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Sample records for single-chamber plethysmography provide

  1. Wenckebach upper rate response in single chamber pacemaker.

    Barold, S S

    2000-07-01

    The Medtronic Minix pacemaker during normal function in the VVT mode was found to exhibit a Wenckenbach upper rate response similar to that of dual chamber devices. This behavior occurred only when the upper rate interval was longer than the pacemaker refractory period. In a single chamber device this response may simulate pacemaker malfunction.

  2. Performance of single chamber biocatalyzed electrolysis with different types of ion exchange membranes

    Rozendal, R.A.; Hamelers, H.V.M.; Molenkamp, R.J.; Buisman, C.J.N.

    2007-01-01

    In this paper hydrogen production through biocatalyzed electrolysis was studied for the first time in a single chamber configuration. Single chamber biocatalyzed electrolysis was tested in two configurations: (i) with a cation exchange membrane (CEM) and (ii) with an anion exchange membrane (AEM).

  3. Phosphate recovery as struvite within a single chamber microbial electrolysis cell

    Cusick, Roland D.; Logan, Bruce E.

    2012-01-01

    An energy efficient method of concurrent hydrogen gas and struvite (MgNH 4PO 4·6H 2O) production was investigated based on bioelectrochemically driven struvite crystallization at the cathode of a single chamber microbial electrolysis struvite

  4. Single-chamber solid oxide fuel cell technology - From its origins to today's state of the art

    Khun, M. [Department of Mechanical Engineering, Ecole Polytechnique de Montreal, Montreal, Quebec, H3T 1J4 (Canada); Napporn, T. W. [Equipe Electrocatalyse, Laboratoire de Catalyse en Chimie Organique, UMR CNRS 6503, Universite de Poitiers, Poitiers (France)

    2010-07-01

    In single-chamber solid oxide fuel cells (SC-SOFCs), both anode and cathode are situated in a common gas chamber and are exposed to a mixture of fuel and oxidant. The working principle is based on the difference in catalytic activity of the electrodes for the respective anodic and cathodic reactions. The resulting difference in oxygen partial pressure between the electrodes leads to the generation of an open circuit voltage. Progress in SC-SOFC technology has enabled the generation of power outputs comparable to those of conventional SOFCs. This paper provides a detailed review of the development of SC-SOFC technology. (author)

  5. Electricity generation from fermented primary sludge using single-chamber air-cathode microbial fuel cells

    Yang, Fei; Ren, Lijiao; Pu, Yuepu; Logan, Bruce E.

    2013-01-01

    Single-chamber air-cathode microbial fuel cells (MFCs) were used to generate electricity from fermented primary sludge. Fermentation (30°C, 9days) decreased total suspended solids (26.1-16.5g/L), volatile suspended solids (24.1-15.3g/L) and pH (5

  6. Copper removal and microbial community analysis in single-chamber microbial fuel cell.

    Wu, Yining; Zhao, Xin; Jin, Min; Li, Yan; Li, Shuai; Kong, Fanying; Nan, Jun; Wang, Aijie

    2018-04-01

    In this study, copper removal and electricity generation were investigated in a single-chamber microbial fuel cell (MFC). Result showed that copper was efficiently removed in the membrane-less MFC with removal efficiency of 98.3% at the tolerable Cu 2+ concentration of 12.5 mg L -1 , the corresponding open circuit voltage and maximum power density were 0.78 V and 10.2 W m -3 , respectively. The mechanism analysis demonstrated that microbial electrochemical reduction contributed to the copper removal with the products of Cu and Cu 2 O deposited at biocathode. Moreover, the microbial community analysis indicated that microbial communities changed with different copper concentrations. The dominant phyla were Proteobacteria and Bacteroidetes which could play key roles in electricity generation, while Actinobacteria and Acidobacteria were also observed which were responsible for Cu-resistant and copper removal. It will be of important guiding significance for the recovery of copper from low concentration wastewater through single-chamber MFC with simultaneous energy recovery. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Phosphate recovery as struvite within a single chamber microbial electrolysis cell.

    Cusick, Roland D; Logan, Bruce E

    2012-03-01

    An energy efficient method of concurrent hydrogen gas and struvite (MgNH(4)PO(4)·6H(2)O) production was investigated based on bioelectrochemically driven struvite crystallization at the cathode of a single chamber microbial electrolysis struvite-precipitation cell (MESC). The MESC cathodes were either stainless steel 304 mesh or flat plates. Phosphate removal ranged from 20% to 40%, with higher removals obtained using mesh cathodes than with flat plates. Cathode accumulated crystals were verified as struvite using a scanning electron microscope capable of energy dispersive spectroscopy (SEM-EDS). Crystal accumulation did not affect the rate of hydrogen production in struvite reactors. The rate of struvite crystallization (g/m(2)-h) and hydrogen production (m(3)/m(3)-d) were shown to be dependent on applied voltage and cathode material. Overall energy efficiencies (substrate and electricity) were high (73 ± 4%) and not dependent on applied voltage. These results show that MESCs may be useful both as a method for hydrogen gas and struvite production. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Enhanced nitrogen removal in single-chamber microbial fuel cells with increased gas diffusion areas

    Yan, Hengjing

    2012-11-23

    Single-chamber microbial fuel cells (MFCs) with nitrifiers pre-enriched at the air cathodes have previously been demonstrated as a passive strategy for integrating nitrogen removal into current-generating bioelectrochemical systems. To further define system design parameters for this strategy, we investigated in this study the effects of oxygen diffusion area and COD/N ratio in continuous-flow reactors. Doubling the gas diffusion area by adding an additional air cathode or a diffusion cloth significantly increased the ammonia and COD removal rates (by up to 115% and 39%), ammonia removal efficiency (by up to 134%), the cell voltage and cathode potentials, and the power densities (by a factor of approximately 2). When the COD/N ratio was lowered from 13 to 3, we found up to 244% higher ammonia removal rate but at least 19% lower ammonia removal efficiency. An increase of COD removal rate by up to 27% was also found when the COD/N ratio was lowered from 11 to 3. The Coulombic efficiency was not affected by the additional air cathode, but decreased by an average of 11% with the addition of a diffusion cloth. Ammonia removal by assimilation was also estimated to understand the ammonia removal mechanism in these systems. These results showed that the doubling of gas diffusion area enhanced N and COD removal rates without compromising electrochemical performance. © 2012 Wiley Periodicals, Inc.

  9. Phosphate recovery as struvite within a single chamber microbial electrolysis cell

    Cusick, Roland D.

    2012-03-01

    An energy efficient method of concurrent hydrogen gas and struvite (MgNH 4PO 4·6H 2O) production was investigated based on bioelectrochemically driven struvite crystallization at the cathode of a single chamber microbial electrolysis struvite-precipitation cell (MESC). The MESC cathodes were either stainless steel 304 mesh or flat plates. Phosphate removal ranged from 20% to 40%, with higher removals obtained using mesh cathodes than with flat plates. Cathode accumulated crystals were verified as struvite using a scanning electron microscope capable of energy dispersive spectroscopy (SEM-EDS). Crystal accumulation did not affect the rate of hydrogen production in struvite reactors. The rate of struvite crystallization (g/m 2-h) and hydrogen production (m 3/m 3-d) were shown to be dependent on applied voltage and cathode material. Overall energy efficiencies (substrate and electricity) were high (73±4%) and not dependent on applied voltage. These results show that MESCs may be useful both as a method for hydrogen gas and struvite production. © 2011 Elsevier Ltd.

  10. Electricity generation from fermented primary sludge using single-chamber air-cathode microbial fuel cells

    Yang, Fei

    2013-01-01

    Single-chamber air-cathode microbial fuel cells (MFCs) were used to generate electricity from fermented primary sludge. Fermentation (30°C, 9days) decreased total suspended solids (26.1-16.5g/L), volatile suspended solids (24.1-15.3g/L) and pH (5.7-4.5), and increased conductivity (2.4-4.7mS/cm), soluble COD (2.66-15.5g/L), and volatile fatty acids (1.9-10.1g/L). To lower the COD and increase pH, fermentation supernatant was diluted with primary effluent before being used in the MFCs. The maximum power density was 0.32±0.01W/m2, compared to 0.24±0.03W/m2 with only primary effluent. Power densities were higher with phosphate buffer added to the supernatant (1.03±0.06W/m2) or the solution (0.87±0.05W/m2). Coulombic efficiencies ranged from 18% to 57%, and sCOD removals from 84% to 94%. These results demonstrated that sludge can effectively be used for power generation when fermented and then diluted with only primary effluent. © 2012 Elsevier Ltd.

  11. Variation of power generation at different buffer types and conductivities in single chamber microbial fuel cells

    Nam, Joo-Youn

    2010-01-15

    Microbial fuel cells (MFCs) are operated with solutions containing various chemical species required for the growth of electrochemically active microorganisms including nutrients and vitamins, substrates, and chemical buffers. Many different buffers are used in laboratory media, but the effects of these buffers and their inherent electrolyte conductivities have not been examined relative to current generation in MFCs. We investigated the effect of several common buffers (phosphate, MES, HEPES, and PIPES) on power production in single chambered MFCs compared to a non-buffered control. At the same concentrations the buffers produced different solution conductivities which resulted in different ohmic resistances and power densities. Increasing the solution conductivities to the same values using NaCl produced comparable power densities for all buffers. Very large increases in conductivity resulted in a rapid voltage drop at high current densities. Our results suggest that solution conductivity at a specific pH for each buffer is more important in MFC studies than the buffer itself given relatively constant pH conditions. Based on our analysis of internal resistance and a set neutral pH, phosphate and PIPES are the most useful buffers of those examined here because pH was maintained close to the pKa of the buffer, maximizing the ability of the buffer to contribute to increase current generation at high power densities. © 2009 Elsevier B.V. All rights reserved.

  12. The variation of power generation with organic substrates in single-chamber microbial fuel cells (SCMFCs).

    Sharma, Yogesh; Li, Baikun

    2010-03-01

    The wastewaters consist of diverse types of organic substrates that can be used as the carbon sources for power generation. To explore the utilization of some of these organics, the electricity generation from three substrates (acetate, ethanol, and glucose) was examined over a concentration range of 0.5-35 mM in single-chamber microbial fuel cells (SCMFCs). The power density generated from glucose was the highest at 401 mW/m(2) followed by acetate and ethanol at 368 mW/m(2) and 302 mW/m(2), respectively. The voltage increased with substrate concentration of 0.5-20mM, but significantly decreased at high substrate concentrations of 20-35 mM. Kinetic analysis indicated that the inhibition in the ethanol-fed MFCs was the highest at the concentration of 35 mM, while inhibition in glucose-fed MFCs was the lowest at the concentration of 20mM. These were in accordance with the extents of voltage decrease at high substrate concentration. Moreover, the effect of the distance between anode and cathode on voltage generation was also investigated. The reduction of the electrode distance by 33% in the glucose-fed MFCs reduced the internal resistance by 73% and led to 20% increase in voltage generation. Published by Elsevier Ltd.

  13. Anode-supported SOFC operated under single-chamber conditions at intermediate temperatures

    Morales, M.; Roa, J.J.; Segarra, M. [Department of Materials Science and Metallurgical Engineering, University of Barcelona, E-08028, Barcelona (Spain); Capdevila, X.G. [Center of Design and Optimization in Avanced Materials, Parc Cientific of Barcelona, E-08028, Barcelona (Spain); Pinol, S. [Institute of Materials Science of Barcelona (CSIC), Campus of the UAB, Bellaterra E-08193, Barcelona (Spain)

    2011-02-15

    Anode-supported SOFC was fabricated using gadolinia doped ceria (GDC) as the electrolyte (15 {mu}m of thickness), Ni-GDC as the anode and La{sub 0.5}Sr{sub 0.5}CoO{sub 3-{delta}}-GDC as the cathode. Catalytic activities of the electrodes and electrical properties of the cell were determined, using mixtures of methane + air, under single-chamber conditions. This work assessed with special and wide emphasis the effect of temperature, gas composition and total flow rate on the cell performance. As a result, operational temperature range of the fuel cell was approximately between 700 and 800 C, which agrees with the results corresponding to the catalytic activities of electrodes. While Ni-GDC anode was enough active towards methane partial oxidation at cell temperatures higher than 700 C, the LSC-GDC cathode was enough inactive towards partial and total oxidation of methane at cell temperatures lower than 800 C. Under optimised gas compositions (CH{sub 4}/O{sub 2}) ratio (1) and total flow rate (530 mL min {sup -1}), power densities of 145 and 235 mW cm {sup -2} were obtained at 705 and 764 C, respectively. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  14. Variation of power generation at different buffer types and conductivities in single chamber microbial fuel cells.

    Nam, Joo-Youn; Kim, Hyun-Woo; Lim, Kyeong-Ho; Shin, Hang-Sik; Logan, Bruce E

    2010-01-15

    Microbial fuel cells (MFCs) are operated with solutions containing various chemical species required for the growth of electrochemically active microorganisms including nutrients and vitamins, substrates, and chemical buffers. Many different buffers are used in laboratory media, but the effects of these buffers and their inherent electrolyte conductivities have not been examined relative to current generation in MFCs. We investigated the effect of several common buffers (phosphate, MES, HEPES, and PIPES) on power production in single chambered MFCs compared to a non-buffered control. At the same concentrations the buffers produced different solution conductivities which resulted in different ohmic resistances and power densities. Increasing the solution conductivities to the same values using NaCl produced comparable power densities for all buffers. Very large increases in conductivity resulted in a rapid voltage drop at high current densities. Our results suggest that solution conductivity at a specific pH for each buffer is more important in MFC studies than the buffer itself given relatively constant pH conditions. Based on our analysis of internal resistance and a set neutral pH, phosphate and PIPES are the most useful buffers of those examined here because pH was maintained close to the pK(a) of the buffer, maximizing the ability of the buffer to contribute to increase current generation at high power densities. Copyright 2009 Elsevier B.V. All rights reserved.

  15. Single chamber microbial fuel cell with spiral anode for dairy wastewater treatment.

    Mardanpour, Mohammad Mahdi; Nasr Esfahany, Mohsen; Behzad, Tayebeh; Sedaqatvand, Ramin

    2012-01-01

    This study reports on the fabrication of a novel annular single chamber microbial fuel cell (ASCMFC) with spiral anode. The stainless steel mesh anode with graphite coating was used as anode. Dairy wastewater, containing complex organic matter, was used as substrate. ASCMFC had been operated for 450 h and results indicated a high open circuit voltage (about 810 mV) compared with previously published results. The maximum power density of 20.2 W/m(3) obtained in this study is significantly greater than the power densities reported in previous studies. Besides, a maximum coulombic efficiency of 26.87% with 91% COD removal was achieved. Good bacterial adhesion on the spiral anode is clearly shown in SEM micrographs. High power density and a successful performance in wastewater treatment in ASCMFC suggest it as a promising alternative to conventional MFCs for power generation and wastewater treatment. ASCMFC performance as a power generator was characterized based on polarization behavior and cell potentials. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Laser induced densification of cerium gadolinium oxide: Application to single-chamber solid oxide fuel cells

    Mariño, Mariana [École Nationale Supérieure des Mines, SPIN-EMSE, CNRS: UMR 5307, LGF, F-42023 Saint-Étienne (France); Rieu, Mathilde, E-mail: rieu@emse.fr [École Nationale Supérieure des Mines, SPIN-EMSE, CNRS: UMR 5307, LGF, F-42023 Saint-Étienne (France); Viricelle, Jean-Paul [École Nationale Supérieure des Mines, SPIN-EMSE, CNRS: UMR 5307, LGF, F-42023 Saint-Étienne (France); Garrelie, Florence [Université Jean Monnet, Laboratoire Hubert Curien, CNRS: UMR 5516, 42000 Saint-Etienne (France)

    2016-06-30

    Graphical abstract: - Highlights: • CGO surface densifications were induced by UV and IR laser irradiations. • Grain growth or densified cracked surfaces were observed by SEM. • UV laser treatments allow a decrease of gas permeation through electrolyte layer. • Electrical conductivity of the electrolyte was modified by laser treatments. • Grain growth of electrolyte induced by UV laser improved cell performances. - Abstract: In single-chamber solid oxide fuel cells (SC-SOFC), anode and cathode are placed in a gas chamber where they are exposed to a fuel/air mixture. Similarly to conventional dual-chamber SOFC, the anode and the cathode are separated by an electrolyte. However, as in the SC-SOFC configuration the electrolyte does not play tightness role between compartments, this one can be a porous layer. Nevertheless, it is necessary to have a diffusion barrier to prevent the transportation of hydrogen produced locally at the anode to the cathode that reduces fuel cell performances. This study aims to obtain directly a diffusion barrier through the surface densification of the electrolyte Ce{sub 0.9}Gd{sub 0.1}O{sub 1.95} (CGO) by a laser treatment. KrF excimer laser and Yb fiber laser irradiations were used at different fluences and number of pulses to modify the density of the electrolyte coating. Microstructural characterizations confirmed the modifications on the surface of the electrolyte for appropriate experimental conditions showing either grain growth or densified but cracked surfaces. Gas permeation and electrical conductivities of the modified electrolyte were evaluated. Finally SC-SOFC performances were improved for the cells presenting grain growth at the electrolyte surface.

  17. Anode-supported single-chamber SOFCs based on gadolinia doped ceria electrolytes

    Morales, M.

    2008-12-01

    Full Text Available The utilization of anode supported electrolytes is a useful strategy to increase the electrical properties of the solid oxide fuel cells, because it is possible to decrease considerably the thickness of the electrolytes. We have prepared successfully singlechamber fuel cells of gadolinia doped ceria electrolytes Ce1-xGdxO2-y (CGO supported on an anode formed by a cermet of Ni-CGO. Mixtures of precursor powders of NiO and gadolinium doped ceria with different particle sizes and compositions were analyzed to obtain optimal bulk porous anodes to be used as anode supported fuel cells. Doped ceria electrolytes were prepared by sol-gel related techniques. Then, ceria based electrolytes were deposited by dip coating at different thickness (15-30 µm using an ink prepared with nanometric powders of electrolytes dispersed in a commercial liquid polymer. Cathodes of La1-xSrxCoO3-s (LSCO were also prepared by sol-gel related techniques and were deposited by dip coating on the electrolyte thick films. Finally, electrical properties were determined in a single-chamber reactor where propane as fuel was mixed with synthetic air above the higher explosive limit. Stable density currents were obtained in these experimental conditions, but flow rates of the carrier gas and propane partial pressure were determinants for the optimization of the electrical properties of the fuel cells.

    La utilización de electrolitos soportados en el ánodo es una estrategia muy útil para mejorar las propiedades eléctricas de las pilas de combustible de óxido sólido, debido a que permiten disminuir considerablemente el espesor de los electrolitos. Para este trabajo, se han preparado exitosamente pilas de combustible de óxido sólido con electrolitos de ceria dopada con Gd, Ce1-xGdxO2-y (CGO soportados sobre un ánodo formado por un cermet de Ni/CGO. Dichas pilas se han

  18. Hydrogen production with effluent from an ethanol–H2-coproducing fermentation reactor using a single-chamber microbial electrolysis cell

    Lu, Lu; Ren, Nanqi; Xing, Defeng; Logan, Bruce E.

    2009-01-01

    Hydrogen can be produced by bacterial fermentation of sugars, but substrate conversion to hydrogen is incomplete. Using a single-chamber microbial electrolysis cell (MEC), we show that additional hydrogen can be produced from the effluent

  19. Nitrogen removal in a single-chamber microbial fuel cell with nitrifying biofilm enriched at the air cathode

    Yan, Hengjing

    2012-05-01

    Nitrogen removal is needed in microbial fuel cells (MFCs) for the treatment of most waste streams. Current designs couple biological denitrification with side-stream or combined nitrification sustained by upstream or direct aeration, which negates some of the energy-saving benefits of MFC technology. To achieve simultaneous nitrification and denitrification, without extra energy input for aeration, the air cathode of a single-chamber MFC was pre-enriched with a nitrifying biofilm. Diethylamine-functionalized polymer (DEA) was used as the Pt catalyst binder on the cathode to improve the differential nitrifying biofilm establishment. With pre-enriched nitrifying biofilm, MFCs with the DEA binder had an ammonia removal efficiency of up to 96.8% and a maximum power density of 900 ± 25 mW/m 2, compared to 90.7% and 945 ± 42 mW/m 2 with a Nafion binder. A control with Nafion that lacked nitrifier pre-enrichment removed less ammonia and had lower power production (54.5% initially, 750 mW/m 2). The nitrifying biofilm MFCs had lower Coulombic efficiencies (up to 27%) than the control reactor (up to 36%). The maximum total nitrogen removal efficiency reached 93.9% for MFCs with the DEA binder. The DEA binder accelerated nitrifier biofilm enrichment on the cathode, and enhanced system stability. These results demonstrated that with proper cathode pre-enrichment it is possible to simultaneously remove organics and ammonia in a single-chamber MFC without supplemental aeration. © 2012 Elsevier Ltd.

  20. Stimulation of electro-fermentation in single-chamber microbial electrolysis cells driven by genetically engineered anode biofilms

    Awate, Bhushan; Steidl, Rebecca J.; Hamlischer, Thilo; Reguera, Gemma

    2017-07-01

    Unwanted metabolites produced during fermentations reduce titers and productivity and increase the cost of downstream purification of the targeted product. As a result, the economic feasibility of otherwise attractive fermentations is low. Using ethanol fermentation by the consolidated bioprocessing cellulolytic bacterium Cellulomonas uda, we demonstrate the effectiveness of anodic electro-fermentations at maximizing titers and productivity in a single-chamber microbial electrolysis cell (SCMEC) without the need for metabolic engineering of the fermentative microbe. The performance of the SCMEC platform relied on the genetic improvements of anode biofilms of the exoelectrogen Geobacter sulfurreducens that prevented the oxidation of cathodic hydrogen and improved lactate oxidation. Furthermore, a hybrid bioanode was designed that maximized the removal of organic acids in the fermentation broth. The targeted approach increased cellobiose consumption rates and ethanol titers, yields, and productivity three-fold or more, prevented pH imbalances and reduced batch-to-batch variability. In addition, the sugar substrate was fully consumed and ethanol was enriched in the broth during the electro-fermentation, simplifying its downstream purification. Such improvements and the possibility of scaling up SCMEC configurations highlight the potential of anodic electro-fermentations to stimulate fermentative bacteria beyond their natural capacity and to levels required for industrial implementation.

  1. Using single-chamber microbial fuel cells as renewable power sources of electro-Fenton reactors for organic pollutant treatment

    Zhu, Xiuping

    2013-05-01

    Electro-Fenton reactions can be very effective for organic pollutant degradation, but they typically require non-sustainable electrical power to produce hydrogen peroxide. Two-chamber microbial fuel cells (MFCs) have been proposed for pollutant treatment using Fenton-based reactions, but these types of MFCs have low power densities and require expensive membranes. Here, more efficient dual reactor systems were developed using a single-chamber MFC as a low-voltage power source to simultaneously accomplish H2O2 generation and Fe2+ release for the Fenton reaction. In tests using phenol, 75±2% of the total organic carbon (TOC) was removed in the electro-Fenton reactor in one cycle (22h), and phenol was completely degraded to simple and readily biodegradable organic acids. Compared to previously developed systems based on two-chamber MFCs, the degradation efficiency of organic pollutants was substantially improved. These results demonstrate that this system is an energy-efficient and cost-effective approach for industrial wastewater treatment of certain pollutants. © 2013 Elsevier B.V.

  2. Factors affecting the performance of a single-chamber microbial fuel cell-type biological oxygen demand sensor.

    Yang, Gai-Xiu; Sun, Yong-Ming; Kong, Xiao-Ying; Zhen, Feng; Li, Ying; Li, Lian-Hua; Lei, Ting-Zhou; Yuan, Zhen-Hong; Chen, Guan-Yi

    2013-01-01

    Microbial fuel cells (MFCs) are devices that exploit microorganisms as biocatalysts to degrade organic matter or sludge present in wastewater (WW), and thereby generate electricity. We developed a simple, low-cost single-chamber microbial fuel cell (SCMFC)-type biochemical oxygen demand (BOD) sensor using carbon felt (anode) and activated sludge, and demonstrated its feasibility in the construction of a real-time BOD measurement system. Further, the effects of anodic pH and organic concentration on SCMFC performance were examined, and the correlation between BOD concentration and its response time was analyzed. Our results demonstrated that the SCMFC exhibited a stable voltage after 132 min following the addition of synthetic WW (BOD concentration: 200 mg/L). Notably, the response signal increased with an increase in BOD concentration (range: 5-200 mg/L) and was found to be directly proportional to the substrate concentration. However, at higher BOD concentrations (>120 mg/L) the response signal remained unaltered. Furthermore, we optimized the SCMFC using synthetic WW, and tested it with real WW. Upon feeding real WW, the BOD values exhibited a standard deviation from 2.08 to 8.3% when compared to the standard BOD5 method, thus demonstrating the practical applicability of the developed system to real treatment effluents.

  3. Enhanced power generation in annular single-chamber microbial fuel cell via optimization of electrode spacing using chocolate industry wastewater.

    Noori, Parisa; Najafpour Darzi, Ghasem

    2016-05-01

    Development and practical application of microbial fuel cell (MFC) is restricted because of the limitations such as low power output. To overcome low power limitation, the optimization of specific parameters including electrode materials and surface area, electrode spacing, and MFC's cell shape was investigated. To the best of our knowledge, no investigation has been reported in the literature to implement an annular single-chamber microbial fuel cell (ASCMFC) using chocolate industry wastewater. ASCMFC was fabricated via optimization of the stated parameters. The aspects of ASCMFC were comprehensively examined. In this study, the optimization of electrode spacing and its impact on performance of the ASCMFC were conducted. Reduction of electrode spacing by 46.15% (1.3-0.7 cm) resulted in a decrease in internal resistance from 100 to 50 Ω, which enhanced the power density and current output to 22.898 W/m(3) and 6.42 mA, respectively. An optimum electrode spacing of 0.7 cm was determined. Through this paper, the effects of these parameters and the performance of ASCMFC are also evaluated. © 2015 International Union of Biochemistry and Molecular Biology, Inc.

  4. Using single-chamber microbial fuel cells as renewable power sources of electro-Fenton reactors for organic pollutant treatment

    Zhu, Xiuping; Logan, Bruce E.

    2013-01-01

    Highlights: ► A new type of electro-Fenton system was developed for wastewater treatment. ► Degradation efficiency of organic pollutants was substantially improved. ► Operation cost was greatly reduced compared to other microbial fuel cell designs. -- Abstract: Electro-Fenton reactions can be very effective for organic pollutant degradation, but they typically require non-sustainable electrical power to produce hydrogen peroxide. Two-chamber microbial fuel cells (MFCs) have been proposed for pollutant treatment using Fenton-based reactions, but these types of MFCs have low power densities and require expensive membranes. Here, more efficient dual reactor systems were developed using a single-chamber MFC as a low-voltage power source to simultaneously accomplish H 2 O 2 generation and Fe 2+ release for the Fenton reaction. In tests using phenol, 75 ± 2% of the total organic carbon (TOC) was removed in the electro-Fenton reactor in one cycle (22 h), and phenol was completely degraded to simple and readily biodegradable organic acids. Compared to previously developed systems based on two-chamber MFCs, the degradation efficiency of organic pollutants was substantially improved. These results demonstrate that this system is an energy-efficient and cost-effective approach for industrial wastewater treatment of certain pollutants

  5. Enhanced Electricity Generation by Using Cheese Whey Wastewater in A Single-chamber Membrane Less Microbial Fuel Cell

    Hassan A.Z. Al-Fetlawi

    2018-02-01

    Full Text Available Microbial fuel cells (MFCs are biochemical-catalyzed systems in which electricity is produced by oxidizing  biodegradable organic matters in presence of  bacteria. Many places suffer from lack of electricity infrastructure or even existence" ,"but in the same area  there is wastewater that can be used to generate clean energy". "A batch system single chamber  and  membrane-less microbial fuel cell is designed with wastewater as inoculum and fuel in the same time(before adding cheese whey at pH =7±0.4 and an operating temperature of 30 0C ". Wastewater samples are collected from the Al-Delmaj marsh site at an initial chemical oxygen demand concentration of 862 mg/l and pH of 7.8 (reduced to 7±0.4 in all experiments by adding HCL acid. Rectangular sheets of graphite and smooth surface carbon fiber of 42 cm2 surface area used for anode and cathode electrodes. The obtained results indicated that the cell performance for the cell using graphite for anode and cathode electrodes is better than that using the carbon fiber of smooth surface .the obtained  open circuit voltage and power per unit surface area (for graphite  were" 190 mV and 5.95 mW/m2 respectively ."Cheese whey as substrate was used to enhance the performance of cell to  439 mV OCV and 121.9mW/m2  maximum power density" .

  6. Effect of short-term alkaline intervention on the performance of buffer-free single-chamber microbial fuel cell.

    Yang, Na; Ren, Yueping; Li, Xiufen; Wang, Xinhua

    2017-06-01

    Anolyte acidification is a drawback restricting the electricity generation performance of the buffer-free microbial fuel cells (MFC). In this paper, a small amount of alkali-treated anion exchange resin (AER) was placed in front of the anode in the KCl mediated single-chamber MFC to slowly release hydroxyl ions (OH - ) and neutralize the H + ions that are generated by the anodic reaction in two running cycles. This short-term alkaline intervention to the KCl anolyte has promoted the proliferation of electroactive Geobacter sp. and enhanced the self-buffering capacity of the KCl-AER-MFC. The pH of the KCl anolyte in the KCl-AER-MFC increased and became more stable in each running cycle compared with that of the KCl-MFC after the short-term alkaline intervention. The maximum power density (P max ) of the KCl-AER-MFC increased from 307.5mW·m -2 to 542.8mW·m -2 , slightly lower than that of the PBS-MFC (640.7mW·m -2 ). The coulombic efficiency (CE) of the KCl-AER-MFC increased from 54.1% to 61.2% which is already very close to that of the PBS-MFC (61.9%). The results in this paper indicate that short-term alkaline intervention to the anolyte is an effective strategy to further promote the performance of buffer-free MFCs. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Estimation of tidal ventilation in preterm and term newborn infants using electromagnetic inductance plethysmography

    Williams, E M; Pickerd, N; Kotecha, S; Eriksen, M; Øygarden, K

    2011-01-01

    Tidal volume (VT) measurements in newborn infants remain largely a research tool. Tidal ventilation and breathing pattern were measured using a new device, FloRight, which uses electromagnetic inductive plethysmography, and compared simultaneously with pneumotachography in 43 infants either receiving no respiratory support or continuous positive airway pressure (CPAP). Twenty-three infants were receiving CPAP (gestational age 28 ± 2 weeks, mean ± SD) and 20 were breathing spontaneously (gestational age 34 ± 4 weeks). The two methods were in reasonable agreement, with VT (r 2 = 0.69) ranging from 5 to 23 ml (4–11 ml kg −1 ) with a mean difference of 0.4 ml and limit of agreement of −4.7 to + 5.5 ml. For respiratory rate, minute ventilation, peak flow and breathing pattern indices, the mean difference between the two methods ranged between 0.7% and 5.8%. The facemask increased the respiratory rate (P < 0.001) in both groups with the change in VT being more pronounced in the infants receiving no respiratory support. Thus, FloRight provides an easy to use technique to measure term and preterm infants in the clinical environment without altering the infant's breathing pattern

  8. Evaluation of mental stress by physiological indices derived from finger plethysmography.

    Minakuchi, Emiko; Ohnishi, Eriko; Ohnishi, Junji; Sakamoto, Shigeko; Hori, Miyo; Motomura, Miwa; Hoshino, Junichi; Murakami, Kazuo; Kawaguchi, Takayasu

    2013-10-12

    Quantitative evaluation of mental stress is important to prevent stress-related disorders. Finger plethysmography (FPG) is a simple noninvasive method to monitor peripheral circulation, and provides many physiological indices. Our purpose is to investigate how FPG-derived indices reflect on mental stress, and to clarify any association between these physiological indices and subjective indices of mental stress. Thirty-one healthy women (mean age, 22 years ± 2) participated. The participants rested by sitting on a chair for 10 min. They then performed a computerized version of the Stroop color-word conflict test (CWT) for 10 min. Finally, they rested for 10 min. FPG was recorded throughout the experiment. The participants completed a brief form of the Profile of Mood States (POMS) questionnaire before and after the test. Using the FPG data, we conducted chaos analysis and fast Fourier transform analysis, and calculated chaotic attractors, the largest Lyapunov exponent, a high-frequency (HF) component, a low-to-high-frequency (LF/HF) ratio, finger pulse rate and finger pulse wave amplitude. The HF component decreased and the LF/HF ratio increased significantly during the test (P stress. Our findings indicate that FPG is one of the easiest methods to evaluate mental stress quantitatively. In particular, the largest Lyapunov exponent and the LF/HF ratio might be associated with acute mental stress. Farther examination is needed to find any association between the physiological indices and various types of mental stress.

  9. An anthropometric model to estimate neonatal fat mass using air displacement plethysmography

    Deierlein Andrea L

    2012-03-01

    Full Text Available Abstract Background Current validated neonatal body composition methods are limited/impractical for use outside of a clinical setting because they are labor intensive, time consuming, and require expensive equipment. The purpose of this study was to develop an anthropometric model to estimate neonatal fat mass (kg using an air displacement plethysmography (PEA POD® Infant Body Composition System as the criterion. Methods A total of 128 healthy term infants, 60 females and 68 males, from a multiethnic cohort were included in the analyses. Gender, race/ethnicity, gestational age, age (in days, anthropometric measurements of weight, length, abdominal circumference, skin-fold thicknesses (triceps, biceps, sub scapular, and thigh, and body composition by PEA POD® were collected within 1-3 days of birth. Backward stepwise linear regression was used to determine the model that best predicted neonatal fat mass. Results The statistical model that best predicted neonatal fat mass (kg was: -0.012 -0.064*gender + 0.024*day of measurement post-delivery -0.150*weight (kg + 0.055*weight (kg2 + 0.046*ethnicity + 0.020*sum of three skin-fold thicknesses (triceps, sub scapular, and thigh; R2 = 0.81, MSE = 0.08 kg. Conclusions Our anthropometric model explained 81% of the variance in neonatal fat mass. Future studies with a greater variety of neonatal anthropometric measurements may provide equations that explain more of the variance.

  10. Long Detection Programming in Single-Chamber Defibrillators Reduces Unnecessary Therapies and Mortality: The ADVANCE III Trial.

    Gasparini, Maurizio; Lunati, Maurizio G; Proclemer, Alessandro; Arenal, Angel; Kloppe, Axel; Martínez Ferrer, Josè B; Hersi, Ahmad S; Gulaj, Marcin; Wijffels, Maurits C E; Santi, Elisabetta; Manotta, Laura; Varma, Niraj

    2017-11-01

    This study sought to evaluate the effects of programming a long detection in single-chamber (VVI) implantable cardioverter-defibrillators (ICDs) in the multicenter prospective ADVANCE III (Avoid DeliVering TherApies for Non-sustained Arrhythmias in ICD PatiEnts III) trial. Programming strategies may reduce unnecessary ICD shocks and their adverse effects but to date have been described only for dual-chamber ICDs. A total of 545 subjects (85% male; atrial fibrillation 25%, left ventricular ejection fraction 31%, ischemic etiology 68%, secondary prevention indications 32%) receiving a VVI ICD were randomized to long detection (30 of 40 intervals) or standard programming (18 of 24 intervals) based on device type, atrial fibrillation history, and indication. In both arms, antitachycardia pacing (ATP) therapy during charging was programmed for episodes with cycle length 320 to 200 ms and shock only for cycle length functions enabled. Therapies delivered were compared using a negative binomial regression model. A total of 267 patients were randomized to long detection and 278 to the control group. Median follow-up was 12 months. One hundred twelve therapies (shocks and ATP) occurred in the long detection arm versus 257 in the control arm, for a 48% reduction with 30 of 40 intervals (95% confidence interval [CI]: 0.36 to 0.76; p = 0.002). In the long detection arm, overall shocks were reduced by 40% compared to the control arm (48 vs. 24; 95% CI: 0.38 to 0.94; p = 0.026) and appropriate shocks by 51% (34 vs. 74; 95% CI: 0.26 to 0.94; p = 0.033). Syncopal events did not differ between arms, but survival improved in the long detection arm. Among patients implanted with a VVI ICD, programming with the long detection interval significantly reduced appropriate therapies, shocks, and all-cause mortality. (Avoid DeliVering TherApies for Non-sustained Arrhythmias in ICD PatiEnts III [ADVANCEIII]; NCT00617175). Copyright © 2017 The Authors. Published by Elsevier Inc. All

  11. A novel biometric signature: multi-site, remote (> 100 m) photo-plethysmography using ambient light

    Verkruijsse, W.; Bodlaender, M.P.

    2010-01-01

    We propose a novel biometric signature based on the principle of multi-site remote photo-plethysmography (remote PPG). This signature can be measured using video cameras. Traditional PPG uses a contact sensor to measure slight skin color changes that occur with every heartbeat. Recently we have

  12. Early and late allergic reaction in the nose assessed by whole body plethysmography

    deBruinWeller, MS; Weller, FR; Scholte, A; Rijssenbeek, LHM; vanderBaan, S; Bogaard, JM; deMonchy, JGR

    Physiological changes during late phase nasal responses after allergen challenge are difficult to establish and different criteria are used for the definition of a positive late phase nasal reaction. The objective of this study was to assess the value of whole body plethysmography in detecting

  13. Early and late allergic reaction in the nose assessed by whole body plethysmography

    de Bruin-Weller, M. S.; Weller, F. R.; Scholte, A.; Rijssenbeek, L. H.; van der Baan, S.; Bogaard, J. M.; de Monchy, J. G.

    1996-01-01

    Physiological changes during late phase nasal responses after allergen challenge are difficult to establish and different criteria are used for the definition of a positive late phase nasal reaction. The objective of this study was to assess the value of whole body plethysmography in detecting

  14. Scoring Tools for the Analysis of Infant Respiratory Inductive Plethysmography Signals.

    Robles-Rubio, Carlos Alejandro; Bertolizio, Gianluca; Brown, Karen A; Kearney, Robert E

    2015-01-01

    Infants recovering from anesthesia are at risk of life threatening Postoperative Apnea (POA). POA events are rare, and so the study of POA requires the analysis of long cardiorespiratory records. Manual scoring is the preferred method of analysis for these data, but it is limited by low intra- and inter-scorer repeatability. Furthermore, recommended scoring rules do not provide a comprehensive description of the respiratory patterns. This work describes a set of manual scoring tools that address these limitations. These tools include: (i) a set of definitions and scoring rules for 6 mutually exclusive, unique patterns that fully characterize infant respiratory inductive plethysmography (RIP) signals; (ii) RIPScore, a graphical, manual scoring software to apply these rules to infant data; (iii) a library of data segments representing each of the 6 patterns; (iv) a fully automated, interactive formal training protocol to standardize the analysis and establish intra- and inter-scorer repeatability; and (v) a quality control method to monitor scorer ongoing performance over time. To evaluate these tools, three scorers from varied backgrounds were recruited and trained to reach a performance level similar to that of an expert. These scorers used RIPScore to analyze data from infants at risk of POA in two separate, independent instances. Scorers performed with high accuracy and consistency, analyzed data efficiently, had very good intra- and inter-scorer repeatability, and exhibited only minor confusion between patterns. These results indicate that our tools represent an excellent method for the analysis of respiratory patterns in long data records. Although the tools were developed for the study of POA, their use extends to any study of respiratory patterns using RIP (e.g., sleep apnea, extubation readiness). Moreover, by establishing and monitoring scorer repeatability, our tools enable the analysis of large data sets by multiple scorers, which is essential for

  15. Scoring Tools for the Analysis of Infant Respiratory Inductive Plethysmography Signals.

    Carlos Alejandro Robles-Rubio

    Full Text Available Infants recovering from anesthesia are at risk of life threatening Postoperative Apnea (POA. POA events are rare, and so the study of POA requires the analysis of long cardiorespiratory records. Manual scoring is the preferred method of analysis for these data, but it is limited by low intra- and inter-scorer repeatability. Furthermore, recommended scoring rules do not provide a comprehensive description of the respiratory patterns. This work describes a set of manual scoring tools that address these limitations. These tools include: (i a set of definitions and scoring rules for 6 mutually exclusive, unique patterns that fully characterize infant respiratory inductive plethysmography (RIP signals; (ii RIPScore, a graphical, manual scoring software to apply these rules to infant data; (iii a library of data segments representing each of the 6 patterns; (iv a fully automated, interactive formal training protocol to standardize the analysis and establish intra- and inter-scorer repeatability; and (v a quality control method to monitor scorer ongoing performance over time. To evaluate these tools, three scorers from varied backgrounds were recruited and trained to reach a performance level similar to that of an expert. These scorers used RIPScore to analyze data from infants at risk of POA in two separate, independent instances. Scorers performed with high accuracy and consistency, analyzed data efficiently, had very good intra- and inter-scorer repeatability, and exhibited only minor confusion between patterns. These results indicate that our tools represent an excellent method for the analysis of respiratory patterns in long data records. Although the tools were developed for the study of POA, their use extends to any study of respiratory patterns using RIP (e.g., sleep apnea, extubation readiness. Moreover, by establishing and monitoring scorer repeatability, our tools enable the analysis of large data sets by multiple scorers, which is essential

  16. Implementation of smart phone video plethysmography and dependence on lighting parameters.

    Fletcher, Richard Ribón; Chamberlain, Daniel; Paggi, Nicholas; Deng, Xinyue

    2015-08-01

    The remote measurement of heart rate (HR) and heart rate variability (HRV) via a digital camera (video plethysmography) has emerged as an area of great interest for biomedical and health applications. While a few implementations of video plethysmography have been demonstrated on smart phones under controlled lighting conditions, it has been challenging to create a general scalable solution due to the large variability in smart phone hardware performance, software architecture, and the variable response to lighting parameters. In this context, we present a selfcontained smart phone implementation of video plethysmography for Android OS, which employs both stochastic and deterministic algorithms, and we use this to study the effect of lighting parameters (illuminance, color spectrum) on the accuracy of the remote HR measurement. Using two different phone models, we present the median HR error for five different video plethysmography algorithms under three different types of lighting (natural sunlight, compact fluorescent, and halogen incandescent) and variations in brightness. For most algorithms, we found the optimum light brightness to be in the range 1000-4000 lux and the optimum lighting types to be compact fluorescent and natural light. Moderate errors were found for most algorithms with some devices under conditions of low-brightness (4000 lux). Our analysis also identified camera frame rate jitter as a major source of variability and error across different phone models, but this can be largely corrected through non-linear resampling. Based on testing with six human subjects, our real-time Android implementation successfully predicted the measured HR with a median error of -0.31 bpm, and an inter-quartile range of 2.1bpm.

  17. Body plethysmography in chronic obstructive pulmonary disease patients: A cross-sectional study

    Yogesh Satyendra Gupta

    2018-01-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is the fourth most common cause of death in the world, for which smoking is a common cause. It is preferable to diagnose COPD at an earlier stage and to assess its progression so that mortality and morbidity of the disease could be reduced. Hence, we conducted this study to assess parameters of body plethysmography in Indian population where the data are lacking and to assess whether the use of body plethysmography can detect COPD earlier. Subjects and Methods: The study was approved by the Ethics Committee at B. J Government Medical College, Pune. In this comparative randomized cross-sectional study, healthy control subjects (CN, smokers without COPD diagnosis (SM who were smoking for more than 5 pack-years and smokers with COPD who were further classified depending upon GOLD criteria as mild COPD (C1, moderate COPD (C2, and severe COPD (C3 (n = 30 each group were considered. All the participants were males who gave written informed consent. Subject underwent routine spirometry (FEV1, FVC, FEV1/FVC, PEFR, and FEF25-75% along with body plethysmography where sGaweff, sGawtot, residual volume (RV, total lung capacity (TLC, and inspiratory capacity (IC were recorded. Statistical Analysis: The differences in lung function were compared between healthy controls and smokers and also between the three groups of COPD severity (GOLD guidelines employing univariate analysis of variance and Bonferroni's post hoc test. Results: Spirometry could not differentiate between smokers without COPD and healthy controls. However, three parameters on body plethysmography (IC, sGawtot, and sGaweff were sensitive enough to detect differences between smokers without COPD and healthy controls. Conclusion: Using body plethysmography, the vexed question troubling the clinician, which of the smokers progress to COPD and who do not before they develop irreversible changes can perhaps be answered if further large

  18. Microstructure of the Ni–Fe–Cu–P melt-spun ribbons produced from the single-chamber and from the double-chamber crucibles

    Ziewiec, Krzysztof, E-mail: kziewiec@up.krakow.pl [Institute of Technology, Faculty of Mathematics, Physics and Technical Science, Pedagogical University of Cracow, ul. Podchorążych 2, PL-30-084 Kraków (Poland); Błachowski, Artur; Ruebenbauer, Krzysztof [Mössbauer Spectroscopy Division, Institute of Physics, Pedagogical University, ul. Podchorążych 2, PL-30-084 Kraków (Poland); Ziewiec, Aneta [AGH University of Science and Technology, Faculty of Metals Engineering and Industrial Computer Science, Al. A. Mickiewicza 30, 30-059 Kraków (Poland); Prusik, Krystian [Faculty of Computer Science and Materials Science, University of Silesia, ul. Bankowa 12, PL-40-007 Katowice (Poland); Latuch, Jerzy [Warsaw University of Technology, Faculty of Materials Science and Engineering, ul. Wołoska 141, PL-02-507 Warszawa (Poland); Zięba, Marcin; Bryła, Krzysztof [Institute of Technology, Faculty of Mathematics, Physics and Technical Science, Pedagogical University of Cracow, ul. Podchorążych 2, PL-30-084 Kraków (Poland)

    2014-12-05

    Highlights: • A new method for production of metallic amorphous/amorphous composite is proposed. • The unique microstructure was obtained by rapid cooling of the two unmixed liquids. • The composite TCMS Ni–Fe–Cu–P amorphous alloy forms ductile fracture. - Abstract: The aim of the work was to investigate the influence of the processing on the final microstructure and properties of the melt-spun Ni–Fe–Cu–P, Ni–Fe–P and Ni–Cu–P alloys ejected in two ways. In the first case, the alloy was molten in a simple single-chamber crucible, then ejected as uniform liquid. In the second case the double-chamber crucible was used, and the flux composed of the two Ni–Fe–P and Ni–Cu–P liquids was cooled on a copper roller before forming a uniform mixture. The two component melt spinning (TCMS) was performed starting from the Ni{sub 40}Fe{sub 40}P{sub 20} and Ni{sub 70}Cu{sub 10}P{sub 20} alloys. Three of the alloys i.e. Ni{sub 55}Fe{sub 20}Cu{sub 4}P{sub 20}, Ni{sub 40}Fe{sub 40}P{sub 20} and Ni{sub 70}Cu{sub 10}P{sub 20} were melt-spun from the traditional single-chamber crucible. The methods applied in this study for microstructural investigations include scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD) and Mössbauer spectroscopy. Thermal stability of the melt-spun alloys was tested using differential scanning calorimetry (DSC). The results of the investigations are described and discussed in terms of the unique features of the TCMS amorphous microstructure. It is shown that this complex phase composition of the amorphous alloy favors formation of the ductile fracture and the multiple shear band formation.

  19. Computerized strain-gauge plethysmography - An alternative method for the detection of lower limb deep venous thrombosis?

