Rea, S. N.

    1979-01-01

    A commercial Czochralski crystal growing furnace was converted to a continuous growth facility by installation of a small, in-situ premelter with attendant silicon storage and transport mechanisms. Using a vertical, cylindrical graphite heater containing a small fused quartz test tube linear from which the molten silicon flowed out the bottom, approximately 83 cm of nominal 5 cm diamter crystal was grown with continuous melt addition furnished by the test tube premelter. High perfection crystal was not obtained, however, due primarily to particulate contamination of the melt. A major contributor to the particulate problem was severe silicon oxide buildup on the premelter which would ultimately drop into the primary melt. Elimination of this oxide buildup will require extensive study and experimentation and the ultimate success of continuous Czochralski depends on a successful solution to this problem. Economically, the continuous Czochralski meets near-term cost goals for silicon sheet material.

  3. Small wind turbines - Technical sheet

    2015-02-01

    This publication first proposes an overview of the technical context of small wind turbines (from less than 1 kW to 36 kW). It discusses issues related to mast height, indicates the various technologies in terms of machine geometry (vertical or horizontal axis), of mast and foundations, of mechanism of orientation with respect to the wind. It also outlines that power curves are not always reliable due to a lack of maturity of techniques and technologies. Other issues are discussed: wind characteristics, and the assessment of the national potential source. The next parts address the regulatory and economic context, environmental impacts (limited impact on landscape, noise), propose an overview of actors and market (supply and demand of small wind turbines in the USA and in France, actors involved in the chain value in France), and give some recommendations for the development of small wind turbines in France. The last part proposes a technical focus on self-consumption by professional in rural areas (production and consumption in farms)

  4. Image Classification of Ribbed Smoked Sheet using Learning Vector Quantization

    Rahmat, R. F.; Pulungan, A. F.; Faza, S.; Budiarto, R.

    2017-01-01

    Natural rubber is an important export commodity in Indonesia, which can be a major contributor to national economic development. One type of rubber used as rubber material exports is Ribbed Smoked Sheet (RSS). The quantity of RSS exports depends on the quality of RSS. RSS rubber quality has been assigned in SNI 06-001-1987 and the International Standards of Quality and Packing for Natural Rubber Grades (The Green Book). The determination of RSS quality is also known as the sorting process. In the rubber factones, the sorting process is still done manually by looking and detecting at the levels of air bubbles on the surface of the rubber sheet by naked eyes so that the result is subjective and not so good. Therefore, a method is required to classify RSS rubber automatically and precisely. We propose some image processing techniques for the pre-processing, zoning method for feature extraction and Learning Vector Quantization (LVQ) method for classifying RSS rubber into two grades, namely RSS1 and RSS3. We used 120 RSS images as training dataset and 60 RSS images as testing dataset. The result shows that our proposed method can give 89% of accuracy and the best perform epoch is in the fifteenth epoch.

  5. Primary care ... where?

    Adcock, G B

    1999-07-01

    Corporate-based nurse managed centers are not the national norm. More prevalent is the use of an occupational health or physician-directed medical model of care. The author describes how a 14-year-old primary care center at a North Carolina computer software company is just "business as usual" when viewed in the context of the company's philosophy, goals, and culture. Included are considerations for nurse practitioners interested in the successful transplantation of this primary care model to other settings.

  6. Lamination sheet of AA BST magnet

    CERN PhotoLab

    1979-01-01

    The AA had 2 types of bending magnets: BLG (window-frame, long and narrow)and BST (H-type, short and wide). The BST had a very wide aperture, 0.564 m of "good field". To demonstrate the size, the petite AA secretary, Val Mansfield, poses with a lamination sheet. See also 7811105, 7906163, 8006050.

  7. Greenland ice sheet mass balance: a review

    Khan, Shfaqat Abbas; Aschwanden, Andy; Bjørk, Anders A.

    2015-01-01

    Over the past quarter of a century the Arctic has warmed more than any other region on Earth, causing a profound impact on the Greenland ice sheet (GrIS) and its contribution to the rise in global sea level. The loss of ice can be partitioned into processes related to surface mass balance...

  8. Multiscale friction modeling for sheet metal forming

    Hol, J.; Cid Alfaro, M.V.; de Rooij, Matthias B.; Meinders, Vincent T.; Felder, Eric; Montmitonnet, Pierre

    2010-01-01

    The most often used friction model for sheet metal forming simulations is the relative simple Coulomb friction model. This paper presents a more advanced friction model for large scale forming simulations based on the surface change on the micro-scale. The surface texture of a material changes when

  9. Chemical Data Reporting Fact Sheet: Chemicals Snapshot

    This fact sheet provides a brief overview of the chemical manufacturing, processing, and use information collected for the 2012 Chemical Data Reporting (CDR) rule. Users do not have access to the complete CDR data set and should draw conclusions with care.

  10. Warm Deep Drawing of Aluminium Sheet

    Bolt, P.J.; Werkhoven, R.J.; van den Boogaard, Antonius H.

    2003-01-01

    Aluminium sheet drawing processes can be improved by manipulating local flow behaviour by means of elevated temperatures and temperature gradients in the tooling. Forming tests showed that a substantial improvement is possible not only for 5xxx but also for 6xxx series alloys. Finite element method

  11. Renewable Energy Project Development Assistance (Fact Sheet)

    2013-07-01

    This fact sheet provides information on the Tribes selected to receive assistance from the U.S. Department of Energy Office of Indian Energy 2013 Strategic Technical Assistance Response Team (START) Program, which provides technical expertise to support the development of next-generation energy projects on tribal lands.

  12. Toxicity of Pesticides. Agrichemical Fact Sheet 2.

    Hock, Winand K.

    This fact sheet gives the acute oral and dermal toxicity (LD 50) of over 250 pesticides in lab animals. The chemicals are categorized as fungicides, herbicides, insecticides, or miscellaneous compounds. One or more trade names are given for each pesticide. In addition, a brief explanation of toxicity determination is given. (BB)

  13. The storm time central plasma sheet

    R. Schödel

    2002-11-01

    Full Text Available The plasma sheet plays a key role during magnetic storms because it is the bottleneck through which large amounts of magnetic flux that have been eroded from the dayside magnetopause have to be returned to the dayside magnetosphere. Using about five years of Geotail data we studied the average properties of the near- and midtail central plasma sheet (CPS in the 10–30 RE range during magnetic storms. The earthward flux transport rate is greatly enhanced during the storm main phase, but shows a significant earthward decrease. Hence, since the magnetic flux cannot be circulated at a sufficient rate, this leads to an average dipolarization of the central plasma sheet. An increase of the specific entropy of the CPS ion population by a factor of about two during the storm main phase provides evidence for nonadiabatic heating processes. The direction of flux transport during the main phase is consistent with the possible formation of a near-Earth neutral line beyond ~20 RE.Key words. Magnetospheric physics (plasma convection; plasma sheet; storms and substorms

  14. Geometry task sheets : grades 3-5

    Rosenberg, Mary

    2009-01-01

    For grades 3-5, our Common Core State Standards-based resource meets the geometry concepts addressed by the NCTM standards and encourages the students to learn and review the concepts in unique ways. Each task sheet is organized around a central problem taken from real-life experiences of the students.

  15. Algebra task sheets : grades pk-2

    Reed, Nat

    2009-01-01

    For grades PK-2, our Common Core State Standards-based resource meets the algebraic concepts addressed by the NCTM standards and encourages the students to learn and review the concepts in unique ways. Each task sheet is organized around a central problem taken from real-life experiences of the students.

  16. Geometry task sheets : grades pk-2

    Rosenberg, Mary

    2009-01-01

    For grades PK-2, our Common Core State Standards-based resource meets the geometry concepts addressed by the NCTM standards and encourages the students to learn and review the concepts in unique ways. Each task sheet is organized around a central problem taken from real-life experiences of the students.

  17. Full size testing of sheet pile walls

    Kuilen, J.W.G. van de; Linden, M.L.R. van der; Katsma, H.; Stolle, P.

    1996-01-01

    Azobé (Lophira alata) is widely used in timber sheet pile walls in the Netherlands. The boards in these walls are coupled and therefore load-sharing can be expected. A simulation model based on the finite element method DIANA (DIANA, 1992) was developed and load-sharing could be calculated. To check

  18. Ice sheets on plastically-yielding beds

    Hewitt, Ian

    2016-11-01

    Many fast flowing regions of ice sheets are underlain by a layer of water-saturated sediments, or till. The rheology of the till has been the subject of some controversy, with laboratory tests suggesting almost perfectly plastic behaviour (stress independent of strain rate), but many models adopting a pseudo-viscous description. In this work, we consider the behaviour of glaciers underlain by a plastic bed. The ice is treated as a viscous gravity current, on a bed that allows unconstrained slip above a critical yield stress. This simplified description allows rapid sliding, and aims to investigate 'worst-case' scenarios of possible ice-sheet disintegration. The plastic bed results in an approximate ice-sheet geometry that is primarily controlled by force balance, whilst ice velocity is determined from mass conservation (rather than the other way around, as standard models would hold). The stability of various states is considered, and particular attention is given to the pace at which transitions between unstable states can occur. Finally, we observe that the strength of basal tills depends strongly on pore pressure, and combine the model with a description of subglacial hydrology. Implications for the present-day ice sheets in Greenland and Antarctica will be discussed. Funding: ERC Marie Curie FP7 Career Integration Grant.

  19. College Experience and Volunteering. Fact Sheet

    Marcelo, Karlo Barrios

    2007-01-01

    College experience and volunteering are positively correlated. Measurable differences in civic activity exist between young people who attend college and young people who do not. This fact sheet explores volunteering as civic engagement among youth with college experience, ages 19-25, which was down for the second year in a row in 2006. The…

  20. Thin sheet numerical modelling of continental collision

    Jimenez-Munt, I.; Garcia-Gastellanos, D.; Fernandez, M.

    2005-01-01

    We study the effects of incorporating surface mass transport and the gravitational potential energy of both crust and lithospheric mantle to the viscous thin sheet approach. Recent 2D (cross-section) numerical models show that surface erosion and sediment transport can play a major role in shaping

  1. 16 CFR 460.13 - Fact sheets.

    2010-01-01

    ... INSULATION § 460.13 Fact sheets. If you are a manufacturer, you must give retailers and installers fact... uses. (b) A heading: “This is ____ insulation.” Fill in the blank with the type and form of your... compressed during installation.” (e) After the chart and any statement dealing with the specific type of...

