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Sample records for staffing levels recommended

  1. Medical physics personnel for medical imaging: requirements, conditions of involvement and staffing levels-French recommendations.

    Science.gov (United States)

    Isambert, Aurélie; Le Du, Dominique; Valéro, Marc; Guilhem, Marie-Thérèse; Rousse, Carole; Dieudonné, Arnaud; Blanchard, Vincent; Pierrat, Noëlle; Salvat, Cécile

    2015-04-01

    The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Quality assurance in radiotherapy: the importance of medical physics staffing levels. Recommendations from an ESTRO/EFOMP joint task group.

    Science.gov (United States)

    Belletti, S; Dutreix, A; Garavaglia, G; Gfirtner, H; Haywood, J; Jessen, K A; Lamm, I L; Mijnheer, B; Noël, A; Nüsslin, F; Rosenow, U; Schneider, P; Seelentag, W; Sheriff, S; Svensson, H; Thwaites, D

    1996-10-01

    The safe application of ionising radiation for diagnosis and therapy requires a high level of knowledge of the underlying processes and of quality assurance. Sophisticated modern equipment can be used effectively for complicated diagnostic and therapeutic techniques only with adequate physics support. In the light of recent analyses and recommendations by national and international societies a joint working group of representatives from ESTRO (European Society for Therapeutic Radiology and Oncology) and from EFOMP (European Federation of Organisations for Medical Physics) was set up to assess the necessary staffing levels for physics support to radiotherapy. The method used to assess the staffing levels, the resulting recommendations and examples of their practical application are described.

  3. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions.

    Science.gov (United States)

    Ms, Suzie Aparicio; Welch Bacon, Cailee E; Parsons, John T; Bay, R Curtis; Cohen, Randy P; DeZeeuw, Terry; McLeod, Tamara C Valovich

    2015-12-01

    The "Appropriate Medical Coverage for Intercollegiate Athletics" (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Cross-sectional study. Web-based survey. Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1-3 FTE athletic trainers for football would change their compliance status. A uniform definition of the term FTE within collegiate athletics is needed to allow for structured

  4. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions

    Science.gov (United States)

    MS, Suzie Aparicio; Welch Bacon, Cailee E.; Parsons, John T.; Bay, R. Curtis; Cohen, Randy P.; DeZeeuw, Terry; McLeod, Tamara C. Valovich

    2015-01-01

    Context The “Appropriate Medical Coverage for Intercollegiate Athletics” (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. Objective To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. Main Outcome Measure(s) The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. Results The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). Conclusions The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1–3 FTE athletic trainers for football would change their

  5. The relationship of California's Medicaid reimbursement system to nurse staffing levels.

    Science.gov (United States)

    Mukamel, Dana B; Kang, Taewoon; Collier, Eric; Harrington, Charlene

    2012-10-01

    Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. Two-stage limited-information maximum-likelihood regressions were used to model the relationship between staffing [registered nurses (RNs), licensed practical nurses, and certified nursing assistants hours per resident day] and the Medicaid payment rate, accounting for the specific structure of the payment system, endogeneity of payment and case-mix, and controlling for facility and market characteristics. A total of 927 California free-standing nursing homes in 2006. The model included facility characteristics (case-mix, size, ownership, and chain affiliation), market competition and excess demand, labor supply and wages, unemployment, and female employment. The instrumental variable for Medicaid reimbursement was the peer group payment rate for 7 geographical market areas, and the instrumental variables for resident case-mix were the average county revenues for professional therapy establishments and the percent of county population aged 65 and over. Consistent with the rate incentives and rational expectation behavior, expected nursing home reimbursement rates in 2008 were associated with increased RN staffing levels in 2006 but had no relationship with licensed practical nurse and certified nursing assistant staffing. The effect was estimated at 2 minutes per $10 increase in rate. The incentives in the Medicaid system impacted only RN staffing suggesting the need to improve the state's rate setting methodology.

  6. [Structure of nurse labor market and determinants of hospital nurse staffing levels].

    Science.gov (United States)

    Park, Bohyun; Seo, Sukyung; Lee, Taejin

    2013-02-01

    To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing. Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions. For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable. The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

  7. Recommended IAEA decommissioning levels

    International Nuclear Information System (INIS)

    Jacquemin, M.

    1977-01-01

    The areas covered by each of the two terms 'decommissioning' and 'dismantling' of a nuclear installation are defined in order to distinguish them with greater accuracy. Decommissioning is first an administrative decision and afterwards all the material operations involved by this decision. Dismantling is only one of the material operations of the decommissioning but it can be the most important. For the IAEA the possible outcomes for a decommissioned installation fall under three main headings (stages) which we call 'decommissioning levels'. - level 1: shut-down with surveillance, - level 2: conditional release for another use, - level 3: unconditional release of the site [fr

  8. [Effects of cost saving strategies and staffing levels on patient and nurse outcomes. A literature review].

    Science.gov (United States)

    Schubert, Maria; Schaffert-Witvliet, Bianca; De Geest, Sabina

    2005-10-01

    The effects of cost saving strategies and changes in staffing levels and skill mix in the inpatient care setting on patient and nurse outcomes have not yet been examined in Switzerland. In 2002 the Swiss Federal Office of Health mandated the Institute of Nursing Science at the University of Basel to conduct a literature review to examine the evidence available on this topic. The literature research and analysis cover the period from 1991 to 2003. Sixty publications out of a total of 260 reviewed abstracts were included and analyzed. The results show that in the inpatient care settings in Switzerland as well as in other countries positions for registered nurses have been reduced and/or the qualification and skill mix in care teams have been downgraded. Given the present health care situation where the intensity and complexity of caring for hospitalized patients is increasing, an imbalance occurs between the need for high quality care and the possibilities to offer this care. This affects patients' and nurses outcomes. The international results show a significant relationship between lower staffing levels and skill mix in care teams and higher complication, "failure-to-rescue", and mortality rates in patients, as well as a lower job satisfaction, and higher fluctuation, burnout and work-related injury rates in nursing personnel. Thus, nursing care within hospitals represents not only a cost factor but also an important quality factor which is essential in order to be able to realize good patient's outcomes.

  9. Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics.

    Science.gov (United States)

    Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado

    2018-01-01

    In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.

  10. The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes

    Science.gov (United States)

    Hyer, Kathryn; Thomas, Kali S.; Branch, Laurence G.; Harman, Jeffrey S.; Johnson, Christopher E.; Weech-Maldonado, Robert

    2011-01-01

    Objective: This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a 4-year period. Methods: Data from Florida staffing reports and the Online Survey Certification and Reporting database examine the relationship among staffing…

  11. Staffing in Radiotherapy: An Activity Based Approach

    International Nuclear Information System (INIS)

    2015-01-01

    Radiotherapy requires competent professional staff to ensure safe and effective patient treatment and management. There is a need to provide guidelines that recommend appropriate staffing levels to support the initiation of new services as well as the expansion or upgrade of existing services as even simple upgrades or replacement of existing equipment may have a significant impact on staffing needs. Similarly, the introduction of education and training programmes will require staffing adjustments. A calculation algorithm was developed to predict staffing levels based on the inputs that are known or can be easily estimated. This publication complements other IAEA publications used to support the initiation of basic radiation medicine services including Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, published in 2008

  12. The effects of ownership, staffing level and organisational justice on nurse commitment, involvement, and satisfaction: a questionnaire study.

    Science.gov (United States)

    Heponiemi, Tarja; Elovainio, Marko; Kouvonen, Anne; Kuusio, Hannamaria; Noro, Anja; Finne-Soveri, Harriet; Sinervo, Timo

    2011-12-01

    Elderly care systems have undergone a lot of changes in many European countries, including Finland. Most notably, the number of private for-profit firms has increased. Previous studies suggest that employee well-being and the quality of care might differ according to the ownership type. The present study examined whether the ownership type and the staffing level were associated with organisational commitment, job involvement, and job satisfaction. In addition, we examined the potential moderating effect of organisational justice on these associations. Cross-sectional questionnaire study. 1047 Finnish female staff members aged 18-69 years working in sheltered housing or nursing homes (units n=179). The relationships were studied with analyses of covariance (ANCOVA), adjusting for the effects of age and case-mix. Organisational commitment and job satisfaction levels were low in for-profit sheltered homes when justice levels were low, but when justice levels were high, for-profit sheltered homes did not differ from other ownership types. Similarly, organisational justice acted as a buffer against low commitment resulting from low staffing levels. Staffing levels were lowest in public sheltered homes and highest in not-for-profit sheltered homes. The results show that organisational justice can act as a buffer against low organisational commitment that results from low staffing levels and working in for-profit sheltered homes. Increasing justice in regard to the management, outcomes, and procedures in the organisation would thus be important. 2011 Elsevier Ltd. All rights reserved.

  13. A survey of nurse staffing levels in interventional radiology units throughout the UK

    International Nuclear Information System (INIS)

    Christie, A.; Robertson, I.

    2016-01-01

    Aim: To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. Materials and methods: A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Results: Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. Conclusion: A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. - Highlights: • A significant disparity exists between the level of nursing support provided in-hours and OOH. • This applies to both the availability of a nurse to scrub and to monitor the patient. • Having a dedicated 24/7 nursing rota is mandatory to providing a deliverable OOH service.

  14. Neuroscience Intermediate-Level Care Units Staffed by Intensivists: Clinical Outcomes and Cost Analysis.

    Science.gov (United States)

    Kyeremanteng, Kwadwo; Hendin, Ariel; Bhardwaj, Kalpana; Thavorn, Kednapa; Neilipovitz, Dave; Kubelik, Dalibour; D'Egidio, Gianni; Stotts, Grant; Rosenberg, Erin

    2017-01-01

    With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units. This retrospective study assessed clinical and cost-related outcomes in an intermediate-level neurosciences acute care unit (NACU) before and after the addition of an intensivist to the unit's care team. Starting in October 2011, an intensivist-led model was adopted in a 16-bed NACU unit, including daytime coverage by a dedicated intensivist. Data were obtained from all patients admitted 1 year prior to and 2 years after this intervention. Primary outcomes were LOS and hospital costs. Safety outcomes included mortality and readmissions. Descriptive and analytic statistics were calculated. Individual and total patient costs were calculated based on per-day NACU and ward cost estimates and significance measured using bootstrapping. A total of 2931 patients were included over the study period. Patients were on average 59.5 years and 53% male. The most common reasons for admission were central nervous system (CNS) tumor (27.6%), ischemic stroke (27%), and subarachnoid hemorrhage (11%). Following the introduction of an intensivist, there was a significant reduction in NACU and hospital LOS, by 1 day and 3 days, respectively. There were no differences in readmissions or mortality. Adding an intensivist produced an individual cost savings of US$963 in NACU and US$2687 per patient total hospital stay. An intensivist-led model of intermediate-level neurointensive care staffed by intensivists is safe, decreases LOS, and produces cost savings in a system increasingly strained to provide quality

  15. Using a nursing productivity committee to achieve cost savings and improve staffing levels and staff satisfaction.

    Science.gov (United States)

    McKenna, Erin; Clement, Kristina; Thompson, Elizabeth; Haas, Kathy; Weber, William; Wallace, Michelle; Stauffer, Cindy; Frailey, Jan; Anderson, Aimee; Deascenti, Missy; Hershiser, Lisa; Roda, Patricia Inama

    2011-12-01

    Challenged by rising costs, higher registered nurse vacancy rates and declining staff morale, a Nursing Productivity Committee was formed to analyze productive and nonproductive hours and seek improvements in our staffing models and scheduling processes. The changes implemented led to lower nurse to patient ratios, better control of labor costs, elimination of agency staff, greater staff satisfaction, and introduction of new technologies. Nurse managers, nursing supervisors, and frontline staff are now more knowledgeable and empowered to use creative solutions to manage their budgets and schedules in these times of fluctuating census and varying vacancy rates.

  16. Raising the Bar with Trades Staffing Guidelines.

    Science.gov (United States)

    Weidner, Theodore J.

    2000-01-01

    Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)

  17. Comprehensive evaluation of contemporary assisted reproduction technology laboratory operations to determine staffing levels that promote patient safety and quality care.

    Science.gov (United States)

    Alikani, Mina; Go, Kathryn J; McCaffrey, Caroline; McCulloh, David H

    2014-11-01

    To consider how staffing requirements have changed with evolving and increasingly more complex assisted reproduction technology (ART) laboratory practice. Analysis by four laboratory directors from three different ART programs of the level of complexity and time requirements for contemporary ART laboratory activities to determine adequate staffing levels. University-based and private ART programs. None. None. Human resource requirements for ART procedures. Both complexity and time required for completion of a contemporary ART cycle have increased significantly compared with the same requirements for the "traditional cycle" of the past. The latter required roughly 9 personnel hours, but a contemporary cycle can require up to 20 hours for completion. Consistent with this increase, a quantitative analysis shows that the number of embryologists required for safe and efficient operation of the ART laboratory has also increased. This number depends on not only the volume but also the types of procedures performed: the higher the number of complex procedures, the more personnel required. An interactive Personnel Calculator is introduced that can help determine staffing needs. The increased complexity of the contemporary ART laboratory requires a new look at the allocation of human resources. Our work provides laboratory directors with a practical, individualized tool to determine their staffing requirements with a view to increasing the safety and efficiency of operations. The work could serve as the basis for revision of the 2008 American Society for Reproductive Medicine (ASRM) staffing guidelines. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Effective Staffing Takes a Village: Creating the Staffing Ecosystem.

    Science.gov (United States)

    Gavigan, Margaret; Fitzpatrick, Therese A; Miserendino, Carole

    2016-01-01

    The traditional approaches to staffing and scheduling are often ineffective in assuring sufficient budgeting and deployment of staff to assure the right nurse at the right time for the right cost. As hospital merger activity increases, this exercise is further complicated by the need to rationalize staffing across multiple enterprises and standardize systems and processes. This Midwest hospital system successfully optimized staffing at the unit and enterprise levels by utilizing operations research methodologies. Savings were reinvested to improve staffing models which provided sufficient nonproductive coverage and patient-driven ratios. Over/under-staffing was eliminated in support of the system's recognition that adequate resource planning and deployment are critical to the culture of safety.

  19. Status of the Texas low-level radioactive waste disposal site - construction sequencing and staffing patterns

    International Nuclear Information System (INIS)

    Jacobi, L.R. Jr.

    1996-01-01

    The Texas Low-Level Radioactive Waste Disposal Authority, an agency of the State of Texas, has been attempting to develop a site for the disposal of low-level radioactive waste in Texas for more than fourteen years. Since 1991, the agency has been evaluating a site near Sierra Blanca, in far west Texas. Site characterization was completed in 1992, and a license application was filed that year. Construction plans were completed in 1993. In April 1996, the licensing agency, the Texas Natural Resource Conservation Commission, completed its review and proposed to issue a license. The administrative hearings on the proposed license should be completed by July 1997. The Authority is prepared to begin construction and operations as soon as a final license can be issued

  20. The European Federation of Organisations for Medical Physics. Policy Statement No. 7.1: The roles, responsibilities and status of the medical physicist including the criteria for the staffing levels in a Medical Physics Department approved by EFOMP Council on 5th February 2016.

    Science.gov (United States)

    Evans, Stephen; Christofides, Stelios; Brambilla, Marco

    2016-04-01

    This EFOMP Policy Statement is an amalgamation and an update of the EFOMP Policy Statements No. 2, 4 and 7. It presents guidelines for the roles, responsibilities and status of the medical physicist together with recommended minimum staffing levels. These recommendations take into account the ever-increasing demands for competence, patient safety, specialisation and cost effectiveness of modern healthcare services, the requirements of the European Union Council Directive 2013/59/Euratom laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation, the European Commission's Radiation Protection Report No. 174: "Guidelines on medical physics expert", as well as the relevant publications of the International Atomic Energy Agency. The provided recommendations on minimum staffing levels are in very good agreement with those provided by both the European Commission and the International Atomic Energy Agency. Copyright © 2016. Published by Elsevier Ltd.

  1. Texas Nurse Staffing Trends Before and After Mandated Nurse Staffing Committees.

    Science.gov (United States)

    Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti

    2015-08-01

    This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives. © The Author(s) 2015.

  2. Staffing Up for Technology Support.

    Science.gov (United States)

    Carter, Kim

    2000-01-01

    Examines current technology staffing in school districts and compares technology-related roles with a similar study conducted in 1997. Discusses job titles; responsibilities; career paths; lack of technology support in schools; district-level support; teacher training; peer assistance; student roles; collaboration with library media specialists;…

  3. Recommended vitamin D levels in the general population.

    Science.gov (United States)

    Varsavsky, Mariela; Rozas Moreno, Pedro; Becerra Fernández, Antonio; Luque Fernández, Inés; Quesada Gómez, José Manuel; Ávila Rubio, Verónica; García Martín, Antonia; Cortés Berdonces, María; Naf Cortés, Silvia; Romero Muñoz, Manuel; Reyes García, Rebeca; Jódar Gimeno, Esteban; Muñoz Torres, Manuel

    2017-03-01

    To provide recommendations based on evidence on the management of vitaminD deficiency in the general population. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the term VitaminD and the name of each issue. Papers in English and Spanish with publication date before 17 March 2016 were included. Recommendations were jointly discussed by the Working Group. This document summarizes the data about vitaminD deficiency in terms of prevalence, etiology, screening indications, adequate levels and effects of supplementation on bone and non-skeletal health outcomes. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Staffing Policy for Solving the Information Security

    Directory of Open Access Journals (Sweden)

    A. I. Tolstoy

    2012-06-01

    Full Text Available Determining staffing policy implementation of information security tasks is given. The basic requirements that must be taken into account when developing policies are defined. The policy framework is determined and recommendations for the design of such policies are formulated. Requirements for the implementation of the policy are defined.

  5. Responses to Human Bioeffluents at Levels Recommended by Ventilation Standards

    DEFF Research Database (Denmark)

    Zhang, Xiaojing; Wargocki, Pawel; Lian, Zhiwei

    2017-01-01

    The purpose of this study was to examine whether exposure to human bioeffluents, at the levels recommended by the current ventilation standards, would cause any effects on humans. Ten subjects were exposed in a low-emission stainless-steel climate chamber for 4.25 hours. The outdoor air supply rate...

  6. Staffing levels in not-for-profit and for-profit long-term care facilities: does type of ownership matter?

    Science.gov (United States)

    McGregor, Margaret J; Cohen, Marcy; McGrail, Kimberlyn; Broemeling, Anne Marie; Adler, Reva N; Schulzer, Michael; Ronald, Lisa; Cvitkovich, Yuri; Beck, Mary

    2005-03-01

    Currently there is a lot of debate about the advantages and disadvantages of for-profit health care delivery. We examined staffing ratios for direct-care and support staff in publicly funded not-for-profit and for-profit nursing homes in British Columbia. We obtained staffing data for 167 long-term care facilities and linked these to the type of facility and ownership of the facility. All staff were members of the same bargaining association and received identical wages in both not-for-profit and for-profit facilities. Similar public funding is provided to both types of facilities, although the amounts vary by the level of functional dependence of the residents. We compared the mean number of hours per resident-day provided by direct-care staff (registered nurses, licensed practical nurses and resident care aides) and support staff (housekeeping, dietary and laundry staff) in not-for-profit versus for-profit facilities, after adjusting for facility size (number of beds) and level of care. The nursing homes included in our study comprised 76% of all such facilities in the province. Of the 167 nursing homes examined, 109 (65%) were not-for-profit and 58 (35%) were for-profit; 24% of the for-profit homes were part of a chain, and the remaining homes were owned by a single operator. The mean number of hours per resident-day was higher in the not-for-profit facilities than in the for-profit facilities for both direct-care and support staff and for all facility levels of care. Compared with for-profit ownership, not-for-profit status was associated with an estimated 0.34 more hours per resident-day (95% confidence interval [CI] 0.18-0.49, p eldery people purchases significantly fewer direct-care and support staff hours per resident-day in for-profit long-term care facilities than in not-for-profit facilities.

  7. A grid to facilitate physics staffing justification.

    Science.gov (United States)

    Klein, Eric E

    2009-12-03

    Justification of clinical physics staffing levels is difficult due to the lack of direction as how to equate clinical needs with the staffing levels and competency required. When a physicist negotiates staffing requests to administration, she/he often refers to American College of Radiology staffing level suggestions, and resources such as the Abt studies. This approach is often met with questions as to how to fairly derive the time it takes to perform tasks. The result is often insufficient and/or inexperienced staff handling complex and cumbersome tasks. We undertook development of a staffing justification grid to equate the clinical needs to the quantity and quality of staffing required. The first step is using the Abt study, customized to the clinical setting, to derive time per task multiplied by the anticipated number of such tasks. Inclusion of vacation, meeting, and developmental time may be incorporated along with allocated time for education and administration. This is followed by mapping the tasks to the level of competency/experience needed. For example, in an academic setting the faculty appointment levels correlate with experience. Non-staff personnel, such as IMRT QA technicians or clerical staff, should also be part of the equation. By using the staffing justification grid, we derived strong documentation to justify a substantial budget increase. The grid also proved useful when our clinical demands changed. Justification for physics staffing can be significantly strengthened with a properly developed data-based time and work analysis. A staffing grid is presented, along with a development methodology that facilitated our justification. Though our grid is for a large academic facility, the methodology can be extended to a non-academic setting, and to a smaller scale. This grid method not only equates the clinical needs with the quantity of staffing, but can also help generate the personnel budget, based on the type of staff and personnel required

  8. Do staffing and workload levels influence the risk of new acquisitions of meticillin-resistant Staphylococcus aureus in a well-resourced intensive care unit?

    Science.gov (United States)

    Kong, F; Cook, D; Paterson, D L; Whitby, M; Clements, A C A

    2012-04-01

    Staffing deficits and workload have may a bearing on transmission of meticillin-resistant Staphylococcus aureus (MRSA) within intensive care units (ICUs). New MRSA acquistions may provide a clearer picture of the relationship between MRSA acquisition and staffing in the ICU setting. To determine whether staffing and bed occupancy rates had an immediate or delayed impact on the number of new MRSA acquisitions in a well-staffed ICU, and whether these variables could be used as predictors of future MRSA acquisitions. Data on new MRSA acquisitions in the ICU of a 796-bed metropolitan Australian hospital between January 2003 and December 2006 were used to build a model to predict the probabilility of actual new MRSA acquisitions in 2007. Cross validation was performed using receiver operator characteristic analysis. Sixty-one new MRSA acquisitions (21 infections, 40 colonizations) were identified in 51 individual weeks over the study period. The number of non-permanent staffing hours was relatively small. The area under the curve in the cross-validation analysis was 0.46 [95% CI 0.25-0.67] which suggests that the model, built on data from 2003-2006, was not able to predict weeks in which new MRSA acquisitions occurred in 2007. The risks posed by high workloads may have been mitigated by good compliance with infection control measures, nurse training and adequate staffing ratios in the ICU. Consequently, staffing policies and the infection control practices in the ICU do not need to be modified to address the rate of new MRSA acquisitions. Copyright © 2011 The Healthcare Infection Society. All rights reserved.

  9. Staffing at the Middle School Level: Are the Least Qualified Principals Assigned to the Neediest School Buildings?

    Science.gov (United States)

    Young, Phillip; Reimer, Donald Paul; Young, Karen Holsey

    2010-01-01

    A structural equation modeling approach is used to assess the relationships among human capital endowments of school principals and characteristics of students at the middle school level. Human capital endowments are measured according to education, teacher experience, and administrator experience, while characteristics of students are assessed…

  10. Operational intervention levels for reactor emergencies IAEA recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Aguiar, Laís A. de; Reis, Arlene A. dos; Santos, Raul dos, E-mail: laguiar@ird.gov.br, E-mail: arlene@ird.gov.br, E-mail: raul@ird.gov.br [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2017-07-01

    The IAEA publication EPR-NPP-OILs-2017, Operational Intervention Levels for Reactor Emergences and Methodology for their Derivation, provides selected default OIL values, describing a methodology for their derivation, as well as practical tools and recommendations for their use. IAEA recommends that tools and default OIL values be directly integrated into national emergency arrangements or reviewed and modified as necessary to meet the specific emergency preparedness and response arrangements. The Institute of Radiation Protection and Dosimetry (IRD) has a Radiological Assessment TEAM (EAR) as pare of its Radiation Emergency Response System. Brazilian regulatory standards address actions for radiation emergencies encompassing necessary measures to assess public exposures, intervention levels to protect the public and recommendations for protective actions as, evacuation, relocation, sheltering and food restrictions. The objective of this paper is to present a discussion the use these OILs, to compare those ones established by the Brazilian standards and to propose a methodology on how OILs can be used by EAR/IRD in case of an emergency at the Brazilian NPP. (author)

  11. Operational intervention levels for reactor emergencies IAEA recommendations

    International Nuclear Information System (INIS)

    Aguiar, Laís A. de; Reis, Arlene A. dos; Santos, Raul dos

    2017-01-01

    The IAEA publication EPR-NPP-OILs-2017, Operational Intervention Levels for Reactor Emergences and Methodology for their Derivation, provides selected default OIL values, describing a methodology for their derivation, as well as practical tools and recommendations for their use. IAEA recommends that tools and default OIL values be directly integrated into national emergency arrangements or reviewed and modified as necessary to meet the specific emergency preparedness and response arrangements. The Institute of Radiation Protection and Dosimetry (IRD) has a Radiological Assessment TEAM (EAR) as pare of its Radiation Emergency Response System. Brazilian regulatory standards address actions for radiation emergencies encompassing necessary measures to assess public exposures, intervention levels to protect the public and recommendations for protective actions as, evacuation, relocation, sheltering and food restrictions. The objective of this paper is to present a discussion the use these OILs, to compare those ones established by the Brazilian standards and to propose a methodology on how OILs can be used by EAR/IRD in case of an emergency at the Brazilian NPP. (author)

  12. Different Levels of Leadership for Learning: Investigating Differences between Teachers Individually and Collectively Using Multilevel Factor Analysis of the 2011-2012 Schools and Staffing Survey

    Science.gov (United States)

    Boyce, Jared; Bowers, Alex J.

    2018-01-01

    This study investigated the differences between how individual teachers perceive leadership for learning and how teachers collectively perceive leadership for learning, using a large nationally generalizable data-set of 7070 schools from the National Center for Education Statistics 2011-2012 Schools and Staffing Survey. This study used…

  13. 42 CFR 9.9 - Facility staffing.

    Science.gov (United States)

    2010-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS STANDARDS OF CARE FOR... of the activities and chimpanzee population of the sanctuary. The level of staffing shall be adequate... issues related to captive nonhuman primates. Experience in these areas dealing specifically with...

  14. 77 FR 14832 - Plumchoice, Inc., Including On-Site Leased Workers From Balance Staffing, Insight Global Staffing...

    Science.gov (United States)

    2012-03-13

    ... Staffing, Insight Global Staffing, and Technisource, Scarborough, ME; Amended Certification Regarding..., Inc., including on-site leased workers from Balance Staffing, Insight Global Staffing, and... from Balance Staffing, Insight Global Staffing, and Technisource, Scarborough, Maine, who became...

  15. Staff Assist: A Resource to Improve Nursing Home Quality and Staffing

    Science.gov (United States)

    Castle, Nicholas G.

    2011-01-01

    Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…

  16. Nursing home staffing requirements and input substitution: effects on housekeeping, food service, and activities staff.

    Science.gov (United States)

    Bowblis, John R; Hyer, Kathryn

    2013-08-01

    To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff. Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements. Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression. OSCAR surveys from 1999 to 2004. Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff. Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels. © Health Research and Educational Trust.

  17. Staffing and job satisfaction: nurses and nursing assistants.

    Science.gov (United States)

    Kalisch, Beatrice; Lee, Kyung Hee

    2014-05-01

    The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. © 2012 John Wiley & Sons Ltd.

  18. Adoption Level of IFAD Project Recommended Farming Practices ...

    African Journals Online (AJOL)

    The study also revealed that 87.2%, 83% and 82.73% of the respondents respectively adopted the use of recommended fertilizer, method and dosage of fertilizer application and the use of seed dressing chemicals. The result further showed that 16.9%, 15.2% and 14.6% of the respondents respectively identified low ...

  19. Fabulous award for staffing app.

    Science.gov (United States)

    2015-12-02

    A safe staffing app giving up-to-date information on the number of nurses on the wards at Nottingham University Hospitals NHS Trust scooped top prize at the inaugural Academy of Fabulous NHS Stuffawards in London last week.

  20. Assessment of activities performed by clinical nurse practitioners and implications for staffing and patient care at primary health care level in South Africa

    Directory of Open Access Journals (Sweden)

    Jude Igumbor

    2016-03-01

    Full Text Available Background: The shortage of nurses in public healthcare facilities in South Africa is well documented; finding creative solutions to this problem remains a priority. Objective: This study sought to establish the amount of time that clinical nurse practitioners (CNPs in one district of the Western Cape spend on clinical services and the implications for staffing and skills mix in order to deliver quality patient care. Methods: A descriptive cross-sectional study was conducted across 15 purposively selected clinics providing primary health services in 5 sub-districts. The frequency of activities and time CNPs spent on each activity in fixed and mobile clinics were recorded. Time spent on activities and health facility staff profiles were correlated and predictors of the total time spent by CNPs with patients were identified. Results: The time spent on clinical activities was associated with the number of CNPs in the facilities. CNPs in fixed clinics spent a median time of about 13 minutes with each patient whereas CNPs in mobile clinics spent 3 minutes. Fixed-clinic CNPs also spent more time on their non-core functions than their core functions, more time with patients, and saw fewer patients compared to mobile-clinic CNPs. Conclusions: The findings give insight into the time CNPs in rural fixed and mobile clinics spend with their patients, and how patient caseload may affect consultation times. Two promising strategies were identified – task shifting and adjustments in health workerd eployment – as ways to address staffing and skills mix, which skills mix creates the potential for using healthcare workers fully whilst enhancing the long-term health of these rural communities.

  1. Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

    Science.gov (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine

    2016-01-01

    To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  2. BMI and recommended levels of physical activity in school children

    Directory of Open Access Journals (Sweden)

    Phillipp Schwarzfischer

    2017-06-01

    Full Text Available Abstract Background Physical activity (PA and its health benefits are a continuous point of discussion. Recommendations for children’s daily PA vary between guidelines. To better define the amount of PA necessary to prevent overweight and obesity in children, further research is needed. The present study investigates children’s compliance to physical activity guidelines (PAGs and the association between objectively measured PA and body mass index (BMI. Methods Participating children were 11 years old (n = 419 and part of the European CHOP trial, which was conducted in Germany, Belgium, Poland, Spain, Italy. At least 2 days of PA measurements were collected from each child using a SenseWear™ armband. BMI was calculated from children’s height and weight. Thresholds of min·day−1 in PA needed to differentiate between normal and excess weight (overweight/obesity were determined with Receiver Operator Characteristics (ROC analysis. Additionally, adjusted linear and logistic regressions models were calculated for group differences and effects of a 5, 15 and 60 min·day−1 increases in PA on BMI. Results Median time spent in total PA was 462 min·day−1 (25th percentile; 75th percentile: 389; 534 and 75 min·day−1 (41; 115 in moderate to vigorous PA (MVPA. Girls spent 36 min·day−1 less in MVPA than boys and overweight/obese children 24 min·day−1 less than normal weight children (linear regression, p < 0.001. 63.2% of the children met PAGs of 60 min·day−1 in MVPA. The optimal threshold for min·day−1 in MVPA determined with ROC analysis was 46 min·day−1. Comparing 5, 15 and 60 min·day−1 increases in PA revealed that an additional 15 min·day−1 of vigorous PA had the same effect as 60 min·day−1 of MVPA. Sedentary time and light PA showed contrary associations to one another, with light PA being negatively and sedentary time being positively associated with excessive weight. Conclusions Current PAGs are

  3. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy's (DOE's) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment safety, and health concerns. For the of the current paper, human resource management activities are identified as ''Staffing'' and include the of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability. The work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  4. Spent Nuclear Fuel Project operational staffing plan

    International Nuclear Information System (INIS)

    Debban, B.L.

    1996-03-01

    Using the Spent Nuclear Fuel (SNF) Project's current process flow concepts and knowledge from cognizant engineering and operational personnel, an initial assessment of the SNF Project radiological exposure and resource requirements was completed. A small project team completed a step by step analysis of fuel movement in the K Basins to the new interim storage location, the Canister Storage Building (CSB). This analysis looked at fuel retrieval, conditioning of the fuel, and transportation of the fuel. This plan describes the staffing structure for fuel processing, fuel movement, and the maintenance and operation (M ampersand O) staffing requirements of the facilities. This initial draft does not identify the support function resources required for M ampersand O, i.e., administrative and engineering (technical support). These will be included in future revisions to the plan. This plan looks at the resource requirements for the SNF subprojects, specifically, the operations of the facilities, balances resources where applicable, rotates crews where applicable, and attempts to use individuals in multi-task assignments. This plan does not apply to the construction phase of planned projects that affect staffing levels of K Basins

  5. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy (DOEs) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment, safety, and health concerns. For the purposes of the current paper, human resource management activities are identified as 'Staffing' and include the process of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability, the work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that, although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  6. Nurse Staffing Patterns and Patient Experience of Care: An Empirical Analysis of U.S. Hospitals.

    Science.gov (United States)

    Oppel, Eva-Maria; Young, Gary J

    2017-08-14

    To examine the relationship between nurse staffing patterns and patients' experience of care in hospitals with a particular focus on staffing flexibility. The study sample comprised U.S. general hospitals between 2010 and 2012. Nurse staffing data came from the American Hospital Association Annual Survey, and patient experience data came from the Medicare Hospital Consumer Assessment of Healthcare Providers and Systems. An observational research design was used entailing a pooled, cross-sectional data set. Regression models were estimated using generalized estimating equation (GEE) and hospital fixed effects. Nurse staffing patterns were assessed based on both levels (i.e., ratio of full-time equivalent nurses per 1,000 patient days) and composition (i.e., skill mix-percentage of registered nurses; staffing flexibility-percentage of part-time nurses). All three staffing variables were significantly associated with patient experience in the GEE analysis, but only staffing flexibility was significant in the fixed-effects analysis. A higher percentage of part-time nurses was positively associated with patient experience. Multiplicative and nonlinear effects for the staffing variables were also observed. Among three staffing variables, flexibility was found to be the most important relative to patient experience. Unobserved hospital characteristics appear to underlie patient experience as well as certain nurse staffing patterns. © Health Research and Educational Trust.

  7. Improving Staffing and Nurse Engagement in a Neuroscience Intermediate Unit.

    Science.gov (United States)

    Nadolski, Charles; Britt, Pheraby; Ramos, Leah C

    2017-06-01

    The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit. The quantitative section focused on a review of the acuity of the patients. The qualitative section was based on descriptive interviews with University Healthcare Consortium nurse managers from similar units. The study reviewed the acuity of 9,832 patient days to determine the accurate acuity of neuroscience intermediate unit patients. Nurse managers at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina were contacted to compare staffing levels. The increase in nurse staffing contributed to an increase in many quality metrics. There were an 80% decrease in controllable nurse turnover and a 75% reduction in falls with injury after the lowered nurse-patient ratio. These 2 metrics established a return on investment for the staffing increase. In addition, the staffing satisfaction question on the Press Ganey employee engagement survey increased from 2.44 in 2013 to 3.72 in 2015 in response to the advocacy of the bedside nurses.

  8. Recommended level of physical activity and health-related quality of life among Japanese adults

    Directory of Open Access Journals (Sweden)

    Nakamura Yoshio

    2007-11-01

    Full Text Available Abstract Background The benefits of a recommended level of physical activity on physiological health indicators such as morbidity and mortality are well-accepted, but less research has addressed whether or not the association between the recommended level of physical activity and a health-related quality of life (HRQOL exists in the Japanese population. Thus, the present study examined whether the recommended physical activity would be associated with HRQOL in the general Japanese middle-aged population. Methods Data were obtained from 1211 male and female respondents (39.4 ± 10.9 year, mean ± SD from an Internet-based survey of registrants of an Internet research service. Physical activity level was estimated from the short form of the International Physical Activity Questionnaire. HRQOL was assessed with the Medical Outcomes Survey Short Form-8 questionnaire (SF-8. Based on the current national guidelines for exercise in Japan, respondents were divided into a recommended group, an insufficient group, and an inactive group according to their estimated weekly physical activity level. Multivariate analyses of covariance were utilized. Results Across both genders, the recommended group had significantly higher physical functioning (PF scores than the inactive group (p Conclusion Individuals who attained the recommended level of physical activity had better scores on some dimensions of HRQOL than those who did not, suggesting that the recommended level of physical activity may be applicable not only to the physiological objective outcomes but also to some dimensions in both the physical and mental aspects of HRQOL.

  9. Recommendations for future low-level and mixed waste management practices at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Jennrich, E.A.; Klein, R.B.; Murphy, E.S.; Shuman, R.; Hickman, W.W.; Rutz, A.C.; Uhl, D.L.

    1989-01-01

    This report describes recommendations concerning the management of low-level radioactive wastes and mixtures at Los Alamos National Laboratory. Performance assessments, characterization, site disposal design, shipment, and storage are discussed

  10. High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

    Science.gov (United States)

    Steach, John C.

    2011-01-01

    This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

  11. Nurse dose: linking staffing variables to adverse patient outcomes.

    Science.gov (United States)

    Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L

    2011-01-01

    Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

  12. Health Promotion and Wellness Staffing Methods

    National Research Council Canada - National Science Library

    Thomsen, Kim

    1999-01-01

    ... injuries, and decrease the number of hospital visits. The Army does not have standardized staffing guidelines or models while the mechanisms to determine requirements are fragmented and inconsistent...

  13. Nurse staffing issues are just the tip of the iceberg: a qualitative study about nurses' perceptions of nurse staffing

    NARCIS (Netherlands)

    van Oostveen, Catharina J.; Mathijssen, Elke; Vermeulen, Hester

    2015-01-01

    To obtain in-depth insight into the perceptions of nurses in the Netherlands regarding current nurse staffing levels and use of nurse-to-patient-ratios (NPR) and patient classification systems (PCS). In response to rising health care demands due to ageing of the patient population and increasing

  14. Leadership, staffing and quality of care in nursing homes

    Directory of Open Access Journals (Sweden)

    Havig Anders

    2011-11-01

    Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses

  15. Leadership, staffing and quality of care in nursing homes

    Science.gov (United States)

    2011-01-01

    Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is

  16. Discussion on Implementation of ICRP Recommendations Concerning Reference Levels and Optimisation

    International Nuclear Information System (INIS)

    2013-02-01

    International Commission on Radiological Protection (ICRP) Publication 103, 'The 2007 Recommendations of the International Commission on Radiological Protection', issued in 2007, defines emergency exposure situations as unexpected situations that may require the implementation of urgent protective actions and perhaps longer term protective actions. The ICRP continues to recommend optimisation and the use of reference levels to ensure an adequate degree of protection in regard to exposure to ionising radiation in emergency exposure situations. Reference levels represent the level of dose or risk above which it is judged to be inappropriate to plan to allow exposures to occur and for which protective actions should therefore be planned and optimised. National authorities are responsible for establishing reference levels. The Expert Group on the Implementation of New International Recommendations for Emergency Exposure Situations (EGIRES) performed a survey to analyse the established processes for optimisation of the protection strategy for emergency exposure situations and for practical implementation of the reference level concept in several member states of the Nuclear Energy Agency (NEA). The EGIRES collected information on several national optimisation strategy definitions, on optimisation of protection for different protective actions, and also on optimisation of urgent protective actions. In addition, national criteria for setting reference levels, their use, and relevant processes, including specific triggers and dosimetric quantifies in setting reference levels, are focus points that the EGIRES also evaluated. The analysis of national responses to this 2011 survey shows many differences in the interpretation and application of the established processes and suggests that most countries are still in the early stages of implementing these processes. Since 2011, national authorities have continued their study of the ICRP recommendations to incorporate them into

  17. How Does Rurality Influence the Staffing of Social Service Departments in Nursing Homes?

    Science.gov (United States)

    Roberts, Amy Restorick; Bowblis, John R

    2017-01-09

    Social service departments in nursing homes (NHs) are staffed by qualified social workers (QSWs) and paraprofessionals. Due to greater workforce challenges in rural areas, this article aims to describe the staffing levels and composition of these departments by rurality. Certification and Survey Provider Enhanced Reports data from 2009 to 2015 are used to examine the effect of rurality on social service staffing using random-effects linear panel regressions. The average NH employed 1.8 full-time equivalents (FTEs), with approximately two thirds of social services staffed by QSWs. Large NHs had more staff, but employed fewer staff hours per resident day. Staffing levels were lower and QSWs made up a smaller percentage of staff in rural areas. National trends indicate variability in staffing by NH size and degree of rurality. Very low staffing within rural NHs is a concern, as staff may have less time to respond to residents' needs and these NHs may utilize fewer QSWs. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Staffing decision processes and issues: Case studies of seven US Nuclear Power Plants

    International Nuclear Information System (INIS)

    Melber, B.; Roussel, A.; Baker, K.; Durbin, N.; Hunt, P.; Hauth, J.; Forslund, C.; Terrill, E.; Gore, B.