    Elford, Julian; Wells, Irving; Cowie, Jim; Hurlock, Carol; Sanders, Hilary

    2000-01-01

    AIM: To test the ability of computerized strain-gauge plethysmography to act as a screening test for lower limb deep venous thrombosis (DVT). MATERIALS AND METHODS: Over an 8-month period, all patients referred to our Medical Assessment Unit with suspected lower limb DVT were considered for inclusion in the study. Each patient underwent both plethysmography and ascending venography within 24 h, and the presence or absence of thrombus in the popliteal, superficial femoral or iliac veins was noted. The results of the two tests were then used to determine the accuracy of computerized strain-gauge plethysmography in detecting above knee DVT. RESULTS: The screening tests and venograms of 239 patients referred with clinically suspected lower limb DVT were compared. The false negative rate of plethysmography was 15.4%, which is significantly different from the 4.8% claimed by the manufacturers of this device (P = 0.00003). CONCLUSIONS: In a population of acute admissions with suspected lower limb DVT, computerized strain-gauge plethysmography is not suitable for use as a screening test due to an unacceptably high proportion of false negative screens. J. Elford (2000)

  20. A membrane-free, continuously feeding, single chamber up-flow biocatalyzed electrolysis reactor for nitrobenzene reduction

    Wang, Ai-Jie; Cui, Dan; Cheng, Hao-Yi; Guo, Yu-Qi; Kong, Fan-Ying; Ren, Nan-Qi; Wu, Wei-Min

    2012-01-01

    Highlights: ► A novel membrane-free up-flow biocatalyzed electrolysis reactor (UBER) was developed. ► Nitrobenzene as the mode of nitroaromatics was efficiently converted to aniline. ► The impact of phosphate buffer and acetate concentrations and power supplied were investigated. ► The prospects of UBER for the recalcitrant compound removal were discussed. - Abstract: A new bioelectrochemical system (BES), a membrane-free, continuous feeding up-flow biocatalyzed electrolysis reactor (UBER) was developed to reduce oxidative toxic chemicals to less- or non-toxic reduced form in cathode zone with oxidation of electron donor in anode zone. Influent was fed from the bottom of UBER and passed through cathode zone and then anode zone. External power source (0.5 V) was provided between anode and cathode to enhance electrochemical reactions. Granular graphite and carbon brush were used as cathode and anode, respectively. This system was tested for the reduction of nitrobenzene (NB) using acetate as electron donor and carbon source. The influent contained NB (50–200 mg L −1 ) and acetate (1000 mg L −1 ). NB was removed by up to 98% mainly in cathode zone. The anode potential maintained under −480 mV. The maximum NB removal rate was up to 3.5 mol m −3 TV d −1 (TV = total empty volume) and the maximum aniline (AN) formation rate was 3.06 mol m −3 TV d −1 . Additional energy required was less than 0.075 kWh mol −1 NB. The molar ratio of NB removed vs acetate consumed varied from 4.3 ± 0.4 to 2.3 ± 0.1 mol mol −1 . Higher influent phosphate or acetate concentration helped NB removal rate. NB could be efficiently reduced to AN as the power supplied of 0.3 V.

  1. Comparison of two plethysmography systems in assessment of forearm blood flow.

    Leslie, Stephen J; Attinà, Teresa; Hultsch, Ellen; Bolscher, Luc; Grossman, Matthias; Denvir, Martin A; Webb, David J

    2004-05-01

    Venous occlusion plethysmography is widely used to assess forearm blood flow (FBF). We compared the established Hokanson system (HEC4) with a newly developed Filtrass 2001 system (F2001). The HEC4 uses mercury-in-Silastic strain gauges, whereas F2001 detects volume changes with a nonmercury linear displacement device. The aim of this study was to evaluate the new F2001 against the HEC4 in terms of repeatability and systematic bias. Ten subjects were studied on 4 separate days in random order using either the HEC4 on both arms, the F2001 on both arms, the HEC4 on the right arm with the F2001 on the left, or the F2001 on the right arm and the HEC4 on the left. Stroop's colored word conflict test and postocclusive hyperemia were used to increase FBF, and lower body negative pressure was used to lower FBF. Stroop's colored word conflict test and lower body negative pressure increased (24.6 +/- 1.5%, n = 240, P 0.05), and there was no systematic bias. The F2001 is a newly developed plethysmography system that does not utilize mercury and is suitable for assessing changes of FBF in physiological studies.

  2. a-Si:H/μc-Si:H solar cells prepared by the single-chamber processes—minimization of phosphorus and boron cross contamination

    Merdzhanova, Tsvetelina, E-mail: t.merdzhanova@fz-juelich.de; Zimmermann, Thomas; Zastrow, Uwe; Gordijn, Aad; Beyer, Wolfhard

    2013-07-01

    Single-chamber processes for the deposition of high efficiency thin-film silicon tandem cells of an a-Si:H p-i-n (top cell)/μc-Si:H p-i-n (bottom cell) structure involving short fabrication time are reported. An industry relevant reactor and an excitation frequency of 13.56 MHz were used. The conversion efficiency is found to be highly sensitive to dopant cross contamination into the μc-Si:H i-layer of the bottom cell and within the n/p-interface of the tunnel recombination junction (TRJ). Different reactor treatments at the p/i-interfaces of the top and bottom cells and at the n/p-interface of the TRJ were applied, aiming to prevent dopant cross contamination. The phosphorus and the boron concentrations were evaluated by secondary ion mass spectrometry measurements. Phosphorus cross contamination after TRJ n-layer deposition is found to result in significant n-type doping of the μc-Si:H i-layer of the bottom cell if no reactor treatment is applied. In situ reactor treatment via an Ar flush and pumping step of 15 min applied at the n/p-interface of TRJ results in reduction of the μc-Si:H i-layer phosphorus concentration to values below 10{sup 17} cm{sup −3}. A conversion efficiency of 11.8% for such tandem cells is demonstrated. Shorter interface treatment time with phosphorus concentrations in the μc-Si:H i-layer of about 5 × 10{sup 17} cm{sup −3} results in lower conversion efficiencies of 10.6%, mainly due to the decrease of open-circuit voltage and fill factor. - Highlights: • Single-chamber process for a-Si:H/μc-Si:H solar cell is developed. • P- and B-contaminations at n/p interface and μc-Si:H i-layer are quantified by SIMS. • Reactor treatment is required at n/p interface for minimum dopant cross contamination. • Ar-flush pumping of reactor reduces P concentration in μc-Si:H i-layer to 10{sup 17} cm{sup −3}{sub .} • Conversion efficiency of 11.4% is reached at reactor treatment time of 17 min.

  3. Horizontal vortex single chamber hydroturbine

    Sergio Antonio Zarate-Orrego

    2016-01-01

    Full Text Available Se evaluó una máquina con alta resistencia de forma para extraer energía de una quebrada, río o corriente marina, y generar electricidad. Sin instrumentos adecuados, la investigación fue cualitativa. Se supuso que si aun así funcionaba, su comportamiento podía mejorar suavizándose la forma. El aparato tiene una tobera semi-convergente de paredes planas, una cámara de vórtice cilíndrica y un rodete. Capta agua por su sección mayor y la descarga tangencialmente por su sección menor en la cámara de vórtice; ésta tiene un orificio en una de sus paredes laterales. Así forma un vórtice horizontal que hace girar un rodete cuyo eje acciona un generador eléctrico. El trabajo experimental realizado mostró que sí es posible producir energía eléctrica con este dispositivo pese a las condiciones adversas en que se ensayó.

  4. Electrochemical characteriztion of the bioanode during simultaneous azo dye decolorization and bioelectricity generation in an air-cathode single chambered microbial fuel cell

    Sun Jian; Hu Yongyou; Hou Bin

    2011-01-01

    To achieve high power output based on simultaneously azo dye decolorization using microbial fuel cell (MFC), the bioanode responses during decolorization of a representative azo dye, Congo red, were investigated in an air-cathode single chambered MFC using representative electrochemical techniques. It has been found that the maximum stable voltage output was delayed due to slowly developed anode potential during Congo red decolorization, indicating that the electrons recovered from co-substrate are preferentially transferred to Congo red rather than the bioanode of the MFC and Congo red decolorization is prior to electricity generation. Addition of Congo red had a negligible effect on the Ohmic resistance (R ohm ) of the bioanode, but the charge-transfer resistance (R c ) and the diffusion resistance (R d ) were significantly influenced. The R c and R d firstly decreased then increased with increase of Congo red concentration, probably due to the fact that the Congo red and its decolorization products can act as electron shuttle for conveniently electrons transfer from bacteria to the anode at low concentration, but result in accelerated consumption of electrons at high concentration. Cyclic voltammetry results suggested that Congo red was a more favorable electron acceptor than the bioanode of the MFC. Congo red decolorization did not result in a noticeable decrease in peak catalytic current until Congo red concentration up to 900 mg l -1 . Long-term decolorization of Congo red resulted in change in catalytic active site of anode biofilm.

  5. Effects of various organic carbon sources on simultaneous V(V) reduction and bioelectricity generation in single chamber microbial fuel cells.

    Hao, Liting; Zhang, Baogang; Cheng, Ming; Feng, Chuanping

    2016-02-01

    Four ordinary carbon sources affecting V(V) reduction and bioelectricity generation in single chamber microbial fuel cells (MFCs) were investigated. Acetate supported highest maximum power density of 589.1mW/m(2), with highest V(V) removal efficiency of 77.6% during 12h operation, compared with glucose, citrate and soluble starch. Exorbitant initial V(V) concentration led to lower V(V) removal efficiencies and power outputs. Extra addition of organics had little effect on the improvement of MFCs performance. V(V) reduction and bioelectricity generation were enhanced and then suppressed by the increase of conductivity. The larger the external resistance, the higher the V(V) removal efficiencies and voltage outputs. High-throughput 16S rRNA gene pyrosequencing analysis implied the accumulation of Enterobacter which had the capabilities of V(V) reduction, electrochemical activity and fermentation, accompanied with other functional species as Pseudomonas, Spirochaeta, Sedimentibacter and Dysgonomonas. This study steps forward to remediate V(V) contaminated environment based on MFC technology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Hydrogen production with effluent from an ethanol–H2-coproducing fermentation reactor using a single-chamber microbial electrolysis cell

    Lu, Lu

    2009-06-01

    Hydrogen can be produced by bacterial fermentation of sugars, but substrate conversion to hydrogen is incomplete. Using a single-chamber microbial electrolysis cell (MEC), we show that additional hydrogen can be produced from the effluent of an ethanol-type dark-fermentation reactor. An overall hydrogen recovery of 83 ± 4% was obtained using a buffered effluent (pH 6.7-7.0), with a hydrogen production rate of 1.41 ± 0.08 m3 H2/m3 reactor/d, at an applied voltage of Eap = 0.6 V. When the MEC was combined with the fermentation system, the overall hydrogen recovery was 96%, with a production rate of 2.11 m3 H2/m3/d, corresponding to an electrical energy efficiency of 287%. High cathodic hydrogen recoveries (70 ± 5% to 94 ± 4%) were obtained at applied voltages of 0.5-0.8 V due to shorter cycle times, and repression of methanogen growth through exposure of the cathode to air after each cycle. Addition of a buffer to the fermentation effluent was critical to MEC performance as there was little hydrogen production using unbuffered effluent (0.0372 m3 H2/m3/d at Eap = 0.6 V, pH 4.5-4.6). These results demonstrate that hydrogen yields from fermentation can be substantially increased by using MECs. © 2009 Elsevier B.V. All rights reserved.

  7. Effect of air-exposed biocathode on the performance of a Thauera-dominated membraneless single-chamber microbial fuel cell (SCMFC).

    Yang, Nuan; Zhan, Guoqiang; Wu, Tingting; Zhang, Yanyan; Jiang, Qinrui; Li, Daping; Xiang, Yuanying

    2018-04-01

    To investigate the effect of air-exposed biocathode (AEB) on the performance of single-chamber microbial fuel cell (SCMFC), wastewater quality, bioelectrochemical characteristics and the electrode biofilms were researched. It was demonstrated that exposing the biocathode to air was beneficial to nitrogen removal and current generation. In Test 1 of 95% AEB, removal rates of ammonia, total nitrogen (TN) and chemical oxygen demand (COD) reached 99.34%±0.11%, 99.34%±0.10% and 90.79%±0.12%, respectively. The nitrogen removal loading rates were 36.38gN/m 3 /day. Meanwhile, current density and power density obtained at 0.7A/m 3 and 104mW/m 3 respectively. Further experiments on open-circuit (Test 2) and carbon source (Test 3) indicated that this high performance could be attributed to simultaneous biological nitrification/denitrification and aerobic denitrification, as well as bioelectrochemical denitrification. Results of community analysis demonstrated that both microbial community structures on the surface of the cathode and in the liquid of the chamber were different. The percentage of Thauera, identified as denitrifying bacteria, maintained at a high level of over 50% in water, but decreased gradually in the AEB. Moreover, the genus Nitrosomonas, Alishewanella, Arcobacter and Rheinheimera were significantly enriched in the AEB, which might contribute to both enhancement of nitrogen removal and electricity generation. Copyright © 2017. Published by Elsevier B.V.

  8. Procedure times, complication rates, and survival times associated with single-chamber versus dual-chamber pacemaker implantation in dogs with clinical signs of bradyarrhythmia: 54 cases (2004-2009).

    Genovese, David W; Estrada, Amara H; Maisenbacher, Herbert W; Heatwole, Bonnie A; Powell, Melanie A

    2013-01-15

    To compare procedure times and major and minor complication rates associated with single-chamber versus dual-chamber pacemaker implantation and with 1-lead, 2-lead, and 3-lead pacemaker implantation in dogs with clinical signs of bradyarrhythmia. Retrospective case series. 54 dogs that underwent pacemaker implantation because of clinical signs of bradyarrhythmia. Medical records of dogs that received pacemakers between July 2004 and December 2009 were reviewed for information regarding signalment, diagnosis, pacemaker implantation, pacemaker type, complications, and survival time. Analyses were performed to determine significant differences in anesthesia time, procedure time, and outcome for dogs on the basis of pacing mode and number of pacing leads. 28 of 54 (51.9%) dogs received single-chamber pacemakers and 26 (48.1%) received dual-chamber pacemakers. Mean ± SD procedural time was significantly longer for patients with dual-chamber pacemakers (133.5 ± 51.3 minutes) than for patients with single-chamber pacemakers (94.9 ± 37.0 minutes), and procedure time increased significantly as the number of leads increased (1 lead, 102.3 ± 51.1 minutes; 2 leads, 114.9 ± 24.8 minutes; 3 leads, 158.2 ± 8.5 minutes). Rates of major and minor complications were not significantly different between dogs that received single-chamber pacemakers and those that received dual-chamber pacemakers or among dogs grouped on the basis of the number of pacing leads placed. Although dual-chamber pacemaker implantation did result in increased procedural and anesthesia times, compared with single-chamber pacemaker implantation, this did not result in a higher complication rate.

  9. CONTACTLESS MEASUREMENT OF KEY PARAMETERS OF LIMB VESSELS ON AN OCCLUSAL PLETHYSMOGRAPHY METHOD

    V. I. Kuznetsov

    2013-01-01

    Full Text Available The purpose of this publication – to familiarize the readers with the newest achievements in the field of vision   machine   technologies   with   regard to the   occlusal   plethysmography.   The   principle   of plethysmograph work is similar to a principle of mechanical occlusal plethysmograph work, with that only a difference that working measuring environment (gas or liquid is replaced with laser labels, and fixation of change of volume is made by machine vision with the subsequent computer processing. Application of laser technologies of machine vision in future considerably simplified process of diagnostics, will allow to carry out diagnostics repeatedly and under various conditions of, for example, case of external action on the examined finiteness of the of heat, cold, physical exercise, and so, is representative of more and accurate picture of the state of blood vessels in the dynamics.

  10. Estimation of the compliance of the human capacitance vessels using radionuclide plethysmography

    Takatsu, Hisato; Gotoh, Kohshi; Suzuki, Takahiko

    1988-01-01

    Radionuclide (RN) plethysmography with Tc-99m RBC was performed in 32 patients with heart disease with the purpose of obtaining compliance of human capacitance vessels. When equilibrium was achieved, RN counts of the region of interest and venous pressure in the forearm were sequentially recorded when the vein of the upper arm was occluded with a cuff inflator. Based on the RN count-venous pressure curve, the specific compliance of the forearm vein and compliance of systemic venous system (SVS) were estimated. In the group of the NYHA functional classification I, which is recognized as hemodynamically ''normal'', the compliance of SVS was 129.8 +- 25.9 ml · mmHg -1 (mean +- SD; n = 9). In comparing the NYHA functional classification and the compliance of SVS, the compliance of SVS was significantly decreased for severer heart failure. Tongue administration of nitroglycerin (0.6 mg) significantly increased the compliance of SVS (p < 0.01). (Namekawa, K.)

  11. Measurement of the specific airway resistance by plethysmography in young children accompanied by an adult

    Klug, B; Bisgaard, H

    1997-01-01

    The purpose of this study was to evaluate a procedure for measurement of specific airway resistance (sRaw) by whole body plethysmography in young awake children accompanied by an adult. sRaw was measured by a single-step procedure, omitting the measurement of the thoracic gas volume. The frequency...... dependency of sRaw was investigated and the accuracy of simulating body temperature, atmospheric pressure and saturation with water vapour (BTPS) conditions by electronic compensation was assessed. One hundred and thirty one children with asthma were studied. In 57 children (mean (SD) age 5.6 (1.8) yrs) who....... In conclusion, the use of electronic compensation for simulating body temperature, atmospheric pressure and saturation with water vapour introduces a bias that affects the accuracy of the estimate of specific airway resistance. Nevertheless, plethysmographic measurements with and without an accompanying adult...

  12. Reproducibility of duplex ultrasonography and air plethysmography used for the evaluation of chronic venous insufficiency.

    Asbeutah, Akram Mahmoud; Riha, Andrea Zdena; Cameron, James Donald; McGrath, Barry Patrick

    2005-04-01

    The purpose of this study was to determine the reproducibility of measurements on duplex ultrasonography (DU) and air plethysmography (APG) in subjects with post-thrombotic syndrome. Duplex ultrasonography and APG were used to measure indices of lower limb venous reflux in 15 limbs with a history of deep vein thrombosis and evidence of venous insufficiency as diagnosed by ultrasonography. Three limbs were in class 0; 4 were in classes 1 to 3; and 8 were in classes 4 to 6, according to clinical, etiologic, anatomic, and pathophysiologic clinical classification. Duplex ultrasonography was performed 3 times on the same day, and venous diameter, area, peak reflux velocity, reflux flow volume, and reflux duration measurements were obtained. Air plethysmography was performed on 2 days, 7 to 10 days apart, with 1 measurement on the first day and 2 measurements on the second day. Values obtained from APG included outflow fraction, venous filling index, ejection fraction, and residual volume fraction. The measurements were performed by a vascular technologist blinded to the previous test results. One-way analysis of variance, the Student paired t test, and Bland-Altman plots were used to examine the statistical differences of the DU and APG parameters for all measurements. The mean coefficient of variation for within-subject measurements of all DU and APG parameters measured was less than 10%. Bland-Altman plots showed that there were no apparent trends with increasing values over a wide range for any of the DU parameters, nor were there any for the APG parameters. Under ideal conditions, when measured by a highly trained technologist, both DU and APG showed satisfactory reproducibility.

  13. Enhancing the performance of single-chambered microbial fuel cell using manganese/palladium and zirconium/palladium composite cathode catalysts.

    Jadhav, Dipak A; Deshpande, Parag A; Ghangrekar, Makarand M

    2017-08-01

    Application of ZrO 2 , MnO 2 , palladium, palladium-substituted-zirconium oxide (Zr 0.98 Pd 0.02 O 2 ) and palladium-substituted-manganese oxide (Mn 0.98 Pd 0.02 O 2 ) cathode catalysts in a single-chambered microbial fuel cell (MFC) was explored. The highest power generation (1.28W/m 3 ) was achieved in MFC with Mn 0.98 Pd 0.02 O 2 catalyst, which was higher than that with MnO 2 (0.58W/m 3 ) alone; whereas, MFC having Zr 0.98 Pd 0.02 O 2 catalyzed cathode and non-catalyzed cathode produced powers of 1.02 and 0.23W/m 3 , respectively. Also, low-cost zirconium-palladium-composite showed better catalytic activity and capacitance over ZrO 2 with 20A/m 3 current production and demonstrated its suitability for MFC applications. Cyclic voltammetry analyses showed higher well-defined redox peaks in composite catalysts (Mn/Zr-Pd-C) over other catalyzed MFCs containing MnO 2 or ZrO 2 . Electrochemical behaviour of composite catalysts on cathode showed higher availability of adsorption sites for oxygen reduction and, hence, enhanced the rate of cathodic reactions. Thus, Mn/Zr-Pd-C-based composite catalysts exhibited superior cathodic performance and could be proposed as alternatives to costly Pd-catalyst for field applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The use of nylon and glass fiber filter separators with different pore sizes in air-cathode single-chamber microbial fuel cells

    Zhang, Xiaoyuan

    2010-01-01

    Separators are needed in microbial fuel cells (MFCs) to reduce electrode spacing and preventing electrode short circuiting. The use of nylon and glass fiber filter separators in single-chamber, air-cathode MFCs was examined for their effect on performance. Larger pore nylon mesh were used that had regular mesh weaves with pores ranging from 10 to 160 μm, while smaller pore-size nylon filters (0.2-0.45 μm) and glass fiber filters (0.7-2.0 μm) had a more random structure. The pore size of both types of nylon filters had a direct and predictable effect on power production, with power increasing from 443 ± 27 to 650 ± 7 mW m-2 for pore sizes of 0.2 and 0.45 μm, and from 769 ± 65 to 941 ± 47 mW m-2 for 10 to 160 μm. In contrast, changes in pore sizes of the glass fiber filters resulted in a relatively narrow change in power (732 ± 48 to 779 ± 43 mW m-2) for pore sizes of 0.7 to 2 μm. An ideal separator should increase both power density and Coulombic efficiency (CE). However, CEs measured for the different separators were inversely correlated with power production, demonstrating that materials which reduced the oxygen diffusion into the reactor also hindered proton transport to the cathode, reducing power production through increased internal resistance. Our results highlight the need to develop separators that control oxygen transfer and facilitate proton transfer to the cathode. © 2010 The Royal Society of Chemistry.

  15. Effects of nitrate and sulfate on the performance and bacterial community structure of membrane-less single-chamber air-cathode microbial fuel cells.

    Seo, Yoonjoo; Kang, Hyemin; Chang, Sumin; Lee, Yun-Yeong; Cho, Kyung-Suk

    2018-01-02

    Membrane-less, single-chamber, air-cathode, microbial fuel cells (ML-SC MFCs) have attracted attention as being suitable for wastewater treatment. In this study, the effects of nitrate and sulfate on the performance of ML-SC MFCs and their bacterial structures were evaluated. The maximum power density increased after nitrate addition from 8.6 mW·m -2 to 14.0 mW·m -2 , while it decreased after sulfate addition from 11.5 mW·m -2 to 7.7 mW·m -2 . The chemical oxygen demand removal efficiencies remained at more than 90% regardless of the nitrate or sulfate additions. The nitrate was removed completely (93.0%) in the ML-SC MFC, while the sulfate removal efficiency was relatively low (17.6%). Clostridium (23.1%), Petrimonas (20.0%), and unclassified Rhodocyclaceae (6.2%) were dominant on the anode before the addition of nitrate or sulfate. After the addition of nitrate, Clostridium was still the most dominant on the anode (23.6%), but Petrimonas significantly decreased (6.0%) and unclassified Rhodocyclaceae increased (17.1%). After the addition of sulfate, the amount of Clostridium almost doubled in the composition on the anode (43.2%), while Petrimonas decreased (5.5%). The bacterial community on the cathode was similar to that on the anode after the addition of nitrate. However, Desulfovibrio was remarkably dominant on the cathode (32.9%) after the addition of sulfate. These results promote a deeper understanding of the effects of nitrate or sulfate on the ML-SC MFCs' performance and their bacterial community.

  16. Vascular Reactivity: Evaluation of an acute suprasystolic occlusion with impedance plethysmography

    Herrera, M C; Bonaudo, M; Conde, A; Palavecino, L

    2007-01-01

    In the clinical set, the evaluation of endothelium- dependent vasodilator response of large vessels is carried out using ultrasound equipment for vascular flow determinations and during administration of vasoactive drugs. This work proposes to use a substantially cheaper technique and a sustained cuff arterial occlusion in order to cause vasodilation. Impedance plethysmography is used to detect the arterial pulse wave over radial artery while the forearm is occluded by above the recording site. From these plethysmographic waves, three indexes and their changes -between control and maximal response post-occlusion- were calculated. 33 complete records obtained from healthy low-risk volunteers were analyzed. Between control and post-occlusion maximal response, 'average percentual change of pulse wave amplitude' were (35±13)%, 'stiffness index' did not show significant differences (6,38±0,98 vs 6,38±0,94 and 'reflection index' was significant lower (58±15 vs 35±16)%. These results indicate that: 1- cuff occlusion maneuver was effective to cause endothelium-dependent vasodilation, 2-changes of pulse wave amplitude and reflection index could be used as markers of athero-arteriosclerotic damage in the vascular bed, even in sub-clinical conditions

  17. Inductive plethysmography potential as a surrogate for ventilatory measurements during rest and moderate physical exercise

    Ramona Cabiddu

    2016-01-01

    Full Text Available Background: Portable respiratory inductive plethysmography (RIP systems have been validated for ventilatory assessment during resting conditions and during incremental treadmill exercise. However, in clinical settings and during field-based exercise, intensity is usually constant and submaximal. A demonstration of the ability of RIP to detect respiratory measurements accurately during constant intensity conditions would promote and validate the routine use of portable RIP devices as an alternative to ergospirometry (ES, the current gold standard technique for ventilatory measures. Objective: To investigate the agreement between respiratory variables recorded by a portable RIP device and by ES during rest and constant intensity exercise. Method: Tidal volume (VT, respiratory rate (RR and minute ventilation (VE were concurrently acquired by portable RIP and ES in seven healthy male volunteers during standing rest position and constant intensity treadmill exercise. Results: Significant agreement was found between RIP and ES acquisitions during the standing rest position and constant intensity treadmill exercise for RR and during the standing rest position for VE. Conclusion: Our results suggest that portable RIP devices might represent a suitable alternative to ES during rest and during constant submaximal exercise.

  18. Body composition following stem cell transplant: comparison of bioimpedance and air-displacement plethysmography.

    Hung, Yun-Chi; Bauer, Judith D; Horsely, Pamela; Ward, Leigh C; Bashford, John; Isenring, Elisabeth A

    2014-09-01

    The aim of this study was to assess the agreement between detected changes in body composition determined by bioimpedance spectroscopy (BIS) and air-displacement plethysmography (ADP) among patients with cancer undergoing peripheral blood stem cell transplantation (PBSCT); and to assess the agreement of absolute values of BIS with ADP and dual energy x-ray (DXA). Forty-four adult hematologic cancer patients undergoing PBSCT completed both BIS and ADP assessment at preadmission and at 3 mo after transplantation. A subsample (n = 11) was assessed by DXA at 3 mo after transplantation. Results were examined for the BIS instrument's default setting and three alternative predictive equations from the literature. Agreement was assessed by the Bland-Altman limits of agreement analysis while correlation was examined using the Lin's concordance correlation. Changes in body composition parameters assessed by BIS were comparable with those determined by ADP regardless of the predictive equations used. Bias of change in fat-free mass was clinically acceptable (all body mass index performed the best. Absolute body composition parameters predicted by the alternative predictive equations agreed with DXA and ADP better than the BIS instrument's default setting. Changes predicted by BIS were similar to those determined by ADP on a group level; however, agreement of predicted changes at an individual level should be interpreted with caution due to wide limits of agreement. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. [Digital blood flow measurement by venous occlusion plethysmography in Raynaud's phenomenon. Value of the rewarming test].

    Cristol, R; Debray, J

    1986-01-01

    The fingertip blood flow measured by mercury strain gauge plethysmography with venous occlusion, at 22 degrees C room temperature, had significantly lower mean values in 190 patients with Raynaud's phenomenon (55 men aged 49 yrs +/- 16, 135 women aged 48 yrs +/- 16) than in 40 age and sex matched controls: 18 ml/100 ml/minute +/- 14.6 versus 35 ml/100 ml/minute +/- 15 at level p less than 0.01. The mean fingertip blood flow was significantly lower (p less than 0.01) in 31 cases of scleroderma and 32 cases of pulpar necrosis (respectively 13 ml +/- 13 and 11 ml +/- 8) than in 55 cases of primary Raynaud's disease (no detectable etiology and normal capillaroscopy 5 years after onset) or in 34 cases of mild Raynaud's phenomenon (respectively 21.6 +/- 16 and 24.4 +/- 18). A warming test (both hands in water at 45 degrees C during 3 minutes) was performed in 50 cases with low basal fingertip blood flow. It induced a "normalized" flow in 22 cases (mostly primary or mild Raynaud), a partly improved flow in 20 cases (mostly secondary Raynaud) and no improvement in 8 cases (scleroderma). The warming test appears to be clinically useful to assess the vasospasm and the vasodilating capabilities.

  20. Characterisation of Brachycephalic Obstructive Airway Syndrome in French Bulldogs Using Whole-Body Barometric Plethysmography

    Liu, Nai-Chieh; Sargan, David R.; Adams, Vicki J.; Ladlow, Jane F.

    2015-01-01

    Brachycephalic obstructive airway syndrome (BOAS) is an important health and welfare problem in several popular dog breeds. Whole-body barometric plethysmography (WBBP) is a non-invasive method that allows safe and repeated quantitative measurements of respiratory cycles on unsedated dogs. Here respiratory flow traces in French bulldogs from the pet population were characterised using WBBP, and a computational application was developed to recognise affected animals. Eighty-nine French bulldogs and twenty non-brachycephalic controls underwent WBBP testing. A respiratory functional grading system was used on each dog based on respiratory signs (i.e. respiratory noise, effort, etc.) before and after exercise. For development of an objective BOAS classifier, functional Grades 0 and I were considered to have insignificant clinical signs (termed here BOAS-) and Grades II and III to have significant signs (termed here BOAS+). A comparison between owner-perception of BOAS and functional grading revealed that 60 % of owners failed to recognise BOAS in dogs that graded BOAS+ in this study.WBBP flow traces were found to be significantly different between non-brachycephalic controls and Grade 0 French bulldogs; BOAS- and BOAS+ French bulldogs. A classifier was developed using quadratic discriminant analysis of the respiratory parameters to distinguish BOAS- and BOAS + French bulldogs, and a BOAS Index was calculated for each dog. A cut-off value of the BOAS Index was selected based on a receiver operating characteristic (ROC) curve. Sensitivity, specificity, positive predictive value, and negative predictive value of the classifier on the training group (n=69) were 0.97, 0.93, 0.95, and 0.97, respectively. The classifier was validated using a test group of French bulldogs (n=20) with an accuracy of 0.95. WBBP offers objective screening for the diagnosis of BOAS in French Bulldogs. The technique may be applied to other brachycephalic breeds affected by BOAS, and possibly to

  1. Measurement of tidal volume using respiratory ultrasonic plethysmography in anaesthetized, mechanically ventilated horses.

    Russold, Elena; Ambrisko, Tamas D; Schramel, Johannes P; Auer, Ulrike; Van Den Hoven, Rene; Moens, Yves P

    2013-01-01

    To compare tidal volume estimations obtained from Respiratory Ultrasonic Plethysmography (RUP) with simultaneous spirometric measurements in anaesthetized, mechanically ventilated horses. Prospective randomized experimental study. Five experimental horses. Five horses were anaesthetized twice (1 week apart) in random order in lateral and in dorsal recumbency. Nine ventilation modes (treatments) were scheduled in random order (each lasting 4 minutes) applying combinations of different tidal volumes (8, 10, 12 mL kg(-1)) and positive end-expiratory pressures (PEEP) (0, 10, 20 cm H(2)O). Baseline ventilation mode (tidal volume=15 mL kg(-1), PEEP=0 cm H(2)O) was applied for 4 minutes between all treatments. Spirometry and RUP data were downloaded to personal computers. Linear regression analyses (RUP versus spirometric tidal volume) were performed using different subsets of data. Additonally RUP was calibrated against spirometry using a regression equation for all RUP signal values (thoracic, abdominal and combined) with all data collectively and also by an individually determined best regression equation (highest R(2)) for each experiment (horse versus recumbency) separately. Agreement between methods was assessed with Bland-Altman analyses. The highest correlation of RUP and spirometric tidal volume (R(2)=0.81) was found with the combined RUP signal in horses in lateral recumbency and ventilated without PEEP. The bias ±2 SD was 0±2.66 L when RUP was calibrated for collective data, but decreased to 0±0.87 L when RUP was calibrated with individual data. A possible use of RUP for tidal volume measurement during IPPV needs individual calibration to obtain limits of agreement within ±20%. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  2. Portable bioimpedance monitor evaluation for continuous impedance measurements. Towards wearable plethysmography applications.

    Ferreira, J; Seoane, F; Lindecrantz, K

    2013-01-01

    Personalised Health Systems (PHS) that could benefit the life quality of the patients as well as decreasing the health care costs for society among other factors are arisen. The purpose of this paper is to study the capabilities of the System-on-Chip Impedance Network Analyser AD5933 performing high speed single frequency continuous bioimpedance measurements. From a theoretical analysis, the minimum continuous impedance estimation time was determined, and the AD5933 with a custom 4-Electrode Analog Front-End (AFE) was used to experimentally determine the maximum continuous impedance estimation frequency as well as the system impedance estimation error when measuring a 2R1C electrical circuit model. Transthoracic Electrical Bioimpedance (TEB) measurements in a healthy subject were obtained using 3M gel electrodes in a tetrapolar lateral spot electrode configuration. The obtained TEB raw signal was filtered in MATLAB to obtain the respiration and cardiogenic signals, and from the cardiogenic signal the impedance derivative signal (dZ/dt) was also calculated. The results have shown that the maximum continuous impedance estimation rate was approximately 550 measurements per second with a magnitude estimation error below 1% on 2R1C-parallel bridge measurements. The displayed respiration and cardiac signals exhibited good performance, and they could be used to obtain valuable information in some plethysmography monitoring applications. The obtained results suggest that the AD5933-based monitor could be used for the implementation of a portable and wearable Bioimpedance plethysmograph that could be used in applications such as Impedance Cardiography. These results combined with the research done in functional garments and textile electrodes might enable the implementation of PHS applications in a relatively short time from now.

  3. Quantitative estimation of compliance of human systemic veins by occlusion plethysmography with radionuclide

    Takatsu, Hisato; Gotoh, Kohshi; Suzuki, Takahiko; Ohsumi, Yukio; Yagi, Yasuo; Tsukamoto, Tatsuo; Terashima, Yasushi; Nagashima, Kenshi; Hirakawa, Senri

    1989-01-01

    Volume-pressure relationship and compliance of human systemic veins were estimated quantitatively and noninvasively using radionuclide. The effect of nitroglycerin (NTG) on these parameters was examined. Plethysmography with radionuclide (RN) was performed using the occlusion method on the forearm in 56 patients with various cardiac diseases after RN angiocardiography with 99m Tc-RBC. The RN counts-venous pressure curve was constructed from (1) the changes in radioactivity from region of interest on the forearm that were considered to reflect the changes in the blood volume of the forearm, and (2) the changes in the pressure of the forearm vein (fv) due to venous occlusion. The specific compliance of the forearm veins (Csp.fv; (1/V)·(ΔV/ΔP)) was obtained graphically from this curve at each patient's venous pressure (Pv). Csp.fv was 0.044±0.012 mmHg -1 in class I (mean±SD; n=13), 0.033±0.007 mmHg -1 in class II (n=30), and 0.019±0.007 mmHg -1 in class III (n=13), of the previous NYHA classification of work tolerance. There were significant differences in Csp.fv among the three classes. The systemic venous blood volume (Vsv) was determined by subtracting the central blood volume, measured by RN-angiocardiography, from total blood volume, measured by the indicator dilution method utilizing 131 I-human serum albumin. Systemic venous compliance (Csv) was calculated from Csv=Csp.fv·Vsv. The Csv was 127.2±24.8 ml·mmHg -1 (mean±SD) in class I, 101.1±24.1 ml·mmHg -1 in class II and 62.2±28.1 ml·mmHg -1 in class III. There were significant differences in Csv among the three classes. The class I Csv value was calculated to be 127.2±24.8 ml·mmHg -1 and the Csv/body weight was calculated to be 2.3±0.7 ml·mmHg -1 ·kg -1 of body weight. The administration of NTG increased Csv significantly in all cases. (J.P.N.)

  4. Mini-PROven. Reduced emissions from small and medium-size coke ovens thanks to single-chamber pressure control; Mini-PROven. Emissionsreduzierung an kleinen und mittleren Koksoefen mit einer Einzelkammerdruckregelung

    Huhn, Friedrich; Krebber, Frank; Kuehn-Gajdzik, Joanna; Ueberschaer, Kerstin [ThyssenKrupp Uhde GmbH, Dortmund (Germany). Coke Plant Technologies Div.

    2012-07-01

    For environment and occupational health reasons it is becoming increasingly important for coke plants to be operated with the lowest possible level of emissions. In the past, changing pressure conditions in each individual oven, with particularly high values at the beginning of the coking period, often resulted in considerable emissions at the oven closures. To prevent this happening on modern large-scale ovens, ThyssenKrupp Uhde developed the PROven trademark (Pressure Regulated Oven), a single-chamber pressure control system which regulates the pressure in the individual coke chambers down to a constantly low level. In the meantime, after many years of successful service, the system has been upgraded in both its design and process engineering. The result is Mini-PROven, which in future can also be retro-fitted to old small and medium-size coke oven batteries in the interest of better environmental protection. (orig.)

  5. Accuracy of Prediction Equations to Assess Percentage of Body Fat in Children and Adolescents with Down Syndrome Compared to Air Displacement Plethysmography

    Gonzalez-Aguero, A.; Vicente-Rodriguez, G.; Ara, I.; Moreno, L. A.; Casajus, J. A.

    2011-01-01

    To determine the accuracy of the published percentage body fat (%BF) prediction equations (Durnin et al., Johnston et al., Brook and Slaughter et al.) from skinfold thickness compared to air displacement plethysmography (ADP) in children and adolescents with Down syndrome (DS). Twenty-eight children and adolescents with DS (10-20 years old; 12…

  6. Towards estimation of respiratory muscle effort with respiratory inductance plethysmography signals and complementary ensemble empirical mode decomposition.

    Chen, Ya-Chen; Hsiao, Tzu-Chien

    2018-07-01

    Respiratory inductance plethysmography (RIP) sensor is an inexpensive, non-invasive, easy-to-use transducer for collecting respiratory movement data. Studies have reported that the RIP signal's amplitude and frequency can be used to discriminate respiratory diseases. However, with the conventional approach of RIP data analysis, respiratory muscle effort cannot be estimated. In this paper, the estimation of the respiratory muscle effort through RIP signal was proposed. A complementary ensemble empirical mode decomposition method was used, to extract hidden signals from the RIP signals based on the frequency bands of the activities of different respiratory muscles. To validate the proposed method, an experiment to collect subjects' RIP signal under thoracic breathing (TB) and abdominal breathing (AB) was conducted. The experimental results for both the TB and AB indicate that the proposed method can be used to loosely estimate the activities of thoracic muscles, abdominal muscles, and diaphragm. Graphical abstract ᅟ.

  7. Association between dental caries and obesity evaluated by air displacement plethysmography in 18-year-old adolescents in Pelotas, Brazil.

    Justo, Fabiano de Castro; Fontanella, Vania Regina Camargo; Feldens, Carlos Alberto; Silva, Alexandre Emidio Ribeiro; Gonçalves, Helen; Assunção, Maria Cecília; Menezes, Ana Maria Baptista

    2015-02-01

    To investigate the association between dental caries and obesity, evaluated by air displacement plethysmography, among 18-year-old adolescents from a birth cohort in the city of Pelotas, Brazil. A cross-sectional study nested in a birth cohort study was conducted in Pelotas, Brazil. A random sample of 986 18-year-old adolescents was selected. The outcome variable was the occurrence of dental caries (DMFT ≥ 1) according to clinical examination by a trained and calibrated dentist. For the exposure variable (obesity), body fat percentage was measured using air displacement plethysmography and classified as normal weight (P95). Sociodemographic and behavior variables were collected using a questionnaire. We performed multivariable Poisson regression analyses with robust variance to examine the association between dental caries and obesity. DMFT ranged from 0 to 19; mean (SD) was 2 (2.3), and median (P25-P75) was 1 (0-3). Body fat percentage ranged from 0.9 to 57.6%; mean (SD) percentage was 24.4% (11.6%), and median (P25-P75) was 25.1% (14.0-32.9%). The prevalence of dental caries was 66.5% (95% CI 63.6-69.5%), being significantly higher in female adolescents with lower maternal education, lower education, and sugar intake more than once a day. There were no differences in the probability of dental caries among individuals with normal weight, overweight, or obesity in the unadjusted model (P = 0.846) or after adjustment for sociodemographic (P = 0.864) variables. Overweight and obesity were not associated with the occurrence of dental caries in 18-year-old adolescents. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Dual- vs. single-chamber defibrillators for primary prevention of sudden cardiac death: long-term follow-up of the Défibrillateur Automatique Implantable-Prévention Primaire registry.

    Defaye, Pascal; Boveda, Serge; Klug, Didier; Beganton, Frankie; Piot, Olivier; Narayanan, Kumar; Périer, Marie-Cécile; Gras, Daniel; Fauchier, Laurent; Bordachar, Pierre; Algalarrondo, Vincent; Babuty, Dominique; Deharo, Jean-Claude; Leclercq, Christophe; Marijon, Eloi; Sadoul, Nicolas

    2017-09-01

    Implantable cardioverter defibrillators (ICDs) are an effective primary prevention of sudden cardiac death. We examined whether dual-chamber (DC) ICDs confer a greater benefit than single-chamber (SC) ICDs, and compared the long-term outcomes of recipients of each type of device implanted for primary prevention. Between 2002 and 2012, the DAI-PP registry consecutively enrolled 1258 SC- and 1280 DC-ICD recipients at 12 French medical centres. The devices were interrogated at 4- to 6-month intervals during outpatient visits, with a focus on the therapies delivered. The study endpoints were incidence of appropriate therapies, ICD-related morbidity, and deaths from all and from specific causes. The mean age of the SC- and DC-ICD recipients was 59 ± 12 and 62 ± 11 years, respectively (PDC- vs. 8.8% in the SC-ICD groups (P= 0.008). Over a mean follow-up of 3.1 ± 2.2 years, pulse generators were replaced in 21.9% of the DC- vs. 13.6% of the SC-ICD group (PDC-ICDs were associated with higher rates of peri-implant complications and generator replacements, whereas the survival and rates of inappropriate shocks were similar in both groups. NCT#01992458. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions please email: journals.permissions@oup.com.

  9. Simultaneous measurement of instantaneous heart rate and chest wall plethysmography in short-term, metronome guided heart rate variability studies: suitability for assessment of autonomic dysfunction.

    Perring, S; Jones, E

    2003-08-01

    Instantaneous heart rate and chest wall motion were measured using a 3-lead ECG and an air pressure chest wall plethysmography system. Chest wall plethysmography traces were found to accurately represent the breathing pattern as measured by spirometry (average correlation coefficient 0.944); though no attempt was made to calibrate plethysmography voltage output to tidal volume. Simultaneous measurements of heart rate and chest wall motion were made for short periods under metronome guided breathing at 6 breaths per minute. The average peak to trough heart rate change per breath cycle (AVEMAX) and maximum correlation between heart rate and breathing cycle (HRBRCORR) were measured. Studies of 44 normal volunteers indicated clear inverse correlation of heart rate variability parameters with age (AVEMAX R = -0.502, P < 0.001) but no significant change in HRBRCORR with age (R = -0.115). Comparison of normal volunteers with diabetics with no history of symptoms associated with autonomic failure indicated significant lower heart rate variability in diabetics (P = 0.005 for AVEMAX) and significantly worse correlation between heart rate and breathing (P < 0.001 for HRBRCORR). Simultaneous measurement of heart rate and breathing offers the possibility of more sensitive diagnosis of autonomic failure in a simple bedside test and gives further insight into the nature of cardio-ventilatory coupling.

  10. Determination of functional residual capacity with 133-xenon radiospirometry. Comparison with body plethysmography and helium spirometry. Effect of body position

    Kauppinen-Walin, K.; Sovijaervi, A.R.A.; Muittari, A.; Uusitalo, A.

    1980-01-01

    The accuracy of 133-xenon radiospirometry for determination of FRC in healthy subjects was studied. Forty volunteers, both smokers and non-smokers, were examined. The FRC of each subject was concurrently determined with radiospirometric, He-dilution in closed circuit, and body plethysmographic methods. The mean FRC measured by radiospirometry (FRCsub(RS)) was 0.72 1 larger than that measured by helium spirometry (FRCsub(He)) in sitting position (P<0.01). In supine position the FRCsub(RS) was 0.65 1 larger than the FRCsub(He) (P<0.01). The body plethysmography (sitting position) gave FRC (TGV) 0.35 1 larger than the FRCsub(He) sitting (P<0.01). The FRCsub(He) and the FRCsub(RS) in the sitting position were 0.48 and 0.55 1 larger than in the supine position (P<0.01), respectively. Trapped air correlated significantly (P<0.01) with the difference FRCsub(RS) - FRCsub(He), when sitting. The results indicated that the FRC determined radiospirometrically is significantly larger than the FRC determined with He-spirometry. The difference is systematic, suggesting that it is caused by 133-xenon dissolved in blood and accumulated in tissues of the thoracic cage and by dissimilar representation of trapped air in FRCsub(RS) and FRCsub(He). After correction for systematic error, the FRC obtained as a by-product of radiospirometry may be used. (author)

  11. Body fat in children measured by DXA, air-displacement plethysmography, TBW and multicomponent models: a systematic review.

    Zanini, Roberta de Vargas; Santos, Iná S; Chrestani, Maria Aurora D; Gigante, Denise Petrucci

    2015-07-01

    To conduct a systematic literature review to identify studies that used indirect methods to assess body fat in healthy children. A systematic review was conducted according to the PRISMA guidelines. We conducted a search in the MEDLINE/PubMed, SciELO and Google Scholar databases. Studies in healthy children aged 0-9 years were eligible for inclusion. Studies were kept or excluded from the review according to eligibility criteria defined a priori. Two independent reviewers conducted all steps in the study selection. Initially, 11,246 articles were retrieved, with 3,593 duplicates. After applying the eligibility criteria, 22 articles were selected for review. The methodology of each study was analyzed by each reviewer individually. The indirect methods used to assess body fat in children included dual-energy X-ray absorptiometry (DXA) (14 articles), air-displacement plethysmography (five articles), multicomponent models (two articles), and total body water (one article). Most studies reported absolute (in kilograms) or relative (percentage) body fat measures. Only seven studies reported the fat mass index (FMI) (kg/m(2)). DXA was the indirect method most frequently used to assess body fat in healthy children. FMI was seldom reported.