  2. Rapidly cast crystalline thin sheet materials

    Warlimont, H.; Emmerich, K.

    1986-01-01

    The current state and progress of casting thin sheet and ribbons directly from the melt are reviewed. First, the solidification phenomena pertinent to the process are outlined. Subsequently, Fe-Si,l Fe-Si-Al, Fe-Nd-B, Ag-Cu-Ti, alloy steels, Ni superalloys and Si are treated as examples. Finally, the information available on process development is critically assessed

  3. World War II Informational Fact Sheets.

    Department of Defense, Washington, DC.

    This commemorative book provides numerous fact sheets on various aspects of World War II, both on the fighting front and the homefront. Replicas of posters of the war era, descriptions of battles with maps, contributions of women and minorities to the war effort, even music of the wartime era, add to this collection of resource materials useful to…

  4. Flammability studies of impregnated paper sheets

    Ivan Simkovic; Anne Fuller; Robert White

    2011-01-01

    Paper sheets impregnated with flame retardants made from agricultural residues and other additives were studied with the cone calorimeter. The use of sugar beet ethanol eluent (SBE), CaCl2, and ZnCl2 lowered the peak rate of heat release (PRHR) the most in comparison to water treated material. The average effective heat of...

  5. Nuclear Data Sheets for A=213

    Basunia, M.S.

    2007-01-01

    Evaluated spectroscopic data and level schemes from radioactive decay and nuclear reaction studies are presented for all nuclei with mass number A=213. This evaluation for A=213 supersedes the earlier one by Y. A. Akovali (1992Ak01), published in Nuclear Data Sheets 66, 237 (1992)

  6. Laboratory Powder Metallurgy Makes Tough Aluminum Sheet

    Royster, D. M.; Thomas, J. R.; Singleton, O. R.

    1993-01-01

    Aluminum alloy sheet exhibits high tensile and Kahn tear strengths. Rapid solidification of aluminum alloys in powder form and subsequent consolidation and fabrication processes used to tailor parts made of these alloys to satisfy such specific aerospace design requirements as high strength and toughness.

  7. MHD Ballooning Instability in the Plasma Sheet

    Cheng, C.Z.; Zaharia, S.

    2003-01-01

    Based on the ideal-MHD model the stability of ballooning modes is investigated by employing realistic 3D magnetospheric equilibria, in particular for the substorm growth phase. Previous MHD ballooning stability calculations making use of approximations on the plasma compressibility can give rise to erroneous conclusions. Our results show that without making approximations on the plasma compressibility the MHD ballooning modes are unstable for the entire plasma sheet where beta (sub)eq is greater than or equal to 1, and the most unstable modes are located in the strong cross-tail current sheet region in the near-Earth plasma sheet, which maps to the initial brightening location of the breakup arc in the ionosphere. However, the MHD beq threshold is too low in comparison with observations by AMPTE/CCE at X = -(8 - 9)R(sub)E, which show that a low-frequency instability is excited only when beq increases over 50. The difficulty is mitigated by considering the kinetic effects of ion gyrorad ii and trapped electron dynamics, which can greatly increase the stabilizing effects of field line tension and thus enhance the beta(sub)eq threshold [Cheng and Lui, 1998]. The consequence is to reduce the equatorial region of the unstable ballooning modes to the strong cross-tail current sheet region where the free energy associated with the plasma pressure gradient and magnetic field curvature is maximum

  8. Glacial Cycles and ice-sheet modelling

    Oerlemans, J.

    1982-01-01

    An attempt is made to simulate the Pleistocene glacial cycles with a numerical model of the Northern Hemisphere ice sheets. This model treats the vertically-integrated ice flow along a meridian, including computation of bedrock adjustment and temperature distribution in the ice. Basal melt water is

  9. Gas isotope separation method using plasma sheet

    Takayama, K.; Takagi, K.; Fukvi, R.

    1988-03-01

    A high frequency electric field is applied to a plasma sheet with a frequency equal to the cyclotronic frequency of the ions to be separated. Because of resonance the cyclotronic radius of the isotope has increased and the electric charge is eliminated by collision with a separator and the isotope is separated in neutral particles [fr

  10. beta-sheet preferences from first principles

    Rossmeisl, Jan; Bækgaard, Iben Sig Buur; Gregersen, Misha Marie

    2003-01-01

    The natural amino acids have different preferences of occurring in specific types of secondary protein structure. Simulations are performed on periodic model â-sheets of 14 different amino acids, at the level of density functional theory, employing the generalized gradient approximation. We find ...

  11. French electric power balance sheet 2007

    Lartigau, Thierry; Pierron, Helene

    2008-01-01

    The mission of RTE, the French electricity Transportation grid, a public service assignment, is to balance the electricity supply and demand in real time. This report presents RTE's technical results for the year 2007: key figures of the electricity balance sheet, progresses in the implementation of market mechanisms, durable rise of RTE's investment, and RTE's commitment in sustainable development

  12. Constitutive Modeling for Sheet Metal Forming

    Barlat, Frederic

    2005-01-01

    This paper reviews aspects of the plastic behaviour common in sheet metals. Macroscopic and microscopic phenomena occurring during plastic deformation are described succinctly. Constitutive models of plasticity suitable for applications to forming, are discussed in a very broad manner. Approaches to plastic anisotropy are described in a somewhat more detailed manner

  13. THE LANGUAGE LABORATORY--WORK SHEET.

    CROSBIE, KEITH

    DESIGNED FOR TEACHERS AND ADMINISTRATORS, THIS WORK SHEET PROVIDES GENERAL AND SPECIFIC INFORMATION ABOUT THE PHILOSOPHY, TYPES, AND USES OF LANGUAGE LABORATORIES IN SECONDARY SCHOOL LANGUAGE PROGRAMS. THE FIRST SECTION DISCUSSES THE ADVANTAGES OF USING THE LABORATORY EFFECTIVELY TO REINFORCE AND CONSOLIDATE CLASSROOM LEARNING, AND MENTIONS SOME…

  14. Aluminium sheet forming at elevated temperatures

    van den Boogaard, Antonius H.; Bolt, P.J.; Werkhoven, R.J.

    2001-01-01

    The formability of aluminum sheet depends on the temperature of the material and the strain rate. E.g. the limiting drawing ratio can be improved by increasing the temperature uniformly, but even more by heating the flange and cooling the punch. To accurately simulate the deep drawing or stretching

  15. Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data.

    Ashworth, Mark; White, Patrick; Jongsma, Hannah; Schofield, Peter; Armstrong, David

    2016-01-01

    Concerns about adverse effects on patient satisfaction may be an important obstacle to attempts to curtail antibiotic prescribing. To determine the relationship between antibiotic prescribing in general practice and reported patient satisfaction. Retrospective cross-sectional study of general practices in England. Data were obtained from the General Practice Patient Survey (GPPS) in 2012 (2.7 million questionnaires in England; 982 999 responses; response rate 36%); the national Quality and Outcomes Framework dataset for England, 2011-2012 (8164 general practices); and general practice and demographic characteristics. Standardised measures of antibiotic prescribing volumes were obtained for each practice in England during 2012-2013, together with 12 other nationally available prescribing variables. The role of antibiotic prescribing volume was identified as a determinant of GPPS scores and adjusted for demographic and practice factors using multiple linear regression. The final dataset consisted of 7800 (95.5%) practices. A total of 33.7 million antibiotic prescriptions were issued to a registered population of 53.8 million patients. Antibiotic prescribing volume was a significant positive predictor of all 'doctor satisfaction' and 'practice satisfaction' scores in the GPPS, and was the strongest predictor of overall satisfaction out of 13 prescribing variables. A theoretical 25% reduction in antibiotic prescribing volume would be associated with 0.5-1.0% lower patient satisfaction scores, a drop of 3-6 centile points in national satisfaction ranking. Patients were less satisfied in practices with frugal antibiotic prescribing. A cautious approach to antibiotic prescribing may require a trade-off in terms of patient satisfaction. © British Journal of General Practice 2016.

  16. National collegiate athletic association division and primary job title of athletic trainers and their job satisfaction or intention to leave athletic training.

    Terranova, Aaron B; Henning, Jolene M

    2011-01-01

    Membership in the National Athletic Trainers' Association (NATA) has declined in recent years, generating much debate about professional commitment. To compare the contributing factors of job satisfaction and intention to leave athletic training of certified athletic trainers (ATs) employed in National Collegiate Athletic Association (NCAA) institutions. Cross-sectional study. A link to a Web-based questionnaire containing the Spector Job Satisfaction Survey (JSS) and an original Intention to Leave Survey (ITLS) was distributed by e-mail to 1003 certified members of the National Athletic Trainers' Association. A total of 191 certified members of the NATA employed in a college or university setting in a primarily clinical capacity; representing all NCAA divisions; and having the job title of head athletic trainer, associate/assistant athletic trainer, or graduate assistant/intern athletic trainer. We used separate 3 x 3 factorial analyses of variance to compare the mean scores of each JSS subscale and of the ITLS with NCAA division and job title. A stepwise multiple regression was used to determine the strength of the relationships between the JSS subscales and the ITLS. We found differences for job title in the subscales of Fringe Benefits (F(2182) = 7.82, P = .001 ) and Operating Conditions (F(2,182) = 12.01, P < .001). The JSS subscale Nature of Work was the'greatest indicator of intention to leave (β = -0.45). We found a strong negative correlation between various facets of job satisfaction and intention to leave athletic training. The NCAA division seemed to have no effect on an individual's job satisfaction or intention to leave the profession. In addition, only Fringe Benefits and Operating Conditions seemed to be affected by job title. The ATs had similar levels of job satisfaction regardless of NCAA division, and their job titles were not a major factor in job satisfaction.

  17. Chemical analysis of rainfall and throughfall in primary forest in the Tapajós National Forest, Belterra, Pará, Brazil

    R.C. Oliveira Junior; M. Keller; J. F. da F. Ramos; T.P. Beldini; P.M Crill; P.B. de Camargo; J. van Haren

    2015-01-01

    The Tapajós National Forest (FLONA Tapajós) has 600,000 hectares of protected forest, and is situated 50 km south of the city of Santarém, Pará, Brazil, a port city of 250,000 inhabitants that is located at the confluence of the Tapajós and Amazon Rivers. There is a lot of farmland in the region, which offers many opportunities to study changes in land use. Selective...