    1994-03-01

    The objective of this report is to identify how decisions are made regarding staffing levels and positions for a sample of U.S. nuclear power plants. In this report, a framework is provided for understanding the major forces driving staffing and the implications of staffing decisions for plant safety. The focus of this report is on driving forces that have led to changes in staffing levels and to the establishment of new positions between the mid-1980s and the early 1990s. Processes used at utilities and nuclear power plants to make and implement these staffing decisions are also discussed in the report. While general trends affecting the plant as a whole are presented, the major emphasis of this report is on staffing changes and practices in the operations department, including the operations shift crew. The findings in this report are based on interviews conducted at seven nuclear power plants and their parent utilities. A discussion of the key findings is followed by a summary of the implications of staffing issues for plant safety

  19. NURSE STAFFING AND RENAL ANAEMIA OUTCOMES IN HAEMODIALYSIS CARE.

    Science.gov (United States)

    Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus

    2016-09-01

    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  20. Staffing for Cyberspace Operations: Summary of Analysis

    Science.gov (United States)

    2016-08-01

    I N S T I T U T E F O R D E F E N S E A N A L Y S E S Staffing for Cyberspace Operations: Summary of Analysis Thomas H. Barth Jerome J. Burke...7013 (a)(16) [Jun 2013]. Staffing for Cyberspace Operations: Summary of Analysis Thomas H. Barth Jerome J. Burke Stanley A. Horowitz Mark F. Kaye...civilian employment. 1 Thomas H. Barth et al., “(U) Staffing for Cyberspace Operations,” IDA Paper P

  1. How Book Publishers are Staffing for Multimedia.

    Science.gov (United States)

    Protsik, Ralph

    1995-01-01

    Examines how book publishers are staffing for multimedia developments. Discussion includes competition from software developers, costs, partnerships, professional organizations as the most innovative electronic publishers, cultural problems, human resource polices, hiring, conflict between print and technology staff, marketing, outside…

  2. [Recommendations for stocking and using antidotes in hospitals of varying levels of complexity].

    Science.gov (United States)

    Aguilar-Salmerón, Raquel; Martínez-Sánchez, Lídia; Broto-Sumalla, Antoni; Fernández de Gamarra-Martínez, Edurne; García-Pelaéz, Milagros; Nogué-Xarau, Santiago

    2016-02-01

    The stocking of antidotes in various care settings is a subject of debate. A group of experts in hospital pharmacy and both adult and pediatric clinical toxicology was formed to review the Spanish and international literature on the subject with the aim of updating recommendations about which antidotes to stock and in what amounts in hospitals of different levels of complexity. The experts also considered the usual indications for the use of antidotes and dosing. The amount to have on hand was defined as enough to treat an adult weighing 70 kg for 24 hours (or 3 such adults in an A-level hospital; ie, a highly complex center or the reference hospital for an area). The group also listed 34 antidotes that B-level hospitals should stock and 22 that other types of hospital should stock. The recommendations also provide a guide for using the antidotes in the forms of presentation available in Spain in 2015, a list of their main indications and recommended doses, and specific notes on each.

  3. Sound levels in a neonatal intensive care unit significantly exceeded recommendations, especially inside incubators.

    Science.gov (United States)

    Parra, Johanna; de Suremain, Aurelie; Berne Audeoud, Frederique; Ego, Anne; Debillon, Thierry

    2017-12-01

    This study measured sound levels in a 2008 built French neonatal intensive care unit (NICU) and compared them to the 2007 American Academy of Pediatrics (AAP) recommendations. The ultimate aim was to identify factors that could influence noise levels. The study measured sound in 17 single or double rooms in the NICU. Two dosimeters were installed in each room, one inside and one outside the incubators, and these conducted measurements over a 24-hour period. The noise metrics measured were the equivalent continuous sound level (L eq ), the maximum noise level (L max ) and the noise level exceeded for 10% of the measurement period (L 10 ). The mean L eq , L 10 and L max were 60.4, 62.1 and 89.1 decibels (dBA), which exceeded the recommended levels of 45, 50 and 65 dBA (p incubator was significantly higher than in the room (+8 dBA, p incubators. A multipronged strategy is required to improve the sound environment and protect the neonates' sensory development. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. Toward a national policy for managing low-level radioactive waste: key issues and recommendations

    International Nuclear Information System (INIS)

    Duerksen, C.J.; Mantell, M.; Thompson, G.P.

    1981-06-01

    The Conservation Foundation, a not-for-profit research and public education organization, asked individuals with diverse backgrounds and viewpoints to come together under Foundation leadership as a Dialogue Group on Low-Level Radioactive Waste Management. The group, including persons who represent waste generators, concerned citizens, state regulators, and environmentalists, met over an 18-month period to discuss issues crucial to the development of a national policy on low-level wastes. The Dialogue Group agreed that three principles, if accepted broadly, would form the basis of a sound national policy for managing low-level radioactive wastes: with proper implementation, technology exists to manage low-level waste safely; generators and their customers should pay disposal costs; and greater public involvement at all stages can improve the disposal system. These principles acted as polestars for the group as it worked toward a series of policy recommendations in four main areas: (1) cleaning up closed commercial sites; (2) remodeling a system for defining and classifying low-level radioactive waste; (3) siting new low-level waste disposal facilities; and (4) decommissioning, long-term care, and liability. This report presents an extensive discussion of these recommendations covering qualifications, limitations, and alternatives

  5. Ship's Officer Staffing Guide: Report of Findings and Recommendations

    National Research Council Canada - National Science Library

    Hatch, William

    2003-01-01

    .... By changing requirements to match inventory the signal sent throughout the MPT system to program, recruit, train, educated and distribute personnel has now had its foundation changed to reflect...

  6. Recommending a minimum English proficiency standard for entry-level nursing.

    Science.gov (United States)

    O'Neill, Thomas R; Tannenbaum, Richard J; Tiffen, Jennifer

    2005-01-01

    When nurses who are educated internationally immigrate to the United States, they are expected to have English language proficiency in order to function as a competent nurse. The purpose of this research was to provide sufficient information to the National Council of State Boards of Nursing (NCSBN) to make a defensible recommended passing standard for English proficiency. This standard was based upon the Test of English as a Foreign Language (TOEFL). A large panel of nurses and nurse regulators (N = 25) was convened to determine how much English proficiency is required to be minimally competent as an entry-level nurse. Two standard setting procedures, the Simulated Minimally Competent Candidate (SMCC) procedure and the Examinee Paper Selection Method, were combined to produce recommendations for each panelist. In conjunction with collateral information, these recommendations were reviewed by the NCSBN Examination Committee, which decided upon an NCSBN recommended standard, a TOEFL score of 220. Because the adoption of this standard rests entirely with the individual state, NCSBN has little more to do with implementing the standard, other than answering questions and providing documentation about the standard.

  7. Human Resources Staffing Plan for the Tank Farm Contractor

    International Nuclear Information System (INIS)

    BOSLEY, J.W.

    2000-01-01

    The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline

  8. Human Resources Staffing Plan for the Tank Farm Contractor

    Energy Technology Data Exchange (ETDEWEB)

    BOSLEY, J.W.

    2000-04-22

    The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline.

  9. Suitability of teriparatide and level of acceptance of pharmacotherapeutic recommendations in a healthcare management area.

    Science.gov (United States)

    Cantudo-Cuenca, Maria Rosa; Guzmán Ramos, Maria Isabel; Cantudo Cuenca, Maria Dolores; Manzano García, Mercedes; Saborido Cansino, Maria Del Carmen; Sánchez Pedrosa, Ana

    2016-06-01

    To analyse the suitability of teriparatide prescriptions for osteoporosis treatment in a health management area, as well as the level of acceptance of pharmacotherapeutic recommendations made to physicians. A prospective interventional study conducted from february 2015 to june 2015. South Seville Health Management Area. Patients receiving teriparatide. Suitability of teriparatide prescriptions according to Clinical Practice Guidelines and level of acceptance of pharmacotherapeutic recommendations. Teriparatide prescriptions were unsuitable in 45 patients (68.2%); 11 due to no indication, 17 patients did not have previous treatments with first-line drugs, 6 due to contraindications and 9 patients were treated for more than 24 months with the drug. Besides, 4 prescriptions were unsuitable because of combination with other therapies. The acceptance of pharmacotherapeutic recommendations was 64.4%, leading to teriparatide discontinuation in 21 patients (72.4%), and a switch to alendronate or ibandronate in another 8 patients. A high percentage of teriparatide prescriptions is unsuitable in our health care management area, but it has decreased after pharmacist intervention. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  10. Optimizing Fire Department Operations Through Work Schedule Analysis, Alternative Staffing, and Nonproductive Time Reduction

    Science.gov (United States)

    2014-09-01

    fatigue attributed to work-related stressors .19 On the other hand, research has shown that the 48/96 schedule exacerbates sleep deprivation issues...health and wellness initiatives, brown-out, fire department funding, peak-usage staffing, four-person staffing, schedule modification, sleep deprivation ...to a significant sleep deprivation risk that impacts the employee’s ability to function at peak levels.7 The 10/14-hour schedule produces better

  11. Recommendations for Training in Pediatric Psychology: Defining Core Competencies Across Training Levels

    Science.gov (United States)

    Janicke, David M.; McQuaid, Elizabeth L.; Mullins, Larry L.; Robins, Paul M.; Wu, Yelena P.

    2014-01-01

    Objective As a field, pediatric psychology has focused considerable efforts on the education and training of students and practitioners. Alongside a broader movement toward competency attainment in professional psychology and within the health professions, the Society of Pediatric Psychology commissioned a Task Force to establish core competencies in pediatric psychology and address the need for contemporary training recommendations. Methods The Task Force adapted the framework proposed by the Competency Benchmarks Work Group on preparing psychologists for health service practice and defined competencies applicable across training levels ranging from initial practicum training to entry into the professional workforce in pediatric psychology. Results Competencies within 6 cluster areas, including science, professionalism, interpersonal, application, education, and systems, and 1 crosscutting cluster, crosscutting knowledge competencies in pediatric psychology, are presented in this report. Conclusions Recommendations for the use of, and the further refinement of, these suggested competencies are discussed. PMID:24719239

  12. Toward cost-effective staffing mixes for Veterans Affairs substance use disorder treatment programs.

    Science.gov (United States)

    Im, Jinwoo J; Shachter, Ross D; Finney, John W; Trafton, Jodie A

    2015-11-23

    In fiscal year (FY) 2008, 133,658 patients were provided services within substance use disorders treatment programs (SUDTPs) in the U.S. Department of Veterans Affairs (VA) health care system. To improve the effectiveness and cost-effectiveness of SUDTPs, we analyze the impacts of staffing mix on the benefits and costs of specialty SUD services. This study demonstrates how cost-effective staffing mixes for each type of VA SUDTPs can be defined empirically. We used a stepwise method to derive prediction functions for benefits and costs based on patients' treatment outcomes at VA SUDTPs nationally from 2001 to 2003, and used them to formulate optimization problems to determine recommended staffing mixes that maximize net benefits per patient for four types of SUDTPs by using the solver function with the Generalized Reduced Gradient algorithm in Microsoft Excel 2010 while conforming to limits of current practice. We conducted sensitivity analyses by varying the baseline severity of addiction problems between lower (2.5 %) and higher (97.5 %) values derived from bootstrapping. Compared to the actual staffing mixes in FY01-FY03, the recommended staffing mixes would lower treatment costs while improving patients' outcomes, and improved net benefits are estimated from $1472 to $17,743 per patient.

  13. Extension Staffing Models to Serve 4-H Clientele in Changing Times

    Directory of Open Access Journals (Sweden)

    Donna R. Gillespie

    2010-03-01

    Full Text Available In response to budget cuts in 2002, 4-H staffing models were restructured. The response by University of Idaho Extension was intended to continue meeting the needs of Idaho’s citizens with fewer UI Extension faculty. This staffing reorganization led to the formation of the District III 4-H Team who united to bring stronger 4-H programs to south central Idaho and expand programs to underserved audiences. Information from surveys and interviews over the past seven years reflects the effectiveness, challenges and successes of the District III 4-H Team. In Making the Best Better: 4-H Staffing Patterns and Trends in the Largest Professional Network in the Nation (2007, author Kirk A. Astroth notes a nationwide change in 4-H leadership at the county level from 4-H faculty to program assistants or coordinators. The information gathered in our research may help other states determine staffing models to meet the needs of clientele in these changing times.

  14. Recommended regulatory program plan for low-level radioactive waste management in Maryland

    International Nuclear Information System (INIS)

    1986-01-01

    The National Program for Low-Level Radioactive Waste Management was instituted by the US Department of Energy to assist the states in carrying out this new federal policy. Based on the premise that the safe disposal of low-level waste is technologically feasible and that states have the necessary degree of authority to set management policy, the National Program is helping them to develop a responsive, comprehensive regulatory program. The State of Maryland is actively engaged with the National Program in its efforts to form a comprehensive management program. The purpose of this plan is to review existing statutory and regulatory program responsibilities and provide a recommended management scheme for low-level radioactive waste

  15. [Geriatric teaching at undergraduate level: are Spanish Medical Schools following European recommendations?].

    Science.gov (United States)

    Mateos-Nozal, Jesús; Cruz-Jentoft, Alfonso Jose; Ribera Casado, José Manuel

    2015-01-01

    To compare the learning objectives proposed by the European Union of Medical Specialists Geriatric section (UEMS-GS) with those approved in Spain for undergraduate teaching. Learning objectives included in the European Undergraduate Curriculum in Geriatric Medicine developed by the UEMS-GS in 2013 were compared with those listed in different Spanish official documents: Boletín Oficial del Estado (BOE, Spanish State Gazette), white book on Medicine of the Spanish Accreditation Agency (ANECA), and list of learning objectives of Spanish Medical Schools. the European curriculum recommends to teach 42 competencies divided in 10 sections, while the BOE mentions 37 general competencies and some other specific competencies, and the ANECA mentions 23 generic and 34 specific competencies (similar to the 37 of the BOE), and a list of common contents in which Geriatrics is included. The BOE includes 38% of the European competencies (range 17-100% of competencies in different sections), while the ANECA includes 52% of them (range 17-100%). Spanish regulations include from one third to half of the European recommendations for Geriatrics teaching at undergraduate level. In the future, it seems advisable that official requirements in Spain should converge with European recommendations. This task should also be performed by Spanish Medical Schools. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  16. Nurse burnout in China: a questionnaire survey on staffing, job satisfaction, and quality of care.

    Science.gov (United States)

    Lu, Minmin; Ruan, Hui; Xing, Weijie; Hu, Yan

    2015-05-01

    The investigators examined how nurse staffing affects nurse job satisfaction and quality of care. Inadequate nurse staffing is a worldwide issue with profound effects on nurse job satisfaction and quality of care. Few studies have examined the relationship between nurse staffing and job satisfaction and quality of care in China. A cross-sectional design was adopted, wherein 873 nurses were surveyed on demographics, nurse staffing, job-related burnout, job dissatisfaction, intent to leave, and quality of care. The median patient-nurse ratio was five; 45.1% nurses reported high levels of job-related burnout, and 55.6%, job dissatisfaction. In adjusted regression models, patient-nurse ratios of four or less were related to a decrease in the odds of job dissatisfaction (odds ratio 0.55, 95% confidence interval 0.36-0.85) and increase in the odds of quality of care (odds ratio 1.78, 95% confidence interval 1.02-2.82). Nurse staffing is associated with job dissatisfaction and quality of care. Nurse managers should maintain an adequate level of nurse staffing, referring to the patient-nurse ratio. They should create new initiatives to increase job satisfaction among nurses and to evaluate their effects. © 2013 John Wiley & Sons Ltd.

  17. Nursing teamwork, staff characteristics, work schedules, and staffing.

    Science.gov (United States)

    Kalisch, Beatrice J; Lee, Hyunhwa

    2009-01-01

    This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.

  18. [Hierarchy of evidence: levels of evidence and grades of recommendation from current use].

    Science.gov (United States)

    Manterola, Carlos; Asenjo-Lobos, Claudla; Otzen, Tamara

    2014-12-01

    There are multiple proposals and classifications that hierarchize evidence, which may confuse those who are dedicated to generate it both in health technology assessments, as for the development of clinical guidelines, etc. The aim of this manuscript is to describe the most commonly used classifications of levels of evidence and grades of recommendation, analyzing their main differences and applications so that the user can choose the one that better suits your needs and take this health decisions basing their practice on the best available evidence. A systematic literature search was performed in PubMed and MEDLINE databases and in Google, Yahoo and Ixquick search engines. A wealth of information concerning levels of evidence and degrees recommendation was obtained. It was summarized the information of the 11 proposals more currently used (CTFPHC, Sackett, USPSTF, CEBM, GRADE, SIGN, NICE, NHMRC, PCCRP, ADA y ACCF/AHA), between which it emphasizes the GRADE WORKING GROUP, incorporated by around 90 national and international organizations such as the World Health Organization, The Cochrane Library, American College of Physicians, American Thoracic Society, UpToDate, etc.; and locally by the Ministry of Health to create clinical practice guidelines.

  19. Tidal extension and sea-level rise: recommendations for a research agenda

    Science.gov (United States)

    Ensign, Scott H.; Noe, Gregory

    2018-01-01

    Sea-level rise is pushing freshwater tides upstream into formerly non-tidal rivers. This tidal extension may increase the area of tidal freshwater ecosystems and offset loss of ecosystem functions due to salinization downstream. Without considering how gains in ecosystem functions could offset losses, landscape-scale assessments of ecosystem functions may be biased toward worst-case scenarios of loss. To stimulate research on this concept, we address three fundamental questions about tidal extension: Where will tidal extension be most evident, and can we measure it? What ecosystem functions are influenced by tidal extension, and how can we measure them? How do watershed processes, climate change, and tidal extension interact to affect ecosystem functions? Our preliminary answers lead to recommendations that will advance tidal extension research, enable better predictions of the impacts of sea-level rise, and help balance the landscape-scale benefits of ecosystem function with costs of response.

  20. Organization and staffing of the regulatory body for nuclear facilities. Safety guide

    International Nuclear Information System (INIS)

    2005-01-01

    The purpose of this safety guide is to provide recommendations for national authorities on the appropriate management system, organization and staffing for the regulatory body responsible for the regulation of nuclear facilities in order to achieve compliance with the applicable safety requirements. This safety guide covers the organization and staffing in relation to nuclear facilities such as: enrichment and fuel manufacturing plants. Nuclear power plants. Other reactors such as research reactors and critical assemblies. Spent fuel reprocessing plants. And radioactive waste management facilities such as treatment, storage and disposal facilities. This safety guide also covers issues related to the decommissioning of nuclear facilities, the closure of waste disposal facilities and site rehabilitation

  1. Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals

    Science.gov (United States)

    Reiter, Kristin L; Harless, David W; Pink, George H; Mark, Barbara A

    2012-01-01

    Objective To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance. Data Sources/Study Setting Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. Study Design The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1 = lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. Data Collection/Extraction Methods Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. Principal Findings Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. Conclusions Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. PMID:22150627

  2. The effects of nurse staffing on hospital financial performance: competitive versus less competitive markets.

    Science.gov (United States)

    Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert

    2013-01-01

    Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing-related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result of better financial performance, particularly in more competitive markets. In this study, we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Nurse staffing levels had a positive association with financial performance (β = 3.3, p = .02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost-cutting measures may be inefficient and negatively affect financial performance.

  3. Minimum nurse staffing legislation and the financial performance of California hospitals.

    Science.gov (United States)

    Reiter, Kristin L; Harless, David W; Pink, George H; Mark, Barbara A

    2012-06-01

    To estimate the effect of minimum nurse staffing ratios on California acute care hospitals' financial performance. Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1=lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. © Health Research and Educational Trust.

  4. Continuous ambulatory peritoneal dialysis patients are unable to increase dietary intake to recommended levels.

    Science.gov (United States)

    Sutton, Debbie; Higgins, Bernie; Stevens, Judith M

    2007-09-01

    This study's objective was to determine whether offering dietary advice was effective in supporting patients in adjusting energy intake. We performed a prospective, randomized, controlled trial of dietary intervention involving 59 patients on continuous ambulatory peritoneal dialysis over a 4-month follow-up period. The study involved outpatients on home-based renal replacement therapy. All participants were adult patients on continuous ambulatory peritoneal dialysis. All eligible patients were invited to take part. Subjects were randomized into two groups: control and intervention. Those with diabetes mellitus, malabsorption, malignancy, or eating disorders were excluded. Baseline measurements to assess current dietary intake and nutritional status were performed in all subjects. Measurements included a 5-day food diary, subjective global assessment (SGA), anthropometry, and serum biochemistry. After analysis of the food diaries, the participants in the control group were given follow-up dietary advice that would enable them to match intake with current dietary recommendations for this group of 1.2 g of protein per kilogram of ideal body weight, 25 cal/kg ideal body weight. Participants in the intervention group were given follow-up dietary advice that would encourage them to match energy intake with an estimate of total energy expenditure based on their calculated basal metabolic rate and physical activity level as designated using information from SGA, with a significantly lower protein intake of 0.8 to 1.0 g/kg ideal body weight and an emphasis on calories from carbohydrate and fat. Both groups completed further 5-day food diaries at 2 and 4 months to assess their ability to make the recommended changes. SGA, anthropometry, and biochemistry were all remeasured at the end of the study period. Differences in energy and protein intakes between and within the two groups from baseline to 4 months were assessed. Protein and energy intakes did not change during 4

  5. Managing the nation's high-level radioactive waste: key issues and recommendations

    International Nuclear Information System (INIS)

    1981-07-01

    To date, no unified national plan has been adopted to develop and implement a comprehensive system of management and disposal of high-level radioactive waste in the United States. Growing public concern about this problem has resulted in a number of recent efforts to develop a national high-level waste management policy. The 96th Congress strove to resolve the central issues, but ultimately failed to pass legislation, partly because of disagreements about the appropriate role of states in the siting of repositories for military waste. Outside government, a number of organizations convened representatives of diverse groups concerned with national high-level radioactive waste management to seek agreement on the major elements of national policy. One such organization was RESOLVE, Center for Environmental Conflict Resolution, which in May 1981 was merged into The Conservation Foundation. RESOLVE convened Forum II, a series of discussions among representatives of environmental, industrial, governmental, and citizen interest groups, in 1981 specifically to address the issues blocking Congressional agreement on high-level waste policy. This report contains the recommendations which resulted from these deliberations. Reprocessing, interim storage, respository development, and licensing requirements are addressed. Federal, state, and public participation in decision making are also discussed

  6. [Algorithms and urinary incontinence in the elderly. Assessment, treatment, recommendations and levels of evidence. Review].

    Science.gov (United States)

    Meyer, P

    2017-03-01

    Search processing algorithms in a primary care setting, analyzing the specifics of care management for seniors suffering from urinary incontinence (UI), described the recommendations and levels of evidence of treatment. A literature review carried out via PubMed ® and websites of scientific societies with search keywords classified according to an algorithm. One hundred algorithms have been discovered in the field of evaluation and treatment of UI. Screening for UI risk factors began early on in the treatment of reversible or chronic comorbidities, avoiding iatrogenic. Specific clinical features (red flags) required specialized advice. Non-pharmacological conservative treatment should be offered first in line for seniors: behavioral therapy, changes in lifestyle, walk, treatment of constipation. For women, pelvic floor muscle training combined biofeedback and functional electrical stimulation. After failure and persistence of UI with urgency, the information of the risk of a possible urinary retention or cognitive impairments preceded the prescription of an anticholinergic and the measurement of post-voiding residue done by ultrasounds. Older age is not a cons-indication for surgery UI least invasive. The cough test and Bonney maneuver can confirm a masked stress urinary incontinence and/or an associated prolapse. Cases of failure of UI, doubtful diagnosis or programmed surgery required urodynamic assessment. Algorithms and recommendations of UI should remain a valuable aid to the clinical assessment, diagnosis and treatment of UI in the elderly. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. Are There Benefits for Gestational Diabetes Mellitus in Treating Lower Levels of Hyperglycemia Than Standard Recommendations?

    Science.gov (United States)

    Nguyen, Thi Hoang Lan; Yang, Ji Wei; Mahone, Michèle; Godbout, Ariane

    2016-12-01

    The new International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations for diagnosis of gestational diabetes mellitus (GDM) are generating discussion regarding their universal adoption. Our centre is currently using stricter GDM diagnostic criteria than those proposed by the IADPSG. Evaluation of complication rates and their predictors in our cohort may provide insight for the care of this high-risk population. Therefore, we determined complication rates and identified antepartum maternal predictors of adverse outcomes in our cohort with mild GDM. A retrospective cohort study was performed between 2005 and 2011. It included women with and without GDM, which was diagnosed if fasting plasma glucose levels were 5.0 or above or 2-hour post 75 gram oral glucose tolerance test (OGTT) were 7.8 mmol/L or higher. A total of 3712 women, with and without diabetes, were included. Rates of macrosomia and pre-eclampsia were significantly higher in the group with GDM but were lower than the rates usually reported. Macrosomia, the need for insulin therapy or caesarean section and postpartum glucose intolerance predictors included prepregnancy body mass index, excessive gestational weight gain and OGTT screening results, although no specific threshold was found. This study provides insight into GDM-related complications rates and the benefits of intervention in a large cohort of women with levels of hyperglycemia lower than those currently recommended for diagnosis of GDM. These findings suggest a continuous association between adverse outcomes and maternal hyperglycemia and highlight the important role of maternal risk factors other than glycemic results in the development of pregnancy-related complications. Milder forms of hyperglycemia that would not be identified by IADPSG guidelines may benefit from treatment. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  8. Selection and development of international indicators on staffing

    NARCIS (Netherlands)

    van Amelsvoort, H.W.C.H.; Hendriks, Maria A.; Scheerens, Jaap

    2000-01-01

    International comparisons of indicators on staffing are regarded as a useful information base to policymakers. Politically relevant staffing indicators in relation to the costs, planning and quality of education deal with training, working conditions, staff characteristics, and stability and

  9. Staffing the Global Organization: "Cultural Nomads"

    Science.gov (United States)

    McPhail, Ruth; Fisher, Ron; Harvey, Michael; Moeller, Miriam

    2012-01-01

    This article explores the evolution of international staffing in an increasingly globalized and hypercompetitive marketplace. As the issue of staff retention becomes critical in global organizations, it is important to understand the types of managers that may be on or assigned to overseas assignments. The purpose of this article is to present a…

  10. The association between nurse staffing and omissions in nursing care: a systematic review.

    Science.gov (United States)

    Griffiths, Peter; Recio-Saucedo, Alejandra; Dall'Ora, Chiara; Briggs, Jim; Maruotti, Antonello; Meredith, Paul; Smith, Gary B; Ball, Jane

    2018-03-08

    To identify nursing care most frequently missed in acute adult inpatient wards and determine evidence for the association of missed care with nurse staffing. Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. Systematic review. We searched the Cochrane Library, CINAHL, Embase and Medline (2006-2016) for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. Eighteen studies gave subjective reports of missed care. 75% or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures is yet to be investigated. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Quality and dose optimized CT trauma protocol. Recommendation from a university level-I trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Kahn, Johannes; Boening, Georg; Rotzinger, Roman; Freyhardt, Patrick; Streitparth, Florian [Charite School of Medicine and Univ. Hospital Berlin (Germany). Dept. of Radiology; Kaul, David [Charite School of Medicine and Univ. Hospital Berlin (Germany). Dept. of Radiation Oncology; Schwabe, Philipp [Charite School of Medicine and Univ. Hospital Berlin (Germany). Dept. of Trauma Surgery; Maurer, Martin H. [Inselspital Bern (Switzerland). Dept. of Diagnostic, Interventional and Pediatric Radiology; Renz, Diane Miriam [Univ. Hospital Jena (Germany). Inst. of Diagnostic and Interventional Radiology

    2017-09-15

    As a supra-regional level-I trauma center, we evaluated computed tomography (CT) acquisitions of polytraumatized patients for quality and dose optimization purposes. Adapted statistical iterative reconstruction [(AS)IR] levels, tube voltage reduction as well as a split-bolus contrast agent (CA) protocol were applied. Materials and Methods 61 patients were split into 3 different groups that differed with respect to tube voltage (120 - 140 kVp) and level of applied ASIR reconstruction (ASIR 20 - 50%). The CT protocol included a native acquisition of the head followed by a single contrast-enhanced acquisition of the whole body (64-MSCT). CA (350 mg/ml iodine) was administered as a split bolus injection of 100 ml (2 ml/s), 20 ml NaCl (1 ml/s), 60 ml (4 ml/s), 40 ml NaCl (4 ml/s) with a scan delay of 85s to detect injuries of both the arterial system and parenchymal organs in a single acquisition. Both the quantitative (SNR/CNR) and qualitative (5-point Likert scale) image quality was evaluated in parenchymal organs that are often injured in trauma patients. Radiation exposure was assessed. The use of IR combined with a reduction of tube voltage resulted in good qualitative and quantitative image quality and a significant reduction in radiation exposure of more than 40% (DLP 1087 vs. 647 mGy x cm). Image quality could be improved due to a dedicated protocol that included different levels of IR adapted to different slice thicknesses, kernels and the examined area for the evaluation of head, lung, body and bone injury patterns. In synopsis of our results, we recommend the implementation of a polytrauma protocol with a tube voltage of 120 kVp and the following IR levels: cCT 5mm: ASIR 20; cCT 0.625 mm: ASIR 40; lung 2.5 mm: ASIR 30, body 5 mm: ASIR 40; body 1.25 mm: ASIR 50; body 0.625 mm: ASIR 0. A dedicated adaptation of the CT trauma protocol (level of reduction of tube voltage and of IR) according to the examined body region (head, lung, body, bone) combined with a

  12. The effects of staffing and training on firm productivity and profit growth before, during, and after the Great Recession.

    Science.gov (United States)

    Kim, Youngsang; Ployhart, Robert E

    2014-05-01

    This study integrates research from strategy, economics, and applied psychology to examine how organizations may leverage their human resources to enhance firm performance and competitive advantage. Staffing and training are key human resource management practices used to achieve firm performance through acquiring and developing human capital resources. However, little research has examined whether and why staffing and training influence firm-level financial performance (profit) growth under different environmental (economic) conditions. Using 359 firms with over 12 years of longitudinal firm-level profit data, we suggest that selective staffing and internal training directly and interactively influence firm profit growth through their effects on firm labor productivity, implying that staffing and training contribute to the generation of slack resources that help buffer and then recover from the effects of the Great Recession. Further, internal training that creates specific human capital resources is more beneficial for prerecession profitability, but staffing is more beneficial for postrecession recovery, apparently because staffing creates generic human capital resources that enable firm flexibility and adaptation. Thus, the theory and findings presented in this article have implications for the way staffing and training may be used strategically to weather economic uncertainty (recession effects). They also have important practical implications by demonstrating that firms that more effectively staff and train will outperform competitors throughout all pre- and postrecessionary periods, even after controlling for prior profitability. (c) 2014 APA, all rights reserved.

  13. Workshops for state review of site suitability criteria for high-level radioactive waste repositories: analysis and recommendations

    International Nuclear Information System (INIS)

    1978-02-01

    The purpose of this report is to present the views and recommendations of invited State officials and legislators participating in a workshop concerned with preliminary site suitability criteria for high level radioactive waste repositories. The workshops were open to the public and were conducted by the U. S. Nuclear Regulatory Commission (NRC) during September 1977 in three regional locations across the United States. This contractor report is the second of two reports and consolidates the discussion by State officials on the role of a State in siting a repository, NRC's waste management program, the transportation of high level wastes, the number and location of repositories and concerns with the socio-economic impacts of siting a repository in a community. The recommendations to the NRC can be categorized into four areas. These were: (1) general recommendations, (2) procedural recommendations, (3) recommendations for improving communications, and (4) specific recommendations on the preliminary siting criteria. The recommendations emphasized the need for early State involvement in the siting process, the need for an impacted State to assess repository operations, the need for early solution of waste transportation concerns, and the requirement that any repository developed insure the protection of the public health and safety as its most important characteristic. Other participant recommendations are included in the body of the report

  14. Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.

    Science.gov (United States)

    Martsolf, Grant R; Auerbach, David; Benevent, Richele; Stocks, Carol; Jiang, H Joanna; Pearson, Marjorie L; Ehrlich, Emily D; Gibson, Teresa B

    2014-11-01

    Inpatient quality deficits have important implications for the health and well-being of patients. They also have important financial implications for payers and hospitals by leading to longer lengths of stay and higher intensity of treatment. Many of these costly quality deficits are particularly sensitive to nursing care. To assess the effect of nurse staffing on quality of care and inpatient care costs. Longitudinal analysis using hospital nurse staffing data and the Healthcare Cost and Utilization Project State Inpatient Databases from 2008 through 2011. Hospital discharges from California, Nevada, and Maryland (n=18,474,860). A longitudinal, hospital-fixed effect model was estimated to assess the effect of nurse staffing levels and skill mix on patient care costs, length of stay, and adverse events, adjusting for patient clinical and demographic characteristics. Increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, but did not lead to increases in patient care costs. Changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs. The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix can lead to improved quality and reduced length of stay at no additional cost.

  15. Computerized nursing staffing: a software evaluation.

    Science.gov (United States)

    Pereira, Irene Mari; Gaidzinski, Raquel Rapone; Fugulin, Fernanda Maria Togeiro; Peres, Heloísa Helena Ciqueto; Lima, Antônio Fernandes Costa; Castilho, Valéria; Mira, Vera Lúcia; Massarollo, Maria Cristina Komatsu Braga

    2011-12-01

    The complexity involved in operationalizing the method for nursing staffing, in view of the uncountable variable related to identifying the workload, the effective working time of the staff, and the Technical Security Index (TSI) revealed the need to develop a software program named: Computerized Nursing Staffing (DIPE, in Portuguese acronyms). This exploratory, descriptive study was performed with the objective to evaluate the technical quality and functional performance of DIPE. Participants were eighteen evaluators, ten of whom where nurse faculty or nurse hospital unit managers, and eight health informatics experts. The software evaluation was performed according to norm NBR ISO/IEC 9126-1, considering the features functionality, reliability, usability, efficiency, and maintainability. The software evaluation reached positive results and agreement among the evaluators for all the evaluated features. The reported suggestions are important for proposing further improving and enhancing the DIPE.

  16. Workshops for state review of site suitability criteria for high-level radioactive waste repositories. analysis and recommendation. Volume 1

    International Nuclear Information System (INIS)

    Kress, H.W.

    1978-02-01

    The purpose of this report is to present the views and recommendations of State officials and legislators participating in a workshop concerned with preliminary site suitability criteria for high-level radioactive waste repositories. The workshops were open to the public and were conducted by the U.S. Nuclear Regulatory Commission (NRC) during September 1977 in three regional locations across the United States. This contractor report is the second of two reports and consolidates the discussion by State officials to the role of a State in siting a repository, NRC's waste management program, the transportation of high-level wastes, the number and location of repositories and concerns with the socio-economic impacts of siting a repository in a community. The recommendations to the NRC can be categorized into four areas. These are: (1) general recommendations, (2) procedural recommendations, (3) recommendations for improving communications, and (4) specific recommendations on the preliminary siting criteria. The recommendations emphasized the need for early State involvement in the siting process, the need for an impacted State to assess repository operations, and the requirement that any repository developed insure the protection of the public health and safety as its most important characteristic

  17. Physician staffing for the practice of psychosomatic medicine in general hospitals: a pilot study.

    Science.gov (United States)

    Kunkel, Elisabeth J S; Del Busto, Elena; Kathol, Roger; Stern, Theodore A; Wise, Thomas N; Stoddard, Frederick R; Straus, Joshua; Saravay, Stephen M; Muskin, Philip R; Dresner, Nehama; Harrington, Colin J; Weiner, Joseph; Barnhill, John; Becker, Madeleine; Joseph, Robert C; Oyesanmi, Olugbenga; Fann, Jesse R; Colon, Eduardo; Epstein, Steven; Weinrieb, Robert

    2010-01-01

    The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients. The authors sought to determine the current staffing patterns and ratios of Psychosomatic Medicine practitioners in general hospitals, to better align manpower with clinical service and educational requirements on consultation-liaison psychiatry services. Program directors of seven academic Psychosomatic Medicine (PM) programs in the Northeast were surveyed to establish current staffing patterns and patient volumes. Survey data were reviewed and analyzed along with data from the literature and The Academy of Psychosomatic Medicine (APM) fellowship directory. Staffing patterns varied widely, both in terms of the number and disciplines of staff providing care for medical and surgical inpatients. The ratio of initial consultations performed per hospital bed varied from 1.6 to 4.6. Although staffing patterns vary, below a minimum staffing level, there is likely to be significant human and financial cost. Efficient sizing of a PM staff must be accomplished in the context of a given institution's patient population, the experience of providers, the presence/absence and needs of trainees, and the financial constraints of the department and institution. National survey data are needed to provide benchmarks for both academic and nonacademic PM services.

  18. Using Recommendation System for E-learning Environments at degree level

    Directory of Open Access Journals (Sweden)

    Rubén González Crespo

    2009-12-01

    Full Text Available Nowadays, new technologies and the fast growth of the Internet have made access to information easier for all kind of people, raising new challenges to education when using Internet as a medium. One of the best examples is how to guide students in their learning processes.The need to look for guidance from their teachers or other companions that many Internet users experience when endeavoring to choose their readings, exercises o practices is a very common reality. In order to cater for this need many different information and recommendation strategies have been developed. Recommendation Systems is one of these.Recommendation Systems try to help the user, presenting him those objects he could be more interested in, based on his known preferences or on those of other users with similar characteristics.This document tries to present the current situation with regards to Recommendation Systems and their application on distance education over the Internet.

  19. Effective Trust-Aware E-learning Recommender System Based on Learning Styles and Knowledge Levels

    Science.gov (United States)

    Dwivedi, Pragya; Bharadwaj, Kamal K.