  12. Centre of Gravity Plethysmography--A Means of Detecting Mass Transfer of Fluid within the Body.

    Buck, Michael

    1988-01-01

    Describes the monitoring of the redistribution of blood by using a technique which detects changes in the center of gravity of the body. Provides information about the principles and application, construction of apparatus, operating routines, and use of the computer as a recorder. Includes suggested investigations, demonstrations, and diagrams.…

  13. Comparison of Body Fat Results from 4 Bioelectrical Impedance Analysis Devices vs. Air Displacement Plethysmography in American Adolescent Wrestlers

    Melissa M. Montgomery

    2017-10-01

    Full Text Available Background: Accurate and accessible methods of body composition are necessary to ensure health and safety of wrestlers during competition. The most valid and reliable instruments are expensive and relatively inaccessible to high school wrestlers; therefore, more practical technology is needed. Objective: To compare body fat percentage (BF% results from 4 bioelectrical impedance analysis (BIA devices to those from air displacement plethysmography (ADP in adolescent wrestlers. Methodology: 134 adolescent male and female wrestlers (1.72±0.9 m, 66.8±14.3 kg, 15.6±1.1 yrs. were tested for hydration and then completed 4 body composition tests with different BIA devices and one with Bod Pod. Relative and absolute agreement were assessed between each BIA device and ADP on a single day. Results: When compared with ADP, all devices demonstrated excellent reliability (ICC (2,1 range: 0.88-0.94, but questionable measurement error (SEM range: 2.3-3.6 %BF. Bland-Altman plots revealed that each bioelectrical impedance device we tested over-estimated body fat percent in high school wrestlers (range: 0.8-3.6 %BF and demonstrated wide 95% limits of agreement (range: 15.0-20.8 %BF compared to ADP. Conclusions: The devices investigated demonstrated reasonable measurement accuracy. However, wide margins of error of each device were noted. Caution should be taken when assessing adolescent wrestlers with lower amounts of body fat, as it may result in failing to identify those who do not meet the minimum body fat percentage for competition. The governing bodies should use the research data in the decision-making process regarding appropriate devices for use in their weight management programs.

  14. Venous filling time using air-plethysmography correlates highly with great saphenous vein reflux time using duplex.

    Lattimer, C R; Azzam, M; Kalodiki, E; Geroulakos, G

    2014-03-01

    Venous filling time (VFT90) is the time taken to reach 90% of the venous volume in the calf. It is recorded by air-plethysmography (APG(®)) and is assumed to measure global venous reflux duration. However, this has never been confirmed by duplex. The aim of the study was to compare VFT on APG to venous reflux time/duration (RT) measured simultaneously with duplex on the same patients. Twenty-six consecutive patients, M:F = 16:10, age (25-78), C1 = 1, C2 = 4, C3 = 8, C4a = 6, C4b = 4, C5 = 2, C6 = 1, underwent simultaneous APG with duplex. The venous filling index (VFI, mL/second), VFT90 (seconds), great saphenous vein (GSV) RT on duplex, averaged thigh GSV diameter and thigh length (length) between the APG sensor air-cuff and duplex transducer were recorded. The VFT100 was calculated by VFT90/0.9. The additional time taken to fill the thigh was achieved using the VFI, length and deep vein diameter (d), to determine the corrected reflux duration: CRD = VFT100 + (length × πd(2)/4 (1/VFI)). Twenty-five patients are presented. One patient with very mild reflux (VFT90 = 55.9 seconds) had an indeterminate endpoint on duplex and was excluded. The median (range) VFI and GSV diameter was 4.9(1.3-15.5) mL/second and 7(4-17) mm, respectively. The VFT90 and VFT100 both correlated with RT on duplex (Spearman, P duplex RT at 24 (16.9) versus 28 (20) seconds respectively, P duplex by performing simultaneous measurements. There was an excellent correlation between the VFT90 versus duplex RT, thereby comparing reverse flow in a single superficial vein against the legs overall venous haemodynamic status. These tests can both be used in the quantification of reflux.

  15. Dynamic tissue phantoms and their use in assessment of a noninvasive optical plethysmography imaging device

    Thatcher, Jeffrey E.; Plant, Kevin D.; King, Darlene R.; Block, Kenneth L.; Fan, Wensheng; DiMaio, J. Michael

    2014-05-01

    Non-contact photoplethysmography (PPG) has been studied as a method to provide low-cost and non-invasive medical imaging for a variety of near-surface pathologies and two dimensional blood oxygenation measurements. Dynamic tissue phantoms were developed to evaluate this technology in a laboratory setting. The purpose of these phantoms was to generate a tissue model with tunable parameters including: blood vessel volume change; pulse wave frequency; and optical scattering and absorption parameters. A non-contact PPG imaging system was evaluated on this model and compared against laser Doppler imaging (LDI) and a traditional pulse oximeter. Results indicate non-contact PPG accurately identifies pulse frequency and appears to identify signals from optically dense phantoms with significantly higher detection thresholds than LDI.

  16. Computer assisted strain-gauge plethysmography is a practical method of excluding deep venous thrombosis

    Goddard, A.J.P.; Chakraverty, S.; Wright, J.

    2001-01-01

    AIM: To evaluate a computed strain-gauge plethysmograph (CSGP) as a screening tool to exclude above knee deep venous thrombosis (DVT). METHODS: The first phase took place in the Radiology department. One hundred and forty-nine patients had both Doppler ultrasound and CSGP performed. Discordant results were resolved by venography where possible. The second phase took place in an acute medical admissions ward using a modified protocol. A further 173 patients had both studies performed. The results were collated and analysed. RESULTS: Phase 1. The predictive value of a negative CSGP study was 98%. There were two false-negative CSGP results (false-negative rate 5%), including one equivocal CSGP study which had deep venous thrombosis on ultrasound examination. Two patients thought to have thrombus on ultrasound proved not to have acute thrombus on venography. Phase 2. The negative predictive value of CSGP using a modified protocol was 97%. There were two definite and one possible false-negative studies (false-negative rate 4-7%). CONCLUSION: Computer strain-gauge plethysmograph can provide a simple, cheap and effective method of excluding lower limb DVT. However, its use should be rigorously assessed in each hospital in which it is used. Goddard, A.J.P., Chakraverty, S. and Wright, J. (2001)

  17. Validity of air-displacement plethysmography in the assessment of body composition changes in a 16-month weight loss program

    Hull Holly R

    2006-08-01

    Full Text Available Abstract Objective To compare the accuracy of air displacement plethysmography (ADP and dual energy x-ray absorptionmetry (DXA in tracking changes in body composition after a 16 month weight loss intervention in overweight and obese females. Methods 93 healthy female subjects (38.9 ± 5.7 yr, 159.8 ± 5.6 cm, 76.7 ± 9.9 kg, 30.0 ± 3.4 kg/m2 completed a 16 month weight loss intervention. Eligible subjects attended 15 treatment sessions occurring over the course of 4 months with educational content including topics relating to physical activity and exercise, diet and eating behavior, and behavior modification. In the remaining 12 months, subjects underwent a lifestyle program designed to increase physical activity and improve eating habits. Before and after the intervention, subjects had their percent body fat (%fat, fat mass (FM, and fat-free mass (FFM assessed by DXA and ADP. Results Significant differences (p ≤ 0.001 were found between DXA and ADP at baseline %fat (46.0 % fat vs. 42.0 % fat, FM (35.3 kg vs. 32.5 kg and FFM (40.8 kg vs. 44.2 kg as well as at post intervention for %fat (42.1% fat vs. 38.3 % fat, FM (30.9 kg vs. 28.4 kg and FFM (41.7 kg vs. 44.7 kg. At each time point, ADP %fat and total FM was significantly lower (p ≤ 0.001 than DXA while FFM was significantly higher (p ≤ 0.001. However, both techniques tracked %fat changes similarly considering that there were no differences between the two means. Furthermore, a Bland-Altman analysis was performed and no significant bias was observed, thus demonstrating the ability of ADP to measure body fat across a wide range of fatness. Conclusion At baseline and post weight loss, a significant difference was found between ADP and DXA. However, the results indicate both methods are highly related and track changes in %fat similarly after a weight loss program in overweight and obese females. Additionally, the mean changes in %fat were similar between the two techniques, suggesting

  18. Blood flow in the limbs of hemiplegic patients by 99mTc-HSA accumulation curve and digital plethysmography

    Kuriyama, Setsuro

    1985-01-01

    Using 99m Tc-Human-Serum-Albumin (HSA) accumulation curve we have studied the blood flow in the lower extremities of the hemiplegic patients. After injection of 5 - 10 mCi of 99m Tc-HSA into v. mediana cubiti by the Oldendolf method, we recorded the RI count from both knees. We have examined 68 hemiplegic patients (male: 26, female: 42, right: 31, left: 37, average age: 61.7 years, average Brunnstrom stage of the lower extremity: 3.73, average duration post-stroke: 20.2 months). We counted the accumulation of the isotope in both knees 1 and 30 minutes after injection, and calculated the percentage (partic side/right and left sides), and named them as ''1-minute value'' and ''30-minute value''. During the 15 months period after an attack, the paretic leg had more blood flow than the non-paretic leg. After 15 months after attack, on the contrary, the paretic leg had less blood flow than the non-paretic leg. This tendency is clear in the left-sided hemiplegic patients. There is no relation between the blood flow and age, and the Brunnstrom stage, and the ability to walk. Using digital plethysmography, we have studied the blood flow in the finger and toe, too. We have examined 57 hemiplegic patients. We have averaged the five hights of the wave (mV/V), and calculated the percentage involved (paretic side/right and left) and labled it ''the paretic blood flow value (of the finger and of the toe)''. During the 12 month period after an attack, the paretic side had more blood flow than the non-paratic side. After 15 month after an attack, on the contrary, the paretic side had less blood flow than the non-paretic side. This tendency is clear in the finger than the toe. There is no correlation between the blood flow and the age, and the Brunnstrom stage, and the ability to walk. (author)

  19. The value of combined strain gauge plethysmography and radioactive iodine fibrinogen scan of the leg in the diagnosis of deep vein thrombosis

    AbuRahma, A.F.; Lawton, W.E. Jr.; Osborne, L.

    1983-01-01

    The fallibility of the clinical diagnosis of deep venous thrombosis has led to a variety of noninvasive diagnostic methods, for example, Doppler ultrasound, plethysmography, 125 I fibrinogen and radionuclide phlebography. This study was undertaken to analyze the value of combined strain gauge plethysmography and 125 I fibrinogen scan of the leg in the diagnosis of deep venous thrombosis. The study was carried out upon 368 patients with suggestive findings of venous thrombosis. Four hundred and fifty strain gauge plethysmograms were reviewed. Venograms were done upon 106 limbs and 125 I fibrinogen leg scans, on 136 limbs. Of the 64 limbs with normal strain gauge plethysmograms which had venograms, 58 were normal, five had incompetent perforators and one limb had deep venous thrombosis. Of the 42 legs with abnormal strain gauge plethysmograms which had venograms, 25 had deep venous thrombosis, 15 had incompetent perforators and two were normal. Twenty-three of 24 legs having both abnormal strain gauge plethysmograms and leg scans were confirmed to have deep venous thrombosis at venography. Fourteen of 18 legs with abnormal strain gauge plethysmograms but normal scans were found to have incompetent perforators. We conclude, that the strain gauge plethysmogram is a reliable test in excluding deep venous thrombosis and, when combined with the fibrinogen leg scan, is reliable in its diagnosis

  20. Is air-displacement plethysmography a reliable method of detecting ongoing changes in percent body fat within obese children involved in a weight management program?

    Ewane, Cecile; McConkey, Stacy A; Kreiter, Clarence D

    2010-01-01

    (percent body fat) over time. The gold standard method, hydrodensitometry, has severe limitations for the pediatric population. OBJECTIVE: This study examines the reliability of air-displacement plethysmography (ADP) in detecting percent body fat changes within obese children over time. METHODS: Percent...... body fat by ADP, weight, and body mass index (BMI) were measured for eight obese children aged 5-12 years enrolled in a weight management program over a 12-month period. These measurements were taken at initial evaluation, 1.5 months, 3 months, 6 months, and 12 months to monitor the progress...... of the subjects and detect any changes in these measures over time. Statistical analysis was used to determine the reliability of the data collected. RESULTS: The reliability estimate for percent body fat by ADP was 0.78. This was much lower than the reliability of BMI, 0.98, and weight measurements, 0...

  1. Anode-supported single-chamber solid oxide fuel cell based on cobalt-free composite cathode of Nd0.5Sr0.5Fe0.8Cu0.2O3-δ-Sm0.2Ce0.8O1.9 at intermediate temperatures

    Yin, Jie-Wei; Zhang, Chunming; Yin, Yi-Mei; Shi, Huangang; Lin, Ye; Lu, Jun; Ma, Zi-Feng

    2015-07-01

    As a candidate of cathode material of single-chamber solid oxide fuel cell (SC-SOFC), cobalt-free mixed ionic electronic conductor (MIEC) Nd0.5Sr0.5Fe0.8Cu0.2O3-δ (NSFCu) is synthesized by sol-gel method with ethylene diamine tetraacetic acid and citric acid as co-complexing agents. The XRD shows NSFCu is stable after CO2 treatment and chemical compatible with SDC at high temperatures. CO2-TPD (CO2-temperature programmed desorption) demonstrates both CO2 adsorption and desorption phenomenon on NSFCu surface. However, the polarization resistances (Rp) of NSFCu and SDC (10:4 in weight) composite electrodes showed no decay in 5% CO2. Single cell using N2-O2-CH4 mixed gas (CH4 to O2 ratio = 1.5) as fuel shows maximum power density of 635 mW cm-2 at 700 °C. These results suggest that NSFCu-SDC is a promising composite cathode material for application in single-chamber solid oxide fuel cell.

  2. Estimation of the compliance of the human capacitance vessels using radionuclide plethysmography. Comparison of the compliance with the NYHA functional classification

    Takatsu, Hisato; Gotoh, Kohshi; Suzuki, Takahiko and others

    1988-01-01

    Radionuclide (RN) plethysmography with Tc-99m RBC was performed in 32 patients with heart disease with the purpose of obtaining compliance of human capacitance vessels. When equilibrium was achieved, RN counts of the region of interest and venous pressure in the forearm were sequentially recorded when the vein of the upper arm was occluded with a cuff inflator. Based on the RN count-venous pressure curve, the specific compliance of the forearm vein and compliance of systemic venous system (SVS) were estimated. In the group of the NYHA functional classification I, which is recognized as hemodynamically ''normal'', the compliance of SVS was 129.8 +- 25.9 ml center dot mmHg/sup -1/ (mean +- SD; n = 9). In comparing the NYHA functional classification and the compliance of SVS, the compliance of SVS was significantly decreased for severer heart failure. Tongue administration of nitroglycerin (0.6 mg) significantly increased the compliance of SVS (p < 0.01). (Namekawa, K.).

  3. Development of electrolyte-supported intermediate-temperature single-chamber solid oxide fuel cells using Ln{sub 0.7}Sr{sub 0.3}Fe{sub 0.8}Co{sub 0.2}O{sub 3-{delta}} (Ln = Pr, La, Gd) cathodes

    Ruiz de Larramendi, I.; Ruiz de Larramendi, J.I.; Rojo, T. [Departamento de Quimica Inorganica, Universidad del Pais Vasco, Apdo.644, 48080 Bilbao (Spain); Lamas, D.G.; Cabezas, M.D.; Walsoee de Reca, N.E. [CINSO, CONICET-CITEFA, J.B. de La Salle 4397 (B1603ALO) Villa Martelli, Pcia. de Buenos Aires (Argentina)

    2009-09-05

    Iron-cobalt-based perovskite oxides with general formula Ln{sub 0.7}Sr{sub 0.3}Fe{sub 0.8}Co{sub 0.2}O{sub 3-{delta}} (where Ln = La, Pr and Gd) have been investigated for their application as intermediate-temperature cathodes in solid oxide fuel cells (SOFCs). Powdered samples of these materials were synthesized by a novel gel combustion process and then characterized by X-ray powder diffraction (XPD) and scanning electron microscopy (SEM). XPD patterns were satisfactorily indexed with an orthorhombic GdFeO{sub 3}-type structure and, for all samples, a mean particle size of less than 1 {mu}m was estimated from the SEM data. Experimental single-chamber SOFCs using with these materials as cathodes and NiO-SDC (samaria-doped ceria) and SDC as anode and electrolyte, respectively, were evaluated at 600 C in a methane/oxygen mixtures. Peak power densities of 65.4, 48.7 and 46.2 mW cm{sup -2} were obtained for Ag vertical stroke Ln{sub 0.7}Sr{sub 0.3}Fe{sub 0.8}Co{sub 0.2}O{sub 3-{delta}} vertical stroke SDC vertical stroke NiO-SDC vertical stroke Pt cells with Ln = Pr, La and Gd, respectively. The relatively high power density obtained for the Pr compound shows that it could be an interesting material for cathode of single-chamber SOFCs. (author)

  4. Body fat measurement by bioelectrical impedance and air displacement plethysmography: a cross-validation study to design bioelectrical impedance equations in Mexican adults

    Valencia Mauro E

    2007-08-01

    Full Text Available Abstract Background The study of body composition in specific populations by techniques such as bio-impedance analysis (BIA requires validation based on standard reference methods. The aim of this study was to develop and cross-validate a predictive equation for bioelectrical impedance using air displacement plethysmography (ADP as standard method to measure body composition in Mexican adult men and women. Methods This study included 155 male and female subjects from northern Mexico, 20–50 years of age, from low, middle, and upper income levels. Body composition was measured by ADP. Body weight (BW, kg and height (Ht, cm were obtained by standard anthropometric techniques. Resistance, R (ohms and reactance, Xc (ohms were also measured. A random-split method was used to obtain two samples: one was used to derive the equation by the "all possible regressions" procedure and was cross-validated in the other sample to test predicted versus measured values of fat-free mass (FFM. Results and Discussion The final model was: FFM (kg = 0.7374 * (Ht2 /R + 0.1763 * (BW - 0.1773 * (Age + 0.1198 * (Xc - 2.4658. R2 was 0.97; the square root of the mean square error (SRMSE was 1.99 kg, and the pure error (PE was 2.96. There was no difference between FFM predicted by the new equation (48.57 ± 10.9 kg and that measured by ADP (48.43 ± 11.3 kg. The new equation did not differ from the line of identity, had a high R2 and a low SRMSE, and showed no significant bias (0.87 ± 2.84 kg. Conclusion The new bioelectrical impedance equation based on the two-compartment model (2C was accurate, precise, and free of bias. This equation can be used to assess body composition and nutritional status in populations similar in anthropometric and physical characteristics to this sample.

  5. Water-displacement plethysmography: a technique for the simultaneous thermal manipulation and measurement of whole-hand and whole-foot blood flows

    Caldwell, Joanne N; Taylor, Nigel A S

    2014-01-01

    The purpose of this project was to design, construct and validate water-displacement plethysmographs for the forearm, hand and foot that could clamp segmental skin temperature whilst simultaneously measuring cutaneous blood flow. Two experiments were performed. In the first, the forearm plethysmograph was validated against a mercury-in-silastic plethysmograph under thermoneutral conditions, with and without forearm heating. Cutaneous vascular conductance was elevated almost three-fold by this treatment, however, there were no significant differences between the two forms of plethysmography in either state (P > 0.05). In study two, hand and foot blood flows were measured under clamped thermoneutral conditions, but with three local skin temperature treatments (5, 25, 40 °C). The hand had significantly higher blood flows than the foot at both 25 °C (4.07 versus 2.20 mL.100 mL  − 1 .min  − 1 ; P < 0.05) and 40 °C (8.20 versus 4.47 mL.100 mL  − 1 .min  − 1 ; P < 0.05). The foot was maximally constricted during the two lower temperatures, yet the cutaneous thermal sensitivity of the hand was almost two-fold greater (P < 0.05). This evidence supports the significant role played by these appendages in heat loss and conservation, and these plethysmographs will now be used to map cutaneous vascular responses (forearm, hand, calf, foot) across combinations of core and local skin temperatures. (paper)

  6. Medicare Provider Data - Hospice Providers

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  7. A comparison of dual-energy X-ray absorptiometry, air displacement plethysmography and A-mode ultrasound to assess body composition in college-age adults.

    Johnson, Kelly E; Miller, Brian; Gibson, Ann L; McLain, Trisha A; Juvancic-Heltzel, Judith A; Kappler, Rachele M; Otterstetter, Ronald

    2017-11-01

    There is currently a dearth of scientific literature exploring the agreement of A-mode ultrasound (US) body composition analysis with dual-energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP). To investigate the agreement of US with DXA and ADP for estimating fat mass (FM) and fat-free mass (FFM). College-age men (n = 33) and women (n = 41) volunteered to participate in this study. Participants were instructed to adhere to the following pretest protocol: refrain from food and drink 12 h prior to testing and wear tight fitting clothing. Body composition (BCA) was assessed using US, DXA and ADP in accordance with the respective manufacturer's guidelines. Two-way mixed-model AVOVA and Bland and Altman techniques were applied to explore agreement for FM and FFM among the three methods: US, ADP and DXA and by sex. There was no statistically significant effect by sex for either FM or FFM across all BCA comparisons (P = 0·504 and 0·510, respectively). US was not statistically different from ADP for FM and FFM (P ≈ 1·00). However, for FM and FFM, there were significant differences between DXA and both US and ADP (P≤0·001). The Bland and Altman analyses revealed large individual differences for all BCA. There was statistical agreement between US and ADP for FM and FFM but lack of agreement for US and ADP when compared to DXA. However, the large limits of agreement between methods warrant caution in generalizing these findings. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  8. Therapy Provider Phase Information

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...

  9. Medical service provider networks.

    Mougeot, Michel; Naegelen, Florence

    2018-05-17

    In many countries, health insurers or health plans choose to contract either with any willing providers or with preferred providers. We compare these mechanisms when two medical services are imperfect substitutes in demand and are supplied by two different firms. In both cases, the reimbursement is higher when patients select the in-network provider(s). We show that these mechanisms yield lower prices, lower providers' and insurer's profits, and lower expense than in the uniform-reimbursement case. Whatever the degree of product differentiation, a not-for-profit insurer should prefer selective contracting and select a reimbursement such that the out-of-pocket expense is null. Although all providers join the network under any-willing-provider contracting in the absence of third-party payment, an asymmetric equilibrium may exist when this billing arrangement is implemented. Copyright © 2018 John Wiley & Sons, Ltd.

  10. Providing free autopoweroff plugs

    Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

    2012-01-01

    Experimental evidence of the effect of providing households with cheap energy saving technology is sparse. We present results from a field experiment in which autopoweroff plugs were provided free of charge to randomly selected households. We use propensity score matching to find treatment effects...

  11. Credential Service Provider (CSP)

    Department of Veterans Affairs — Provides a VA operated Level 1 and Level 2 credential for individuals who require access to VA applications, yet cannot obtain a credential from another VA accepted...

  12. MAX Provider Characteristics

    U.S. Department of Health & Human Services — The MAX Provider Characteristics (PC) File Implementation Report describes the design, implementation, and results of the MAXPC prototype, which was based on three...

  13. Provider software buyer's guide.

    1994-03-01

    To help long term care providers find new ways to improve quality of care and efficiency, Provider magazine presents the fourth annual listing of software firms marketing computer programs for all areas of nursing facility operations. On the following five pages, more than 80 software firms display their wares, with programs such as minimum data set and care planning, dietary, accounting and financials, case mix, and medication administration records. The guide also charts compatible hardware, integration ability, telephone numbers, company contacts, and easy-to-use reader service numbers.

  14. What HERA may provide?

    Jung, Hannes [DESY, Hamburg (Germany); De Roeck, Albert [CERN, Genf (Switzerland); Bartles, Jochen [Univ. Hamburg (DE). Institut fuer Theoretische Physik II] (and others)

    2008-09-15

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  15. What HERA may provide?

    Jung, Hannes; De Roeck, Albert; Bartles, Jochen

    2008-09-01

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  16. Provider of Services File

    U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...

  17. Improved performance of single-chamber microbial fuel cells through control of membrane deformation

    Zhang, Xiaoyuan; Cheng, Shaoan; Huang, Xia; Logan, Bruce E.

    2010-01-01

    , but in initial experiments we observed the opposite using a membrane electrode assembly MFC. The reason was identified to be membrane deformation, which resulted in water and gas trapped between the membrane and cathode. To correct this, stainless steel mesh

  18. Enhanced nitrogen removal in single-chamber microbial fuel cells with increased gas diffusion areas

    Yan, Hengjing; Regan, John M.

    2012-01-01

    significantly increased the ammonia and COD removal rates (by up to 115% and 39%), ammonia removal efficiency (by up to 134%), the cell voltage and cathode potentials, and the power densities (by a factor of approximately 2). When the COD/N ratio was lowered

  19. Variation of power generation at different buffer types and conductivities in single chamber microbial fuel cells

    Nam, Joo-Youn; Kim, Hyun-Woo; Lim, Kyeong-Ho; Shin, Hang-Sik; Logan, Bruce E.

    2010-01-01

    Microbial fuel cells (MFCs) are operated with solutions containing various chemical species required for the growth of electrochemically active microorganisms including nutrients and vitamins, substrates, and chemical buffers. Many different buffers

  20. Electrochemical analysis of separators used in single-chamber, air-cathode microbial fuel cells

    Wei, Bin

    2013-02-01

    Polarization, solution-separator, charge transfer, and diffusion resistances of clean and used separator electrode assemblies were examined in microbial fuel cells using current-voltage curves and electrochemical impedance spectroscopy (EIS). Current-voltage curves showed the total resistance was reduced at low cathode potentials. EIS results revealed that at a set cathode potential of 0.3 V diffusion resistance was predominant, and it substantially increased when adding separators. However, at a lower cathode potential of 0.1 V all resistances showed only slight differences with and without separators. Used separator electrode assemblies with biofilms had increased charge transfer and diffusion resistances (0.1 V) when one separator was used; however, charge transfer resistance increased, and diffusion resistance did not appreciably change with four separators. Adding a plastic mesh to compress the separators improved maximum power densities. These results show the importance of pressing separators against the cathode, and the adverse impacts of biofilm formation on electrochemical performance. © 2012 Elsevier Ltd. All Rights Reserved.

  1. Improved performance of single-chamber microbial fuel cells through control of membrane deformation.

    Zhang, Xiaoyuan; Cheng, Shaoan; Huang, Xia; Logan, Bruce E

    2010-03-15

    Cation (CEMs) and anion exchange membrane (AEMs) are commonly used in microbial fuel cells (MFCs) to enhance Coulombic efficiencies (CEs) by reducing the flux of oxygen through the cathode to bacteria on the anode. AEMs typically work better than CEMs, but in initial experiments we observed the opposite using a membrane electrode assembly MFC. The reason was identified to be membrane deformation, which resulted in water and gas trapped between the membrane and cathode. To correct this, stainless steel mesh was used to press the membrane flat against the cathode. With the steel mesh, AEM performance increased to 46+/-4 W/m(3) in a single cathode MFC, and 98+/-14 W/m(3) in a double-cathode MFC. These power densities were higher than those using a CEM of 32+/-2 W/m(3) (single cathode) and 63+/-6 W/m(3) (double cathode). Higher pH gradients across the membrane and salt precipitation on the cathode were responsible for the reduced performance of the CEM compared to the AEM. CEs reached over 90% for both membranes at >2A/m(2). These results demonstrate the importance of avoiding water accumulation in thin films between membranes and electrodes, and explain additional reasons for poorer performance of CEMs compared to AEMs. (c) 2009 Elsevier B.V. All rights reserved.

  2. Improved performance of single-chamber microbial fuel cells through control of membrane deformation

    Zhang, Xiaoyuan

    2010-03-01

    Cation (CEMs) and anion exchange membrane (AEMs) are commonly used in microbial fuel cells (MFCs) to enhance Coulombic efficiencies (CEs) by reducing thefluxof oxygen through the cathode to bacteriaonthe anode. AEMs typically work better than CEMs, but in initial experiments we observed the opposite using a membrane electrode assembly MFC. The reason was identified to be membrane deformation, which resulted in water and gas trapped between the membrane and cathode. To correct this, stainless steel mesh was used to press the membrane flat against the cathode. With the steel mesh, AEM performance increased to 46±4W/m3 in a single cathode MFC, and 98±14W/m3 in a double-cathode MFC. These power densities were higher than those using a CEM of 32±2W/m3 (single cathode) and 63±6W/m3 (double cathode). Higher pH gradients across the membrane and salt precipitation on the cathode were responsible for the reduced performance of the CEM compared to the AEM. CEs reached over 90% for both membranes at >2A/m2. These results demonstrate the importance of avoiding water accumulation in thin films between membranes and electrodes, and explain additional reasons for poorer performance of CEMs compared to AEMs. © 2009 Elsevier B.V.

  3. Vertically aligned carbon nanotubes as anode and air-cathode in single chamber microbial fuel cells

    Amade, R.; Moreno, H. A.; Hussain, S.; Vila-Costa, M.; Bertran, E.

    2016-10-01

    Electrode optimization in microbial fuel cells is a key issue to improve the power output and cell performance. Vertically aligned carbon nanotubes (VACNTs) grown on low cost stainless-steel mesh present an attractive approach to increase the cell performance while avoiding the use of expensive Pt-based materials. In comparison with non-aligned carbon nanotubes (NACNTs), VACNTs increase the oxygen reduction reaction taking place at the cathode by a factor of two. In addition, vertical alignment also increases the power density up to 2.5 times with respect to NACNTs. VACNTs grown at the anode can further improve the cell performance by increasing the electrode surface area and thus the electron transfer between bacteria and the electrode. The maximum power density obtained using VACNTs was 14 mW/m2 and 160 mV output voltage.

  4. Note: A single-chamber tool for plasma activation and surface functionalization in microfabrication

    Bowman, Adam J.; Scherrer, Joseph R.; Reiserer, Ronald S., E-mail: ron.reiserer@vanderbilt.edu [Vanderbilt Institute for Integrative Biosystems Research and Education and Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee 37235 (United States)

    2015-06-15

    We present a simple apparatus for improved surface modification of polydimethylsiloxane (PDMS) microfluidic devices. A single treatment chamber for plasma activation and chemical/physical vapor deposition steps minimizes the time-dependent degradation of surface activation that is inherent in multi-chamber techniques. Contamination and deposition irregularities are also minimized by conducting plasma activation and treatment phases in the same vacuum environment. An inductively coupled plasma driver allows for interchangeable treatment chambers. Atomic force microscopy confirms that silane deposition on PDMS gives much better surface quality than standard deposition methods, which yield a higher local roughness and pronounced irregularities in the surface.

  5. Electricity generation of single-chamber microbial fuel cells at low temperatures

    Cheng, Shaoan

    2011-01-01

    Practical applications of microbial fuel cells (MFCs) for wastewater treatment will require operation of these systems over a wide range of wastewater temperatures. MFCs at room or higher temperatures (20-35°C) are relatively well studied compared those at lower temperatures. MFC performance was examined here over a temperature range of 4-30°C in terms of startup time needed for reproducible power cycles, and performance. MFCs initially operated at 15°C or higher all attained a reproducible cycles of power generation, but the startup time to reach stable operation increased from 50h at 30°C to 210h at 15°C. At temperatures below 15°C, MFCs did not produce appreciable power even after one month of operation. If an MFC was first started up at temperature of 30°C, however, reproducible cycles of power generation could then be achieved at even the two lowest temperatures of 4°C and 10°C. Power production increased linearly with temperature at a rate of 33±4mW°C-1, from 425±2mWm-2 at 4°C to 1260±10mWm-2 at 30°C. Coulombic efficiency decreased by 45% over this same temperature range, or from CE=31% at 4°C to CE=17% at 30°C. These results demonstrate that MFCs can effectively be operated over a wide range of temperatures, but our findings have important implications for the startup of larger scale reactors where low wastewater temperatures could delay or prevent adequate startup of the system. © 2010 Elsevier B.V.

  6. Increasing power generation for scaling up single-chamber air cathode microbial fuel cells

    Cheng, Shaoan; Logan, Bruce E.

    2011-01-01

    Scaling up microbial fuel cells (MFCs) requires a better understanding the importance of the different factors such as electrode surface area and reactor geometry relative to solution conditions such as conductivity and substrate concentration. It is shown here that the substrate concentration has significant effect on anode but not cathode performance, while the solution conductivity has a significant effect on the cathode but not the anode. The cathode surface area is always important for increasing power. Doubling the cathode size can increase power by 62% with domestic wastewater, but doubling the anode size increases power by 12%. Volumetric power density was shown to be a linear function of cathode specific surface area (ratio of cathode surface area to reactor volume), but the impact of cathode size on power generation depended on the substrate strength (COD) and conductivity. These results demonstrate the cathode specific surface area is the most critical factor for scaling-up MFCs to obtain high power densities. © 2010 Elsevier Ltd.

  7. Electrochemical analysis of separators used in single-chamber, air-cathode microbial fuel cells

    Wei, Bin; Tokash, Justin C.; Zhang, Fang; Kim, Younggy; Logan, Bruce E.

    2013-01-01

    Polarization, solution-separator, charge transfer, and diffusion resistances of clean and used separator electrode assemblies were examined in microbial fuel cells using current-voltage curves and electrochemical impedance spectroscopy (EIS). Current-voltage curves showed the total resistance was reduced at low cathode potentials. EIS results revealed that at a set cathode potential of 0.3 V diffusion resistance was predominant, and it substantially increased when adding separators. However, at a lower cathode potential of 0.1 V all resistances showed only slight differences with and without separators. Used separator electrode assemblies with biofilms had increased charge transfer and diffusion resistances (0.1 V) when one separator was used; however, charge transfer resistance increased, and diffusion resistance did not appreciably change with four separators. Adding a plastic mesh to compress the separators improved maximum power densities. These results show the importance of pressing separators against the cathode, and the adverse impacts of biofilm formation on electrochemical performance. © 2012 Elsevier Ltd. All Rights Reserved.

  8. Increasing power generation for scaling up single-chamber air cathode microbial fuel cells

    Cheng, Shaoan

    2011-03-01

    Scaling up microbial fuel cells (MFCs) requires a better understanding the importance of the different factors such as electrode surface area and reactor geometry relative to solution conditions such as conductivity and substrate concentration. It is shown here that the substrate concentration has significant effect on anode but not cathode performance, while the solution conductivity has a significant effect on the cathode but not the anode. The cathode surface area is always important for increasing power. Doubling the cathode size can increase power by 62% with domestic wastewater, but doubling the anode size increases power by 12%. Volumetric power density was shown to be a linear function of cathode specific surface area (ratio of cathode surface area to reactor volume), but the impact of cathode size on power generation depended on the substrate strength (COD) and conductivity. These results demonstrate the cathode specific surface area is the most critical factor for scaling-up MFCs to obtain high power densities. © 2010 Elsevier Ltd.

  9. Parameter estimation and characterization of a single-chamber microbial fuel cell for dairy wastewater treatment.

    Sedaqatvand, Ramin; Nasr Esfahany, Mohsen; Behzad, Tayebeh; Mohseni, Madjid; Mardanpour, Mohammad Mahdi

    2013-10-01

    In this study, for the first time, the conduction-based model is extended, and then combined with Genetic Algorithm to estimate the design parameters of a MFC treating dairy wastewater. The optimized parameters are, then, validated. The estimated half-saturation potential of -0.13 V (vs. SHE) is in good agreement while the biofilm conductivity of 8.76×10(-4) mS cm(-1) is three orders of magnitude lower than that previously-reported for pure-culture biofilm. Simulations show that the ohmic and concentration overpotentials contribute almost equally in dropping cell voltage in which the concentration film and biofilm conductivity comprise the main resistances, respectively. Thus, polarization analysis and determining the controlling steps will be possible through that developed extension. This study introduces a reliable method to estimate the design parameters of a particular MFC and to characterize it. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Electricity generation of single-chamber microbial fuel cells at low temperatures

    Cheng, Shaoan; Xing, Defeng; Logan, Bruce E.

    2011-01-01

    Practical applications of microbial fuel cells (MFCs) for wastewater treatment will require operation of these systems over a wide range of wastewater temperatures. MFCs at room or higher temperatures (20-35°C) are relatively well studied compared

  11. Building Service Provider Capabilities

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    2015-01-01

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...... process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....... of the services, such as sequential or reciprocal task activities, influence the development of different types of capabilities. We study five cases of offshore-outsourced knowledge-intensive business services that are distinguished according to their reciprocal or sequential task activities in their production...

  12. Providing x-rays

    Mallozzi, P.J.; Epstein, H.M.

    1985-01-01

    This invention provides an apparatus for providing x-rays to an object that may be in an ordinary environment such as air at approximately atmospheric pressure. The apparatus comprises: means (typically a laser beam) for directing energy onto a target to produce x-rays of a selected spectrum and intensity at the target; a fluid-tight enclosure around the target; means for maintaining the pressure in the first enclosure substantially below atmospheric pressure; a fluid-tight second enclosure adjoining the first enclosure, the common wall portion having an opening large enough to permit x-rays to pass through but small enough to allow the pressure reducing means to evacuate gas from the first enclosure at least as fast as it enters through the opening; the second enclosure filled with a gas that is highly transparent to x-rays; the wall of the second enclosure to which the x-rays travel having a portion that is highly transparent to x-rays (usually a beryllium or plastic foil), so that the object to which the x-rays are to be provided may be located outside the second enclosure and adjacent thereto and thus receive the x-rays substantially unimpeded by air or other intervening matter. The apparatus is particularly suited to obtaining EXAFS (extended x-ray fine structure spectroscopy) data on a material

  13. Why healthcare providers merge.

    Postma, Jeroen; Roos, Anne-Fleur

    2016-04-01

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities.

  14. PROVIDING WOMEN, KEPT MEN

    Mojola, Sanyu A

    2014-01-01

    This paper draws on ethnographic and interview based fieldwork to explore accounts of intimate relationships between widowed women and poor young men that emerged in the wake of economic crisis and a devastating HIV epidemic among the Luo ethnic group in Western Kenya. I show how the cooptation of widow inheritance practices in the wake of an overwhelming number of widows as well as economic crisis resulted in widows becoming providing women and poor young men becoming kept men. I illustrate how widows in this setting, by performing a set of practices central to what it meant to be a man in this society – pursuing and providing for their partners - were effectively doing masculinity. I will also show how young men, rather than being feminized by being kept, deployed other sets of practices to prove their masculinity and live in a manner congruent with cultural ideals. I argue that ultimately, women’s practice of masculinity in large part seemed to serve patriarchal ends. It not only facilitated the fulfillment of patriarchal expectations of femininity – to being inherited – but also served, in the end, to provide a material base for young men’s deployment of legitimizing and culturally valued sets of masculine practice. PMID:25489121

  15. Providing Compassion through Flow

    Lydia Royeen

    2015-07-01

    Full Text Available Meg Kral, MS, OTR/L, CLT, is the cover artist for the Summer 2015 issue of The Open Journal of Occupational Therapy. Her untitled piece of art is an oil painting and is a re-creation of a photograph taken while on vacation. Meg is currently supervisor of outpatient services at Rush University Medical Center. She is lymphedema certified and has a specific interest in breast cancer lymphedema. Art and occupational therapy serve similar purposes for Meg: both provide a sense of flow. She values the outcomes, whether it is a piece of art or improved functional status

  16. Energy providers: customer expectations

    Pridham, N.F.

    1997-01-01

    The deregulation of the gas and electric power industries, and how it will impact on customer service and pricing rates was discussed. This paper described the present situation, reviewed core competencies, and outlined future expectations. The bottom line is that major energy consumers are very conscious of energy costs and go to great lengths to keep them under control. At the same time, solutions proposed to reduce energy costs must benefit all classes of consumers, be they industrial, commercial, institutional or residential. Deregulation and competition at an accelerated pace is the most likely answer. This may be forced by external forces such as foreign energy providers who are eager to enter the Canadian energy market. It is also likely that the competition and convergence between gas and electricity is just the beginning, and may well be overshadowed by other deregulated industries as they determine their core competencies

  17. What HERA May Provide?

    Jung, Hannes; /DESY; De Roeck, Albert; /CERN; Bartels, Jochen; /Hamburg U., Inst. Theor. Phys. II; Behnke, Olaf; Blumlein, Johannes; /DESY; Brodsky, Stanley; /SLAC /Durham U., IPPP; Cooper-Sarkar, Amanda; /Oxford U.; Deak, Michal; /DESY; Devenish, Robin; /Oxford U.; Diehl, Markus; /DESY; Gehrmann, Thomas; /Zurich U.; Grindhammer, Guenter; /Munich, Max Planck Inst.; Gustafson, Gosta; /CERN /Lund U., Dept. Theor. Phys.; Khoze, Valery; /Durham U., IPPP; Knutsson, Albert; /DESY; Klein, Max; /Liverpool U.; Krauss, Frank; /Durham U., IPPP; Kutak, Krzysztof; /DESY; Laenen, Eric; /NIKHEF, Amsterdam; Lonnblad, Leif; /Lund U., Dept. Theor. Phys.; Motyka, Leszek; /Hamburg U., Inst. Theor. Phys. II /Birmingham U. /Southern Methodist U. /DESY /Piemonte Orientale U., Novara /CERN /Paris, LPTHE /Hamburg U. /Penn State U.

    2011-11-10

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. The HERA accelerator and the HERA experiments H1, HERMES and ZEUS stopped running in the end of June 2007. This was after 15 years of very successful operation since the first collisions in 1992. A total luminosity of {approx} 500 pb{sup -1} has been accumulated by each of the collider experiments H1 and ZEUS. During the years the increasingly better understood and upgraded detectors and HERA accelerator have contributed significantly to this success. The physics program remains in full swing and plenty of new results were presented at DIS08 which are approaching the anticipated final precision, fulfilling and exceeding the physics plans and the previsions of the upgrade program. Most of the analyses presented at DIS08 were still based on the so called HERA I data sample, i.e. data taken until 2000, before the shutdown for the luminosity upgrade. This sample has an integrated luminosity of {approx} 100 pb{sup -1}, and the four times larger statistics sample from HERA II is still in the process of being analyzed.

  18. Preferred Provider Organization (PPO) Plans

    ... Find & compare doctors, hospitals, & other providers Preferred Provider Organization (PPO) Plans How PPO Plans Work A Medicare ... extra for these benefits. Related Resources Health Maintenance Organization (HMO) Private Fee-for-Service (PFFS) Special Needs ...

  19. Would it provide Free Education?

    First page Back Continue Last page Overview Graphics. Would it provide Free Education? Would it provide Free Education? Would it provide Compulsory Education? Would it guarantee education of equitable quality? Would it prevent discrimination? Would it stop schools that promote inequality & discrimination? NO! NO!

  20. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care.

    Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B

    2017-01-01

    A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of

  1. Patient choice of providers in a preferred provider organization.

    Wouters, A V; Hester, J

    1988-03-01

    This article is an analysis of patient choice of providers by the employees of the Security Pacific Bank of California and their dependents who have access to the Med Network Preferred Provider Organization (PPO). The empirical results show that not only is the PPO used by individuals who require relatively little medical care (as measured by predicted office visit charges) but that the PPO is most intensively used for low-risk services such as treatment for minor illness and preventive care. Also, the most likely Security Pacific Health Care beneficiary to use a PPO provider is a recently hired employee who lives in the south urban region, has a relatively low income, does not have supplemental insurance coverage, and is without previous attachments to non-PPO primary care providers. In order to maximize their ability to reduce plan paid benefits, insurers who contract with PPOs should focus on increasing PPO utilization among poorer health risks.

  2. Perspectives of addiction treatment providers

    Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the ...

  3. Babesiosis for Health Care Providers

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  4. Incentives and provider payment methods.

    Barnum, H; Kutzin, J; Saxenian, H

    1995-01-01

    The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.

  5. Medicare Referring Provider DMEPOS PUF

    U.S. Department of Health & Human Services — This dataset, which is part of CMSs Medicare Provider Utilization and Payment Data, details information on Durable Medical Equipment, Prosthetics, Orthotics and...

  6. Lodging Update: Providence, Rhode Island

    Ragel Roginsky

    2013-04-01

    Full Text Available Each quarter, Pinnacle Advisory Group prepares an analysis of the New England lodging industry, which provides a regional summary and then focuses in depth on a particular market. These reviews look at recent and proposed supply changes, factors affecting demand and growth rates, and the effects of interactions between such supply and demand trends. In this issue, the authors spotlight the lodging market in Providence, Rhode Island.

  7. Accuracy of whole-body plethysmography requires biological calibration

    Poorisrisak, Porntiva; Vrang, Carsten; Henriksen, Jorn Molgaard

    2009-01-01

    procedure: (1) seven healthy young children were brought to each of the six centers for sRaw measurements; and (2) 105 healthy preschool children (52 boys; mean age, 5.1 years; interquartile range, 4.3 to 6.0) were recruited locally for sRaw measurements. RESULTS: (1) The sRaw of the seven-children study...... preschool children) were generated and were without significant difference between centers and independent of height, weight, age, and gender. We subsequently pooled these normative data (105 children) with our previous data from 121 healthy young children (overall mean sRaw, 1.27; SD, 0.25). CONCLUSION......: Control using biological standards revealed errors in the factory setting and highlights the need for developing methods for verification of resistance measures to assure accuracy. Normative data were subsequently generated. Importantly, other centers using such normative data should first consider proper...

  8. [Methodical aspects of pneumatic segment plethysmography. III. Measuring tourniquet problems].

    Bethge, K P; de Caleya, D

    1976-08-01

    The question, to which extent utilization of different plethysmographic cuffs influenced the assessment of volume changes, was examined in 40 healthy individuals as well as by means of an experimental model. It could be shown that plethysmographic results varied significantly according to the design of the cuffs: 1.a) Utilization of short (19.5 cm) cuffs that did not cover the entire thigh circumference resulted in significantly lower arterial inflow and pressure-dependent venous capacity measurements as compared to long cuffs (48.8 cm). b) This result was confirmed by use of a newly developed "calibration-cylinder" demonstrating that use of the short cuff showed only 62.2% of the true volume change, use of the long cuff, however, 89.6%. Deficiency of thigh contact is discussed as possible etiologic factor for this difference. 2. The cover material of the cuff also influenced the results significantly since results could be improved from 62.2% to 86.9% (short cuff) and from 89.6% to 95.1% (long cuff) by use of double layer non-compliant cloth. The reason for this finding is thought to be the compliance of conventional cloth. 3. Comparison of two cuffs with identical shape and dimensions resulted in significantly lower volume changes using hard stiff rubber as compared to soft compliant rubber. These findings suggest some recommendations for optimal design of plethysmographic cuffs. Cuffs should not underestimate volume changes obtained with the "calibration-cylinder" by more than 10%.

  9. Ancillary Services Provided from DER

    Campbell, J.B.

    2005-12-21

    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  10. Ecosystem services provided by waterbirds.

    Green, Andy J; Elmberg, Johan

    2014-02-01

    Ecosystem services are ecosystem processes that directly or indirectly benefit human well-being. There has been much recent literature identifying different services and the communities and species that provide them. This is a vital first step towards management and maintenance of these services. In this review, we specifically address the waterbirds, which play key functional roles in many aquatic ecosystems, including as predators, herbivores and vectors of seeds, invertebrates and nutrients, although these roles have often been overlooked. Waterbirds can maintain the diversity of other organisms, control pests, be effective bioindicators of ecological conditions, and act as sentinels of potential disease outbreaks. They also provide important provisioning (meat, feathers, eggs, etc.) and cultural services to both indigenous and westernized societies. We identify key gaps in the understanding of ecosystem services provided by waterbirds and areas for future research required to clarify their functional role in ecosystems and the services they provide. We consider how the economic value of these services could be calculated, giving some examples. Such valuation will provide powerful arguments for waterbird conservation. © 2013 The Authors. Biological Reviews © 2013 Cambridge Philosophical Society.