  18. Design of the MISMIP+, ISOMIP+, and MISOMIP ice-sheet, ocean, and coupled ice sheet-ocean intercomparison projects

    Asay-Davis, Xylar; Cornford, Stephen; Martin, Daniel; Gudmundsson, Hilmar; Holland, David; Holland, Denise

    2015-04-01

    The MISMIP and MISMIP3D marine ice sheet model intercomparison exercises have become popular benchmarks, and several modeling groups have used them to show how their models compare to both analytical results and other models. Similarly, the ISOMIP (Ice Shelf-Ocean Model Intercomparison Project) experiments have acted as a proving ground for ocean models with sub-ice-shelf cavities.As coupled ice sheet-ocean models become available, an updated set of benchmark experiments is needed. To this end, we propose sequel experiments, MISMIP+ and ISOMIP+, with an end goal of coupling the two in a third intercomparison exercise, MISOMIP (the Marine Ice Sheet-Ocean Model Intercomparison Project). Like MISMIP3D, the MISMIP+ experiments take place in an idealized, three-dimensional setting and compare full 3D (Stokes) and reduced, hydrostatic models. Unlike the earlier exercises, the primary focus will be the response of models to sub-shelf melting. The chosen configuration features an ice shelf that experiences substantial lateral shear and buttresses the upstream ice, and so is well suited to melting experiments. Differences between the steady states of each model are minor compared to the response to melt-rate perturbations, reflecting typical real-world applications where parameters are chosen so that the initial states of all models tend to match observations. The three ISOMIP+ experiments have been designed to to make use of the same bedrock topography as MISMIP+ and using ice-shelf geometries from MISMIP+ results produced by the BISICLES ice-sheet model. The first two experiments use static ice-shelf geometries to simulate the evolution of ocean dynamics and resulting melt rates to a quasi-steady state when far-field forcing changes in either from cold to warm or from warm to cold states. The third experiment prescribes 200 years of dynamic ice-shelf geometry (with both retreating and advancing ice) based on a BISICLES simulation along with similar flips between warm and

  19. Establishing a faith-based organisation nursing school within a national primary health care programme in rural Tanzania: an auto-ethnographic case study

    Alexander Bischoff

    2016-05-01

    Full Text Available Background: In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO nursing school and make recommendations for other similar initiatives. Design: This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Results: Six themes emerged from the experiences that shaped the course of the project: 1 Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public–private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2 Communication was an important and often underrated factor for all types of development projects. 3 Managing the unknown and 4 managing expectations characterised the project inception. Almost all themes had to do with 5 handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6 the need to adjust to ever-changing targets. Conclusions: This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1 Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2 Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve

  20. Establishing a faith-based organisation nursing school within a national primary health care programme in rural Tanzania: an auto-ethnographic case study.

    Bischoff, Alexander

    2016-01-01

    In 2007, the Tanzanian government called for improvements in its primary health care services. Part of this initiative was to accelerate the training rate for nurses qualified to work in rural areas. The aim of this study was to reflect on the issues experienced whilst establishing and implementing a faith-based organisation (FBO) nursing school and make recommendations for other similar initiatives. This paper describes an auto-ethnographic case study design to identify the key difficulties involved with establishing and implementing a new nursing school, and which factors helped the project achieve its goals. Six themes emerged from the experiences that shaped the course of the project: 1) Motivation can be sustained if the rationale of the project is in line with its aims. Indeed, the project's primary health care focus was to strengthen the nursing workforce and build a public-private partnership with an FBO. All these were strengths, which helped in the midst of all the uncertainties. 2) Communication was an important and often underrated factor for all types of development projects. 3) Managing the unknown and 4) managing expectations characterised the project inception. Almost all themes had to do with 5) handling conflicts. With so many participants having their own agendas, tensions were unavoidable. A final theme was 6) the need to adjust to ever-changing targets. This retrospective auto-ethnographic manuscript serves as a small-scale case study, to illustrate how issues that can be generalised to other settings can be deconstructed to demonstrate how they influence health development projects in developing countries. From this narrative of experiences, key recommendations include the following: 1) Find the right ratio of stakeholders, participants, and agendas, and do not overload the project; 2) Be alert and communicate as much as possible with staff and do not ignore issues hoping they will solve themselves; 3) Think flexibly and do not stubbornly

  1. Clouds enhance Greenland ice sheet mass loss

    Van Tricht, Kristof; Gorodetskaya, Irina V.; L'Ecuyer, Tristan; Lenaerts, Jan T. M.; Lhermitte, Stef; Noel, Brice; Turner, David D.; van den Broeke, Michiel R.; van Lipzig, Nicole P. M.

    2015-04-01

    Clouds have a profound influence on both the Arctic and global climate, while they still represent one of the key uncertainties in climate models, limiting the fidelity of future climate projections. The potentially important role of thin liquid-containing clouds over Greenland in enhancing ice sheet melt has recently gained interest, yet current research is spatially and temporally limited, focusing on particular events, and their large scale impact on the surface mass balance remains unknown. We used a combination of satellite remote sensing (CloudSat - CALIPSO), ground-based observations and climate model (RACMO) data to show that liquid-containing clouds warm the Greenland ice sheet 94% of the time. High surface reflectivity (albedo) for shortwave radiation reduces the cloud shortwave cooling effect on the absorbed fluxes, while not influencing the absorption of longwave radiation. Cloud warming over the ice sheet therefore dominates year-round. Only when albedo values drop below ~0.6 in the coastal areas during summer, the cooling effect starts to overcome the warming effect. The year-round excess of energy due to the presence of liquid-containing clouds has an extensive influence on the mass balance of the ice sheet. Simulations using the SNOWPACK snow model showed not only a strong influence of these liquid-containing clouds on melt increase, but also on the increased sublimation mass loss. Simulations with the Community Earth System Climate Model for the end of the 21st century (2080-2099) show that Greenland clouds contain more liquid water path and less ice water path. This implies that cloud radiative forcing will be further enhanced in the future. Our results therefore urge the need for improving cloud microphysics in climate models, to improve future projections of ice sheet mass balance and global sea level rise.

  2. Nonlinear dynamics of thin current sheets

    Daughton, William

    2002-01-01

    Observations indicate that the current sheet in the Earth's geomagnetic tail may compress to a thickness comparable to an ion gyro-radius prior to substorm onset. In recent years, there has been considerable controversy regarding the kinetic stability of these thin structures. In particular, the growth rate of the kink instability and its relevance to magnetotail dynamics is still being debated. In this work, a series of fully kinetic particle-in-cell simulations are performed for a thin Harris sheet. The ion to electron mass ratio is varied between m i /m e =4→400 and careful comparisons are made with a formally exact approach to the linear Vlasov theory. At low mass ratio m i /m e <64, the simulations are in excellent agreement with the linear theory, but at high mass ratio the kink instability is observed to grow more rapidly in the kinetic simulations than predicted by theory. The resolution to this apparent discrepancy involves the lower hybrid instability which is active on the edge of the sheet and rapidly produces nonlinear modifications to the initial equilibrium. The nature of this nonlinear deformation is characterized and a simple model is proposed to explain the physics. After the growth and saturation of the lower hybrid fluctuations, the deformed current sheet is similar in structure to a Harris equilibrium with an additional background population. This may explain the large growth rate of the kink instability at later times, since this type of modification to the Harris sheet has been shown to greatly enhance the growth rate of the kink mode

  3. Monitoring biodiversity loss with primary species-occurrence data: toward national-level indicators for the 2010 target of the convention on biological diversity.

    Soberón, Jorge; Peterson, A Townsend

    2009-02-01

    Development of effective indicators is indispensable for countries and societies to monitor effects of their actions on biodiversity, as is recognized in decision VI/26 of the Convention on Biological Diversity. Good indicators would ideally be scalable, at least for the different scales that characterize biodiversity patterns and process. Existing indicators are mostly global in scope, and often based on secondary information, such as classifications of endangered species, rather than on primary data. We propose a complementary approach, based on the increased availability of raw data about occurrences of species, cutting-edge modeling techniques for estimating distributional areas, and land-use information based on remotely sensed data to allow estimation of rates of range loss for species affected by land-use conversion. This method can be implemented by developing countries, given increasing availability of data and the open and well-documented nature of the techniques required.

  4. Municipal Management, Infrastructure And Perception Of Users: A Description Of National Program For Improving Access And Quality Of Primary Care In The Brazilian Semiarid

    Marília Gomes de Sousa Bezerra

    2017-09-01

    Full Text Available Introduction: The Ministry of Health with the aim of improving the service provided by the Unified Health System has been creating work tools to identify which points need to receive more attention to be optimized. Objective: Description of the role of municipal management, infrastructure assessment and perception of users of primary care. Method: Cross-sectional and descriptive study, conducted with Basic Units of Piauí municipality in 2015. The data were represented by tables. Results: 90% of the units reported receiving support for the planning and organization of the work process. Only 14, 81% of the units have equipment and supplies for proper operation. Users recommend the service in 92,62% of the cases. Conclusion: despite the precarious structure of the basic units of the county, the population still recognizes them as the best care.

  5. How do primary care doctors in England and Wales code and manage people with chronic kidney disease? Results from the National Chronic Kidney Disease Audit.

    Kim, Lois G; Cleary, Faye; Wheeler, David C; Caplin, Ben; Nitsch, Dorothea; Hull, Sally A

    2017-10-16

    In the UK, primary care records are electronic and require doctors to ascribe disease codes to direct care plans and facilitate safe prescribing. We investigated factors associated with coding of chronic kidney disease (CKD) in patients with reduced kidney function and the impact this has on patient management. We identified patients meeting biochemical criteria for CKD (two estimated glomerular filtration rates 90 days apart) from 1039 general practitioner (GP) practices in a UK audit. Clustered logistic regression was used to identify factors associated with coding for CKD and improvement in coding as a result of the audit process. We investigated the relationship between coding and five interventions recommended for CKD: achieving blood pressure targets, proteinuria testing, statin prescription and flu and pneumococcal vaccination. Of 256 000 patients with biochemical CKD, 30% did not have a GP CKD code. Males, older patients, those with more severe CKD, diabetes or hypertension or those prescribed statins were more likely to have a CKD code. Among those with continued biochemical CKD following audit, these same characteristics increased the odds of improved coding. Patients without any kidney diagnosis were less likely to receive optimal care than those coded for CKD [e.g. odds ratio for meeting blood pressure target 0.78 (95% confidence interval 0.76-0.79)]. Older age, male sex, diabetes and hypertension are associated with coding for those with biochemical CKD. CKD coding is associated with receiving key primary care interventions recommended for CKD. Increased efforts to incentivize CKD coding may improve outcomes for CKD patients. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

  6. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardiovascular disease in UK general practice: a national retrospective cohort study.