    2013-01-01

    In the age of information explosion, e-learning recommender systems (ELRSs) have emerged as the most essential tool to deliver personalized learning resources to learners. Due to enormous amount of information on the web, learner faces problem in searching right information. ELRSs deal with the problem of information overload effectively and…

  20. High-level panel of experts to recommend future course for IAEA

    International Nuclear Information System (INIS)

    2008-01-01

    Full text: A high-level panel of experts, charged by IAEA Director General Mohamed ElBaradei with making an assessment of the challenges the IAEA will face up to the year 2020 and beyond, holds its initial meetings in Vienna 25 - 26 February. The Commission of Eminent Persons, under the chairmanship of former Mexican President, Ernesto Zedillo, includes 18 senior international figures, and will make recommendations on ways in which the Agency can prepare to meet its expanding workload. The Commission's findings are intended to stimulate further discussion - among Member States, between the States and the IAEA Secretariat, and by the broader public - about the future of the Agency and how best it can contribute in the coming years to the efforts of the international community to achieve development, peace and security, said IAEA Director General Mohamed ElBaradei. The members of the Commission are: Dr. Ernesto Zedillo (Chairman) - Director of the Yale Center for the Study of Globalization; former President of Mexico; Ambassador Oluyemi Adeniji - former Minister of Foreign Affairs, Nigeria; former Member of the Board of Governors of the IAEA; Lakhdar Brahimi - Visiting Scholar at the Institute for Advanced Study, Princeton, New Jersey; former UN Under-Secretary-General, Special Adviser to the Secretary-General, and Chair of the Panel on UN Peace Operations; Lajos Bokros - Professor of Economics and Public Policy, and Chief Operating Officer of the Central European University, Budapest, Hungary; Dr. Rajagopala Chidambaram - Principal Scientific Advisor to the Government of India; DAE Homi Bhabha Professor; former Chairman of the Atomic Energy Commission; former Director of the Bhabha Atomic Research Centre; Senator Lamberto Dini - President of the Foreign Affairs Committee of the Italian Senate; Gareth Evans - President and Chief Executive Officer, International Crisis Group, Brussels; former Australian Foreign Minister 1988-1998; former Minister for Resources and

  1. Nuclear power plant organization and staffing for improved performance: Lessons learned

    International Nuclear Information System (INIS)

    1998-11-01

    Experience from well operated nuclear power plants (NPPs) around the world indicates that an organizational structure which efficiently supports plant operation is essential in economically achieving both high level of safety and operational performance. At the same time energy markets are being opened to competition in many Member States. It is in consideration of this new competitive energy market that the overall objective of this document is to provide NPP managers information on lessons learned on improving the organization and staffing of NPP activities. Within this overall objective, specific objectives are to: Identify organisational design and staffing principles, Provide examples of how NPPs implement these principles, Identify typical NPP staffing levels, Factors affecting these levels, and staffing trends among various NPP types. Although it is not expected that any particular utility or NPP manager would consider all of the suggestions provided here to be appropriate, it is anticipated that nearly every NPP manager in IAEA Member States would find some ideas useful in improving the efficiency and effectiveness of NPP activities

  2. Development and application of an objective staffing calculator for antimicrobial stewardship programs in the Veterans Health Administration.

    Science.gov (United States)

    Echevarria, Kelly; Groppi, Julie; Kelly, Allison A; Morreale, Anthony P; Neuhauser, Melinda M; Roselle, Gary A

    2017-11-01

    The development and validation of a staffing calculator and its use in creating staffing guidance for antimicrobial stewardship programs (ASPs) in Veterans Health Administration (VHA) facilities are described. The Tools and Resources Work Group of the Antimicrobial Stewardship Task Force and PBM Clinical Pharmacy Practice Office of the Department of Veterans Affairs developed, tested, and validated a staffing calculator to track patient care and ASP management activities needed to maintain a comprehensive ASP. Time spent on activities was based on time-in-motion tracking studies and input from experienced antimicrobial stewards. The staffing calculator was validated across VHA facilities of varying sizes and complexities to determine the number of needed clinical pharmacist full-time equivalents (FTEs) to implement and maintain ASPs per 100 occupied beds. A total of 12 facilities completed the staffing calculator for 1 calendar week. The median number of occupied beds was 226. Most facilities had at least 100 occupied beds, and 6 of the 12 were considered high complexity facilities. The median calculated FTE personnel requirement was 2.62, or 1.01 per 100 occupied beds. The majority of FTE time (70%) was spent on patient care activities and 30% on program management activities, including infectious diseases or ASP rounds. The final recommendations indicated that in order to implement and manage a robust ASP, a pharmacist FTE investment of 1.0 per 100 occupied beds would be needed. A staffing calculator to account for the time needed to implement ASP activities and provide staffing guidance across a large health-care system was validated. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. Organisational quality, nurse staffing and the quality of chronic disease management in primary care: observational study using routinely collected data.

    Science.gov (United States)

    Griffiths, Peter; Maben, Jill; Murrells, Trevor

    2011-10-01

    An association between quality of care and staffing levels, particularly registered nurses, has been established in acute hospitals. Recently an association between nurse staffing and quality of care for several chronic conditions has also been demonstrated for primary care in English general practice. A smaller body of literature identifies organisational factors, in particular issues of human resource management, as being a dominant factor. However the literature has tended to consider staffing and organisational factors separately. We aim to determine whether relationships between the quality of clinical care and nurse staffing in general practice are attenuated or enhanced when organisational factors associated with quality of care are considered. We further aim to determine the relative contribution and interaction between these factors. We used routinely collected data from 8409 English general practices. The data, on organisational factors and the quality of clinical care for a range of long term conditions, is gathered as part of "Quality and Outcomes Framework" pay for performance system. Regression models exploring the relationship of staffing and organisational factors with care quality were fitted using MPLUS statistical modelling software. Higher levels of nurse staffing, clinical recording, education and reflection on the results of patient surveys were significantly associated with improved clinical care for COPD, CHD, Diabetes and Hypothyroidism after controlling for organisational factors. There was some evidence of attenuation of the estimated nurse staffing effect when organisational factors were considered, but this was small. The effect of staffing interacted significantly with the effect of organisational factors. Overall however, the characteristics that emerged as the strongest predictors of quality of clinical care were not staffing levels but the organisational factors of clinical recording, education and training and use of patient

  4. Risk-Adjusted Staffing to Improve Patient Value.

    Science.gov (United States)

    Pappas, Sharon; Davidson, Nan; Woodard, Jim; Davis, Jennifer; Welton, John M

    2015-01-01

    The presence of hospital-acquired conditions, infections, or other adverse events are a reflection of inadequate patient safety and can have short and long-term impacts of quality of life for patients as well as financial implications for the hospital. Using unit-level information to develop a tool, the Patient Risk Assessment Profile, nurses on an inpatient surgical unit proactively assessed patient risk to guide staffing decisions and nurse-patient assignment with the goal to improve patient value, reduce adverse events, and avoid unnecessary hospital costs. Findings showed decreased adverse event rates for patient falls, catheter-acquired urinary tract infection, central line-acquired blood stream infection, and pressure ulcer prevalence after the intervention was implemented. In addition, end-of-shift over-time and patient cost per case decreased as well yielding an operational impact in hospital financial performance.

  5. Brown & Smith Communication Solutions: A Staffing System Simulation

    Science.gov (United States)

    Small, Erika E.; Doll, Jessica L.; Bergman, Shawn M.; Heggestad, Eric D.

    2018-01-01

    Developing students' practical skills in strategic staffing and selection within the classroom can be challenging. This article describes a staffing system simulation designed to engage students and develop applied skills in strategic recruiting, assessment, and evaluation of job applicants. Instructors looking for a multifaceted team project…

  6. Managerial Ownership in Nursing Homes: Staffing, Quality, and Financial Performance.

    Science.gov (United States)

    Huang, Sean Shenghsiu; Bowblis, John R

    2017-06-20

    Ownership of nursing homes (NHs) has primarily focused broadly on differences between for-profit (FP), nonprofit (NFP), and government-operated facilities. Yet, among FPs, the understanding of detailed ownership structures at individual NHs is rather limited. Particularly, NH administrators may hold significant equity interests in their facilities, leading to heterogeneous financial incentives and NH outcomes. Through the principal-agent theory, this article studies how managerial ownership of individual facilities affects NH outcomes. We use a unique panel dataset of Ohio NHs (2005-2010) to empirically examine the relationship between managerial equity ownership and NH staffing, quality, and financial performance. We identify facility administrators as owner-managers if they have more than 5% of the equity stakes or are relatives of the owners. The statistical analysis is based on the pooled ordinary least squares and NH-fixed effect models. We find that owner-managed NHs are associated with higher nursing staff levels compared to other FP NHs. Surprisingly, despite higher staffing levels, owner-managed NHs are not associated with better quality and we find no statistically significant difference in financial performance between owner-managed and nonowner-managed FP NHs. Our results do not support the principal-agent model and we offer alternative explanations for future research. Our findings provide empirical evidence that NH ownership structures are more nuanced than simply broadly categorizing facilities as FP or NFP, and our results do not fully align with the standard principal-agent model. The role of managerial ownership should be considered in future NH research and policy discussions. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Ex vivo changes in blood glucose levels seldom change blood glucose control algorithm recommendations

    NARCIS (Netherlands)

    de Groene, L.; Harmsen, R. E.; Binnekade, J. M.; Spronk, P. E.; Schultz, M. J.

    2010-01-01

    Background. Hyperglycemia and glycemic variabilities are associated with adverse outcomes in critically ill patients. Blood glucose control with insulin mandates an adequate and precise assessment of blood glucose levels. Blood glucose levels, however, can change ex vivo after sampling. The aim of

  8. A hybrid fuzzy-ontology based intelligent system to determine level of severity and treatment recommendation for Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Torshizi, Abolfazl Doostparast; Zarandi, Mohammad Hossein Fazel; Torshizi, Ghazaleh Doostparast; Eghbali, Kamyar

    2014-01-01

    This paper deals with application of fuzzy intelligent systems in diagnosing severity level and recommending appropriate therapies for patients having Benign Prostatic Hyperplasia. Such an intelligent system can have remarkable impacts on correct diagnosis of the disease and reducing risk of mortality. This system captures various factors from the patients using two modules. The first module determines severity level of the Benign Prostatic Hyperplasia and the second module, which is a decision making unit, obtains output of the first module accompanied by some external knowledge and makes an appropriate treatment decision based on its ontology model and a fuzzy type-1 system. In order to validate efficiency and accuracy of the developed system, a case study is conducted by 44 participants. Then the results are compared with the recommendations of a panel of experts on the experimental data. Then precision and accuracy of the results were investigated based on a statistical analysis. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Credit Crisis with focus on level three valuations anFAS157: Analysis and Recommendations for Change

    Directory of Open Access Journals (Sweden)

    Ph.D. candidate Arber H. Hoti

    2012-05-01

    Full Text Available The paper examines the effect of level three valuations and FAS 157 implications on investors, auditors’ work, valuation disclosures and gives recommendations for improvements based on best practices. The aim of this research is to demonstrate that the fair value measurements should not be suspended. The standards provide for measurement of fair value in all market conditions. Therefore, level 3 measurements or mark-to-model is an answer for many issuers that are not sure how to measure their assets and liabilities at the fair value. The paper concludes that fair value measurement has not caused the current crisis and has no pro-cyclical effect and suggests several recommendations for policy makers and regulators.

  10. The Size and Scope of Collegiate Athletic Training Facilities and Staffing.

    Science.gov (United States)

    Gallucci, Andrew R; Petersen, Jeffrey C

    2017-08-01

      Athletic training facilities have been described in terms of general design concepts and from operational perspectives. However, the size and scope of athletic training facilities, along with staffing at different levels of intercollegiate competition, have not been quantified.   To define the size and scope of athletic training facilities and staffing levels at various levels of intercollegiate competition. To determine if differences existed in facilities (eg, number of facilities, size of facilities) and staffing (eg, full time, part time) based on the level of intercollegiate competition.   Cross-sectional study.   Web-based survey.   Athletic trainers (ATs) who were knowledgeable about the size and scope of athletic training programs.   Athletic training facility size in square footage; the AT's overall facility satisfaction; athletic training facility component spaces, including satellite facilities, game-day facilities, offices, and storage areas; and staffing levels, including full-time ATs, part-time ATs, and undergraduate students.   The survey was completed by 478 ATs (response rate = 38.7%) from all levels of competition. Sample means for facilities were 3124.7 ± 4425 ft 2 (290.3 ± 411 m 2 ) for the central athletic training facility, 1013 ± 1521 ft 2 (94 ± 141 m 2 ) for satellite athletic training facilities, 1272 ± 1334 ft 2 (118 ± 124 m 2 ) for game-day athletic training facilities, 388 ± 575 ft 2 (36 ± 53 m 2 ) for athletic training offices, and 424 ± 884 ft 2 (39 ± 82 m 2 ) for storage space. Sample staffing means were 3.8 ± 2.5 full-time ATs, 1.6 ± 2.5 part-time ATs, 25 ± 17.6 athletic training students, and 6.8 ± 7.2 work-study students. Division I schools had greater resources in multiple categories (P training staffing and facilities. The results (1) suggest that the ATs were satisfied with their facilities and (2) highlight the differences in resources among competition levels.

  11. The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members.

    Science.gov (United States)

    Helfrich, Christian D; Simonetti, Joseph A; Clinton, Walter L; Wood, Gordon B; Taylor, Leslie; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V; Fihn, Stephan D; Nelson, Karin M

    2017-07-01

    Work-related burnout is common in primary care and is associated with worse patient safety, patient satisfaction, and employee mental health. Workload, staffing stability, and team completeness may be drivers of burnout. However, few studies have assessed these associations at the team level, and fewer still include members of the team beyond physicians. To study the associations of burnout among primary care providers (PCPs), nurse care managers, clinical associates (MAs, LPNs), and administrative clerks with the staffing and workload on their teams. We conducted an individual-level cross-sectional analysis of survey and administrative data in 2014. Primary care personnel at VA clinics responding to a national survey. Burnout was measured with a validated single-item survey measure dichotomized to indicate the presence of burnout. The independent variables were survey measures of team staffing (having a fully staffed team, serving on multiple teams, and turnover on the team), and workload both from survey items (working extended hours), and administrative data (patient panel overcapacity and average panel comorbidity). There were 4610 respondents (estimated response rate of 20.9%). The overall prevalence of burnout was 41%. In adjusted analyses, the strongest associations with burnout were having a fully staffed team (odds ratio [OR] = 0.55, 95% CI 0.47-0.65), having turnover on the team (OR = 1.67, 95% CI 1.43-1.94), and having patient panel overcapacity (OR = 1.19, 95% CI 1.01-1.40). The observed burnout prevalence was 30.1% lower (28.5% vs. 58.6%) for respondents working on fully staffed teams with no turnover and caring for a panel within capacity, relative to respondents in the inverse condition. Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.

  12. Environmental Education. University Level. 10 Years Development; Recommendations. Denmark, Finland, Iceland, Norway, Sweden.

    Science.gov (United States)

    Nordic Council of Ministers, Copenhagen (Denmark).

    The Nordic countries have worked together over the last decade to enhance the efforts of environmental educators. This document details: (1) the history and activities of the group responsible for the coordination of efforts at the university level; (2) the types of environmental education occurring in Denmark, Iceland, Finland, Norway, and…

  13. Planning a Master's Level Curriculum According to Career Space Recommendations Using Concept Mapping Techniques

    Science.gov (United States)

    Toral Marin, Sergio L.; Martineztorres, Rocio; Barrero Garcia, Federico J.; Vazquez, Sergio Gallardo; Vargas, Enrique; Ayala, Vicente Gonzalez

    2006-01-01

    Nowadays the European Universities are worried about how to adapt higher education to the new European Higher Education Area, as proposed in the Bologna Magna Charta Universitatum of 1998, and signed by 32 European Education Ministers. One of the key points in this higher education reform was the introduction of new Master's level curricula. These…

  14. Summary (and) recommendations

    International Nuclear Information System (INIS)

    1992-01-01

    This report looks at the Health and Safety record at the Atomic Weapons Establishment at Aldermaston. The last outside report was by Pochin in 1978 which recommended that staffing for health physicists and maintenance staff should be increased and that some buildings where solid and liquid radioactive wastes were processed should be replaced. A new facility to process contaminated heavy equipment was also recommended. This report finds that none of the recommendations have been fully implemented. It also lists accidents, fires and worker contamination. It is concluded that some of the problems are that nuclear weapons production is inherently unsafe and cannot be made safe, that the secrecy surrounding the establishments' safety record is not good for improving it and finally the report calls for production at Aldermaston to be halted. (UK)

  15. Reducing the Impact of Immigration Enforcement Policies to Ensure the Health of North Carolinians: Statewide Community-Level Recommendations.

    Science.gov (United States)

    Mann, Lilli; Simán, Florence M; Downs, Mario; Sun, Christina J; de Hernandez, Brisa Urquieta; García, Manuel; Alonzo, Jorge; Lawlor, Emma; Rhodes, Scott D

    2016-01-01

    Research indicates that fear of immigration enforcement among Latinos in North Carolina results in limited access to and utilization of health services and negative health consequences. This project developed recommendations to mitigate the public health impact of immigration enforcement policies in North Carolina. Our community-based participatory research partnership conducted 6 Spanish-language report-backs (an approach to sharing, validating, and interpreting data) and 3 bilingual forums with community members and public health leaders throughout North Carolina. The goals of these events were to discuss the impact of immigration enforcement on Latino health and develop recommendations to increase health services access and utilization. Findings from the report-backs and forums were analyzed using grounded theory to identify and refine common recommendations. A total of 344 people participated in the report-backs and forums. Eight recommendations emerged: increase knowledge among Latinos about local health services; build capacity to promote policy changes; implement system-level changes among organizations providing health services; train lay health advisors to help community members navigate systems; share Latinos' experiences with policy makers; reduce transportation barriers; increase schools' support of Latino families; and increase collaboration among community members, organizations, health care providers, and academic researchers. Representatives from 16 of 100 North Carolina counties participated. These 16 counties represent geographically diverse regions, and many of these counties have large Latino populations. Immigration enforcement is a public health issue. Participants proposed developing new partnerships, identifying strategies, and implementing action steps for carrying out recommendations to reduce negative health outcomes among Latinos in North Carolina. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights

  16. Designing Dietary Recommendations Using System Level Interactomics Analysis and Network-Based Inference

    Directory of Open Access Journals (Sweden)

    Tingting Zheng

    2017-09-01

    diet in disease development. Due to the complexity of analyzing the food composition and eating patterns of individuals our in silico analysis, using large-scale gene expression datasets and network-based topological features, may serve as a proof-of-concept in nutritional systems biology for identifying diet-disease relationships and subsequently designing dietary recommendations.

  17. A recommended procedure for establishing the source level relationships between heroin case samples of unknown origins

    Directory of Open Access Journals (Sweden)

    Kar-Weng Chan

    2014-06-01

    Full Text Available A recent concern of how to reliably establish the source level relationships of heroin case samples is addressed in this paper. Twenty-two trafficking heroin case samples of unknown origins seized from two major regions (Kuala Lumpur and Penang in Malaysia were studied. A procedure containing six major steps was followed to analyze and classify these samples. Subsequently, with the aid of statistical control samples, reliability of the clustering result was assessed. The final outcome reveals that the samples seized from the two regions in 2013 had highly likely originated from two different sources. Hence, the six-step procedure is sufficient for any chemist who attempts to assess the relative source level relationships of heroin samples.

  18. Recommended aerobic fitness level for metabolic health in children and adolescents: a study of diagnostic accuracy

    DEFF Research Database (Denmark)

    Adegboye, Amanda Ra; Anderssen, Sigmund A; Froberg, Karsten

    2011-01-01

    would be expected by chance (AUC >0.5) for all cut-offs. Conclusions Aerobic fitness is easy to measure, and is an accurate tool for screening children with clustering of cardiovascular risk factors. Promoting physical activity in children with aerobic fitness level lower than the suggested cut...... including Denmark, Portugal, Estonia and Norway. Participants 4500 schoolchildren aged 9 or 15 years. Main Outcome Measure Aerobic fitness was expressed as peak oxygen consumption relative to bodyweight (mlO(2)/min/kg). Results Risk factors included in the composite risk score (mean of z-scores) were...

  19. Pre-hospital severe traumatic brain injury - comparison of outcome in paramedic versus physician staffed emergency medical services.

    Science.gov (United States)

    Pakkanen, Toni; Virkkunen, Ilkka; Kämäräinen, Antti; Huhtala, Heini; Silfvast, Tom; Virta, Janne; Randell, Tarja; Yli-Hankala, Arvi

    2016-04-29

    Traumatic brain injury (TBI) is one of the leading causes of death and permanent disability. Emergency Medical Services (EMS) personnel are often the first healthcare providers attending patients with TBI. The level of available care varies, which may have an impact on the patient's outcome. The aim of this study was to evaluate mortality and neurological outcome of TBI patients in two regions with differently structured EMS systems. A 6-year period (2005 - 2010) observational data on pre-hospital TBI management in paramedic-staffed EMS and physician-staffed EMS systems were retrospectively analysed. Inclusion criteria for the study were severe isolated TBI presenting with unconsciousness defined as Glasgow coma scale (GCS) score ≤ 8 occurring either on-scene, during transportation or verified by an on-call neurosurgeon at admission to the hospital. For assessment of one-year neurological outcome, a modified Glasgow Outcome Score (GOS) was used. During the 6-year study period a total of 458 patients met the inclusion criteria. One-year mortality was higher in the paramedic-staffed EMS group: 57 % vs. 42 %. Also good neurological outcome was less common in patients treated in the paramedic-staffed EMS group. We found no significant difference between the study groups when considering the secondary brain injury associated vital signs on-scene. Also on arrival to ED, the proportion of hypotensive patients was similar in both groups. However, hypoxia was common in the patients treated by the paramedic-staffed EMS on arrival to the ED, while in the physician-staffed EMS almost none of the patients were hypoxic. Pre-hospital intubation by EMS physicians probably explains this finding. The results suggest to an outcome benefit from physician-staffed EMS treating TBI patients. ClinicalTrials.gov ID NCT01454648.

  20. Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

    Directory of Open Access Journals (Sweden)

    Sachin Logani

    2011-01-01

    Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.

  1. Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults

    Directory of Open Access Journals (Sweden)

    Peter D. Hart

    2017-01-01

    Full Text Available Objectives The purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA with health status and preventive health behavior in adults. Methods A total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables. Results Overall, 53.9% (95% confidence interval [CI], 51.9 to 55.9% of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1% reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3% who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker. Conclusions In this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA.

  2. Overburdened Systems and Dealing With Disaster: Nursing Administrators' Experiences and Nursing Leadership Recommendations From a State-Level Perspective.

    Science.gov (United States)

    Millet, Clair P; Porche, Demetrius J

    Hurricane Katrina made landfall on the Louisiana coast on August 29, 2005. Since 2005, there has been a dramatic increase in natural, infectious, and man-made disasters. It is more evident that nursing leaders and administrators need to be prepared for all hazards. The purpose of this article is to provide nursing administrators with a perspective of state-level leadership during a natural disaster and to suggest recommendations based on lessons learned during Hurricanes Katrina, Rita, Gustav, and Ike in 2005. These come from a state governmental public health and a state nursing school within an academic health sciences center.

  3. Managerial implications of calculating optimal nurse staffing in medical units.

    Science.gov (United States)

    Bordoloi, S K; Weatherby, E J

    2000-07-01

    A critical managerial decision in health care organizations is the staffing decision. We offer a model to derive an optimum mix of different staff categories that minimizes total cost subject to constraints imposed by the patient acuity system and minimum staffing policies in a medical unit of Fairbanks Memorial Hospital, Alaska. We also indicate several managerial implications on how our results and their sensitivity analyses can be used effectively in decision making in a variety of categories.

  4. Managerial implications of calculating optimum nurse staffing in medical units.

    Science.gov (United States)

    Bordoloi, S K; Weatherby, E J

    1999-01-01

    A critical managerial decision in health care organizations is the staffing decision. We offer a model to derive an optimum mix of different staff categories that minimizes total cost subject to constraints imposed by the patient acuity system and minimum staffing policies in a medical unit of Fairbanks Memorial Hospital, Alaska. We also indicate several managerial implications on how our results and their sensitivity analyses can be used effectively in decision making in a variety of categories.

  5. Provider staffing effect on a decision aid intervention.

    Science.gov (United States)

    Ersek, Mary; Sefcik, Justine S; Lin, Feng-Chang; Lee, Tae Joon; Gilliam, Robin; Hanson, Laura C

    2014-02-01

    This study examined the association between Nurse Practitioner (NP) and Physician Assistant (PA) staffing in nursing homes and the effect of a decision aid regarding feeding options in dementia on the frequency of surrogate-provider discussions and on surrogates' decisional conflict. We compared these outcomes for facilities that had no NPs/PAs, part-time-only NP/PA staffing, and full-time NP/PA staffing. The sample included 256 surrogate decision makers from 24 nursing homes. The decision aid was associated with significant increases in discussion rates in facilities with part-time or no NP/PA staffing (26% vs. 51%, p vs. 41%, p vs. -0.047, p = .008, and -0.30 vs. -0.68, p = .014, respectively). Sites with full-time NP/PA staffing had high baseline rates of discussions (41%). These findings suggest that the decision aid and full-time NP/PA staffing can enhance surrogate decision making in nursing homes.

  6. Improvements to the DOE low-level waste regulatory structure and process under recommendation 94-2 - progress to date

    International Nuclear Information System (INIS)

    Regnier, E.

    1995-01-01

    Among the concerns expressed by the Defense Nuclear Facility Safety Board (DNFSB) in its Recommendation 94-2 was the lack of a clearly defined and effective internal Department of Energy (DOE) regulatory oversight and enforcement process for ensuring that low-level radioactive waste management health, safety, and environmental requirements are met. Therefore, part of the response to the DNFSB concern is a task to clarify and strengthen the low-level waste management regulatory structure. This task is being conducted in two steps. First, consistent with the requirements of the current DOE waste management order and within the framework of the current organizational structure, interim clarification of a review process and the associated organizational responsibilities has been issued. Second, in coordination with the revision of the waste management order and consistent with the organizational responsibilities resulting from the strategic alignment of DOE, a rigorous, more independent regulatory oversight structure will be developed

  7. Improvements to the DOE low-level waste regulatory structure and process under recommendation 94-2 - progress to date

    Energy Technology Data Exchange (ETDEWEB)

    Regnier, E.

    1995-12-31

    Among the concerns expressed by the Defense Nuclear Facility Safety Board (DNFSB) in its Recommendation 94-2 was the lack of a clearly defined and effective internal Department of Energy (DOE) regulatory oversight and enforcement process for ensuring that low-level radioactive waste management health, safety, and environmental requirements are met. Therefore, part of the response to the DNFSB concern is a task to clarify and strengthen the low-level waste management regulatory structure. This task is being conducted in two steps. First, consistent with the requirements of the current DOE waste management order and within the framework of the current organizational structure, interim clarification of a review process and the associated organizational responsibilities has been issued. Second, in coordination with the revision of the waste management order and consistent with the organizational responsibilities resulting from the strategic alignment of DOE, a rigorous, more independent regulatory oversight structure will be developed.

  8. Enhancing an oncologist's recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial.

    Science.gov (United States)

    Winters-Stone, Kerri M; Moe, Esther L; Perry, Cynthia K; Medysky, Mary; Pommier, Rodney; Vetto, John; Naik, Arpana

    2018-03-01

    Fatigue is a troublesome symptom for breast cancer patients, which might be mitigated with exercise. Cancer patients often prefer their oncologist recommend an exercise program, yet a recommendation alone may not be enough to change behavior. Our study determined whether adding an exercise DVD to an oncologist's recommendation to exercise led to better outcomes than a recommendation alone. Ninety breast cancer patients, at varying phases of treatment and stages of disease, were randomized to receive the following: an oncologist verbal recommendation to exercise (REC; n = 43) or REC plus a cancer-specific yoga DVD (REC + DVD; n = 47). Fatigue, vigor, and depression subscales of the Profile of Mood States, and physical activity levels (MET-min/week), exercise readiness, and self-efficacy were assessed at baseline, 4, and 8 weeks. Analyses controlled for age, time since diagnosis, and metastatic disease. Over 8 weeks, women in REC + DVD used the DVD an average of twice per week. The REC + DVD group had greater reductions in fatigue (- 1.9 ± 5.0 vs. - 1.0 ± 3.5, p = 0.02), maintained exercise readiness (- 0.1 ± 1.1 vs. - 0.3 ± 1.3; p = 0.03), and reported less of a decrease in physical activity (- 420 ± 3075 vs. - 427 ± 5060 MET-min/week, p = 0.06) compared to REC only. A low-cost, easily distributed, and scalable yoga-based DVD could be a simple booster to an oncologist's advice that motivates breast cancer patients, even those with advanced disease and/or in treatment, to engage in self-care, e.g., exercise, to manage fatigue. ClinicalTrials.gov Identifier: NCT03120819.

  9. Some historical background to the IAEA Definition and Recommendations concerning high-level radioactive wastes or other high-level radioactive matter unsuitable for dumping at sea

    International Nuclear Information System (INIS)

    Nishiwaki, Y.

    1981-01-01

    The need for internationally acceptable standards and regulations for preventing pollution of the sea by radioactive materials was recognized by the United Nations Conference on the Law of the Sea, which adopted the Convention on the High Seas in April 1958. Article 25 of the Convention provides that ''every State shall take measures to prevent pollution of the seas from the dumping of radioactive wastes, taking into account any standards and regulations which may be formulated by the competent international organizations.'' The Conference also adopted a resolution recommending that the IAEA pursue studies and take action to assist States in controlling the discharge of radioactive materials into the sea. When the Convention on the Prevention of Marine Pollution by Dumping of Wastes and Other Matter was adopted at the Intergovernmental Conference in London, 1972, the IAEA was given specific responsibilities to define criteria and standards for dealing with the questions of sea disposal of radioactive wastes. The IAEA Definition and Recommendations concerning ''high-level radioactive wastes or other high-level radioactive matter unsuitable for dumping at sea'' identify material, the radioactive content of which is at such a level that the Parties to the Convention would wish to prevent any participating State from issuing a special permit even after a detailed appraisal of the safety of the proposed operation, and even for the sector of the marine environment furthest removed from man, i.e. the deep sea with depth greater than 4000 m. Some historical background to these problems is discussed and some of the Japanese findings of the deep sea survey in the Pacific are introduced for comparison with the North Atlantic data which formed a basis of the IAEA Definition and Recommendations for the London Dumping Convention

  10. Physician staffing needs in critical care departments.

    Science.gov (United States)

    Gómez Tello, V; Ruiz Moreno, J; Weiss, M; González Marín, E; Merino de Cos, P; Franco Garrobo, N; Alonso Ovies, A; Montejo González, J C; Iber, T; Marx, G; Córcoles González, V; Gordo Vidal, F; Palencia Herrejón, E; Roca Guiseris, J

    Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds ratio), thus generating incomplete and minimalistic information. The Spanish Society of Intensive Care Medicine and Coronary Units established a Technical Committee of experts, the purpose of which was to draft recommendations regarding requirements for medical professionals in the ICU. The Technical Committee defined the following categories: 1) Patient care-related aspects; 2) Activities outside the ICU; 3) Patient safety and clinical management aspects; 4) Teaching; and 5) Research. A subcommittee was established with experts pertaining to each activity category, defining criteria for quantifying the percentage time of the intensivists dedicated to each task, and taking into account occupational category. A quantitative method was applied, the parameters of which were the number of procedures or tasks and the respective estimated indicative times for patient care-related activities within or outside the context of the DCCM, as well as for teaching and research activities. Regarding non-instrumental activities, which are more difficult to evaluate in real time, a matrix of range versus productivity was applied, defining approximate percentages according to occupational category. All activities and indicative times were tabulated, and a spreadsheet was created that modified a previously designed model in order to perform calculations according to the total sum of hours worked and the hours stipulated in the respective work contract. The competencies needed and the tasks which a Department of Critical Care Medicine professional must perform far exceed those of a purely patient care-related character, and cannot be quantified using structural criteria

  11. Identifying environmental, social, and psychological correlates of meeting the recommended physical activity levels for colon cancer prevention among Japanese adults.

    Science.gov (United States)

    Ishii, Kaori; Shibata, Ai; Oka, Koichiro

    2013-11-01

    Although physical activity reduces the risk of diseases such as cancer, diabetes and cardiovascular disease, a large proportion of the population is not sufficiently physically active. Therefore, the present study examined the environmental, social, and psychological correlates for meeting the 2 recommended physical activity criteria: ≥420 min per week of at least moderate-intensity activity (MPA criterion) and ≥210 min per week of vigorous activity (VPA criterion) for colon cancer prevention among Japanese adults. Cross-sectional study. The sample included 2000 Japanese adults aged 20-79 years. An Internet-based survey was used to assess seven sociodemographic variables (e.g., education level, employment status), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising, residential area), social variables (social support), psychological variables (self-efficacy, perceived positive (pros) and negative (cons) aspects of exercise), and physical activity. The adjusted odds of meeting each physical activity criterion by these variables were calculated. Overall, 22.3% of the study population met the criterion of MPA, and 7.3% met the criterion of VPA. Having high self-efficacy, fewer perceived cons, possessing home fitness equipment, reporting enjoyable scenery, and living in a rural area were significantly associated with meeting the recommended criteria. Participants who met the 2 activity recommendations differed by self-efficacy, cons, possession of home fitness equipment, reporting of enjoyable scenery, and residential area. These findings imply that strategies to promote more intense physical activities specifically in terms of these variables may be necessary for colon cancer prevention. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  12. Recommendations for codes and standards to be used for design and fabrication of high level waste canister

    International Nuclear Information System (INIS)

    Bermingham, A.J.; Booker, R.J.; Booth, H.R.; Ruehle, W.G.; Shevekov, S.; Silvester, A.G.; Tagart, S.W.; Thomas, J.A.; West, R.G.

    1978-01-01

    This study identifies codes, standards, and regulatory requirements for developing design criteria for high-level waste (HLW) canisters for commercial operation. It has been determined that the canister should be designed as a pressure vessel without provision for any overpressure protection type devices. It is recommended that the HLW canister be designed and fabricated to the requirements of the ASME Section III Code, Division 1 rules, for Code Class 3 components. Identification of other applicable industry and regulatory guides and standards are provided in this report. Requirements for the Design Specification are found in the ASME Section III Code. It is recommended that design verification be conducted principally with prototype testing which will encompass normal and accident service conditions during all phases of the canister life. Adequacy of existing quality assurance and licensing standards for the canister was investigated. One of the recommendations derived from this study is a requirement that the canister be N stamped. In addition, acceptance standards for the HLW waste should be established and the waste qualified to those standards before the canister is sealed. A preliminary investigation of use of an overpack for the canister has been made, and it is concluded that the use of an overpack, as an integral part of overall canister design, is undesirable, both from a design and economics standpoint. However, use of shipping cask liners and overpack type containers at the Federal repository may make the canister and HLW management safer and more cost effective. There are several possible concepts for canister closure design. These concepts can be adapted to the canister with or without an overpack. A remote seal weld closure is considered to be one of the most suitable closure methods; however, mechanical seals should also be investigated

  13. Mandatory and Voluntary Disclosures of Serbian Listed Companies - Achieved Level and Some Recommendation for Improving their Relevance

    Directory of Open Access Journals (Sweden)

    Ksenija Denčić-Mihajlov

    2016-04-01

    Full Text Available Purpose – This paper investigates mandatory and voluntary disclosure practices of non-financial listed companies on the Belgrade Stock Exchange. The results help in determining the level of transparency of Serbian s listed companies and in formulating recommendations for improving the quality and relevance of disclosed information. Design/methodology/approach – We focus on modeling both mandatory and voluntary disclosure indices for financial and non-financial information in order to evaluate the level of disclosure of 63 Serbian companies for reporting period 2012. Findings – We found the low level of both mandatory and voluntary disclosures. Concerning mandatary disclosure, the information that is least frequently disclosed by the sample companies are those related to the material content of the financial statements (information on changes in accounting estimates and corrections of fundamental errors in the previous period, as well as related companies. Serbian companies usually disclose information that contributes to their greater visibility. Similar to the mandatory disclosure, usually published voluntary information are mostly "neutral" from the point of impact on the values reported in the financial statements, which do not contribute to a better understanding of the financial position, profitability and cash flows of the company. Research limitations/implications – There is a limitation concerning the sample size (which is generally intrinsic to Serbian capital market size and the sample structure (research is limited to listed non-financial companies. The study covers the annual reports for 2012 which in Serbia coincides with a crisis period. The same research methodology could be applied on a larger and comprehensive database (non-listed companies and include period after 2012, which will allow the analysis of evolution of disclosure practices by companies within new accounting framework. Originality/value – The authors give

  14. Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria

    Directory of Open Access Journals (Sweden)

    Karien Jooste

    2013-01-01

    Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.

  15. National survey of crystalline rocks and recommendations of regions to be explored for high-level radioactive waste repository sites

    International Nuclear Information System (INIS)

    Smedes, H.W.

    1983-04-01

    A reconnaissance of the geological literature on large regions of exposed crystalline rocks in the United States provides the basis for evaluating if any of those regions warrant further exploration toward identifying potential sites for development of a high-level radioactive waste repository. The reconnaissance does not serve as a detailed evaluation of regions or of any smaller subunits within the regions. Site performance criteria were selected and applied insofar as a national data base exists, and guidelines were adopted that relate the data to those criteria. The criteria include consideration of size, vertical movements, faulting, earthquakes, seismically induced ground motion, Quaternary volcanic rocks, mineral deposits, high-temperature convective ground-water systems, hydraulic gradients, and erosion. Brief summaries of each major region of exposed crystalline rock, and national maps of relevant data provided the means for applying the guidelines and for recommending regions for further study. It is concluded that there is a reasonable likelihood that geologically suitable repository sites exist in each of the major regions of crystalline rocks. The recommendation is made that further studies first be conducted of the Lake Superior, Northern Appalachian and Adirondack, and the Southern Appalachian Regions. It is believed that those regions could be explored more effectively and suitable sites probably could be found, characterized, verified, and licensed more readily there than in the other regions

  16. National survey of crystalline rocks and recommendations of regions to be explored for high-level radioactive waste repository sites

    Energy Technology Data Exchange (ETDEWEB)

    Smedes, H.W.

    1983-04-01

    A reconnaissance of the geological literature on large regions of exposed crystalline rocks in the United States provides the basis for evaluating if any of those regions warrant further exploration toward identifying potential sites for development of a high-level radioactive waste repository. The reconnaissance does not serve as a detailed evaluation of regions or of any smaller subunits within the regions. Site performance criteria were selected and applied insofar as a national data base exists, and guidelines were adopted that relate the data to those criteria. The criteria include consideration of size, vertical movements, faulting, earthquakes, seismically induced ground motion, Quaternary volcanic rocks, mineral deposits, high-temperature convective ground-water systems, hydraulic gradients, and erosion. Brief summaries of each major region of exposed crystalline rock, and national maps of relevant data provided the means for applying the guidelines and for recommending regions for further study. It is concluded that there is a reasonable likelihood that geologically suitable repository sites exist in each of the major regions of crystalline rocks. The recommendation is made that further studies first be conducted of the Lake Superior, Northern Appalachian and Adirondack, and the Southern Appalachian Regions. It is believed that those regions could be explored more effectively and suitable sites probably could be found, characterized, verified, and licensed more readily there than in the other regions.

  17. The Effect of Oncologists’ Exercise Recommendation on the Level of Exercise and Quality of Life in Breast and Colorectal Cancer Survivors: Randomized Controlled Trial

    Science.gov (United States)

    Park, Ji-Hye; Lee, Junga; Oh, Minsuk; Park, Hyuna; Chae, Jisuk; Kim, Dong-Il; Lee, Mikyoung; Yoon, Yong Jin; Lee, Chulwon; Kim, Nam Kyu; Jones, Lee W.; Kim, Seung Il; Park, Se Ho; Jeon, Justin Y.