  11. Enstore with Chimera namespace provider

    Litvintsev, Dmitry; Moibenko, Alexander; Oleynik, Gene; Zalokar, Michael

    2012-01-01

    Enstore is a mass storage system developed by Fermilab that provides distributed access and management of data stored on tapes. It uses a namespace service, PNFS, developed by DESY to provide a filesystem-like view of the stored data. PNFS is a legacy product and is being replaced by a new implementation, called Chimera, which is also developed by DESY. Chimera offers multiple advantages over PNFS in terms of performance and functionality. The Enstore client component, encp, has been modified to work with Chimera, as well as with any other namespace provider. We performed high load end-to-end acceptance test of Enstore with the Chimera namespace. This paper describes the modifications to Enstore, the test procedure and the results of the acceptance testing.

  12. Dangertalk: Voices of abortion providers.

    Martin, Lisa A; Hassinger, Jane A; Debbink, Michelle; Harris, Lisa H

    2017-07-01

    Researchers have described the difficulties of doing abortion work, including the psychosocial costs to individual providers. Some have discussed the self-censorship in which providers engage in to protect themselves and the pro-choice movement. However, few have examined the costs of this self-censorship to public discourse and social movements in the US. Using qualitative data collected during abortion providers' discussions of their work, we explore the tensions between their narratives and pro-choice discourse, and examine the types of stories that are routinely silenced - narratives we name "dangertalk". Using these data, we theorize about the ways in which giving voice to these tensions might transform current abortion discourse by disrupting false dichotomies and better reflecting the complex realities of abortion. We present a conceptual model for dangertalk in abortion discourse, connecting it to functions of dangertalk in social movements more broadly. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. EAMJ Provider April 10.indd

    2010-04-04

    Apr 4, 2010 ... from 14 to 30 days in studies done in Europe and. North America ... to confirmatory laboratory diagnostic test was 56.2 days (n=83, range 1 to 985 days, standard .... (9,10). In a population based study in German, Volker ... risk factors for provider delays (9). ... mammographic reliability for cancer diagnosis at.

  14. Device provides controlled gas leaks

    Kami, S. K.; King, H. J.

    1968-01-01

    Modified palladium leak device provides a controlled release /leak/ of very small quantities of gas at low or medium pressures. It has no moving parts, requires less than 5 watts to operate, and is capable of releasing the gas either continuously or in pulses at adjustable flow rates.

  15. Twitter for travel medicine providers.

    Mills, Deborah J; Kohl, Sarah E

    2016-03-01

    Travel medicine practitioners, perhaps more so than medical practitioners working in other areas of medicine, require a constant flow of information to stay up-to-date, and provide best practice information and care to their patients. Many travel medicine providers are unaware of the popularity and potential of the Twitter platform. Twitter use among our travellers, as well as by physicians and health providers, is growing exponentially. There is a rapidly expanding body of published literature on this information tool. This review provides a brief overview of the ways Twitter is being used by health practitioners, the advantages that are peculiar to Twitter as a platform of social media, and how the interested practitioner can get started. Some key points about the dark side of Twitter are highlighted, as well as the potential benefits of using Twitter as a way to disseminate accurate medical information to the public. This article will help readers develop an increased understanding of Twitter as a tool for extracting useful facts and insights from the ever increasing volume of health information. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  16. Ecosystem services provided by bats.

    Kunz, Thomas H; Braun de Torrez, Elizabeth; Bauer, Dana; Lobova, Tatyana; Fleming, Theodore H

    2011-03-01

    Ecosystem services are the benefits obtained from the environment that increase human well-being. Economic valuation is conducted by measuring the human welfare gains or losses that result from changes in the provision of ecosystem services. Bats have long been postulated to play important roles in arthropod suppression, seed dispersal, and pollination; however, only recently have these ecosystem services begun to be thoroughly evaluated. Here, we review the available literature on the ecological and economic impact of ecosystem services provided by bats. We describe dietary preferences, foraging behaviors, adaptations, and phylogenetic histories of insectivorous, frugivorous, and nectarivorous bats worldwide in the context of their respective ecosystem services. For each trophic ensemble, we discuss the consequences of these ecological interactions on both natural and agricultural systems. Throughout this review, we highlight the research needed to fully determine the ecosystem services in question. Finally, we provide a comprehensive overview of economic valuation of ecosystem services. Unfortunately, few studies estimating the economic value of ecosystem services provided by bats have been conducted to date; however, we outline a framework that could be used in future studies to more fully address this question. Consumptive goods provided by bats, such as food and guano, are often exchanged in markets where the market price indicates an economic value. Nonmarket valuation methods can be used to estimate the economic value of nonconsumptive services, including inputs to agricultural production and recreational activities. Information on the ecological and economic value of ecosystem services provided by bats can be used to inform decisions regarding where and when to protect or restore bat populations and associated habitats, as well as to improve public perception of bats. © 2011 New York Academy of Sciences.

  17. Microneurografia e pletismografia de oclusão venosa na insuficiência cardíaca: correlação com prognóstico Microneurografía y pletismografía de oclusión venosa en la insuficiencia cardiaca: correlación con pronóstico Microneurography and venous occlusion plethysmography in heart failure: correlation with prognosis

    Robinson Tadeu Munhoz

    2009-01-01

    Full Text Available FUNDAMENTO: Microneurografia e pletismografia de oclusão venosa podem ser considerados métodos de avaliação da atividade simpática. OBJETIVO: Avaliar a intensidade da atividade simpática através da microneurografia e da pletismografia de oclusão venosa em pacientes com insuficiência cardíaca, e correlacionar essa intensidade com prognóstico. MÉTODOS: 52 pacientes com insuficiência cardíaca (FE 53,5 impulsos/min para ANSM (S=90,55. E=73,68% e 1,81 ml/min/100gr (PFUNDAMENTO: Microneurografía y pletismografía de oclusión venosa se pueden considerar como métodos de evaluación de la actividad simpática. OBJETIVO: Evaluar la intensidad de la actividad simpática a través de la microneurografía y de la pletismografía de oclusión venosa en pacientes con insuficiencia cardiaca, y correlacionar esa intensidad con pronóstico. MÉTODOS: Un total de 52 pacientes con insuficiencia cardiaca (FE 53,5 impulsos/min para ANSM (S=90,55. E=73,68% y 1,81 ml/min/100gr (PBACKGROUND: Microneurography and venous occlusion plethysmography can be considered methods of assessment of the sympathetic activity. OBJECTIVE: To evaluate the intensity of the sympathetic activity through microneurography and venous occlusion plethysmography in patients with heart failure (HF and correlate this intensity with prognosis. METHODS: 52 patients with HF (ejection fraction 53.5 impulses/min for MSNA (S=90.55. E=73.68% and 1.81 ml/min/100gr (P<0.001. Logistic regression analysis: the higher the MSNA and the lower the MBF, the higher is the probability of death. CONCLUSION: The intensity of the MSNA and the MBF can be considered prognostic markers in advanced HF.

  18. Management systems for service providers

    Bolokonya, Herbert Chiwalo

    2015-02-01

    In the field of radiation safety and protection there are a number of institutions that are involved in achieving different goals and strategies. These strategies and objectives are achieved based on a number of tools and systems, one of these tools and systems is the use of a management system. This study aimed at reviewing the management system concept for Technical Service Providers in the field of radiation safety and protection. The main focus was on personal monitoring services provided by personal dosimetry laboratories. A number of key issues were found to be prominent to make the management system efficient. These are laboratory accreditation, approval; having a customer driven operating criteria; and controlling of records and good reporting. (au)

  19. Providing solutions to engineering problems

    Connop, R.P.P.

    1991-01-01

    BNFL has acquired unique experience over a period of 40 years in specifying, designing and constructing spent fuel reprocessing and associated waste management plant. This experience is currently used to support a pound 5.5 billion capital investment programme. This paper reviews a number of engineering problems and their solutions to highlight BNFL experience in providing comprehensive specification, design and engineering and project management services. (author)

  20. Support Net for Frontline Providers

    2016-03-01

    learning style , as well as treatment readiness (Proudfoot et al., 2011). Several channels of delivery include audio, video, email correspondence and...Provided Resources (1) o “Self assessment, resources were good.” Coaching (2) o “During this coaching period, I had a death of a parent , I did find the...Secondary Traumatic Stress Scale. Res Soc Work Pract. 2004; 14(1):27–35. 21. Pyevich CM, Newman E, Daleiden E. The relationship among cognitive

  1. Electrochemically exfoliated graphene anodes with enhanced biocurrent production in single-chamber air-breathing microbial fuel cells.

    Najafabadi, Amin Taheri; Ng, Norvin; Gyenge, Előd

    2016-07-15

    Microbial fuel cells (MFCs) present promising options for environmentally sustainable power generation especially in conjunction with waste water treatment. However, major challenges remain including low power density, difficult scale-up, and durability of the cell components. This study reports enhanced biocurrent production in a membrane-free MFC, using graphene microsheets (GNs) as anode and MnOx catalyzed air cathode. The GNs are produced by ionic liquid assisted simultaneous anodic and cathodic electrochemical exfoliation of iso-molded graphite electrodes. The GNs produced by anodic exfoliation increase the MFC peak power density by over 300% compared to plain carbon cloth (i.e., 2.85Wm(-2) vs 0.66Wm(-2), respectively), and by 90% compared to conventional carbon black (i.e., Vulcan XC-72) anode. These results exceed previously reported power densities for graphene-containing MFC anodes. The fuel cell polarization results are corroborated by electrochemical impedance spectroscopy indicating three times lower charge transfer resistance for the GN anode. Material characterizations suggest that the best performing GN samples were of relatively smaller size (~500nm), with higher levels of ionic liquid induced surface functionalization during the electrochemical exfoliation process. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Nitrogen removal in a single-chamber microbial fuel cell with nitrifying biofilm enriched at the air cathode

    Yan, Hengjing; Saito, Tomonori; Regan, John M.

    2012-01-01

    biofilm MFCs had lower Coulombic efficiencies (up to 27%) than the control reactor (up to 36%). The maximum total nitrogen removal efficiency reached 93.9% for MFCs with the DEA binder. The DEA binder accelerated nitrifier biofilm enrichment on the cathode

  3. Using single-chamber microbial fuel cells as renewable power sources of electro-Fenton reactors for organic pollutant treatment

    Zhu, Xiuping; Logan, Bruce E.

    2013-01-01

    accomplish H2O2 generation and Fe2+ release for the Fenton reaction. In tests using phenol, 75±2% of the total organic carbon (TOC) was removed in the electro-Fenton reactor in one cycle (22h), and phenol was completely degraded to simple and readily

  4. Comparison of Geometrical Layouts for a Multi-Box Aerosol Model from a Single-Chamber Dispersion Study

    Alexander C. Ø. Jensen

    2018-04-01

    Full Text Available Models are increasingly used to estimate and pre-emptively calculate the occupational exposure of airborne released particulate matter. Typical two-box models assume instant and fully mixed air volumes, which can potentially cause issues in cases with fast processes, slow air mixing, and/or large volumes. In this study, we present an aerosol dispersion model and validate it by comparing the modelled concentrations with concentrations measured during chamber experiments. We investigated whether a better estimation of concentrations was possible by using different geometrical layouts rather than a typical two-box layout. A one-box, two-box, and two three-box layouts were used. The one box model was found to underestimate the concentrations close to the source, while overestimating the concentrations in the far field. The two-box model layout performed well based on comparisons from the chamber study in systems with a steady source concentration for both slow and fast mixing. The three-box layout was found to better estimate the concentrations and the timing of the peaks for fluctuating concentrations than the one-box or two-box layouts under relatively slow mixing conditions. This finding suggests that industry-relevant scaled volumes should be tested in practice to gain more knowledge about when to use the two-box or the three-box layout schemes for multi-box models.

  5. Spatial distribution of bacterial communities on volumetric and planar anodes in single-chamber air-cathode microbial fuel cells

    Vargas, Ignacio T.

    2013-05-29

    Pyrosequencing was used to characterize bacterial communities in air-cathode microbial fuel cells across a volumetric (graphite fiber brush) and a planar (carbon cloth) anode, where different physical and chemical gradients would be expected associated with the distance between anode location and the air cathode. As expected, the stable operational voltage and the coulombic efficiency (CE) were higher for the volumetric anode than the planar anode (0.57V and CE=22% vs. 0.51V and CE=12%). The genus Geobacter was the only known exoelectrogen among the observed dominant groups, comprising 57±4% of recovered sequences for the brush and 27±5% for the carbon-cloth anode. While the bacterial communities differed between the two anode materials, results showed that Geobacter spp. and other dominant bacterial groups were homogenously distributed across both planar and volumetric anodes. This lends support to previous community analysis interpretations based on a single biofilm sampling location in these systems. © 2013 Wiley Periodicals, Inc.

  6. Time-course correlation of biofilm properties and electrochemical performance in single-chamber microbial fuel cells

    Ren, Zhiyong; Ramasamy, Ramaraja P.; Cloud-Owen, Susan Red; Yan, Hengjing; Mench, Matthew M.; Regan, John M.

    2011-01-01

    The relationship between anode microbial characteristics and electrochemical parameters in microbial fuel cells (MFCs) was analyzed by time-course sampling of parallel single-bottle MFCs operated under identical conditions. While voltage stabilized within 4. days, anode biofilms continued growing during the six-week operation. Viable cell density increased asymptotically, but membrane-compromised cells accumulated steadily from only 9% of total cells on day 3 to 52% at 6. weeks. Electrochemical performance followed the viable cell trend, with a positive correlation for power density and an inverse correlation for anode charge transfer resistance. The biofilm architecture shifted from rod-shaped, dispersed cells to more filamentous structures, with the continuous detection of Geobacter sulfurreducens-like 16S rRNA fragments throughout operation and the emergence of a community member related to a known phenazine-producing Pseudomonas species. A drop in cathode open circuit potential between weeks two and three suggested that uncontrolled biofilm growth on the cathode deleteriously affects system performance. © 2010 Elsevier Ltd.

  7. Anolyte recycling enhanced bioelectricity generation of the buffer-free single-chamber air-cathode microbial fuel cell.

    Ren, Yueping; Chen, Jinli; Shi, Yugang; Li, Xiufen; Yang, Na; Wang, Xinhua

    2017-11-01

    Anolyte acidification is an inevitable restriction for the bioelectricity generation of buffer-free microbial fuel cells (MFCs). In this work, acidification of the buffer-free KCl anolyte has been thoroughly eliminated through anolyte recycling. The accumulated HCO 3 - concentration in the recycled KCl anolyte was above 50mM, which played as natural buffer and elevated the anolyte pH to above 8. The maximum power density (P max ) increased from 322.9mWm -2 to 527.2mWm -2 , which is comparable with the phosphate buffered MFC. Besides Geobacter genus, the gradually increased anolyte pH and conductivity induced the growing of electrochemically active Geoalkalibacter genus, in the anode biofilm. Anolyte recycling is a feasible strategy to strengthen the self-buffering capacity of buffer-free MFCs, thoroughly eliminate the anolyte acidification and prominently enhance the electric power. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Spatial distribution of bacterial communities on volumetric and planar anodes in single-chamber air-cathode microbial fuel cells

    Vargas, Ignacio T.; Albert, Istvan U.; Regan, John M.

    2013-01-01

    Pyrosequencing was used to characterize bacterial communities in air-cathode microbial fuel cells across a volumetric (graphite fiber brush) and a planar (carbon cloth) anode, where different physical and chemical gradients would be expected

  9. Providing cleaner air to Canadians

    2001-02-01

    This booklet is designed to explain salient aspects of the Ozone Annex, negotiated and signed recently by Canada and the United States, in a joint effort to improve air quality in North America. By significantly reducing the transboundary flows of air pollutants that cause smog, the Ozone Annex will benefit some 16 million people in central and eastern Canada and provide an example for a future round of negotiations to address concerns of the millions of Canadians and Americans who live in the border area between British Columbia and Washington State. The brochure provide summaries of the Canadian and American commitments, focusing on transportation, monitoring and reporting. The Ozone Annex complements other air quality initiatives by the Government of Canada enacted under the Environmental Protection Act, 1999. These measures include regulations to reduce sulphur content to 30 parts per million by Jan 1, 2005; proposing to restrict toxic particulate matter (PM) to less than 10 microns; establishing daily smog forecasts in the Maritimes and committing to a national program built upon existing smog advisories and forecasts in Quebec, Ontario and British Columbia; and investing in more clean air research through the newly created Canadian Foundation for Climate and Atmospheric Sciences

  10. Providing Southern Perspectives on CSR

    Jeppesen, Søren; Kothuis, Bas

    The article seeks to contribute to the SMEs and CSR literature in developing countries by providing; a) a ‘Southern’ SME perspective, which includes the voices of managers and workers, b) a perspective of CSR, which opens up to informal CSR practices that SMEs undertake, and c) an analysis...... of the key institutional issues affecting the CSR practices of SMEs. It presents perceptions of CSR practices among 21 SMEs in the garment industry in South Africa, based on 40 interviews with managers and 19 interviews with workers through the use of qualitative and quantitative interview frameworks....... It highlights a high degree of similarities between managers and workers, though knowledge of (cognitive level) the concept ‘CSR’ differ considerably. Informal practices are widespread and of key importance to the SMEs, expressed by managers and workers alike. History, industry and manager-workers relations...

  11. Wind Turbine Providing Grid Support

    2011-01-01

    changing the operation of the wind turbine to a more efficient working point.; When the rotational speed of the rotor reaches a minimum value, the wind turbine enters a recovery period to re-accelerate the rotor to the nominal rotational speed while further contributing to the stability of the electrical......A variable speed wind turbine is arranged to provide additional electrical power to counteract non-periodic disturbances in an electrical grid. A controller monitors events indicating a need to increase the electrical output power from the wind turbine to the electrical grid. The controller...... is arranged to control the wind turbine as follows: after an indicating event has been detected, the wind turbine enters an overproduction period in which the electrical output power is increased, wherein the additional electrical output power is taken from kinetic energy stored in the rotor and without...

  12. Vaccines provided by family physicians.

    Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F

    2010-01-01

    This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.

  13. Environmental standards provide competitive advantage

    Chynoweth, E.; Kirshner, E.

    1993-01-01

    Quality organizations are breaking new ground with the development of international standards for environmental management. These promise to provide the platform for chemical companies wanting to establish their environmental credibility with a global audience. open-quotes It will be similar to auditing our customers to ISO 9000 close-quote, says the environmental manager for a European chemical firm. open-quote We will only want to deal with people who have got their environmental act together. And we'll be in a better competitive positions close-quote. The International Organization for Standardization (ISO;Geneva) has set up a taskforce to develop an environmental management standard, which is expected to be completed by the mid-1990s. Observers think the ISO standard will draw heavily on the British Standard Institute's (BSI;London) environmental management standard, BS7750, which will likely be the first system adopted in the world. Published last year, BS7750 has been extensively piloted in the UK (CW, Sept. 30, 1992, p. 62) and is now set to be revised before being offically adopted by BSI. The UK's Chemical Industries Association (CIA;London) is anxious to prevent a proliferation of standards, and its report on BS7750 pilot projects calls for an approach integrating quality, environment, and health and safety. But standard setters, including ISO, appear to be moving in the opposite direction. In the US, the American national Standards Institute (ANSI;Washington) has started work on an environmental management standard

  14. Providing global WLCG transfer monitoring

    Andreeva, J; Dieguez Arias, D; Campana, S; Keeble, O; Magini, N; Molnar, Z; Ro, G; Saiz, P; Salichos, M; Tuckett, D; Flix, J; Oleynik, D; Petrosyan, A; Uzhinsky, A; Wildish, T

    2012-01-01

    The WLCG[1] Transfers Dashboard is a monitoring system which aims to provide a global view of WLCG data transfers and to reduce redundancy in monitoring tasks performed by the LHC experiments. The system is designed to work transparently across LHC experiments and across the various technologies used for data transfer. Currently each LHC experiment monitors data transfers via experiment-specific systems but the overall cross-experiment picture is missing. Even for data transfers handled by FTS, which is used by 3 LHC experiments, monitoring tasks such as aggregation of FTS transfer statistics or estimation of transfer latencies are performed by every experiment separately. These tasks could be performed once, centrally, and then served to all experiments via a well-defined set of APIs. In the design and development of the new system, experience accumulated by the LHC experiments in the data management monitoring area is taken into account and a considerable part of the code of the ATLAS DDM Dashboard is being re-used. The paper describes the architecture of the Global Transfer monitoring system, the implementation of its components and the first prototype.

  15. Computerized provider order entry systems.

    2001-01-01

    Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use.

  16. Providing value in ambulatory anesthesia.

    Fosnot, Caroline D; Fleisher, Lee A; Keogh, John

    2015-12-01

    colonoscopies. With this projected increase in the demand for anesthesia services nationwide comes the analysis of its financial feasibility. Some early data looking at endoscopist-administered sedation conclude that it offers higher patient satisfaction, there were less adverse effects than anesthesiologist-administered sedation, and is economically advantageous. This and future retrospective studies will help to guide healthcare policymakers and physicians to come to a conclusion about providing ambulatory services for these millions of patients. Ambulatory anesthesia's popularity continues to rise and anesthetic techniques will continue to morph and adapt to the needs of patients seeking ambulatory surgery. Alterations in already existing medications are promising as these modifications allow for quicker recovery from anesthesia or minimization of the already known undesirable side-effects. PONV, pain, obstructive sleep apnea, and chronic comorbidities (hypertension, cardiac disease, and diabetes mellitus) are perioperative concerns in ambulatory settings as more patients are safely being treated in ambulatory settings. Regional anesthesia stands out as a modality that has multiple advantages to general anesthesia, providing a minimal recovery period and a decrease in postanesthesia care unit stay. The implementation of the Affordable Healthcare Act specifically affects ambulatory settings as the demand and need for patients to have screening procedures with anesthesia. The question remains what the best strategy is to meet the needs of our future patients while preserving economically feasibility within an already strained healthcare system.

  17. Insure Kids Now (IKN) (Dental Care Providers)

    U.S. Department of Health & Human Services — The Insure Kids Now (IKN) Dental Care Providers in Your State locator provides profile information for oral health providers participating in Medicaid and Children's...

  18. Discussing Diabetes with Your Healthcare Provider

    ... of this page please turn Javascript on. Feature: Diabetes Discussing Diabetes with Your Healthcare Provider Past Issues / Fall 2009 Table of Contents Diabetes Medicines—Always Discuss Them with Your Healthcare Provider ...

  19. Identifiable Data Files - Medicare Provider Analysis and ...

    U.S. Department of Health & Human Services — The Medicare Provider Analysis and Review (MEDPAR) File contains data from claims for services provided to beneficiaries admitted to Medicare certified inpatient...

  20. Institutional Provider and Beneficiary Summary PUF

    U.S. Department of Health & Human Services — The CMS IPBS PUFs are aggregated files in which each record summarizes information for a particular institutional provider. An institutional provider refers to a...

  1. Medicare Provider Payment Data - Skilled Nursing Facilities

    U.S. Department of Health & Human Services — The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare...

  2. Medicare Provider Data - Part D Prescriber

    U.S. Department of Health & Human Services — The Part D Prescriber Public Use File (PUF) provides information on prescription drugs prescribed by individual physicians and other health care providers and paid...

  3. Factors Influencing Self Employment Media Service Providers ...

    Factors Influencing Self Employment Media Service Providers among Tertiary ... role stereotype and common business practices on media self employment in ... Sex, Psycho-social Characteristics, self Employment, Providing Media Services.

  4. Medicare Provider Data - Physician and Other Supplier

    U.S. Department of Health & Human Services — The Physician and Other Supplier Public Use File (Physician and Other Supplier PUF) provides information on services and procedures provided to Medicare...

  5. Co-providing: understanding the logistics.

    Dickerson, Pamela S

    2011-11-01

    Continuing nursing education providers have sometimes said that they don't want to co-provide because "it's too much trouble" or they "won't be able to control what happens" or because they don't understand the process. This column clarifies the logistics of the co-provider relationship. Copyright 2011, SLACK Incorporated.

  6. Piezoelectric pump and pressurised circuit provided therewith

    Van Es, Johannes; Wits, Wessel Willems

    2015-01-01

    A piezoelectric pump for use in a pressurised circuit is provided, comprising a pump chamber (5) with an inlet (6) provided with a one way inlet valve (7), for connection to a feeding line (8) of the pressurised circuit and an outlet (9) provided with a one way outlet valve (10), for connection to a

  7. Provider-Independent Use of the Cloud

    Harmer, Terence; Wright, Peter; Cunningham, Christina; Perrott, Ron

    Utility computing offers researchers and businesses the potential of significant cost-savings, making it possible for them to match the cost of their computing and storage to their demand for such resources. A utility compute provider enables the purchase of compute infrastructures on-demand; when a user requires computing resources a provider will provision a resource for them and charge them only for their period of use of that resource. There has been a significant growth in the number of cloud computing resource providers and each has a different resource usage model, application process and application programming interface (API)-developing generic multi-resource provider applications is thus difficult and time consuming. We have developed an abstraction layer that provides a single resource usage model, user authentication model and API for compute providers that enables cloud-provider neutral applications to be developed. In this paper we outline the issues in using external resource providers, give examples of using a number of the most popular cloud providers and provide examples of developing provider neutral applications. In addition, we discuss the development of the API to create a generic provisioning model based on a common architecture for cloud computing providers.

  8. 5 CFR 890.910 - Provider information.

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Provider information. 890.910 Section 890.910 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS..., and FEHB Benefit Payments § 890.910 Provider information. The hospital provider information used to...

  9. Home care providers to the rescue

    Hansen, Steen Møller; Brøndum, Stig; Thomas, Grethe

    2015-01-01

    AIM: To describe the implementation of a novel first-responder programme in which home care providers equipped with automated external defibrillators (AEDs) were dispatched in parallel with existing emergency medical services in the event of a suspected out-of-hospital cardiac arrest (OHCA......). METHODS: We evaluated a one-year prospective study that trained home care providers in performing cardiopulmonary resuscitation (CPR) and using an AED in cases of suspected OHCA. Data were collected from cardiac arrest case files, case files from each provider dispatch and a survey among dispatched...... providers. The study was conducted in a rural district in Denmark. RESULTS: Home care providers were dispatched to 28 of the 60 OHCAs that occurred in the study period. In ten cases the providers arrived before the ambulance service and subsequently performed CPR. AED analysis was executed in three cases...

  10. Enabling Wireless Cooperation in User Provided Networks

    Rolla, Vitor Guerra

    2015-01-01

    Tese de doutoramento em Ciências e Tecnologias da Informação, apresentada ao Departamento de Engenharia Informática da Faculdade de Ciências e Tecnologia da Universidade de Coimbra This doctoral thesis investigates user provided networks. Such networks have become important research subjects in the field of informatics engineering due to the recent popularity of smart phones. User provided networks are independent from traditional Internet service providers. Communication and informati...

  11. Browsing for the Best Internet Access Provider?

    Weil, Marty

    1996-01-01

    Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

  12. a qualitative study of providers' perspectives

    Background: Glaucoma management is challenging to patients as well as to the eye care providers.The study is aimed at describing the challenges faced by providers using qualitative methods. Methods: In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres ...

  13. Medicaid provider reimbursement policy for adult immunizations.

    Stewart, Alexandra M; Lindley, Megan C; Cox, Marisa A

    2015-10-26

    State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Observational analysis using document review and a survey. Medicaid administrators in 50 states and the District of Columbia. Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Piezo pump and pressurized circuit provided therewith

    Van Es, Johannes; Wits, Wessel Willems

    2015-01-01

    A piezo pump for use in a pressurized circuit includes a pump chamber with an inlet provided with a one way inlet valve, for connection to a feeding line of the pressurized circuit and an outlet provided with a one way outlet valve, for connection to a discharge line of the pressurized circuit and a

  15. Organizational culture associated with provider satisfaction.

    Scammon, Debra L; Tabler, Jennifer; Brunisholz, Kimberly; Gren, Lisa H; Kim, Jaewhan; Tomoaia-Cotisel, Andrada; Day, Julie; Farrell, Timothy W; Waitzman, Norman J; Magill, Michael K

    2014-01-01

    Organizational culture is key to the successful implementation of major improvement strategies. Transformation to a patient-centered medical home (PCHM) is such an improvement strategy, requiring a shift from provider-centric care to team-based care. Because this shift may impact provider satisfaction, it is important to understand the relationship between provider satisfaction and organizational culture, specifically in the context of practices that have transformed to a PCMH model. This was a cross-sectional study of surveys conducted in 2011 among providers and staff in 10 primary care clinics implementing their version of a PCMH: Care by Design. Measures included the Organizational Culture Assessment Instrument and the American Medical Group Association provider satisfaction survey. Providers were most satisfied with quality of care (mean, 4.14; scale of 1-5) and interactions with patients (mean, 4.12) and were least satisfied with time spent working (mean, 3.47), paperwork (mean, 3.45), and compensation (mean, 3.35). Culture profiles differed across clinics, with family/clan and hierarchical cultures the most common. Significant correlations (P ≤ .05) between provider satisfaction and clinic culture archetypes included family/clan culture negatively correlated with administrative work; entrepreneurial culture positively correlated with the Time Spent Working dimension; market/rational culture positively correlated with how practices were facing economic and strategic challenges; and hierarchical culture negatively correlated with the Relationships with Staff and Resource dimensions. Provider satisfaction is an important metric for assessing experiences with features of a PCMH model. Identification of clinic-specific culture archetypes and archetype associations with provider satisfaction can help inform practice redesign. Attention to effective methods for changing organizational culture is recommended.

  16. Effective communication with primary care providers.

    Smith, Karen

    2014-08-01

    Effective communication requires direct interaction between the hospitalist and the primary care provider using a standardized method of information exchange with the opportunity to ask questions and assign accountability for follow-up roles. The discharge summary is part of the process but does not provide the important aspects of handoff, such as closed loop communication and role assignments. Hospital discharge is a significant safety risk for patients, with more than half of discharged patients experiencing at least one error. Hospitalist and primary care providers need to collaborate to develop a standardized system to communicate about shared patients that meets handoff requirements. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Healthcare providers' attitudes and perceptions in infection ...

    EB

    Objectives: To assess the attitudes and perceptions of healthcare providers ... antibiotics and only 32% always send a sample for culture sensitivity ..... resistance - A global issue of concern. Asian J. Pharma Clin Res. 2009; 2(2): 34 - 39. 4.

  18. Medicare Provider Utilization and Payment Data - Outpatient

    U.S. Department of Health & Human Services — The Outpatient Utilization and Payment Public Use File (Outpatient PUF) presents information on common outpatient services provided to Medicare fee-for-service...

  19. Medicare Referring Provider (DMEPOS) Data CY2013

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) released a new dataset, the Referring Provider Durable Medical Equipment, Prosthetics, Orthotics and Supplies...

  20. Medicare Provider Utilization and Payment Data

    U.S. Department of Health & Human Services — CMS has released a series of publicly available data files that summarize the utilization and payments for procedures, services, and prescription drugs provided to...

  1. Medicare Provider Analysis and Review (MEDPAR)

    U.S. Department of Health & Human Services — MEDPAR files contain information on Medicare beneficiaries using hospital inpatient services. The data is provided by the state and the Diagnosis Related Groups...

  2. Ecolo Watt. Ecologic comparison of electricity providers

    2007-09-01

    As consumers now can choose their electricity provider, Greenpeace proposes Ecolo Watt, a system which assesses the different providers, more particularly in terms of protection of the environment. This document first describes the electricity market liberalisation (principle, market opening process, a shake-up of the French electric landscape, obligations for the providers). It presents the green electricity market (original guarantees, the questionable system of green certificates, and the Eve label). It describes the methodology adopted for the Ecolo Watt comparative assessment: assessment criteria, final mark. It presents the ranking of electricity providers while analysing their energy mix, their energy policy, their energy service and sales policy, the quality and transparency of information). Detailed results are presented for each operator

  3. VT Wireless Internet Service Providers 2006

    Vermont Center for Geographic Information — (Link to Metadata) The VT Wireless Internet Service Provider (ISP) dataset (WISP2006) includes polygons depicting the extent of Vermont's WISP broadband system as of...

  4. Provider Customer Service Program - Performance Data

    U.S. Department of Health & Human Services — CMS is continuously analyzing performance and quality of the Provider Customer Service Programs (PCSPs) of the contractors and will be identifying trends and making...

  5. National Provider Identifier Standard - Data Dissemination

    U.S. Department of Health & Human Services — The National Plan and Provider Enumeration System, NPPES, downloadable file, also referred to as the NPI Downloadable File, contains FOIA disclosable NPPES health...

  6. Medicare Referring Provider DMEPOS PUF CY2013

    U.S. Department of Health & Human Services — This dataset, which is part of CMSs Medicare Provider Utilization and Payment Data, details information on Durable Medical Equipment, Prosthetics, Orthotics and...

  7. Medicare Provider Utilization and Payment Data - Inpatient

    U.S. Department of Health & Human Services — The data provided here include hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS)...

  8. parents' and healthcare providers perspectives about hospitalised

    2013-04-04

    Apr 4, 2013 ... and the parents and healthcare providers' views on hospitalised children being visited ... because it promotes healing, gives the sick child psychological satisfaction and ..... Mental Health in Early Post-Second World War.

  9. Parents' and healthcare providers perspectives about hospitalised ...

    Parents' and healthcare providers perspectives about hospitalised children being visited by other ... Log in or Register to get access to full text downloads. ... children should be visited by other children has been accorded minimal attention.

  10. CARAVAN: Providing Location Privacy for VANET

    Sampigethaya, Krishna; Huang, Leping; Li, Mingyan; Poovendran, Radha; Matsuura, Kanta; Sezaki, Kaoru

    2005-01-01

    .... This type of tracking leads to threats on the location privacy of the vehicle's user. In this paper, we study the problem of providing location privacy in VANET by allowing vehicles to prevent tracking of their broadcast communications...

  11. VT Wireless Internet Service Providers 2007

    Vermont Center for Geographic Information — (Link to Metadata) The VT Wireless Internet Service Provider (ISP) dataset (WISP2007) includes polygons depicting the extent of Vermont's WISP broadband system as of...

  12. Mental Health Insurance Parity and Provider Wages.

    Golberstein, Ezra; Busch, Susan H

    2017-06-01

    Policymakers frequently mandate that employers or insurers provide insurance benefits deemed to be critical to individuals' well-being. However, in the presence of private market imperfections, mandates that increase demand for a service can lead to price increases for that service, without necessarily affecting the quantity being supplied. We test this idea empirically by looking at mental health parity mandates. This study evaluated whether implementation of parity laws was associated with changes in mental health provider wages. Quasi-experimental analysis of average wages by state and year for six mental health care-related occupations were considered: Clinical, Counseling, and School Psychologists; Substance Abuse and Behavioral Disorder Counselors; Marriage and Family Therapists; Mental Health Counselors; Mental Health and Substance Abuse Social Workers; and Psychiatrists. Data from 1999-2013 were used to estimate the association between the implementation of state mental health parity laws and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and average mental health provider wages. Mental health parity laws were associated with a significant increase in mental health care provider wages controlling for changes in mental health provider wages in states not exposed to parity (3.5 percent [95% CI: 0.3%, 6.6%]; pwages. Health insurance benefit expansions may lead to increased prices for health services when the private market that supplies the service is imperfect or constrained. In the context of mental health parity, this work suggests that part of the value of expanding insurance benefits for mental health coverage was captured by providers. Given historically low wage levels of mental health providers, this increase may be a first step in bringing mental health provider wages in line with parallel health professions, potentially reducing turnover rates and improving treatment quality.

  13. Medicaid provider reimbursement policy for adult immunizations☆

    Stewart, Alexandra M.; Lindley, Megan C.; Cox, Marisa A.

    2015-01-01

    Background State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Objective Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Design Observational analysis using document review and a survey. Setting and participants Medicaid administrators in 50 states and the District of Columbia. Measurements Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Results Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Limitations Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Conclusions Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. PMID:26403369

  14. Arkansas community pharmacists' opinions on providing immunizations.

    Pace, Anne C; Flowers, Schwanda K; Hastings, Jan K

    2010-10-01

    To determine community pharmacists' attitudes and knowledge on providing immunizations including perceived barriers to immunizing. The study also examined the percentage of Arkansas pharmacists providing immunizations and the utilization of student pharmacists. Survey. Arkansas community pharmacies from February to March 2009. Community pharmacists. Mailed survey. Perceived barriers to providing immunizations, pharmacists' attitudes regarding immunizations, number of immunization-certified pharmacists, immunization administration rates within the last year, and senior student pharmacists utilization. A total of 350 surveys were mailed, and 129 were returned. In all, 79% of the respondents believed administering immunizations has advanced or significantly advanced the profession. Being certified and attitude toward providing immunizations were correlated; 37% of the respondents held certification to immunize, of which 77% reported immunizing within the last year. Commonly reported barriers included time (76%) followed by reimbursement and legal liability. Only half the respondents realized fourth year student pharmacists could immunize and only 33% of certified pharmacists utilized student pharmacists to immunize. Pharmacists perceive many barriers to providing immunizations. Training student pharmacists to give immunizations may not result in them providing immunizations upon graduation. Additional education on overcoming potential barriers and using senior student pharmacists to administer immunizations is needed.

  15. Provider self-disclosure during contraceptive counseling.

    McLean, Merritt; Steinauer, Jody; Schmittdiel, Julie; Chan, Pamela; Dehlendorf, Christine

    2017-02-01

    Provider self-disclosure (PSD) - defined as providers making statements regarding personal information to patients - has not been well characterized in the context of contraceptive counseling. In this study, we describe the incidence, content and context of contraceptive PSD. This mixed methods analysis used data from the Provider-Patient Contraceptive Counseling study, for which 349 family planning patients were recruited from 2009 to 2012 from six clinics in the San Francisco Bay Area. Audio-recordings from their visits were analyzed for the presence or absence of PSD, and those visits with evidence of PSD were analyzed using qualitative methods. The associations of patient and provider demographics and patient satisfaction measures, obtained from survey data, with PSD were analyzed using bivariable and multivariable analyses. Thirty-seven percent of providers showed evidence of PSD during at least one visit, and PSD occurred in 9% of clinic visits. Fifty-four percent of PSD statements were about intrauterine devices. About half of PSD statements occurred prior to the final selection of the contraceptive method and appeared to influence the choice of method. In post-visit surveys, all patients who reported receiving PSD considered it to be appropriate, and patient-reported PSD was not statistically associated with measures of patient satisfaction. This study provides some support for the appropriateness of PSD during family planning encounters, at least as practiced during the sampled visits. Further research could explore whether this counseling strategy has an impact on patients' ability to identify the best contraceptive methods for them. In this study, PSD did not have a demonstrated negative effect on the provider-patient relationship. In almost half of visits, PSD appeared to influence patients' choice of a method; whether this influence is beneficial needs further research. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Logistic service providers and sustainable physical distribution

    Stef Weijers

    2012-06-01

    Full Text Available Background: Logistic Service Providers main concern was to ensure reliability for a low price (Christopher, 2005. Dutch Logistic Service Providers still have these two aspects at the top of their list, but also have to take in a new aspect: sustainability. 88% Of the investigated Logistic Service Providers have included sustainability in the company's goals. These Logistic Service Providers have developed different strategies to achieve a higher level of sustainability. This paper presents the results of a study into what Logistic Service Providers say what they are doing, or intend to do, to improve sustainability for their transport services. In this way insight is given in the attitude of Dutch Logistic Service Providers towards sustainability and how they intend to translate this into business practise: internal solutions or new methods incorporating external partners. Methods: Various methods of the investigations were used, among which the analysis of the statements about the sustainabilityon the websites of various companies as well as the questionnaire per Internet. The research covered 50 largest logistics companies operating in the Netherlands and 60 companies that competed for the award "Lean and Green" advertised in the Netherlands. In addition, the Internet survey was answered by 41 companies that belong to the network of our university. Results: The investigation has shown that sustainability is handled by the logistics company as an integral part of the corporate strategy. In contrast, shippers depend in the choice of logistics services primarily on such classical aspects as the reliability or the price and the sustainability play a minor role. Conclusions: Trying to find methods to improve the sustainability, Dutch logistics service providers, in the first place, look for solutions that increase the efficiency and therefore the cost reduction potential. Solutions, which require the involvement of clients, were less often

  17. Engaging service providers in improving industry performance

    Oberth, R.

    2012-01-01

    Effective task leadership is the key to achieving results in the nuclear industry and in most other industries. One of the themes of this conference is to discuss how the nuclear industry can undertake Issue-Identification and Definition as a means of 'identifying what needs attention' and then 'defining what needs to be done to make that happen'. I will explore this theme from the perspective of the 'Service Provider' - which by the definition of this conference includes everyone not within an operating utility - meaning 'those involved in everything from inspection and repair to research and plant architecture' - basically the member companies of my association, OCI. Our members take the definition of the roles and responsibilities of the 'Service Provider' community very seriously. In the context of this discussion a key utility function is the early definition of requirements and expectations of Service Providers in supplying to these requirements. Let's explore for a moment the Service Provider role and perspective. Service Providers are by nature pro-active - they seek ways to engage with utilities (and tier one vendors) to solve problems and achieve good outcomes. They come to industry conferences like this one to learn about upcoming utility programs and supply opportunities and how they can improve performance. Service Providers particularly want to hear senior utility people comment on emerging issues even those at the very early identification stage. Some Clarification of Roles is in Order - as that is the focus of this conference: 'Issue-Identification and Definition'. 'Issue-Identification' is the utility's job - it is the utility's role to identify as early as possible 'what needs attention and what their needs and expectations are'. This takes place before service provider engagement. 'Issue-Definition' is more challenging. It means 'determining and prioritizing what needs to be done to deal with the situation at hand'. This typically involves

  18. Parent-provider communication during hospitalization.

    Fisher, Mark J; Broome, Marion E

    2011-02-01

    Parents and health care providers interact and communicate with each other during a child's hospitalization. The purpose of this study was to compare communication experiences of parents, nurses, and physicians. A unique aspect of this study involved combining three individual data sources into a collective unit of study (triad). Triads involved in the care of three children in the inpatient setting of an urban children's hospital served as the sample for this study (n = 10). Participants were asked semistructured questions during face-to-face interviews. Findings included (a) the importance of providing information by health care providers using a caring and inclusive approach, (b) the benefits of establishing interpersonal connections and nurturing relationships, and (c) the identification of specific behaviors in all members of the triad that contribute to and sustain positively perceived communication. Future research directions examining triadic interactions, communication, and relationships among parents, nurses, and physicians are recommended. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. 5th Annual Provider Software Buyer's Guide.

    1995-03-01

    To help long term care providers find new ways to improve quality of care and efficiency, PROVIDER presents the fifth annual listing of software firms marketing computer programs for all areas of long term care operations. On the following five pages, more than 70 software firms display their wares, with programs such as minimum data set and care planning, dietary, accounting and financials, case mix, and medication administration records. The guide also charts compatible hardware, integration ability, telephone numbers, company contacts, and easy-to-use reader service numbers.

  20. Accountability Requirements in the Cloud Provider Chain

    Martin Gilje Jaatun

    2018-04-01

    Full Text Available In order to be responsible stewards of other people’s data, cloud providers must be accountable for their data handling practices. The potential long provider chains in cloud computing introduce additional accountability challenges, with many stakeholders involved. Symmetry is very important in any requirements’ elicitation activity, since input from diverse stakeholders needs to be balanced. This article ventures to answer the question “How can one create an accountable cloud service?” by examining requirements which must be fulfilled to achieve an accountability-based approach, based on interaction with over 300 stakeholders.

  1. Providing Feedback: Practical Skills and Strategies.

    Sarkany, David; Deitte, Lori

    2017-06-01

    Feedback is an essential component of education. It is designed to influence, reinforce, and change behaviors, concepts, and attitudes in learners. Although providing constructive feedback can be challenging, it is a learnable skill. The negative consequences of destructive feedback or lack of feedback all together are far-reaching. This article summarizes the components of constructive feedback and provides readers with tangible skills to enhance their ability to give effective feedback to learners and peers. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Outpatient provider concentration and commercial colonoscopy prices.

    Pozen, Alexis

    2015-01-01

    The objective was to evaluate the magnitude of various contributors to outpatient commercial colonoscopy prices, including market- and provider-level factors, especially market share. We used adjudicated fee-for-service facility claims from a large commercial insurer for colonoscopies occurring in hospital outpatient department or ambulatory surgery center from October 2005 to December 2012. Claims were matched to provider- and market-level data. Linear fixed effects regressions of negotiated colonoscopy price were run on provider, system, and market characteristics. Markets were defined as counties. There were 178,433 claims from 169 providers (104 systems). The mean system market share was 76% (SD = 0.34) and the mean real (deflated) price was US$1363 (SD = 374), ranging from US$169 to US$2748. For every percentage point increase in a system or individual facility's bed share, relative price increased by 2 to 4 percentage points; this result was stable across a number of specifications. Market population and price were also consistently positively related, though this relation was small in magnitude. No other factor explained price as strongly as market share. Price variation for colonoscopy was driven primarily by market share, of particular concern as the number of mergers increases in wake of the recession and the Affordable Care Act. Whether variation is justified by better quality care requires further research to determine whether quality is subsumed in prices. © The Author(s) 2015.

  3. SYSTEM ORGANIZATION OF MATERIAL PROVIDING OF BUILDING

    A. V. Rаdkеvich

    2014-04-01

    Full Text Available Purpose. Development of scientific-methodical bases to the design of rational management of material streams in the field of building providing taking into account intersystem connections with the enterprises of building industry. Methodology. The analysis of last few years of functioning of building industry in Ukraine allows distinguishing a number of problems that negatively influence the steady development of building, as the component of the state economics system. Therefore the research of existent organization methods of the system of building objects providing with material resources is extremely necessary. In connection with this the article justifies the use of method of hierarchies analysis (Saati method for finding the optimal task solution of fixing the enterprises of building industry after building objects. Findings. Results give an opportunity to guidance of building organization to estimate and choose advantageous suppliers - enterprises of building industry, to conduct their rating, estimation taking into account basic descriptions, such as: quality, price, reliability of deliveries, specialization, financial status etc. Originality. On the basis of Saati method the methodologies of organization are improved, planning and managements of the reliable system of providing of building necessary material resources that meet the technological requirements of implementation of building and installation works. Practical value. Contribution to the decisions of many intricate organizational problems that are accompanied by the problems of development of building, provided due to organization of the reliable system of purchase of material resources.

  4. Provider-associated factors in obstetric interventions

    Pel, M.; Heres, M. H.; Hart, A. A.; van der Veen, F.; Treffers, P. E.

    1995-01-01

    OBJECTIVE: To assess which factors influence provider-associated differences in obstetric interventions. STUDY DESIGN: A survey of obstetricians and co-workers in a sample consisting of 38 Dutch hospitals was taken, using a questionnaire that contained questions about personal and hospital-policy

  5. Providence Sponsors Diocesan Teacher Recruiting Campaign.

    Dygert, William

    2001-01-01

    Addresses the issue of teacher recruitment in Providence, Rhode Island. Explains that the Catholic education staff designed a campaign that involved creating marketing materials, advertising in daily newspapers, and holding job fairs and open houses. Stresses the importance of promoting teaching at Catholic schools as both rewarding and…

  6. Intentional Planning to Provide Technology to Students

    Flagg-Williams, Joan B.; Rey, Janice M.