    Jianhua Wu

    Full Text Available Guidelines indicate eligibility for lipid lowering drugs, but it is not known to what extent GPs' follow guidelines in routine clinical practice or whether additional clinical factors systematically influence their prescribing decisions.A retrospective cohort analysis was undertaken using electronic primary care records from 421 UK general practices. At baseline (May 2008 patients were aged 30 to 74 years, free from cardiovascular disease and not taking lipid lowering drugs. The outcome was prescription of a lipid lowering drug within the next two years. The proportions of eligible and ineligible patients prescribed lipid lowering drugs were reported and multivariable logistic regression models were used to investigate associations between age, sex, cardiovascular risk factors and prescribing.Of 365,718 patients with complete data, 13.8% (50,558 were prescribed lipid lowering drugs: 28.5% (21,101/74,137 of those eligible and 10.1% (29,457/291,581 of those ineligible. Only 41.7% (21,101/50,558 of those prescribed lipid lowering drugs were eligible. In multivariable analysis prescribing was most strongly associated with increasing age (OR for age ≥ 65 years 4.21; 95% CI 4.05-4.39; diabetes (OR 4.49; 95% CI 4.35-4.64; total cholesterol level ≥ 7 mmol/L (OR 2.20; 95% CI 2.12-2.29; and ≥ 4 blood pressure measurements in the past year (OR 4.24; 95% CI 4.06-4.42. The predictors were similar in eligible and ineligible patients.Most lipid lowering drugs for primary prevention are prescribed to ineligible patients. There is underuse of lipid lowering drugs in eligible patients.

  7. Measuring Quality of Healthcare Outcomes in Type 2 Diabetes from Routine Data: a Seven-nation Survey Conducted by the IMIA Primary Health Care Working Group.

    Hinton, W; Liyanage, H; McGovern, A; Liaw, S-T; Kuziemsky, C; Munro, N; de Lusignan, S

    2017-08-01

    Background: The Institute of Medicine framework defines six dimensions of quality for healthcare systems: (1) safety, (2) effectiveness, (3) patient centeredness, (4) timeliness of care, (5) efficiency, and (6) equity. Large health datasets provide an opportunity to assess quality in these areas. Objective: To perform an international comparison of the measurability of the delivery of these aims, in people with type 2 diabetes mellitus (T2DM) from large datasets. Method: We conducted a survey to assess healthcare outcomes data quality of existing databases and disseminated this through professional networks. We examined the data sources used to collect the data, frequency of data uploads, and data types used for identifying people with T2DM. We compared data completeness across the six areas of healthcare quality, using selected measures pertinent to T2DM management. Results: We received 14 responses from seven countries (Australia, Canada, Italy, the Netherlands, Norway, Portugal, Turkey and the UK). Most databases reported frequent data uploads and would be capable of near real time analysis of healthcare quality.The majority of recorded data related to safety (particularly medication adverse events) and treatment efficacy (glycaemic control and microvascular disease). Data potentially measuring equity was less well recorded. Recording levels were lowest for patient-centred care, timeliness of care, and system efficiency, with the majority of databases containing no data in these areas. Databases using primary care sources had higher data quality across all areas measured. Conclusion: Data quality could be improved particularly in the areas of patient-centred care, timeliness, and efficiency. Primary care derived datasets may be most suited to healthcare quality assessment. Georg Thieme Verlag KG Stuttgart.

  8. A Case Study and Balance Sheet Approach to Unemployment.

    Hesketh, Beryl; And Others

    1987-01-01

    Describes positive and negative aspects of employment and unemployment in a balance sheet framework. Discusses the value of the balance sheet approach in understanding individual differences in reactions to unemployment. (Author/KS)

  9. Disposal sheet for preventing scattering of radioactive contaminated material

    Miyasaka, Shun-ichi; Kurioka, Hitoshi; Nakamura, Kenjiro.

    1990-01-01

    Upon disposal of vinyl sheets at the final stage of dismantling operation for nuclear buildings, etc., radioactive contaminated materials caused by cutting concretes, etc. remain on the sheets. In view of the above, members capable of restoring original shape due to the temperature difference are attached to the sheet main body so that the sheet main body may be folded into a bag-like shape. Since the members as described above are bent upon temperature elevation in the sheets, the sheet main body is pulled by the members and then spontaneously folded into a bag-like shape. As a result, the radioactive contaminated materials remaining on the sheets are wrapped into the sheet main body free from touch to operator's hands or without scattering to the surrounding. This can prevent operator's external and internal exposure. (T.M.)

  10. An ice sheet model validation framework for the Greenland ice sheet

    Price, Stephen F.; Hoffman, Matthew J.; Bonin, Jennifer A.; Howat, Ian M.; Neumann, Thomas; Saba, Jack; Tezaur, Irina; Guerber, Jeffrey; Chambers, Don P.; Evans, Katherine J.; Kennedy, Joseph H.; Lenaerts, Jan; Lipscomb, William H.; Perego, Mauro; Salinger, Andrew G.; Tuminaro, Raymond S.; van den Broeke, Michiel R.; Nowicki, Sophie M. J.

    2017-01-01

    We propose a new ice sheet model validation framework - the Cryospheric Model Comparison Tool (CmCt) - that takes advantage of ice sheet altimetry and gravimetry observations collected over the past several decades and is applied here to modeling of the Greenland ice sheet. We use realistic simulations performed with the Community Ice Sheet Model (CISM) along with two idealized, non-dynamic models to demonstrate the framework and its use. Dynamic simulations with CISM are forced from 1991 to 2013, using combinations of reanalysis-based surface mass balance and observations of outlet glacier flux change. We propose and demonstrate qualitative and quantitative metrics for use in evaluating the different model simulations against the observations. We find that the altimetry observations used here are largely ambiguous in terms of their ability to distinguish one simulation from another. Based on basin-scale and whole-ice-sheet-scale metrics, we find that simulations using both idealized conceptual models and dynamic, numerical models provide an equally reasonable representation of the ice sheet surface (mean elevation differences of framework demonstrates that our proposed metrics can distinguish relatively better from relatively worse simulations and that dynamic ice sheet models, when appropriately initialized and forced with the right boundary conditions, demonstrate a predictive skill with respect to observed dynamic changes that have occurred on Greenland over the past few decades. An extensible design will allow for continued use of the CmCt as future altimetry, gravimetry, and other remotely sensed data become available for use in ice sheet model validation.

  11. Using smooth sheets to describe groundfish habitat in Alaskan waters, with specific application to two flatfishes

    Zimmermann, Mark; Reid, Jane A.; Golden, Nadine

    2016-01-01

    In this analysis we demonstrate how preferred fish habitat can be predicted and mapped for juveniles of two Alaskan groundfish species – Pacific halibut (Hippoglossus stenolepis) and flathead sole (Hippoglossoides elassodon) – at five sites (Kiliuda Bay, Izhut Bay, Port Dick, Aialik Bay, and the Barren Islands) in the central Gulf of Alaska. The method involves using geographic information system (GIS) software to extract appropriate information from National Ocean Service (NOS) smooth sheets that are available from NGDC (the National Geophysical Data Center). These smooth sheets are highly detailed charts that include more soundings, substrates, shoreline and feature information than the more commonly-known navigational charts. By bringing the information from smooth sheets into a GIS, a variety of surfaces, such as depth, slope, rugosity and mean grain size were interpolated into raster surfaces. Other measurements such as site openness, shoreline length, proportion of bay that is near shore, areas of rocky reefs and kelp beds, water volumes, surface areas and vertical cross-sections were also made in order to quantify differences between the study sites. Proper GIS processing also allows linking the smooth sheets to other data sets, such as orthographic satellite photographs, topographic maps and precipitation estimates from which watersheds and runoff can be derived. This same methodology can be applied to larger areas, taking advantage of these free data sets to describe predicted groundfish essential fish habitat (EFH) in Alaskan waters.

  12. Effect of Temperature and Sheet Temper on Isothermal Solidification Kinetics in Clad Aluminum Brazing Sheet

    Benoit, Michael J.; Whitney, Mark A.; Wells, Mary A.; Winkler, Sooky

    2016-09-01

    Isothermal solidification (IS) is a phenomenon observed in clad aluminum brazing sheets, wherein the amount of liquid clad metal is reduced by penetration of the liquid clad into the core. The objective of the current investigation is to quantify the rate of IS through the use of a previously derived parameter, the Interface Rate Constant (IRC). The effect of peak temperature and initial sheet temper on IS kinetics were investigated. The results demonstrated that IS is due to the diffusion of silicon (Si) from the liquid clad layer into the solid core. Reduced amounts of liquid clad at long liquid duration times, a roughened sheet surface, and differences in resolidified clad layer morphology between sheet tempers were observed. Increased IS kinetics were predicted at higher temperatures by an IRC model as well as by experimentally determined IRC values; however, the magnitudes of these values are not in good agreement due to deficiencies in the model when applied to alloys. IS kinetics were found to be higher for sheets in the fully annealed condition when compared with work-hardened sheets, due to the influence of core grain boundaries providing high diffusivity pathways for Si diffusion, resulting in more rapid liquid clad penetration.

  13. Laser-sheet imaging of HE-driven interfaces

    Benjamin, R.F.; Rightley, P.M.; Kinkead, S.; Martin, R.A.; Critchfield, R.; Sandoval, D.L.; Holmes, R.; Gorman, T.