    2016-01-01

    Purpose The purpose of this study was to examine the effect of an oncologists’ exercise recommendation with and without exercise motivation package on the amount of exercise participation and quality of life (QOL) in breast and colon cancer survivors. Methods A total of 162 early stage breast and colorectal cancer survivors who completed primary and adjuvant treatments were recruited for this study. Participants were randomly assigned into one of three groups: 1) control (N=59), 2) Oncologists’ exercise recommendation (N=53), and 3) Oncologists’ exercise recommendation with exercise motivation package (N=50). At baseline and after 4 weeks, the level of exercise participation and QOL were assessed. Results A total of 130 (80.7%) participants completed the 4-week assessment. The result showed that participants who only received oncologists’ exercise recommendation did not increase their exercise participation level. But participants who received oncologist’s exercise recommendation with motivation package significantly increased the level of exercise participation [4.30±7.84 Metabolic Equivalent of Task (MET) hour per week, pexercise recommendation may not be enough to increase exercise participation.. Exercise motivation package with oncologists’ exercise recommendation may be ideal to increase exercise participation to cancer survivor Implications of cancer survivors The providence of exercise motivation package in addition to oncologists’ exercise recommendation to increase the level of exercise among breast and colorectal cancer survivors should be considered. PMID:25965782

  18. The Leapfrog initiative for intensive care unit physician staffing and its impact on intensive care unit performance: a narrative review.

    Science.gov (United States)

    Gasperino, James

    2011-10-01

    The field of critical care has changed markedly in recent years to accommodate a growing population of chronically critically ill patients. New administrative structures have evolved to include divisions, departments, and sections devoted exclusively to the practice of critical care medicine. On an individual level, the ability to manage complex multisystem critical illnesses and to introduce invasive monitoring devices defines the intensivist. On a systems level, critical care services managed by an intensivist-led multidisciplinary team are now recognized by their ability to efficiently utilize hospital resources and improve patient outcomes. Due to the numerous cost and quality issues related to the delivery of critical care medicine, intensive care unit physician staffing (IPS) has become a charged subject in recent years. Although the federal government has played a large role in regulating best practices by physicians, other third parties have entered the arena. Perhaps the most influential of these has been The Leapfrog Group, a consortium representing 130 employers and 65 Fortune 500 companies that purchase health care for their employees. This group has proposed specific regulatory guidelines for IPS that are purported to result in substantial cost containment and improved quality of care. This narrative review examines the impact of The Leapfrog Group's recommendations on critical care delivery in the United States. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Do informed consent documents for chiropractic clinical research studies meet readability level recommendations and contain required elements: a descriptive study.

    Science.gov (United States)

    Twist, Elissa; Lawrence, Dana J; Salsbury, Stacie A; Hawk, Cheryl

    2014-01-01

    Informed consent documents (ICD) in research are designed to educate research participants about the nature of the research project in which he or she may participate. United States (US) law requires the documents to contain specific elements present and be written in a way that is understandable to research participants. The purpose of this research is to determine if ICDs from randomized controlled trials conducted at chiropractic colleges meet recommended readability standards and contain the 13 content items required by US law. This study was approved by Palmer College of Chiropractic's IRB #2012-12-3-T and was conducted between December 3, 2012 and February 14, 2013. We contacted the research directors of five chiropractic colleges that have received federal funding supporting their clinical research. A total of 13 informed consent documents from four chiropractic colleges were analyzed using the Flesch-Kincaid measurement. We assigned a grade-level readability score to the document based on the average of three separate grade level scores conducted on the three largest uninterrupted blocks of text. Content of the 13 ICDs was assessed using a 13-element checklist. A point was given for every element present in the document, giving a score range of "0, no elements are present", to "13, all elements are present." The mean Flesch-Kincaid grade level readability was 10.8 (range 7.2 -14.0). Our sample had a mean readability score 2.8 grade levels above the generally-accepted US average reading level. Content varied among the 13 informed consent forms, ranging from only nine elements present in one document to all 13 required in five documents. Additionally, we collated the risks presented in each document. These results strongly suggest that chiropractic clinical researchers are not developing ICDs at a readability level congruent with the national average acceptable level. The low number of elements in some of the informed consent documents raises concern that not

  20. Excellence and evidence in staffing: a data-driven model for excellence in staffing (2nd edition).

    Science.gov (United States)

    Baggett, Margarita; Batcheller, Joyce; Blouin, Ann Scott; Behrens, Elizabeth; Bradley, Carol; Brown, Mary J; Brown, Diane Storer; Bolton, Linda Burnes; Borromeo, Annabelle R; Burtson, Paige; Caramanica, Laura; Caspers, Barbara A; Chow, Marilyn; Christopher, Mary Ann; Clarke, Sean P; Delucas, Christine; Dent, Robert L; Disser, Tony; Eliopoulos, Charlotte; Everett, Linda Q; Garcia, Amy; Glassman, Kimberly; Goodwin, Susan; Haagenson, Deb; Harper, Ellen; Harris, Kathy; Hoying, Cheryl L; Hughes-Rease, Marsha; Kelly, Lesly; Kiger, Anna J; Kobs-Abbott, Ann; Krueger, Janelle; Larson, Jackie; March, Connie; Martin, Deborah Maust; Mazyck, Donna; Meenan, Penny; McGaffigan, Patricia; Myers, Karen K; Nell, Kate; Newcomer, Britta; Cathy, Rick; O'Rourke, Maria; Rosa, Billy; Rose, Robert; Rudisill, Pamela; Sanford, Kathy; Simpson, Roy L; Snowden, Tami; Strickland, Bob; Strohecker, Sharon; Weems, Roger B; Welton, John; Weston, Marla; Valentine, Nancy M; Vento, Laura; Yendro, Susan

    2014-01-01

    The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research

  1. Cluster approach to staffing in the agricultural sector

    Directory of Open Access Journals (Sweden)

    Belaia Nataliia Vladimirovna

    2013-08-01

    Full Text Available The state of agricultural sector influences every person, determines the potential of national economy and politics. That is why the development of agricultural sector has always been one of the most urgent tasks for Russia and its regions. For the last few years the large-scale government support of the agricultural sector has been maintained which made the problem of peopleware of agricultural sector to be very significant. Staffing is known as fundamental principle of peopleware. Altai region is one of the farm production leaders, and problems of agricultural staffing are becoming more and more important.

  2. Determinants and effects of nurse staffing intensity and skill mix in residential care/assisted living settings.

    Science.gov (United States)

    Stearns, Sally C; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L; Konrad, Thomas R; Sloane, Philip D

    2007-10-01

    Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes. We obtained longitudinal data for 1,894 residents of 170 residential care/assisted living facilities participating in the Collaborative Studies of Long-Term Care. Descriptive statistics assessed the levels of direct care staff (registered nurse, licensed practical nurse, personal care aide). Regression analyses evaluated the relationship between two staffing measures (intensity measured as care hours per resident and skill mix measured as the percentage of total care hours by licensed nurses), facility characteristics, and four health outcomes (mortality, nursing home transfer, hospitalization, and incident morbidity). Care hours per resident decreased with facility size (economies of scale) only for very small facilities and increased with dementia prevalence (case-mix effect). Licensed staff accounted for a greater proportion of total hours in nonprofit settings. Health outcomes did not vary by total care hours per resident, but hospitalization rates were significantly lower in facilities with higher proportions of skilled staff hours; this effect was stronger as dementia case mix increased. Current staffing levels for the outcomes analyzed meet most residents' needs. Reduced hospitalization in relation to greater use of licensed staff suggests that increased use of these workers might result in reductions in acute care expenditures.

  3. The Effect of Iodine Levels Above of NRC Recommendations on Performance and Thyroidal Hormones in Holstein Dairy Cows

    Directory of Open Access Journals (Sweden)

    mohammad ali nurozian

    2016-06-01

    Full Text Available In order to survey of using iodine levels above of NRC recommendations on performance and thyroidal hormones, sixteen Holstein dairy cows with the average live body weight and daily milk production of 652 ± 43 and 32.9 ± 2.4 kg respectively, allocated to 4 treatments in a complete randomized design. The dietary treatments were 1 the basal diet (without Potassium Iodide as control diet, 2, 3 and 4, the basal diet plus 2.5, 5 and 7.5 mg/kg DM Potassium Iodide respectively. The number of replications in each treatment was 4 cows. The dry matter intake (DMI, milk yield and composition were compared between treatments. The iodine concentrations in feed, water, urine and blood as well as thyroidal hormones (T3 and T4 were determined. There were no significant differences between treatments for DMI, milk yield and compositions as well as diet efficiency. Iodine contents in blood and urine were affected by iodine supplementation and increased significantly (P

  4. Ontario: linking nursing outcomes, workload and staffing decisions in the workplace: the Dashboard Project.

    Science.gov (United States)

    Fram, Nancy; Morgan, Beverley

    2012-03-01

    Research shows that nurses want to provide more input into assessing patient acuity, changes in patient needs and staffing requirements. The Dashboard Project involved the further development and application of an electronic monitoring tool that offers a single source of nursing, patient and organizational information. It is designed to help inform nurse staffing decisions within a hospital setting. The Dashboard access link was installed in computers in eight nursing units within the Hamilton Health Sciences (HHS) network. The Dashboard indicators are populated from existing information/patient databases within the Decision Support Department at HHS. Committees composed of the unit manager, staff nurses, project coordinator, financial controller and an information controller met regularly to review the Dashboard indicators. Participants discussed the ability of the indicators to reflect their patients' needs and the feasibility of using the indicators to inform their clinical staffing plans. Project findings suggest that the Dashboard is a work in progress. Many of the indicators that had originally been incorporated were refined and will continue to be revised based on suggestions from project participants and further testing across HHS. Participants suggested the need for additional data, such as the time that nurses are off the unit (for code blue response, patient transfers and accompanying patients for tests); internal transfers/bed moves to accommodate patient-specific issues and particularly to address infection control issues; deaths and specific unit-centred data in addition to the generic indicators. The collaborative nature of the project enabled staff nurses and management to work together on a matter of high importance to both, providing valuable recommendations for shared nursing and interprofessional planning, further Dashboard development and project management.

  5. Low-level radioactive waste from commercial nuclear reactors. Volume 1. Recommendations for technology developments with potential to significantly improve low-level radioactive waste management

    Energy Technology Data Exchange (ETDEWEB)

    Rodgers, B.R.; Jolley, R.L.

    1986-02-01

    The overall task of this program was to provide an assessment of currently available technology for treating commercial low-level radioactive waste (LLRW), to initiate development of a methodology for choosing one technology for a given application, and to identify research needed to improve current treatment techniques and decision methodology. The resulting report is issued in four volumes. Volume 1 provides an executive summary and a general introduction to the four-volume set, in addition to recommendations for research and development (R and D) for low-level radioactive waste (LLRW) treatment. Generic, long-range, and/or high-risk programs identified and prioritized as needed R and D in the LLRW field include: (1) systems analysis to develop decision methodology; (2) alternative processes for dismantling, decontaminating, and decommissioning; (3) ion exchange; (4) incinerator technology; (5) disposal technology; (6) demonstration of advanced technologies; (7) technical assistance; (8) below regulatory concern materials; (9) mechanical treatment techniques; (10) monitoring and analysis procedures; (11) radical process improvements; (12) physical, chemical, thermal, and biological processes; (13) fundamental chemistry; (14) interim storage; (15) modeling; and (16) information transfer. The several areas are discussed in detail.

  6. 77 FR 40638 - Syniverse Technologies, Inc., Including On-Site Leased Workers From Insight Global Stone Staffing...

    Science.gov (United States)

    2012-07-10

    ... Insight Global Stone Staffing, and Randstad Formerly Known as Sapphire Technologies, Watertown, MA... workers from Insight Global, Stone Staffing, Randstad formerly known as Sapphire Technologies, Watertown... telecommunication services. The company reports that workers leased from Insight Global, Stone Staffing, Randstad...

  7. Relationship Between Staffing and Utilization of Special Collections ...

    African Journals Online (AJOL)

    Findings showed that, there was a gross under-utilization of special collections by users in the libraries studied. A further analysis revealed that significant relationships between staffing with utilization of special collections information resources existed. Based on the findings, the study concluded that, there was gross ...

  8. 5 CFR 9701.363 - Special staffing payments.

    Science.gov (United States)

    2010-01-01

    ... HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Special Payments § 9701.363 Special... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Special staffing payments. 9701.363 Section 9701.363 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT...

  9. Staffing UK University Campuses Overseas: Lessons from MNE Practice

    Science.gov (United States)

    Salt, John; Wood, Peter

    2014-01-01

    This article suggests that as their internal labor markets become more multinational in scope, UK universities may acquire similar staffing characteristics to commercial multinational enterprises (MNEs). Comparing evidence from four UK universities with several surveys of MNEs it concludes that, although there are broad similarities in the…

  10. The labor market effects of California's minimum nurse staffing law.

    Science.gov (United States)

    Munnich, Elizabeth L

    2014-08-01

    In 2004, California became the first state to implement statewide minimum nurse-to-patient ratios in general hospitals. In spite of years of work to establish statewide staffing regulations, there is little evidence that the law was effective in attracting more nurses to the hospital workforce or improving patient outcomes. This paper examines the effects of this legislation on employment and wages of registered nurses. By using annual financial data from California hospitals, I show that nurse-to-patient ratios in medical/surgical units increased substantially following the staffing mandate. However, survey data from two nationally representative datasets indicate that the law had no effect on the aggregate number of registered nurses or the hours they worked in California hospitals, and at most a modest effect on wages. My findings suggest that offsetting changes in labor demand due to hospital closures, combined with reclassification of workers within hospitals, and mitigated the employment effects of California's staffing regulation. This paper cautions that California's experience with minimum nurse staffing legislation may not be generalizable to states considering similar policies in very different hospital markets. Copyright © 2013 John Wiley & Sons, Ltd.

  11. Healthcare security staffing for smaller facilities: where science meets art.

    Science.gov (United States)

    Warren, Bryan

    2013-01-01

    Obtaining effective security resourcing and staffing for smaller healthcare facilities presents many difficulties, according to the author In this article, he provides guidance to security practitioners on taking existing data and translating it into a language that administration will understand and appreciate.

  12. Flexible nurse staffing based on hourly bed census predictions

    NARCIS (Netherlands)

    Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.

    2012-01-01

    Workload on nursing wards depends highly on patient arrivals and patient lengths of stay, which are both inherently variable. Predicting this workload and staffing nurses accordingly is essential for guaranteeing quality of care in a cost effective manner. This paper introduces a stochastic method

  13. Flexible nurse staffing based on hourly bed census predictions

    NARCIS (Netherlands)

    Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.

    Workloads in nursing wards depend highly on patient arrivals and lengths of stay, both of which are inherently variable. Predicting these workloads and staffing nurses accordingly are essential for guaranteeing quality of care in a cost-effective manner. This paper introduces a stochastic method

  14. Staffing requirements for future small and medium reactors

    International Nuclear Information System (INIS)

    McQuade, D.

    2001-01-01

    As power generators around the world grapple with the challenges of the environment, deregulation, competitions and changing prices of fuels, the economics of running a future power plant are influenced significantly by the component of labour costs. These costs, from plant staff, corporate support and purchased services, will affect the overall plant economics. To achieve improved efficiency and effectiveness of organization structures and staff, vendors and utilities are working jointly to apply lessons learned for future designs. This paper will examine the experience gained to date with Canadian CANDU 6 type reactors both in Canada and abroad. The strategies which have been very successful will be reviewed, together with the results of collaboration between Atomic Energy of Canada and the utilities. An assessment of the staffing numbers is provided as a comparison between current number at a Canadian utility and the projected number from a future plant with the improvements in the design. The influence to the overall plant economics are discussed with some broad generalities that look at the effects of increasing and reducing staff levels showing the probable impact on capacity factor. The lessons from other plants can contribute significantly to the performance improvement process. The paper points to the need for a balanced approach in the future for the distribution of operating maintenance and administration (OM and A) cost between nuclear safety studies; maintenance programs and staff training. In the future, utilities, together with the designers, will have to greatly improve plant maintenance and training. The improved design features detailed in the paper will support this strategy by utilizing operational experience. (author)

  15. Counselees’ expressed level of understanding of the risk estimate and surveillance recommendation are not associated with breast cancer surveillance adherence.

    NARCIS (Netherlands)

    Albada, A.; Dulmen, S. van; Dijkstra, H.; Wieffer, I.; Witkamp, A.; Ausems, M.G.E.M.

    2016-01-01

    We studied counselees’ expressed understanding of the risk estimate and surveillance recommendation in the final consultation for breast cancer genetic counseling in relation with their risk perception, worry and cancer surveillance adherence 1 year post-counseling. Consecutive counselees were

  16. Experiences and lessons learnt on staffing from the first Indian nuclear power plant (PHWR)

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.

    2001-01-01

    Three decades of operating experience in India has led to sustained high performance of NPPs. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. Specific qualification levels apply to each position - six at management positions, five licensed positions with the rest qualified through an equivalent training scheme. Practically all O and M activities are carried out on-site by the utility manpower with minimum involvement of contractors. The entire process of human resource development is in-house - with each NPP organisation comprised of 30% experienced staff transferred from older NPPs and 70% totally developed out of fresh recruits. Four to eight years lead time goes to qualify fresh recruits depending on the position. This optimisation of manpower is a result of continuous learning - through operating experience and regulatory feed back and self assessment for (i) optimising quantum of work load and (ii) improving productivity. For the first category, design improvements over older NPP's increased reliability, operability, maintainability and human factors are described separately in the companion paper. In this paper the organisation factors are discussed, starting with the initial lessons that demanded improved management and enhanced quality programmes and caused temporarily, high demand of staffing for bringing out new systems, e.g., (i) attaining maturity of units; (ii) standardising training, retraining and cross training and qualifications; (in) job rotations, (iv) in service inspection of reactor components; (v) quality audits. The experiences on subsequent optimisation of staffing levels are outlined. (author)

  17. Recommended safety, reliability, quality assurance and management aerospace techniques with possible application by the DOE to the high-level radioactive waste repository program

    International Nuclear Information System (INIS)

    Bland, W.M. Jr.

    1985-05-01

    Aerospace SRQA and management techniques, principally those developed and used by the NASA Lyndon B. Johnson Space Center on the manned space flight programs, have been assessed for possible application by the DOE and the DOE-contractors to the high level radioactive waste repository program that results from the implementation of the NWPA of 1982. Those techniques believed to have the greatest potential for usefulness to the DOE and the DOE-contractors have been discussed in detail and are recommended to the DOE for adoption; discussion is provided for the manner in which this transfer of technology can be implemented. Six SRQA techniques and two management techniques are recommended for adoption by the DOE; included with the management techniques is a recommendation for the DOE to include a licensing interface with the NRC in the application of the milestone reviews technique. Three other techniques are recommended for study by the DOE for possible adaptation to the DOE program

  18. Health Care Evolution Is Driving Staffing Industry Transformation.

    Science.gov (United States)

    Faller, Marcia; Gogek, Jim

    2016-01-01

    The powerful transformation in the health care industry is reshaping not only patient care delivery and the business of health care but also demanding new strategies from vendors who support the health care system. These new strategies may be most evident in workforce solutions and health care staffing services. Consolidation of the health care industry has created increased demand for these types of services. Accommodating a changing workforce and related pressures resulting from health care industry transformation has produced major change within the workforce solutions and staffing services sector. The effect of the growth strategy of mergers, acquisitions, and organic development has revealed organizational opportunities such as expanding capacity for placing physicians, nurses, and allied professionals, among other workforce solutions. This article shares insights into workforce challenges and solutions throughout the health care industry.

  19. Comparing the staffing models of outsourcing in selected companies

    OpenAIRE

    Chaloupková, Věra

    2010-01-01

    This thesis deals with problems of takeover of employees in outsourcing. The capital purpose is to compare the staffing model of outsourcing in selected companies. To compare in selected companies I chose multi-criteria analysis. This thesis is dividend into six chapters. The first charter is devoted to the theoretical part. In this charter describes the basic concepts as outsourcing, personal aspects, phase of the outsourcing projects, communications and culture. The rest of thesis is devote...

  20. Application of international recommendations and guidance on low level radioactive waste management and remediation of contaminated land at the national level: Experience of regulatory support in Northwest Russia

    International Nuclear Information System (INIS)

    Sneve, M.; Smith, G.M.; Kerrigan, E

    2005-01-01

    This paper notes the developments in international recommendations on radioactive waste management and remediation of contaminated land and considers their implementation in the context of the Norwegian Plan of Action to improve nuclear safety in North West Russia. Summary information is provided on projects to implement waste management activities (so-called Industrial Projects) and on projects to support regulatory supervision of waste management activities (so-called Regulatory Support Projects). The links between international recommendations and national practice are discussed and it is concluded that, in practice, the details of national standards differ both among themselves and, in some respects, from the recommendations of the ICRP and IAEA. Examples of further potential collaboration projects are listed. While separate responsibilities among organisations have to clear and maintained, combined involvement of operators and regulators is recognised as a prioritised area in future cooperation between NRPA and Russia. (author)

  1. STAFFING DALAM ALQURAN DAN HADIS DITINJAU DARI MANAJEMEN PENDIDIKAN

    Directory of Open Access Journals (Sweden)

    Tuti Andriani

    2016-08-01

    Full Text Available Staffing in an organization can be defined as a series of processes and efforts to acquire, develop, motivate, and evaluate the overall human resources. It is required within the organization in achieving its goals. In staffing, putting a person in a work should be in accordance with his capabilities and expertise so that all are expected to be achieved. Job placement principle is the principle of humanity, democracy, the right man on the right place, equal pay for equal work, unity of direction, the principle of unity of purpose, unity of command, Efficiency and Productivity Work. The concept is the placement, promotion, transfer and demotion. Staffing in the Qur'an and Hadith seen from education management is an employee must complete properly, responsibility, trust, has the capability and expertise, serve, work ethic, strong and trustworthy, honest, sincere, true and trustful, physical and mental strength, and high manners. Professionalism in view of sharia is characterized by three things, namely ahliyah (expertise, himmatul 'charity (high work ethic, trustworthy (reliable.

  2. Recommendation of maximum allowable noise levels for offshore wind power systems; Empfehlung von Laermschutzwerten bei der Errichtung von Offshore-Windenergieanlagen (OWEA)

    Energy Technology Data Exchange (ETDEWEB)

    Werner, Stefanie [Umweltbundesamt, Dessau-Rosslau (Germany). Fachgebiet II 2.3

    2011-05-15

    When offshore wind farms are constructed, every single pile is hammered into the sediment by a hydraulic hammer. Noise levels at Horns Reef wind farm were in the range of 235 dB. The noise may cause damage to the auditory system of marine mammals. The Federal Environmental Office therefore recommends the definition of maximum permissible noise levels. Further, care should be taken that no marine mammals are found in the immediate vicinity of the construction site. (AKB)

  3. International recommendations

    International Nuclear Information System (INIS)

    Lindell, Bo

    1986-01-01

    Full text: This short presentation will indicate the general radiation protection background to protective measures against foodstuffs contaminated with radioactive substances. A number of international organizations are involved in various aspects of radiation protection, for example, the International Atomic Energy Agency (IAEA), the United Nations Food and Agriculture Organization (FAO), the United Nations Environment Programme (UNEP), and the World Health Organization (WHO). Two international organizations, however, provide the basic background. These are the International Commission on Radiological Protection (ICRP) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). UNSCEAR provides the scientific information on radiation levels and effects. It consists of 21 member countries, with truly international coverage. It issues reports to the UN General Assembly, including comprehensive scientific annexes. Its latest comprehensive report was issued in 1982, the next is expected to be published in 1988. That report will include an assessment of the radiological consequences of the Chernobyl accident. The ICRP is a non-governmental organization. It has issued recommendations on radiation protection since 1928. The postulated biological basis for radiation protection recommendations involves two types of biological effects. The so-called non-stochastic effects, mainly due to cell death, appear only when the radiation doses exceed a certain threshold value. These effects, therefore, can only appear after high accidental exposures. After the Chernobyl accident, they only affected about 200 individuals involved in fire extinction and rescue work at the damaged nuclear power plant. Stochastic effects, with some simplification, may be seen as the result of initial changes in the genetic code of some surviving cells. If these cells are germ cells, this may lead to hereditary harm. If they are somatic cells, the result could be cancer

  4. Determinants of hospital fall rate trajectory groups: a longitudinal assessment of nurse staffing and organizational characteristics.

    Science.gov (United States)

    Everhart, Damian; Schumacher, Jessica R; Duncan, R Paul; Hall, Allyson G; Neff, Donna F; Shorr, Ronald I

    2014-01-01

    Patient falls in acute care hospitals represent a significant patient safety concern. Although cross-sectional studies have shown that fall rates vary widely between acute care hospitals, it is not clear whether hospital fall rates remain consistent over time. The aim of this study was to determine whether hospitals can be categorized into fall rate trajectory groups over time and to identify nurse staffing and hospital characteristics associated with hospital fall rate trajectory groups. We conducted a 54-month (July 2006-December 2010) longitudinal study of U.S. acute care general hospitals participating in the National Database for Nursing Quality Indicators (2007). We used latent class growth modeling to categorize hospitals into groups based on their long-term fall rates. Nurse staffing and hospital characteristics associated with membership in the highest hospital fall rate group were identified using logistic regression. A sample of 1,529 hospitals (mean fall rate of 3.65 per 1,000 patient days) contributed data to the analysis. Latent class growth modeling findings classified hospital into three groups based on fall rate trajectories: consistently high (mean fall rate of 4.96 per 1,000 patient days), consistently medium (mean fall rate of 3.63 per 1,000 patient days), and consistently low (mean fall rate of 2.50 per 1,000 patient days). Hospitals with higher total nurse staffing (odds ratio [OR] = 0.92, 95% confidence interval [CI] [0.85, 0.99]), Magnet status (OR = 0.49, 95% CI [0.35, 0.70]), and bed size greater than 300 beds (OR = 0.70, 95% CI [0.51, 0.94]) were significantly less likely to be categorized in the "consistently high" fall rate group. Over this 54-month period, hospitals were categorized into three groups based on long-term fall rates. Hospital-level factors differed among these three groups. This suggests that there may be hospitals in which "best practices" for fall prevention might be identified. In addition, administrators may be able

  5. Radiotherapy staffing in the European countries

    DEFF Research Database (Denmark)

    Lievens, Yolande; Defourny, Noémie; Coffey, Mary

    2014-01-01

    BACKGROUND: The ESTRO Health Economics in Radiation Oncology (HERO) project has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The first milestone was to assess ......, but also the stage in technology adoption along with treatment complexity and the different professional roles and responsibilities within each country. Our data underpin the need for accurate prediction models and long-term education and training programmes........5 (0-12.6) for dosimetrists, 26.6 (1.9-78) for RTTs and 14.8 (0.4-61.0) for radiotherapy nurses. The combined average for physicists and dosimetrists is 9.8 per million inhabitants and 36.9 for RTT and nurses. Radiation oncologists on average treat 208.9 courses per year (range: 99.9-348.8), physicists...... and dosimetrists conjointly treat 303.3 courses (range: 85-757.7) and RTT and nurses 76.8 (range: 25.7-156.8). In countries with higher GNI per capita, all personnel categories treat fewer courses per annum than in less affluent countries. This relationship is most evident for RTTs and nurses. Different clusters...

  6. Output capabilities of personal music players and assessment of preferred listening levels of test subjects: outlining recommendations for preventing music-induced hearing loss.

    Science.gov (United States)

    Breinbauer, Hayo A; Anabalón, Jose L; Gutierrez, Daniela; Cárcamo, Rodrigo; Olivares, Carla; Caro, Jorge

    2012-11-01

    Our goal was to assess the impact of personal music players, earphones, and music styles on output, the subject's preferred listening levels, and outline recommendations for the prevention of music-induced hearing loss. Experimental study. Personal music players' output capabilities and volunteers' preferred output levels were assessed in different settings. Based on current noise-induced hearing loss exposure limits, recommendations were outlined. On three different devices and earphone types and 10 music styles, free field equivalent sound pressure output levels were assessed by applying a microphone probe inside the auditory canal. Forty-five hearing-healthy volunteers were asked to select preferred listening levels in different background noise scenarios. Sound pressure output reached 126 dB. No difference was found between device types, whereas earbud and supra-aural earphones showed significantly lower outputs than in-ear earphones (P music style groups were identified with as much as 14.4 dB difference between them. In silence, 17.8% of volunteers spontaneously selected a listening level above 85 dB. With 90 dB background noise, 40% selected a level above 94 dB. Earphone attenuation capability was found to correlate significantly with preferred level reductions (r = 0.585, P help in reducing comfortable listening levels and should be preferred. A risk table was elaborated, presenting time limits before reaching a risky exposure. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  7. Influence of design improvements in optimising staffing of NPPs - an Indian experience

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.

    2001-01-01

    Three decades of operating experience in India has led to sustained high performance of NPP's. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. The organisational factors that led to optimising of staff are described in the companion paper. This optimisation of manpower is a result of continuous learning - for (i) optimising quantum of workload and (ii) improving productivity. For the first category, design improvements over older Indian NPP's have increased reliability, operability, maintainability and human factors. Few examples: (i) improved man-machine interface in plant controls and on-power refuelling system with operator guidance, logging as well as diagnostic/health monitoring features; (ii) spread out layout for better access and ease of maintenance, separation of plant services for unit-1 from unit-2 and, removal of reactor auxiliaries out to separate buildings; (iii) reduction of maintenance tasks through redesigned equipment and improved condition monitoring means. However, design and procedural improvements also include additional equipment for upgradation of safety measures, e.g. larger number of safety related pumps separate switchyard control room and increased service system equipment. This paper outlines experience of design improvements in optimising staffing and uses a specific case illustration to establish the findings for better use of staff. (author)

  8. Enhancing Nursing Staffing Forecasting With Safety Stock Over Lead Time Modeling.

    Science.gov (United States)

    McNair, Douglas S

    2015-01-01

    In balancing competing priorities, it is essential that nursing staffing provide enough nurses to safely and effectively care for the patients. Mathematical models to predict optimal "safety stocks" have been routine in supply chain management for many years but have up to now not been applied in nursing workforce management. There are various aspects that exhibit similarities between the 2 disciplines, such as an evolving demand forecast according to acuity and the fact that provisioning "stock" to meet demand in a future period has nonzero variable lead time. Under assumptions about the forecasts (eg, the demand process is well fit as an autoregressive process) and about the labor supply process (≥1 shifts' lead time), we show that safety stock over lead time for such systems is effectively equivalent to the corresponding well-studied problem for systems with stationary demand bounds and base stock policies. Hence, we can apply existing models from supply chain analytics to find the optimal safety levels of nurse staffing. We use a case study with real data to demonstrate that there are significant benefits from the inclusion of the forecast process when determining the optimal safety stocks.

  9. Copper, selenium and zinc levels after bariatric surgery in patients recommended to take multivitamin-mineral supplementation.

    Science.gov (United States)

    Papamargaritis, Dimitris; Aasheim, Erlend T; Sampson, Barry; le Roux, Carel W

    2015-01-01

    Bariatric surgery is widely performed to improve obesity-related disorders, but can lead to nutrient deficiencies. In this study we examined serum trace element concentrations before and after bariatric surgery. We obtained serum trace element concentrations by inductively coupled plasma-mass spectrometry (ICP-MS) method in 437 patients (82% women, median preoperative body-mass index 46.7 kg/m(2) [interquartile range 42-51]) undergoing either gastric banding (22.7%), sleeve gastrectomy (20.1%), or gastric bypass (57.3%) procedures. Trace element data were available for patients preoperatively (n = 44); and 3 (n = 208), 6 (n = 174), 12 (n = 122), 18 (n = 39), 24 (n = 44) and 36 months (n = 14) post-operatively. All patients were recommended to take a multivitamin-mineral supplement after surgery. Copper deficiency was found in 2% of patients before surgery; and after surgery deficiency rates ranged from 0 to 5% with no significant change in median concentrations during follow-up (p = 0.68). Selenium deficiency was reported in 2% of patients before surgery; and after surgery deficiency rates ranged from 11 to 15% with a near-significant change in median concentrations (p = 0.056). Zinc deficiency was reported in 7% before surgery; and after surgery deficiency rates ranged from 7 to 15% with no significant change in median concentrations (p = 0.39). In bariatric surgery patients recommended to take multivitamin-mineral supplements, serum copper, zinc and selenium concentrations were mostly stable during the first years after bariatric surgery. There was a possible tendency for selenium concentrations to decline during the early postoperative period. Copyright © 2014 Elsevier GmbH. All rights reserved.

  10. Workshops for state review of site suitability criteria for high-level radioactive waste repositories: analysis and recommendations

    International Nuclear Information System (INIS)

    1978-02-01

    The responses from various discussion groups on site suitability criteria for high-level radioactive waste repositories are presented. The consensus, principal concern, and minority opinion on each issue are given. The visual aids used in the workshop are included

  11. Impact of nonphysician staffing on outcomes in a medical ICU.

    Science.gov (United States)

    Gershengorn, Hayley B; Wunsch, Hannah; Wahab, Romina; Leaf, David; Brodie, Daniel; Li, Guohua; Factor, Phillip

    2011-06-01

    As the number of ICU beds and demand for intensivists increase, alternative solutions are needed to provide coverage for critically ill patients. The impact of different staffing models on the outcomes of patients in the medical ICU (MICU) remains unknown. In our study, we compare outcomes of nonphysician provider-based teams to those of medical house staff-based teams in the MICU. We conducted a retrospective review of 590 daytime (7:00 am-7:00 pm) admissions to two MICUs at one hospital. In one MICU staffed by nurse practitioners and physician assistants (MICU-NP/PA) there were nonphysicians (nurse practitioners and physicians assistants) during the day (7:00 am-7:00 pm) with attending physician coverage overnight. In the other MICU, there were medicine residents (MICU-RES) (24 h/d). The outcomes investigated were hospital mortality, length of stay (LOS) (ICU, hospital), and posthospital discharge destination. Three hundred two patients were admitted to the MICU-NP/PA and 288 to the MICU-RES. Mortality probability model III (MPM(0)-III) predicted mortality was similar (P = .14). There was no significant difference in hospital mortality (32.1% for MICU-NP/PA vs 32.3% for MICU-RES, P = .96), MICU LOS (4.22 ± 2.51 days for MICU-NP/PA vs 4.44 ± 3.10 days for MICU-RES, P = .59), or hospital LOS (14.01 ± 2.92 days for MICU-NP/PA vs 13.74 ± 2.94 days for MICU-RES, P = .86). Discharge to a skilled care facility (vs home) was similar (37.1% for MICU-NP/PA vs 32.5% for MICU-RES, P = .34). After multivariate adjustment, MICU staffing type was not associated with hospital mortality (P = .26), MICU LOS (P = .29), hospital LOS (P = .19), or posthospital discharge destination (P = .90). Staffing models including daytime use of nonphysician providers appear to be a safe and effective alternative to the traditional house staff-based team in a high-acuity, adult ICU.

  12. When caring stops, staffing doesn't matter: part II.

    Science.gov (United States)

    Douglas, Kathy

    2011-01-01

    Response to a column on caring and staffing struck a cord with Nursing Economic$ readers worldwide. Measuring caring is complicated and a healthy debate exists over how exactly to do it. The extraordinary work of Dr. Jean Watson is an excellent resource for understanding how to measure and monitor caring. Beneath the instruments for measuring caring sits foundational work that can help us clarify and understand the topic of caring and just where it sits in our philosophies, intentions, patient care models, and care delivery systems.

  13. California's minimum-nurse-staffing legislation and nurses' wages.

    Science.gov (United States)

    Mark, Barbara; Harless, David W; Spetz, Joanne

    2009-01-01

    In 2004, California became the first state to implement minimum-nurse-staffing ratios in acute care hospitals. We examined the wages of registered nurses (RNs) before and after the legislation was enacted. Using four data sets-the National Sample Survey of Registered Nurses, the Current Population Survey, the National Compensation Survey, and the Occupational Employment Statistics Survey-we found that from 2000 through 2006, RNs in California metropolitan areas experienced real wage growth as much as twelve percentage points higher than the growth in the wages of nurses employed in metropolitan areas outside of California.

  14. Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

    Directory of Open Access Journals (Sweden)

    Faul, Mark

    2014-11-01

    Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.   Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need.     Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need.  Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the

  15. Authority of Pharmacists to Administer Human Papillomavirus Vaccine: Alignment of State Laws With Age-Level Recommendations.

    Science.gov (United States)

    Dingman, Deirdre A; Schmit, Cason D

    One strategy to increase the uptake of human papillomavirus (HPV) vaccine among adolescents is through the use of pharmacists. Our objectives were to (1) use a publicly available database to describe the statutory and regulatory authority of pharmacists to administer the HPV vaccine in the United States and (2) discuss how the current status of laws may influence achievement of the Healthy People 2020 goal of 80% HPV vaccination rate for teenagers aged 13-15. Using information from the Centers for Disease Control and Prevention's (CDC's) Public Health Law Program database, we identified state laws in effect as of January 1, 2016, giving pharmacists authority to administer vaccines. We used a standardized analysis algorithm to determine whether states' laws (1) authorized pharmacists to administer HPV vaccine, (2) required third-party authorization for pharmacist administration, and (3) restricted HPV vaccine administration by pharmacists to certain patient age groups. Of 50 states and the District of Columbia, 40 had laws expressly granting pharmacists authority to administer HPV vaccine to patients, but only 22 had laws that authorized pharmacists to vaccinate preadolescents aged 11 or 12 (ie, the CDC-recommended age group). Pharmacists were granted prescriptive authority by 5 states, and they were given authority pursuant to general (non-patient-specific) third-party authorization (eg, a licensed health care provider) by 32 states or patient-specific third-party authorization by 3 states. Most states permitted pharmacists to administer HPV vaccines only to boys and girls older than 11 or 12, which may hinder achievement of the Healthy People 2020 goal for HPV vaccination. Efforts should be made to strengthen the role of pharmacists in addressing this public health issue.

  16. Radiotherapy facilities, equipment, and staffing in Poland: 2005–2011

    Science.gov (United States)

    Reinfuss, Marian; Byrski, Edward; Malicki, Julian

    2013-01-01

    Background and purpose To evaluate the current status of radiotherapy facilities, staffing, and equipment, treatment and patients in Poland for the years 2005–2011 following implementation of the National Cancer Programme. Methods A survey was sent to the radiotherapy centres in Poland to collect data on available equipment, staffing, and treatments in the years 2005–2011. Results In 2011, 76,000 patients were treated with radiotherapy at 32 centres vs. 63,000 patients at 23 centres in 2005. Number of patients increased by 21%. In 2011, there were 453 radiation oncologists – specialists (1 in 168 patients), 325 medical physicists (1 in 215 patients), and 883 radiotherapy technicians (1 in 86 patients) vs. 320, 188, and 652, respectively, in 2005. The number of linear accelerators increased by 60%, from 70 units in 2005 to 112 in 2011. The current linac/patient ratio in Poland is 1 linac per 678 patients. Waiting times from diagnosis to the start of treatment has decreased. Conclusion Compared to 2005, there are more treatment facilities, more and better equipment (linacs), and more cancer care specialists. There are still large differences between the 16 Polish provinces in terms of equipment availability and ease of access to treatment. However, radiotherapy services in Poland have improved dramatically since the year 2005. PMID:24416548

  17. The level of perceived quality and safety of health services by recipients. Recommendations and inter- ventions for health care policies

    Directory of Open Access Journals (Sweden)

    Foteini Koulouri

    2017-06-01

    Full Text Available In recent years, the importance of the quality in health sector is more and more acknowledged. In broader terms the literature on quality in health care contributed to this, and stressed the importance of meeting the needs of the service recipient. Safety and quality in health care constitute a multi-dimensional parameter and involve many factors and various resources. Safety is positively associated to the quality, as the existence of the one ensures the improvement of the other. Thus, there is a great effort to create a framework, through guidelines and instructions that could contribute to the protection and development of quality and safety. It is important that this framework includes many features that have been expressed as requests by the patients themselves and which can contribute to the development of realistic and effective recommendations for improvement. Greek reality reveals certain gaps in safety and quality of services delivered, so the main attention has to be focused on developing an integral national health policy; the development of guidelines and the appropriate evaluation of their implementation could be a first effective approach. Formulating an institutional framework about safety and quality in health sector should be incorporated in the culture of all health organizations. To this end, the involvement of health professionals is a vital and strategic point. Health care practitioners should incorporate safety and quality culture in their daily routine and health managers should enact efficient ways of evaluation and control mechanisms in order to achieve better outcomes. Motivation to this direction and active participation should be encouraged with positive approaches, away from any kind of sanction. Any mistakes, adverse effects and deviations should be identified, reported, analyzed and formulate the base of the corrective action. In conclusion, safety and quality in health sector are essential and strongly associated

  18. Differences in Perceptions of the Food Environment Between African American Men Who Did and Did Not Consume Recommended Levels of Fruits and Vegetables.