    2016-01-01

    Mobile technology plays a prominent role in teaching and learning. To address this vital component of teacher preparation, the education department of a small college provided the freshman class with iPads. iPads were selected because they are common in public schools, lightweight, portable, touch-screen controlled and have an abundance of…

  7. Provider expectations and father involvement: learning from ...

    2013-12-17

    Dec 17, 2013 ... in Gauteng's poor and black communities with fathers that did not ... affect fathers' ability to live up to provider expectations. ... On the contrary, father absence can exacerbate household poverty and “can ... socio-emotional development of the children, although such effects are not uniformly .... explanation.

  8. Providing anesthesia in resource-limited settings.

    Dohlman, Lena E

    2017-08-01

    The article reviews the reality of anesthetic resource constraints in low and middle-income countries (LMICs). Understanding these limitations is important to volunteers from high-income countries who desire to teach or safely provide anesthesia services in these countries. Recently published information on the state of anesthetic resources in LMICs is helping to guide humanitarian outreach efforts from high-income countries. The importance of using context-appropriate anesthesia standards and equipment is now emphasized. Global health experts are encouraging equal partnerships between anesthesia health care providers working together from different countries. The key roles that ketamine and regional anesthesia play in providing well tolerated anesthesia for cesarean sections and other common procedures is increasingly recognized. Anesthesia can be safely given in LMICs with basic supplies and equipment, if the anesthesia provider is trained and vigilant. Neuraxial and regional anesthesia and the use of ketamine as a general anesthetic appear to be the safest alternatives in low-resource countries. Environmentally appropriate equipment should be encouraged and pulse oximeters should be in every anesthetizing location. LMICs will continue to need support from outside sources until capacity building has made more progress.

  9. Experiences of healthcare providers managing sexual assault ...

    Experiences of healthcare providers managing sexual assault victims in the emergency unit Part 2: Discussion of results and literature control. ... It was recommended that members of the multidisciplinary team engage in community activities and that the community participate in matters pertaining to sexual assault.

  10. Providing Career Guidance for Young Women.

    Colby, Pamela G.

    This module is directed at personnel working or planning to work in the areas of guidance, counseling, placement and follow-through in junior and senior high school settings, grades 7-12. The module topic is career guidance for young women of junior and senior high school age, aand the focus will be on providing nonbiased career guidance which…

  11. 78 FR 14034 - Health Insurance Providers Fee

    2013-03-04

    ... Health Insurance Providers Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... insurance for United States health risks. This fee is imposed by section 9010 of the Patient Protection and... insurance for United States health risks. DATES: Written or electronic comments must be received by June 3...

  12. 42 CFR 410.134 - Provider qualifications.

    2010-10-01

    ... after December 22, 2000: (a) Holds a bachelor's or higher degree granted by a regionally accredited college or university in the United States (or an equivalent foreign degree) with completion of the... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider...

  13. Utilization of Smartphone Applications by Anesthesia Providers

    Michael S. Green

    2018-01-01

    Full Text Available Health care-related apps provide valuable facts and have added a new dimension to knowledge sharing. The purpose of this study is to understand the pattern of utilization of mobile apps specifically created for anesthesia providers. Smartphone app stores were searched, and a survey was sent to 416 anesthesia providers at 136 anesthesiology residency programs querying specific facets of application use. Among respondents, 11.4% never used, 12.4% used less than once per month, 6.0% used once per month, 12.1% used 2-3 times per month, 13.6% used once per week, 21% used 2-3 times per week, and 23.5% used daily. Dosage/pharmaceutical apps were rated the highest as most useful. 24.6% of the participants would pay less than $2.00, 25.1% would pay $5.00, 30.3% would pay $5–$10.00, 9.6% would pay $10–$25.00, 5.1% would pay $25–$50.00, and 5.1% would pay more than $50.00 if an app saves 5–10 minutes per day or 30 minutes/week. The use of mobile phone apps is not limited to reiterating information from textbooks but provides opportunities to further the ever-changing field of anesthesiology. Our survey illustrates the convenience of apps for health care professionals. Providers must exercise caution when selecting apps to ensure best evidence-based medicine.

  14. SPACEWAY: Providing affordable and versatile communication solutions

    Fitzpatrick, E. J.

    1995-08-01

    By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.

  15. The EU as an international security provider

    Rodt, Annemarie Peen; Wolff, Stefan; Whitman, Richard

    2015-01-01

    This contribution develops a framework of analysis that covers the actors involved in the policy making process of international security provision, the dynamics of this process itself, its outcomes (concrete strategies and policies) and their impact. Our efforts to establish such a framework...... of analysis, which could serve as the foundation for a mid-range theory of the EU as an international security provider, will examine the relevance of, and apply, existing theories of international relations/international security and foreign policy analysis to the specific case of the EU. The framework...... that will emerge from this analysis will then be tested and applied empirically in the following contributions that focus on how particular policies are formulated and implemented, and that analyse, in single and comparative case studies, the impact and effectiveness of the EU as an international security provider....

  16. Informed consent - Providing information about prenatal examinations

    Dahl, Katja; Kesmodel, Ulrik; Hvidman, Lone

    as well.The review is based on systematic search strategy in the electronic databases Medline and Science Citation. Additional studies were identified through reference lists of individual papers obtained. Improving knowledge scores and reducing decisional conflict can be obtained by group counselling...... pregnant women about prenatal examinations. Women's knowledge, decisional conflict, satisfaction and anxiety will be explored as compared with different ways and different groups of health professionals providing information. To what extent information empowers informed decision making will be explored...

  17. Providing Device Independence to Mobile Services

    Nylander, Stina; Bylund, Markus

    2002-01-01

    People want user interfaces to services that are functional and well suited to the device they choose for access. To provide this, services must be able to offer device specific user interfaces for the wide range of devices available today. We propose to combine the two dominant approaches to platform independence, "Write Once, Run Every-where™" and "different version for each device", to create multiple device specific user interfaces for mobile services. This gives possibilities to minimize...

  18. Research utilization among children's mental health providers

    Ferguson H Bruce

    2008-04-01

    Full Text Available Abstract Background Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH service provider organizations in Ontario, Canada. Methods A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. Results There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use – access, assess, adapt, and apply – research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. Conclusion These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

  19. Research utilization among children's mental health providers.

    Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean

    2008-04-09

    Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

  20. PROVIDING QUALITY – A KEY TO SUCCESS

    Oana Staiculescu; Angel-Cristian Staiculescu

    2012-01-01

    Providing a high quality products and services is a key to business success. That is because high quality promotes customer satisfaction and customer satisfaction has a direct link to business revenue. Clients want quality products and services in order to feel they are getting value for money, especially in these hard economic times. Although it is well known that advertising may win new customers, quality can be the reason to keep them. A good manager is aware that the costs of winning mark...

  1. Outsourcing gets providers back to the basics.

    Watson, S

    1995-05-01

    Information technology is advancing so quickly that many organizations can't keep up. That's why demand for the outsourcing of data processing functions is growing as providers and payers attempt to implement the latest technology while holding costs down. Those investigating outsourcing must carefully scrutinize whether an arrangement actually will cut costs, experts advise. And clients should review contract terms to ensure all expectations are spelled out.

  2. Providing Real Research Opoportunities to Undergraduates

    Ragozzine, Darin

    2016-01-01

    The current approach to undergraduate education focuses on teaching classes which provide the foundational knowledge for more applied experiences such as scientific research. Like most programs, Florida Institute of Technology (Florida Tech or FIT) strongly encourages undergraduate research, but is dominated by content-focused courses (e.g., "Physical Mechanics"). Research-like experiences are generally offered through "lab" classes, but these are almost always reproductions of past experiments: contrived, formulaic, and lacking the "heart" of real (i.e., potentially publishable) scientific research. Real research opportunities 1) provide students with realistic insight into the actual scientific process; 2) excite students far more than end-of-chapter problems; 3) provide context for the importance of learning math, physics, and astrophysics concepts; and 4) allow unique research progress for well-chosen problems. I have provided real research opportunities as an "Exoplanet Lab" component of my Introduction to Space Science (SPS1020) class at Florida Tech, generally taken by first-year majors in our Physics, Astronomy & Astrophysics, Planetary Science, and Astrobiology degree programs. These labs are a hybrid between citizen science (e.g., PlanetHunters) and simultaneously mentoring ~60 undergraduates in similar small research projects. These projects focus on problems that can be understood in the context of the course, but which benefit from "crowdsourcing". Examples include: dividing up the known planetary systems and developing a classification scheme and organizing them into populations (Fall 2013); searching through folded light curves to discover new exoplanets missed by previous pipelines (Fall 2014); and fitting n-body models to all exoplanets with known Transit Timing Variations to estimate planet masses (Fall 2015). The students love the fact that they are doing real potentially publishable research: not many undergraduates can claim to have discovered

  3. Offshore Outsourcing Induced by Domestic Providers

    Yutian Chen; Pradeep Dubey; Debapriya Sen

    2005-01-01

    We show that offshore outsourcing can occur even when there are no economies of scale or cost advantages for the foreign firms. What drives the phenomenon is that domestic firms, by accepting orders for intermediate goods, incur the disadvantage of becoming Stackelberg followers in the ensuing competition to sell the final good. Thus they have incentive to quote high provider prices to ward off future competitors, compelling them to outsource offshore.

  4. Providing Music Notation Services over Internet

    Solomon , Mike; Fober , Dominique; Orlarey , Yann; Letz , Stéphane

    2014-01-01

    International audience; The GUIDO project gathers a textual format for music representation, a rendering engine operating on this format, and a library providing a high level support for all the services related to the GUIDO format and it's graphic rendering. The project includes now an HTTP server that allows users to access the musical-score-related functions in the API of the GUIDOEngine library via uniform resource identifiers (URIs). This article resumes the core tenants of the REST arch...

  5. ACCOUNTING TREATMENTS USED FOR ACCOUNTING SERVICES PROVIDERS

    ŢOGOE GRETI DANIELA; AVRAM MARIOARA; AVRAM COSTIN DANIEL

    2014-01-01

    The theme of our research is the ways of keeping accounting entities that are the object of the provision of services in the accounting profession. This paper aims to achieve a parallel between the ways of organizing financial records - accounting provided by freelancers and companies with activity in the financial - accounting. The first step in our scientific research is to establish objectives chosen area of scientific knowledge. Our scientific approach seeks to explain thr...

  6. Providing Technical assistance on corruption control

    Serge, Lortie

    2012-01-01

    The phenomenon referred to as corruption has now been generating a high degree of interest for over twenty years. It has in fact spawned not only an abundant literature but also a monitoring and advisory industry whose specific outlook heavily shapes the debate on integrity issues. This industry is widely supported by aid providers, be it the international financing institutions or national development agencies. At this juncture, it therefore seemed worthwhile to examine more critically an ar...

  7. ACCOUNTING TREATMENTS USED FOR ACCOUNTING SERVICES PROVIDERS

    ŢOGOE GRETI DANIELA

    2014-08-01

    Full Text Available The theme of our research is the ways of keeping accounting entities that are the object of the provision of services in the accounting profession. This paper aims to achieve a parallel between the ways of organizing financial records - accounting provided by freelancers and companies with activity in the financial - accounting. The first step in our scientific research is to establish objectives chosen area of scientific knowledge. Our scientific approach seeks to explain through a thorough and detailed approach as different sides (conceptual and practical looking projections of accounting issues related to regulatory developments and practices in the field. This paper addresses various concepts, accounting treatments, and books and accounting documents used both freelancers in providing accounting services and legal persons authorized accounting profession. In terms of methodology and research perspective, the whole scientific approach combined with quantitative and qualitative research theoretical perspective (descriptive-conceptual with practice perspective (empirical analyzing the main contributions of various authors (Romanian and foreign to knowledge in the field. Following the survey believe that the amendments to the national legislation will support entities providing accounting services, by cutting red tape on Administrative Burdens, and consequently will increase profitability and increase service quality.

  8. Patients Provide Recommendations for Improving Patient Satisfaction.

    Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J

    2016-04-01

    National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  9. Mitigating Provider Uncertainty in Service Provision Contracts

    Smith, Chris; van Moorsel, Aad

    Uncertainty is an inherent property of open, distributed and multiparty systems. The viability of the mutually beneficial relationships which motivate these systems relies on rational decision-making by each constituent party under uncertainty. Service provision in distributed systems is one such relationship. Uncertainty is experienced by the service provider in his ability to deliver a service with selected quality level guarantees due to inherent non-determinism, such as load fluctuations and hardware failures. Statistical estimators utilized to model this non-determinism introduce additional uncertainty through sampling error. Inability of the provider to accurately model and analyze uncertainty in the quality level guarantees can result in the formation of sub-optimal service provision contracts. Emblematic consequences include loss of revenue, inefficient resource utilization and erosion of reputation and consumer trust. We propose a utility model for contract-based service provision to provide a systematic approach to optimal service provision contract formation under uncertainty. Performance prediction methods to enable the derivation of statistical estimators for quality level are introduced, with analysis of their resultant accuracy and cost.

  10. Do burn centers provide juvenile firesetter intervention?

    Ahrns-Klas, Karla S; Wahl, Wendy L; Hemmila, Mark R; Wang, Stewart C

    2012-01-01

    Juvenile firesetting activity accounts for a significant number of annual injuries and property damage, yet there is sparse information on intervention in the burn literature. To quantify juvenile firesetting intervention (JFSI) in burn centers, a 23-question survey was sent to all directors listed in the American Burn Association Burn Care Facilities Directory.Sixty-four out of 112 (57%) surveys were returned. This represents responses from 79% of currently verified burn centers. When queried on interventions provided to a juvenile firesetter admitted to their unit, 38% report having their own JFSI program and 38% refer the child to fire services. Two thirds of units without a JFSI program treat pediatric patients. Units that previously had a JFSI program report lack of staffing and funding as most common reasons for program discontinuation. Almost all (95%) stated that a visual tool demonstrating legal, financial, social, future, and career ramifications associated with juvenile firesetting would be beneficial to their unit. Many burn units that treat pediatric patients do not have JFSI and rely on external programs operated by fire services. Existing JFSI programs vary greatly in structure and method of delivery. Burn centers should be involved in JFSI, and most units would benefit from a new video toolkit to assist in providing appropriate JFSI. Study results highlight a need for burn centers to collaborate on evaluating effectiveness of JFSI programs and providing consistent intervention materials based on outcomes research.

  11. Supercapacitor to Provide Ancillary Services: Preprint

    Muljadi, Eduard [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gevorgian, Vahan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Luo, Yusheng [Idaho National Laboratory; Mohanpurkar, M. [Idaho National Laboratory; Hovsapian, R. [Idaho National Laboratory; Koritarov, V. [Argonne National Laboratory

    2017-10-09

    Supercapacitor technology has reached a level of maturity as a viable energy storage option available to support a modern electric power system grid; however, its application is still limited because of its energy capacity and the cost of the commercial product. In this paper, we demonstrate transient models of supercapacitor energy storage plants operating in coordination with run-of-the-river (ROR), doubly-fed induction generator hydropower plants (HPP) using a system control concept and architecture developed. A detailed transient model of a supercapacitor energy storage device is coupled with the grid via a three-phase inverter/rectifier and bidirectional DC-DC converter. In addition, we use a version of a 14-bus IEEE test case that includes the models of the supercapacitor energy storage device, ROR HPPs, and synchronous condensers that use the rotating synchronous generators of retired coal-powered plants. The purpose of the synchronous condensers is to enhance the system stability by providing voltage and reactive power control, provide power system oscillations damping, and maintain system inertia at secure levels. The control layer provides coordinated, decentralized operation of distributed ROR HPPs and energy storage as aggregate support to power system operations.

  12. Provider volume and outcomes for oncological procedures.

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  13. Threatened corals provide underexplored microbial habitats.

    Shinichi Sunagawa

    2010-03-01

    Full Text Available Contemporary in-depth sequencing of environmental samples has provided novel insights into microbial community structures, revealing that their diversity had been previously underestimated. Communities in marine environments are commonly composed of a few dominant taxa and a high number of taxonomically diverse, low-abundance organisms. However, studying the roles and genomic information of these "rare" organisms remains challenging, because little is known about their ecological niches and the environmental conditions to which they respond. Given the current threat to coral reef ecosystems, we investigated the potential of corals to provide highly specialized habitats for bacterial taxa including those that are rarely detected or absent in surrounding reef waters. The analysis of more than 350,000 small subunit ribosomal RNA (16S rRNA sequence tags and almost 2,000 nearly full-length 16S rRNA gene sequences revealed that rare seawater biosphere members are highly abundant or even dominant in diverse Caribbean corals. Closely related corals (in the same genus/family harbored similar bacterial communities. At higher taxonomic levels, however, the similarities of these communities did not correlate with the phylogenetic relationships among corals, opening novel questions about the evolutionary stability of coral-microbial associations. Large proportions of OTUs (28.7-49.1% were unique to the coral species of origin. Analysis of the most dominant ribotypes suggests that many uncovered bacterial taxa exist in coral habitats and await future exploration. Our results indicate that coral species, and by extension other animal hosts, act as specialized habitats of otherwise rare microbes in marine ecosystems. Here, deep sequencing provided insights into coral microbiota at an unparalleled resolution and revealed that corals harbor many bacterial taxa previously not known. Given that two of the coral species investigated are listed as threatened under

  14. Does Industrial Ecology provide any new Perspectives?

    Røine, Kjetil

    2000-01-01

    The research question in this report was, as the title alludes: Does industrial ecology provide any new perspectives? If yes, what are the new aspects? To answer these questions, a literature study has been conducted. The answer to the first question is yes. We claim that what is new about industrial ecology is the expansion of the system borders within which the actors operate. Bearing this in mind, it is proposed that the most important issue in industrial ecology is to unite the two m...

  15. Providing hedging protection for the transaction

    Richardson, D.W.

    1999-01-01

    This presentation dealt with methods for assessing commodity price risk in an asset transaction; the setting of risk management objectives; building hedging into the financing; and internal reporting and accounting to mitigate trading risks. It also provided some recent examples of successful hedging in gas asset transactions. The objectives of risk management and the nature of hedging and speculation were explored. An approach to price risk management was proposed. The development of price risk management tools, and techniques for managing risks involving interest rates, foreign exchange, and commodities were examined. figs

  16. Sensors Provide Early Warning of Biological Threats

    2009-01-01

    Early Warning Inc. of Troy, New York, licensed powerful biosensor technology from Ames Research Center. Incorporating carbon nanotubes tipped with single strands of nucleic acid from waterborne pathogens, the sensor can detect even minute amounts of targeted, disease causing bacteria, viruses, and parasites. Early Warning features the NASA biosensor in its water analyzer, which can provide advance alert of potential biological hazards in water used for agriculture, food and beverages, showers, and at beaches and lakes -- within hours instead of the days required by conventional laboratory methods.

  17. Zika Virus: Critical Information for Emergency Providers.

    Shastry, Siri; Koenig, Kristi L; Hirshon, Jon Mark

    2016-08-01

    Zika virus is an arbovirus of the Flaviviridae family. It is primarily a minimally symptomatic mosquito-borne infection. However, with Zika's 2015 to 2016 introduction into the Western Hemisphere and its dramatic and rapid spread, it has become a public health concern, in large part due to congenital abnormalities associated with infection in pregnant women. In early 2016, the World Health Organization declared the microcephaly and other neurologic conditions associated with Zika virus infection a public health emergency of international concern. This article discusses the current epidemiologic and clinical understanding of Zika virus, focusing on critical information needed by emergency providers. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Power beaming providing a space power infrastructure

    Bamberger, J.A.; Coomes, E.P.

    1992-01-01

    This paper, based on two levels of technology maturity, applied the power beaming concept to four panned satellite constellations. The analysis shows that with currently available technology, power beaming can provide mass savings to constellations in orbits ranging from low-Earth orbit to geosynchronous orbit. Two constellations, space surveillance and tracking system and space-based radar, can be supported with current technology. The other two constellations, space-based laser array and boost surveillance and tracking system, will require power and transmission system improvements before their breakeven specific mass is achieved. A doubling of SP-100 conversion efficiency from 10 to 20% would meet or exceed breakeven for these constellations

  19. Ancillary services provided by PV power plants

    Antonio PIERNO

    2016-07-01

    Full Text Available Renewable energy sources are widely utilized in distributed generation systems, and, recently, they are also considered for providing ancillary services. The paper is focused on PV plants, a survey of the most interesting papers published in the literature in the last decade is reported and the main characteristics of the technical proposals, with their advantages and limits, are evidenced. The results are schematically shown in a table that immediately gives the opportunity to be aware of what was already done, representing a reference tool.

  20. Social capital and trust in providers.

    Ahern, Melissa M; Hendryx, Michael S

    2003-10-01

    Trust in providers has been in decline in recent decades. This study attempts to identify sources of trust in characteristics of health care systems and the wider community. The design is cross-sectional. Data are from (1) the 1996 Household Survey of the Community Tracking Study, drawn from 24 Metropolitan Statistical Areas; (2) a 1996 multi-city broadcast media marketing database including key social capital indicators; (3) Interstudy; (4) the American Hospital Association; and (5) the American Medical Association. Independent variables include individual socio-demographic variables, HMO enrollment, community-level health sector variables, and social capital. The dependent variable is self-reported trust in physicians. Data are merged from the various sources and analyzed using SUDAAN. Subjects include adults in the Household Survey who responded to the items on trust in physicians (N=17,653). Trust in physicians is independently predicted by community social capital (pSocial capital plays a role in how health care is perceived by citizens, and how health care is delivered by providers. Efforts to build trust and collaboration in a community may improve trust in physicians, health care quality, access, and preserve local health care control.

  1. Will British weather provide reliable electricity?

    Oswald, James; Raine, Mike; Ashraf-Ball, Hezlin

    2008-01-01

    There has been much academic debate on the ability of wind to provide a reliable electricity supply. The model presented here calculates the hourly power delivery of 25 GW of wind turbines distributed across Britain's grid, and assesses power delivery volatility and the implications for individual generators on the system. Met Office hourly wind speed data are used to determine power output and are calibrated using Ofgem's published wind output records. There are two main results. First, the model suggests that power swings of 70% within 12 h are to be expected in winter, and will require individual generators to go on or off line frequently, thereby reducing the utilisation and reliability of large centralised plants. These reductions will lead to increases in the cost of electricity and reductions in potential carbon savings. Secondly, it is shown that electricity demand in Britain can reach its annual peak with a simultaneous demise of wind power in Britain and neighbouring countries to very low levels. This significantly undermines the case for connecting the UK transmission grid to neighbouring grids. Recommendations are made for improving 'cost of wind' calculations. The authors are grateful for the sponsorship provided by The Renewable Energy Foundation

  2. Green roofs provide habitat for urban bats

    K.L. Parkins

    2015-07-01

    Full Text Available Understanding bat use of human-altered habitat is critical for developing effective conservation plans for this ecologically important taxon. Green roofs, building rooftops covered in growing medium and vegetation, are increasingly important conservation tools that make use of underutilized space to provide breeding and foraging grounds for urban wildlife. Green roofs are especially important in highly urbanized areas such as New York City (NYC, which has more rooftops (34% than green space (13%. To date, no studies have examined the extent to which North American bats utilize urban green roofs. To investigate the role of green roofs in supporting urban bats, we monitored bat activity using ultrasonic recorders on four green and four conventional roofs located in highly developed areas of NYC, which were paired to control for location, height, and local variability in surrounding habitat and species diversity. We then identified bat vocalizations on these recordings to the species level. We documented the presence of five of nine possible bat species over both roof types: Lasiurus borealis, L. cinereus, L. noctivagans, P. subflavus,andE. fuscus. Of the bat calls that could be identified to the species level, 66% were from L. borealis. Overall levels of bat activity were higher over green roofs than over conventional roofs. This study provides evidence that, in addition to well documented ecosystem benefits, urban green roofs contribute to urban habitat availability for several North American bat species.

  3. Topical isoflavones provide effective photoprotection to skin.

    Lin, Jing-Yi; Tournas, Joshua A; Burch, James A; Monteiro-Riviere, Nancy A; Zielinski, Jan

    2008-04-01

    Isoflavones, one main group of phytoestrogens, have antioxidative and photoprotective effects in cellular and mouse studies. The aim of this study is to obtain a more comprehensive understanding of the isoflavone-mediated photoprotection with the pig skin model, a more human-resembling model. The pig skin was treated with five well-known isoflavone compounds (genistein, equol, daidzein, biochanin A, and formononetin) and one antioxidant combination solution of 15% vitamin C and 1% vitamin E and 0.5% ferulic acid (CEF) daily for 4 days. Skin was irradiated with solar-simulated UV irradiation, 1 to 5 minimal erythema dose (MED) at 1-MED intervals. Evaluation was carried out 24 h later by colorimeter-measured erythema and sunburn cell numbers. Topical application of 0.5% solutions of three individual phytoestrogens - genistein, daidzein, biochanin A - are better than similar solutions of equol or formononetin in protecting pig skin from solar-simulated ultraviolet (SSUV)-induced photodamage, as measured by sunburn cell formation and/or erythema. However, the protection was less than that provided by a topical combination antioxidant standard containing 15% L-ascorbic acid, 1%alpha-tocopherol, and 0.5% ferulic acid. Isoflavones provide effective photoprotection and are good candidate ingredients for protection against ultraviolet (UV) photodamage.

  4. Cost Calculation Model for Logistics Service Providers

    Zoltán Bokor

    2012-11-01

    Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly

  5. A 5 year longitudinal study of water quality for final rinsing in the single chamber washer-disinfector with a reverse osmosis plant.

    Uetera, Yushi; Kishii, Kozue; Yasuhara, Hiroshi; Kumada, Naohito; Moriya, Kyoji; Saito, Ryoichi; Okazaki, Mitsuhiro; Misawa, Yoshiki; Kawamura, Kunio

    2013-01-01

    This report deals with the construction and management of the reverse osmosis (RO) water system for final rinsing of surgical instruments in the washer-disinfector. Numerous operational challenges were encountered in our RO water system and these were analyzed utilizing the Ishikawa Fishbone diagram. The aim was to find potential problems and promote preventive system management for RO water. It was found that the measures that existed were inappropriate for preventing contamination in the heat-labile RO water system. The storage tank was found to be significantly contaminated and had to be replaced with a new one equipped with a sampling port and water drainage system. Additional filters and an UV treatment lamp were installed. The whole system disinfection started 1.5 years later using a peracetic acid-based compound after confirming the material compatibility. Operator errors were found when a new water engineer took over the duty from his predecessor. It was also found that there were some deficiencies in the standard operating procedures (SOPs), and that on-the-job training was not enough. The water engineer failed to disinfect the sampling port and water drainage system. The RO membrane had been used for 4 years, even though the SOP standard specified changing it as every 3 years. Various bacteria, such as Rothia mucilaginosa, were cultured from the RO water sampled from the equipment. Because Rothia mucilaginosa is a resident in the oral cavity and upper respiratory tract, it is believed that the bacteria were introduced into the system by the maintenance personnel or working environment. Therefore, the presence of R. mucilaginosa implied the failure of sanitary maintenance procedures. This study suggests that water systems should be designed based on the plans for profound system maintenance. It also suggests that SOP and on-the job training are essential to avoid any operator errors. These results must be carefully considered when either constructing new RO systems or performing maintenance and periodical examination of the equipment. Reverse osmosis (RO) water is used for final rinsing in our washer-disinfector. The authors used the Ishikawa Fishbone diagram to clarify the critical points for optimizing RO water quality. There existed no measures to prevent contamination in the heat-labile RO water system. The storage tank was significantly contaminated and had to be replaced with a new one equipped with a sampling port and water drainage system. Additional filters and an UV treatment lamp were installed. The whole system disinfection started 1.5 years later using a peracetic acid-based compound after confirming the material compatibility. Operator errors occurred when a new water engineer took over the duty from his predecessor. There were neither standard operating procedures (SOPs) nor on-the-job training. The new water engineer had failed to disinfect the sampling port and water drainage system. Rothia mucilaginosa was cultured from the RO water. It is a resident in the oral cavity and upper respiratory tract. This implied the possible failure of sanitary procedures in the system maintenance. The Ishikawa Fishbone diagram was useful for this study. It suggests that water systems should be designed with plans for system maintenance taken into account. It also suggests that SOP and on-the job training are essential in order to avoid operator errors.

  6. Reduction of the phosphorus contamination for plasma deposition of p—i—n microcrystalline silicon solar cells in a single chamber

    Guang-Hong, Wang; Xiao-Dan, Zhang; Sheng-Zhi, Xu; Xin-Xia, Zheng; Chang-Chun, Wei; Jian, Sun; Shao-Zhen, Xiong; Xin-Hua, Geng; Ying, Zhao

    2010-01-01

    This paper investigates several pretreatment techniques used to reduce the phosphorus contamination between solar cells. They include hydrogen plasma pretreatment, deposition of a p-type doped layer, i-a-Si:H or μc-Si:H covering layer between solar cells. Their effectiveness for the pretreatment is evaluated by means of phosphorus concentration in films, the dark conductivity of p-layer properties and cell performance. (cross-disciplinary physics and related areas of science and technology)

  7. Depth dependence of the single chamber response function of the I'mRT MatriXX array in a 6 MV photon beam

    Alashrah, Saleh

    2013-01-01

    One of the factors which influence the spatial resolution of a 2D detector array is the size of the single detector, another the transport of the secondary electrons from the walls into the measuring volume. In this study, the single ion chamber dose response function of an I'mRT MatriXX array was determined by comparison between slit beam dose profiles measured with the array and with EBT2 radiochromic film in a solid water-equivalent phantom at a shallow depth of 0.5 cm and at a depth of 5 cm beyond the depth dose maximum for a 6 MV photon beam. The dose response functions were obtained using two methods, the best fit method and the deconvolution method. At the shallow depth, a Lorentz function and at 5 cm depth a Gaussian function, both with the same FWHM of 7.4 mm within limits of uncertainty, were identified as the best suited dose response functions of the 4.5 mm diameter single array chamber. These dose response functions were then tested on various dose profiles whose true shape had been determined with EBT2 film and with the IC03 ionization chamber. By convolving these with the Lorentz kernel (at shallow depth) and the Gaussian kernel (at 5 cm depth) the signal profiles measured with the I'mRT MatriXX array were closely approximated. Thus, the convolution of TPS-calculated dose profiles with these dose response functions can minimize the differences between calculation and measurement which occur due to the limited spatial resolution of the I'mRT MatriXX detector. (orig.)

  8. The use of nylon and glass fiber filter separators with different pore sizes in air-cathode single-chamber microbial fuel cells

    Zhang, Xiaoyuan; Cheng, Shaoan; Huang, Xia; Logan, Bruce E.

    2010-01-01

    on performance. Larger pore nylon mesh were used that had regular mesh weaves with pores ranging from 10 to 160 μm, while smaller pore-size nylon filters (0.2-0.45 μm) and glass fiber filters (0.7-2.0 μm) had a more random structure. The pore size of both types

  9. Optical fiber head for providing lateral viewing

    Everett, Matthew J.; Colston, Billy W.; James, Dale L.; Brown, Steve; Da Silva, Luiz

    2002-01-01

    The head of an optical fiber comprising the sensing probe of an optical heterodyne sensing device includes a planar surface that intersects the perpendicular to axial centerline of the fiber at a polishing angle .theta.. The planar surface is coated with a reflective material so that light traveling axially through the fiber is reflected transverse to the fiber's axial centerline, and is emitted laterally through the side of the fiber. Alternatively, the planar surface can be left uncoated. The polishing angle .theta. must be no greater than 39.degree. or must be at least 51.degree.. The emitted light is reflected from adjacent biological tissue, collected by the head, and then processed to provide real-time images of the tissue. The method for forming the planar surface includes shearing the end of the optical fiber and applying the reflective material before removing the buffer that circumscribes the cladding and the core.

  10. Development of Model for Providing Feasible Scholarship

    Harry Dhika

    2016-05-01

    Full Text Available The current work focuses on the development of a model to determine a feasible scholarship recipient on the basis of the naiv¨e Bayes’ method using very simple and limited attributes. Those attributes are the applicants academic year, represented by their semester, academic performance, represented by their GPa, socioeconomic ability, which represented the economic capability to attend a higher education institution, and their level of social involvement. To establish and evaluate the model performance, empirical data are collected, and the data of 100 students are divided into 80 student data for the model training and the remaining of 20 student data are for the model testing. The results suggest that the model is capable to provide recommendations for the potential scholarship recipient at the level of accuracy of 95%.

  11. Data governance for health care providers.

    Andronis, Katerina; Moysey, Kevin

    2013-01-01

    Data governance is characterised from broader definitions of governance. These characteristics are then mapped to a framework that provides a practical representation of the concepts. This representation is further developed with operating models and roles. Several information related scenarios covering both clinical and non-clinical domains are considered in information terms and then related back to the data governance framework. This assists the reader in understanding how data governance would help address the issues or achieve a better outcome. These elements together enable the reader to gain an understanding of the data governance framework and how it applies in practice. Finally, some practical advice is offered for establishing and operating data governance as well as approaches for justifying the investment.

  12. Providing Universal Health Insurance Coverage in Nigeria.

    Okebukola, Peter O; Brieger, William R

    2016-07-07

    Despite a stated goal of achieving universal coverage, the National Health Insurance Scheme of Nigeria had achieved only 4% coverage 12 years after it was launched. This study assessed the plans of the National Health Insurance Scheme to achieve universal health insurance coverage in Nigeria by 2015 and discusses the challenges facing the scheme in achieving insurance coverage. In-depth interviews from various levels of the health-care system in the country, including providers, were conducted. The results of the analysis suggest that challenges to extending coverage include the difficulty in convincing autonomous state governments to buy into the scheme and an inadequate health workforce that might not be able to meet increased demand. Recommendations for increasing the scheme's coverage include increasing decentralization and strengthening human resources for health in the service delivery systems. Strong political will is needed as a catalyst to achieving these goals. © The Author(s) 2016.

  13. Providing Virtual Execution Environments: A Twofold Illustration

    Grehant, Xavier

    2008-01-01

    Platform virtualization helps solving major grid computing challenges: share resource with flexible, user-controlled and custom execution environments and in the meanwhile, isolate failures and malicious code. Grid resource management tools will evolve to embrace support for virtual resource. We present two open source projects that transparently supply virtual execution environments. Tycoon has been developed at HP Labs to optimise resource usage in creating an economy where users bid to access virtual machines and compete for CPU cycles. SmartDomains provides a peer-to-peer layer that automates virtual machines deployment using a description language and deployment engine from HP Labs. These projects demonstrate both client-server and peer-to-peer approaches to virtual resource management. The first case makes extensive use of virtual machines features for dynamic resource allocation. The second translates virtual machines capabilities into a sophisticated language where resource management components can b...

  14. Multicultural Nursing: Providing Better Employee Care.

    Rittle, Chad

    2015-12-01

    Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided. © 2015 The Author(s).

  15. Supercomputing Centers and Electricity Service Providers

    Patki, Tapasya; Bates, Natalie; Ghatikar, Girish

    2016-01-01

    from a detailed, quantitative survey-based analysis and compare the perspectives of the European grid and SCs to the ones of the United States (US). We then show that contrary to the expectation, SCs in the US are more open toward cooperating and developing demand-management strategies with their ESPs......Supercomputing Centers (SCs) have high and variable power demands, which increase the challenges of the Electricity Service Providers (ESPs) with regards to efficient electricity distribution and reliable grid operation. High penetration of renewable energy generation further exacerbates...... this problem. In order to develop a symbiotic relationship between the SCs and their ESPs and to support effective power management at all levels, it is critical to understand and analyze how the existing relationships were formed and how these are expected to evolve. In this paper, we first present results...

  16. New consumer services provided by smart metering

    Daminov Ildar

    2015-01-01

    Full Text Available This paper focuses on the issues of smart metering market and considers different services provided by smart metering from consumer point of view. Firstly, smart metering deployment challenges emerging and conventional tariffs, which modify a consumer behavior and thus, the entire electric energy market can be optimized since the customer is motivated to consume less energy. Secondly, the authors illustrate changes in electricity quality, which have an impact on consumer relations with utility. Additionally, two main indices of grid resilience – SAIDI and SAIFI – are exemplified to reveal the improvement potential of smart metering implementation in certain regions of Russia that also influence the consumer. Finally, in-home display and privacy problem directly reflect the consumer’s behavior, thus the private life rights should not be violated as they are guaranteed by law.

  17. Fallout radiation protection provided by transportation vehicles

    Burson, Z.G.

    1972-10-20

    Fallout radiation protection factors (PF's) were estimated for a variety of civilian transportation vehicles using measurements of the natural terrain radiation as a source. The PF values are below 2 in light vehicles, truck beds, or trailers; from 2.5 to 3 in the cabs of heavy trucks and in a railway guard car; and from 3.0 to 3.5 in the engineer's seat of heavy locomotives. This information can be useful in planning the possible movement of personnel from or through areas contaminated either by a wartime incident or a peacetime accident. The information may also be useful for studying the reduction of exposure to the natural terrestrial radiation environment provided by vehicles.

  18. Providing better indoor environmental quality brings economicbenefits

    Fisk, William; Seppanen, Olli

    2007-06-01

    This paper summarizes the current scientific evidence that improved indoor environmental quality can improve work performance and health. The review indicates that work and school work performance is affected by indoor temperature and ventilation rate. Pollutant source removal can sometimes improve work performance. Based on formal statistical analyses of existing research results, quantitative relationships are provided for the linkages of work performance with indoor temperature and outdoor air ventilation rate. The review also indicates that improved health and related financial savings are obtainable from reduced indoor tobacco smoking, prevention and remediation of building dampness, and increased ventilation. Example cost-benefit analyses indicate that many measures to improve indoor temperature control and increase ventilation rates will be highly cost effective, with benefit-cost ratios as high as 80 and annual economic benefits as high as $700 per person.

  19. Multiagency Initiative to Provide Greenhouse Gas Information

    Boland, Stacey W.; Duren, Riley M.

    2009-11-01

    Global Greenhouse Gas Information System Workshop; Albuquerque, New Mexico, 20-22 May 2009; The second Greenhouse Gas Information System (GHGIS) workshop brought together 74 representatives from 28 organizations including U.S. government agencies, national laboratories, and members of the academic community to address issues related to the understanding, operational monitoring, and tracking of greenhouse gas emissions and carbon offsets. The workshop was held at Sandia National Laboratories and organized by an interagency collaboration among NASA centers, Department of Energy laboratories, and the U.S. National Oceanic and Atmospheric Administration. It was motivated by the perceived need for an integrated interagency, community-wide initiative to provide information about greenhouse gas sources and sinks at policy-relevant temporal and spatial scales. Such an initiative could significantly enhance the ability of national and regional governments, industry, and private citizens to implement and evaluate effective climate change mitigation policies.

  20. INTEGRATED INFORMATION SYSTEM ARCHITECTURE PROVIDING BEHAVIORAL FEATURE

    Vladimir N. Shvedenko

    2016-11-01

    Full Text Available The paper deals with creation of integrated information system architecture capable of supporting management decisions using behavioral features. The paper considers the architecture of information decision support system for production system management. The behavioral feature is given to an information system, and it ensures extraction, processing of information, management decision-making with both automated and automatic modes of decision-making subsystem being permitted. Practical implementation of information system with behavior is based on service-oriented architecture: there is a set of independent services in the information system that provides data of its subsystems or data processing by separate application under the chosen variant of the problematic situation settlement. For creation of integrated information system with behavior we propose architecture including the following subsystems: data bus, subsystem for interaction with the integrated applications based on metadata, business process management subsystem, subsystem for the current state analysis of the enterprise and management decision-making, behavior training subsystem. For each problematic situation a separate logical layer service is created in Unified Service Bus handling problematic situations. This architecture reduces system information complexity due to the fact that with a constant amount of system elements the number of links decreases, since each layer provides communication center of responsibility for the resource with the services of corresponding applications. If a similar problematic situation occurs, its resolution is automatically removed from problem situation metamodel repository and business process metamodel of its settlement. In the business process performance commands are generated to the corresponding centers of responsibility to settle a problematic situation.

  1. Reimbursement issues facing patients, providers, and payers.

    Antman, K

    1993-11-01

    and decisions by the insurance industry have a direct impact on physicians, facilitating, or often impeding, the care physicians are able to provide. Who makes health policy decisions? Increasingly, these decisions are being made not by physicians, but by public health experts, economists, and, more recently, large industries grappling with the cost of providing insurance coverage (and its effects on competitive pricing in a world market). Therefore, physicians need to position themselves to influence the development of medical policy, particularly as it relates to the prevention, diagnosis, and treatment of patients with cancer.

  2. PROVIDING R-TREE SUPPORT FOR MONGODB

    L. Xiang

    2016-06-01

    Full Text Available Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB’s features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  3. Providing R-Tree Support for Mongodb

    Xiang, Longgang; Shao, Xiaotian; Wang, Dehao

    2016-06-01

    Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB's features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  4. The ethics of providing hope in psychotherapy.

    Dembo, Justine Sarah; Clemens, Norman A

    2013-07-01

    The instillation of hope is a common factor in most psychotherapies. A considerable literature exists on the ethics of providing false or positively biased hope in non-psychiatric medical settings, and ethicists have generally concluded that this practice is unethical. However, the literature on the ethics of encouraging hope in psychotherapy, especially in the case of treatment-resistant mental illness, is sparse. The author explores two clinical cases with the intention of examining the nature of hope, false hope, positive illusions, and denial, as they relate to our definitions of mental health and psychotherapy. The cases highlight the ethics of balancing an acknowledgment of likely treatment futility with a desire to hope. Clinical psychological studies on depressive realism and optimistic bias indicate that some degree of positive bias, referred to by some authors as "the optimal margin of illusion," is in fact necessary to promote what we define as "good mental health;" conversely, stark realism is correlated with mild to moderate depression. An examination of the existential literature, including Ernest Becker's work, The Denial of Death, indicates that without the defense mechanism of denial, human beings tend to experience paralytic despair as a result of being fallible, mortal creatures in a frightening world. The combination of these diverse bodies of literature, along with the surprising outcomes of our case examples, leads to an unexpected conclusion: it may occasionally be ethical to encourage some degree of optimistic bias, and perhaps even positive illusion, when treating patients in psychotherapy.

  5. Providing primary standard calibrations beyond 20 MHz

    Bickley, C J; Zeqiri, B; Robinson, S P

    2004-01-01

    The number of applications of medical ultrasound utilising frequencies in excess of 20 MHz has shown a consistent increase over recent years. Coupled with the commercial availability of wide-bandwidth hydrophones whose response extends beyond 40 MHz, this has driven a growing need to develop hydrophone calibration techniques at elevated frequencies. The current National Physical Laboratory primary standard method of calibrating hydrophones is based on an optical interferometer. This has been in operation for around 20 years and provides traceability over the frequency range of 0.3 to 20 MHz. More recently, calibrations carried out using the interferometer have been extended to 60 MHz, although the uncertainties associated with these calibrations are poor, being in excess of ±20% at high frequencies. Major contributions to the degraded calibration uncertainties arise from poor signal-to-noise at higher frequencies, the frequency response of the photodiodes used and the noise floor of the instrument. To improve the uncertainty of hydrophone calibrations above 20 MHz, it has been necessary to build and commission a new interferometer. Important features of the new primary standard are its use of a higher power laser to improve the signal-to-noise ratio, along with photodiodes whose greater bandwidth to improve the overall frequency response. This paper describes the design of key aspects of the new interferometer. It also presents some initial results of the performance assessment, including a detailed comparison of calibrations of NPL reference membrane hydrophones, undertaken using old and new interferometers for calibration up to 40 MHz

  6. Can Economics Provide Insights into Trust Infrastructure?

    Vishik, Claire

    Many security technologies require infrastructure for authentication, verification, and other processes. In many cases, viable and innovative security technologies are never adopted on a large scale because the necessary infrastructure is slow to emerge. Analyses of such technologies typically focus on their technical flaws, and research emphasizes innovative approaches to stronger implementation of the core features. However, an observation can be made that in many cases the success of adoption pattern depends on non-technical issues rather than technology-lack of economic incentives, difficulties in finding initial investment, inadequate government support. While a growing body of research is dedicated to economics of security and privacy in general, few theoretical studies in this area have been completed, and even fewer that look at the economics of “trust infrastructure” beyond simple “cost of ownership” models. This exploratory paper takes a look at some approaches in theoretical economics to determine if they can provide useful insights into security infrastructure technologies and architectures that have the best chance to be adopted. We attempt to discover if models used in theoretical economics can help inform technology developers of the optimal business models that offer a better chance for quick infrastructure deployment.

  7. Waste gas could provide power for ships

    1970-07-18

    Dual-fuel engines are not new, but a version has been produced which, when used on ships carrying liquefied natural gas (LNG) could operate almost completely on waste gas. In its gas-operating mode, an engine can use the waste gas boiled off an LNG cargo. This wastage, normally allowed to escape to atmosphere, is about 0.25% of the cargo per day. Calculations have shown that this is enough to provide almost all the propulsion needs of a tanker under full cargo. This design is important in that it is suitable for the larger vessels now being required to carry LNG from N. Africa to North America, a journey where the costs of fuel are very considerable. Tests on the engine have indicated that power output is reduced to something like 80% of power under diesel fuel. However, additional advantages, such as cleaner engines with reduced maintenance costs, will help to tip the economic balance even further in favor of the dual purpose unit. This system also is applicable to stationary generating plant, again particularly on LNG tankage units where the same degree of gas boil-off applies.

  8. Family benefits - Obligation to provide information

    HR Department

    2015-01-01

    Pursuant to Article R V 1.38 of the Staff Regulations, members of the personnel are reminded that they are required to inform the Organization in writing, within 30 calendar days, of any change in their family situation (marriage, partnership, birth of a child, etc.) and of the amount of any financial benefit of a similar nature to those provided for in the Staff Regulations (e.g. family allowance, child allowance, infant allowance, non-resident allowance or international indemnity) to which they or a member of their family may be entitled from a source other than CERN.   The procedures to be followed are available in the Admin e-guide: https://admin-eguide.web.cern.ch/en/procedure/change-family-situation Members of the personnel are also reminded that any false declaration or failure to make a declaration with a view to deceiving others or achieving a gain resulting in a loss of funds or reputation for CERN constitutes fraud and may lead to disciplinary action in accordance with Article S ...

  9. Dental practice satisfaction with preferred provider organizations

    Schilling Elizabeth A

    2007-11-01

    Full Text Available Abstract Background Despite their increasing share of the dental insurance market, little is known about dental practices' satisfaction with preferred provider organizations (PPOs. This analysis examined practice satisfaction with dental PPOs and the extent to which satisfaction was a function of communications from the plan, claims handling and compensation. Methods Data were collected through telephone surveys with dental practices affiliated with MetLife between January 2002 and December 2004. Each respondent was asked a series of questions related to their satisfaction with a systematically selected PPO with which they were affiliated. Six different PPO plans had sufficient observations to allow for comparative analysis (total n = 4582. Multiple imputation procedures were used to adjust for item non-response. Results While the average level of overall satisfaction with the target plan fell between "very satisfied" and "satisfied," regression models revealed substantial differences in overall satisfaction across the 6 PPOs (p Conclusion Results demonstrate the importance of compensation to dental practice satisfaction with PPOs. However, these results also highlight the critical role of service-related factors in differentiating plans and suggest that there are important non-monetary dimensions of PPO performance that can be used to recruit and retain practices.