    1998-01-01

    This is the final report of a three-year, Laboratory Directed Research and Development (LDRD) project at Los Alamos National Laboratory (LANL). The authors made substantial progress in developing the MILSI (Multiple Imaging of Laser-Sheet Illumination) technique for high explosive (HE)-driven fluid interfaces. They observed the instability, but have not yet measured the instability growth rate. They developed suitable sample containers and optical systems for studying the Rightmyer-Meshkov instability of perturbed water/bromoform interfaces and they successfully fielded the new MILSI diagnostic at two firing-site facilities. The problem continues to be of central importance to the inertial confinement fusion (ICF) and weapons physics communities

  14. Patient satisfaction with primary health care - a comparison between the insured and non-insured under the National Health Insurance Policy in Ghana

    Fenny, Ama Pokuah; Enemark, Ulrika; Asante, Felix A

    2014-01-01

    Ghana has initiated various health sector reforms over the past decades aimed at strengthening institutions, improving the overall health system and increasing access to healthcare services by all groups of people. The National Health Insurance Scheme (NHIS) instituted in 2005, is an innovative...... system aimed at making health care more accessible to people who need it. Currently, there is a growing amount of concern about the capacity of the NHIS to make quality health care accessible to its clients. A number of studies have concentrated on the effect of health insurance status on demand...... for health services, but have been quiet on supply side issues. The main aim of this study is to examine the overall satisfaction with health care among the insured and uninsured under the NHIS. The second aim is to explore the relations between overall satisfaction and socio-demographic characteristics...

  15. In-hospital mortality, 30-day readmission, and length of hospital stay after surgery for primary colorectal cancer: A national population-based study.

    Pucciarelli, S; Zorzi, M; Gennaro, N; Gagliardi, G; Restivo, A; Saugo, M; Barina, A; Rugge, M; Zuin, M; Maretto, I; Nitti, D

    2017-07-01

    The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included. The adjusted odd ratios for risk factors for in-hospital mortality, 30-day readmission, and LOS were calculated using multilevel multivariable logistic regression. Among the 353 941 patients, rates of in-hospital mortality and 30-day readmission were 2.5% and 6%, respectively, and the median LOS was 13 days. High comorbidity, emergent/urgent admission, male gender, creation of a stoma, and an open approach increased the risks of all the outcomes at multivariable analysis. Age, hospital volume, hospital geographic location, and discharge to home/non-home produced different effects depending on the outcome considered. The most frequent causes of readmission were infection (19%) and bowel obstruction (14.6%). We assessed national averages for mortality, LOS and readmission and related trends over a 10-year time. Laparoscopic surgery was the only one that could be modified by improving surgical education. Higher hospital volume was associated with a LOS reduction, but our findings only partially support a policy of centralization for colorectal cancer procedures. Surgical site infection was identified as the most preventable cause of readmission. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  16. Boundary layers as the primary transport regions of the earth's magnetotail

    Eastman, T.E.; Frank, L.A.; Huang, C.Y.

    1985-01-01

    A comprehensive survey of ISEE and IMP LEPEDEA plasma measurements in the earth's magnetotail reveals that the magnetospheric boundary layer and the plasma sheet boundary layer are the primary transport regions there. These plasma measurements also distinguish various components of the plasma sheet, including the central plasma sheet and plasma sheet boundary layer. A significant new result reported here is the existence of cold-and hot-plasma components that are spatially copresent within the central plasma sheet. Such plasma components cannot be explained merely by temporal variations in spectra involving the entire plasma sheet. Contributions to a low-temperature component of the plasma sheet enter directly from the boundary layer located along the magnetotail flanks. Field-aligned flows predominate within the plasma sheet boundary layer, which is almost always present and is located near the northern and southern border of the plasma sheet. The plasma sheet boundary layer comprises highly anisotropic ion distributions, including counteracting ion beams, that evolve into the hot, isotropic component of the plasma sheet

  17. 49 CFR 1243.2 - Condensed balance sheet.

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Condensed balance sheet. 1243.2 Section 1243.2... § 1243.2 Condensed balance sheet. Commencing with reports for the 3 months beginning January 1, 1972, and... hereby, required to compile and file quarterly reports of balance sheet items in accordance with...

  18. 17 CFR 210.7-03 - Balance sheets.

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Balance sheets. 210.7-03... 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975 Insurance Companies § 210.7-03 Balance sheets. (a... otherwise permitted by the Commission, should appear on the face of the balance sheets and in the notes...

  19. 14 CFR Section 3 - Chart of Balance Sheet Accounts

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Chart of Balance Sheet Accounts Section 3 Section 3 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION... Balance Sheet Classifications Section 3 Chart of Balance Sheet Accounts [See footnotes at end of table...

  20. Bamboo Fibre Reinforced Cement Used as a Roofing Sheet | Alade ...

    Bamboo fibre roofing sheet was able to withstand an average load of 51Kg, which is above the minimum required strength of 50kg. Comparatively, Asbestos roofing sheets and coconut fibre roofing sheets of similar dimensions had failure loads of 104.65Kg and 79Kg respectively. When immersed in water, bamboo fibre ...

  1. 17 CFR 210.5-02 - Balance sheets.

    2010-04-01

    ... customers at the date of the balance sheet. Include a general description of the prerequisites for billing... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Balance sheets. 210.5-02... Balance sheets. The purpose of this rule is to indicate the various line items and certain additional...

  2. Reducing Test Anxiety while Increasing Learning: The Cheat Sheet

    Erbe, Brigitte

    2007-01-01

    Student learning is greatly enhanced by studying prior to an exam. Allowing students to prepare a cheat sheet for the exam helps structure this study time and deepens learning. The crib sheet is well defined: one double-sided page of notes. An award for the best and most creative cheat sheet allows the instructor to appreciate the students'…

  3. 17 CFR 229.1001 - (Item 1001) Summary term sheet.

    2010-04-01

    ... sheet that is written in plain English. The summary term sheet must briefly describe in bullet point format the most material terms of the proposed transaction. The summary term sheet must provide security... transaction. The bullet points must cross-reference a more detailed discussion contained in the disclosure...

  4. Analysis of Financial Position Based on the Balance Sheet

    Spineanu-Georgescu Luciana

    2011-01-01

    Analysis of financial position based on the balance sheet is mainly aimed at assessing the extent to which financial structure chosen by the firm, namely, financial resources, covering the needs reflected in the balance sheet financed. This is done through an analysis known as horizontal analysis balance sheet financial imbalances.

  5. School performance from primary education in the adolescent offspring of parents with schizophrenia and bipolar disorder- a national, register-based study

    Ranning, Anne; Laursen, Thomas; Agerbo, Esben

    2017-01-01

    BACKGROUND: Schizophrenia (SZ) and bipolar disorder (BP) are causes of severe disability worldwide and parents' severe mental illness (SMI) is associated with childhood adversity, and socio-emotional and cognitive problems in children. Yet, how parental BP and SZ affect educational attainment in ...... education. In contrast, the children of parents with BP were indistinguishable from the reference group regarding school grades. This signifies that specificity of parental severe mental illness is important in relation to educational achievement of children.......BACKGROUND: Schizophrenia (SZ) and bipolar disorder (BP) are causes of severe disability worldwide and parents' severe mental illness (SMI) is associated with childhood adversity, and socio-emotional and cognitive problems in children. Yet, how parental BP and SZ affect educational attainment...... in offspring is still unclear. METHOD: We included all children (N = 684.248) born and living in Denmark between 1986 and 1996 and their parents. Our follow-up lasted from 1986 until children's graduation in 2014. The main outcome variable was their school grades following their primary education. School...

  6. Substorms in the Inner Plasma Sheet

    Le Contel, O.; Perraut, S.; Roux, A.; Pellat, R.; Korth, A.

    Thin Current Sheets (TCS) are regularly formed prior to substorm breakup, even in the near-Earth plasma sheet, as close as the geostationary orbit. A self-consistent kinetic theory describing the response of the plasma sheet to an electromagnetic perturbation is given. This perturbation corresponds to an external forcing, for instance caused by the solar wind (not an internal instability). The equilibrium of the configuration of this TCS in the presence of a time varying perturbation is shown to produce a strong parallel thermal anisotropy (T∥ > T⊺) of energetic electrons and ions (E>50keV) as well as an enhanced diamagnetic current carried by low energy ions (Ecurrents tend to enhance the confinement of this current sheet near the magnetic equator. These results are compared with data gathered by GEOS-2 at the geostationary orbit, where the magnetic signatures of TCS, and parallel anisotropies are regularly observed prior to breakup. By ensuring quasi-neutrality everywhere we find, when low frequency electromagnetic perturbations are applied, that although the magnetic field line remains an equipotential to the lowest order in Te/Ti, a field-aligned potential drop exists to the next order in (Te/Ti). Thus the development of a TCS implies the formation of a field-aligned potential drop (~= few hundred volts) to ensure the quasi-neutrality everywhere. For an earthward directed pressure gradient, a field-aligned electric field, directed towards the ionosphere, is obtained, on the western edge of the perturbation (i.e. western edge of the current sheet). Thus field aligned beams of electrons are expected to flow towards the equatorial region on the western edge of the current sheet. We study the stability of these electron beams and show that they are unstable to ``High Frequency'' (HF) waves. These ``HF'' waves are regularly observed at frequencies of the order of the proton gyrofrequency (fH+) just before, or at breakup. The amplitude of these HF waves is so

  7. The Rapid Ice Sheet Change Observatory (RISCO)

    Morin, P.; Howat, I. M.; Ahn, Y.; Porter, C.; McFadden, E. M.