    Science.gov (United States)

    Griffith, Derek M; Cornish, Emily K; McKissic, Sydika A; Dean, Donnatesa A L

    2016-12-01

    African American men have high rates of chronic disease morbidity and mortality associated with their low rates of fruit and vegetable consumption. In an effort to inform tailored behavioral interventions for this demographic, we sought to assess if men with healthier eating practices viewed their environment differently than those who ate less healthy. We segmented participants into high/low healthy eating categories based on the daily fruit and vegetable serving recommendations from the U.S. Department of Agriculture to determine if differences among environmental and social barriers were associated with different healthy eating patterns. We found key differences between men who consumed the recommended amount of fruits and vegetables (five or more servings/day, high healthy eating) and men who did not (low healthy eating). Men who consumed recommended levels of fruits and vegetables found eating healthy to be easy, and they described how they were able to overcome barriers such as the cost of healthy food, their limited knowledge of nutrition guidelines, and their lack of willpower to make healthier food choices. Men with healthier eating practices also identified individuals, plans, and resources they used or could use to help them have healthier eating practices. Conversely, men who were not eating recommended levels of fruits and vegetables also found eating healthy to be easy; however, they identified barriers limiting their access and did not articulate strategies to overcome these perceived barriers. Many of these men also indicated that they did not have social support to help them engage in healthier eating practices. These findings highlight the need to understand how African American men's conceptualization of environmental resources and social supports relate to their eating practices. © 2016 Society for Public Health Education.

  19. Improvements in nuclear plant staffing resulting from the AP600 design programme

    International Nuclear Information System (INIS)

    Mycoff, C.

    2001-01-01

    The staffing for a single-unit AP600 is estimated to require a staff for operation and maintenance about 32% smaller than current generation power plants of similar size. These staffing reductions are driven primarily by various features incorporated into the AP600 plant design. (author)

  20. Development of Staffing Patterns in Six New Medical Schools Established 1952-1960.

    Science.gov (United States)

    National Institutes of Health (DHEW), Bethesda, MD. Resources Analysis Branch.

    This summary report of staffing patterns in 6 medical schools established between 1952 and 1960 is the first phase of a proposed study of biomedical staffing requirements in institutions of higher education, 1965-1975. The 6 schools are: the University of Miami, Albert Einstein College of medicine at Yeshiva University, the University of Florida,…

  1. Pre-hospital critical care by anaesthesiologist-staffed pre-hospital services in Scandinavia

    DEFF Research Database (Denmark)

    Krüger, A J; Lossius, H M; Mikkelsen, S

    2013-01-01

    All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...

  2. Unusual spine anatomy contributing to wrong level spine surgery: a case report and recommendations for decreasing the risk of preventable 'never events'

    Directory of Open Access Journals (Sweden)

    Lindley Emily M

    2011-12-01

    calling it "T7-8", then the correct level can be found intraoperatively even in the case of abnormal segmentation. We recommend working closely with radiology during preoperative planning to identify unusual anatomy that may have been overlooked. We also recommend that radiology colleagues use the same system of identifying pathological levels when dictating their reports. Together, these strategies can reduce the risk of wrong level surgery and increase patient safety.

  3. Staffing and Workflow of a Maturing Institutional Repository

    Directory of Open Access Journals (Sweden)

    Debora L. Madsen

    2013-02-01

    Full Text Available Institutional repositories (IRs have become established components of many academic libraries. As an IR matures it will face the challenge of how to scale up its operations to increase the amount and types of content archived. These challenges involve staffing, systems, workflows, and promotion. In the past eight years, Kansas State University's IR (K-REx has grown from a platform for student theses, dissertations, and reports to also include faculty works. The initial workforce of a single faculty member was expanded as a part of a library-wide reorganization, resulting in a cross-departmental team that is better able to accommodate the expansion of the IR. The resultant need to define staff responsibilities and develop resources to manage the workflows has led to the innovations described here, which may prove useful to the greater library community as other IRs mature.

  4. Analysis of patients with decompression illness transported via physician-staffed emergency helicopters

    Directory of Open Access Journals (Sweden)

    Yasumasa Oode

    2015-01-01

    Full Text Available Context: There have been few reports investigating the effects of air transportation on patients with decompression illness (DCI. Aims: To investigate the influence of air transportation on patients with DCI transported via physician-staffed emergency helicopters (HEMS: Emergency medical system of physician-staffed emergency helicopters. Settings and Design: A retrospective medical chart review in a single hospital. Materials and Methods: A medical chart review was retrospectively performed in all patients with DCI transported via HEMS between July 2009 and June 2013. The exclusion criteria included cardiopulmonary arrest on surfacing. Statistical analysis used: The paired Student′s t-test. Results: A total of 28 patients were treated as subjects. Male and middle-aged subjects were predominant. The number of patients who suddenly surfaced was 15/28. All patients underwent oxygen therapy during flight, and all but one patient received the administration of lactate Ringer fluid. The subjective symptoms of eight of 28 subjects improved after the flight. The range of all flights under 300 m above sea level. There were no significant differences between the values obtained before and after the flight for Glasgow coma scale, blood pressure, and heart rate. Concerning the SpO 2 , statistically significant improvements were noted after the flight (96.2 ± 0.9% versus 97.3 ± 0.7%. There were no relationships between an improvement in subjective symptoms and the SpO 2 . Conclusion: Improvements in the subjective symptoms and/or SpO 2 of patients with DCI may be observed when the patient is transported via HEMS under flights less than 300 m in height with the administration of oxygen and fluids.

  5. Recommender systems

    CERN Document Server

    Kembellec, Gérald; Saleh, Imad

    2014-01-01

    Acclaimed by various content platforms (books, music, movies) and auction sites online, recommendation systems are key elements of digital strategies. If development was originally intended for the performance of information systems, the issues are now massively moved on logical optimization of the customer relationship, with the main objective to maximize potential sales. On the transdisciplinary approach, engines and recommender systems brings together contributions linking information science and communications, marketing, sociology, mathematics and computing. It deals with the understan

  6. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada

    Science.gov (United States)

    Battista, Jerry J.; Patterson, Michael S.; Beaulieu, Luc; Sharpe, Michael B.; Schreiner, L. John; MacPherson, Miller S.; Van Dyk, Jacob

    2012-01-01

    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center‐specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per‐case staffing ratios were also determined for larger‐scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center‐specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full‐time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively. PACS numbers: 87.55.N‐, 87.55.Qr PMID:22231223

  7. [Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications].

    Science.gov (United States)

    Kim, Yunmi; You, Sunju; Kim, Jinhyun

    2017-12-01

    This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future. © 2017 Korean Society of Nursing Science

  8. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada.

    Science.gov (United States)

    Battista, Jerry J; Clark, Brenda G; Patterson, Michael S; Beaulieu, Luc; Sharpe, Michael B; Schreiner, L John; MacPherson, Miller S; Van Dyk, Jacob

    2012-01-05

    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center-specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per-case staffing ratios were also determined for larger-scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center-specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full-time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively.

  9. Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis.

    Science.gov (United States)

    Park, Claire Su-Yeon

    2017-08-01

    To propose a new theory pinpointing the optimal nurse staffing threshold delivering the maximum quality of care relative to attendant costs in home health care. Little knowledge exists on the theoretical foundation addressing the inter-relationship among quality of care, nurse staffing, and cost. Theory synthesis. Cochrane Library, PubMed, CINAHL, EBSCOhost Web and Web of Science (25 February - 26 April 2013; 20 January - 22 March 2015). Most of the existing theories/models lacked the detail necessary to explain the relationship among quality of care, nurse staffing and cost. Two notable exceptions are: 'Production Function for Staffing and Quality in Nursing Homes,' which describes an S-shaped trajectory between quality of care and nurse staffing and 'Thirty-day Survival Isoquant and Estimated Costs According to the Nurse Staff Mix,' which depicts a positive quadric relationship between nurse staffing and cost according to quality of care. A synthesis of these theories led to an innovative multi-dimensional econometric theory helping to determine the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way. The theory-driven threshold, navigated by Mathematical Programming based on the Duality Theorem in Mathematical Economics, will help nurse executives defend sufficient nurse staffing with scientific justification to ensure optimal patient care; help stakeholders set an evidence-based reasonable economical goal; and facilitate patient-centred decision-making in choosing the institution which delivers the best quality of care. A new theory to determine the optimum nurse staffing maximizing quality of care relative to cost was proposed. © 2017 The Author. Journal of Advanced Nursing © John Wiley & Sons Ltd.

  10. Homeless Caseload is Associated with Behavioral Health and Case Management Staffing in Health Centers.

    Science.gov (United States)

    Jones, Emily B; Zur, Julia; Rosenbaum, Sara

    2017-07-01

    Community health centers provide co-located medical, behavioral, and case management services to meet the unique and complex needs of the underserved, including homeless individuals. Multivariate analysis of staffing patterns in health centers serving high homeless caseloads highlights above-average behavioral and case management staffing, regardless of Health Care for the Homeless funding status. Rural health centers and those in the South had lower behavioral health and enabling services staffing. Implications include the need to monitor disparities, link health centers with available technical assistance, and emphasize integrating co-located behavioral health, enabling, and medical services through grant oversight mechanisms.

  11. Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia

    Directory of Open Access Journals (Sweden)

    Schroder Kate

    2010-06-01

    Full Text Available Abstract Background The Ministry of Health (MOH in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear. Methods We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007, the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018. Results With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels. Conclusions Meeting the minimum need for health workers in Zambia this decade will require an increase in health

  12. Defining conditions where long-term glucocorticoid treatment has an acceptably low level of harm to facilitate implementation of existing recommendations

    DEFF Research Database (Denmark)

    Strehl, Cindy; Bijlsma, Johannes W J; de Wit, Maarten

    2016-01-01

    There is convincing evidence for the known and unambiguously accepted beneficial effects of glucocorticoids at low dosages. However, the implementation of existing recommendations and guidelines on the management of glucocorticoid therapy in rheumatic diseases is lagging behind. As a first step...... literature search, breakout groups critically reviewed the evidence on the four most worrisome adverse effects of glucocorticoid therapy (osteoporosis, hyperglycaemia/diabetes mellitus, cardiovascular diseases and infections) and presented their results to the other group members following a structured...... to improve implementation, we aimed at defining conditions under which long-term glucocorticoid therapy may have an acceptably low level of harm. A multidisciplinary European League Against Rheumatism task force group of experts including patients with rheumatic diseases was assembled. After a systematic...

  13. Factoring in weather variation to capture the influence of urban design and built environment on globally recommended levels of moderate to vigorous physical activity in children.

    Science.gov (United States)

    Katapally, Tarun Reddy; Rainham, Daniel; Muhajarine, Nazeem

    2015-11-30

    In curbing physical inactivity, as behavioural interventions directed at individuals have not produced a population-level change, an ecological perspective called active living research has gained prominence. However, active living research consistently underexplores the role played by a perennial phenomenon encompassing all other environmental exposures-variation in weather. After factoring in weather variation, this study investigated the influence of diverse environmental exposures (including urban design and built environment) on the accumulation of globally recommended moderate to vigorous physical activity levels (MVPA) in children. This cross-sectional observational study is part of an active living initiative set in the Canadian prairie city of Saskatoon. As part of this study, Saskatoon's neighbourhoods were classified based on urban street design into grid-pattern, fractured grid-pattern and curvilinear types of neighbourhoods. Moreover, diverse environmental exposures were measured including, neighbourhood built environment, and neighbourhood and household socioeconomic environment. Actical accelerometers were deployed between April and June 2010 (spring-summer) to derive MVPA of 331 10-14-year-old children in 25 1-week cycles. Each cycle of accelerometry was conducted on a different cohort of children within the total sample and matched with weather data obtained from Environment Canada. Multilevel modelling using Hierarchical Linear and Non-linear Modelling software was conducted by factoring in weather variation to depict the influence of diverse environmental exposures on the accumulation of recommended MVPA. Urban design, including diversity of destinations within neighbourhoods played a significant role in the accumulation of MVPA. After factoring in weather variation, it was observed that children living in neighbourhoods closer to the city centre (with higher diversity of destinations) were more likely to accumulate recommended MVPA. The findings

  14. Avoiding crisis: right-sizing staffing for the future.

    Science.gov (United States)

    Best, Michele L

    2002-01-01

    Workforce issues, especially recruitment and retention of qualified laboratory staff, are major strategic issues that will continue to face laboratory managers over the next 10 years. Major factors affecting the laboratory labor market in the next decade include increased health-care and laboratory testing needs of an aging population, the graying of the laboratory workforce as baby boomers retire, and new technology development. At least two of these factors will increase the demand for qualified laboratory professionals. Vacancy rates for laboratory professionals are increasing at a significant rate and will continue over the next 10 years. Planning will require creativity in staff recruitment and retention strategies and in human resources. Laboratorians no longer will have the luxury of using medical technologists for nonspecialized testing assignments and will need to develop more creative recruiting approaches using fewer highly qualified testing personnel. This article proposes a staffing deployment model that will use medical technologist education and skills more appropriately, will improve retention of medical technologists, and will alleviate the shortage of medical technologists by reducing dependence on them as routine laboratory testing personnel.

  15. Synthesis of the project leadership staffing needs for successful development of alternative delivery programs.

    Science.gov (United States)

    2017-08-01

    This research provides a synthesis of practices in organizational structuring and professional staffing of the innovative delivery units in several state DOTs across the nation that are actively utilizing alternative project delivery. Several major c...

  16. Suitability of teriparatide and level of acceptance of pharmacotherapeutic recommendations in a healthcare management areaSuitability of teriparatide and level of acceptance of pharmacotherapeutic recommendations in a healthcare management area DOI:\t10.7399/fh.2016.40.4.9953

    Directory of Open Access Journals (Sweden)

    Maria Rosa Cantudo-Cuenca

    2016-07-01

    Full Text Available Objective: To analyse the suitability of teriparatide prescriptions for osteoporosis treatment in a health management area, as well as the level of acceptance of pharmacotherapeutic recommendations made to physicians. Design: A prospective interventional study conducted from february 2015 to june 2015. Setting: South Seville Health Management Area. Participants: Patients receiving teriparatide. Main measurements: Suitability of teriparatide prescriptions according to Clinical Practice Guidelines and level of acceptance of pharmacotherapeutic recommendations. Results: Teriparatide prescriptions were unsuitable in 45 patients (68.2%; 11 due to no indication, 17 patients did not have previous treatments with first-line drugs, 6 due to contraindications and 9 patients were treated for more than 24 months with the drug. Besides, 4 prescriptions were unsuitable because of combination with other therapies. The acceptance of pharmacotherapeutic recommendations was 64.4%, leading to teriparatide discontinuation in 21 patients (72.4%, and a switch to alendronate or ibandronate in another 8 patients. Conclusions: A high percentage of teriparatide prescriptions is unsuitable in our health care management area, but it has decreased after pharmacist intervention.

  17. Using cereal to increase dietary fiber intake to the recommended level and the effect of fiber on bowel function in healthy persons consuming North American diets.

    Science.gov (United States)

    Vuksan, Vladimir; Jenkins, Alexandra L; Jenkins, David J A; Rogovik, Alexander L; Sievenpiper, John L; Jovanovski, Elena

    2008-11-01

    Dietary fiber intake remains low despite increasing evidence for its health benefits, including laxation. We aimed to assess the effects of increasing fiber intake on bowel habits and gastrointestinal tolerance in healthy persons consuming a typical Canadian or US diet. Under a randomized crossover design, 23 free-living participants consumed a typical Canadian or US diet (35% fat, 12 g fiber/d) and received 25.0-28.7 g fiber/d from each of 5 breakfast cereals: All-Bran (AB), Bran Buds with Corn (BBC), Bran Buds with Psyllium (BBP), BBC with viscous fiber blend (VFB), or a low-fiber control for 3 wk, with each study arm separated by a washout of >/=1 wk. Seven-day stool collections and a symptom diary were obtained during the last week of each study arm. All study cereals induced significant (P effective than other cereals in terms of increasing fecal wet weight (P fibers (ie, AB and BBC) and their mixtures with water-soluble fibers (ie, BBP and VFB) in the form of breakfast cereals (2.5 servings/d) proved to be a practical way of increasing fiber intake to recommended levels, while maintaining a good level of tolerance.

  18. Association between patient classification systems and nurse staffing costs in intensive care units: An exploratory study.

    Science.gov (United States)

    Stafseth, Siv K; Tønnessen, Tor Inge; Fagerström, Lisbeth

    2018-04-01

    Nurse staffing costs represent approximately 60% of total intensive care unit costs. In order to analyse resource allocation in intensive care, we examined the association between nurse staffing costs and two patient classification systems: the nursing activities score (NAS) and nine equivalents of nursing manpower use score (NEMS). A retrospective descriptive correlational analysis of nurse staffing costs and data of 6390 patients extracted from a data warehouse. Three intensive care units in a university hospital and one in a regional hospital in Norway. Nurse staffing costs, NAS and NEMS. For merged data from all units, the NAS was more strongly correlated with monthly nurse staffing costs than was the NEMS. On separate analyses of each ICU, correlations were present for the NAS on basic costs and external overtime costs but were not significant. The annual mean nurse staffing cost for 1% of NAS was 20.9-23.1 euros in the units, which was comparable to 53.3-81.5 euros for 1 NEMS point. A significant association was found between monthly costs, NAS, and NEMS. Cost of care should be based on individual patients' nursing care needs. The NAS makes nurses' workload visible and may be a helpful classification system in future planning and budgeting of intensive care resources. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Community health centers employ diverse staffing patterns, which can provide productivity lessons for medical practices.

    Science.gov (United States)

    Ku, Leighton; Frogner, Bianca K; Steinmetz, Erika; Pittman, Patricia

    2015-01-01

    Community health centers are at the forefront of ambulatory care practices in their use of nonphysician clinicians and team-based primary care. We examined medical staffing patterns, the contributions of different types of staff to productivity, and the factors associated with staffing at community health centers across the United States. We identified four different staffing patterns: typical, high advanced-practice staff, high nursing staff, and high other medical staff. Overall, productivity per staff person was similar across the four staffing patterns. We found that physicians make the greatest contributions to productivity, but advanced-practice staff, nurses, and other medical staff also contribute. Patterns of community health center staffing are driven by numerous factors, including the concentration of clinicians in communities, nurse practitioner scope-of-practice laws, and patient characteristics such as insurance status. Our findings suggest that other group medical practices could incorporate more nonphysician staff without sacrificing productivity and thus profitability. However, the new staffing patterns that evolve may be affected by characteristics of the practice location or the types of patients served. Project HOPE—The People-to-People Health Foundation, Inc.

  20. The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

    Science.gov (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

    2015-09-01

    Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically

  1. [Recommendations for the selection of storage media for archiving digital radiological image data based on the comparison of retrieval times at different PACS archive levels].

    Science.gov (United States)

    Wirth, S; Treitl, M; Lucke, A; Mittermaier, I; Nissen-Meyer, S; Villain, S; Pfeifer, K-J; Reiser, M

    2005-02-01

    Recommendations for archiving digital radiological image data based on the comparison of retrieval times for different PACS archive levels. For a large PACS installation (Agfa Impax, Release 4.1), image retrieval times for radiological standard examinations (chest radiographs with 2, MRI with 250, CT with 100 and 1000 images; n = 120, each) from hard disk array, magneto-optical disk (MOD), and magnetic tape archives (TAPE) were examined in high and low network traffic load. Even large CT examinations (1000 images) were available from hard disk arrays within 4.0 +/- 0.8 s, smaller studies within 1.8 +/- 0.3 s. Radiographic image retrieval from MOD (30 +/- 4.7 s) was more then 50 % faster than from TAPE. For typical cross-sectional studies, the velocity gain amounted to 19 %. For both technologies, no significant difference was found for large CT examinations (651 +/- 144 s). For high and low network traffic load scenarios, image retrieval times from hard disk, MOD, and TAPE archives increased by 87 %, 7 %, and 22 %, respectively. Hard disk arrays are specifically suited as departmental intermediate storage media because they allow fast access to current and previous examinations within a short time. Performance properties enable both MOD and TAPE systems to serve as long-term archives. However, MOD archives are less flexible in the expansion of storage capacity and at present the medium costs per memory unit are about 2 - 3 times higher than for tape archives. The use of existing MOD-archives may be adequate as intermediate archives. For new PACS installations or system expansions, however, it is recommended to combine a sufficiently large local data memory (RAID) with data storage on tape archives outside the radiological unit that can be used by other departments as well. Future development of hard disk prices will show whether archiving for the whole data retention period may be handled by RAID systems. In any case, prefetching problems and waiting periods for

  2. Dedicated operating room for trauma: a costly recommendation.

    Science.gov (United States)

    Brasel, K J; Akason, J; Weigelt, J A

    1998-05-01

    A dedicated operating room (OR) for urgent trauma cases is suggested by the American College of Surgeons Committee on Trauma as a necessary component of a Level I or II trauma center. We describe a cost analysis of this recommendation. Two models for staffing urgent trauma cases were constructed. Urgent trauma cases were defined as those taken to the OR within 30 minutes of arrival. In one model the OR was available 24 hours a day with in-hospital personnel. The second model used an out-of-hospital call schedule, assuming a patient-ready OR in 30 minutes. Costs and revenue per urgent case were calculated. A break-even analysis shows the number of cases required for costs to equal revenue. In the 24-hour model, the cost/urgent case is $14,288; in the call-schedule model $3,243. The number of cases to break even in the 24-hour model is 1210; in the call-schedule model 375. A call-schedule model is the least costly way to staff an OR for urgent trauma cases.

  3. The influence of staffing and timetabling on achieving competence in surgical extractions.

    Science.gov (United States)

    Moore, U; Durham, J; Corbett, I; Thomson, P

    2009-02-01

    Competence based education is becoming more important in dentistry and medicine. In dentistry clinical skills are assessed using longitudinal assessments or structured objective clinical tests. We have previously presented the assessment of competence in surgical extractions however the success rate for this was poor. The opportunity to alter staffing levels and timetabling arose and we present the influence of this on the achievement of competence. The competence assessments and portfolios of two consecutive years of dental undergraduates were examined after completing their surgical extraction course. The first cohort received 9 sessions of teaching spread over 2 years with one staff supervisor per session. The second cohort received 10 sessions with varying numbers of staff supervisors. The first cohort required 210 staff sessions and performed 275 surgical extractions (mean 4), and 23% achieved competence. The second cohort required 240 staff sessions and performed 403 surgical extractions (mean 6), and 66% achieved competence. Thirty six extra sessions were provided for students in the second cohort who failed to complete their competence during the allocated blocks and following this 99% of the second cohort achieved competence. These differences are significant (P timetabling changes which focus student experience and learning.

  4. Parental recommendations for population level interventions to support infant and family dietary choices: a qualitative study from the Growing Up in Wales, Environments for Healthy Living (EHL) study.

    Science.gov (United States)

    Khanom, Ashrafunnesa; Hill, Rebecca A; Morgan, Kelly; Rapport, Frances L; Lyons, Ronan A; Brophy, Sinead

    2015-03-11

    Childhood obesity presents a challenge to public health. This qualitative study explored the main barriers to dietary choices faced by parents with infants, and the types of interventions and policy level recommendations they would like to see put in place, to promote a healthier food environment. 61 semi-structured interviews with prospective parents and parents of infants (61 mothers and 35 fathers) were conducted. Families were selected according to community deprivation levels using the Townsend Deprivation Index to ensure a representative sample from deprived and affluent neighbourhoods. Inductive thematic analysis was used to analyse the data. Parents identified triggers which led to unhealthy dietary choices such as reliance on fast food outlets due to; shift work, lack of access to personal transport, inability to cook, their own childhood dietary experiences, peer pressure and familial relationships. Parents who made healthy dietary choices reported learning cooking skills while at university, attending community cooking classes, having access to quality food provided by church and community organisations or access to Healthy Start vouchers. They called for a reduction in supermarket promotion of unhealthy food and improved access to affordable and high-quality fresh produce in the local area and in supermarkets. There was a strong message to policy makers to work with commercial companies (food manufactures) as they have resources to lower costs and target messages at a diverse population. Provision of targeted advice to fathers, minority ethnic parents, and tailored and practical advice and information on how to purchase, prepare, store and cook food was requested, along with community cookery classes and improved school cookery lessons. There is a need for parent directed community/population level interventions that aims to reduce socio-ecological barriers to making healthy dietary choices. Parents desired improvements in meals provided in workplaces

  5. Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database

    Directory of Open Access Journals (Sweden)

    Yasunaga Hideo

    2012-05-01

    Full Text Available Abstract Background Little is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume. Methods We analyzed 131,394 patients undergoing lung lobectomy, esophagectomy, gastrectomy, colorectal surgery, hepatectomy or pancreatectomy for cancer between July and December, 2007–2008, using the Japanese Diagnosis Procedure Combination database linked to the Survey of Medical Institutions data. Physician-to-bed ratio (PBR and nurse-to-bed ratio (NBR were determined for each hospital. Hospital volume was categorized into low, medium and high for each of six cancer surgeries. Failure to rescue (FTR was defined as a proportion of inhospital deaths among those with postoperative complications. Multi-level logistic regression analysis was performed to examine the association between physician/nurse staffing and FTR, adjusting for patient characteristics and hospital volume. Results Overall inhospital mortality was 1.8%, postoperative complication rate was 15.2%, and FTR rate was 11.9%. After adjustment for hospital volume, FTR rate in the group with high PBR (≥19.7 physicians per 100 beds and high NBR (≥77.0 nurses per 100 beds was significantly lower than that in the group with low PBR ( Conclusions Well-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.

  6. Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)--steps towards an international consensus.

    Science.gov (United States)

    Birke-Sorensen, H; Malmsjo, M; Rome, P; Hudson, D; Krug, E; Berg, L; Bruhin, A; Caravaggi, C; Chariker, M; Depoorter, M; Dowsett, C; Dunn, R; Duteille, F; Ferreira, F; Francos Martínez, J M; Grudzien, G; Ichioka, S; Ingemansson, R; Jeffery, S; Lee, C; Vig, S; Runkel, N; Martin, R; Smith, J

    2011-09-01

    Negative pressure wound therapy (NPWT) is becoming a commonplace treatment in many clinical settings. New devices and dressings are being introduced. Despite widespread adoption, there remains uncertainty regarding several aspects of NPWT use. To respond to these gaps, a global expert panel was convened to develop evidence-based recommendations describing the use of NPWT. In a previous communication, we have reviewed the evidence base for the use of NPWT within trauma and reconstructive surgery. In this communication, we present results of the assessment of evidence relating to the different NPWT treatment variables: different wound fillers (principally foam and gauze); when to use a wound contact layer; different pressure settings; and the impact of NPWT on bacterial bioburden. Evidence-based recommendations were obtained by a systematic review of the literature, grading of evidence and drafting of the recommendations by a global expert panel. Evidence and recommendations were graded according to the Scottish Intercollegiate Guidelines Network (SIGN) classification system. In general, there is relatively weak evidence on which to base recommendations for any one NPWT treatment variable over another. Overall, 14 recommendations were developed: five for the choice of wound filler and wound contact layer, four for choice of pressure setting and five for use of NPWT in infected wounds. With respect to bioburden, evidence suggests that reduction of bacteria in wounds is not a major mode of action of NPWT. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Ten-year trends in family medicine residency productivity and staffing: impact of electronic health records, resident duty hours, and the medical home.

    Science.gov (United States)

    Lesko, Sarah; Hughes, Lauren; Fitch, Wes; Pauwels, Judith

    2012-02-01

    Electronic health records (EHRs), resident duty hour restrictions, and Patient-centered Medical Home (PCMH) innovations have all impacted the clinical practices of residency programs over the past decade. The University of Washington Family Medicine Network (UWFMN) residencies have collaborated for 10 years in collecting and comparing data regarding the productivity and operations of their training programs to identify the program-level effects of such changes. Based on five survey results from 2000 to 2010, this study examines changes in faculty and resident productivity and staffing models of UWFMN residency training clinics using a standardized methodology, specifically describing the productivity impact of EHR changes and duty hour restrictions and the implementation of the PCMH by residencies. Data were systematically collected via standardized questionnaire, evaluated for quality, clarified, and then analyzed. Resident productivity decreased over the 10-year interval, with resident total yearly patient visits down 17.2%. Core family medicine faculty productivity was highly variable among programs, and nonphysician provider visits increased. Faculty part-time status increased. Front office, medical assistant, and nursing staffing grew significantly, but other administrative staff decreased, resulting in minimal change in total non-provider staffing. A majority of programs engaged in PCMH initiatives in 2010 and had implemented an EHR. Physician productivity in UWFMN residency programs decreased for all resident physicians from 2000 to 2010, likely due to a combination of decreased resident duty hours and other clinical practice changes. Productivity trends have implications for the structure and training requirements for family medicine residency programs.

  8. An international comparison of commercial nuclear power plant staffing regulations and practice, 1980--1990

    International Nuclear Information System (INIS)

    Melber, B.; Hauth, J.; Terrill, E.; Berk, B.; Gore, B.

    1994-03-01

    In this report an international review of regulatory and industry practices is provided in the area of nuclear power plant staffing during the 1980s in Canada, France, Germany, Japan, Sweden, and the United Kingdom. The objective of this review is to highlight trends in staffing regulatory approaches, industry practices, and issues of concern in other countries that have potential relevance to nuclear power plant staffing issues in the United States. The decade of the 1980s was marked by a great deal of growth in nuclear power operations internationally; however, growth of nuclear power is not expected to continue in the 1990s except in France and Japan. A continuum of regulatory approaches to staffing was identified, ranging from prescribed regulations that are applied to all licensees (Germany is most similar to the United States in this regard), to indirect staffing regulations where the regulatory authority oversees plant operating practices that are agreed to in the plant operating license (most notably, France and the United Kingdom). Most of the changes observed in staffing regulations and practices in the early 1980s were made in response to the accident at the Three Mile Island Unit 2 nuclear power plant (TMI) in 1979. These changes included the widespread issuance of new operator and licensing requirements and the establishment of national training centers. After the post-TMI changes were implemented, a period of relative stability followed. Changes in the latter half of the 1980s have focused on continuing improvements and additions to training curricula and methods, most notably increased reliance on simulator training

  9. Implementing an inclusive staffing model for today's reference services a practical guide for librarians

    CERN Document Server

    Nims, Julia K; Stevens, Robert

    2013-01-01

    Reference service remains a core function of modern libraries. However, how and where we provide assistance has evolved with changing technologies and the shifting habits and preferences of our users. One way libraries can provide the on-demand, in-person assistance while managing and developing new services and resources that will benefit current and future users is to reconsider how their reference points and services are staffed and adopt a staff-based reference model. In Implementing an Inclusive Staffing Model for Today's Reference Services, Nims, Storm, and Stevens describe step-by-step

  10. Managing Person-Centered Dementia Care in an Assisted Living Facility: Staffing and Time Considerations.

    Science.gov (United States)

    Simmons, Sandra F; Coelho, Chris S; Sandler, Andrew; Shah, Avantika S; Schnelle, John F

    2017-06-02

    To describe (a) the unlicensed staff time necessary to provide quality activities of daily living (ADL) care to residents receiving dementia care within an assisted living facility and (b) a staff management approach to maintain quality ADL care. Supervisory staff used a standardized observational method to measure ADL care quality and the staff time to provide care during the morning and evening across 12 consecutive months. Staff were given individual feedback about the quality of their care provision following each observation. The average staff time to provide ADL care averaged 35 (± 11) minutes per resident per care episode with bathing and 18 (± 6) minutes/resident/care episode without bathing. Morning ADL care required significantly more staff time than evening care. There was not a significant relationship between residents' levels of cognitive impairment or ADL dependency and the staff time to provide ADL care. Quality ADL care was maintained for 12 months. This study provides novel data related to the amount of staff time necessary to provide quality ADL care for persons with dementia in an assisted living care setting. This study also describes a standardized approach to staff management that was effective in maintaining quality ADL care provision. Assisted living facilities should consider these data when determining the necessary unlicensed staffing level to provide person-centered ADL care and how to effectively manage direct care providers. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Determinants and Effects of Nurse Staffing Intensity and Skill Mix in Residential Care/Assisted Living Settings

    Science.gov (United States)

    Stearns, Sally C.; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L.; Konrad, Thomas R.; Sloane, Philip D.

    2007-01-01

    Purpose: Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes.…

  12. 75 FR 45166 - Jeld-Wen, Inc., Hawkins Window Division, Including On-Site Leased Workers of Nicolet Staffing...

    Science.gov (United States)

    2010-08-02

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,014] Jeld-Wen, Inc., Hawkins Window Division, Including On-Site Leased Workers of Nicolet Staffing, Hawkins, WI; Notice of Negative...., Hawkins Window Division, including on-site leased workers of Nicolet Staffing, Hawkins, Wisconsin. Signed...

  13. Guam Medical Staffing Plan Needs Improvement to Ensure Eligible Beneficiaries Will Have Adequate Access to Health Care

    Science.gov (United States)

    2012-05-16

    Commandant of the Marine Corps submits updated force projections and the Secretary of Defense submits a master plan to Congress. Guam Realignment...are responsible for medical personnel assets. 5 NMW personnel used the following formula to determine physician staffing requirements...Okinawa discussed staffing requirements for multiple specialties, including pediatrics , psychiatry, psychology, and emergency room care. NMW

  14. 45 CFR 1336.65 - Staffing and organization of the Revolving Loan Fund: Responsibilities of the Loan Administrator.

    Science.gov (United States)

    2010-10-01

    ... organization table, including: (a) The structure and composition of the Board of Directors of the RLF; (b) The... 45 Public Welfare 4 2010-10-01 2010-10-01 false Staffing and organization of the Revolving Loan... Hawaiian Revolving Loan Fund Demonstration Project § 1336.65 Staffing and organization of the Revolving...

  15. Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia-A multi-centre study.

    Science.gov (United States)

    Shridhar, Krithiga; Millett, Christopher; Laverty, Anthony A; Alam, Dewan; Dias, Amit; Williams, Joseph; Dhillon, Preet K

    2016-08-02

    We report the prevalence of recommended physical activity levels (RPALs) and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes. This analysis on rural South Asian children aged 5-14 years (n = 564) is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218) and Bangladesh (Matlab; n = 200). Data on socio-demographic and lifestyle factors (physical activity (PA); diet) were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no); leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day) were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores). The majority of children (71.8 %) belonged to households where a parent had at least a secondary education. Two-thirds (66.7 %) actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10-14 years, OR = 2.0; 95 % CI: 1.3, 3.0) and female (OR = 1.7; 95 % CI: 1.1, 2.5) children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0), children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5), and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1). Sedentary activity ≤ 2 h/day was associated with younger children (5-9 years, OR = 1.6; 95 % CI: 1.1, 2.4), children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1) and Chennai (OR = 2.5; 95 % CI: 1.5, 4.3) and low household education

  16. Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia—A multi-centre study

    Directory of Open Access Journals (Sweden)

    Krithiga Shridhar

    2016-08-01

    Full Text Available Abstract Background We report the prevalence of recommended physical activity levels (RPALs and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes. Methods This analysis on rural South Asian children aged 5–14 years (n = 564 is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218 and Bangladesh (Matlab; n = 200. Data on socio-demographic and lifestyle factors (physical activity (PA; diet were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no; leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores. Results The majority of children (71.8 % belonged to households where a parent had at least a secondary education. Two-thirds (66.7 % actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10–14 years, OR = 2.0; 95 % CI: 1.3, 3.0 and female (OR = 1.7; 95 % CI: 1.1, 2.5 children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0, children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5, and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1. Sedentary activity ≤ 2 h/day was associated with younger children (5–9 years, OR = 1.6; 95 % CI: 1.1, 2.4, children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1 and Chennai (OR = 2.5; 95

  17. A Functional Model of Quality Assurance for Psychiatric Hospitals and Corresponding Staffing Requirements.

    Science.gov (United States)

    Kamis-Gould, Edna; And Others

    1991-01-01

    A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…

  18. Library/Media Centers in U.S. Public Schools: Growth, Staffing, and Resources. Executive Summary

    Science.gov (United States)

    Tuck, Kathy D.; Holmes, Dwight R.

    2016-01-01

    This study analyzes data collected between 2000 and 2013 from the annual National Center for Education Statistics (NCES) Common Core of Data (CCD) Local Education Agency (School District) Universe Survey; the NCES Schools and Staffing Survey (SASS); and the U.S. Census Bureau Small Area Income and Poverty Estimates Survey (SAIPE). The findings…

  19. Survey of foreign reactor operator qualifications, training, and staffing requirements. Final report

    International Nuclear Information System (INIS)

    Au, M.L.; DiSalvo, R.; Merschoff, E.

    1982-05-01

    The report is a compilation of the data obtained from a survey of foreign nuclear power plant operator requirements. Included among the considerations are: (1) shift staffing; (2) operator eligibility; (3) operator training programs; (4) operator licensing or certification; and (5) operator retraining. The data obtained from this survey are presented in matrix form and contrasted with U.S. requirements

  20. 76 FR 14101 - Commercial Furniture Group, Inc., Including On-Site Leased Workers From Staffing Solutions...

    Science.gov (United States)

    2011-03-15

    ... Furniture Group, Inc., Including On-Site Leased Workers From Staffing Solutions; Morristown, TN; Commercial Furniture Group, Inc., Chicago, IL; Amended Certification Regarding Eligibility To Apply for Worker... Adjustment Assistance on May 5, 2010, applicable to workers of Commercial Furniture Group, Inc., including on...

  1. Physical Attacks: An Analysis of Teacher Characteristics Using the Schools and Staffing Survey

    Science.gov (United States)

    Williams, Thomas O., Jr.; Ernst, Jeremy V.

    2016-01-01

    This study investigated physical attacks as reported by public school teachers on the most recent Schools and Staffing Survey (SASS) from the National Center for Education Statistics administered by the Institute of Educational Sciences. For this study, characteristics of teachers who responded affirmatively to having been physically attacked in…

  2. Outcomes and Costs of Community Living: Semi-Independent Living and Fully Staffed Group Homes

    Science.gov (United States)

    Felce, David; Perry, Jonathan; Romeo, Renee; Robertson, Janet; Meek, Andrea; Emerson, Eric; Knapp, Martin

    2008-01-01

    In a matched-groups design, costs and quality of life outcomes for adults with intellectual disabilities with relatively low support needs were compared between those in fully staffed group homes (n = 35) and in semi-independent living (n = 35). Data were collected on participant characteristics, setting organization, various lifestyle outcomes,…

  3. A Staffing Profile of United States Online Database Producers: A Model and Discussion of Educational Implications.

    Science.gov (United States)

    Lowry, Glenn R.