  10. Contingency management: perspectives of Australian service providers.

    Cameron, Jacqui; Ritter, Alison

    2007-03-01

    Given the very positive and extensive research evidence demonstrating efficacy and effectiveness of contingency management, it is important that Australia explore whether contingency management has a role to play in our own treatment context. Qualitative interviews were conducted with 30 experienced alcohol and drug practitioners, service managers and policy-makers in Victoria. Interviewees were selected to represent the range of drug treatment services types and included rural representation. A semi-structured interview schedule, covering their perceptions and practices of contingency management was used. All interviews were transcribed verbatim and analysed using N2 qualitative data analysis program. The majority of key informants were positively inclined toward contingency management, notwithstanding some concerns about the philosophical underpinnings. Concerns were raised in relation to the use of monetary rewards. Examples of the use of contingency management provided by key informants demonstrated an over-inclusive definition: all the examples did not adhere to the key principles of contingency management. This may create problems if a structured contingency management were to be introduced in Australia. Contingency management is an important adjunctive treatment intervention and its use in Australia has the potential to enhance treatment outcomes. No unmanageable barriers were identified in this study.

  11. Providing effective supervision in clinical neuropsychology.

    Stucky, Kirk J; Bush, Shane; Donders, Jacobus

    2010-01-01

    A specialty like clinical neuropsychology is shaped by its selection of trainees, educational standards, expected competencies, and the structure of its training programs. The development of individual competency in this specialty is dependent to a considerable degree on the provision of competent supervision to its trainees. In clinical neuropsychology, as in other areas of professional health-service psychology, supervision is the most frequently used method for teaching a variety of skills, including assessment, report writing, differential diagnosis, and treatment. Although much has been written about the provision of quality supervision in clinical and counseling psychology, very little published guidance is available regarding the teaching and provision of supervision in clinical neuropsychology. The primary focus of this article is to provide a framework and guidance for the development of suggested competency standards for training of neuropsychological supervisors, particularly at the residency level. In this paper we outline important components of supervision for neuropsychology trainees and suggest ways in which clinicians can prepare for supervisory roles. Similar to Falender and Shafranske (2004), we propose a competency-based approach to supervision that advocates for a science-informed, formalized, and objective process that clearly delineates the competencies required for good supervisory practice. As much as possible, supervisory competencies are related to foundational and functional competencies in professional psychology, as well as recent legislative initiatives mandating training in supervision. It is our hope that this article will foster further discussion regarding this complex topic, and eventually enhance training in clinical neuropsychology.

  12. Attitudes of Healthcare Providers towards Providing Contraceptives for Unmarried Adolescents in Ibadan, Nigeria

    Ahanonu, Ezihe Loretta

    2014-01-01

    Objective This study sought to assess the attitude of Healthcare Providers towards providing contraceptives for unmarried adolescents in four Local Government Areas in Ibadan, Nigeria. Materials and methods A cross-sectional descriptive study was conducted among 490 Healthcare Providers in 24 randomly selected healthcare facilities using self-administered, pre-tested questionnaires. Results More than half (57.5%) of the respondents perceived the provision of contraceptives for unmarried adole...

  13. Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy.

    Stone, Alexander B; Sheinberg, Rosanne; Bertram, Amanda; Seymour, Anastasia Rowland

    2016-04-01

    This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use.

  14. Provider Opinions Regarding the Development of a Stigma-Reduction Intervention Tailored for Providers

    Mittal, Dinesh; Corrigan, Patrick; Drummond, Karen L.; Porchia, Sylvia; Sullivan, Greer

    2016-01-01

    Interventions involving contact with a person who has recovered from mental illness are most effective at reducing stigma. This study sought input from health care providers to inform the design of a contact intervention intended to reduce provider stigma toward persons with serious mental illness. Using a purposive sampling strategy, data were…

  15. Providing nuclear pharmacy education via the internet

    Hilliard, N.L.; Pickett, M.; Thaxton, P.; Norenberg, J.P.; Wittstrom, K.; Rhodes, B.

    2002-01-01

    Aim: (1) Increase the nuclear pharmacy education opportunities across the United States and the around the world. (2) Establish collaborative educational agreements between colleges of pharmacy and local nuclear pharmacy preceptors. (3) Decrease the shortage of radio pharmacists. 4) Provide nuclear education courses to supplement existing educational programs. Materials and Methods: Nuclear Education Online (www.nuclearonline.org) is an educational consortium between the University of Arkansas for Medical Sciences and the University of New Mexico. The faculty members from each institution have collaborated to design an online didactic curriculum and experiential training materials. The didactic portion is delivered via WebCT (www.webct.com) and involves interactive studies with faculty from UNM and UAMS. The student-centered curriculum is based on the APhA Syllabus for Nuclear Pharmacy Training and includes interactive web-based course materials, discussion groups, preceptor-led activities and problem-based learning (PBL) case studies based upon actual clinical studies and real-life pharmacy situations. Individual units of study include Nuclear Physics, Radiation Biology, Radiation Safety, Instrumentation, and Radiochemistry/Radiopharmacology. Students can begin the program at anytime. Once a cohort of students is established, the students proceed through the PBL cases, working interactively as a group. Results: Since June 2001, over 26 students have completed the 10-week certificate program. These students have been located across the U.S. and in Saudi Arabia. Fifteen students have completed individual courses in nuclear physics and instrumentation through colleges of pharmacy course offerings using the NEO faculty as instructors. Student evaluations revealed that 78% of the students thought that the NEO program was a 'great way to learn' (highest rating). When comparing PBL to a traditional classroom setting, two thirds of students preferred problem

  16. Providing Data Access for Interdisciplinary Research

    Hooper, R. P.; Couch, A.

    2012-12-01

    Developing an interdisciplinary understanding of human and environmental interactions with water requires access to a variety of data kinds collected by various organizations. The CUAHSI Hydrologic Information System (HIS) is a standards-based, services-oriented architecture designed for time-series data. Such data represents an important type of data in water studies. Through the efforts of HIS, a standard transmission language, WaterML2, has been adopted by the Open Geospatial Consortium and is under consideration by the World Meteorologic Organization as an international standards. Web services have also been developed to retrieve data and metadata. HIS is completed with a metadata catalog, hosted by San Diego Supercomputing Center, which indexes more than 20 million time series provided from over 90 different services. This catalog is supported through a hierarchically organized controlled vocabulary that is open for community input and mediation. Data publishers include federal agencies, universities, state agencies, and non-profit organizations such as watershed associations. Accessing data from such a broad spectrum of sources through a uniform service standard promises to truly transform the way in which hydrologic research is done. CUAHSI HIS is a large-scale prototype at this time, but a proposal is under consideration by the National Science Foundation to operationalize HIS through a data facility, tentatively called the CUAHSI Water Data Center. Establishing HIS is an important step to enable research into human-environment interactions with water, but it is only one step. Other data structures will need to be made accessible and interoperable to support this research. Some data—such as two-dimensional GIS coverages—already have widely used standards for transmission and sharing. The US Federal government has long operated a clearinghouse for federal geographic data that is now being augmented with other services such as ArcGIS OnLine. Other data

  17. Provider confidence in opioid prescribing and chronic pain management: results of the Opioid Therapy Provider Survey

    Pearson, Amy CS; Moman, Rajat N; Moeschler, Susan M; Eldrige, Jason S; Hooten, W Michael

    2017-01-01

    Introduction Many providers report lack of confidence in managing patients with chronic pain. Thus, the primary aim of this study was to investigate the associations of provider confidence in managing chronic pain with their practice behaviors and demographics. Materials and methods The primary outcome measure was the results of the Opioid Therapy Provider Survey, which was administered to clinicians attending a pain-focused continuing medical education conference. Nonparametric correlations were assessed using Spearman’s rho. Results Of the respondents, 55.0% were women, 92.8% were white, and 56.5% were physicians. Primary care providers accounted for 56.5% of the total respondents. The majority of respondents (60.8%) did not feel confident managing patients with chronic pain. Provider confidence in managing chronic pain was positively correlated with 1) following an opioid therapy protocol (P=0.001), 2) the perceived ability to identify patients at risk for opioid misuse (P=0.006), and 3) using a consistent practice-based approach to improve their comfort level with prescribing opioids (Pcorrelated with the perception that treating pain patients was a “problem in my practice” (P=0.005). Conclusion In this study, the majority of providers did not feel confident managing chronic pain. However, provider confidence was associated with a protocolized and consistent practice-based approach toward managing opioids and the perceived ability to identify patients at risk for opioid misuse. Future studies should investigate whether provider confidence is associated with measurable competence in managing chronic pain and explore approaches to enhance appropriate levels of confidence in caring for patients with chronic pain. PMID:28652805

  18. Duty to provide care to Ebola patients: the perspectives of Guinean lay people and healthcare providers.

    Kpanake, Lonzozou; Tonguino, Tamba Kallas; Sorum, Paul Clay; Mullet, Etienne

    2018-05-21

    To examine the views of Guinean lay people and healthcare providers (HCPs) regarding the acceptability of HCPs' refusal to provide care to Ebola patients. From October to December 2015, lay people (n=252) and HCPs (n=220) in Conakry, Guinea, were presented with 54 sample case scenarios depicting a HCP who refuses to provide care to Ebola patients and were instructed to rate the extent to which this HCP's decision is morally acceptable. The scenarios were composed by systematically varying the levels of four factors: (1) the risk of getting infected, (2) the HCP's working conditions, (3) the HCP's family responsibilities and (4) the HCP's professional status. Five clusters were identified: (1) 18% of the participants expressed the view that HCPs have an unlimited obligation to provide care to Ebola patients; (2) 38% held that HCPs' duty to care is a function of HCPs' working conditions; (3) 9% based their judgments on a combination of risk level, family responsibilities and working conditions; (4) 23% considered that HCPs do not have an obligation to provide care and (5) 12% did not take a position. Only a small minority of Guinean lay people and HCPs consider that HCPs' refusal to provide care to Ebola patients is always unacceptable. The most commonly endorsed position is that HCPs' duty to provide care to Ebola patients is linked to society's reciprocal duty to provide them with the working conditions needed to fulfil their professional duty. © 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.

  19. Serving some and serving all: how providers navigate the challenges of providing racially targeted health services.

    Zhou, Amy

    2017-10-01

    Racially targeted healthcare provides racial minorities with culturally and linguistically appropriate health services. This mandate, however, can conflict with the professional obligation of healthcare providers to serve patients based on their health needs. The dilemma between serving a particular population and serving all is heightened when the patients seeking care are racially diverse. This study examines how providers in a multi-racial context decide whom to include or exclude from health programs. This study draws on 12 months of ethnographic fieldwork at an Asian-specific HIV organization. Fieldwork included participant observation of HIV support groups, community outreach programs, and substance abuse recovery groups, as well as interviews with providers and clients. Providers managed the dilemma in different ways. While some programs in the organization focused on an Asian clientele, others de-emphasized race and served a predominantly Latino and African American clientele. Organizational structures shaped whether services were delivered according to racial categories. When funders examined client documents, providers prioritized finding Asian clients so that their documents reflected program goals to serve the Asian population. In contrast, when funders used qualitative methods, providers could construct an image of a program that targets Asians during evaluations while they included other racial minorities in their everyday practice. Program services were organized more broadly by health needs. Even within racially targeted programs, the meaning of race fluctuates and is contested. Patients' health needs cross cut racial boundaries, and in some circumstances, the boundaries of inclusion can expand beyond specific racial categories to include racial minorities and underserved populations more generally.

  20. Standardizing communication from acute care providers to primary care providers on critically ill adults.

    Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

    2015-11-01

    To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

  1. Achieving health care cost containment through provider payment reform that engages patients and providers.

    Ginsburg, Paul B

    2013-05-01

    The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers.

  2. Instrument comprising a cable or tube provided provided with a propulsion device

    Breedveld, P.

    2006-01-01

    The invention relates to an instrument (1) comprising a cable or tube (3), at a distal end of which a propulsion device (4) is provided for moving the cable or tube in a hollow space, the propulsion device being shaped like a donut lying in a plane at right angles to the longitudinal direction of

  3. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

    2014-01-01

    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  4. Comparing Intentions to Use University-Provided vs Vendor-Provided Multibiometric Authentication in Online Exams

    Levy, Yair; Ramim, Michelle M.; Furnell, Steven M.; Clarke, Nathan L.

    2011-01-01

    Purpose: Concerns for information security in e-learning systems have been raised previously. In the pursuit for better authentication approaches, few schools have implemented students' authentication during online exams beyond passwords. This paper aims to assess e-learners' intention to provide multibiometric data and use of multibiometrics…

  5. Health service providers in Somalia: their readiness to provide malaria case-management.

    Noor, Abdisalan M; Rage, Ismail A; Moonen, Bruno; Snow, Robert W

    2009-05-13

    Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first-line therapy. 31.4% of

  6. Health service providers in Somalia: their readiness to provide malaria case-management

    Moonen Bruno

    2009-05-01

    Full Text Available Abstract Background Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Methods Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. Results There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53

  7. Provider-based Medicare risk contracting and subcontracting: opportunities and risks for provider sponsored organizations.

    Levin, H A; Zenner, P A; Kipp, R A; Whitney, E L

    1997-01-01

    Provider sponsored organizations (PSOs) are increasingly acquiring the risk for the management of Medicare Risk patients by accepting capitation directly from the Health Care Financing Administration (HCFA) or through contracts with HMOs or other organizations contracting with HCFA. The Medicare population and the requirements that the federal administration has put into place with respect to risk contracting are unique and demand specific responses on the part of the PSO for a contract to be successful. The PSO is cautioned to understand the actuarial risk, the clinical uniqueness of the Medicare beneficiary, Medicare reimbursement regulatory requirements, utilization management needs, and necessary reporting before entering into a contractual arrangement. This article attempts to describe some of the more common issues a provider organization must consider.

  8. A novel compliance measurement in radial arteries using strain-gauge plethysmography

    Liu, Shing-Hong; Tyan, Chu-Chang; Chang, Kang-Ming

    2009-01-01

    We propose a novel method for assessing the compliance of the radial artery by using a two-axis mechanism and a standard positioning procedure for detecting the optimal measuring site. A modified sensor was designed to simultaneously measure the arterial diameter change waveform (ADCW) and pressure pulse waveform with a strain gauge and piezoresistor. In the x-axis scanning, the sensor could be placed close to the middle of the radial artery when the ADCW reached the maximum amplitude. In the z-axis scanning, the contact pressure was continuously increased for data measurement. Upon the deformation of the strain gauge following the change in the vascular cross-section, the ADCW was transferred to the change of the vascular radius. The loaded strain compliance of the radial artery (C strain ) can be determined by dividing the dynamic changed radius by the pulse pressure. Twenty-three untreated, mild or moderate hypertensive patients aged 29–85 were compared with 14 normotensive patients aged 25–62. The maximum strain compliance between the two groups was significantly different (p < 0.005). Of the hypertensive patients, 14 were at risk of developing hyperlipidemia. There was a significant difference between this and the normotension group (p < 0.005)

  9. A novel compliance measurement in radial arteries using strain-gauge plethysmography.

    Liu, Shing-Hong; Tyan, Chu-Chang; Chang, Kang-Ming

    2009-09-01

    We propose a novel method for assessing the compliance of the radial artery by using a two-axis mechanism and a standard positioning procedure for detecting the optimal measuring site. A modified sensor was designed to simultaneously measure the arterial diameter change waveform (ADCW) and pressure pulse waveform with a strain gauge and piezoresistor. In the x-axis scanning, the sensor could be placed close to the middle of the radial artery when the ADCW reached the maximum amplitude. In the Z-axis scanning, the contact pressure was continuously increased for data measurement. Upon the deformation of the strain gauge following the change in the vascular cross-section, the ADCW was transferred to the change of the vascular radius. The loaded strain compliance of the radial artery (C(strain)) can be determined by dividing the dynamic changed radius by the pulse pressure. Twenty-three untreated, mild or moderate hypertensive patients aged 29-85 were compared with 14 normotensive patients aged 25-62. The maximum strain compliance between the two groups was significantly different (p < 0.005). Of the hypertensive patients, 14 were at risk of developing hyperlipidemia. There was a significant difference between this and the normotension group (p < 0.005).

  10. Development of a Respiratory Inductive Plethysmography Module Supporting Multiple Sensors for Wearable Systems

    Zhengbo Zhang

    2012-09-01

    Full Text Available In this paper, we present an RIP module with the features of supporting multiple inductive sensors, no variable frequency LC oscillator, low power consumption, and automatic gain adjustment for each channel. Based on the method of inductance measurement without using a variable frequency LC oscillator, we further integrate pulse amplitude modulation and time division multiplexing scheme into a module to support multiple RIP sensors. All inductive sensors are excited by a high-frequency electric current periodically and momentarily, and the inductance of each sensor is measured during the time when the electric current is fed to it. To improve the amplitude response of the RIP sensors, we optimize the sensing unit with a matching capacitor parallel with each RIP sensor forming a frequency selection filter. Performance tests on the linearity of the output with cross-sectional area and the accuracy of respiratory volume estimation demonstrate good linearity and accurate lung volume estimation. Power consumption of this new RIP module with two sensors is very low. The performance of respiration measurement during movement is also evaluated. This RIP module is especially desirable for wearable systems with multiple RIP sensors for long-term respiration monitoring.

  11. Whole Body Plethysmography Reveals Differential Ventilatory Responses to Ozone in Rat Models of Cardiovascular Disease

    Increasingly, urban air pollution is recognized as an important determinant of cardiovascular disease. Host susceptibility to air pollution can vary due to genetic predisposition and underlying disease. To elucidate key factors of host ...

  12. Serial lung model for simulation and parameter estimation in body plethysmography

    A.F.M. Verbraak (Anton); J.M. Bogaard (Jan); J.E.W. Beneken; E.J. Hoorn (Ewout); A. Versprille (Adrian)

    1991-01-01

    textabstractA serial lung model with a compressible segment has been implemented to simulate different types of lung and airway disorders such as asthma, emphysema, fibrosis and upper airway obstruction. The model described can be used during normal breathing, and moreover the compliant segment is

  13. Using LabVIEW to facilitate calibration and verification for respiratory impedance plethysmography.

    Ellis, W S; Jones, R T

    1991-12-01

    A system for calibrating the Respitrace impedance plethysmograph was developed with the capacity to quantitatively verify the accuracy of calibration. LabVIEW software was used on a Macintosh II computer to create a user-friendly environment, with the added benefit of reducing development time. The system developed enabled a research assistant to calibrate the Respitrace within 15 min while achieving an accuracy within the normally accepted 10% deviation when the Respitrace output is compared to a water spirometer standard. The system and methods described were successfully used in a study of 10 subjects smoking cigarettes containing marijuana or cocaine under four conditions, calibrating all subjects to 10% accuracy within 15 min.

  14. Blood pressure measurement of all five fingers by strain gauge plethysmography

    Hirai, M; Nielsen, S L; Lassen, N A

    1976-01-01

    of the other fingers was measured using a 24-mm-wide cuff. Blood pressure at the proximal phalanx was higher than that at the intermediate phalanx in all fingers except finger V. The difference of blood pressure values corresponded well with circumference of the finger. In 15 normal subjects, blood pressure...... at the proximal phalanx was compared in fingers I, III, IV, and V, using 16, 20, 24 and 24 mm wide cuffs. Finger blood pressure was closest to arm systolic blood pressure when a 24-mm or 27-mm-wide cuff was used in fingers I, III, and IV, and with a 20-mm-wide cuff in finger V. As the standard deviation......The aim of the present paper was to study the methodological problems involved in measuring systolic blood pressure in all five fingers by the strain gauge technique. In 24 normal subjects, blood pressure at the proximal phalanx of finger I and both at the proximal and the intermediate phalanx...

  15. [Sequelae of unilateral deep venous thrombosis in plethysmography of the calf].

    Zicot, M; Depairon, M

    1982-01-01

    Twenty four patients suffering from unilateral venous disturbances revealed by Doppler and secondary to a deep venous thrombosis were examined. The calf venous haemodynamics was analyzed by use of a strain-jauge plethysmograph. We determined the increase in venous volume due to the inflation of a thigh pneumatic cuff (pressure at 20, 40 and 60 mm Hg; delta V20, delta V40, delta V60). The maximal venous output (Vout) was measured after a quick release of the 60 mm Hg pressure. The maximal venous drainage (VMM) was assessed during a rhythmic exercise (tiptoeing) while standing; delta V20, delta V40 and delta V60 were nearly constantly reduced on the abnormal side (t of Student respectively 3.49; 6.09 and 5.07). Vout dropped proportionaly to delta V60. Some abnormalities due to valvular insufficiency were frequently present in the beginning of the inflation curve at the level of the abnormal limbs. VMM was nearly always largely decreased on the affected side (t = 5.43). The unilateral flow disturbances displayed by the Doppler were regularly going with abnormalities of the capacitive system, well demonstrated by comparison with the non-affected limbs.

  16. Quantitative determination of arterial wall mechanics with pulse oximetric finger plethysmography.

    Kato, R; Sato, J; Iuchi, T; Higuchi, Y

    1999-10-30

    The plethysmographic wave of pulse oximetry reflects arterial pulsation at the fingertip. Since arterial pressure and the pulsatile component of the arterial cross section represent the input and output of the fingertip arterial system, respectively, arterial wall mechanics may be delineated from their relationship. We aimed to construct a mathematical model of the fingertip arterial wall from the relationship between the plethysmographic wave and arterial pressure. The pulse oximetric plethysmographic signal at the forefinger and pressure at the ipsilateral radial artery were measured. Employing the data, simple mathematical models with one to four mechanical elements were tested in terms of the goodness of fit and the physiological implications. The determined model was applied to the data obtained during administration of vasoactive agents in anesthetized patients. The mathematical model suited for describing arterial wall mechanics was a four-element, two-compartment model. The two compartments represent passive mechanical and active contractile properties, respectively. In the application of the model to the anesthetized patients, the vasoactive agents produced changes in the model parameters that implied mechanical alterations in the arterial wall. These findings suggest the benefit of the four-element, two-compartment model in analyzing peripheral vascular wall mechanics influenced by various stimuli in intensive care and anesthesia.

  17. Acute changes in forearm venous volume and tone using radionuclide plethysmography

    Manyari, D.E.; Malkinson, T.J.; Robinson, V.; Smith, E.R.; Cooper, K.E.

    1988-01-01

    In this investigation blood pool scintigraphy was validated as a method to study acute changes in human forearm veins. Changes in regional forearm vascular volume (capacity) and the occluding pressure-volume (P-V) relationship induced by sublingual nifedipine (NIF) and nitroglycerin (GTN) were recorded in 16 patients with simultaneous data collection by the radionuclide and the mercury-in-rubber strain-gauge techniques. The standard error of estimate (Syx) between successive control measurements using the radionuclide method was 3.1% compared with 3.2% for the strain-gauge method. The venous P-V curves were highly reproducible using both techniques. Strain gauge and radionuclide measurements of acute changes in forearm venous volume correlated well (r = 0.86; Syx = 7%, n = 156). After 20 mg of NIF or 0.6 mg of GTN, mean heart rate increased from 71 +/- 10 to 77 +/- 9 and from 68 +/- 10 to 75 +/- 11 beats/min, respectively, and group systolic blood pressure decreased from 128 +/- 22 to 120 +/- 19 and from 136 +/- 18 to 126 +/- 23 mmHg, respectively (P less than 0.05). At venous occluding pressures of 0 and 30 mmHg, the forearm vascular volume did not change after NIF (2 +/- 4 and -1 +/- 4%; P greater than 0.05), whereas it increased after GTN (8 +/- 5 and 12 +/- 7%; P less than 0.001). The forearm venous P-V relationship did not change after NIF, whereas a significant rightward shift (venodilation, with an increase in unstressed volume) occurred after GTN

  18. Venous muscle pump function during pregnancy. Assessment by ambulatory strain-gauge plethysmography

    Struckmann, J R; Meiland, H; Bagi, P

    1990-01-01

    The venous muscle pump function was quantitatively assessed through pregnancy weeks 16, 30, 38 and 3 months (week 53) following delivery, in 24 pregnant women who completed a normal pregnancy. A statistically significant increase was found in the mean venous reflux (P less than 0.01), which was r...... primarily by mechanical obstruction, or hormonal influence other than that of estradiol, estriol or progesterone. 17% (4.7-37%) of the women with a normal pregnancy developed a pathological venous muscle pump function....... virtually disappeared post partum, corresponding to the muscle pump normalization. No statistical correlation was found between venous muscle pump values and changes in hormone concentrations of estradiol, estriol and progesterone. It is suggested that venous insufficiency development in pregnancy is caused...

  19. Research and Practice Communications Between Oral Health Providers and Prenatal Health Providers: A Bibliometric Analysis.

    Skvoretz, John; Dyer, Karen; Daley, Ellen; Debate, Rita; Vamos, Cheryl; Kline, Nolan; Thompson, Erika

    2016-08-01

    Objectives We aimed to examine scholarly collaboration between oral health and prenatal providers. Oral disease is a silent epidemic with significant public health implications for pregnant women. Evidence linking poor oral health during pregnancy to adverse pregnancy and birth outcomes requires oral health and prenatal providers to communicate on the prevention, treatment and co-management matters pertaining to oral health issues among their pregnant patients. The need for inter-professional collaboration is highlighted by guidelines co-endorsed by the American College of Obstetricians and Gynecologists and the American Dental Association, stressing the importance of oral health care during pregnancy. Methods To assess if interdisciplinary communication occurs between oral health and prenatal disciplines, we conducted a network analysis of research on pregnancy-related periodontal disease. Results Social Network analysis allowed us to identify communication patterns between communities of oral health and prenatal professionals via scientific journals. Analysis of networks of citations linking journals in different fields reveals a core-periphery pattern dominated by oral health journals with some participation from medicine journals. However, an analysis of dyadic ties of citation reveals statistically significant "inbreeding" tendencies in the citation patterns: both medical and oral health journals tend to cite their own kind at greater-than-chance levels. Conclusions Despite evidence suggesting that professional collaboration benefits patients' overall health, findings from this research imply that little collaboration occurs between these two professional groups. More collaboration may be useful in addressing women's oral-systemic health concerns that result in adverse pregnancy outcomes.

  20. Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows.

    Jain, Parul; Slater, Michael D

    2013-01-01

    Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed.

  1. Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

    Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

    2017-07-14

    Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

  2. Non-physician providers as clinical providers in cystic fibrosis: survey of U.S. programs.

    Brown, Rebekah F; Willey-Courand, Donna Beth; George, Cindy; McMullen, Ann; Dunitz, Jordan; Slovis, Bonnie; Perkett, Elizabeth

    2013-04-01

    Non-physician providers (NPPs) including nurse practitioners (NPs) and physician assistants (PAs) are important members of CF care teams, but limited data exist about the extent NPPs are involved in CF care. A subcommittee was established by the CF Foundation to gather information about current involvement of NPPs. Surveys were sent to adult, pediatric and affiliate CF program directors (PDs) and NPPs working in US CF programs. Responses were received from 108 PDs (49% pediatric, 34% adult, 17% affiliate). Overall, 53% of the 108 programs had NPPs and 70% had or planned to hire NPPs. Reasons for NPP use included ideal clinical role (75%), expansion of services (72%), and physician shortage (40%). The survey collected 73 responses from NPPs (96% NPs, 4% PAs) who worked in pediatric (49%), adult (29%), affiliate (3%), or multiple programs (19%). Training occurred on the job in 88% and from prior CF experience in 21%. NPPs provided coverage in outpatient clinics (82%), inpatient care (64%), and weekend and/or night call (22%). In addition to clinical roles, NPPs are involved in education (95%), research (81%), and leadership (55%). The major obstacle reported by PDs and NPPs was billing with only 12% of programs reporting NPP salaries covered by billing revenue alone. Salary support included hospital support (67%), billing (39%), center grant (35%), and other grant/contract (25%). NPPs bill for outpatient and inpatient care in 65% and 28% of programs, respectively. NPPs are working with physicians in many centers and have the potential to help meet the increasing clinical workforce demands. Further evaluation of financial issues is indicated to continue the support of NPP jobs in CF. Roles and expectations need to be clearly defined. Initial and ongoing training standards and opportunities should be explored. Copyright © 2012 Wiley Periodicals, Inc.

  3. The Net Neutrality Debate: Analysis of economic implications of net neutrality on internet service providers, content providers and internet users

    Møinichen, Jørgen

    2014-01-01

    This thesis studies the economic implications of a transition from a neutral to a non-neutral network. A mathematical model with an end to end ecosystem is developed, which includes a backbone internet service provider that provides connectivity for the content providers. The model also includes internet users that pay an access internet service provider for connectivity to interact with the content providers, advertisers that pay the content providers, and access internet service providers t...

  4. 48 CFR 1604.7201 - FEHB Program Large Provider Agreements.

    2010-10-01

    ... FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Large Provider... into any Large Provider Agreement; and (ii) Not less than 60 days before exercising renewals or other...

  5. Childcare Providers: Work Stress and Personal Well-Being

    Faulkner, Monica; Gerstenblatt, Paula; Lee, Ahyoung; Vallejo, Viana; Travis, Dnika

    2016-01-01

    Childcare providers face multiple work-related stressors. Small studies of childcare providers have suggested that providers have high levels of depression compared to the general population. However, unlike other caregiving professions, the research examining childcare providers is sparse, and there is little information to inform practices and…

  6. 33 CFR 155.4032 - Other resource provider considerations.

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Other resource provider... Salvage and Marine Firefighting § 155.4032 Other resource provider considerations. (a) Use of resource providers not listed in the VRP. If another resource provider, not listed in the approved plan for the...

  7. Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers systematic reviews of provider assessment and feedback and provider incentives.

    Sabatino, Susan A; Habarta, Nancy; Baron, Roy C; Coates, Ralph J; Rimer, Barbara K; Kerner, Jon; Coughlin, Steven S; Kalra, Geetika P; Chattopadhyay, Sajal

    2008-07-01

    Most major medical organizations recommend routine screening for breast, cervical, and colorectal cancers. Screening can lead to early detection of these cancers, resulting in reduced mortality. Yet not all people who should be screened are screened, either regularly or, in some cases, ever. This report presents results of systematic reviews of effectiveness, applicability, economic efficiency, barriers to implementation, and other harms or benefits of two provider-directed intervention approaches to increase screening for breast, cervical, and colorectal cancers. These approaches, provider assessment and feedback, and provider incentives encourage providers to deliver screening services at appropriate intervals. Evidence in these reviews indicates that provider assessment and feedback interventions can effectively increase screening by mammography, Pap test, and fecal occult blood test. Health plans, healthcare systems, and cancer control coalitions should consider such evidence-based findings when implementing interventions to increase screening use. Evidence was insufficient to determine the effectiveness of provider incentives in increasing use of any of these tests. Specific areas for further research are suggested in this report, including the need for additional research to determine whether provider incentives are effective in increasing use of any of these screening tests, and whether assessment and feedback interventions are effective in increasing other tests for colorectal cancer (i.e., flexible sigmoidoscopy, colonoscopy, or double-contrast barium enema).

  8. 78 FR 19949 - The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers

    2013-04-02

    ... 26 CFR Part 1 The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance... limitation for remuneration provided by certain health insurance providers under section 162(m)(6) of the Internal Revenue Code (Code). These regulations affect health insurance providers that pay such...

  9. Electronic health records: eliciting behavioral health providers' beliefs.

    Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

    2012-04-01

    Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

  10. Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight.

    Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L

    2017-06-01

    To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Search for an Emergency Contraception Provider in the United States

    ... emergency contraception provider. Concerned about cost? Click here . ---------- Emergency contraceptive pills are stocked by all major pharmacy chains, ... daily birth control pills you can use as emergency contraceptive pills. You can search for a provider in ...

  12. Provider Specific Data for Public Use in SAS Format

    U.S. Department of Health & Human Services — The Fiscal Intermediary maintains the Provider Specific File (PSF). The file contains information about the facts specific to the provider that affects computations...

  13. How Do Health Care Providers Diagnose Turner Syndrome?

    ... Email Print How do health care providers diagnose Turner syndrome? Health care providers use a combination of physical ... the X chromosomes is partially or completely missing. Turner syndrome also can be diagnosed during pregnancy by testing ...

  14. How Do Health Care Providers Diagnose Cushing's Syndrome?

    ... Email Print How do health care providers diagnose Cushing syndrome? Diagnosing Cushing syndrome can be complex and difficult. This syndrome is ... health care provider may try different tests. Diagnosing Cushing syndrome often requires several steps. If you are being ...

  15. Comprehensive Care For Joint Replacement Model - Provider Data

    U.S. Department of Health & Human Services — Comprehensive Care for Joint Replacement Model - provider data. This data set includes provider data for two quality measures tracked during an episode of care:...

  16. Addressing the use of cloud computing for web hosting providers

    Fitó, Josep Oriol; Guitart Fernández, Jordi

    2009-01-01

    Nobody doubts about cloud computing is and will be a sea change for the Information Tech nology. Specifically, we address an application of this emerging paradigm into the web hosting providers. We create the Cloud Hosting Provider (CHP): a web hosting provider that uses the outsourcing technique in order to take advantage of cloud computing infrastructures (i.e. cloud-based outsourcing) for providing scalability and availability capabilities to the web applications deployed. Hence, the...

  17. 28 CFR 36.310 - Transportation provided by public accommodations.

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Transportation provided by public... BASIS OF DISABILITY BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Specific Requirements § 36.310 Transportation provided by public accommodations. (a) General. (1) A public accommodation that provides...

  18. Methods for providing intermediates in the synthesis of atorvastatin.

    Dömling, Alexander Stephan Siegfried

    2016-01-01

    The invention relates to the field of medicinal chemistry, In particular, it relates to methods for providing intermediates in the synthesis of Atorvastatin, a competitive inhibitor of HMG-Co A reductase. Provided is a process for providing a compound having a Formula (I) or a pharmaceutically

  19. 42 CFR 433.66 - Permissible provider-related donations.

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Permissible provider-related donations. 433.66... Requirements State Financial Participation § 433.66 Permissible provider-related donations. (a) General rule... provider-related donations without a reduction in FFP, only in accordance with the requirements of this...

  20. Security measures effect over performance in service provider network

    pc

    2018-03-05

    Mar 5, 2018 ... Abstract—network security is defined as a set of policies and actions taken by a ... These threats are linked with the following factors that are ... typically smaller than those in the service provider space. ... Service providers cannot manage to provide ... e the DB performance effect ... r the business needs [10].

  1. Outsourcing customer support : The role of provider customer focus

    Wuyts, S.H.K.; Rindfleisch, A.; Citrin, A.

    An increasing number of firms are outsourcing customer support to external service providers. This creates a triadic setting in which an outsourcing provider serves end customers on behalf of its clients. While outsourcing presents an opportunity to serve customers, service providers differ in their

  2. Provider-sponsored HMOs: make, buy, or joint venture?

    Clay, S B

    1997-03-01

    Providers can sponsor their own HMOs in one of three ways: by creating their own HMO, by joint venturing with an existing HMO, or by purchasing an existing HMO. When selecting the best option, providers must consider various market conditions. Managed care penetration in the area, potential competitive responses of existing HMOs, market demand, provider reputation, and provider marketing ability will all influence the feasibility of each option. Providers also must examine their own organizational identity, their ability to raise the necessary capital to start an HMO, their managed care expertise and risk contracting experience, and their information systems capabilities.

  3. Healthcare Providers' Responses to Narrative Communication About Racial Healthcare Disparities.

    Burgess, Diana J; Bokhour, Barbara G; Cunningham, Brooke A; Do, Tam; Gordon, Howard S; Jones, Dina M; Pope, Charlene; Saha, Somnath; Gollust, Sarah E

    2017-10-25

    We used qualitative methods (semi-structured interviews with healthcare providers) to explore: 1) the role of narratives as a vehicle for raising awareness and engaging providers about the issue of healthcare disparities and 2) the extent to which different ways of framing issues of race within narratives might lead to message acceptance for providers' whose preexisting beliefs about causal attributions might predispose them to resist communication about racial healthcare disparities. Individual interviews were conducted with 53 providers who had completed a prior survey assessing beliefs about disparities. Participants were stratified by the degree to which they believed providers contributed to healthcare inequality: low provider attribution (LPA) versus high provider attribution (HPA). Each participant read and discussed two differently framed narratives about race in healthcare. All participants accepted the "Provider Success" narratives, in which interpersonal barriers involving a patient of color were successfully resolved by the provider narrator, through patient-centered communication. By contrast, "Persistent Racism" narratives, in which problems faced by the patient of color were more explicitly linked to racism and remained unresolved, were very polarizing, eliciting acceptance from HPA participants and resistance from LPA participants. This study provides a foundation for and raises questions about how to develop effective narrative communication strategies to engage providers in efforts to reduce healthcare disparities.

  4. Campus Health Centers' Lack of Information Regarding Providers: A Content Analysis of Division-I Campus Health Centers' Provider Websites.

    Perrault, Evan K

    2018-07-01

    Campus health centers are a convenient, and usually affordable, location for college students to obtain health care. Staffed by licensed and trained professionals, these providers can generally offer similar levels of care that providers at off-campus clinics can deliver. Yet, previous research finds students may forgo this convenient, on-campus option partially because of a lack of knowledge regarding the quality of providers at these campus clinics. This study sought to examine where this information deficit may come from by analyzing campus health centers' online provider information. All Division-I colleges or universities with an on-campus health center, which had information on their websites about their providers (n = 294), had their providers' online information analyzed (n = 2,127 providers). Results revealed that schools commonly offer professional information (e.g., provider specialties, education), but very little about their providers outside of the medical context (e.g., hobbies) that would allow a prospective student patient to more easily relate. While 181 different kinds of credentials were provided next to providers' names (e.g., MD, PA-C, FNP-BC), only nine schools offered information to help students understand what these different credentials meant. Most schools had information about their providers within one-click of the homepage. Recommendations for improving online information about campus health center providers are offered.

  5. Electronic consultation system demonstrates educational benefit for primary care providers.

    Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S

    2017-01-01

    Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

  6. Are Private Providers more Productive and Efficient than Public Providers of International Education? Evidence from New Zealand

    Dayal TALUKDER

    2011-10-01

    Full Text Available This study has investigated the productivity growth and efficiency of private and public providers of international education in New Zealand. It has used secondary data to calculate the DEA-based Malmquist productivity index for measuring Total Factor Productivity (TFP-growth and efficiency of both public and private providers of international education during 1999-2010. The study has found that private providers experienced a larger TFP-growth than that of public providers during 1999-2004. However, they experienced a sharp decline in TFP-growth since 2005 through to 2010 and experienced a much smaller TFP-growth than that of public providers during this period. Conversely, public providers experienced a positive TFP-growth during 1999-2004 but they experienced a negative TFP-growth since 2005 through to 2010. Considering efficiency, both private and public providers experienced almost a constant Technical Efficiency Change (TEC having a same level of efficiency of one. Both private and public providers exhibited a constant return to scale during 1999-2010. This study argues that on an average, private providers are more productive than public providers of international education. However, they are not more efficient than public providers as both types of providers exhibited a constant return to scale during 1999-2010. This study also argues that TFP-growth of New Zealand’s international education was determined by Technological Change (TC, not by TEC during this period.

  7. Internet health information in the patient-provider dialogue.

    Hong, Traci

    2008-10-01

    A patient discussing Internet health information with a health care provider (referred to as "patient-provider communication about Internet health information") can contribute positively to health outcomes. Although research has found that once Internet access is achieved, there are no ethnic differences in Internet health information seeking, it is unclear if there are ethnic differences in patient-provider communication about Internet health information. To help fill this gap in the literature, the National Cancer Institute's Health Information National Trends Survey 2005 was analyzed with Stata 9. Two sets of logistic regression analyses were conducted, one for a subsample of Internet users (n = 3,244) and one for a subsample of Internet users who are first-generation immigrants (n = 563). The dependent variable was patient-provider communication about Internet health information, which assessed whether survey participants had discussed online health information with a health care provider. The predictor variables included trust of health care provider, trust of online health information, Internet use, health care coverage, frequency of visits to health care provider, health status, and demographics. Among all Internet users, Whites had higher levels of patient-provider communication about Internet health information than Blacks and Asians. Similarly, among Internet users who are immigrants, Whites had higher levels of patient-provider communication about Internet health information than Blacks and Asians. While the digital divide is narrowing in terms of Internet access, racial differences in patient-provider communication about Internet health information may undermine the potential benefits of the information age.

  8. Provider attributes correlation analysis to their referral frequency and awards.

    Wiley, Matthew T; Rivas, Ryan L; Hristidis, Vagelis

    2016-03-14

    There has been a recent growth in health provider search portals, where patients specify filters-such as specialty or insurance-and providers are ranked by patient ratings or other attributes. Previous work has identified attributes associated with a provider's quality through user surveys. Other work supports that intuitive quality-indicating attributes are associated with a provider's quality. We adopt a data-driven approach to study how quality indicators of providers are associated with a rich set of attributes including medical school, graduation year, procedures, fellowships, patient reviews, location, and technology usage. In this work, we only consider providers as individuals (e.g., general practitioners) and not organizations (e.g., hospitals). As quality indicators, we consider the referral frequency of a provider and a peer-nominated quality designation. We combined data from the Centers for Medicare and Medicaid Services (CMS) and several provider rating web sites to perform our analysis. Our data-driven analysis identified several attributes that correlate with and discriminate against referral volume and peer-nominated awards. In particular, our results consistently demonstrate that these attributes vary by locality and that the frequency of an attribute is more important than its value (e.g., the number of patient reviews or hospital affiliations are more important than the average review rating or the ranking of the hospital affiliations, respectively). We demonstrate that it is possible to build accurate classifiers for referral frequency and quality designation, with accuracies over 85 %. Our findings show that a one-size-fits-all approach to ranking providers is inadequate and that provider search portals should calibrate their ranking function based on location and specialty. Further, traditional filters of provider search portals should be reconsidered, and patients should be aware of existing pitfalls with these filters and educated on local

  9. Positional differences in reactive hyperemia provide insight into initial phase of exercise hyperemia.

    Jasperse, Jeffrey L; Shoemaker, J Kevin; Gray, Eric J; Clifford, Philip S

    2015-09-01

    Studies have reported a greater blood flow response to muscle contractions when the limb is below the heart compared with above the heart, and these results have been interpreted as evidence for a skeletal muscle pump contribution to exercise hyperemia. If limb position affects the blood flow response to other vascular challenges such as reactive hyperemia, this interpretation may not be correct. We hypothesized that the magnitude of reactive hyperemia would be greater with the limb below the heart. Brachial artery blood flow (Doppler ultrasound) and blood pressure (finger-cuff plethysmography) were measured in 10 healthy volunteers. Subjects lay supine with one arm supported in two different positions: above or below the heart. Reactive hyperemia was produced by occlusion of arterial inflow for varying durations: 0.5 min, 1 min, 2 min, or 5 min in randomized order. Peak increases in blood flow were 77 ± 11, 178 ± 24, 291 ± 25, and 398 ± 33 ml/min above the heart and 96 ± 19, 279 ± 62, 550 ± 60, and 711 ± 69 ml/min below the heart (P different responses depending on limb position. To determine whether these differences were due to mechanisms intrinsic to the arterial wall, a second set of experiments was performed in which acute intraluminal pressure reduction for 0.5 min, 1 min, 2 min, or 5 min was performed in isolated rat soleus feed arteries (n = 12). The magnitude of dilation upon pressure restoration was greater when acute pressure reduction occurred from 85 mmHg (mimicking pressure in the arm below the heart; 28.3 ± 7.9, 37.5 ± 5.9, 55.1 ± 9.9, and 68.9 ± 8.6% dilation) than from 48 mmHg (mimicking pressure in the arm above the heart; 20.8 ± 4.8, 22.6 ± 4.4, 31.2 ± 5.8, and 49.2 ± 7.1% dilation). These data support the hypothesis that arm position differences in reactive hyperemia are at least partially mediated by mechanisms intrinsic to the arterial wall. Overall, these results suggest the need to reevaluate studies employing positional

  10. Health Care Providers' Spirit at Work Within a Restructured Workplace.

    Wagner, Joan I J; Brooks, Denise; Urban, Ann-Marie

    2018-01-01

    Spirit at work (SAW) research emerged as a response to care provider determination to maintain a healthy and productive health care work environment, despite restructuring. The aim of this descriptive mixed-methods research is to present the care provider's perceptions of SAW. SAW is a holistic measure of care provider workplace outcomes, defined as the unique experience of individuals who are passionate about and energized by their work. A mixed group of licensed and unlicensed care providers in a continuing care workplace were surveyed. Eighteen Likert-type scale survey questions were further informed by two open-ended questions. Results indicated that unlicensed continuing care providers' perceptions of SAW are lower than licensed care providers. Responses suggest that open discussion between managers and team members, combined with structured workplace interventions, will lead to enhanced SAW and improved patient care. Further research on SAW within the continuing care workplace is required.

  11. Using attribution theory to examine community rehabilitation provider stigma.

    Strauser, David R; Ciftci, Ayse; O'Sullivan, Deirdre

    2009-03-01

    This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences in their stigmatizing tendencies on subscales of controllability and stability for different categories of disabilities. Specifically, service providers with a master's degree had more stigmatizing beliefs for psychosis and cocaine addiction, compared with service providers with a bachelor's degree. Service providers with either a bachelor's degree or master's degree reported lower levels of stigma overall for five of the six categories of disability compared with their community college student counterparts. No differences were found for length of time working with persons with psychiatric disabilities.

  12. Smoking Cessation Counseling Beliefs and Behaviors of Outpatient Oncology Providers

    Danhauer, Suzanne C.; Tooze, Janet A.; Blackstock, A. William; Spangler, John; Thomas, Leslie; Sutfin, Erin L.

    2012-01-01

    Purpose. Many cancer patients continue to smoke after diagnosis, increasing their risk for treatment complications, reduced treatment efficacy, secondary cancers, and reduced survival. Outpatient oncology providers may not be using the “teachable moment” of cancer diagnosis to provide smoking cessation assistance. Providers and Methods. Physicians and midlevel providers (n = 74) who provide outpatient oncology services completed an online survey regarding smoking cessation counseling behaviors, beliefs, and perceived barriers. Outpatient medical records for 120 breast, lung, head and neck, colon, prostate, and acute leukemia cancer patients were reviewed to assess current smoking cessation assessment and intervention documentation practices. Results. Providers reported commonly assessing smoking in new patients (82.4% frequently or always), but rates declined at subsequent visits for both current smokers and recent quitters. Rates of advising patients to quit smoking were also high (86.5% frequently or always), but oncology setting. PMID:22334454

  13. Providers' Attitudes Toward Evidence-Based Practices: Is it Just About Providers, or do Practices Matter, Too?

    Reding, Michael E. J.; Chorpita, Bruce F.; Lau, Anna S.; Innes-Gomberg, Debbie

    2014-01-01

    Evidence-based practice (EBP) attitudes were measured in a sample of Los Angeles County mental health service providers. Three types of data were collected: provider demographic characteristics, attitudes toward EBP in general, and attitudes toward specific EBPs being implemented in the county. Providers could reliably rate characteristics of specific EBPs, and these ratings differed across interventions. Preliminary implementation data indicate that appealing features of an EBP relate to the degree to which providers use it. These findings suggest that assessing EBP-specific attitudes is feasible and may offer implementation-relevant information beyond that gained solely from providers' general attitudes toward EBP. PMID:24166077

  14. Cloud Provider Capacity Augmentation Through Automated Resource Bartering

    Gohera, Syeda ZarAfshan; Bloodsworth, Peter; Rasool, Raihan Ur; McClatchey, Richard

    2018-01-01

    Growing interest in Cloud Computing places a heavy workload on cloud providers which is becoming increasingly difficult for them to manage with their primary datacenter infrastructures. Resource limitations can make providers vulnerable to significant reputational damage and it often forces customers to select services from the larger, more established companies, sometimes at a higher price. Funding limitations, however, commonly prevent emerging and even established providers from making con...