    2010-12-01

    The recent expansion of observational capacity from space has revealed dramatic, rapid changes in the Earth’s ice cover. These discoveries have fundamentally altered how scientists view ice-sheet change. Instead of just slow changes in snow accumulation and melting over centuries or millennia, important changes can occur in sudden events lasting only months, weeks, or even a single day. Our understanding of these short time- and space-scale processes, which hold important implications for future global sea level rise, has been impeded by the low temporal and spatial resolution, delayed sensor tasking, incomplete coverage, inaccessibility and/or high cost of data available to investigators. New cross-agency partnerships and data access policies provide the opportunity to dramatically improve the resolution of ice sheet observations by an order of magnitude, from timescales of months and distances of 10’s of meters, to days and meters or less. Advances in image processing technology also enable application of currently under-utilized datasets. The infrastructure for systematically gathering, processing, analyzing and distributing these data does not currently exist. Here we present the development of a multi-institutional, multi-platform observatory for rapid ice change with the ultimate objective of helping to elucidate the relevant timescales and processes of ice sheet dynamics and response to climate change. The Rapid Ice Sheet Observatory (RISCO) gathers observations of short time- and space-scale Cryosphere events and makes them easily accessible to investigators, media and general public. As opposed to existing data centers, which are structured to archive and distribute diverse types of raw data to end users with the specialized software and skills to analyze them, RISCO focuses on three types of geo-referenced raster (image) data products in a format immediately viewable with commonly available software. These three products are (1) sequences of images

  8. The evolution of the Antarctic ice sheet at the Eocene-Oligocene Transition.

    Ladant, Jean-Baptiste; Donnadieu, Yannick; Dumas, Christophe

    2017-04-01

    An increasing number of studies suggest that the Middle to Late Eocene has witnessed the waxing and waning of relatively small ephemeral ice sheets. These alternating episodes culminated in the Eocene-Oligocene transition (34 - 33.5 Ma) during which a sudden and massive glaciation occurred over Antarctica. Data studies have demonstrated that this glacial event is constituted of two 50 kyr-long steps, the first of modest (10 - 30 m of equivalent sea level) and the second of major (50 - 90 m esl) glacial amplitude, and separated by 200 kyrs. Since a decade, modeling studies have put forward the primary role of CO2 in the initiation of this glaciation, in doing so marginalizing the original "gateway hypothesis". Here, we investigate the impacts of CO2 and orbital parameters on the evolution of the ice sheet during the 500 kyrs of the EO transition using a tri-dimensional interpolation method. The latter allows precise orbital variations, CO2 evolution and ice sheet feedbacks (including the albedo) to be accounted for. Our results show that orbital variations are instrumental in initiating the first step of the EO glaciation but that the primary driver of the major second step is the atmospheric pCO2 crossing a modelled glacial threshold of 900 ppm. Although model-dependant, this higher glacial threshold makes a stronger case for ephemeral Middle-Late Eocene ice sheets. In addition, sensitivity tests demonstrate that the small first step only exists if the absolute pCO2 value remains within 100 ppm higher than the glacial threshold during the first 250 kyrs of the transition. Thereby, the pCO2 sufficiently counterbalances the strong insolation minima occurring at 33.9 and 33.8 Ma but is low enough to allow the ice sheet to nucleate. Nevertheless, questions remain as to what may cause this pCO2 drop.

  9. Apparatus for forming an explosively expanded tube-tube sheet joint

    Schroeder, J.W.

    1984-01-01

    The invention relates to apparatus for expanding a tube into a bore formed in a tube sheet. According to the invention, a primary explosive containing a relatively high number of grains of explosive per unit length extends within the tube coextensive with that portion of the tube to be expanded. An energy transfer cord extends between a detonator and the primary explosive and includes a relatively low number of grains of explosive per unit length which are insufficient to detonate the primary explosive. The transfer cord is covered by a sheath to contain the debris and gases associated with the explosion of the explosive therein. A booster extends between the energy transfer cord and the primary explosive and contains an explosive which can be detonated by the explosive in the energy transfer cord and can, upon exploding, in turn detonate the primary explosive. (author)

  10. Optimal Management Strategies for Primary HPV Testing for Cervical Screening: Cost-Effectiveness Evaluation for the National Cervical Screening Program in Australia.

    Simms, Kate T; Hall, Michaela; Smith, Megan A; Lew, Jie-Bin; Hughes, Suzanne; Yuill, Susan; Hammond, Ian; Saville, Marion; Canfell, Karen

    2017-01-01

    Several countries are implementing a transition to HPV testing for cervical screening in response to the introduction of HPV vaccination and evidence indicating that HPV screening is more effective than cytology. In Australia, a 2017 transition from 2-yearly conventional cytology in 18-20 to 69 years to 5-yearly primary HPV screening in 25 to 74 years will involve partial genotyping for HPV 16/18 with direct referral to colposcopy for this higher risk group. The objective of this study was to determine the optimal management of women positive for other high-risk HPV types (not 16/18) ('OHR HPV'). We used a dynamic model of HPV transmission, vaccination, natural history and cervical screening to determine the optimal management of women positive for OHR HPV. We assumed cytology triage testing was used to inform management in this group and that those with high-grade cytology would be referred to colposcopy and those with negative cytology would receive 12-month surveillance. For those with OHR HPV and low-grade cytology (considered to be a single low-grade category in Australia incorporating ASC-US and LSIL), we evaluated (1) the 20-year risk of invasive cervical cancer assuming this group are referred for 12-month follow-up vs. colposcopy, and compared this to the risk in women with low-grade cytology under the current program (i.e. an accepted benchmark risk for 12-month follow-up in Australia); (2) the population-level impact of the whole program, assuming this group are referred to 12-month surveillance vs. colposcopy; and (3) the cost-effectiveness of immediate colposcopy compared to 12-month follow-up. Evaluation was performed both for HPV-unvaccinated cohorts and cohorts offered vaccination (coverage ~72%). The estimated 20-year risk of cervical cancer is ≤1.0% at all ages if this group are referred to colposcopy vs. ≤1.2% if followed-up in 12 months, both of which are lower than the ≤2.6% benchmark risk in women with low-grade cytology in the current

  11. Sjögren SER: National registry of the Spanish Society of Rheumatology of patients with primary Sjögren syndrome: Objectives and methodology.

    Fernández Castro, Mónica; Andreu, Jose Luis; Sánchez-Piedra, Carlos; Martínez Taboada, Víctor; Olivé, Alejandro; Rosas, José; Sánchez-Alonso, Fernando

    2016-01-01

    To describe the objectives and methods of the Spanish Society of Rheumatology primary Sjögren syndrome (pSS) registry (SJOGREN-SER) METHODS: This is a multicenter descriptive transversal study of a cohort of pSS patients fulfilling European/American consensus criteria collected from Rheumatology clinics all over Spain. Patients were included by randomisation from an anonymised list provided by every department. Data were collected by reviewing clinical records and an interviewing the patients. Two hundred and ninety eight variables were investigated: epidemiological, clinical, serological characteristics, treatments and complications. Informed consent was obtained and local ethics committees approved the study. Variables were analysed by descriptive statistical methods, using means, medians, and rates, with their deviations and interquartile ranges (p25-p75). A total of 3 rheumatology departments participated in the registry. A total of 437 patients were included. And 95% of them were women, with a median age of 58. Median age at pSS 's diagnosis was 50 years. Dryness symptoms (95%) were the most frequent complaint and anti-Ro/SS-A were present in 94% of the cases. Only 27% of the patients fulfilled the new 2012 SICCA-ACR classification criteria. SJOGREN-SER has been designed in order to characterize a representative pSS Spanish cohort, in clinical daily practice, to analyze the magnitude and distribution of its manifestations, activity, accumulated damage and therapeutic management of the disease. This will allow broadening the knowledge of this disease and plan strategies of action in pSS. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  12. Healthcare is primary

    Raman Kumar

    2015-01-01

    Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  13. Pulsar current sheet C̆erenkov radiation

    Zhang, Fan

    2018-04-01

    Plasma-filled pulsar magnetospheres contain thin current sheets wherein the charged particles are accelerated by magnetic reconnections to travel at ultra-relativistic speeds. On the other hand, the plasma frequency of the more regular force-free regions of the magnetosphere rests almost precisely on the upper limit of radio frequencies, with the cyclotron frequency being far higher due to the strong magnetic field. This combination produces a peculiar situation, whereby radio-frequency waves can travel at subluminal speeds without becoming evanescent. The conditions are thus conducive to C̆erenkov radiation originating from current sheets, which could plausibly serve as a coherent radio emission mechanism. In this paper we aim to provide a portrait of the relevant processes involved, and show that this mechanism can possibly account for some of the most salient features of the observed radio signals.

  14. Neutral sheet crossings in the distant magnetotail

    Heikkila, W.J.; Slavin, J.A.; Smith, E.J.; Baker, D.N.; Zwickl, R.D.

    1985-01-01

    We have analyzed the magnetic field data from ISEE-3 in the distant magnetotail for 18 crossings of the cross-tail current sheet (or so-called natural sheet) to determine the direction of the normal component B/sub z/. The crossings occurred near the middle of the aberrated magnetotail (0 0.4 nT), consistent with closed field lines connected to the earth. In 3 cases B/sub z/ was very close to zero; in several instances there was structure in B/sub y/, suggesting localized currents with x or z directions. One may have been a magnetopause crossing. The strong preponderance of northward B/sub z/ favors a model of the magnetotail which is dominated by boundary layer plasma, flowing tailward on closed magnetic field lines, which requires the existence of an electric field in the sense from dusk to dawn. 37 refs., 15 figs., 1 tab

  15. Assembly for testing weldability of sheet metal

    David, S.A.; Woodhouse, J.J.

    1985-01-01

    A test assembly for determining the weldability of sheet metal includes a base having a flat side surface with an annular groove in the side surface, a counterbore being formed in the outer wall of the groove and the surface portion of the base circumscribed by the inner wall of the groove being substantially coplanar with the bottom of the counterbore, a test disk of sheet metal the periphery of which is positioned in the counterbore and the outer surface of which is coplanar with one side of the base, and a clamp ring overlying the side surface of the base and the edge portion of the test disk and a plurality of clamp screws which extend through the clamp ring for holding the periphery of the test disk against the bottom of the counterbore

  16. Ranking beta sheet topologies of proteins

    Fonseca, Rasmus; Helles, Glennie; Winter, Pawel

    2010-01-01

    One of the challenges of protein structure prediction is to identify long-range interactions between amino acids. To reliably predict such interactions, we enumerate, score and rank all beta-topologies (partitions of beta-strands into sheets, orderings of strands within sheets and orientations...... of paired strands) of a given protein. We show that the beta-topology corresponding to the native structure is, with high probability, among the top-ranked. Since full enumeration is very time-consuming, we also suggest a method to deal with proteins with many beta-strands. The results reported...... in this paper are highly relevant for ab initio protein structure prediction methods based on decoy generation. The top-ranked beta-topologies can be used to find initial conformations from which conformational searches can be started. They can also be used to filter decoys by removing those with poorly...

  17. Lubricant Test Methods for Sheet Metal Forming

    Bay, Niels; Olsson, David Dam; Andreasen, Jan Lasson

    2008-01-01

    appearing in different sheet forming operations such as stretch forming, deep drawing, ironing and punching. The laboratory tests have been especially designed to model the conditions in industrial production. Application of the tests for evaluating new lubricants before introducing them in production has......Sheet metal forming of tribologically difficult materials such as stainless steel, Al-alloys and Ti-alloys or forming in tribologically difficult operations like ironing, punching or deep drawing of thick plate requires often use of environmentally hazardous lubricants such as chlorinated paraffin...... oils in order to avoid galling. The present paper describes a systematic research in the development of new, environmentally harmless lubricants focusing on the lubricant testing aspects. A system of laboratory tests has been developed to study the lubricant performance under the very varied conditions...