    1983-01-01

    Reports results of survey of United States online database producers designed to determine number of personnel employed in intellectual production of databases and provide basis for generation of people employed in frequently recurring staff categories. Implications for education based on needs suggested by staffing patterns are examined.…

  4. 76 FR 73683 - Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing...

    Science.gov (United States)

    2011-11-29

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... refrigerators and trash compactors. The notice was published in the Federal Register on October 25, 2010 (75 FR...

  5. 76 FR 72978 - Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing...

    Science.gov (United States)

    2011-11-28

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... workers are engaged in the production of refrigerators and trash compactors. The notice was published in...

  6. 75 FR 16512 - Willstaff Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working...

    Science.gov (United States)

    2010-04-01

    ... Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working On-Site at Tyler Pipe... MDS Industrial Resources, Inc., working on-site at Tyler Pipe Company, Waterworks Division, South... Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., working on-site at Tyler Pipe...

  7. Library/Media Centers in U.S. Public Schools: Growth, Staffing, and Resources. Full Report

    Science.gov (United States)

    Tuck, Kathy D.; Holmes, Dwight R.

    2016-01-01

    At the request of New Business Item: 89 (NBI: 89) adopted at the 2015 NEA Representative Assembly, this study examines the extent to which students have access to public school library/media centers with qualified staff and up-to-date resources. The study explores trends in library/media center openings and closings as well as staffing patterns…

  8. Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal Analysis

    Science.gov (United States)

    Kim, Hongsoo; Harrington, Charlene; Greene, William H.

    2009-01-01

    Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…

  9. Successful Implementation of Six Sigma to Schedule Student Staffing for Circulation Service Desks

    Science.gov (United States)

    Jankowski, Janiece

    2013-01-01

    In fall of 2011 the University at Buffalo Libraries circulation department undertook Six Sigma training for the purpose of overhauling its student scheduling process. The department was able to mitigate significant staffing budgetary reductions and resource reallocations and to overcome the unique challenges of scheduling student labor for a…

  10. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief... Profile. ER06JA00.000 ER06JA00.001 ER06JA00.002 ...

  11. 45 CFR 1321.9 - Organization and staffing of the State agency.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Organization and staffing of the State agency. 1321.9 Section 1321.9 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.9...

  12. Reversing Course: The Troubled State of Academic Staffing and a Path Forward

    Science.gov (United States)

    American Federation of Teachers (NJ), 2008

    2008-01-01

    Over the last generation, the instructional staffing system in American higher education has experienced a significant reduction in the proportion of jobs for full-time tenured and tenure-track faculty members and a dramatic growth in fixed-term full- and part-time instructional jobs without tenure. About 70 percent of the people teaching in…

  13. Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals

    Science.gov (United States)

    Casey, Michelle M.; Moscovice, Ira S.; Davidson, Gestur

    2006-01-01

    Context: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. Purpose: This study assessed the capacity of small rural hospitals to implement medication safety…

  14. Achievement of physical activity recommendation and activity levels in students of human medicine compared with the general Austrian population aged between 20 and 29 years.

    Science.gov (United States)

    Lackinger, Christian; Dorner, Thomas Ernst

    2015-03-01

    Weekly 150 min of moderate to vigorous physical activity and muscle-strengthening activities are a major public health goal. The International Physical Activity Questionnaire-short form was applied in 467 students of the 4th year at the Medical University of Vienna and compared with subsamples of data from the Austrian Health Interview Survey, 795 subjects with and 1131 subjects without higher education aged 20-29 years. Median values for weekly total energy expenditure were 3083, 3048, and 3816 MET-minutes (P students, higher and lower educated subjects of the general population. Energy expenditure with vigorous intensity was highest in medical students. A total of 39.4 % of medical students reached the minimum requirements of the national physical activity recommendations. Although medical students are taught those recommendation and are aware of their health benefits, only a minority reach them. If medical students engage in physical activity, they do it with higher intensity than the general population.

  15. Some of the bases of the IAEA definition and recommendations concerning high-level radioactive waste unsuitable for dumping at sea and some of the Japanese findings of deep sea survey in the Pacific

    International Nuclear Information System (INIS)

    Nishiwaki, Y.

    1980-01-01

    The Provisional Definition and Recommendations Concerning Radioactive Wastes and Other Radioactive Matter referred to in Annexes I and II to the London Convention of 1972 on the Prevention of Marine Pollution by Dumping of Wastes and Other Matter have been reviewed and revised by the IAEA during 1975-1978. The Revised Definition and Recommendations and of the Annex thereto for the purposes of the Convention emphasize that the definition and recommendations set forth by the IAEA should not be interpreted as precluding the adoption of more restrictive requirements by any Party to the Convention or appropriate national authorities, and that nothing in the document shall be construed as encouraging the dumping at sea of radioactive waste or other radioactive matter. With these reservations, the Definition of High-Level Radioacive Wastes or Other High-Level Radioactive Matter Unsuitable for Dumping at Sea is given, distinguishing between α-emitters, β/γ-emitters with half-lives of at least 0.5 years and of unknown half-lives; and tritium and β/γ-emitters with half-lives of less than 0.5 years. Bases of the IAEA definition and recommendations concerning high level radioactive waste unsuitable for dumping at sea and reservations attached to the given concentration limits are discussed. (orig.) [de

  16. Design studies on staffing requirements for the new generation nuclear power units of WWER-640 and BN-800 reactor types

    International Nuclear Information System (INIS)

    Solovyov, D.F.

    2001-01-01

    The paper outlines the main staffing requirements for the new generation power units with nuclear reactors. These requirements were developed taking into account IAEA recommendations. NPP staffing structure is described, including the main and auxiliary personnel. The main principles of personnel number determination are given. Special attention is taken to the issues of personnel skill and training, including both theoretical education and practical work on the power units in operation. The use of simulators, system of knowledge control and structure of training are considered. ''Shopless'' staffing structure approach is proposed for the NPP, assuming that the main scope of repair work is performed by the central repair organization, thus increasing the quality of repair and decreasing the number of personnel on the plant. Data are given on the personnel number for the WWER-640 and the BN-800 reactor designs. Specialists of the ''ATOMENERGOPROJECT'' Institute started their work on staffing on the early development stage of the basic design of WWER-640 reactor power unit which is the forerunner of the new generation reactors. This work was based on the approaches taken by the chief engineers of NPPs in operation during their meeting held in 1989 in Kalinin NPP. At this meeting definite decision was taken on changing over to involving manufacturer in the repair work of NPP components using manufacturer's technology. In 1992 the meeting of representatives of suppliers of the main components was held where representatives of ''ATOMENERGOREMONT'' and ''LENENERGOREMONT'' were present. The suppliers agreed on carrying out repair works on the components they produced. For this purpose special departments were set up having some experience. This repair work is already carried out by ''ATOMENERGOREMONT'' on some nuclear power plants. ''LENENERGOREMONT'' has gained considerable experience in this kind of repair work on the turbines of LO-1 and LO-2 NPP in Finland. Within the

  17. Licensing an assured isolation facility for low-level radioactive waste. Volume 2: Recommendations on the content and review of an application

    International Nuclear Information System (INIS)

    Silverman, D.J.; Bauser, M.A.; Baird, R.D.

    1998-07-01

    This report provides a detailed set of proposed criteria and guidance for the preparation of a license application for an assured isolation facility (AIF). The report is intended to provide a detailed planning basis upon which a prospective applicant may begin pre-licensing discussions with the Nuclear Regulatory Commission and initiate development of a license application. The report may also be useful to the NRC or to state regulatory agencies that may be asked to review such an application. Volume 1 of this report provides background information, and describes the licensing approach and methodology. Volume 2 identifies specific information that is recommended for inclusion in a license application

  18. Licensing an assured isolation facility for low-level radioactive waste. Volume 2: Recommendations on the content and review of an application

    Energy Technology Data Exchange (ETDEWEB)

    Silverman, D.J.; Bauser, M.A. [Morgan, Lewis and Bockius, Washington, DC (United States); Baird, R.D. [Rogers and Associates Engineering Corp., Salt Lake City, UT (United States)

    1998-07-01

    This report provides a detailed set of proposed criteria and guidance for the preparation of a license application for an assured isolation facility (AIF). The report is intended to provide a detailed planning basis upon which a prospective applicant may begin pre-licensing discussions with the Nuclear Regulatory Commission and initiate development of a license application. The report may also be useful to the NRC or to state regulatory agencies that may be asked to review such an application. Volume 1 of this report provides background information, and describes the licensing approach and methodology. Volume 2 identifies specific information that is recommended for inclusion in a license application.

  19. Accuracy of emergency medical dispatchers' subjective ability to identify when higher dispatch levels are warranted over a Medical Priority Dispatch System automated protocol's recommended coding based on paramedic outcome data.

    Science.gov (United States)

    Clawson, Jeff; Olola, Christopher H O; Heward, Andy; Scott, Greg; Patterson, Brett

    2007-08-01

    To establish the accuracy of the emergency medical dispatcher's (EMD's) decisions to override the automated Medical Priority Dispatch System (MPDS) logic-based response code recommendations based on at-scene paramedic-applied transport acuity determinations (blue-in) and cardiac arrest (CA) findings. A retrospective study of a 1 year dataset from the London Ambulance Service (LAS) National Health Service (NHS) Trust was undertaken. We compared all LAS "bluing in" frequency (BIQ) and cardiac arrest quotient (CAQ) outcomes of the incidents automatically recommended and accepted as CHARLIE-level codes, to those receiving EMD DELTA-overrides from the auto-recommended CHARLIE-level. We also compared the recommended DELTA-level outcomes to those in the higher ECHO-override cases. There was no significant association between outcome (CA/Blue-in) and the determinant codes (DELTA-override and CHARLIE-level) for both CA (odds ratio (OR) 0, 95% confidence interval (CI) 0 to 41.14; p = 1.000) and Blue-in categories (OR 0.89, 95% CI 0.34 to 2.33; p = 1.000). Similar patterns were observed between outcome and all DELTA-level and ECHO-override codes for both CA (OR 0, 95% CI 0 to 70.05; p = 1.000) and Blue-in categories (OR 1.17, 95% CI 0 to 7.12; p = 0.597). This study contradicts the belief that EMDs can accurately perceive when a patient or situation requires more resources than the MPDS's structured interrogation process logically indicates. This further strengthens the concept that automated, protocol-based call taking is more accurate and consistent than the subjective, anecdotal or experience-based determinations made by individual EMDs.

  20. Brief summary of staffing levels at Fermilab during initial construction years

    International Nuclear Information System (INIS)

    Livdahl, P.V.

    1983-11-01

    This paper very briefly summarizes the work of the various groups that were involved from the beginning through the end of the initial construction phase of the Fermilab project (defined here to be July 1, 1972) and the final construction or completion phase which is here defined as December 31, 1973. The numbers in this report have been gathered by examining the personnel records of Fermilab with the research being done by Chuck Marofske, the Head of Laboratory Services and his staff and by assembling information from the memories of people still with the laboratory in 1983. Since there was much mobility within the laboratory during the construction years and frequent reorganizations were the norm, the numbers presented herein can not be considered to be more accurate than about +- 5%

  1. 45 CFR 303.20 - Minimum organizational and staffing requirements.

    Science.gov (United States)

    2010-10-01

    ...) Locate. Activities associated with locating a noncustodial parent. (4) Financial assessment. Activities... required by the Office. (6) Financial control of the operation of the plan. (7) Operation of the State... structure and sufficient resources at the State and local level to meet the performance and time standards...

  2. The Universal Recommender

    OpenAIRE

    Kunegis, Jérôme; Said, Alan; Umbrath, Winfried

    2009-01-01

    We describe the Universal Recommender, a recommender system for semantic datasets that generalizes domain-specific recommenders such as content-based, collaborative, social, bibliographic, lexicographic, hybrid and other recommenders. In contrast to existing recommender systems, the Universal Recommender applies to any dataset that allows a semantic representation. We describe the scalable three-stage architecture of the Universal Recommender and its application to Internet Protocol Televisio...

  3. Medical physics in Europe following recommendations of the International Atomic Energy Agency

    International Nuclear Information System (INIS)

    Casar, Bozidar; Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

    2016-01-01

    Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral

  4. Medical physics in Europe following recommendations of the International Atomic Energy Agency

    Science.gov (United States)

    Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

    2016-01-01

    Background Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Conclusions Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear

  5. Medical physics in Europe following recommendations of the International Atomic Energy Agency.

    Science.gov (United States)

    Casar, Bozidar; Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

    2016-03-01

    Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral

  6. Guidelines for equipment and staffing of radiotherapy facilities in the European countries

    DEFF Research Database (Denmark)

    Dunscombe, Peter; Grau, Cai; Defourny, Noémie

    2014-01-01

    BACKGROUND AND PURPOSE: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project...... changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed...... guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. CONCLUSION: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon...

  7. Industrial Fuel Gas Demonstration Plant Program: staffing plan. Deliverable No. 34

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-05-01

    This report describes the staffing plans of each industrial team member during final design and construction of the IFGDP. The internal organization of each team member, including the delegation of authority and responsibility within the structure, is discussed. The primary function of the various organizational units are also identified. In addition, a brief summary of the Phase II role of each industrial partner is included. The overall Phase II organization chart is attached.

  8. Generalizable items and modular structure for computerised physician staffing calculation on intensive care units.

    Science.gov (United States)

    Weiss, Manfred; Marx, Gernot; Iber, Thomas

    2017-08-04

    Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks. All three tasks have to be taken into account for calculating the required number of physicians. The calculation tool further allows to determine minimal personnel staffing, distribution of calculated personnel demand regarding type of employee due to working hours per year, shift work or standby duty. This model was introduced and described first by the German Board of Anesthesiologists and the German Society of Anesthesiology and Intensive Care Medicine in 2008 and since has been implemented and updated 2012 in Germany. The modular, flexible nature of the Excel-based calculation tool should allow adaption to the respective legal and organizational demands of different countries. After 8 years of experience with this calculation, we report the generalizable key aspects which may help physicians all around the world to justify realistic workload-oriented personnel staffing needs.

  9. A scientific model to determine the optimal radiographer staffing component in a nuclear medicine department

    International Nuclear Information System (INIS)

    Shipanga, A.N.; Ellmann, A.

    2004-01-01

    Full text: Introduction: Nuclear medicine in South Africa is developing fast. Much has changed since the constitution of a scientific model for determining an optimum number of radiographer posts in a Nuclear Medicine department in the late 1980's. Aim: The aim of this study was to ascertain whether the number of radiographers required by a Nuclear Medicine department can still be determined according to the norms established in 1988. Methods: A quantitative study using non-experimental evaluation design was conducted to determine the ratios between current radiographer workload and staffing norms. The workload ratios were analysed using the procedures statistics of the Nuclear Medicine department at Tygerberg Hospital. Radiographers provided data about their activities related to patient procedures, including information about the condition of the patients, activities in the radiopharmaceutical laboratory, and patient related administrative tasks. These were factored into an equation relating this data to working hours, including vacation and sick leave. The calculation of Activity Standards and an annual Standard Workload was used to finally calculate the staffing requirements for a Nuclear Medicine department. Results: Preliminary data confirmed that old staffing norms cannot be used in a modern Nuclear Medicine department. Protocols for several types of study have changed, including the additional acquisition of tomographic studies. Interest in the use of time-consuming non-imaging studies has been revived and should be factored Into the equation. Conclusions: All Nuclear Medicine departments In South Africa, where the types of studies performed have changed over the past years, should look carefully at their radiographer staffing ratio to ascertain whether the number of radiographers needed is adequate for the current workload. (author)

  10. Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study.

    Science.gov (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

    2015-10-01

    To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  11. Evaluation of a Peer-Staffed Hotline for Families Who Received Genetic Testing for Risk of Breast Cancer

    National Research Council Canada - National Science Library

    Coyne, James

    2004-01-01

    This project proposed to develop, implement, and evaluate a peer-staffed toll-free hotline for individuals at high risk of developing hereditary breast cancer, either through family history or known BRCA1/2 mutations...

  12. Strategies for using international domain standards within a national context: The case of the Dutch temporary staffing industry

    NARCIS (Netherlands)

    Folmer, Erwin Johan Albert; van Bekkum, Michael; Verhoosel, Jack

    2009-01-01

    This paper will discuss strategies for using international domain standards within a national context. The various strategies are illustrated by means of a case study of the temporary staffing industry.

  13. [Relationship between nurse staffing and nursing outcomes: a narrative review of literature].

    Science.gov (United States)

    Petrucci, Cristina; Calandro, Maria Teresa; Tresulti, Federica; Baldacchini, Antonio; Lancia, Loreto

    2015-01-01

    The measurement of nursing sensitive outcomes represents a fundamental element in "Health Management" in order to assess the suitability and quality of care given, particoulaly in hospitals for the acutely ill. To highlight how some variables connected with nurse-staffing can determine the quality of processes and the care outcomes. A narrative review of international literature has been carried out on investigating possible correlation between nurse-staffing characteristics and care outcomes regarding patients, taking into account primary and secondary sources, written either in English or Italian, without time limits. The bibliographical research strategies used, have brought about the restitution of no. 4244 articles were retrived, of these 56 were analyzed. Articles were categorized into 3 specific areas: 1) Which aspects determine the efficacy and quality of nursing care; 2) The direct effects of nursing care on care outcomes; 3) The indirect effects of nursing care on care outcomes. Results confirm the existence of a noticeable relationship between the main components of nurse-staffing and the direct and indirect outcomes on patients health. Longitudinal studies shound be carried out highlighting the results obtained up till now even more and assist in accurately measuring the importance of possible predictive variables on care outcomes correlated to nursing care.

  14. Hospital nurse staffing and patient mortality, emotional exhaustion, and job dissatisfaction.

    Science.gov (United States)

    Halm, Margo; Peterson, Michelle; Kandels, Mary; Sabo, Julie; Blalock, Miriam; Braden, Rebecca; Gryczman, Anna; Krisko-Hagel, Kathryn; Larson, Dave; Lemay, Diane; Sisler, Bette; Strom, Linda; Topham, Debra

    2005-01-01

    To conduct an investigation similar to a landmark study that investigated the association between nurse-to-patient ratio and patient mortality, failure-to-rescue, emotional exhaustion and job satisfaction of nurses. Cross-sectional analysis of 2709 general, orthopedic, and vascular surgery patients, and 140 staff nurses (42% response rate) caring for these patients in a large Midwestern institution. The main outcome measures were mortality, failure-to-rescue, emotional exhaustion, and job dissatisfaction. Staffing was not a significant predictor of mortality or failure-to-rescue, nor did clinical specialty predict emotional exhaustion or job dissatisfaction. Although these findings reinforce adequate staffing ratios at this institution, programs that support nurses in their daily practice and positively impact job satisfaction need to be explored. The Nursing Research Council not only has heightened awareness of how staffing ratios affect patient and nurse outcomes, but also a broader understanding of how the research process can be used to effectively shape nurse's practice and work environments.

  15. Staffing requirements for future small and medium reactors (SMRs) based on operating experience and projections

    International Nuclear Information System (INIS)

    2001-01-01

    At the time of this study there were about 160 small and medium sized nuclear power reactors (referred to as SMRs) in operation worldwide, and about 25 more under construction. Operation and maintenance costs for operating SMRs represent a substantial portion of the cost of electricity produced. Of these costs, the direct and indirect cost of staff represents the major cost component. In recent years, particularly since 1990, there has been increased interest in SMRs by many developing countries wishing to take advantage of nuclear power and several small and medium reactor designs are in various stages of development. To enhance the economic competitive position of SMRs relative to alternative methods of electricity generation, it is essential to ensure that new SMRs can be operated reliably and efficiently using the optimum number of staff. This publication reviews the lessons learned from the reactor operation, and the insights gained through the design of new SMRs, with a view to optimizing staffing in order to improve overall plant economics without compromising safety.This publication is intended to evaluate the estimated staffing size of various SMRs, the staff qualification and training required for the operation of future SMRs. and the key issues which impact the staffing requirements that should be considered in the development and deployment of future SMRs

  16. A service review to assess if innovative intensive phosphate dietary education can help reduce phosphate levels to the recommended range in a hemodialysis population.

    Science.gov (United States)

    Duff, Eileen A; Chawke, Fiona M

    2017-10-01

    Studies suggest that hemodialysis (HD) patients are less likely to adhere to phosphate dietary restriction than to potassium, sodium, or fluid restriction. It is particularly important that dietary education is provided appropriately, consistently, and reinforced regularly to encourage compliance with diet and phosphate-binder regimens. Patient awareness of the consequences of a chronically raised phosphate and its treatment is associated with lower serum phosphate levels. The aim of this study was to assess the impact of a structured educational program on patient knowledge and control of serum phosphate in a maintenance HD population. Thirty-six patients with a phosphate level >1.7 mmol/L for the previous 3 months were assessed. A phosphate knowledge questionnaire was devised by the authors and completed by the patient group. This focused on patient knowledge of dietary sources of phosphate and complications of high phosphate levels. The education program was divided into three modules and was based around diet, phosphate additives, and complications of hyperphosphatemia. Visual aids, oral, and written information were provided to each patient throughout the sessions. Seventeen patients completed the education sessions. The knowledge and food frequency questionnaire were repeated at the end of the modules to assess change. Phosphate levels dropped from an average of 2.12-1.73 mmol/L over the education period with a significance level of P = 0.000481 (significant if P phosphate levels and an improved phosphate knowledge among our sampled HD population. This education program shows that discovering novel ways of education is crucial to enhancing dietetic practice with renal dietitians best placed to deliver patient specific phosphate education. © 2017 International Society for Hemodialysis.

  17. Establishing Proficiency Levels for the Delaware Student Testing Program in Science and Social Studies, Grades 4 & 6. Report and Recommendations to the Delaware State Board of Education.

    Science.gov (United States)

    Delaware State Dept. of Education, Dover. Assessment and Accountability Branch.

    This document contains the results of a standard setting conducted in January 2002 on the Delaware Student Testing Program (DSTP) Science and Social Studies tests at grades 4 and 6. Each standard setting process entailed convening four groups, one for each grade level and content area, and each group met for 2 days. At the standard setting judges…

  18. The Problem of Soil Erosion in Developing Countries--Direct and Indirect Causes and Recommendations for Reducing It to a Sustainable Level.

    Science.gov (United States)

    Middlebrook, Cathy H.; Goode, Pamela M.

    1992-01-01

    Presents direct and indirect causes of erosion in developing countries. Identifies soil conservation developments ranging from major international policy reforms to small-scale, local farming programs. Suggests that strategies at all levels, and the political will to implement them, are needed if erosion is to be reduced to a sustainable rate. (23…

  19. Impact of a More Stringent Blood Lead Level Recommendation for Children (Ages 1-5): Vulnerabilities Related to Housing, Food Security, Vitamins, and Environmental Toxicants

    Science.gov (United States)

    The adverse health effects of lead (Pb) exposure in young children are well known. Non-Hispanic black children historically have higher blood Pb levels (BLL) compared to Mexican-Americans and non- Hispanic white children (CDC-MMWR). In the past, BLL tests below 10 µg/dL m...

  20. The significance of staffing and work environment for quality of care and the recruitment and retention of care workers. Perspectives from the Swiss Nursing Homes Human Resources Project (SHURP)

    OpenAIRE

    Zúñiga, Franziska

    2015-01-01

    While the demand for high quality of care in nursing homes is rising, recruiting and retaining qualified staff is becoming increasingly difficult. Burgeoning chronic illness rates, complex medical and psychosocial situations, and the rising challenge of mental health disorders such as dementia compound the problem. Current research shows a tendency for higher staffing levels to correlate with higher quality care; however, the results are inconclusive. Further, while work environment factors s...

  1. Implementation of a Team-based Physician Staffing Model at an Academic Emergency Department

    Directory of Open Access Journals (Sweden)

    Jose V. Nable

    2014-09-01

    Full Text Available Introduction: There is scant literature regarding the optimal resident physician staffing model of academic emergency departments (ED that maximizes learning opportunities. A department of emergency medicine at a large inner-city academic hospital initiated a team-based staffing model. Its pre-interventional staffing model consisted of residents and attending physicians being separately assigned patients, resulting in residents working with two different faculty providers in the same shift. This study aimed to determine if the post-interventional team-based system, in which residents were paired with a single attending on each shift, would result in improved residents’ learning and clinical experiences as manifested by resident evaluations and the number of patients seen. Methods: This retrospective before-and-after study at an academic ED with an annual volume of 52,000 patients examined the mean differences in five-point Likert-scale evaluations completed by residents assessing their ED rotation experiences in both the original and team-based staffing models. The residents were queried on their perceptions of feeling part of the team, decision-making autonomy, clinical experience, amount of supervision, quality of teaching, and overall rotational experience. We also analyzed the number of patients seen per hour by residents. Paired sample t-tests were performed. Residents who were in the program in the year preceding and proceeding the intervention were eligible for inclusion. Results: 34 of 38 eligible residents were included (4 excluded for lack of evaluations in either the pre- or post-intervention period. There was a statistically significant improvement in resident perception of the quality and amount of teaching, 4.03 to 4.27 (mean difference=0.24, p=0.03. There were non-statistically significant trends toward improved mean scores for all other queries. Residents also saw more patients following the initiation of the team-based model

  2. Decision and Recommendation Concerning the Application of the Paris Convention on Third Party Liability in the Field of Nuclear Energy to Nuclear Installations for the Disposal of Certain Types of Low-level Radioactive Waste (This Decision and Recommendation was adopted at the 133. Session of the Steering Committee for Nuclear Energy held on 3-4 November 2016.)

    International Nuclear Information System (INIS)

    2017-01-01

    The steering committee, having regard to the Convention on Third Party Liability in the Field of Nuclear Energy of 29 July 1960, as amended by the Additional Protocol of 28 January 1964, by the Protocol of 16 November 1982 and by the Protocol of 12 February 2004, and in particular Article 1(b) thereof; Considering that, by virtue of that Article, the Steering Committee may, if in its view the small extent of the risks involved so warrants, exclude any nuclear installation, nuclear fuel or nuclear substances from the application of the Paris Convention; having regard to Article 8(b) and Article 10(b) of the Statute of the OECD Nuclear Energy Agency; considering that nuclear installations for the disposal of low-level radioactive waste are covered by the provisions of the Paris Convention; considering that it should be made possible for Contracting Parties to cease the application of the Paris Convention to a nuclear installation for the disposal of certain types of low-level radioactive waste where the risks involved are so limited; noting the attached Explanatory Note; decides that any Contracting Party may cease to apply the Paris Convention to a nuclear installation for the disposal of low-level radioactive waste, provided that the provisions set out in the Appendix to this Decision and Recommendation and any additional conditions which the Contracting Party may judge appropriate to establish are met; recommends that the Contracting Parties which make use of this option notify the other Contracting Parties, as well as the Nuclear Energy Agency; and recommends that the Nuclear Energy Agency, as appropriate, analyses periodically the experience gained by the Contracting Parties which use this option and reports back to all the Contracting Parties. (authors)

  3. The effect of recommending a CPP-ACPF product on salivary and plaque pH levels in orthodontic patients: a randomized cross-over clinical trial.

    Science.gov (United States)

    Heshmat, Haleh; Banava, Sepideh; Mohammadi, Ebrahim; Kharazifard, Mohammad Javad; Mojtahedzadeh, Faramarz

    2014-11-01

    Along with their re-mineralizing capacity, calcium phosphopeptide-amorphous calcium phosphate products combined with fluoride (CPP-ACPF) could also be beneficial by neutralizing acidic salivary and plaque pH. The purpose was to evaluate the effect of CPP-ACPF on salivary and plaque pH in orthodontic patients. As a triple-blind, cross-over randomized trial, 30 orthodontic patients with fixed appliances (age range = 15.70 ± 4.08 years) were recruited and randomly assigned to two groups. A CPP-ACPF paste (MI Paste Plus, GC America, Alsip, IL) was used by group 1 (n = 15) and a placebo by group 2 (n = 15) for 1 month. After a 1 month washout period, patients used the alternative paste for another month. Plaque and salivary pH levels were measured at all before and after periods. By applying MI Paste Plus, the plaque pH increased from 5.81 ± 0.45 to 6.60 ± 0.38 (p pH recordings, which were 6.72 ± 0.43 and 6.71 ± 0.38, respectively, remained statistically unchanged (p > 0.05). MI Paste Plus can be clinically beneficial in increasing plaque pH levels, but has no effect on the salivary pH.

  4. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Fitzgerald, Oliver; Wells, George A

    2009-01-01

    and discussed various models for association and prediction related to the statistical strength domain. In addition, 3 Delphi exercises addressing longitudinal study design for RA, PsA, and AS were conducted within the working group and members of the Assessments in SpondyloArthritis International Society (ASAS...... Biomarker Group has successfully formulated a levels of evidence scheme and a study design template that will provide guidance to conduct validation studies in the setting of soluble biomarkers proposed to replace the measurement of damage endpoints in RA, PsA, and AS....... arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework...

  5. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    DEFF Research Database (Denmark)

    Maksymowych, W.P.; Fitzgerald, O.; Wells, G.A.

    2009-01-01

    and discussed various models for association and prediction related to the statistical strength domain. In addition, 3 Delphi exercises addressing longitudinal study design for RA, PsA, and AS were conducted within the working group and members of the Assessments in SpondyloArthritis International Society (ASAS...... Biomarker Group has successfully formulated a levels of evidence scheme and a study design template that will provide guidance to conduct validation studies in the setting of soluble biomarkers proposed to replace the measurement of damage endpoints in RA, PsA, and AS Udgivelsesdato: 2009/8...... arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework...

  6. Recommendations to the NRC for review criteria for alternative methods of low-level radioactive waste disposal: Task 2a, Below-ground vaults

    International Nuclear Information System (INIS)

    Denson, R.H.; Bennett, R.D.; Wamsley, R.M.; Bean, D.L.; Ainsworth, D.L.

    1987-12-01

    The US Army Engineer Waterways Experiment Station (WES) and the US Army Engineer Division, Huntsville (HNDED) have developed general design criteria and specific design review criteria for the below-ground vault (BGV) alternative method of low-level radioactive waste (LLW) disposal. A BGV is a reinforced concrete vault (floor, walls, and roof) placed underground below the frost line, and above the water table, surrounded by filter blanket and drainage zones and covered with a low permeability earth layer and top soil with vegetation. Eight major review criteria categories have been developed ranging from the loads imposed on the BGV structure through material quality and durability considerations. Specific design review criteria have been developed in detail for seven of the eight major categories. 59 refs., 14 figs., 2 tabs

  7. Recommendations to the NRC for review criteria for alternative methods of low-level radioactive waste disposal: Task 2b: Earth-mounded concrete bunkers

    International Nuclear Information System (INIS)

    Denson, R.H.; Bennett, R.D.; Wamsley, R.M.; Bean, D.L.; Ainsworth, D.L.

    1988-01-01

    The US Army Engineers Waterways Experiment Station (WES) and US Army Engineer Division, Huntsville (HNDED) have developed general design criteria and specific design review criteria for the earth-mounded concrete bunker (EMCB) alternative method of low-level radioactive waste (LLW) disposal. An EMCB is generally described as a reinforced concrete vault placed below grade, underneath a tumulus, surrounded by filter-blanket and drainage zones. The tumulus is covered over with a low permeability cover layer and top soil with vegetation. Eight major review criteria categories have been developed ranging from the loads imposed on the EMCB structure through material quality and durability considerations. Specific design review criteria have been developed in detail for each of the eight major categories. 63 refs., 13 figs., 2 tabs

  8. The Impact of an Electronic Medication Administration Record (eMAR) and Computerized Physician Order Entry (CPOE) on Nurse Extender and Unit Clerk Staffing.

    Science.gov (United States)

    Robinson, Edmondo J; Bergey, Meredith R; Brady, Elizabeth; Mapp, Alexandra M; Goldsack, Jennifer C

    2017-12-01

    The aim of this study is to describe the impact of the introduction of health information technology (HIT) on the utilization and payroll costs of nurse extenders and unit clerks in medicine and surgery units in a large regional health system. Long-term policy goals of HIT implementation are reported to include system-level reductions in labor costs, achieved through improved efficiency. Using a retrospective cohort model, we analyzed how hours worked per patient day and staffing costs per patient day varied with the implementation of HIT over time at 2 different hospitals within a health system. Implementation of electronic medication administration records was not associated with significant changes in staffing or labor costs. Both labor hours and costs associated with nurse extenders and unit clerks were significantly reduced after the subsequent addition of computerized provider order entry. Simultaneously, units that did not implement any HIT experienced a significant increase in both labor hours and costs. Health information technology implementation in the inpatient setting is associated with significant savings in labor hours and costs in non-registered nursing roles.

  9. Crystalline Repository Project: Review and comment of the Leech Lake Reservation Business Committee: Draft area recommendation report

    International Nuclear Information System (INIS)

    1986-09-01

    The Leech Lake Reservation Business Committee (LLRBC) has reviewed five documents related to the US Department of Energy's Crystalline Repository Project (CRP). They are the ''National Survey of Crystalline Rocks,'' ''General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories;' Final Siting Guidelines (10 CFR Part 960),'' ''Regional Characterization Reports for the North Central Region,'' the ''Region to Area Screening Methodology Document'' (SMD) and the ''Draft Area Recommendation Report'' (DARR). The comments and discussions of issues contained in this review will be considered in the preparation of the Final Area Recommendation Report, which will formally identify potentially acceptable sites for a second national repository for the permanent disposal of high level nuclear waste. Following a review of the above referenced documents, the LLRBC has concluded that the identification of potentially acceptable sites in the Draft Area Recommendation Report is based upon inferior and incomplete technical information being applied to a flawed screening process which, among other deficiencies, pays little attention to the importance of hydrological factors in the siting process. Although the DOE prefers that comments from states and tribes be directed at the Draft Area Recommendation Report alone, the Leech Lake Reservation Business Committee is extremely concerned about inadequacies in the ''National Survey of Crystalline Rocks'' (ORCD-1), which serves as the foundation for all siting work done to date. The national survey was conducted utilizing little of the time or staffing required for this important phase of the Crystalline Repository Program. As a result, the national survey is based upon out-of-date scientific literature, exaggerates certain screening variables that favor the selection of regions in the eastern US and arbitrarily eliminated the few western crystalline rock bodies that passed the questionable screening process utilized

  10. Medical Physics Practice Guidelines - the AAPM's minimum practice recommendations for medical physicists.

    Science.gov (United States)

    Mills, Michael D; Chan, Maria F; Prisciandaro, Joann I; Shepard, Jeff; Halvorsen, Per H

    2013-11-04

    The AAPM has long advocated a consistent level of medical physics practice, and has published many recommendations and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physics practice. Despite these concerted and enduring efforts, the profession does not have clear and concise statements of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. To this end, the AAPM has recently endorsed the development of MPPGs, which may be generated in collaboration with other professional societies. The MPPGs are intended to be freely available to the general public. Accrediting organizations, regulatory agencies, and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider prudent in clinical practice settings. Support includes, but is not limited to, staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This article has described the purpose, scope, and process for the development of MPPGs.

  11. Variation Across U.S. Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing.

    Science.gov (United States)

    Han, Kihye; Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy; Yang, Bo Kyum

    2017-01-01

    Though more people in the United States currently reside in assisted living facilities (ALFs) than nursing homes, little is known about ALF admission policies, resident care needs, and staffing characteristics. We therefore conducted this study using a nationwide sample of ALFs to examine these factors, along with comparison of ALFs by size. Cross-sectional secondary data analysis using data from the 2010 National Survey of Residential Care Facilities. Measures included nine admission policy items, seven items on the proportion of residents with selected conditions or care needs, and six items on staffing characteristics (e.g., access to licensed nurse, aide training). Facilities (n = 2,301) were divided into three categories by size: small, 4 to 10 beds; medium, 11 to 25 beds; and large, 26 or more beds. Analyses took complex sampling design effects into account to project national U.S. estimates. More than half of ALFs admitted residents with considerable healthcare needs and served populations that required nursing care, such as for transfers, medications, and eating or dressing. Staffing was largely composed of patient care aides, and fewer than half of ALFs had licensed care provider (registered nurse, licensed practical nurse) hours. Smaller facilities tended to have more inclusive admission policies and residents with more complex care needs (more mobility, eating and medication assistance required, short-term memory issues, p < .01) and less access to licensed nurses than larger ALFs (p < .01). This study suggests ALFs are caring for and admitting residents with considerable care needs, indicating potential overlap with nursing home populations. Despite this finding, ALF regulations lag far behind those in effect for nursing homes. In addition, measurement of care outcomes is critically needed to ensure appropriate ALF care quality. As more people choose ALFs, outcome measures for ALFs, which are now unavailable, should be developed to allow for oversight

  12. [Danish emergency departments are not staffed by consultants 24/7].

    Science.gov (United States)

    Mackenhauer, Julie; Møller, Cecilie; Fjældstad, Alexander; Østervig, Rebecca; Kole, Ayhan Al; Folkestad, Lars; Hallas, Peter; Brabrand, Mikkel; Møllekær, Anders; Kirkegaard, Hans

    2013-02-18

    The Danish health care system is undergoing a major reorganisation, resulting in fewer emergency departments (ED) with consultants in attendance 24/7. This questionnaire-based study evaluates the status of the reorganisation with emphasis on physician attendance and recruitment. 76% of the EDs are not staffed by consultants 24/7, 51% report difficulties in recruiting qualified personnel and 33% report problems connected to retaining them. 71% believe that a specialty in emergency medicine could help solve these problems. Danish EDs do not comply with the visions of the reorganisation plan.

  13. How to Do More with Less: Handling an Increased Workload While Maintaining Human Capital Level

    National Research Council Canada - National Science Library

    Doerr, Jr., James C; Glazman, Emily

    2008-01-01

    .... The issue cannot be over simplified as several separate and key situational factors play into an agency's ability to keep the level of human capital static, despite fluctuations in staffing, type...

  14. Predicting future staffing needs at teaching hospitals: use of an analytical program with multiple variables.

    Science.gov (United States)

    Mitchell, Christine C; Ashley, Stanley W; Zinner, Michael J; Moore, Francis D

    2007-04-01

    To develop a model to predict future staffing for the surgery service at a teaching hospital. Tertiary hospital. A computer model with potential future variables was constructed. Some of the variables were distribution of resident staff, fellows, and physician extenders; salary/wages; work hours; educational value of rotations; work units, inpatient wards, and clinics; future volume growth; and efficiency savings. Outcomes Number of staff to be hired, staffing expense, and educational impact. On a busy general surgery service, we estimated the impact of changes in resident work hours, service growth, and workflow efficiency in the next 5 years. Projecting a reduction in resident duty hours to 60 hours per week will require the hiring of 10 physician assistants at a cost of $1 134 000, a cost that is increased by $441 000 when hiring hospitalists instead. Implementing a day of didactic and simulator time (10 hours) will further increase the costs by $568 000. A 10% improvement in the efficiency of floor care, as might be gained by advanced information technology capability or by regionalization of patients, can mitigate these expenses by as much as 21%. On the other hand, a modest annual growth of 2% will increase the costs by $715 000 to $2 417 000. To simply replace residents with alternative providers requires large amounts of human and fiscal capital. The potential for simple efficiencies to mitigate some of this expense suggests that traditional patterns of care in teaching hospitals will have to change in response to educational mandates.