  15. Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

    Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

    2017-07-01

    To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

  16. Improving Educational Outcomes by Providing Educational Services through Mobile Technology

    Hosam Farouk El-Sofany

    2013-01-01

    The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great co...

  17. Providing Formative Feedback: Language Technologies for Lifelong Learning CONSPECT tool

    Berlanga, Adriana

    2011-01-01

    Berlanga, A. J. (2011). Providing Formative Feedback: Language Technologies for Lifelong Learning CONSPECT tool. Presentation given at the Onderwijslunch, University of Maastricht. January, 18, 2011, Maastricht, The Netherlands.

  18. Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine.

    Manning, Blaine T; Bohl, Daniel D; Hannon, Charles P; Redondo, Michael L; Christian, David R; Forsythe, Brian; Nho, Shane J; Bach, Bernard R

    2018-04-01

    Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician's midlevel provider to patients when initially selecting a physician. Cross-sectional study; Level of evidence, 3. A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians. Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician's midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation. As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient

  19. Health Care Provider Accommodations for Patients with Communication Disorders

    Burns, Michael I.; Baylor, Carolyn; Dudgeon, Brian J.; Starks, Helene; Yorkston, Kathryn

    2017-01-01

    Health care providers can experience increased diffculty communicating with adult patients during medical interactions when the patients have communication disorders. Meeting the communication needs of these patients can also create unique challenges for providers. The authors explore Communication Accommodation Theory (H. Giles, 1979) as a guide…

  20. 48 CFR 1652.204-74 - Large provider agreements.

    2010-10-01

    ... FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION CLAUSES AND FORMS CONTRACT CLAUSES Texts of FEHBP... Large Provider Agreement; and (ii) Not less than 60 days before exercising a renewal or other option, or... exercising a simple renewal or other option contemplated by a Large Provider Agreement that OPM previously...

  1. 42 CFR 422.204 - Provider selection and credentialing.

    2010-10-01

    ... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Relationships With Providers § 422.204... with respect to providers and suppliers who have signed contracts or participation agreements that— (1... indicators such as those collected through quality improvement programs, utilization management systems...

  2. Initial Validation of the Mental Health Provider Stigma Inventory

    Kennedy, Stephanie C.; Abell, Neil; Mennicke, Annelise

    2017-01-01

    Objective: To conduct an initial validation of the mental health provider stigma inventory (MHPSI). The MHPSI assesses stigma within the service provider--client relationship on three domains--namely, attitudes, behaviors, and coworker influence. Methods: Initial validation of the MHPSI was conducted with a sample of 212 mental health employees…

  3. 25 CFR 20.402 - When are protective services provided?

    2010-04-01

    ... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.402 When are protective services provided? Protective services are provided when children or adults: (a) Are deprived temporarily or permanently of needed supervision by responsible adults; (b) Are neglected, abused or exploited...

  4. Impact of Health Care Provider's Training on Patients ...

    Material and Methods: A situation analysis was done before training to assess existing practice of providers' communication skills and patient's satisfaction. All care providers in labour ward were trained and their practice was assessed before and after training. A ten percent sample of patients delivered in hospital before ...

  5. Ten ways for provider units to weather this economic downturn.

    Bernard, Amy

    2009-05-01

    The current economic recession challenges all continuing nursing education provider units to review operational practices and explore ways to maintain and ensure financial viability. Adjustments in programs are likely, as nurses seek more cost-effective ways of meeting their continuing education requirements. Further, employers are reducing staff and budgets. As a result, provider units need to reassess operations and refocus outcomes.

  6. 42 CFR 495.304 - Medicaid provider scope and eligibility.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Medicaid provider scope and eligibility. 495.304 Section 495.304 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.304 Medicaid provider scope and...

  7. 42 CFR 495.310 - Medicaid provider incentive payments.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Medicaid provider incentive payments. 495.310 Section 495.310 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.310 Medicaid provider incentive...

  8. Providing Medical Care in Yekaterynoslav during World War I

    V.V. Haponov

    2015-04-01

    Full Text Available Providing medical care to the ill and wounded persons during World War I in Yekaterynoslav is described. The history of the creation of field hospitals, military hospitals, Red Cross hospitals and church-monument to the fallen heroes is presented. The selfless work of military medical personnel is shown. Biographical information about a doctor, public figure Yefim Pavlovskyi is provided.

  9. The Content-Provider Paradox: Universities in the Information Ecosystem.

    Vaidhyanathan, Siva

    2002-01-01

    Asserts that universities' rush to abandon their role as "national parks" in the information ecosystem in favor of becoming profitable "content providers" has led to a paradox: to generate new knowledge, researchers and teachers need broad content freedom, but the role of content provider requires highly restrictive policies to…

  10. Predictors of radiation exposure to providers during percutaneous nephrolithotomy

    David L Wenzler

    2017-01-01

    Conclusion: Increased stone burden, partial or staghorn calculi, surgery and fluoroscopy duration, and absence of preexisting access were associated with high provider radiation exposure. Radiation safety awareness is essential to minimize exposure and to protect the patient and all providers from potential radiation injury.

  11. 28 CFR 92.8 - Providing recruitment services.

    2010-07-01

    ... populations to a police department. The recruitment strategies employed may include: (a) A process for... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Providing recruitment services. 92.8... POLICING SERVICES (COPS) Police Recruitment Program Guidelines § 92.8 Providing recruitment services. The...

  12. Evaluation of patients ' satisfaction with quality of care provided at ...

    Background: The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery. Objective: This study was aimed at evaluating patientsf satisfaction with quality of care provided ...

  13. 42 CFR 489.102 - Requirements for providers.

    2010-10-01

    ..., nursing facilities, home health agencies, providers of home health care (and for Medicaid purposes... individual's admission as a resident. (3)(i) In the case of a home health agency, in advance of the... 42 Public Health 5 2010-10-01 2010-10-01 false Requirements for providers. 489.102 Section 489.102...

  14. Health Providers' Perception towards Safe Abortion Service at ...

    In Ethiopia, unsafe abortion accounts up to 32% of maternal deaths. The perception of health providers towards safe abortion provision at selected health facilities in Addis Ababa, Ethiopia was assessed. A stratified random sampling was used to select 431 health providers. A cross-sectional study was conducted from ...

  15. Demographics of US pediatric contact dermatitis registry providers.

    Goldenberg, Alina; Jacob, Sharon E

    2015-01-01

    Children are as likely as adults to be sensitized and reactive to contact allergens. However, the prevailing data on pediatric allergic contact dermatitis are quantitatively and qualitatively limited because of a narrow geographic localization of data-reporting providers. The aim of the study was to present the first quarter results from the Loma Linda Pediatric Contact Dermatitis Registry focused on registered providers who self-identified as providing care for pediatric allergic contact dermatitis (ACD) within the United States. The US providers were invited to join the registry via completion of an online, secure, 11-question registration survey addressing demographics and clinical practice essentials. The presented results reflect data gathered within the first quarter of registry recruitment; registration is ongoing. Of 169 responders from 48 states, the majority of providers were female (60.4%), academic (55.6%), and dermatologists (76.3%). Based on individual provider averages, the minimum cumulative number of pediatric patch-test evaluations performed each year ranged between 1372 and 3468 children. The Pediatric Contact Dermatitis Registry provides a description of the current leaders in the realm of pediatric ACD and gaps, which are in need of attention. The registry allows for a collaborative effort to exchange information, educate providers, and foster investigative research with the hope of legislation that can reduce the disease burden of ACD in US children.

  16. Damage Detection/Locating System Providing Thermal Protection

    Woodard, Stanley E. (Inventor); Jones, Thomas W. (Inventor); Taylor, Bryant D. (Inventor); Qamar, A. Shams (Inventor)

    2010-01-01

    A damage locating system also provides thermal protection. An array of sensors substantially tiles an area of interest. Each sensor is a reflective-surface conductor having operatively coupled inductance and capacitance. A magnetic field response recorder is provided to interrogate each sensor before and after a damage condition. Changes in response are indicative of damage and a corresponding location thereof.

  17. Access to finance from different finance provider types

    Wulandari, Eliana; Meuwissen, Miranda P.M.; Karmana, Maman H.; Oude Lansink, Alfons G.J.M.

    2017-01-01

    Analysing farmer knowledge of the requirements of finance providers can provide valuable insights to policy makers about ways to improve farmers’ access to finance. This study compares farmer knowledge of the requirements to obtain finance with the actual requirements set by different finance

  18. Framing the future: sme logistics service providers and scenario planning

    Stef Weijers; Reinder Pieters; Allan Woodburn; Hans-Heinrich Glöckner

    2013-01-01

    In recent years, the transport industry has encountered numerous challenges. It experienced strong growth, but also many uncertainties. In many cases, logistics service providers were forced to change their strategy. So, the question for logistics service providers arises “how to deal best with

  19. 20 CFR 670.640 - Are students provided with clothing?

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Are students provided with clothing? 670.640 Section 670.640 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR THE JOB... the work force. Center operators and other service providers must issue clothing and clothing...

  20. How Childcare Providers Interpret "Reasonable Suspicion" of Child Abuse

    Levi, Benjamin H.; Crowell, Kathryn; Walsh, Kerryann; Dellasega, Cheryl

    2015-01-01

    Background: Childcare providers are often "first responders" for suspected child abuse, and how they understand the concept of "reasonable suspicion" will influence their decisions regarding which warning signs warrant reporting. Objective: The purpose of this study was to investigate how childcare providers interpret the…

  1. 5 CFR 9701.407 - Monitoring performance and providing feedback.

    2010-01-01

    ... feedback. 9701.407 Section 9701.407 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN... performance and providing feedback. In applying the requirements of the performance management system and its... organization; and (b) Provide timely periodic feedback to employees on their actual performance with respect to...

  2. 78 FR 17612 - Health Insurance Providers Fee; Correction

    2013-03-22

    ... Health Insurance Providers Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... guidance on the annual fee imposed on covered entities engaged in the business of providing health insurance for United States health risks. FOR FURTHER INFORMATION CONTACT: Charles J. Langley, Jr. at (202...

  3. Health Providers' Counselling of Caregivers in the Integrated ...

    Results: Health providers performed well in assessing the child's problem (85%); listening (100%); use of simple language (95%); use of kind tone of voice (99%); showing interest in caregivers (99%); giving feeding ... Keywords: Child, preschool; infant; health-provider; caregiver; counselling; IMCI-counselling; Uganda

  4. Attitudes and Perceptions of Healthcare Providers and Medical ...

    Purpose: To explore healthcare providers' (HCPs) and medical students' attitudes to, and perceptions of the pharmaceutical services that clinical pharmacists can provide in United Arab Emirates. Methods: A total of 535 participants (265 HCPs and 270 medical students) were asked to complete a questionnaire over a ...

  5. Gateway to Quality: Online Professional Development for Family Childcare Providers

    Durden, Tonia; Mincemoyer, Claudia; Crandall, Leslie; Alviz, Kit; Garcia, Aileen

    2016-01-01

    High-quality family childcare (FCC) can positively influence all areas of a child's growth and development. Thus, it is important to invest in efforts to increase quality, including providing professional development to enhance the skills of those caring for children in their homes. This study explores the characteristics of FCC providers who…

  6. Understanding Emotional Development: Helping Early Childhood Providers Better Support Families

    Edwards, Nicole Megan

    2012-01-01

    This article is intended to provide early childhood providers with a concise overview of emerging emotional development in young children (birth-5), the important role of primary caregivers, and the link between parenting, emotional development, and behavior. Specific suggestions that have been shared with urban Head Start mothers are offered,…

  7. ContextProvider: Context awareness for medical monitoring applications.

    Mitchell, Michael; Meyers, Christopher; Wang, An-I Andy; Tyson, Gary

    2011-01-01

    Smartphones are sensor-rich and Internet-enabled. With their on-board sensors, web services, social media, and external biosensors, smartphones can provide contextual information about the device, user, and environment, thereby enabling the creation of rich, biologically driven applications. We introduce ContextProvider, a framework that offers a unified, query-able interface to contextual data on the device. Unlike other context-based frameworks, ContextProvider offers interactive user feedback, self-adaptive sensor polling, and minimal reliance on third-party infrastructure. ContextProvider also allows for rapid development of new context and bio-aware applications. Evaluation of ContextProvider shows the incorporation of an additional monitoring sensor into the framework with fewer than 100 lines of Java code. With adaptive sensor monitoring, power consumption per sensor can be reduced down to 1% overhead. Finally, through the use of context, accuracy of data interpretation can be improved by up to 80%.

  8. Costs and Performance of English Mental Health Providers.

    Moran, Valerie; Jacobs, Rowena

    2017-06-01

    Despite limited resources in mental health care, there is little research exploring variations in cost performance across mental health care providers. In England, a prospective payment system for mental health care based on patient needs has been introduced with the potential to incentivise providers to control costs. The units of payment under the new system are 21 care clusters. Patients are allocated to a cluster by clinicians, and each cluster has a maximum review period. The aim of this research is to explain variations in cluster costs between mental health providers using observable patient demographic, need, social and treatment variables. We also investigate if provider-level variables explain differences in costs. The residual variation in cluster costs is compared across providers to provide insights into which providers may gain or lose under the new financial regime. The main data source is the Mental Health Minimum Data Set (MHMDS) for England for the years 2011/12 and 2012/13. Our unit of observation is the period of time spent in a care cluster and costs associated with the cluster review period are calculated from NHS Reference Cost data. Costs are modelled using multi-level log-linear and generalised linear models. The residual variation in costs at the provider level is quantified using Empirical Bayes estimates and comparative standard errors used to rank and compare providers. There are wide variations in costs across providers. We find that variables associated with higher costs include older age, black ethnicity, admission under the Mental Health Act, and higher need as reflected in the care clusters. Provider type, size, occupancy and the proportion of formal admissions at the provider-level are also found to be significantly associated with costs. After controlling for patient- and provider-level variables, significant residual variation in costs remains at the provider level. The results suggest that some providers may have to increase

  9. Providers' Perceptions of Challenges in Obstetrical Care for Somali Women

    Jalana N. Lazar

    2013-01-01

    Full Text Available Background. This pilot study explored health care providers’ perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers’ experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC. Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement.

  10. Employee motivation in Product-Service-System providers

    Kreye, Melanie

    2016-01-01

    This research investigates how intrinsic and extrinsic motivation factors contribute to employee motivation in providers of Product-Service Systems (PSS). Employee motivation determines the quality of the delivered service and is thus an area of great importance for PSS providers. We present rich...... case-based data collected through semi-structured interviews, a survey and secondary sources. The analysis showed the particularly high importance of intrinsic and individual motivation factors such as the fulfilling nature of the work and skill development showing the ownership and pride service...... employees took in their work. Further, the organisation needs to set the context of high employee motivation by enabling flexibility and performance feedback. Our research contributes to the literature by providing a first empirical study of employee motivation in PSS providers and thus providing important...

  11. Providing a computing environment for a high energy physics workshop

    Nicholls, J.

    1991-03-01

    Although computing facilities have been provided at conferences and workshops remote from the hose institution for some years, the equipment provided has rarely been capable of providing for much more than simple editing and electronic mail over leased lines. This presentation describes the pioneering effort involved by the Computing Department/Division at Fermilab in providing a local computing facility with world-wide networking capability for the Physics at Fermilab in the 1990's workshop held in Breckenridge, Colorado, in August 1989, as well as the enhanced facilities provided for the 1990 Summer Study on High Energy Physics at Snowmass, Colorado, in June/July 1990. Issues discussed include type and sizing of the facilities, advance preparations, shipping, on-site support, as well as an evaluation of the value of the facility to the workshop participants

  12. EMS providers do not use FOAM for education.

    Bucher, Joshua; Donovan, Colleen; McCoy, Jonathan

    2018-05-24

    Free open access to medical education (FOAM, #FOAM) is the free availability of educational materials on various medicine topics. We hope to evaluate the use of social media and FOAM by emergency medical services (EMS) providers. We designed an online survey distributed to EMS providers with questions about demographics and social media/FOAM use by providers. The survey was sent to the American College of Emergency Physicians (ACEP) EMS Listserv of medical directors and was asked to be distributed to their respective agencies. The survey was designed to inquire about the providers' knowledge of FOAM and social media and their use of the above for EMS education. There were 169 respondents out of a total of 523 providers yielding a response rate of 32.3%. Fifty-three percent of respondents are paramedics, 37% are EMT-Basic trained, and the remainder (16%) were "other." The minority (20%) of respondents had heard of FOAM. However, 54% of respondents had heard of "free medical education online" regarding pertinent topics. Of the total respondents who used social media for education, 31% used Facebook and 23% used blogs and podcasts as resources for online education. Only 4% of respondents stated they produced FOAM content. Seventy-six percent of respondents said they were "interested" or "very interested" in using FOAM for medical education. If FOAM provided continuing medical education (CME), 83% of respondents would be interested in using it. Social media is not used frequently by EMS providers for the purposes of FOAM. There is interest within EMS providers to use FOAM for education, even if CME was not provided. FOAM can provide a novel area of education for EMS.

  13. Otolaryngology Needs in a Free Clinic Providing Indigent Care.

    Hu, Amanda; Sibert, Thomas; Zhao, Wei; Zarro, Vincent

    2016-06-01

    To determine the otolaryngology needs in a free clinic providing care to medically indigent patients, as perceived by the patients and health care providers. Cross-sectional survey. A survey was administered to patients and health care providers of a free clinic from September 2014 through January 2015 in an urban, inner-city location. One hundred and thirty-seven patients (35.8% male, age 50.8 ± 13.0 years) completed the survey. Mean household income was $29,838 ± $10,425; 32.1% spoke English; 54.7% were employed; 10.2% had health insurance; and 37.2% had seen a primary care provider outside of the free clinic. The top three otolaryngology symptoms among patients were sleep apnea/snoring (39.4%), heartburn/reflux (30.7%), and dizziness (29.9%). Eleven health care providers (45% male, age 50.5 ± 15.3 years, 63.6% physician, 36% nurse) completed the survey. Providers perceived the following otolaryngology complaints as the most prevalent, in descending order: cough, nasal congestion, reflux/heartburn, sore throat, and ear infection/otalgia. Providers felt that sleep apnea and hearing loss were the less common otolaryngology complaints, whereas surveyed patients indicated these symptoms with high frequency. The most requested diagnostic tool among patients and providers was chest X-rays. There are unmet otolaryngology needs in a free clinic. Medically indigent patients have significant barriers to accessing health care. Patient and provider perceptions of top otolaryngology complaints differed, but both identified access to chest X-rays as a major unmet need. Knowledge of patient perceptions may help providers elicit the breadth of otolaryngology complaints. 4. Laryngoscope, 126:1321-1326, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  14. WIC providers' perspectives on offering smoking cessation interventions.

    Aquilino, Mary Lober; Goody, Cynthia M; Lowe, John B

    2003-01-01

    To examine the perspectives of WIC clinic providers on offering smoking cessation interventions for pregnant women. Four focus groups consisting of WIC nurses, dietitians, and social workers (N = 25) were conducted at WIC clinics in eastern Iowa. Researchers developed discussion guidelines to determine how WIC providers currently approached pregnant women who smoke cigarettes and what they considered barriers to providing effective smoking cessation interventions. Code mapping was used to analyze focus group discussions. Factors influencing the ability of WIC staff to provide a smoking cessation intervention for pregnant women included available time, clinic priorities, staff approaches to clients, and staff training. In addition, providers expressed concerns about educational materials for clients as well as additional client issues that prevented smoking cessation. The absence of mechanisms to track clinic outcomes related to smoking cessation was also noted. WIC providers have time limitations that may necessitate minimal or low-intensity interventions for smoking cessation, but did not know that such approaches are actually effective. WIC providers require more education about the entire issue of smoking cessation in order to become more proactive in their attempts to help pregnant women quit. Training that enhances self-efficacy and understanding of the impact of smoking on mothers, infants, and children should be initiated to motivate staff to intervene. Another strategy to motivate WIC staff in this regard could be tracking clinic outcomes in helping women to quit smoking or prevent relapse.

  15. Characteristics of Adolescents Lacking Provider-Recommended Human Papillomavirus Vaccination.

    Krakow, Melinda; Beavis, Anna; Cosides, Olivia; Rositch, Anne F

    2017-05-01

    To characterize subgroups of teens in the United States for whom provider recommendation is less likely to impact human papillomavirus (HPV) vaccine initiation. We analyzed provider-verified vaccination data from the Centers for Disease Control and Prevention's 2014 National Immunization Survey-Teen. Poisson regression models identified characteristics associated with the lack of HPV vaccine initiation among teens who received a provider recommendation (n = 12,742). Top qualitative reasons for nonvaccination among teens who received a provider recommendation were summarized (n = 1,688). Among teens with provider recommendations, males, younger teens, and white teens were less likely to initiate vaccination, compared to peers. Believing the vaccine was unnecessary, concerns about safety and lack of vaccine knowledge were common reasons parents did not initiate the vaccine, despite receiving provider recommendations. These key subgroups and barriers to HPV vaccination should be targeted with interventions that complement provider recommendation to achieve broad vaccine uptake in the United States. Published by Elsevier Inc.

  16. Privately Provided Accommodation Service Quality and Customer Satisfaction

    Joshua Mugambwa

    2016-04-01

    Full Text Available Privately provided accommodation is a growing service in Uganda’s higher education sector due to education liberalization and demand for education. This research took a case study of Nsamizi Training Institute of Social Development (NTISD to determine the relationship between privately provided accommodation service quality and customer satisfaction. Specifically, the objectives of the study were (a to find out the relationship between security and NTISD students’ satisfaction with privately provided accommodation, and (b to find out the hierarchical level of importance of NTISD student satisfaction of the three service quality dimensions (reliability, security, and tangibles with privately provided accommodation. Using quantitative and qualitative modes of data analysis and a sample of 300 students from 20 private hostels, this study established a strong positive significant relationship between security and satisfaction regarding privately provided accommodation. This implies that accommodation service providers should increase the quality of security so as to increase the satisfaction of students regarding privately provided accommodation. The study established the hierarchical order of importance from the most important service quality dimension, respectively, as follows: reliability, security, and tangibles. Therefore, private accommodation service managers should pay extra attention to the dimensions in the same order.

  17. Advance Directives in Hospice Healthcare Providers: A Clinical Challenge.

    Luck, George R; Eggenberger, Terry; Newman, David; Cortizo, Jacqueline; Blankenship, Derek C; Hennekens, Charles H

    2017-11-01

    On a daily basis, healthcare providers, especially those dealing with terminally ill patients, such as hospice workers, witness how advance directives help ensure the wishes of patients. They also witness the deleterious consequences when patients fail to document the care they desire at their end of life. To the best of our knowledge there are no data concerning the prevalence of advance directives among hospice healthcare providers. We therefore explored the prevalence and factors influencing completion rates in a survey of hospice healthcare providers. Surveys that included 32 items to explore completion rates, as well as barriers, knowledge, and demographics, were e-mailed to 2097 healthcare providers, including employees and volunteers, at a nonprofit hospice. Of 890 respondents, 44% reported having completed an advance directive. Ethnicity, age, relationship status, and perceived knowledge were all significant factors influencing the completion rates, whereas years of experience or working directly with patients had no effect. Procrastination, fear of the subject, and costs were common reasons reported as barriers. Upon completion of the survey, 43% said they will now complete an advance directive, and 45% will talk to patients and families about their wishes. The majority of hospice healthcare providers have not completed an advance directive. These results are very similar to those for other healthcare providers treating patients with terminal diseases, specifically oncologists. Because, at completion, 43% said that they would now complete an advance directive, such a survey of healthcare providers may help increase completion rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

    Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

    2017-10-31

    The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

  19. Customer assessment of long-term care pharmacy provider services.

    Clark, Thomas R

    2008-09-01

    Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

  20. Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review.

    Luu, Ngoc-Phuong; Pitts, Samantha; Petty, Brent; Sawyer, Melinda D; Dennison-Himmelfarb, Cheryl; Boonyasai, Romsai Tony; Maruthur, Nisa M

    2016-04-01

    Most research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communication and its impact on quality of care. We searched the MEDLINE, CINAHL, Scopus, EMBASE, and Cochrane databases for English-language articles describing direct communication between outpatient providers and acute care providers around patients presenting to the emergency department or admitted to the hospital. We conducted double, independent review of titles, abstracts, and full text articles. Conflicts were resolved by consensus. Included articles were abstracted using standardized forms. We maintained search results via Refworks (ProQuest, Bethesda, MD). Risk of bias was assessed using a modified version of the Downs' and Black's tool. Of 4009 citations, twenty articles evaluated direct provider-to-provider communication around the outpatient to acute care transition. Most studies were cross-sectional (65%), conducted in the US (55%), and studied communication between primary care and inpatient providers (62%). Of three studies reporting on the association between communication and 30-day readmissions, none found a significant association; of these studies, only one reported a measure of association (adjusted OR for communication vs. no communication, 1.08; 95% CI 0.92-1.26). The literature on provider-to-provider communication at the transition from outpatient to acute care is sparse and heterogeneous. Given the known importance of communication for other transitions of care, future studies are needed on provider-to-provider communication during this transition. Studies evaluating ideal methods for communication to reduce medical errors, utilization, and optimize patient satisfaction at this transition are especially needed.

  1. The effect of narrow provider networks on health care use.

    Atwood, Alicia; Lo Sasso, Anthony T

    2016-12-01

    Network design is an often overlooked aspect of health insurance contracts. Recent policy factors have resulted in narrower provider networks. We provide plausibly causal evidence on the effect of narrow network plans offered by a large national health insurance carrier in a major metropolitan market. Our econometric design exploits the fact that some firms offer a narrow network plan to their employees and some do not. Our results show that narrow network health plans lead to reductions in health care utilization and spending. We find evidence that narrow networks save money by selecting lower cost providers into the network. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Provider integration and local market conditions: a contingency theory perspective.

    Young, G J; Parker, V A; Charns, M P

    2001-01-01

    In recent years we have witnessed an expanding array of organizational arrangements for providing health care services in the U.S. These arrangements integrate previously independent providers at one or more points on the continuum of care. The presence of so many of these arrangements raises the question of whether certain types are more effective than are others to help providers adapt to their environment. This article discusses contingency theory as a conceptual lens for guiding empirical studies of the effectiveness of different types of arrangements.

  3. Claims Procedure for Plans Providing Disability Benefits. Final rule.

    2016-12-19

    This document contains a final regulation revising the claims procedure regulations under the Employee Retirement Income Security Act of 1974 (ERISA) for employee benefit plans providing disability benefits. The final rule revises and strengthens the current rules primarily by adopting certain procedural protections and safeguards for disability benefit claims that are currently applicable to claims for group health benefits pursuant to the Affordable Care Act. This rule affects plan administrators and participants and beneficiaries of plans providing disability benefits, and others who assist in the provision of these benefits, such as third-party benefits administrators and other service providers.

  4. Diarrhea - what to ask your health care provider - adult

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health ... medicines, vitamins, herbs, or supplements I take cause diarrhea? Should I stop taking any of them? What ...

  5. Skin Diseases: Questions for Your Health Care Provider

    Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Questions for Your Health Care Provider Past ... dermatitis worse? What are the most common irritants? Skin cancer What type of skin cancer do I ...

  6. Find Ryan White HIV/AIDS Medical Care Providers

    U.S. Department of Health & Human Services — The Find Ryan White HIV/AIDS Medical Care Providers tool is a locator that helps people living with HIV/AIDS access medical care and related services. Users can...

  7. How Do Health Care Providers Diagnose Intellectual & Developmental Disabilities (IDDs)?

    ... www.nbstrn.org/ or the Centers for Disease Control and Prevention webpage at http://www.cdc.gov/ncbddd/birthdefects/diagnosis.html . Prenatal Screening Health care providers recommend that certain pregnant ...

  8. The status of occupational safety among health service providers in ...

    identify and bring under control at workplaces all health risks; provide ... on the status of occupational safety among hospital workers in Tanzania. ..... The assistance from the IPC/IS. National ... tions of the Healthcare Infection Prevention.

  9. Choosing the right health care provider for pregnancy and childbirth

    ... page: //medlineplus.gov/ency/patientinstructions/000596.htm Choosing the right health care provider for pregnancy and childbirth To use the sharing features on this page, please enable JavaScript. ...

  10. Modeling Market Shares of Competing (e)Care Providers

    van Ooteghem, Jan; Tesch, Tom; Verbrugge, Sofie; Ackaert, Ann; Colle, Didier; Pickavet, Mario; Demeester, Piet

    In order to address the increasing costs of providing care to the growing group of elderly, efficiency gains through eCare solutions seem an obvious solution. Unfortunately not many techno-economic business models to evaluate the return of these investments are available. The construction of a business case for care for the elderly as they move through different levels of dependency and the effect of introducing an eCare service, is the intended application of the model. The simulation model presented in this paper allows for modeling evolution of market shares of competing care providers. Four tiers are defined, based on the dependency level of the elderly, for which the market shares are determined. The model takes into account available capacity of the different care providers, in- and outflow distribution between tiers and churn between providers within tiers.

  11. Institutions, culture and migrants' preference for state-provided welfare

    Schmidt-Catran, Alexander; Careja, Romana

    2017-01-01

    Using the difference-in-differences estimator and data provided by the German Socio-Economic Panel, this article explores migrants’ preferences for state-provided welfare. The study finds evidence that over time, the preferences of immigrants and natives become more similar. We interpret this fin......Using the difference-in-differences estimator and data provided by the German Socio-Economic Panel, this article explores migrants’ preferences for state-provided welfare. The study finds evidence that over time, the preferences of immigrants and natives become more similar. We interpret...... this finding as evidence that the culture of home countries does not have a time-invariant effect, and that immigrants’ welfare preferences are subject to a socializing effect of the host countries’ welfare regime....

  12. Personal Perspectives on Providing Services to Foster Youth

    Whitman, Kenyon L.

    2018-01-01

    Utilizing an academic capital framework and student perspectives, this chapter provides insight into the ways that programs and services can help students develop the skills needed to succeed in college.

  13. Providers' perceptions of parental concerns about HPV vaccination.

    Perkins, Rebecca B; Clark, Jack A

    2013-05-01

    Parental resistance is often posited to explain low rates of human papillomavirus (HPV) vaccine uptake. We sought to describe providers' perceptions of parents' attitudes towards HPV vaccination. Thirty-four providers from four federally qualified community health centers participated in semi-structured interviews related to their experiences discussing HPV vaccination with low-income and minority parents. Providers found that parents were eager to prevent cancer in their daughters. Safety concerns and feeling that vaccination was unnecessary for virgins were reasons for declining vaccination. Providers found that immigrants from low-resource settings were more receptive to HPV vaccination than White middle-class parents due both to personal experience with vaccine-preventable diseases and cervical cancer and more realistic impressions of their children's sexual activity. Immigrants from low-resource settings may be particularly receptive to HPV vaccination, while White middle-class parents may be more likely to defer vaccination due to concerns about safety or sexual issues.

  14. Ecosystem services provided by pacific NW Estuaries: State of knowledge

    Coastal regions in the United States are rapidly developing areas, with increasing urbanization and growing populations. Estuarine and nearshore coastal marine waters provide valuable ecosystem services to resident and transient human communities. In the Pacific Northwest (PNW)...

  15. Patients' Evaluations of Gynecologic Services Provided by Nurse Practitioners.

    Wagener, J. Mark; Carter, Glenna

    1978-01-01

    The development, operating principles, and users' evaluations of a broad based gynecologic program emphasizing effective birth control on a university campus are discussed. A major feature explored is the use of nurse practitioners as the primary service providers. (JMF)

  16. How Do Health Care Providers Diagnose Klinefelter Syndrome?

    ... Email Print How do health care providers diagnose Klinefelter syndrome (KS)? The only way to confirm the presence ... in 166 boys, adolescents and adults with nonmosaic Klinefelter syndrome: A Copenhagen experience. Acta Paediatrica , Jun;100(6), ...

  17. Using the National Provider Identifier for Health Care...

    U.S. Department of Health & Human Services — The establishment in recent years of a National Provider Identifier (NPI) offers a new method for counting and categorizing physicians and other health care...

  18. factors influencing the choice of health care providing facility among

    In the public sector ... Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local ... the consumer of healthcare services cannot control. ..... Acquisition of Stable Food.

  19. Circular, explosion-proof lamp provides uniform illumination

    1966-01-01

    Circular explosion-proof fluorescent lamp is fitted around a TV camera lens to provide shadowless illumination with a low radiant heat flux. The lamp is mounted in a transparent acrylic housing sealed with clear silicone rubber.

  20. Recommendations for providing protection during the transport of uranium hexafluoride

    1987-06-01

    In July 1986 a group of consultants was convened by the IAEA to provide initial guidance on the transport of UF 6 and the regulations for it considering the hazards posed by this material. A Technical Committee meeting was held in November 1986 to finalize the development of the recommendations for providing protection during the transport of UF 6 . This report provides the recommendations resulting from the meetings of these experts. The IAEA recommends that national competent authorities and other relevant national regulatory and standards-related organizations, and appropriate international organizations seriously consider all of the information provided in this report especially the additional requirements set forth in Section III.3 concerning design, manufacturing and testing requirements, design approval requirements, requirements on loading for transport, and requirements for quality assurance and maintenance. This report also deals with United Nations' Recommendations of the Transport of Dangerous Goods, International Modal Regulatory Documents, ANSIN14.1-1982 and ISO/DIS/7195 Standards

  1. Arbitrary Deprivation of an Unregistered Credit Provider's Right to ...

    Arbitrary Deprivation of an Unregistered Credit Provider's Right to Claim Restitution of Performance Rendered Opperman v Boonzaaier (24887/2010) 2012 ZAWCHC 27 (17 April 2012) and National Credit Regulator v Opperman 2013 2 SA 1 (CC)

  2. IPPS Provider Summary for the Top 100 DRGs - FY2011

    U.S. Department of Health & Human Services — A provider level summary of Inpatient Prospective Payment System (IPPS) discharges, average charges and average Medicare payments for the Top 100 Diagnosis-Related...

  3. Electronic circuit provides automatic level control for liquid nitrogen traps

    Turvy, R. R.

    1968-01-01

    Electronic circuit, based on the principle of increased thermistor resistance corresponding to decreases in temperature provides an automatic level control for liquid nitrogen cold traps. The electronically controlled apparatus is practically service-free, requiring only occasional reliability checks.

  4. 75 FR 37971 - Providing Stability and Security for Medicare Reimbursements

    2010-06-30

    ... Part IV The President Memorandum of June 25, 2010--Providing Stability and Security for Medicare Reimbursements #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 75, No. 125 / Wednesday...

  5. 42 CFR 422.354 - Requirements for affiliated providers.

    2010-10-01

    ... satisfaction that it meets the following requirements: (a) The providers are affiliated. For purposes of this..., not less than 51 percent of the voting rights or governance right of another. [63 FR 18134, Apr. 14...

  6. MEDICARE: Improvements Needed in Provider Communications and Contracting Procedures

    Aronovitz, Leslie

    2001-01-01

    .... Under Medicare's fee-for-service system-which accounts for over 80 percent of program beneficiaries physicians, hospitals, and other providers submit claims to receive reimbursement for services...

  7. Customer-Provider Strategic Alignment: A Maturity Model

    Luftman, Jerry; Brown, Carol V.; Balaji, S.

    This chapter presents a new model for assessing the maturity of a ­customer-provider relationship from a collaborative service delivery perspective: the Customer-Provider Strategic Alignment Maturity (CPSAM) Model. This model builds on recent research for effectively managing the customer-provider relationship in IT service outsourcing contexts and a validated model for assessing alignment across internal IT service units and their business customers within the same organization. After reviewing relevant literature by service science and information systems researchers, the six overarching components of the maturity model are presented: value measurements, governance, partnership, communications, human resources and skills, and scope and architecture. A key assumption of the model is that all of the components need be addressed to assess and improve customer-provider alignment. Examples of specific metrics for measuring the maturity level of each component over the five levels of maturity are also presented.

  8. OPPS Provider Summary for 30 Selected APC Groups - CY2011

    U.S. Department of Health & Human Services — A provider level summary of Outpatient Prospective Payment System (OPPS) average estimated submitted charges and average Medicare Payments for 30 selected Ambulatory...

  9. Strategic information systems planning for health service providers.

    Moriarty, D D

    1992-01-01

    There is significant opportunity for health service providers to gain competitive advantage through the innovative use of strategic information systems. This analysis presents some key strategic information systems issues that will enable managers to identify opportunities within their organizations.

  10. Athena: Providing Insight into the History of the Universe

    Murphy, Gloria A.

    2010-01-01

    The American Institute for Aeronautics and Astronautics has provided a Request for Proposal which calls for a manned mission to a Near-Earth Object. It is the goal of Team COLBERT to respond to their request by providing a reusable system that can be implemented as a solid stepping stone for future manned trips to Mars and beyond. Despite Team COLBERT consisting of only students in Aerospace Engineering, in order to achieve this feat, the team must employ the use of Systems Engineering. Tools and processes from Systems Engineering will provide quantitative and semi-quantitative tools for making design decisions and evaluating items such as budgets and schedules. This paper will provide an in-depth look at some of the Systems Engineering processes employed and will step through the design process of a Human Asteroid Exploration System.

  11. Mental Health Providers: Credentials, Services Offered and What to Expect

    ... and specific services they offer Treatment approaches and philosophy Which insurance providers they work with Office hours, ... trademarks of Mayo Foundation for Medical Education and Research. © 1998-2018 Mayo Foundation for Medical Education and ...

  12. Health Worker Opinion/Perception of Health Services provided to ...

    Nancy Kamau

    VDH Industrial Hygiene CC.PO. Box ... conducted to establish relations of mining activities to human health at Selebi. Phikwe is called for. .... Table 1: Demographic data of health service providers and patients in the study area. Medical ...

  13. Satisfaction with information provided to Danish cancer patients

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit

    2013-01-01

    To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction.......To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction....

  14. Planning start-up: digital educational game solutions provider

    Paschalis, Antreas; Ibironke, Fakinkunmi; Essa, Lubna; Alsatrawi, Ali Jawad

    2015-01-01

    Game-based learning is a growing field that provides education with a new perspective of teaching through games. Game based learning is still considered an emerging field due to problems that have been identified in its real applications in official education in classes. The research conducted shows a very attractive market ahead for game based learning around the world. However the businesses success in this domain lie in providing value proposition that addresses the real barriers faced tod...

  15. Randomized, Controlled Trial of CBT Training for PTSD Providers

    2016-10-01

    implement and evaluate a cost effective, web based self-paced training program to provide skills- oriented continuing education for mental health...Product Aim(s) The purpose of this study is to design, implement and evaluate a web based training program providing skills- oriented continuing education ...Rates and Data Quality i. The team collaborated with the VHA NCPTSD to monitor the collection rates and data quality on a weekly basis . b. Create Interim

  16. Quantifying the Lateral Bracing Provided by Standing Steam Roof Systems

    Sorensen, Taylor J.

    2016-01-01

    One of the major challenges of engineering is finding the proper balance between economical and safe. Currently engineers at Nucor Corporation have ignored the additional lateral bracing provided by standing seam roofing systems to joists because of the lack of methods available to quantify the amount of bracing provided. Based on the results of testing performed herein, this bracing is significant, potentially resulting in excessively conservative designs and unnecessary costs. This proje...

  17. Surrogate pregnancy: a guide for Canadian prenatal health care providers

    Reilly, Dan R.

    2007-01-01

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is l...

  18. Physical Profiling Performance of Air Force Primary Care Providers

    2017-08-09

    AFRL-SA-WP-TR-2017-0014 Physical Profiling Performance of Air Force Primary Care Providers Anthony P. Tvaryanas1; William P...COVERED (From – To) September 2016 – January 2017 4. TITLE AND SUBTITLE Physical Profiling Performance of Air Force Primary Care Providers...encounter with their primary care team. An independent medical standards subject matter expert (SME) reviewed encounters in the electronic health record

  19. Military Medics Insight into Providing Womens Health Services

    2015-12-22

    determining a patient’s preference in a provider rather than gender (Buck & Littleton, 2014). Medics, particularly male medics, were keenly aware of...KS, Littleton HL. (2014). Stereotyped beliefs about male and female OB-GYNS: relationship to provider choice and patient satisfaction. Journal of...health care resource during deployment. Male and female IDCs felt obligated to educate women about how to conduct themselves on ship. In a

  20. Accuracy of marketing claims by providers of stereotactic radiation therapy.

    Narang, Amol K; Lam, Edwin; Makary, Martin A; Deweese, Theodore L; Pawlik, Timothy M; Pronovost, Peter J; Herman, Joseph M

    2013-01-01

    Direct-to-consumer advertising by industry has been criticized for encouraging overuse of unproven therapies, but advertising by health care providers has not been as carefully scrutinized. Stereotactic radiation therapy is an emerging technology that has sparked controversy regarding the marketing campaigns of some manufacturers. Given that this technology is also being heavily advertised on the Web sites of health care providers, the accuracy of providers' marketing claims should be rigorously evaluated. We reviewed the Web sites of all U.S. hospitals and private practices that provide stereotactic radiation using two leading brands of stereotactic radiosurgery technology. Centers were identified by using data from the manufacturers. Centers without Web sites were excluded. The final study population consisted of 212 centers with online advertisements for stereotactic radiation. Web sites were evaluated for advertisements that were inconsistent with advertising guidelines provided by the American Medical Association. Most centers (76%) had individual pages dedicated to the marketing of their brand of stereotactic technology that frequently contained manufacturer-authored images (50%) or text (55%). Advertising for the treatment of tumors that have not been endorsed by professional societies was present on 66% of Web sites. Centers commonly claimed improved survival (22%), disease control (20%), quality of life (17%), and toxicity (43%) with stereotactic radiation. Although 40% of Web sites championed the center's regional expertise in delivering stereotactic treatments, only 15% of Web sites provided data to support their claims. Provider advertisements for stereotactic radiation were prominent and aggressive. Further investigation of provider advertising, its effects on quality of care, and potential oversight mechanisms is needed.

  1. Providing Nuclear Criticality Safety Analysis Education through Benchmark Experiment Evaluation

    Bess, John D.; Briggs, J. Blair; Nigg, David W.

    2009-01-01

    One of the challenges that today's new workforce of nuclear criticality safety engineers face is the opportunity to provide assessment of nuclear systems and establish safety guidelines without having received significant experience or hands-on training prior to graduation. Participation in the International Criticality Safety Benchmark Evaluation Project (ICSBEP) and/or the International Reactor Physics Experiment Evaluation Project (IRPhEP) provides students and young professionals the opportunity to gain experience and enhance critical engineering skills.

  2. Financial impact to providers using pediatric combination vaccines.

    Shen, Angela K; Sobczyk, Elizabeth; Simonsen, Lone; Khan, Farid; Esber, Allahna; Andreae, Margie C

    2011-12-01

    To understand the financial impact to providers for using a combination vaccine (Pediarix [GlaxoSmithKline Biologicals, King of Prussia, PA]) versus its equivalent component vaccines for children aged 1 year or younger. Using a subscription remittance billing service offered to private-practice office-based physicians, we analyzed charge and payment information submitted by providers to insurance payers from June 2007 through July 2009. We analyzed provider and payer characteristics, payer comments, and the ratio of vaccine product to immunization administration (IA) codes and computed total charges and payments to providers for both arms of the study. Most providers in our data set were pediatricians (74%), and most payers were commercial (75%), primarily managed care. The ratio of the number of vaccine products to the number of IAs was 1:1 in the majority of the claims. Twenty percent of claims were paid with no adjustment by the payer, whereas 76% of the claims were adjusted for charges that exceeded the contract arrangement or the fee schedule. Providers received $23 less from commercial payers and $13 less from Medicaid for the use of Pediarix compared with the equivalent component vaccines. The mean commercial payment was greater for age-specific Current Procedural Terminology IA codes 90465 and 90466 than for non-age-specific codes 90471 and 90472, whereas the reverse was true for Medicaid. Providers who administer vaccines to children face a reduction in payment when choosing to provide combination vaccines. The new IA codes should be monitored for correction of financial barriers to the use of combination vaccines.

  3. FACTORS PROVIDING THE STRENGHT AND DURABILITY OF CONCRETE

    Bahattin KÜÇÜK

    2000-01-01

    Full Text Available In this study, it has been stated that the project strenght of concrete structures assumed in static and reinforced concrete calculations should also be provided for the concrete produced in construction sites. The effective factors for the production of high quality concrete are explained by interpreting previously made experimantal studies. In this way, by giving preference to scientific studies, engineers, architects, contractors and subcontractors in construction sector are provided to gain practical experience.

  4. Providing Learning Computing Labs using Hosting and Virtualization Technologies

    Armide González

    2011-05-01

    Full Text Available This paper presents a computing hosting system to provide virtual computing laboratories for learning activities. This system is based on hosting and virtualization technologies. All the components used in its development are free software tools. The computing lab model provided by the system is a more sustainable and scalable alternative than the traditional academic computing lab, and it requires lower costs of installation and operation.

  5. Providing general and preconception health care to low income women in family planning settings: perception of providers and clients.

    Bronstein, Janet M; Felix, Holly C; Bursac, Zoran; Stewart, M Kathryn; Foushee, H Russell; Klapow, Joshua

    2012-02-01

    This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006-2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.

  6. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

  7. Sexual health service providers' perceptions of transgender youth in England.

    Lefkowitz, Ayla R F; Mannell, Jenevieve

    2017-05-01

    Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings. © 2017 John Wiley & Sons Ltd.

  8. Basics of Compounding: Providing Pharmacy Services to Bariatric Surgery Patients.

    McElhiney, Linda F

    2018-01-01

    With the rise in obesity, more individuals are choosing bariatric surgery as a means to successfully lose weight and resolve co-morbidities. These patients need lifelong support from friends, family, and healthcare providers. Pharmacists need to be knowledgeable of the unique needs of these patients in order to provide information and recommendations on drug therapies and supplements. When a patient is wheeled out of the operating room following bariatric surgery, his or her life instantly changes. Like an infant, the patient has to slowly learn how to eat and drink again. Physical activity significantly increases. Taste perception changes. Serious medical problems, such as hypertension, type II diabetes, and hypercholesterolemia completely resolve within a couple of months. The patient has to be disciplined and follow the instructions of the bariatric team and other healthcare providers. Since the patient's gastrointestinal tract has been significantly altered, drug therapies may require some modifications too. Bariatric or weight loss surgery is definitely not the easy way to lose weight, but it is a very powerful tool for the patient. Weight loss, and maintaining that weight loss, is a lifelong journey for the patient that requires support from the bariatric team, healthcare provider(s), co-workers, friends, and family. Pharmacists may also provide support for these patients through counseling about their supplements, medications, and compounding medications to meet their specific needs. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  9. The provider perception inventory: psychometrics of a scale designed to measure provider stigma about HIV, substance abuse, and MSM behavior.