  18. The state of the Greenland Ice Sheet

    Simonsen, Sebastian Bjerregaard

    Firn is defined as snow that has survived a melt season and provides the link between the high-frequency variability of the atmosphere to the ”slower” reacting ice sheet.In this thesis, firn is described by a theoretical and statistical approach to accommodate the variability in observed firn...... compaction on ice sheet scales. The modeling objectives are multiple and aim at estimating the contribution from the firn to the observed volume change of the GrIS and to the diffusion of stable water isotopes. The firn modeling then provides crucial information on total mass balance of the Gr......IS and the paleo-temperature reconstructions retrieved from ice cores.The dynamical firn model developed in this thesis explains13 % of the observed volume change of the GrIS from 2003-2008, without contributing to the global sea-level rise. This emphasizes the need for well constraint firn-compaction models. Here...

  19. Spatiotemporal Variability of Meltwater Refreezing in Southwest Greenland Ice Sheet Firn

    Rennermalm, A. K.; Hock, R.; Tedesco, M.; Corti, G.; Covi, F.; Miège, C.; Kingslake, J.; Leidman, S. Z.; Munsell, S.

    2017-12-01

    A substantial fraction of the summer meltwater formed on the surface of the Greenland ice sheet is retained in firn, while the remaining portion runs to the ocean through surface and subsurface channels. Refreezing of meltwater in firn can create impenetrable ice lenses, hence being a crucial process in the redistribution of surface runoff. To quantify the impact of refreezing on runoff and current and future Greenland surface mass balance, a three year National Science Foundation funded project titled "Refreezing in the firn of the Greenland ice sheet: Spatiotemporal variability and implications for ice sheet mass balance" started this past year. Here we present an overview of the project and some initial results from the first field season in May 2017 conducted in proximity of the DYE-2 site in the percolation zone of the Southwest Greenland ice sheet at elevations between 1963 and 2355 m a.s.l.. During this fieldwork two automatic weather stations were deployed, outfitted with surface energy balance sensors and 16 m long thermistor strings, over 300 km of ground penetrating radar data were collected, and five 20-26 m deep firn cores were extracted and analyzed for density and stratigraphy. Winter snow accumulation was measured along the radar tracks. Preliminary work on the firn-core data reveals increasing frequency and thickness of ice lenses at lower ice-sheet elevations, in agreement with other recent work in the area. Data collected within this project will facilitate advances in our understanding of the spatiotemporal variability of firn refreezing and its role in the hydrology and surface mass balance of the Greenland Ice Sheet.

  20. Primary explosives

    Matyas, Robert; Pachman, Jiri [Pardubice Univ. (Czech Republic). Faculty of Chemical Technology

    2013-06-01

    The first chapter provides background such as the basics of initiation and differences between requirements on primary explosives used in detonators and igniters. The authors then clarify the influence of physical characteristics on explosive properties, focusing on those properties required for primary explosives. Furthermore, the issue of sensitivity is discussed. All the chapters on particular groups of primary explosives are structured in the same way, including introduction, physical and chemical properties, explosive properties, preparation and documented use.

  1. Validation and Design of Sheet Retrofits

    2010-10-31

    Air Force Research Laboratory (AFRL), Tyndall Air Force Base, FL, and documented in this report used a polypropylene sheet that exhibited a balance of...The packaging of Loctite 3030 and DP-8010 indicates that they have a worklife of 3 min. and 10 min., respectively. Both adhesives require minimal... worklife . They then used the same procedure to apply the DP-8010 to the remaining three samples. Again, they prepared two samples with a smooth bonding

  2. Computer-readable ''Nuclear Data Sheets''

    Ewbank, W.B.

    1975-01-01

    The evaluated nuclear structure data contained in ''Nuclear Data Sheets'' are available in computer-readable form. Experimentally established properties of nuclear levels are included as well as radiations from nuclear reactions and radioactive decay. Portions of the data can be selected for distribution in several formats on magnetic tape or computer cards. A variety of different listing and drawing formats are also available. 4 figures

  3. Laminated multilayer sheet structure and its utilization

    Chiba, K.; Itoh, K.; Mitani, Y.; Sobajima, S.; Yonemura, U.

    1980-01-01

    A laminated multilayer sheet structure is described comprising (A) an opaque flexible sheet layer, and (B) a flexible layer laminated on the surface of layer (A) and composed of a transparent thermic ray reflecting layer (B 1 ) bonded to a transparent synthetic resin layer (B 2 ), said layer (B 1 ) being a transparent thermic ray reflecting layer composed of (I) a layer of a metal having a thickness of about 50 to about 600 A, said metal being selected from the group consisting of gold, silver, copper, aluminum and a mixture of alloy of at least two of said metals, and (II) a high refractive substance layer having a thickness of about 50 to about 600 A, of an oxide of titanium derived from a layer of an organic titanium compound of the formula Ti 1 O/sub m/R/sub n/, where R is alkyl of 1-20 carbon atoms, l=1-30, m=4+3(1-1), and n=4+2(1-1), and containing the organic residual moiety of the organic titanium compound, the amount of said organic residual moiety being 0.1 to 30% by weight based on the weight of the high refractive substance layer; or said layer (B 1 ) being a transparent semiconductive layer having a thickness of about 500 to about 5,000 a and being composed of a compound selected from the group consisting of indium oxide, tin oxide, cadmium oxide, antimony oxide, copper iodide, and a mixture of at least two of said compounds. A method is described for heat-insulating a room, which comprises applying to the surface of a floor, wall, ceiling or partition in the room a laminated multilayer sheet structure comprising (A) an opaque flexible sheet layer, and (B) a flexible layer laminated on the surface of layer (A) and composed of a transparent thermic ray reflecting layer (B 1 ) bonded to a transparent synthetic resin layer

  4. Nuclear data sheets update for A = 197

    Chunmei, Zhou [Chinese Nuclear Data Center, Beijing, BJ (China)

    1996-06-01

    The Nuclear Data Sheet for A = 197 has been carried out on the basis of the nuclear reaction and decay experiments leading to all the nuclei with mass number A = 197 since cutoff date of the last evaluation, December 1989. Most evaluation data have been updated or revised. The nuclei of updated data mainly are {sup 197}Hg, {sup 197}Pb, {sup 197}Bi and {sup 197}Po. The adopted levels and adopted gamma radiations for all nuclei are shown in the tables.

  5. Photovoltaic self-consumption: reference activity sheets

    2016-01-01

    In order to promote the use of photovoltaic energy in self-consumption, Enerplan, the French association of solar energy professionals, has edited a set of reference sheets comprising the main technical and economic data of recent installations (cold generation facility, water treatment plant, farm, commercial and public buildings), in various French regions: description of the installation, project owner testimony, technical characteristics of the site, expected results, economic data, production/consumption results

  6. Ice Sheet System Model as Educational Entertainment

    Perez, G.

    2013-12-01

    Understanding the importance of polar ice sheets and their role in the evolution of Sea Level Rise (SLR), as well as Climate Change, is of paramount importance for policy makers as well as the public and schools at large. For example, polar ice sheets and glaciers currently account for 1/3 of the SLR signal, a ratio that will increase in the near to long-term future, which has tremendous societal ramifications. Consequently, it is important to increase awareness about our changing planet. In our increasingly digital society, mobile and web applications are burgeoning venues for such outreach. The Ice Sheet System Model (ISSM) is a software that was developed at the Jet Propulsion Laboratory/CalTech/NASA, in collaboration with University of California Irvine (UCI), with the goal of better understanding the evolution of polar ice sheets. It is a state-of-the-art framework, which relies on higher-end cluster-computing to address some of the aforementioned challenges. In addition, it is a flexible framework that can be deployed on any hardware; in particular, on mobile platforms such as Android or iOS smart phones. Here, we look at how the ISSM development team managed to port their model to these platforms, what the implications are for improving how scientists disseminate their results, and how a broader audience may familiarize themselves with running complex climate models in simplified scenarios which are highly educational and entertaining in content. We also look at the future plans toward a web portal fully integrated with mobile technologies to deliver the best content to the public, and to provide educational plans/lessons that can be used in grades K-12 as well as collegiate under-graduate and graduate programs.

  7. Single sheet metal oxides and hydroxides

    Huang, Lizhi

    The synthesis of layered double hydroxides (LDHs) provides a relatively easy and traditional way to build versatile chemical compounds with a rough control of the bulk structure. The delamination of LDHs to form their single host layers (2D nanosheets) and the capability to reassemble them offer......) Delamination of the LDHs structure (oxGRC12) with the formation of single sheet iron (hydr)oxide (SSI). (3) Assembly of the new 2D nanosheets layer by layer to achieve desired functionalities....

  8. The stretch zone of automotive steel sheets

    The stretch zone of automotive steel sheets. L' AMBRIŠKO1,∗ and L PEŠEK2. 1Institute of Structural Engineering, Faculty of Civil Engineering,. Technical University of Košice, Vysokoškolská 4, 042 00 Košice, Slovak Republic. 2Department of Materials Science, Faculty of Metallurgy,. Technical University of Košice, Letná 9, ...

  9. Fabrication of Carbon Nanotube Polymer Actuator Using Nanofiber Sheet

    Kato, Hayato; Shimizu, Akikazu; Sato, Taiga; Kushida, Masahito

    2017-11-01

    Carbon nanotube polymer actuators were developed using composite nanofiber sheets fabricated by multi-walled carbon nanotubes(MWCNTs) and poly (vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP). Nanofiber sheets were fabricated by electrospinning method. The effect of flow rate and polymer concentration on nanofiber formation were verified for optimum condition for fabricating nanofiber sheets. We examined the properties of MWCNT/PVDF-HFP nanofiber sheets, as follows. Electrical conductivity and mechanical strength increased as the MWCNT weight ratio increased. We fabricated carbon nanotube polymer actuators using MWCNT/PVDF-HFP nanofiber sheets and succeeded in operating of our actuators.

  10. Orientation and Morphology Effects in Rapid Silicon Sheet Solidification

    Ciszek, T. F.