  15. Association between Nurse Staffing and In-Hospital Bone Fractures: A Retrospective Cohort Study.

    Science.gov (United States)

    Morita, Kojiro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

    2017-06-01

    To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. We conducted a retrospective cohort study to examine the association of inpatient nurse-to-occupied bed ratio (NBR) with in-hospital fractures. Multivariable logistic regression with generalized estimating equations was performed, adjusting for patient characteristics and hospital characteristics. We identified 770,373 patients aged 50 years or older who underwent planned major surgery for some forms of cancer or cardiovascular diseases. We used ICD-10 codes and postoperative procedure codes to identify patients with in-hospital fractures. Hospital characteristics were obtained from the "Survey of Medical Institutions and Hospital Report" and "Annual Report for Functions of Medical Institutions." Overall, 662 (0.09 percent) in-hospital fractures were identified. Logistic regression analysis showed that the proportion of in-hospital fractures in the group with the highest NBR was significantly lower than that in the group with the lowest NBR (adjusted odd ratios, 0.67; 95 percent confidence interval, 0.44-0.99; p = .048). Sufficient nurse staffing may be important to reduce postsurgical in-hospital fractures in acute care hospitals. © Health Research and Educational Trust.

  16. Lessons learned from Gen II NPP staffing approaches applicable to new reactors - 15003

    International Nuclear Information System (INIS)

    Goodnight, C.

    2015-01-01

    This paper discusses lessons learned from the operation of the Gen II fleet of existing nuclear power plants (NPPs), in terms of staffing, that can be applied to the final design, deployment, and operation of new reactor designs. The most significant of these lessons is the need to appropriately staff the facility, having the right number of people with the required skills and experience. This begs the question of how to identify those personnel requirements. For NPPs, there are five key factors that ultimately will determine the effectiveness and costs of operating nuclear power plants (NPPs): 1) The Nuclear Steam Supply System (NSSS) and the layout of the plant site; 2) The processes which the operating organization applies; 3) The organizational structure of the operating organization; 4) The organizational culture of the operating organization, and 5) The regulatory framework under which the licensee must operate. In summary, this paper identifies opportunities to minimize staffing and costs learned from Gen II NPPs that may be applicable for new nuclear plants. (author)

  17. [Model to predict staffing for anesthesiology and post-anesthesia intensive care units and pain clinics].

    Science.gov (United States)

    Canet, J; Moral, V; Villalonga, A; Pelegrí, D; Gomar, C; Montero, A

    2001-01-01

    Human resources account for a large part of the budgets of anesthesia and post-anesthesia intensive care units and pain clinics (A-PICU-PC). Adequate staffing is a key factor in providing for both effective care and professional staff development. Changes in professional responsibilities have rendered obsolete the concept of one anesthesiologist per operating room. Duties must be analyzed objectively to facilitate understanding between hospital administrators and A-PICU-PC chiefs of service when assigning human resources. The Catalan Society of Anesthesiology, Post-anesthesia Intensive Care and Pain Therapy has developed a model for estimating requirements for A-PICU-PC staffing based on three factors: 1) Definition of staff positions that must be filled and criteria for assigning human resources; 2) Estimation of non-care-related time required by the department for training, teaching, research and internal management, and 3) Estimation of staff required to cover absences from work for vacations, personal leave or illness. The model revealed that the ratio of number of staff positions to number of persons employed by an A-PICU-PC is approximately 1.3. Differences in the nature of services managed by an A-PICU-PC or the type of hospital might change the ratio slightly. The model can be applied universally, independently of differences that might exist among departments. Widespread application would allow adoption of a common language to be used by health care managers and A-PICU-PC departments when discussing a basis for consensus about our specialty.

  18. Trust for intelligent recommendation

    CERN Document Server

    Bhuiyan, Touhid

    2013-01-01

    Recommender systems are one of the recent inventions to deal with the ever-growing information overload in relation to the selection of goods and services in a global economy. Collaborative Filtering (CF) is one of the most popular techniques in recommender systems. The CF recommends items to a target user based on the preferences of a set of similar users known as the neighbors, generated from a database made up of the preferences of past users. In the absence of these ratings, trust between the users could be used to choose the neighbor for recommendation making. Better recommendations can b

  19. A consensus-based template for documenting and reporting in physician-staffed pre-hospital services

    DEFF Research Database (Denmark)

    Kruger, Andreas J; Lockey, David; Kurola, Jouni

    2011-01-01

    -staffed pre-hospital services in Europe. METHODS: Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary...... have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care....

  20. [Patient safety recommendations for out of operating room procedure sedation].

    Science.gov (United States)

    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Patient safety recommendations for out of operating room procedure sedation.

    Science.gov (United States)

    Arnal Velasco, D; Romero García, E; Martínez Palli, G; Muñoz Corsini, L; Rey Martínez, M; Postigo Morales, S

    2016-12-01

    There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review. These recommendations were validated by an expert panel of 31 anaesthesiologists through two rounds of an adaptation of the Delphi Method where more than 70% agreement was required. The resulting recommendations include previous evaluation, material and staffing needs for sedation for procedures, post-sedation recommendations and activity and quality control advice. We present patient centred recommendations for the safe use of sedation for out of the operating room procedures from the point of view of the professionals with the most experience in its administration. We believe that these can be used as a guide to reduce variability and increase patient safety in the organisation of healthcare. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    McAlindon, T. E.; Driban, J. B.; Henrotin, Y.

    2015-01-01

    The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct......, and reporting of clinical trials for knee OA we initially drafted recommendations through an iterative process. Members of the working group included representatives from industry and academia. After the working group members reviewed a final draft, they scored the appropriateness for recommendations. After...... and index knee, describing interventions, patient-reported and physical performance measures, structural outcome measures, biochemical biomarkers, and reporting recommendations. In summary, the working group identified 25 recommendations that represent the current best practices regarding clinical trials...

  3. Trust and Recommendations

    Science.gov (United States)

    Victor, Patricia; de Cock, Martine; Cornelis, Chris

    Recommendation technologies and trust metrics constitute the two pillars of trust-enhanced recommender systems. We discuss and illustrate the basic trust concepts such as trust and distrust modeling, propagation and aggregation. These concepts are needed to fully grasp the rationale behind the trust-enhanced recommender techniques that are discussed in the central part of the chapter, which focuses on the application of trust metrics and their operators in recommender systems. We explain the benefits of using trust in recommender algorithms and give an overview of state-of-the-art approaches for trust-enhanced recommender systems. Furthermore, we explain the details of three well-known trust-based systems and provide a comparative analysis of their performance. We conclude with a discussion of some recent developments and open challenges, such as visualizing trust relationships in a recommender system, alleviating the cold start problem in a trust network of a recommender system, studying the effect of involving distrust in the recommendation process, and investigating the potential of other types of social relationships.

  4. The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction.

    Science.gov (United States)

    Sheward, Louisa; Hunt, Jennifer; Hagen, Suzanne; Macleod, Margaret; Ball, Jane

    2005-01-01

    To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables. Concern about the impact of restructuring of nurse staffing, and reports of nurse shortages, on nurse and patient outcomes led to the research being reported on in this article. A questionnaire survey of registered nurses in Scotland and England. A questionnaire survey of the hospitals in which these nurses worked. Respondents in the two countries were similar in terms of demographic, work and employment characteristics. Significant relationships were found using the combined English and Scottish data between nurse patient ratios and (1) emotional exhaustion and (2) dissatisfaction with current job reported by nurses. Increasing numbers of patients to nurses was associated with increasing risk of emotional exhaustion and dissatisfaction with current job.

  5. Strategic foresight, leadership, and the future of rural healthcare staffing in the United States.

    Science.gov (United States)

    Reimers-Hild, Connie

    2018-04-10

    This article uses a strategic foresight tool, megatrends, to examine forces influencing long-term healthcare staffing in the rural United States. Two megatrends-exponential advances in science and technology and the continued evolution of the decentralized global marketplace-will influence and ultimately help shape the future of rural healthcare. Successful health ecosystems of the future will need to be customer-driven, more affordable, and tech-savvy. Successful evolution in an era of continuous change will require a blend of intentional engagement with stakeholders, strategic foresight, and future-focused leadership. More research is needed to fully understand not only the challenges of rural healthcare but also the emerging opportunities.

  6. An Innovative Approach to Staffing a Simulation Center in a College of Health Professions.

    Science.gov (United States)

    Berro, Elizabeth A; Knoesel, Joanne M

    2016-01-01

    The current limited number of nurse faculty and available clinical sites requires innovative strategies to provide education to current and future nurses. Simulation centers and clinical education laboratories can meet this need, but staffing issues can be problematic. This article describes how an urban university developed a cost-effective model to staff its clinical education laboratory. After two faculty members proposed a pilot program to fully integrate simulation into both the accelerated and traditional undergraduate nursing programs on two campuses, a need was identified for more nursing staff dedicated to the simulation program. Knowing that many recent nurse graduates were available while waiting to obtain their first nursing position, these new nurses were recruited to serve in a volunteer capacity, supporting nursing faculty in the simulation program. The new nurse graduate volunteer position quickly evolved into a paid nurse intern position and has proven to benefit students, faculty, and new nurse graduates. Copyright 2016, SLACK Incorporated.

  7. 9 CFR 310.1 - Extent and time of post-mortem inspection; post-mortem inspection staffing standards.

    Science.gov (United States)

    2010-01-01

    ... 288 4 4 2 289 to 316 5 4 2 317 to 343 5 5 2 (3) Swine Inspection. The following inspection staffing standards are applicable to swine slaughter configurations. The inspection standards for all slaughter lines..., liver, heart, lungs, and mediastinal lymph nodes. In addition, for one- and two-inspector lines, the...

  8. 75 FR 69468 - Progressive Furniture, Inc., Including On-Site Leased Workers From Onin Staffing, a Subsidiary of...

    Science.gov (United States)

    2010-11-12

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,756] Progressive Furniture, Inc., Including On-Site Leased Workers From Onin Staffing, a Subsidiary of Sauder Furniture, Claremont, NC; Notice of Affirmative Determination Regarding Application for Reconsideration On July 19, 2010...

  9. 77 FR 63873 - Johnson Controls, Inc. Including On-Site Leased Workers of Valley Staffing and AZ Quality Hudson...

    Science.gov (United States)

    2012-10-17

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,067] Johnson Controls, Inc... workers of Johnson Controls, Inc., including on-site leased workers from Valley Staffing, Hudson... subject firm. The company reports that workers leased from AZ Quality were employed on-site at the Hudson...

  10. 77 FR 19719 - Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing, IBM...

    Science.gov (United States)

    2012-04-02

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation... Staffing, Fort Smith, Arkansas. The workers are engaged in the production of refrigerators and trash... trash compactors to Mexico. The amended notice applicable to TA-W-74,593 is hereby issued as follows...

  11. 75 FR 77665 - Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing and...

    Science.gov (United States)

    2010-12-13

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing and Andrews International, Fort Smith... subject firm. The workers are engaged in the production of refrigerators and trash compactors. The company...

  12. Design Effects and Generalized Variance Functions for the 1990-91 Schools and Staffing Survey (SASS). Volume I. User's Manual.

    Science.gov (United States)

    Salvucci, Sameena; And Others

    This user's manual summarizes the results and use of design effects and generalized variance functions (GVF) to approximate standard errors for the 1990-91 Schools and Staffing Survey (SASS). It is Volume I of a two-volume publication that is part of the Technical Report series of the National Center for Education Statistics (NCES). The SASS is a…

  13. The Impact of Office Automation on the Roles and Staffing Patterns of Office Employees: A Case Study.

    Science.gov (United States)

    Goodrich, Elizabeth A.

    1989-01-01

    The study examined impact of office automation on the roles and staffing patterns of office employees at the National Institute of Neurological and Communicative Disorders and Stroke. Results of an interview study indicate that automation has had a favorable impact on the way work is accomplished and on the work environment. (Author/CH)

  14. Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy.

    Science.gov (United States)

    Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M

    2015-04-01

    (1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  15. 77 FR 29362 - Kohler Company, Malvern Division, Including On-Site Leased Workers From Manpower Staffing and Dow...

    Science.gov (United States)

    2012-05-17

    ... Division, Including On-Site Leased Workers From Manpower Staffing and Dow Cleaning Services, Malvern, AR..., and components. The company reports that workers from Dow Cleaning Services were employed on-site at... leased from Dow Cleaning Services working on-site at the Malvern, Arkansas location of Kohler Company...

  16. Research recommendations [Chapter 10

    Science.gov (United States)

    Daniel G. Neary; Alvin L. Medina; John N. Rinne

    2012-01-01

    This chapter contains a number of research recommendations that have developed from the 15 years of research on the UVR conducted by the Southwest Watershed Science Team, as well as from insights from key cooperators and contacts. It is meant to be our best insight as to where efforts should go now. Achieving these recommendations will depend on a number of factors,...

  17. Context-aware recommender system based on ontology for recommending tourist destinations at Bandung

    Science.gov (United States)

    Rizaldy Hafid Arigi, L.; Abdurahman Baizal, Z. K.; Herdiani, Anisa

    2018-03-01

    Recommender System is software that is able to provide personalized recommendation suits users’ needs. Recommender System has been widely implemented in various domains, including tourism. One approach that can be done for more personalized recommendations is the use of contextual information. This paper proposes a context aware recommender based ontology system in the tourism domain. The system is capable of recommending tourist destinations by using user preferences of the categories of tourism and contextual information such as user locations, weather around tourist destinations and close time of destination. Based on the evaluation, the system has accuracy of of 0.94 (item recommendation precision evaluated by expert) and 0.58 (implicitly from system-end user interaction). Based on the evaluation of user satisfaction, the system provides a satisfaction level of more than 0.7 (scale 0 to 1) for speed factors for providing liked recommendations (PE), informative description of recommendations (INF) and user trust (TR).

  18. Recommendations for safer radiotherapy: what’s the message?

    International Nuclear Information System (INIS)

    Dunscombe, Peter

    2012-01-01

    Radiotherapy, with close to a million courses delivered per year in North America, is a very safe and effective intervention for a devastating disease. However, although rare, several deeply regrettable incidents have occurred in radiotherapy and have rightly been the subject of considerable public interest. Partly in response to reports of these incidents a variety of authoritative organizations across the globe has harnessed the expertise amongst their members in attempts to identify the measures that will make radiotherapy safer. While the intentions of all these organizations are clearly good it is challenging for the health care providers in the clinic to know where to start with so much advice coming from so many directions. Through a mapping exercise we have identified commonalities between recommendations made in seven authoritative documents and identified those issues most frequently cited. The documents reviewed contain a total of 117 recommendations. Using the 37 recommendations in “Towards Safer Radiotherapy” as the initial base layer, recommendations in the other documents were mapped, adding to the base layer to accommodate all the recommendations from the additional six documents as necessary. This mapping exercise resulted in the distillation of the original 117 recommendations down to 61 unique recommendations. Twelve topics were identified in three or more of the documents as being pertinent to the improvement of patient safety in radiotherapy. They are, in order of most to least cited: training, staffing, documentation, incident learning, communication, check lists, quality control and preventive maintenance, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment, and safety culture. This analysis provides guidance for the selection of those activities most likely to enhance safety and quality in radiotherapy based on the frequency of citation in selected recent authoritative literature.

  19. Recommendations for safer radiotherapy: what’s the message?

    Directory of Open Access Journals (Sweden)

    Peter eDunscombe

    2012-09-01

    Full Text Available Radiotherapy, with close to a million courses delivered per year in North America, is a very safe and effective intervention for a devastating disease. However, although rare, several deeply regrettable incidents have occurred in radiotherapy and have rightly been the subject of considerable public interest. Partly in response to reports of these incidents a variety of authoritative organizations across the globe has harnessed the expertise amongst their members in attempts to identify the measures that will make radiotherapy safer. While the intentions of all these organizations are clearly good it is challenging for the health care providers in the clinic to know where to start with so much advice coming from so many directions. Through a mapping exercise we have identified commonalities between recommendations made in seven authoritative documents and identified those issues most frequently cited. The documents reviewed contain a total of 117 recommendations. Using the 37 recommendations in Towards Safer Radiotherapy as the initial base layer, recommendations in the other documents were mapped, adding to the base layer to accommodate all the recommendations from the additional six documents as necessary. This mapping exercise resulted in the distillation of the original 117 recommendations down to 61 unique recommendations. Twelve topics were identified in three or more of the documents as being pertinent to the improvement of patient safety in radiotherapy. They are, in order of most to least cited: training, staffing, documentation, incident learning, communication, check lists, quality control and preventive maintenance, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment and safety culture. This analysis provides guidance for the selection of those activities most likely to enhance safety and quality in radiotherapy based on the frequency of citation in selected recent authoritative literature.

  20. Recommender Systems for Learning

    CERN Document Server

    Manouselis, Nikos; Verbert, Katrien; Duval, Erik

    2013-01-01

    Technology enhanced learning (TEL) aims to design, develop and test sociotechnical innovations that will support and enhance learning practices of both individuals and organisations. It is therefore an application domain that generally covers technologies that support all forms of teaching and learning activities. Since information retrieval (in terms of searching for relevant learning resources to support teachers or learners) is a pivotal activity in TEL, the deployment of recommender systems has attracted increased interest. This brief attempts to provide an introduction to recommender systems for TEL settings, as well as to highlight their particularities compared to recommender systems for other application domains.

  1. Search and Recommendation

    DEFF Research Database (Denmark)

    Bogers, Toine

    2014-01-01

    In just a little over half a century, the field of information retrieval has experienced spectacular growth and success, with IR applications such as search engines becoming a billion-dollar industry in the past decades. Recommender systems have seen an even more meteoric rise to success with wide......-scale application by companies like Amazon, Facebook, and Netflix. But are search and recommendation really two different fields of research that address different problems with different sets of algorithms in papers published at distinct conferences? In my talk, I want to argue that search and recommendation...... are more similar than they have been treated in the past decade. By looking more closely at the tasks and problems that search and recommendation try to solve, at the algorithms used to solve these problems and at the way their performance is evaluated, I want to show that there is no clear black and white...

  2. [Recommendations for neonatal transport].

    Science.gov (United States)

    Moreno Hernando, J; Thió Lluch, M; Salguero García, E; Rite Gracia, S; Fernández Lorenzo, J R; Echaniz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Sánchez Luna, M

    2013-08-01

    During pregnancy, it is not always possible to identify maternal or foetal risk factors. Infants requiring specialised medical care are not always born in centres providing intensive care and will need to be transferred to a referral centre where intensive care can be provided. Therefore Neonatal Transport needs to be considered as part of the organisation of perinatal health care. The aim of Neonatal Transport is to transfer a newborn infant requiring intensive care to a centre where specialised resources and experience can be provided for the appropriate assessment and continuing treatment of a sick newborn infant. Intrauterine transfer is the ideal mode of transport when the birth of an infant with risk factors is diagnosed. Unfortunately, not all problems can be detected in advance with enough time to safely transfer a pregnant woman. Around 30- 50% of risk factors will be diagnosed during labour or soon after birth. Therefore, it is important to have the knowledge and resources to resuscitate and stabilise a newborn infant, as well as a specialised neonatal transport system. With this specialised transport it is possible to transfer newly born infants with the same level of care that they would receive if they had been born in a referral hospital, without increasing their risks or affecting the wellbeing of the newborn. The Standards Committee of the Spanish Society of Neonatology reviewed and updated recommendations for intrauterine transport and indications for neonatal transfer. They also reviewed organisational and logistic factors involved with performing neonatal transport. The Committee review included the type of personnel who should be involved; communication between referral and receiving hospitals; documentation; mode of transport; equipment to stabilise newly born infants; management during transfer, and admission at the referral hospital. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  3. Probabilistic approaches to recommendations

    CERN Document Server

    Barbieri, Nicola; Ritacco, Ettore

    2014-01-01

    The importance of accurate recommender systems has been widely recognized by academia and industry, and recommendation is rapidly becoming one of the most successful applications of data mining and machine learning. Understanding and predicting the choices and preferences of users is a challenging task: real-world scenarios involve users behaving in complex situations, where prior beliefs, specific tendencies, and reciprocal influences jointly contribute to determining the preferences of users toward huge amounts of information, services, and products. Probabilistic modeling represents a robus

  4. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Emery, C. A.; Roos, Ewa M.; Verhagen, E.

    2015-01-01

    the design, conduct and analytical approaches to RCTs evaluating the preventative effect of joint injury prevention strategies. Recommendations regarding the design, conduct, and reporting of RCTs evaluating injury prevention interventions were established based on the consensus of nine researchers...... regarding the research question, research design, study participants, randomization, baseline characteristics, intervention, outcome measurement, analysis, implementation, cost evaluation, reporting and future considerations including the impact on development of PTOA. Methodological recommendations...

  5. Metadata Quality in Institutional Repositories May be Improved by Addressing Staffing Issues

    Directory of Open Access Journals (Sweden)

    Elizabeth Stovold

    2016-09-01

    Full Text Available A Review of: Moulaison, S. H., & Dykas, F. (2016. High-quality metadata and repository staffing: Perceptions of United States–based OpenDOAR participants. Cataloging & Classification Quarterly, 54(2, 101-116. http://dx.doi.org/10.1080/01639374.2015.1116480 Objective – To investigate the quality of institutional repository metadata, metadata practices, and identify barriers to quality. Design – Survey questionnaire. Setting – The OpenDOAR online registry of worldwide repositories. Subjects – A random sample of 50 from 358 administrators of institutional repositories in the United States of America listed in the OpenDOAR registry. Methods – The authors surveyed a random sample of administrators of American institutional repositories included in the OpenDOAR registry. The survey was distributed electronically. Recipients were asked to forward the email if they felt someone else was better suited to respond. There were questions about the demographics of the repository, the metadata creation environment, metadata quality, standards and practices, and obstacles to quality. Results were analyzed in Excel, and qualitative responses were coded by two researchers together. Main results – There was a 42% (n=21 response rate to the section on metadata quality, a 40% (n=20 response rate to the metadata creation section, and 40% (n=20 to the section on obstacles to quality. The majority of respondents rated their metadata quality as average (65%, n=13 or above average (30%, n=5. No one rated the quality as high or poor, while 10% (n=2 rated the quality as below average. The survey found that the majority of descriptive metadata was created by professional (84%, n=16 or paraprofessional (53%, n=10 library staff. Professional staff were commonly involved in creating administrative metadata, reviewing the metadata, and selecting standards and documentation. Department heads and advisory committees were also involved in standards and documentation

  6. Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface.

    Science.gov (United States)

    Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E

    2010-08-23

    The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the

  7. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study.

    Science.gov (United States)

    Aiken, Linda H; Sloane, Douglas M; Bruyneel, Luk; Van den Heede, Koen; Griffiths, Peter; Busse, Reinhard; Diomidous, Marianna; Kinnunen, Juha; Kózka, Maria; Lesaffre, Emmanuel; McHugh, Matthew D; Moreno-Casbas, M T; Rafferty, Anne Marie; Schwendimann, Rene; Scott, P Anne; Tishelman, Carol; van Achterberg, Theo; Sermeus, Walter

    2014-05-24

    Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether differences in patient to nurse ratios and nurses' educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures. For this observational study, we obtained discharge data for 422,730 patients aged 50 years or older who underwent common surgeries in 300 hospitals in nine European countries. Administrative data were coded with a standard protocol (variants of the ninth or tenth versions of the International Classification of Diseases) to estimate 30 day in-hospital mortality by use of risk adjustment measures including age, sex, admission type, 43 dummy variables suggesting surgery type, and 17 dummy variables suggesting comorbidities present at admission. Surveys of 26,516 nurses practising in study hospitals were used to measure nurse staffing and nurse education. We used generalised estimating equations to assess the effects of nursing factors on the likelihood of surgical patients dying within 30 days of admission, before and after adjusting for other hospital and patient characteristics. An increase in a nurses' workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7% (odds ratio 1·068, 95% CI 1·031-1·106), and every 10% increase in bachelor's degree nurses was associated with a decrease in this likelihood by 7% (0·929, 0·886-0·973). These associations imply that patients in hospitals in which 60% of nurses had bachelor's degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor's degrees and nurses cared

  8. A Hybrid Recommender System Based on User-Recommender Interaction

    OpenAIRE

    Zhang, Heng-Ru; Min, Fan; He, Xu; Xu, Yuan-Yuan

    2015-01-01

    Recommender systems are used to make recommendations about products, information, or services for users. Most existing recommender systems implicitly assume one particular type of user behavior. However, they seldom consider user-recommender interactive scenarios in real-world environments. In this paper, we propose a hybrid recommender system based on user-recommender interaction and evaluate its performance with recall and diversity metrics. First, we define the user-recommender interaction...

  9. Distributed Deliberative Recommender Systems

    Science.gov (United States)

    Recio-García, Juan A.; Díaz-Agudo, Belén; González-Sanz, Sergio; Sanchez, Lara Quijano

    Case-Based Reasoning (CBR) is one of most successful applied AI technologies of recent years. Although many CBR systems reason locally on a previous experience base to solve new problems, in this paper we focus on distributed retrieval processes working on a network of collaborating CBR systems. In such systems, each node in a network of CBR agents collaborates, arguments and counterarguments its local results with other nodes to improve the performance of the system's global response. We describe D2ISCO: a framework to design and implement deliberative and collaborative CBR systems that is integrated as a part of jcolibritwo an established framework in the CBR community. We apply D2ISCO to one particular simplified type of CBR systems: recommender systems. We perform a first case study for a collaborative music recommender system and present the results of an experiment of the accuracy of the system results using a fuzzy version of the argumentation system AMAL and a network topology based on a social network. Besides individual recommendation we also discuss how D2ISCO can be used to improve recommendations to groups and we present a second case of study based on the movie recommendation domain with heterogeneous groups according to the group personality composition and a group topology based on a social network.

  10. Recommender system based on scarce information mining.

    Science.gov (United States)

    Lu, Wei; Chung, Fu-Lai; Lai, Kunfeng; Zhang, Liang

    2017-09-01

    Guessing what user may like is now a typical interface for video recommendation. Nowadays, the highly popular user generated content sites provide various sources of information such as tags for recommendation tasks. Motivated by a real world online video recommendation problem, this work targets at the long tail phenomena of user behavior and the sparsity of item features. A personalized compound recommendation framework for online video recommendation called Dirichlet mixture probit model for information scarcity (DPIS) is hence proposed. Assuming that each clicking sample is generated from a representation of user preferences, DPIS models the sample level topic proportions as a multinomial item vector, and utilizes topical clustering on the user part for recommendation through a probit classifier. As demonstrated by the real-world application, the proposed DPIS achieves better performance in accuracy, perplexity as well as diversity in coverage than traditional methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Customer Perception of a Supermarket Nutrition Centre Staffed by a Registered Dietitian.

    Science.gov (United States)

    Evans, KATE; Taper, JANETTE; Quintal, DEBORAH

    2000-01-01

    The purpose of this study was to examine consumers' attitudes toward a supermarket nutrition centre staffed full time by a registered dietitian. A questionnaire was administered over three consecutive days in that store and in a control store that was similar to the experimental site in every way, except for the absence of a nutrition centre. Participants were chosen randomly at timed intervals in specific areas of the store. Of 428 customers approached, 232 agreed to participate in the survey. At the experimental site, 75% of the participants were extremely satisfied with the registered dietitian's services and 69% ranked having a registered dietitian on staff in any store as extremely important, compared to 31% at the control site (p importance of 13 required and optional services offered by the supermarkets, 15% of participants at the experimental site ranked having a registered dietitian on staff in the top five, compared with 4% at the control site (p service. There may therefore be an expanded role for registered dietitians in the supermarket setting.

  12. Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries?

    Science.gov (United States)

    Mark, Barbara A; Hughes, Linda C; Belyea, Michael; Chang, Yunkyung; Hofmann, David; Jones, Cheryl B; Bacon, Cynthia T

    2007-01-01

    Hospital nurses have one of the highest work-related injury rates in the United States. Yet, approaches to improving employee safety have generally focused on attempts to modify individual behavior through enforced compliance with safety rules and mandatory participation in safety training. We examined a theoretical model that investigated the impact on nurse injuries (back injuries and needlesticks) of critical structural variables (staffing adequacy, work engagement, and work conditions) and further tested whether safety climate moderated these effects. A longitudinal, non-experimental, organizational study, conducted in 281 medical-surgical units in 143 general acute care hospitals in the United States. Work engagement and work conditions were positively related to safety climate, but not directly to nurse back injuries or needlesticks. Safety climate moderated the relationship between work engagement and needlesticks, while safety climate moderated the effect of work conditions on both needlesticks and back injuries, although in unexpected ways. DISCUSSION AND IMPACT ON INDUSTRY: Our findings suggest that positive work engagement and work conditions contribute to enhanced safety climate and can reduce nurse injuries.

  13. The Nuclear Education and Staffing Challenge: Rebuilding Critical Skills in Nuclear Science and Technology

    International Nuclear Information System (INIS)

    Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.

    2005-01-01

    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs

  14. Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review.

    Science.gov (United States)

    Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto

    2016-01-01

    Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.

  15. The Nuclear Education and Staffing Challenge: Rebuilding Critical Skills in Nuclear Science and Technology

    International Nuclear Information System (INIS)

    Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.

    2005-01-01

    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory were 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs

  16. The nuclear education and staffing challenge: Rebuilding critical skills in nuclear science and technology

    International Nuclear Information System (INIS)

    Wogman, N.A.; Bond, L.J.; Waltar, A.E.; Leber, R.E.

    2005-01-01

    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of nuclear legacies, global security, nonproliferation, homeland security and national defense, radiobiology and nuclear energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. Current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs are presented. (author)

  17. Analysis of patients with bodyboarding injuries transported by physician-staffed emergency helicopter

    Directory of Open Access Journals (Sweden)

    Kazuhiko Omori

    2015-01-01

    Full Text Available Context: There have been no reports that have studied the characteristics specific to bodyboard injuries. Aims: To clarify characteristics to bodyboard injuries. Settings and Design: A retrospective medical chart review. Materials and Methods: A medical chart review was retrospectively performed for all patients with spinal cord injuries transported via physician-staffed emergency helicopters between January 2009 and October 2013. The subjects were divided into two groups based on whether they had a spinal cord injury induced by bodyboarding (Bodyboard group, n = 14 or not (Control group, n = 14. Statistical Analysis Used: Using a χ2 -test, Mann-Whitney U-test and non-paired Student′s t-test. Results: All but one of the subjects had spinal canal stenosis. The age of the patients in the Bodyboard group was younger than that of the Control group. The ratio of males and Glasgow Coma Scale of the Bodyboard group were higher than those on the Control group. The spinal cord injury induced by bodyboarding typically occurred after impacts of the head or face with the sea bottom while the subject was being buffeted by the waves. The severity of the spinal cord injury in the Bodyboard group was lower than that in the Control group. Conclusion: Bodyboarding tended to induce spinal cord injuries after the head or face collided with the sea bottom, and was more common in middle-aged males during the summer season, and was associated with a favorable outcome.

  18. PROBLEMS OF TRANSPORT COMPLEX STAFFING OF UKRAINIAN SSR IN 1960-1980

    Directory of Open Access Journals (Sweden)

    Anatoliy Gorban

    2016-11-01

    Full Text Available In the article the staffing problems of transport complex in the period of its fundamental technical change and intensive development of 1960–1980-ies are described. The main purpose of this article is to analyze the peculiarities of personnel potential development of transport complex of the Ukrainian SSR in the years of the intensive development of transport sectors, figure out the social component of the measures to improve the efficiency of transport networks. Methodology. In this article we used the method of analysis. The qualitative personnel structure, training of skilled workers in the educational institutions and other forms of improvement of personal skills of transport workers are analyzed. The causes of staff turnover and low labour discipline are studied. Practical implementation. This article shows the possible opportunities for the modern transport complex of Ukraine, how to be successful and competitive in the market. The historical background of this article can be very useful for present managers of the transport complex. Results. The author makes a general conclusion that the main causes of personnel fluctuation in transport brunches are low wages, pour conditions of work and lack of accomodations for the staff. The social and practical measures to improve effectiveness of work with personnel of all brunches of transport system are characterized.

  19. Ant colony optimization and event-based dynamic task scheduling and staffing for software projects

    Science.gov (United States)

    Ellappan, Vijayan; Ashwini, J.

    2017-11-01

    In programming change organizations from medium to inconceivable scale broadens, the issue of wander orchestrating is amazingly unusual and testing undertaking despite considering it a manual system. Programming wander-organizing requirements to deal with the issue of undertaking arranging and in addition the issue of human resource portion (also called staffing) in light of the way that most of the advantages in programming ventures are individuals. We propose a machine learning approach with finds respond in due order regarding booking by taking in the present arranging courses of action and an event based scheduler revives the endeavour arranging system moulded by the learning computation in perspective of the conformity in event like the begin with the Ander, the instant at what time possessions be free starting to ended errands, and the time when delegates stick together otherwise depart the wander inside the item change plan. The route toward invigorating the timetable structure by the even based scheduler makes the arranging method dynamic. It uses structure components to exhibit the interrelated surges of endeavours, slip-ups and singular all through different progression organizes and is adjusted to mechanical data. It increases past programming wander movement ask about by taking a gander at a survey based process with a one of a kind model, organizing it with the data based system for peril assessment and cost estimation, and using a choice showing stage.

  20. Archetypal Game Recommender Systems

    DEFF Research Database (Denmark)

    Sifa, Rafet; Bauckhage, C.; Drachen, Anders

    2014-01-01

    Contemporary users (players, consumers) of digital games have thousands of products to choose from, which makes nding games that t their interests challenging. Towards addressing this challenge, in this paper two dierent formulations of Archetypal Analysis for Top-L recommender tasks using implicit...... feedback are presented: factor- and neighborhood-oriented models. These form the rst application of rec- ommender systems to digital games. Both models are tested on a dataset of 500,000 users of the game distribution platform Steam, covering game ownership and playtime data across more than 3000 games....... Compared to four other recommender models (nearest neighbor, two popularity mod- els, random baseline), the archetype based models provide the highest recall rates showing that Archetypal Analysis can be successfully applied for Top-L recommendation purposes...

  1. Recommending Multidimensional Queries

    Science.gov (United States)

    Giacometti, Arnaud; Marcel, Patrick; Negre, Elsa

    Interactive analysis of datacube, in which a user navigates a cube by launching a sequence of queries is often tedious since the user may have no idea of what the forthcoming query should be in his current analysis. To better support this process we propose in this paper to apply a Collaborative Work approach that leverages former explorations of the cube to recommend OLAP queries. The system that we have developed adapts Approximate String Matching, a technique popular in Information Retrieval, to match the current analysis with the former explorations and help suggesting a query to the user. Our approach has been implemented with the open source Mondrian OLAP server to recommend MDX queries and we have carried out some preliminary experiments that show its efficiency for generating effective query recommendations.

  2. Nurse staffing and system integration and change indicators in acute care hospitals: evidence from a balanced scorecard.

    Science.gov (United States)

    McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl

    2008-01-01

    This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

  3. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing.

    Science.gov (United States)

    Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F

    2014-05-01

    Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.

  4. New Insulin Delivery Recommendations.

    Science.gov (United States)

    Frid, Anders H; Kreugel, Gillian; Grassi, Giorgio; Halimi, Serge; Hicks, Debbie; Hirsch, Laurence J; Smith, Mike J; Wellhoener, Regine; Bode, Bruce W; Hirsch, Irl B; Kalra, Sanjay; Ji, Linong; Strauss, Kenneth W

    2016-09-01

    Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions. These recommendations were informed by a large international survey of current practice and were written and vetted by 183 diabetes experts from 54 countries at the Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop held in Rome, Italy, in 2015. Recommendations are organized around the themes of anatomy, physiology, pathology, psychology, and technology. Key among the recommendations are that the shortest needles (currently the 4-mm pen and 6-mm syringe needles) are safe, effective, and less painful and should be the first-line choice in all patient categories; intramuscular injections should be avoided, especially with long-acting insulins, because severe hypoglycemia may result; lipohypertrophy is a frequent complication of therapy that distorts insulin absorption, and, therefore, injections and infusions should not be given into these lesions and correct site rotation will help prevent them; effective long-term therapy with insulin is critically dependent on addressing psychological hurdles upstream, even before insulin has been started; inappropriate disposal of used sharps poses a risk of infection with blood-borne pathogens; and mitigation is possible with proper training, effective disposal strategies, and the use of safety devices. Adherence to these new recommendations should lead to more effective therapies, improved outcomes, and lower costs for patients with diabetes. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  5. Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

    International Nuclear Information System (INIS)

    Dunscombe, Peter; Grau, Cai; Defourny, Noémie; Malicki, Julian; Borras, Josep M.; Coffey, Mary; Bogusz, Marta; Gasparotto, Chiara; Slotman, Ben; Lievens, Yolande; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; De Hertogh, Olivier; Hadjieva, Tatiana; Petera, Jiri; Eriksen, Jesper Grau; Jaal, Jana; Bly, Ritva; Azria, David

    2014-01-01

    Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need

  6. Recommendations for Alternative Credit.

    Science.gov (United States)

    Lenderman, Ed; And Others

    Following a review of the mathematics topics taught in accounting, electronics, auto, food and clothing, and metals courses at Linn-Benton Community College, Albany, Oregon, recommendations were made to grant one semester of mathematics credit for completing a two-year sequence of these courses. The other required semester of mathematics should be…

  7. Privacy in Recommender Systems

    NARCIS (Netherlands)

    Jeckmans, Arjan; Beye, Michael; Erkin, Zekeriya; Erkin, Zekeriya; Hartel, Pieter H.; Lagendijk, Reginald; Tang, Qiang; Ramzan, Naeem; van Zwol, Roelof; Lee, Jong-Seok; Clüver, Kai; Hua, Xian-Sheng

    In many online applications, the range of content that is offered to users is so wide that a need for automated recommender systems arises. Such systems can provide a personalized selection of relevant items to users. In practice, this can help people find entertaining movies, boost sales through

  8. Privacy enhanced recommender system

    NARCIS (Netherlands)

    Erkin, Zekeriya; Erkin, Zekeriya; Beye, Michael; Veugen, Thijs; Lagendijk, Reginald L.

    2010-01-01

    Recommender systems are widely used in online applications since they enable personalized service to the users. The underlying collaborative filtering techniques work on user’s data which are mostly privacy sensitive and can be misused by the service provider. To protect the privacy of the users, we

  9. Chapter 10: Management recommendations

    Science.gov (United States)

    Deborah M. Finch; Janie Agyagos; Tracy McCarthey; Robert M. Marshall; Scott H. Stoleson; Mary J. Whitfield

    2000-01-01

    This chapter was developed over a series of meetings using a group-consensus process. Our recommendations are based on published results, on information compiled in the previous chapters, on expert opinion, and on unpublished data of conservation team members. This chapter is available as temporary guidance until the Recovery Plan for the southwestern willow flycatcher...

  10. Aggregated recommendation through random forests.

    Science.gov (United States)

    Zhang, Heng-Ru; Min, Fan; He, Xu

    2014-01-01

    Aggregated recommendation refers to the process of suggesting one kind of items to a group of users. Compared to user-oriented or item-oriented approaches, it is more general and, therefore, more appropriate for cold-start recommendation. In this paper, we propose a random forest approach to create aggregated recommender systems. The approach is used to predict the rating of a group of users to a kind of items. In the preprocessing stage, we merge user, item, and rating information to construct an aggregated decision table, where rating information serves as the decision attribute. We also model the data conversion process corresponding to the new user, new item, and both new problems. In the training stage, a forest is built for the aggregated training set, where each leaf is assigned a distribution of discrete rating. In the testing stage, we present four predicting approaches to compute evaluation values based on the distribution of each tree. Experiments results on the well-known MovieLens dataset show that the aggregated approach maintains an acceptable level of accuracy.

  11. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Kraus, V B; Blanco, F J; Englund, M

    2015-01-01

    The objective of this work was to describe requirements for inclusion of soluble biomarkers in osteoarthritis (OA) clinical trials and progress toward OA-related biomarker qualification. The Guidelines for Biomarkers Working Group, representing experts in the field of OA biomarker research from...... both academia and industry, convened to discuss issues related to soluble biomarkers and to make recommendations for their use in OA clinical trials based on current knowledge and anticipated benefits. This document summarizes current guidance on use of biomarkers in OA clinical trials...... and their utility at five stages, including preclinical development and phase I to phase IV trials. As demonstrated by this summary, biomarkers can provide value at all stages of therapeutics development. When resources permit, we recommend collection of biospecimens in all OA clinical trials for a wide variety...