    Windsor, Liliane C; Benoit, Ellen; Ream, Geoffrey L; Forenza, Brad

    2013-01-01

    Nongay identified men who have sex with men and women (NGI MSMW) and who use alcohol and other drugs are a vulnerable, understudied, and undertreated population. Little is known about the stigma faced by this population or about the way that health service providers view and serve these stigmatized clients. The provider perception inventory (PPI) is a 39-item scale that measures health services providers' stigma about HIV/AIDS, substance use, and MSM behavior. The PPI is unique in that it was developed to include service provider stigma targeted at NGI MSMW individuals. PPI was developed through a mixed methods approach. Items were developed based on existing measures and findings from focus groups with 18 HIV and substance abuse treatment providers. Exploratory factor analysis using data from 212 health service providers yielded a two dimensional scale: (1) individual attitudes (19 items) and (2) agency environment (11 items). Structural equation modeling analysis supported the scale's predictive validity (N=190 sufficiently complete cases). Overall findings indicate initial support for the psychometrics of the PPI as a measure of service provider stigma pertaining to the intersection of HIV/AIDS, substance use, and MSM behavior. Limitations and implications to future research are discussed.

  10. Accuracy of Referring Provider and Endoscopist Impressions of Colonoscopy Indication.

    Naveed, Mariam; Clary, Meredith; Ahn, Chul; Kubiliun, Nisa; Agrawal, Deepak; Cryer, Byron; Murphy, Caitlin; Singal, Amit G

    2017-07-01

    Background: Referring provider and endoscopist impressions of colonoscopy indication are used for clinical care, reimbursement, and quality reporting decisions; however, the accuracy of these impressions is unknown. This study assessed the sensitivity, specificity, positive and negative predictive value, and overall accuracy of methods to classify colonoscopy indication, including referring provider impression, endoscopist impression, and administrative algorithm compared with gold standard chart review. Methods: We randomly sampled 400 patients undergoing a colonoscopy at a Veterans Affairs health system between January 2010 and December 2010. Referring provider and endoscopist impressions of colonoscopy indication were compared with gold-standard chart review. Indications were classified into 4 mutually exclusive categories: diagnostic, surveillance, high-risk screening, or average-risk screening. Results: Of 400 colonoscopies, 26% were performed for average-risk screening, 7% for high-risk screening, 26% for surveillance, and 41% for diagnostic indications. Accuracy of referring provider and endoscopist impressions of colonoscopy indication were 87% and 84%, respectively, which were significantly higher than that of the administrative algorithm (45%; P 90%) for determining screening (vs nonscreening) indication, but specificity of the administrative algorithm was lower (40.3%) compared with referring provider (93.7%) and endoscopist (84.0%) impressions. Accuracy of endoscopist, but not referring provider, impression was lower in patients with a family history of colon cancer than in those without (65% vs 84%; P =.001). Conclusions: Referring provider and endoscopist impressions of colonoscopy indication are both accurate and may be useful data to incorporate into algorithms classifying colonoscopy indication. Copyright © 2017 by the National Comprehensive Cancer Network.

  11. The state of the psychology health service provider workforce.

    Michalski, Daniel S; Kohout, Jessica L

    2011-12-01

    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of the PsyD degree and the formalization of the predoctoral internship placement system (the APPIC Match) have been well noted, but efforts to gain a complete understanding of professional practice are lacking. Specifically, piecemeal research on the provider workforce has led to the study of specific subpopulations using varying approaches and definitions of those providing direct clinical service. Consequently, estimates of the supply and need for health service providers are distinctly divergent and generate protracted debate in organized psychology. The APA membership directory and the APA Doctorate Employment Surveys have traditionally been relied on for workforce analyses. Yet, these data have become characterized by limited generalizability in recent years because of declining survey response rates and the fact that APA member data may not be as representative of the entire psychology health service provider population as they were previously. The 2008 APA Survey of Psychology Health Service Providers targeted these limitations by including nonmember psychologists in the sampling frame. Results revealed emerging themes in the demographics, work settings, and delivery of health services of the psychology health service provider workforce. Future areas of research for APA and organized psychology to undertake in addressing need and demand are suggested. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

  12. Integrating advanced practice providers into medical critical care teams.

    McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

    2013-03-01

    Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

  13. Building capacity in social service agencies to employ peer providers.

    Gates, Lauren B; Mandiberg, James M; Akabas, Sheila H

    2010-01-01

    While there is evidence that peer providers are valuable to service delivery teams, the agencies where they work face difficulties in fulfilling the potential of including peers on staff effectively. The purpose of this article is to report findings of a pilot test of a workplace strategy that promoted inclusion of peer providers at social service agencies by building organizational capacity to support people with mental health conditions in peer provider roles. The strategy included training, goal setting and ongoing consultation. Seventy-one peer, non-peer and supervisory staff participated from 6 agencies over a one year period. Goal attainment scaling and data from in-depth interviews about perceptions of differences in the ways in which staff are supported, administered prior to and after the consultation period, were used to assess strategy impact. Most frequently staff set goals to respond to role conflict or a lack of support. Staff that met or exceeded their goals utilized the formal structure of consultation to improve communication among themselves, had leadership that sanctioned changes and felt that their participation was of value to the organization and contributed to their individual development. Strategy participation promoted inclusion by initiating changes to policies and practices that devalued the peer provider role, increased skill sets, and formalized lines of communication for sharing information and understanding related to peer providers. Findings demonstrate that a strategy of training, goal setting and consultation can positively affect perceptions of inclusion, and promote implementation of practices associated with inclusive workplaces.

  14. Complexities of Providing Dental Hygiene Services in Community Care Settings.

    Zarkowski, Pamela; Aksu, Mert N

    2016-06-01

    Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits. Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care 'beyond the operatory.' An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Hiring appropriate providers for different populations: acute care nurse practitioners.

    Haut, Cathy; Madden, Maureen

    2015-06-01

    Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. ©2015 American Association of Critical-Care Nurses.

  16. Invisible Support: Effects on the Provider's Positive and Negative Affect.

    König, Claudia; Stadler, Gertraud; Knoll, Nina; Ochsner, Sibylle; Hornung, Rainer; Scholz, Urte

    2016-07-01

    Social support that goes unnoticed by receivers (i.e. invisible support) seems to be most beneficial for the receivers' well-being. The providers' well-being, however, has been neglected so far. This study examines how invisible support is related to the providers' well-being and whether this association is dependent on the providers' relationship satisfaction. Overall, 97 non-smoking partners of smokers who were about to quit smoking were examined. Invisible support was assessed dyadically: partners' reports on smoking-specific provided social support together with smokers' reports on received support were assessed at baseline. Partners' relationship satisfaction was also assessed at baseline. Partners' positive and negative affect were measured at baseline and six-week follow-up. No main effects of invisible instrumental or emotional support occurred. However, partners' relationship satisfaction moderated the association between invisible instrumental support and change in partners' negative and positive affect: For partners with lower relationship satisfaction more invisible instrumental support was related to increased negative affect and decreased positive affect, whereas for partners with higher relationship satisfaction the inverse effects occurred. The study's results emphasise that invisible instrumental support might have emotional costs for the providers. Relationship satisfaction seems to serve as a protective factor. © 2016 The International Association of Applied Psychology.

  17. Brief Mindfulness Practices for Healthcare Providers - A Systematic Literature Review.

    Gilmartin, Heather; Goyal, Anupama; Hamati, Mary C; Mann, Jason; Saint, Sanjay; Chopra, Vineet

    2017-10-01

    Mindfulness practice, where an individual maintains openness, patience, and acceptance while focusing attention on a situation in a nonjudgmental way, can improve symptoms of anxiety, burnout, and depression. The practice is relevant for health care providers; however, the time commitment is a barrier to practice. For this reason, brief mindfulness interventions (eg, ≤ 4 hours) are being introduced. We systematically reviewed the literature from inception to January 2017 about the effects of brief mindfulness interventions on provider well-being and behavior. Studies that tested a brief mindfulness intervention with hospital providers and measured change in well-being (eg, stress) or behavior (eg, tasks of attention or reduction of clinical or diagnostic errors) were selected for narrative synthesis. Fourteen studies met inclusion criteria; 7 were randomized controlled trials. Nine of 14 studies reported positive changes in levels of stress, anxiety, mindfulness, resiliency, and burnout symptoms. No studies found an effect on provider behavior. Brief mindfulness interventions may be effective in improving provider well-being; however, larger studies are needed to assess an impact on clinical care. Published by Elsevier Inc.

  18. Low-Value Service Use in Provider Organizations.

    Schwartz, Aaron L; Zaslavsky, Alan M; Landon, Bruce E; Chernew, Michael E; McWilliams, J Michael

    2018-02-01

    To assess whether provider organizations exhibit distinct profiles of low-value service provision. 2007-2011 Medicare fee-for-service claims and enrollment data. Use of 31 services that provide minimal clinical benefit was measured for 4,039,733 beneficiaries served by 3,137 provider organizations. Variation across organizations, persistence within organizations over time, and correlations in use of different types of low-value services within organizations were estimated via multilevel modeling, with adjustment for beneficiary sociodemographic and clinical characteristics. Organizations provided 45.6 low-value services per 100 beneficiaries on average, with considerable variation across organizations (90th/10th percentile ratio, 1.78; 95 percent CI, 1.72-1.84), including substantial between-organization variation within hospital referral regions (90th/10th percentile ratio, 1.66; 95 percent CI, 1.60-1.71). Low-value service use within organizations was highly correlated over time (r, 0.98; 95 percent CI, 0.97-0.99) and positively correlated between 13 of 15 pairs of service categories (average r, 0.26; 95 percent CI, 0.24-0.28), with the greatest correlation between low-value imaging and low-value cardiovascular testing and procedures (r, 0.54). Use of low-value services in provider organizations exhibited substantial variation, high persistence, and modest consistency across service types. These findings are consistent with organizations shaping the practice patterns of affiliated physicians. © Health Research and Educational Trust.

  19. Behavioral and Psychosocial Characteristics Among Head Start Childcare Providers.

    Ling, Jiying

    2017-01-01

    The aim of the study was twofold: (a) describe behavioral and psychosocial characteristics of Head Start childcare providers including technology use, physical activity, nutrition, depression, and quality of life and (b) examine associations among these characteristics. Using a cross-sectional design, a nonrandom sample of 80 Head Start childcare providers completed an online survey via SurveyMonkey. About 80.1% were overweight or obese. Nearly all had a computer or smartphone. About 55% met the national physical activity recommendation of 150 min/week. Approximately 56.2% did not know the recommended daily servings of fruits and vegetables, and 26.3% had ≥3 servings of vegetables per day. About 38.8% had major depression or dysthymia, and 31.3% had depressive symptoms. The top two perceived health needs were weight loss and stress management. Providing a health promotion and stress management program to childcare providers may benefit both providers and children, considering the strong influence of teachers on children.

  20. Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets.

    Scheffler, Richard M; Arnold, Daniel R

    2017-09-01

    Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration-as measured by the Herfindahl-Hirschman Index (HHI)-interact and are correlated with prices. We found evidence that in the range of the Department of Justice's and Federal Trade Commission's definition of a moderately concentrated market (HHI of 1,500-2,500), insurers have the bargaining power to reduce provider prices in highly concentrated provider markets. In particular, hospital admission prices were 5 percent lower and cardiologist, radiologist, and hematologist/oncologist visit prices were 4 percent, 7 percent, and 19 percent lower, respectively, in markets with high provider concentration and insurer HHI above 2,000, compared to such markets with insurer HHI below 2,000. We did not find evidence that high insurer concentration reduced visit prices for primary care physicians or orthopedists, however. The policy dilemma that arises from our findings is that there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums. Large purchasers of health insurance such as state and federal governments, as well as the use of regulatory approaches, could provide a solution. Project HOPE—The People-to-People Health Foundation, Inc.

  1. Applying the balanced scorecard in healthcare provider organizations.

    Inamdar, Noorein; Kaplan, Robert S; Bower, Marvin

    2002-01-01

    Several innovative healthcare executives have recently introduced a new business strategy implementation tool: the Balanced Scorecard. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: It aligns the organization around a more market-oriented, customer-focused strategy It facilitates, monitors, and assesses the implementation of the strategy It provides a communication and collaboration mechanism It assigns accountability for performance at all levels of the organization It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes. We surveyed executives in nine provider organizations that were implementing the Balanced Scorecard. We asked about the following issues relating to its implementation and effect: 1. The role of the Balanced Scorecard in relation to a well-defined vision, mission, and strategy 2. The motivation for adopting the Balanced Scorecard 3. The difference between the Balanced Scorecard and other measurement systems 4. The process followed to develop and implement the Balanced Scorecard 5. The challenges and barriers during the development and implementation process 6. The benefits gained by the organization from adoption and use. The executives reported that the Balanced Scorecard strategy implementation and performance management tool could be successfully applied in the healthcare sector, enabling organizations to improve their competitive market positioning, financial results, and customer satisfaction. This article concludes with guidelines for other healthcare provider organizations to capture the benefits of the Balanced Scorecard performance management system.

  2. EMSC program manager survey on education of prehospital providers.

    Ngo, Thuy L; Belli, Karen; Shah, Manish I

    2014-01-01

    Although pediatric-specific objectives for the initial education of prehospital providers have been established, uniform implementation of these objectives and guidelines for hours of required pediatric continuing education (CE) for prehospital providers have not been established. To examine the content and number of hours of pediatric-specific education that prehospital providers receive during initial certification and recertification. Second, to identify barriers to implementing specific requirements for pediatric education of prehospital providers. Electronic surveys were sent to 55 EMS for Children (EMSC) State Partnership grantee program managers inquiring about the certification and recertification processes of prehospital providers and barriers to receiving pediatric training in each jurisdiction. We had a 91% response rate for our survey. Specified pediatric education hours exist in more states and territories for recertification (63-67%) than initial certification (41%). Limitations in funding, time, instructors, and accessibility are barriers to enhancing pediatric education. Modifying statewide policies on prehospital education and increasing hands-on training may overcome identified barriers.

  3. Pain Management in CKD: A Guide for Nephrology Providers.

    Koncicki, Holly M; Unruh, Mark; Schell, Jane O

    2017-03-01

    Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis. Management of pain begins with the development of a shared treatment plan, identification of appropriate medications, and continual follow-up and assessment of efficacy and adverse effects. Through adequate pain management, providers can positively affect the health of individual patients and the performance of health care systems. Copyright © 2016 National Kidney Foundation, Inc. All rights reserved.

  4. Modeling patients' acceptance of provider-delivered e-health.

    Wilson, E Vance; Lankton, Nancy K

    2004-01-01

    Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

  5. Financial risk sharing with providers in health maintenance organizations, 1999.

    Gold, Marsha R; Lake, Timothy; Hurley, Robert; Sinclair, Michael

    2002-01-01

    The transfer of financial risk from health maintenance organizations (HMOs) to providers is controversial. To provide timely national data on these practices, we conducted a telephone survey in 1999 of a multi-staged probability sample of HMOs in 20 of the nation's 60 largest markets, accounting for 86% of all HMO enrollees nationally. Among those sampled, 82% responded. We found that HMOs' provider networks with physicians, hospitals, skilled nursing homes, and home health agencies are complex and multi-tiered Seventy-six percent of HMOs in our study use contracts for their HMO products that involve global, professional services, or hospital risk capitation to intermediate entities. These arrangements account for between 24.5 million and 27.4 million of the 55.9 million commercial and Medicare HMO enrollees in the 60 largest markets. While capitation arrangements are particularly common in California, they are more common elsewhere than many assume. The complex layering of risk sharing and delegation of care management responsibility raise questions about accountability and administrative costs in managed care. Do complex structures provide a way to involve providers more directly in managed care, or do they diffuse authority and add to administrative costs?

  6. Paradigm lost: provider concentration and the failure of market theory.

    Vladeck, Bruce C

    2014-06-01

    In classic market theory, increased concentration among providers leads to higher prices for consumers. In the world of contemporary health policy, many stakeholders echo the classic market theory, blaming high health care prices on the increased concentration of providers, such as occurs when hospitals merge or are acquired by other hospitals. Thus, the consolidation of providers has become a convenient target for policy makers who want to be viewed as actively pursuing solutions to the growth in health care spending. Yet many of the factors fueling increased provider concentration are widely believed to be desirable, or practically unavoidable. Meanwhile, health care prices are increasing at historically low levels. Thus, there appears to be a contradiction between efforts to contain health care prices and the fact that aggressive policies aimed at reducing provider concentration might be ineffective and could even have the unintended effect of stunting positive developments. In a group of Health Affairs articles, William Sage and Paul Ginsburg and Gregory Pawlson respond to this conundrum by proposing a range of policy alternatives that, in this author's opinion, are either impractical or counterproductive because they have their roots in classical economic models of an industry with pervasive market failure. More effective and practical responses may be less theoretically elegant but more realistic and more reasonable. Project HOPE—The People-to-People Health Foundation, Inc.

  7. The APT program plan: Providing an assured tritium production capability

    Lisowski, P.W.; Anderson, J.L.; Bishop, W.P.; Boggs, B.; Hall, K.

    1996-01-01

    Tritium is a radioactive hydrogen isotope used in all U.S. nuclear weapons. Because the half-life of tritium is short, 12.3 yr, it must be periodically replenished. To provide a new source, the U.S. Department of Energy (DOE) is sponsoring conceptual design and engineering development and demonstration activities for a plant that will use a high-power proton linear accelerator to produce tritium and will go on-line no later than 2007. The APT project is in the process of completing the conceptual design for a tritium production plant. In addition, there are several important areas under engineering development and demonstration that will ensure an efficient, cost-effective plant design and provide an adequate margin of tritium production. Information provided from this work will be used by the DOE in its 1998 choice of production technology implementation

  8. Surrogate pregnancy: a guide for Canadian prenatal health care providers

    Reilly, Dan R.

    2007-01-01

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks ofsurrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support. PMID:17296962

  9. The financial impact of deployments on reserve health care providers.

    Petinaux, Bruno

    2008-08-01

    This study retrospectively surveyed the financial impact of deployments on 17 U.S. Army Reserve health care providers. Due to multiple mobilizations, 29 separate deployments were reported. The deployments, mostly between 2001 and 2005, typically lasted 3 months during which 86% reported no civilian income and 76% reported no civilian benefits. Solo practice providers reported the greatest financial losses due to continuing financial responsibility related to their civilian practice despite being deployed. Overall, 2 deployments did not change, 9 increased, and 16 decreased the medical officer's income. Two were not reported. In this small retrospective convenience sample study, solo practice U.S. Army Reserve health care providers were found to be at highest risk of financial losses during military deployments. This being said, no price can be put on the privilege of serving our men and women in uniform.

  10. HIV testing and counseling: test providers' experiences of best practices.

    Myers, Ted; Worthington, Catherine; Haubrich, Dennis J; Ryder, Karen; Calzavara, Liviana

    2003-08-01

    Although education is central to HIV testing and counseling, little is known about the educational processes within the testing experience. This study investigated test providers' understandings of testing and counseling best practices. Interviews with a purposive sample of 24 test providers were thematically analyzed. Analysis revealed five best practices specific to HIV education and public health--ensuring information and education for HIV risk reduction, individualization of risk assessment, ensuring test results are given in person, providing information and referrals, and facilitating partner notification--and six practices not specific to HIV counseling relationship building. The latter were building trust and rapport; maintaining professional boundaries; ensuring a comfortable, safe environment; ensuring confidentiality; imparting nonjudgmntal attitude; and self-determination. The identified best practices demonstrated remarkable consistency across respondent subgroups. Although counseling was seen as largely educational and with a preventive focus, it included individualized messages based on assessments of risk, knowledge, and social and cultural characteristics.

  11. Method for providing uranium with a protective copper coating

    Waldrop, Forrest B.; Jones, Edward

    1981-01-01

    The present invention is directed to a method for providing uranium metal with a protective coating of copper. Uranium metal is subjected to a conventional cleaning operation wherein oxides and other surface contaminants are removed, followed by etching and pickling operations. The copper coating is provided by first electrodepositing a thin and relatively porous flash layer of copper on the uranium in a copper cyanide bath. The resulting copper-layered article is then heated in an air or inert atmosphere to volatilize and drive off the volatile material underlying the copper flash layer. After the heating step an adherent and essentially non-porous layer of copper is electro-deposited on the flash layer of copper to provide an adherent, multi-layer copper coating which is essentially impervious to corrosion by most gases.

  12. Prejudice and discrimination from mental health service providers.

    Nemec, Patricia B; Swarbrick, Margaret; Legere, Lyn

    2015-06-01

    This column describes the experience of prejudice and discrimination that some mental health service users encounter in their interactions with service providers and organizations. The intent of this column is to highlight potential action steps to address the negative beliefs and attitudes of service providers that contribute to prejudice and discrimination. This description draws from published material and the authors' experience. If the most effective approaches to reduce public prejudice and discrimination toward people diagnosed with a mental illness are education and contact, then those methods may be useful methods to help mental health service providers view and engage persons served from a strengths-based recovery and wellness orientation. (c) 2015 APA, all rights reserved).

  13. Conceptual Models of the Individual Public Service Provider

    Andersen, Lotte Bøgh; Pedersen, Lene Holm; Bhatti, Yosef

    are used to gain insight on the motivation of public service providers; namely principal-agent theory, self-determination theory and public service motivation theory. We situate the theoretical discussions in the context of public service providers being transferred to private organizations......Individual public service providers’ motivation can be conceptualized as either extrinsic, autonomous or prosocial, and the question is how we can best theoretically understand this complexity without losing too much coherence and parsimony. Drawing on Allison’s approach (1969), three perspectives...... theoretical – to develop a coherent model of individual public service providers – but the empirical illustration also contributes to our understanding of motivation in the context of public sector outsourcing....

  14. Real-time water quality monitoring and providing water quality ...

    EPA and the U.S. Geological Survey (USGS) have initiated the “Village Blue” research project to provide real-time water quality monitoring data to the Baltimore community and increase public awareness about local water quality in Baltimore Harbor and the Chesapeake Bay. The Village Blue demonstration project complements work that a number of state and local organizations are doing to make Baltimore Harbor “swimmable and fishable” 2 by 2020. Village Blue is designed to build upon EPA’s “Village Green” project which provides real-time air quality information to communities in six locations across the country. The presentation, “Real-time water quality monitoring and providing water quality information to the Baltimore Community”, summarizes the Village Blue real-time water quality monitoring project being developed for the Baltimore Harbor.

  15. Surrogate pregnancy: a guide for Canadian prenatal health care providers.

    Reilly, Dan R

    2007-02-13

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks of surrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support.

  16. System and Method for Providing a Climate Data Persistence Service

    Schnase, John L. (Inventor); Ripley, III, William David (Inventor); Duffy, Daniel Q. (Inventor); Thompson, John H. (Inventor); Strong, Savannah L. (Inventor); McInerney, Mark (Inventor); Sinno, Scott (Inventor); Tamkin, Glenn S. (Inventor); Nadeau, Denis (Inventor)

    2018-01-01

    A system, method and computer-readable storage devices for providing a climate data persistence service. A system configured to provide the service can include a climate data server that performs data and metadata storage and management functions for climate data objects, a compute-storage platform that provides the resources needed to support a climate data server, provisioning software that allows climate data server instances to be deployed as virtual climate data servers in a cloud computing environment, and a service interface, wherein persistence service capabilities are invoked by software applications running on a client device. The climate data objects can be in various formats, such as International Organization for Standards (ISO) Open Archival Information System (OAIS) Reference Model Submission Information Packages, Archive Information Packages, and Dissemination Information Packages. The climate data server can enable scalable, federated storage, management, discovery, and access, and can be tailored for particular use cases.

  17. Do prehospital providers and emergency nurses agree on triage assignment?

    Skjøt-Arkil, Helene; Pontoppidan, Louise L; Laursen, Jens O

    2018-01-01

    OBJECTIVES: The aim of this study was to investigate the agreement on triage level between prehospital providers and emergency department (ED) nurses in clinical practice when using the same triage system. The objectives were as follows: (a) What is the agreement of triage between prehospital...... providers and ED nurses, when using Danish Emergency Process Triage (DEPT) correctly? (b) Which part of the triage process yields the highest agreement regarding the final triage? METHODS: The study was a prospective and observational efficacy study. Patients transported to the ED by ambulances were...... included. They were triaged by prehospital providers while being transported by ambulance to the ED, and by ED nurses upon arrival. Triage was done using the DEPT - a five-level triage system based on vital signs and a presenting complaint algorithm. An agreement analysis was performed. RESULTS: DEPT...

  18. Evaluating Common Privacy Vulnerabilities in Internet Service Providers

    Kotzanikolaou, Panayiotis; Maniatis, Sotirios; Nikolouzou, Eugenia; Stathopoulos, Vassilios

    Privacy in electronic communications receives increased attention in both research and industry forums, stemming from both the users' needs and from legal and regulatory requirements in national or international context. Privacy in internet-based communications heavily relies on the level of security of the Internet Service Providers (ISPs), as well as on the security awareness of the end users. This paper discusses the role of the ISP in the privacy of the communications. Based on real security audits performed in national-wide ISPs, we illustrate privacy-specific threats and vulnerabilities that many providers fail to address when implementing their security policies. We subsequently provide and discuss specific security measures that the ISPs can implement, in order to fine-tune their security policies in the context of privacy protection.

  19. Obtaining and providing health information in the community pharmacy setting.

    Iwanowicz, Susan L; Marciniak, Macary Weck; Zeolla, Mario M

    2006-06-15

    Community pharmacists are a valuable information resource for patients and other healthcare providers. The advent of new information technology, most notably the Internet, coupled with the rapid availability of new healthcare information, has fueled this demand. Pharmacy students must receive training that enables them to meet this need. Community advanced pharmacy practice experiences (APPEs) provide an excellent opportunity for students to develop and master drug information skills in a real-world setting. Preceptors must ensure that students are familiar with drug information resources and can efficiently identify the most useful resource for a given topic. Students must also be trained to assess the quality of resources and use this information to effectively respond to drug or health information inquiries. This article will discuss key aspects of providing drug information in the community pharmacy setting and can serve as a guide and resource for APPE preceptors.

  20. Metagenomes provide valuable comparative information on soil microeukaryotes

    Jacquiod, Samuel Jehan Auguste; Stenbæk, Jonas; Santos, Susana

    2016-01-01

    has been identified. Our analyses suggest that publicly available metagenome data can provide valuable information on soil microeukaryotes for comparative purposes when handled appropriately, complementing the current view provided by ribosomal amplicon sequencing methods......., providing microbiologists with substantial amounts of accessible information. We took advantage of public metagenomes in order to investigate microeukaryote communities in a well characterized grassland soil. The data gathered allowed the evaluation of several factors impacting the community structure......, including the DNA extraction method, the database choice and also the annotation procedure. While most studies on soil microeukaryotes are based on sequencing of PCR-amplified taxonomic markers (18S rRNA genes, ITS regions), this work represents, to our knowledge, the first report based solely...

  1. Optimizing Tobacco Cessation Resource Awareness Among Patients and Providers.

    Ma, Laura; Donohue, Caitlin; DeNofrio, Tina; Vitale Pedulla, Lillian; Haddad, Robert I; Rabinowits, Guilherme

    2016-01-01

    Despite receiving a cancer diagnosis, many patients continue to use tobacco during treatment, negatively affecting their outcomes. We hypothesized that limited tobacco cessation (TC) discussion among patients and providers was partially the result of providers' lack of awareness of current TC resources available. We surveyed the head and neck oncology providers (HNOPs) at Dana-Farber Cancer Institute to evaluate their awareness of existing TC resources within the community and performed a 6-month medical record review of active tobacco users (ATUs) to evaluate the frequency of documented TC discussions in clinic. We educated the HNOPs about available TC resources, developed a TC resource teaching sheet, placed a provider alert page in examination rooms as a reminder of TC discussions, and built a TC discussion template to ease documentation. Four weeks postintervention, we resurveyed providers and again performed medical record reviews of ATUs. Preintervention, 13% of HNOPs were aware of TC resources available, and TC discussion documentation was 28%. Postintervention, 100% of HNOPs became aware of the TC resources available, and documentations increased to 56% at 5 months. Identification of ATUs increased from six to 13 per month to 17 to 33 per month post intervention. Eighty-eight percent of HNOPs felt the intervention prompted TC discussions in clinic with their ATUs. The limited number of TC discussions among patients and providers was at least partially the result of unawareness of TC resources available within the community. Educating HNOPs and alerting them to ATUs at their clinic visits successfully prompted TC discussions in clinic. Copyright © 2015 by American Society of Clinical Oncology.

  2. Informing parents about expanded newborn screening: influences on provider involvement.

    Hayeems, Robin Z; Miller, Fiona A; Little, Julian; Carroll, June C; Allanson, Judith; Chakraborty, Pranesh; Wilson, Brenda J; Bytautas, Jessica P; Christensen, Robert J

    2009-09-01

    Expanded newborn screening (NBS) identifies some disorders for which clinical benefit is uncertain, as well as "incidental" findings (eg, carrier status), thus enhancing the need to inform parents about NBS before sample collection. A self-complete survey was sent to a cross-sectional, stratified, random sample of 5 provider groups in Ontario (obstetricians, midwives, family physicians, pediatricians, and nurses). Univariate and multivariate analyses were used to investigate the effects of core beliefs, perceived barriers, and demographic characteristics on the reported frequency of informing parents about NBS before sample collection. Virtually all of the midwives and almost half of the nurses reported discussing NBS with parents, whereas less than one sixth of the physicians did so. Providers who perceived a responsibility to inform parents were 3 times more likely to report doing so than those who did not perceive this responsibility (odds ratio: 2.9 [95% confidence interval: 2.1-4.1]). Those who lacked confidence to inform parents were 70% less likely to discuss NBS with parents compared with those who did not experience this cognitive barrier (odds ratio: 0.3 [95% confidence interval: 0.2-0.4]). Controlling for these covariates, family physicians and obstetricians were more likely than pediatricians to inform parents. These results provide guidance for capacity building among providers who are positioned to inform parents about NBS before sample collection. Our findings call for targeted educational interventions that consider patterns of provider practice related to prenatal and NBS care, seek to redress confidence limitations, and engage key provider groups in the importance of this professional responsibility.

  3. Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

    Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C

    2013-07-23

    Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and

  4. Factors Affecting Number of Diabetes Management Activities Provided by Pharmacists.

    Lo, Annie; Lorenz, Kathleen; Cor, Ken; Simpson, Scot H

    2016-12-01

    Legislative changes since 2007 have given Alberta pharmacists additional authorizations and new practice settings, which should enhance provision of clinical services to patients. This study examined whether these changes are related to the number of diabetes management activities provided by pharmacists. Cross-sectional surveys of Alberta pharmacists were conducted in 2006 and 2015. Both questionnaires contained 63 diabetes management activities, with response options to indicate how frequently the activity was provided. Respondents were grouped by survey year, practice setting, diabetes-specific training and additional authorizations. The number of diabetes management activities provided often or always were compared among groups by using analysis of variance. Data from 128 pharmacists participating in the 2006 survey were compared with 256 pharmacists participating in the 2015 survey; overall mean age was 41.6 (±10.9) years, 245 (64%) were women, mean duration of practice was 16.1 (±11.8) years, 280 (73%) were community pharmacists, 75 (20%) were certified diabetes educators (CDEs), and 100 (26%) had additional prescribing authorization (APA). Pharmacists provided a mean of 28.7 (95% CI 26.3 to 31.2) diabetes management activities in 2006 and 35.2 (95% CI 33.4-37.0) activities in 2015 (p<0.001). Pharmacists who were CDEs provided significantly more activities compared to other pharmacists (p<0.001). In 2015, working in a primary care network and having APA were also associated with provision of more activities (p<0.05 for both comparisons). Pharmacists provided more diabetes management activities in 2015 than in 2006. The number of diabetes management activities was also associated with being a CDE, working in a primary care network or having APA. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  5. Payeeship, financial leverage, and the client-provider relationship.

    Angell, Beth; Martinez, Noriko I; Mahoney, Colleen A; Corrigan, Patrick W

    2007-03-01

    Although representative payeeship provided within clinical settings is believed to have therapeutic benefits, its potential negative impact on the therapeutic alliance or client-provider relationship is of concern. This study examined the effects of payeeship and perceived financial leverage on positive and negative dimensions of the client-provider relationship. The sample consisted of 205 adults ages 18 to 65 with axis I disorders who were receiving mental health services from a large urban community mental health clinic. Information about money management characteristics and ratings of the client-provider relationship were collected via face-to-face interview. Fifty-three percent of the sample had a payee or money manager, and 79% of this group had a clinician payee. Respondents with co-occurring psychotic and substance use disorders, lower functioning, and lower insight about their illness were more likely to have a clinician payee. Forty percent of those with a clinician payee reported perceived financial leverage. Having a clinician payee was also associated with perceived financial leverage and with higher levels of conflict in the case management relationship. When examined in combination, financial leverage was found to mediate the effects of payeeship on conflict in the case management relationship (mean+/-SE=2.37+/-1.33, 95% confidence interval=16-5.52, pconflict in the therapeutic alliance when used as a source of treatment leverage. Although payeeship provides important support and may enhance functional outcomes for the patient, decisions about using the mechanism for promoting treatment adherence should take into account the potential disruption to the client-provider relationship.

  6. Patient-provider language concordance and colorectal cancer screening.

    Linsky, Amy; McIntosh, Nathalie; Cabral, Howard; Kazis, Lewis E

    2011-02-01

    Patient-provider language barriers may play a role in health-care disparities, including obtaining colorectal cancer (CRC) screening. Professional interpreters and language-concordant providers may mitigate these disparities. DESIGN, SUBJECTS, AND MAIN MEASURES: We performed a retrospective cohort study of individuals age 50 years and older who were categorized as English-Concordant (spoke English at home, n = 21,594); Other Language-Concordant (did not speak English at home but someone at their provider's office spoke their language, n = 1,463); or Other Language-Discordant (did not speak English at home and no one at their provider's spoke their language, n = 240). Multivariate logistic regression assessed the association of language concordance with colorectal cancer screening. Compared to English speakers, non-English speakers had lower use of colorectal cancer screening (30.7% vs 50.8%; OR, 0.63; 95% CI, 0.51-0.76). Compared to the English-Concordant group, the Language-Discordant group had similar screening (adjusted OR, 0.84; 95% CI, 0.58-1.21), while the Language-Concordant group had lower screening (adjusted OR, 0.57; 95% CI, 0.46-0.71). Rates of CRC screening are lower in individuals who do not speak English at home compared to those who do. However, the Language-Discordant cohort had similar rates to those with English concordance, while the Language-Concordant cohort had lower rates of CRC screening. This may be due to unmeasured differences among the cohorts in patient, provider, and health care system characteristics. These results suggest that providers should especially promote the importance of CRC screening to non-English speaking patients, but that language barriers do not fully account for CRC screening rate disparities in these populations.

  7. How to Provide Live Library Information via SMS Using Twilio

    Mike Beccaria

    2011-07-01

    Full Text Available Paul Smith’s College provides library hours and workstation availability using SMS Text Messages. The service was implemented using an easy and affordable web-based API for SMS sending and receiving, from twilio.com. A new class of ‘cloud-based‘ SMS vendors make simple SMS-based services efficient and cost-effective to implement, and have many possible applications in the library environment. A simple PHP example is provided which supplies workstation availability over SMS based on a database of computer availability from a previous Code4Lib Journal Article.

  8. Provide good air quality for people and improve their productivity

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...... air" to each individual. The application of this concept is discussed....

  9. Listeriosis and Toxoplasmosis in Pregnancy: Essentials for Healthcare Providers.

    Pfaff, Nicole Franzen; Tillett, Jackie

    2016-01-01

    Listeriosis and toxoplasmosis are foodborne illnesses that can have long-term consequences when contracted during pregnancy. Listeriosis is implicated in stillbirth, preterm labor, newborn sepsis, and meningitis, among other complications. Toxoplasmosis is associated with blindness, cognitive delays, seizures, and hearing loss, among other significant disabilities. Healthcare providers who understand the fundamentals of Listeria and Toxoplasma infection will have the tools to identify symptoms and high-risk behaviors, educate women to make safer decisions, and provide anticipatory guidance if a pregnant woman would become infected with either of these foodborne illnesses.

  10. Interactions between patients and dental care providers: does gender matter?

    Inglehart, Marita R

    2013-04-01

    Research findings concerning the role of gender in patient-physician interactions can inform considerations about the role of gender in patient-dental care provider interactions. Medical research showed that gender differences in verbal and nonverbal communication in medical settings exist and that they affect the outcomes of these interactions. The process of communication is shaped by gender identities, gender stereotypes, and attitudes. Future research needs to consider the cultural complexity and diversity in which gender issues are embedded and the degree to which ongoing value change will shape gender roles and in turn interactions between dental patients and their providers. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers.

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E

    2017-06-08

    Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in

  12. LED provides engineering and electrooptics support to the Laser Program

    Pehrson, D.

    1985-01-01

    The work of the Laser Engineering Division is reviewed. The division provides engineering and electrooptics support to the laser program. The laser program has been an integral part of the efforts to explore the potential of lasers in harnessing thermonuclear fusion for energy and for defense-related physics studies and in efficiently separating fissile fuels

  13. Primary Health Care Providers' Knowledge Gaps on Parkinson's Disease

    Thompson, Megan R.; Stone, Ramona F.; Ochs, V. Dan; Litvan, Irene

    2013-01-01

    In order to determine primary health care providers' (PCPs) knowledge gaps on Parkinson's disease, data were collected before and after a one-hour continuing medical education (CME) lecture on early Parkinson's disease recognition and treatment from a sample of 104 PCPs participating at an annual meeting. The main outcome measure was the…

  14. VET Providers Planning to Deliver Degrees: Good Practice Guide

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…

  15. Private Training Providers: Their Characteristics and Training Activities. Support Document

    Harris, Roger; Simons, Michele; McCarthy, Carmel

    2006-01-01

    This document was produced by the authors based on their research for the report, "Private Training Providers: Their Characteristics and Training Activities," [ED495181] and is an added resource for further information. That study examined the nature of the training activity of private registered training organisations (RTOs) offered to…

  16. An Innovative Interdisciplinary Approach to Providing Internships for College Seniors

    Fuller, Kathy

    2015-01-01

    The undergraduate Business and Human Development (HD) Departments at California State University San Marcos (CSUSM), are collaborating in an innovative interdisciplinary approach to supporting internships with local businesses in order to provide college seniors with experiences in the area of career development known as the "Senior…

  17. Knowledge, attitudes and acceptability to provider-initiated HIV ...

    Abstract: Provider-initiated HIV testing and counseling (PITC) is referred to as routine ... group discussions (FGDs) were conducted with 99 (73 female and 26 male) .... spoke of the right of a sick individual to ask for voluntary counseling and testing. ..... of testing HIV positive: a comparison of stand alone center versus mobile ...

  18. Facilitating Navigation in Quality Manuals by Providing Bookmarks or Similar

    Shaharum bin Ramli

    2012-01-01

    Nuclear Malaysia level quality manuals need to be shared with all divisions. A manual is usually distributed in the form of an electronic document that contains all procedures. Navigation from one heading or procedure to another should be facilitated by providing bookmarks or similar. This paper shows how to do it for Microsoft Word and PDF documents. (author)

  19. Classroom Animals Provide More than Just Science Education

    Herbert, Sandra; Lynch, Julianne

    2017-01-01

    Keeping classroom animals is a common practice in many classrooms. Their value for learning is often seen narrowly as the potential to involve children in learning biological science. They also provide opportunities for increased empathy, as well as socio-emotional development. Realization of their potential for enhancing primary children's…

  20. Metadata and Providing Access to e-Books

    Vasileiou, Magdalini; Rowley, Jennifer; Hartley, Richard

    2013-01-01

    In the very near future, students are likely to expect their universities to provide seamless access to e-books through online library catalogues and virtual learning environments. A paradigm change in terms of the format of books, and especially textbooks, which could have far-reaching impact, is on the horizon. Based on interviews with a number…

  1. Brand name changes help health care providers win market recognition.

    Keesling, G

    1993-01-01

    As the healthcare industry continues to recognize the strategic implications of branding, more providers will undertake an identity change to better position themselves in competitive markets. The paper examines specific healthcare branding decisions, the reasons prompting brand name decisions and the marketing implications for a change in brand name.

  2. Integrating alternative providers into managed care: a case study.

    Broida, M

    1997-09-01

    Alternative medical techniques have become extremely popular, particularly in the western United States. Washington State recently enacted a law requiring certain health plans to include alternative providers on their physician panels. The author describes the efforts of one MCO to comply.

  3. Employability Skills of International Accounting Graduates: Internship Providers' Perspectives

    Jackling, Beverley; Natoli, Riccardo

    2015-01-01

    Purpose: The purpose of this paper is to report on the perceptions of internship providers with respect to the employability skills of international accounting graduates that undertake a Professional Year Program (PYP) incorporating a 12-week (240 hour) internship. Design/methodology/approach: The study involved a survey of internship providers…

  4. Should doctors provide futile medical treatment if patients or their ...

    Ethically and legally doctors are not obliged to provide futile treatment to patients, even if the patient or their proxies are prepared to pay for it. However, it may be justified where such treatment is harmless and has a placebo effect. In deciding about a request for futile treatment, doctors should be guided by the ethical ...

  5. Providing Homeless Adults with Advantage: A Sustainable University Degree Program

    Sinatra, Richard; Lanctot, Melissa Kim

    2016-01-01

    A university partnered with the New York City Department of Homeless Services (NYC DHS) to provide cohorts of adults a 60-credit Associate Degree Program in Business Administration over a 2-year period. Results of two cohorts of 30 Advantage Academy Program graduates revealed significant improvement in College Board AccuPlacer (ACPL) Arithmetic…

  6. Provider Perspectives on Promoting Cervical Cancer Screening Among Refugee Women.

    Zhang, Ying; Ornelas, India J; Do, H Hoai; Magarati, Maya; Jackson, J Carey; Taylor, Victoria M

    2017-06-01

    Many refugees in the United States emigrated from countries where the incidence of cervical cancer is high. Refugee women are unlikely to have been screened for cervical cancer prior to resettlement in the U.S. National organizations recommend cervical cancer screening for refugee women soon after resettlement. We sought to identify health and social service providers' perspectives on promoting cervical cancer screening in order to inform the development of effective programs to increase screening among recently resettled refugees. This study consisted of 21 in-depth key informant interviews with staff from voluntary refugee resettlement agencies, community based organizations, and healthcare clinics serving refugees in King County, Washington. Interview transcripts were analyzed to identify themes. We identified the following themes: (1) refugee women are unfamiliar with preventive care and cancer screening; (2) providers have concerns about the timing of cervical cancer education and screening; (3) linguistic and cultural barriers impact screening uptake; (4) provider factors and clinic systems facilitate promotion of screening; and (5) strategies for educating refugee women about screening. Our findings suggest that refugee women are in need of health education on cervical cancer screening during early resettlement. Frequent messaging about screening could help ensure that women receive screening within the early resettlement period. Health education videos may be effective for providing simple, low literacy messages in women's native languages. Appointments with female clinicians and interpreters, as well as clinic systems that remind clinicians to offer screening at each appointment could increase screening among refugee women.

  7. 75 FR 71448 - Notice of Intent To Provide Supplemental Funding

    2010-11-23

    ... dollars loss annually due to Medicare/Medicaid fraud, error and abuse. The Centers for Medicare & Medicaid Services data has revealed that Medicare fraud is rampant in the Hispanic community. Hispanic older adults... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Notice of Intent To Provide...

  8. SupportNet for Frontline Behavioral Health Providers

    2013-07-01

    such as self-efficacy, more in individualistic cultures (typically Western countries) than in collectivistic cultures (typically Eastern European...were invariant across the 2 studies, which indicated that the STSE Scale may be a culturally unbiased instrument. Keywords: secondary traumatic...the STSE Scale among workers providing services to traumatized civilian population within a different cultural context (in Poland). Extending the

  9. Pathways of Adult Children Providing Care to Older Parents

    Barnett, Amanda E.

    2013-01-01

    Guided by life course and stress process theory, this study investigated pathways of adult child caregivers' family (caregiving, marital, parenting) and nonfamily (employment) roles. Eight waves of data from the Health and Retirement Study were analyzed for 1,300 adult child caregivers. Latent class analysis provided strong evidence for a 4-class…

  10. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  11. Service providers' perception of the quality of emergency obsteric ...

    Facility/staff themes which emerged as contributing to the poor care were; inadequate resources, inadequate staffing, poor teamwork, and inadequate knowledge/supervision. Conclusion The findings of this study reveal that health care workers rate the quality of emergency obstetric care they provide as poor. They were ...

  12. 32 CFR 199.6 - TRICARE-authorized providers.

    2010-07-01

    ... shall implement an effective program to assure a safe environment for patients, staff, and visitors... structured therapeutic environment. Residential treatment is differentiated from: (i) Acute psychiatric care... requirements for a qualified mental health provider but are actively working toward licensure or certification...

  13. Elementary School Counselors' Collaboration with Community Mental Health Providers

    Moran, Kristen; Bodenhorn, Nancy

    2015-01-01

    Perceptions and experiences of elementary school counselors' collaborative efforts with community mental health providers are examined through this exploratory phenomenological study. Ten participants engaged in two in-depth interviews. Collaboration was considered an effective way to increase services to students and their families. Six themes…

  14. Providing for Disabled Students: University of Grenoble, France.

    PEB Exchange, 2000

    2000-01-01

    Examines how France's University of Grenoble provides for its disabled students in its residence halls, including a description of the university's service for disabled service. A hospital/education center where disabled students can receive care and physiotherapy while attending school is highlighted. (GR)

  15. Providers' perceptions of the implementation of a performance ...

    partly due to the lack of a system for reminding providers that patients were due to complete the ... system was feasible to implement as part of standard practice in ... Although the SAATSA is completed by the patients, in cases where they have ... platform is an important goal for this initiative; in the short term we are trying to ...

  16. The expectations of fathers concerning care provided by midwives to ...

    2012-04-06

    Apr 6, 2012 ... qualitative interviews were conducted with fathers about the care provided to their .... Caring, care: (Note: In this study the terms 'care' and 'caring' .... the coder to compare and discuss their analysis in order to ..... contact and by talking. ... couple; fathers focused on the baby's face, open eyes and facial.

  17. 32 CFR 199.14 - Provider reimbursement methods.

    2010-07-01

    ... physicians. (6) All services provided by nurse anesthetists. (7) All services related to discharges involving... more accurate data became available. (v) No update for inflation. The children's hospital differential... considered lower volume hospitals. (B) Hospitals that subsequently become higher volume hospitals. In any...

  18. A framework for providing ergonomic feedback using smart cameras.

    Chen, Chih-Wei; Maatta, T.T.; Wong, K.; Aghajan, H.

    2012-01-01

    The importance of proper ergonomics for the health and wellbeing of office workers is being increasingly promoted by federal agencies, such as the OSHA (Occupational Safety and Health Administration) and the NIOSH (National Institute for Occupational Safety and Health), which provide guidelines for

  19. Obesity among health service providers in Nigeria: danger to long ...

    Introduction: Obesity is a global epidemic. There are rising rates of obesity and its associated disorders, especially in developing countries, including among Health Service Providers (HSPs). Obesity is associated with early retirement, increased morbidity and mortality. Thus, obesity has the potential of reducing long-term ...

  20. Switching Service Providers: Reasons, Service Types, and Sequences

    In Keaveney.s (1995) landmark study on the reasons for switching service providers, data were gathered using critical incident technique (CIT); here the original findings are tested using survey method. Keaveney.s typology of reasons for switching is supported across a range of categories but, in this new study, the reasons ...