    1984-01-01

    Radial growth anisotropies and equilibrium forms of point nucleated, dislocation free silicon sheets spreading horizontally on the free surface of a silicon melt were measured for (100), (110), (111), and (112) sheet planes. The growth process was recorded. Qualitative Wulff surface free energy polar plots were deduced from the equilibrium shapes for each sheet plane. Predicted geometries for the tip shape of unidirectional, dislocation free, horizontally grown sheets growing in various directions within the planes were analyzed. Polycrystalline sheets and dendrite propagation were analyzed. For dendrites, growth rates on the order of 2.5 m/min and growth rate anisotropies of 25 are measured.

  11. Single Point Incremental Forming using a Dummy Sheet

    Skjødt, Martin; Silva, Beatriz; Bay, Niels

    2007-01-01

    A new version of single point incremental forming (SPIF) is presented. This version includes a dummy sheet on top of the work piece, thus forming two sheets instead of one. The dummy sheet, which is in contact with the rotating tool pin, is discarded after forming. The new set-up influences....... The possible influence of friction between the two sheets is furthermore investigated. The results show that the use of a dummy sheet reduces wear of the work piece to almost zero, but also causes a decrease in formability. Bulging of the planar sides of the pyramid is reduced and surface roughness...

  12. Primary fibromyalgia

    Jacobsen, S; Jensen, L T; Foldager, M

    1990-01-01

    Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact....

  13. Patient Satisfaction with Primary Health Care – A Comparison between the Insured and Non-Insured under the National Health Insurance Policy in Ghana

    Fenny, Ama P.; Enemark, Ulrika; Asante, Felix A.; Hansen, Kristian S.

    2014-01-01

    Ghana has initiated various health sector reforms over the past decades aimed at strengthening institutions, improving the overall health system and increasing access to healthcare services by all groups of people. The National Health Insurance Scheme (NHIS) instituted in 2005, is an innovative system aimed at making health care more accessible to people who need it. Currently, there is a growing amount of concern about the capacity of the NHIS to make quality health care accessible to its clients. A number of studies have concentrated on the effect of health insurance status on demand for health services, but have been quiet on supply side issues. The main aim of this study is to examine the overall satisfaction with health care among the insured and uninsured under the NHIS. The second aim is to explore the relations between overall satisfaction and socio-demographic characteristics, health insurance and the various dimensions of quality of care. This study employs logistic regression using household survey data in three districts in Ghana covering the 3 ecological zones (coastal, forest and savannah). It identifies the service quality factors that are important to patients’ satisfaction and examines their links to their health insurance status. The results indicate that a higher proportion of insured patients are satisfied with the overall quality of care compared to the uninsured. The key predictors of overall satisfaction are waiting time, friendliness of staff and satisfaction of the consultation process. These results highlight the importance of interpersonal care in health care facilities. Feedback from patients’ perception of health services and satisfaction surveys improve the quality of care provided and therefore effort must be made to include these findings in future health policies. PMID:24999137

  14. Patient satisfaction with primary health care - a comparison between the insured and non-insured under the National Health Insurance Policy in Ghana.

    Fenny, Ama Pokuaa; Enemark, Ulrika; Asante, Felix A; Hansen, Kristian S

    2014-04-01

    Ghana has initiated various health sector reforms over the past decades aimed at strengthening institutions, improving the overall health system and increasing access to healthcare services by all groups of people. The National Health Insurance Scheme (NHIS) instituted in 2005, is an innovative system aimed at making health care more accessible to people who need it. Currently, there is a growing amount of concern about the capacity of the NHIS to make quality health care accessible to its clients. A number of studies have concentrated on the effect of health insurance status on demand for health services, but have been quiet on supply side issues. The main aim of this study is to examine the overall satisfaction with health care among the insured and uninsured under the NHIS. The second aim is to explore the relations between overall satisfaction and socio-demographic characteristics, health insurance and the various dimensions of quality of care. This study employs logistic regression using household survey data in three districts in Ghana covering the 3 ecological zones (coastal, forest and savannah). It identifies the service quality factors that are important to patients' satisfaction and examines their links to their health insurance status. The results indicate that a higher proportion of insured patients are satisfied with the overall quality of care compared to the uninsured. The key predictors of overall satisfaction are waiting time, friendliness of staff and satisfaction of the consultation process. These results highlight the importance of interpersonal care in health care facilities. Feedback from patients' perception of health services and satisfaction surveys improve the quality of care provided and therefore effort must be made to include these findings in future health policies.

  15. Mass balance of the Antarctic ice sheet.

    Wingham, D J; Shepherd, A; Muir, A; Marshall, G J

    2006-07-15

    The Antarctic contribution to sea-level rise has long been uncertain. While regional variability in ice dynamics has been revealed, a picture of mass changes throughout the continental ice sheet is lacking. Here, we use satellite radar altimetry to measure the elevation change of 72% of the grounded ice sheet during the period 1992-2003. Depending on the density of the snow giving rise to the observed elevation fluctuations, the ice sheet mass trend falls in the range -5-+85Gtyr-1. We find that data from climate model reanalyses are not able to characterise the contemporary snowfall fluctuation with useful accuracy and our best estimate of the overall mass trend-growth of 27+/-29Gtyr-1-is based on an assessment of the expected snowfall variability. Mass gains from accumulating snow, particularly on the Antarctic Peninsula and within East Antarctica, exceed the ice dynamic mass loss from West Antarctica. The result exacerbates the difficulty of explaining twentieth century sea-level rise.

  16. Sheet production apparatus for removing a crystalline sheet from the surface of a melt using gas jets located above and below the crystalline sheet

    Kellerman, Peter L.; Thronson, Gregory D.

    2017-06-14

    In one embodiment, a sheet production apparatus comprises a vessel configured to hold a melt of a material. A cooling plate is disposed proximate the melt and is configured to form a sheet of the material on the melt. A first gas jet is configured to direct a gas toward an edge of the vessel. A sheet of a material is translated horizontally on a surface of the melt and the sheet is removed from the melt. The first gas jet may be directed at the meniscus and may stabilize this meniscus or increase local pressure within the meniscus.

  17. Joining of Aluminium Alloy Sheets by Rectangular Mechanical Clinching

    Abe, Y.; Mori, K.; Kato, T.

    2011-01-01

    A mechanical clinching has the advantage of low running costs. However, the joint strength is not high. To improve the maximum load of the joined sheets by a mechanical clinching, square and rectangular mechanical clinching were introduced. In the mechanical clinching, the two sheets are mechanically joined by forming an interlock between the lower and upper sheets by the punch and die. The joined length with the interlock was increased by the rectangular punch and die. The deforming behaviours of the sheets in the mechanical clinching were investigated, and then the interlock in the sheets had distribution in the circumference of the projection. Although the interlocks were formed in both projection side and diagonal, the interlock in the diagonal was smaller because of the long contact length between the lower sheet and the die cavity surface. The maximum load of the joined sheets by the rectangular mechanical clinching was two times larger than the load by the round mechanical clinching.

  18. Simulations of the Scandinavian ice sheet and its subsurface conditions

    Boulton, G.S.; Caban, P.; Hulton, N.

    1999-12-01

    An ice sheet model has been applied to an approximate flow line through the area of the Fennoscandian ice sheet. The modelled ice sheet fluctuations have been matched with stratigraphic evidence of Weichselian ice sheet fluctuation in order to simulate ice sheet attributes through time along the flowline. The model predicts extensive melting at the base of the ice sheet. This output has been used as an input to a simplified model of hydrogeology along the southern flank of the ice sheet so as to reconstruct patterns of subglacial groundwater flow. The output from the model is also used to estimate patterns of subglacial stress and strain. Results suggest that large scale subglacial groundwater catchment are formed which were quite different in extent from modern catchment; that fossil subglacial groundwaters should be found at sampling depths; and much fracturing in shallow bedrock in Sweden could be glacially generated

  19. Simulations of the Scandinavian ice sheet and its subsurface conditions

    Boulton, G.S.; Caban, P.; Hulton, N. [Edinburgh Univ. (United Kingdom). Dept of Geology and Geophysics

    1999-12-01

    An ice sheet model has been applied to an approximate flow line through the area of the Fennoscandian ice sheet. The modelled ice sheet fluctuations have been matched with stratigraphic evidence of Weichselian ice sheet fluctuation in order to simulate ice sheet attributes through time along the flowline. The model predicts extensive melting at the base of the ice sheet. This output has been used as an input to a simplified model of hydrogeology along the southern flank of the ice sheet so as to reconstruct patterns of subglacial groundwater flow. The output from the model is also used to estimate patterns of subglacial stress and strain. Results suggest that large scale subglacial groundwater catchment are formed which were quite differentin extent from modern catchment; that fossil subglacial groundwaters should be found at sampling depths; and much fracturing in shallow bedrock in Sweden could be glacially generated.

  20. Ethnic variations in incidence of asthma episodes in England & Wales:national study of 502,482 patients in primary care

    Sheikh Aziz

    2005-10-01

    Full Text Available Summary Background Recent studies have demonstrated marked international variations in the prevalence of asthma, but less is known about ethnic variations in asthma epidemiology within individual countries and in particular the impact of migration on risk of developing asthma. Recent within country comparisons have however revealed that despite originating from areas of the world with a low risk for developing asthma, South Asian and Afro-Caribbean people in the UK are significantly (3× and 2× respectively more likely to be admitted to hospital for asthma related problems than Whites. Methods Using data from the Fourth National Study of Morbidity Statistics in General Practice, a one-percent broadly representative prospective cohort study of consultations in general practice, we investigated ethnic variations in incident asthma consultations (defined as new or first consultations, and compared consultation rates between those born inside and outside the UK (migrant status. Logistic regression models were used to examine the combined effects of ethnicity and migration on asthma incident consultations. Results Results showed significantly lower new/first asthma consultation rates for Whites than for each of the ethnic minority groups studied (mean age-adjusted consultation rates per 1000 patient-years: Whites 26.4 (95%CI 26.4, 26.4; South Asians 30.4 (95%CI 30.3, 30.5; Afro-Caribbeans 35.1 (95%CI 34.9, 35.3; and Others 27.8 (27.7, 28.0. Within each of these ethnic groups, those born outside of the UK showed consistently lower rates of incident asthma consultations. Modelling the combined effects of ethnic and migrant status revealed that UK-born South Asians and Afro-Caribbeans experienced comparable risks for incident GP consultations for asthma to UK-born Whites. Non-UK born Whites however experienced reduced risks (adjusted OR 0.82, 95%CI 0.69, 0.97 whilst non-UK born South Asians experienced increased risks (adjusted OR 1.33, 95%CI 1.04, 1