  12. Recommending audio mixing workflows

    OpenAIRE

    Sauer, Christian; Roth-Berghofer, Thomas; Auricchio, Nino; Proctor, Sam

    2013-01-01

    This paper describes our work on Audio Advisor, a workflow recommender for audio mixing. We examine the process of eliciting, formalising and modelling the domain knowledge and expert’s experience. We are also describing the effects and problems associated with the knowledge formalisation processes. We decided to employ structured case-based reasoning using the myCBR 3 to capture the vagueness encountered in the audio domain. We detail on how we used extensive similarity measure modelling to ...

  13. Badali recommends simplified bills

    International Nuclear Information System (INIS)

    Anon

    2003-01-01

    A report on the variety of retail electricity bills across the province, authored by Salvatore Badali of Deloitte Consulting, was recently released by the Ontario Government. The report was commissioned by the Government to examine the underlying reasons for the significant format differences and the wide variation of fixed and variable charges among the approximately 95 local electricity distribution companies across the province. Regarding the appropriateness of the charges the report recommends common definitions for local distribution company (LDC) fixed and variable costs, and consideration of options for reducing LDC charges, mainly by consolidating the sector and sharing such services as customer billing, accounting and out sourcing operations. Seven recommendations deal with bill simplification. These include bills that are clear and easy to read and provide sufficient information for consumers to verify charges; promote energy conservation, e.g. by including historical information; allow comparisons between retail suppliers and distributors; accommodate revenue collection, marketing needs and other billing services. The report also recommends clearly defined and consistently used terminology for standardized line items, suggests ways to provide consumer information in a form useful for making energy conservation decisions, development of an LDC scorecard to enable stake holders to compare their own LDCs with LDCs around the province, creation of a conservation and bill calculation website, consideration of further use of shared services, and solutions to address the removal of line losses from invoices

  14. ICRS Recommendation Document

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Engelhart, Luella; Ranstam, Jonas

    2011-01-01

    and function evaluated for validity and psychometric properties in patients with articular cartilage lesions. Results: The knee-specific instruments, titled the International Knee Documentation Committee Subjective Knee Form and the Knee injury and Osteoarthritis and Outcome Score, both fulfill the basic......, and confirmatory longitudinal studies are needed prior to recommending this scale for use in cartilage repair. Inclusion of a generic measure is feasible in cartilage repair studies and allows analysis of health-related quality of life and health economic outcomes. The Marx or Tegner Activity Rating Scales...

  15. The outcomes of psychiatric inpatients by proportion of experienced psychiatrists and nurse staffing in hospital: New findings on improving the quality of mental health care in South Korea.

    Science.gov (United States)

    Han, Kyu-Tae; Kim, Sun Jung; Jang, Sung-In; Hahm, Myung-Il; Kim, Seung Ju; Lee, Seo Yoon; Park, Eun-Cheol

    2015-10-30

    Readmission rates for mental health care are higher in South Korea than other Organization for Economic Development (OECD) countries. Therefore, it is worthwhile to continue investigating how to reduce readmissions. Taking a novel approach, we determined the relationship between psychiatrist experience and mental health care readmission rates. We used National Health Insurance claim data (N=21,315) from 81 hospitals to analyze readmissions within 30 days of discharge for "mood disorders" or "schizophrenia, schizotypal and delusional disorders" during 2010-2013. In this study, multilevel models that included both patient and hospital-level variables were analyzed to examine associations with readmission. Readmissions within 30 days of discharge accounted for 1079 (5.1%) claims. Multilevel analysis demonstrated that the proportion of experienced psychiatrists at a hospital was inversely associated with risk of readmission (OR: 0.79, 95% CI: 0.74-0.84 per 10% increase in experienced psychiatrists). Readmission rates for psychiatric disorders within 30 days of discharge were lower in hospitals with a higher number of nurses (OR: 0.95, 95% CI: 0.94-0.96 per 10 nurses). In conclusion, health policymakers and hospital managers should make an effort to reduce readmissions for psychiatric disorders and other diseases by considering the role that physician experience plays and nurse staffing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Ebola virus: recommendations

    CERN Multimedia

    CERN Medical Service

    2014-01-01

    The CERN Medical Service has been closely following, in particular via the WHO, the development of the Ebola virus outbreak currently affecting some African countries. This infectious disease may be passed on through direct contact with the bodily fluids of a sick person.   Based on the recommendations of the WHO and the two Host States, Switzerland and France, as updated on their respective websites, so far there has been no ban on travel to the countries concerned. However, unless it is absolutely essential, you are advised not to visit any of the countries affected by Ebola (Guinea, Republic of Sierra Leone, Liberia, Nigeria). The two Host States have established an alert system, and a check is carried out on departure from the airports of those countries. It is strongly recommended that you contact the Medical Service if you are travelling to those countries. We remind you to observe the basic rules of hygiene such as frequent hand washing, whatever your destination. The Medical Service is...

  17. To Meet the Needs of the Nations: Staffing the U.S. Civil Service and the Public Service of Canada

    Science.gov (United States)

    1992-01-01

    the Civil Service Reform Act of 1978, it is my honor to submit the U.S. Merit Systems Protection Board report titled "To Meet the Needs of the...Representatives Washington, DC 2 05 027 92-02948 "IuIII II IIIh I A Spedal Study TO MEET THE NEEDS OF THE NATIONS: STAFFING THE U.S. CiVIL SERVICE AND THE PUBLIC...ing close scutiny in appeals, inc flg ones that am a useful way to meet the needs of rapidly chang- reach the Fdu comt. As oe depotinental Ing Izadons

  18. Mining and representing recommendations in actively evolving recommender systems

    DEFF Research Database (Denmark)

    Assent, Ira

    2010-01-01

    Recommender systems provide an automatic means of filtering out interesting items, usually based on past similarity of user ratings. In previous work, we have suggested a model that allows users to actively build a recommender network. Users express trust, obtain transparency, and grow (anonymous......) recommender connections. In this work, we propose mining such active systems to generate easily understandable representations of the recommender network. Users may review these representations to provide active feedback. This approach further enhances the quality of recommendations, especially as topics...... of interest change over time. Most notably, it extends the amount of control users have over the model that the recommender network builds of their interests....

  19. Decline in Reference Transactions with Few Questions Referred to Librarian when the Reference Desk is Staffed by a Paraprofessional. A Review of: Dinkins, D., & Ryan, S. M. (2010. Measuring referrals: The use of paraprofessionals at the reference desk. The Journal of Academic Librarianship, 36(4, 279-286.

    Directory of Open Access Journals (Sweden)

    Diana K. Wakimoto

    2011-03-01

    Full Text Available Objective — To determine the type and percentage of questions referred to a librarian by a paraprofessional (i.e., an individual without an MLIS staffing the reference desk, whether the percentage of referrals would decrease over time, and any consequences from having a paraprofessional rather than a librarian staffing the desk.Design — Quantitative analysis of reference desk transaction statistics.Setting — Reference desk at the main library of Stetson University, a private university in the United States of America with approximately 2,500 FTE (full-time equivalent students.Subjects — A total of 486 reference desk transactions recorded by a paraprofessional staffing the reference desk during the Fall and Spring semesters of the 2008-2009 academic year.Methods — The first year that he worked in the Library at Stetson University, a paraprofessional recorded all reference desk transactions during his shift from 10:00am to 12:00pm, four days a week, for the Fall and Spring semesters of the 2008-2009 academic year. This paraprofessional, with computer expertise, received "relatively minimal" (p. 281 training on "reference desk policies and procedures… the use of the catalogue and the subscription databases" (p. 281. For each transaction, the paraprofessional categorized the question as "direction, " "reference, " or "machine. " He was instructed to contact a librarian if he could not answer a reference question. The paraprofessional also completed a questionnaire regarding his level of comfort answering questions and his thoughts on the training at the end of his first year of staffing the reference desk.Main Results — In the Fall semester, 9.5% of all reference desk transactions were referred to a librarian. This decreased to 4.2% of the total transactions during the Spring semester. The percentage of reference questions referred to a librarian in the Fall semester was 21.9% and only 5.0% in the Spring semester. There was a 49

  20. What mineral and vitamin levels to recommend in swine diets? Que níveis de vitamina e mineral são recomendados em rações de suínos?

    Directory of Open Access Journals (Sweden)

    Didier Gaudré

    2009-07-01

    Full Text Available Minerals, including trace-elements, and vitamins are currently introduced into the pig diet in order to obtain suitable performances for the modern pig genotype bred in confinement. Most of the mineral and vitamin contents of cereals and usual protein compounds are characterized by their poor and variable availability. Supplemental diets are then usually needed. This paper, based on literature data, reviews the pig requirement for minerals and vitamins in order to ensure economic and profitable performance. Recent research has focused on phosphorus due to environmental considerations. The widespread use of microbial phytase has decreased the need for inorganic phosphates. Cereals are particularly deficient in calcium and sodium, consequently limestone and salt are necessary to meet the pig need for these minerals. Zinc and copper are recognized as growth promoting agents but their use at high levels is detrimental to the environment. The pig diets usually contain supplemental contents of iron, manganese, cobalt, iodine and selenium. The need for these elements in pig diets is described individually. Vitamin E and choline represent the most expensive vitamins added. Choline is then usually not incorporated into the pig fattening diet taking into account the choline contents of the raw materials, while vitamin E is included at a lower level than those which improve the meat quality. Our recent research has dealt with increased levels of vitamins added in combination, calculating higher requirement of the modern pig genotype. Fewer improvements have been obtained in this way, suggesting that recommendations proposed by INRA in 1984 are mainly justified.Minerais, inclusive elementos traços, e vitaminas são atualmente adicionados nas rações de suínos objetivando obter performance adequada para genótipos modernos criados em confinamento. A maioria do conteúdo de mineral e vitamina dos cereais e compostos protéicos é caracterizada por sua

  1. Organization and staffing practices in US cardiac intensive care units: a survey on behalf of the American Heart Association Writing Group on the Evolution of Critical Care Cardiology.

    Science.gov (United States)

    O'Malley, Ryan G; Olenchock, Benjamin; Bohula-May, Erin; Barnett, Christopher; Fintel, Dan J; Granger, Christopher B; Katz, Jason N; Kontos, Michael C; Kuvin, Jeffrey T; Murphy, Sabina A; Parrillo, Joseph E; Morrow, David A

    2013-03-01

    The cardiac intensive care unit (CICU) has evolved into a complex patient-care environment with escalating acuity and increasing utilization of advanced technologies. These changing demographics of care may require greater clinical expertise among physician providers. Despite these changes, little is known about present-day staffing practices in US CICUs. We conducted a survey of 178 medical directors of ICUs caring for cardiac patients to assess unit structure and physician staffing practices. Data were obtained from 123 CICUs (69% response rate) that were mostly from academic medical centres. A majority of hospitals utilized a dedicated CICU (68%) and approximately half of those hospitals employed a 'closed' unit model. In 46% of CICUs, an intensivist consult was available, but not routinely involved in care of critically ill cardiovascular patients, while 11% did not have a board-certified intensivist available for consultation. Most CICU directors (87%) surveyed agreed that a closed ICU structure provided better care than an open ICU and 81% of respondents identified an unmet need for cardiologists with critical care training. We report contemporary structural models and staffing practices in a sample of US ICUs caring for critically ill cardiovascular patients. Although most hospitals surveyed had dedicated CICUs, a minority of CICUs employed a 'closed' CICU model and few had routine intensivist staffing. Most CICU directors agree that there is a need for cardiologists with intensivist training and expertise. These survey data reveal potential areas for continued improvement in US CICU organizational structure and physician staffing.

  2. "Highly recommended introduction"

    DEFF Research Database (Denmark)

    Christiansen, Ask Vest

    2009-01-01

    by detachment, normatively and morally. Besides researching the actual abuse, individually and in aggregate, they also study structural circumstances that promote the use of drugs in sports; besides evaluations of the efficacy of the anti-doping efforts, they consider the effects of various anti-doping schemes...... on the integrity and privacy of the athletes. Ask Vest Christiansen, himself an internationally renowned scholar in the field, has read a recent, thus detached, introduction to drug use in sports, An Introduction to Drugs in Sport: Addicted to Winning by Ivan Waddington and Andy Smith (Routledge). Christiansen...... finds much to appreciate in the book, and a couple of disconcerting mistakes and misjudgments notwithstanding, he recommends the book as a solid introduction to the problem of doping – knowledgeable, well written and easy to read....

  3. Conclusions and recommendations

    International Nuclear Information System (INIS)

    1984-01-01

    The FAO/IAEA/GSF/SIDA Co-ordinated Research Programme on Cereal Grain Protein Improvement by Nuclear Techniques was a follow-up to the FAO/IAEA/GSF Co-ordinated Research Programme on the Use of Nuclear Techniques for Seed Protein Improvement. It was initiated in 1969 and ended in 1981. The objectives of the meeting were to review and evaluate the achievements of the current and previous programmes in order to draw conclusions on the possibility of genetic improvement of cereal grain protein using nuclear techniques, to identify unsolved problems and to discuss and propose possible approaches for their solution. Through reviews and discussions, conclusions and recommendations were made by the participants

  4. Urgent recommendation. Interim report

    International Nuclear Information System (INIS)

    Nakano, Masayuki

    2000-01-01

    The Investigation Committee for Critical Accident at Uranium Processing Plant was founded immediately after the accident to investigate the cause of the accident and to establish measures to prevent the similar accident. On September 30, 1999 around 10:35, the Japan's first criticality accident occurred at JCO Co. Ltd. Uranium processing plant (auxiliary conversion plant) located at Tokai-mura Ibaraki-ken. The criticality continued on and off for approximately 20 hours after the first instantaneous criticality. The accident led the recommendation of tentative evacuation and sheltering indoors for residents living in the neighborhood. The serious exposure to neutrons happened to three workers. The dominant effect is dose due to neutrons and gamma rays from the precipitation tank. When the accident took place, three workers dissolved sequentially about 2.4 kg uranium powder with 18.8 % enrichment in the 10-litter bucket with nitric acid. The procedure of homogenization of uranium nitrate was supposed to be controlled using the shape-limited narrow storage column. Actually, however, the thick and large precipitation tank was used. As a result, about 16.6 kg of uranium was fed into the tank, which presumably caused criticality. The first notification by JCO was delayed and the following communication was not smooth. This led to the delay of correct understanding of the situation and made the initial proper response difficult, then followed by insufficient communication between the nation, prefecture, and local authority. Urgent recommendations were made on the following items; (1) Safety measures to be taken at the accident site, (2) health cares for residents and others, (3) Comprehensive safety securing at nuclear operators such as Establishment of the effective audit system, Safety education for employees and Qualification and licensing system, Safety related documents, etc. (4) Reconstruction of the government's safety regulations such as How safety regulation

  5. Improving the letter of recommendation.

    Science.gov (United States)

    Prager, Jeremy D; Myer, Charles M; Pensak, Myles L

    2010-09-01

    The selection of applicants to otolaryngology training programs is a challenging task. Applicants and their evaluators rely on objective and subjective data to facilitate the selection process. Unfortunately, data are often less helpful than either side assumes, suffering from poor validity and reliability in predicting future performance. The traditional resume-based letter of recommendation bears some responsibility in this. It is often a lengthy reiteration of already available objective data and contains nonstandardized, superlative evaluations of personal attributes. As a result, many letters are similar, describing "excellent" candidates who have done well on previous examinations and clerkships. Research has indicated improved reliability and satisfaction as well as decreased time expenditure using standardized letters of recommendation. These letters demonstrate how basic, easy-to-implement improvements can create letters that provide accurate information, separate applicants, and improve the selection process. Consideration should be given to adopting these improvements at the program director and/or educational committee level. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  6. Recommendation in evolving online networks

    Science.gov (United States)

    Hu, Xiao; Zeng, An; Shang, Ming-Sheng

    2016-02-01

    Recommender system is an effective tool to find the most relevant information for online users. By analyzing the historical selection records of users, recommender system predicts the most likely future links in the user-item network and accordingly constructs a personalized recommendation list for each user. So far, the recommendation process is mostly investigated in static user-item networks. In this paper, we propose a model which allows us to examine the performance of the state-of-the-art recommendation algorithms in evolving networks. We find that the recommendation accuracy in general decreases with time if the evolution of the online network fully depends on the recommendation. Interestingly, some randomness in users' choice can significantly improve the long-term accuracy of the recommendation algorithm. When a hybrid recommendation algorithm is applied, we find that the optimal parameter gradually shifts towards the diversity-favoring recommendation algorithm, indicating that recommendation diversity is essential to keep a high long-term recommendation accuracy. Finally, we confirm our conclusions by studying the recommendation on networks with the real evolution data.

  7. Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters.

    Science.gov (United States)

    Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe

    2013-06-01

    There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

  8. Ransomware - Threats Vulnerabilities And Recommendations

    Directory of Open Access Journals (Sweden)

    Nadeem Shah

    2017-06-01

    Full Text Available Attack methodologies transform with the transforming dynamics of technology. Consequently it becomes imperative that individuals and organization implement the highest levels of security within their devices and infrastructure for optimal protection against these rapidly evolving attacks. Ransomware is one such attack that never fails to surprise in terms of its ability to identify vulnerabilities and loopholes in technology. This paper discusses the categories of ransomware its common attack vectors and provides a threat landscape with the aim to highlight the true potential and destructive nature of such malware based attacks. In this paper we also present the most current ransomware attack that is still a potential threat and also provide recommendations and strategies for prevention and protection against these attacks. A novel solution is also discussed that could be further worked upon in the future by other researchers and vendors of security devices.

  9. Urgent recommendation. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Masayuki [International Affairs and Safeguards Division, Atomic Energy Bureau, Science and Technology Agency, Tokyo (Japan)

    2000-12-01

    The Investigation Committee for Critical Accident at Uranium Processing Plant was founded immediately after the accident to investigate the cause of the accident and to establish measures to prevent the similar accident. On September 30, 1999 around 10:35, the Japan's first criticality accident occurred at JCO Co. Ltd. Uranium processing plant (auxiliary conversion plant) located at Tokai-mura Ibaraki-ken. The criticality continued on and off for approximately 20 hours after the first instantaneous criticality. The accident led the recommendation of tentative evacuation and sheltering indoors for residents living in the neighborhood. The serious exposure to neutrons happened to three workers. The dominant effect is dose due to neutrons and gamma rays from the precipitation tank. When the accident took place, three workers dissolved sequentially about 2.4 kg uranium powder with 18.8 % enrichment in the 10-litter bucket with nitric acid. The procedure of homogenization of uranium nitrate was supposed to be controlled using the shape-limited narrow storage column. Actually, however, the thick and large precipitation tank was used. As a result, about 16.6 kg of uranium was fed into the tank, which presumably caused criticality. The first notification by JCO was delayed and the following communication was not smooth. This led to the delay of correct understanding of the situation and made the initial proper response difficult, then followed by insufficient communication between the nation, prefecture, and local authority. Urgent recommendations were made on the following items; (1) Safety measures to be taken at the accident site, (2) health cares for residents and others, (3) Comprehensive safety securing at nuclear operators such as Establishment of the effective audit system, Safety education for employees and Qualification and licensing system, Safety related documents, etc. (4) Reconstruction of the government's safety regulations such as How safety

  10. National Recommended Water Quality Criteria

    Data.gov (United States)

    U.S. Environmental Protection Agency — The National Recommended Water Quality Criteria is a compilation of national recommended water quality criteria for the protection of aquatic life and human health...

  11. Site Recommendation Subsurface Layout

    International Nuclear Information System (INIS)

    C.L. Linden

    2000-01-01

    The purpose of this analysis is to develop a Subsurface Facility layout that is capable of accommodating the statutory capacity of 70,000 metric tons of uranium (MTU), as well as an option to expand the inventory capacity, if authorized, to 97,000 MTU. The layout configuration also requires a degree of flexibility to accommodate potential changes in site conditions or program requirements. The objective of this analysis is to provide a conceptual design of the Subsurface Facility sufficient to support the development of the Subsurface Facility System Description Document (CRWMS M andO 2000e) and the ''Emplacement Drift System Description Document'' (CRWMS M andO 2000i). As well, this analysis provides input to the Site Recommendation Consideration Report. The scope of this analysis includes: (1) Evaluation of the existing facilities and their integration into the Subsurface Facility design. (2) Identification and incorporation of factors influencing Subsurface Facility design, such as geological constraints, thermal loading, constructibility, subsurface ventilation, drainage control, radiological considerations, and the Test and Evaluation Facilities. (3) Development of a layout showing an available area in the primary area sufficient to support both the waste inventories and individual layouts showing the emplacement area required for 70,000 MTU and, if authorized, 97,000 MTU

  12. Staffing in postnatal units: is it adequate for the provision of quality care? Staff perspectives from a state-wide review of postnatal care in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Lumley Judith

    2006-07-01

    Full Text Available Abstract Background State-wide surveys of recent mothers conducted over the past decade in Victoria, one state of Australia, have identified that women are consistently less satisfied with the care they received in hospital following birth compared with other aspects of maternity care. Little is known of caregivers' perspectives on the provision ofhospital postnatal care: how care is organised and provided in different hospitals; what constrains the provision of postnatal care (apart from funding and what initiatives are being undertaken to improve service delivery. A state-widereview of organisational structures and processes in relation to the provision of hospital postnatal care in Victoria was undertaken. This paper focuses on the impact of staffing issues on the provision of quality postnatal care from the perspective of care providers. Methods A study of care providers from Victorian public hospitals that provide maternity services was undertaken. Datawere collected in two stages. Stage one: a structured questionnaire was sent to all public hospitals in Victoria that provided postnatal care (n = 73, exploring the structure and organisation of care (e.g. staffing, routine observations, policy framework and discharge planning. Stage two: 14 maternity units were selected and invited to participate in a more in-depth exploration of postnatal care. Thirty-eight key informant interviews were undertaken with midwives (including unit managers, associate unit managers and clinical midwives and a medical practitioner from eachselected hospital. Results Staffing was highlighted as a major factor impacting on the provision of quality postnatal care. There were significant issues associated with inadequate staff/patient ratios; staffing mix; patient mix; prioritisation of birth suites over postnatal units; and the use of non-permanent staff. Forty-three percent of hospitals reported having only midwives (i.e. no non-midwives providing postnatal care

  13. Adherence to clinic recommendations among patients with phenylketonuria in the United States.

    Science.gov (United States)

    Jurecki, E R; Cederbaum, S; Kopesky, J; Perry, K; Rohr, F; Sanchez-Valle, A; Viau, K S; Sheinin, M Y; Cohen-Pfeffer, J L

    2017-03-01

    Assess current management practices of phenylketonuria (PKU) clinics across the United States (US) based on the key treatment metrics of blood phenylalanine (Phe) concentrations and blood Phe testing frequency, as well as patient adherence to their clinic's management practice recommendations. An online survey was conducted with medical professionals from PKU clinics across the US from July to September 2015. Forty-four clinics participated in the survey and account for approximately half of PKU patients currently followed in clinics in the US (Berry et al., 2013). The majority of PKU clinics recommended target blood Phe concentrations to be between 120 and 360μM for all patients; the upper threshold was relaxed by some clinics for adult patients (from 360 to 600μM) and tightened for patients who are pregnant/planning to become pregnant (to 240μM). Patient adherence to these recommendations (percentage of patients with blood Phe below the upper recommended threshold) was age-dependent, decreasing from 88% in the 0-4years age group to 33% in adults 30+ years. Patient adherence to recommendations for blood testing frequency followed a similar trend. Higher staffing intensity (specialists per 100 PKU patients) was associated with better patient adherence to clinics' blood Phe concentrations recommendations. Clinic recommendations of target blood Phe concentrations in the US are now stricter compared to prior years, and largely reflect recent guidelines by the American College of Medical Genetics and Genomics (Vockley et al., 2014). Adherence to recommended Phe concentrations remains suboptimal, especially in older patients. However, despite remaining above the guidelines, actual blood Phe concentrations in adolescents and adults are lower than those reported in the past (Walter et al., 2002; Freehauf et al., 2013). Continued education and support for PKU patients by healthcare professionals, including adequate clinic staffing, are needed to improve adherence

  14. Joint safety recommendations

    International Nuclear Information System (INIS)

    Birkhofer, A.; Cogne, F.X.

    1996-01-01

    In 1992, the French utility EdF, a consortium of German utilities, and the vendor NPI, a joint venture of Siemens and Framatome, joint the efforts in developing an advanced reactor concept called EPR (European Pressurized water Reactor). Therefore, the French and German safety authorities decided to work out a common safety approach which has been laid down in the form of recommendations firstly drawn up by GRS and IPSN and then reviewed by the French and German Nuclear Safety commissions GPR and RSK. The main objective of this approach is the strengthening of accident prevention through optimization of defense-in-depth. Particular objectives are the improvement of plant behavior during transients, especially by increasing thermal inertia and the grace periods for interventions by the control room personnel, the reduction of the possibility of common cause failures, a further improvement of the man-machine interface, the simplification of the systems configuration, and the use of advanced information technology. These objectives are similar to those of many other evolutionary rector concepts. Regarding severe accidents, the French-German approach surpasses current evolutionary developments. One of the fundamental aims is the practical elimination of accidents situations which would lead to large early releases such as containment bypass, shutdown states and open containment building, reactivity accidents, high pressure core melt, depressurization of the RPV or global hydrogen detonation. The dual concept of 'practical elimination' of scenarios or phenomena and of 'dealing with them' is essential for the consistency of the approach and the safety demonstration. This would be expressed by no permanent relocation, no need for emergency evacuation outside the immediate vicinity of the plant, limited sheltering and no long-term restriction in the consumption of food. Such a reduction of radioactive release implies a substantial improvement of the containment function

  15. Multi-Criteria Recommender Systems

    Science.gov (United States)

    Adomavicius, Gediminas; Manouselis, Nikos; Kwon, Youngok

    This chapter aims to provide an overview of the class of multi-criteria recommender systems. First, it defines the recommendation problem as a multicriteria decision making (MCDM) problem, and reviews MCDM methods and techniques that can support the implementation of multi-criteria recommenders. Then, it focuses on the category of multi-criteria rating recommenders - techniques that provide recommendations by modelling a user's utility for an item as a vector of ratings along several criteria. A review of current algorithms that use multi-criteria ratings for calculating predictions and generating recommendations is provided. Finally, the chapter concludes with a discussion on open issues and future challenges for the class of multi-criteria rating recommenders.

  16. Clustering recommendations to compute agent reputation

    Science.gov (United States)

    Bedi, Punam; Kaur, Harmeet

    2005-03-01

    Traditional centralized approaches to security are difficult to apply to multi-agent systems which are used nowadays in e-commerce applications. Developing a notion of trust that is based on the reputation of an agent can provide a softer notion of security that is sufficient for many multi-agent applications. Our paper proposes a mechanism for computing reputation of the trustee agent for use by the trustier agent. The trustier agent computes the reputation based on its own experience as well as the experience the peer agents have with the trustee agents. The trustier agents intentionally interact with the peer agents to get their experience information in the form of recommendations. We have also considered the case of unintentional encounters between the referee agents and the trustee agent, which can be directly between them or indirectly through a set of interacting agents. The clustering is done to filter off the noise in the recommendations in the form of outliers. The trustier agent clusters the recommendations received from referee agents on the basis of the distances between recommendations using the hierarchical agglomerative method. The dendogram hence obtained is cut at the required similarity level which restricts the maximum distance between any two recommendations within a cluster. The cluster with maximum number of elements denotes the views of the majority of recommenders. The center of this cluster represents the reputation of the trustee agent which can be computed using c-means algorithm.

  17. Adoption of Recommended Agrochemical Practices among Crop ...

    African Journals Online (AJOL)

    This study assessed the level of adoption of recommended agrochemical practices among crop farmers in Kaduna and Ondo States of Nigeria. It measured the perception of farmers on pesticides and their knowledge on the harmful effects of pesticides. A total of 260 crop farmers who have sustained the use of ...

  18. IMIA Educational Recommendations and Nursing Informatics

    NARCIS (Netherlands)

    Mantas, John; Hasman, Arie

    2017-01-01

    The updated version of the IMIA educational recommendations has given an adequate guidelines platform for developing educational programs in Biomedical and Health Informatics at all levels of education, vocational training, and distance learning. This chapter will provide a brief introduction of the

  19. Cancer screening recommendations: an international comparison of high income countries.

    Science.gov (United States)

    Ebell, Mark H; Thai, Thuy Nhu; Royalty, Kyle J

    2018-01-01

    Recommendations regarding cancer screening vary from country to country, and may also vary within countries depending on the organization making the recommendations. The goal of this study was to summarize the cancer screening recommendations from the 21 countries with the highest per capita spending on healthcare. Cancer screening guidelines were identified for each country based on a review of the medical literature, internet searches, and contact with key informants in most countries. The highest level recommendation was identified for each country, in the order of national recommendation, cancer society recommendation, or medical specialty society recommendation. Breast cancer screening recommendations were generally consistent across countries, most commonly recommending mammography biennially from ages 50 to 69 or 70 years. In the USA, specialty societies generally offered more intensive screening recommendations. All countries also recommend cervical cancer screening, although there is some heterogeneity regarding the test (cytology or HPV or both) and the age of initiation and screening interval. Most countries recommend colorectal cancer screening using fecal immunochemical (FIT) testing, while only seven countries recommend general or selective screening for prostate cancer, and a similar number explicitly recommend against screening for prostate cancer. Screening for lung and skin cancer is only recommended by a few countries. Greater per capita healthcare expenditures are not associated with greater screening intensity, with the possible exception of prostate cancer. Guidelines for cancer screening differ between countries, with areas of commonality but also clear differences. Recommendations have important commonalities for well-established cancer screening programs such as breast and cervical cancer, with greater variation between countries regarding prostate, colorectal, lung, and skin cancer screening. Ideally, recommendations should be made by a

  20. Recommendation Process in SR1 Web Document Recommender System

    Directory of Open Access Journals (Sweden)

    Dan MUNTEANU

    2008-12-01

    Full Text Available This paper presents a recommender system for web documents (given as bookmarks. The system uses for classification a combination of content, event and collaborative filters and for recommendation a modified Pearson-r algorithm. The algorithm for recommendation is using not only the correlation between users but also the similarity between classes. Some experimental results that support this approach are also presented.

  1. Recommendations on the Nature and Level of U.S. Participation in the International Thermonuclear Experimental Reactor Extension of the Experimental Reactor Extension of the Engineering Design Activities. Panel Report To Fusion Energy Sciences Advisory Committee (FESAC)

    International Nuclear Information System (INIS)

    1998-01-01

    The DOE Office of Energy Research chartered through the Fusion Energy Sciences Advisory Committee (FESAC) a panel to 'address the topic of U. S. participation in an ITER construction phase, assuming the ITER Parties decide to proceed with construction.' (Attachment 1: DOE Charge, September 1996). Given that there is expected to be a transition period of three to five years between the conclusion of the Engineering Design Activities (EDA) and the possible construction start, the DOE Office of Energy Research expanded the charge to 'include the U.S. role in an interim period between the EDA and construction.' (Attachment 2: DOE Expanded Charge, May 1997). This panel has heard presentations and received input from a wide cross-section of parties with an interest in the fusion program. The panel concluded it could best fulfill its responsibility under this charge by considering the fusion energy science and technology portion of the U.S. program in its entirety. Accordingly, the panel is making some recommendations for optimum use of the transition period considering the goals of the fusion program and budget pressures.

  2. Recommendations for intervention

    International Nuclear Information System (INIS)

    Touzet, R.; Descalzo, A.; Peralta, O.

    2013-01-01

    The objective of this work is set a 'radiological protection criteria' for patients and staff involved for the purpose of the doses involved are as low as reasonably achievable considering the limitations that each technique and its objectives. Establish criteria for injury prevention in the patient's skin for long exposures and intense when complications arise in the process. Set levels for some well Dimensional procedures. Establish procedures for patient dosimetry control and operator personnel. These criteria will be established by the interventional radiology team with participation of specialists in radiation protection, medical physics, dosimetry and X rays equipment specialists

  3. Recommendation systems in software engineering

    CERN Document Server

    Robillard, Martin P; Walker, Robert J; Zimmermann, Thomas

    2014-01-01

    With the growth of public and private data stores and the emergence of off-the-shelf data-mining technology, recommendation systems have emerged that specifically address the unique challenges of navigating and interpreting software engineering data.This book collects, structures and formalizes knowledge on recommendation systems in software engineering. It adopts a pragmatic approach with an explicit focus on system design, implementation, and evaluation. The book is divided into three parts: "Part I - Techniques" introduces basics for building recommenders in software engineering, including techniques for collecting and processing software engineering data, but also for presenting recommendations to users as part of their workflow.?"Part II - Evaluation" summarizes methods and experimental designs for evaluating recommendations in software engineering.?"Part III - Applications" describes needs, issues and solution concepts involved in entire recommendation systems for specific software engineering tasks, fo...

  4. "Get a Blue and You Will See Your Money Back Again": Staffing and Marketing the English Prep School, 1890-1912

    Science.gov (United States)

    Benson, John

    2014-01-01

    This article explores the ways in which English prep schools were staffed and marketed in the years before the First World War. Its aim more specifically is to employ a biographical approach to consider the emphasis that the schools placed upon sport, and in particular the extent to which they recruited Oxford and Cambridge Blues as teachers…

  5. Perceptions of Risk and Safety in the ICU: A Qualitative Study of Cognitive Processes Relating to Staffing.

    Science.gov (United States)

    D'Lima, Danielle M; Murray, Eleanor J; Brett, Stephen J

    2018-01-01

    The aims of this study were to 1) examine individual professionals' perceptions of staffing risks and safe staffing in intensive care and 2) identify and examine the cognitive processes that underlie these perceptions. Qualitative case study methodology with nurses, doctors, and physiotherapists. Three mixed medical and surgical adult ICUs, each on a separate hospital site within a 1,200-bed academic, tertiary London hospital group. Forty-four ICU team members of diverse professional backgrounds and seniority. None. Four themes (individual, team, unit, and organizational) were identified. Individual care provision was influenced by the pragmatist versus perfectionist stance of individuals and team dynamics by the concept of an "A" team and interdisciplinary tensions. Perceptions of safety hinged around the importance of achieving a "dynamic balance" influenced by the burden of prevailing circumstances and the clinical status of patients. Organizationally, professionals' risk perceptions affected their willingness to take personal responsibility for interactions beyond the unit. This study drew on cognitive research, specifically theories of cognitive dissonance, psychological safety, and situational awareness to explain how professionals' cognitive processes impacted on ICU behaviors. Our results may have implications for relationships, management, and leadership in ICU. First, patient care delivery may be affected by professionals' perfectionist or pragmatic approach. Perfectionists' team role may be compromised and they may experience cognitive dissonance and subsequent isolation/stress. Second, psychological safety in a team may be improved within the confines of a perceived "A" team but diminished by interdisciplinary tensions. Third, counter intuitively, higher "situational" awareness for some individuals increased their stress and anxiety. Finally, our results suggest that professionals have varying concepts of where their personal responsibility to minimize

  6. Comparison of physician staffed emergency teams with paramedic teams assisted by telemedicine--a randomized, controlled simulation study.

    Science.gov (United States)

    Rörtgen, Daniel; Bergrath, Sebastian; Rossaint, Rolf; Beckers, Stefan K; Fischermann, Harold; Na, In-Sik; Peters, David; Fitzner, Christina; Skorning, Max

    2013-01-01

    Emergency medical services (EMSs) vary considerably. While some are physician staffed, most systems are run by paramedics. The objective of this randomized, controlled simulation study was to compare the emergency care between physician staffed EMS teams (control group) and paramedic teams that were supported telemedically by an EMS physician (telemedicine group). Overall 16 teams (1 EMS physician, 2 paramedics) were randomized to the control group or the telemedicine group. Telemedical functionalities included two-way audio communication, transmission of vital data (numerical values and curves) and video streaming from the scenario room to the remotely located EMS physician. After a run-in scenario all teams completed four standardized scenarios, in which no highly invasive procedures (e.g. thoracic drain) were required, two using high-fidelity simulation (burn trauma, intoxication) and two using standardized patients (renal colic, barotrauma). All scenarios were videotaped and analyzed by two investigators using predefined scoring items. Non case-specific items (31 vs. 31 scenarios): obtaining of 'symptoms', 'past medical history' and 'events' were carried out comparably, but in the telemedicine group 'allergies' (17 vs. 28, OR 7.69, CI 2.1-27.9, p=0.002) and 'medications' (17 vs. 27, OR 5.55, CI 1.7-18.0, p=0.004) were inquired more frequently. No significant differences were found regarding the case-specific items and in both groups no potentially dangerous mistreatments were observed. Telemedically assisted paramedic care was feasible and at least not inferior compared to standard EMS teams with a physician on-scene in these scenarios. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. Recommendation Sets and Choice Queries

    DEFF Research Database (Denmark)

    Viappiani, Paolo Renato; Boutilier, Craig

    2011-01-01

    Utility elicitation is an important component of many applications, such as decision support systems and recommender systems. Such systems query users about their preferences and offer recommendations based on the system's belief about the user's utility function. We analyze the connection between...... the problem of generating optimal recommendation sets and the problem of generating optimal choice queries, considering both Bayesian and regret-based elicitation. Our results show that, somewhat surprisingly, under very general circumstances, the optimal recommendation set coincides with the optimal query....

  8. Classification of Recommender Expertise in the Wikipedia Recommender System

    DEFF Research Database (Denmark)

    Jensen, Christian D.; Pilkauskas, Povilas; Lefévre, Thomas

    2011-01-01

    to the quality of articles. The Wikipedia Recommender System (WRS) was developed to help users determine the credibility of articles based on feedback from other Wikipedia users. The WRS implements a collaborative filtering system with trust metrics, i.e., it provides a rating of articles which emphasizes...... an evaluation of four existing knowledge classification schemes with respect to these requirements. This evaluation helped us identify a classification scheme, which we have implemented in the current version of the Wikipedia Recommender System....... feedback from recommenders that the user has agreed with in the past. This exposes the problem that most recommenders are not equally competent in all subject areas. The first WRS prototype did not include an evaluation of the areas of expertise of recommenders, so the trust metric used in the article...

  9. Classification of Recommender Expertise in the Wikipedia Recommender System

    DEFF Research Database (Denmark)

    Jensen, Christian D.; Pilkauskas, Povilas; Lefevre, Thomas

    2011-01-01

    to the quality of articles. The Wikipedia Recommender System (WRS) was developed to help users determine the credibility of articles based on feedback from other Wikipedia users. The WRS implements a collaborative filtering system with trust metrics, i.e., it provides a rating of articles "which emphasizes...... an evaluation of four existing knowledge classification schemes with respect to these requirements. This evaluation helped us identify a classification scheme, which we have implemented in the current version of the Wikipedia Recommender System....... feedback from recommenders that the user has agreed with in the past. This exposes the problem that most recommenders are not equally competent in all subject areas. The first WRS prototype did not include an evaluation of the areas of expertise of recommenders, so the trust metric used in the article...

  10. Recommendations for the LHC safety alarm system

    CERN Document Server

    Laeger, H

    1999-01-01

    A working group was set up to define the LHC safety alarm system, also known as Alarm-of-Level-3-System (AL3S). The mandate asked for recommendations to be elaborated on four items: the overall concept of the AL3S for machine and experiments, the transmission and display of safety alarms, the AL3S during civil engineering construction, and the transition from the present LEP to the final LHC safety alarm system. The members of the working group represented a wide range of interest and experience including the CERN Fire Brigade, safety officers from experiments and machines, and specialists for safety and control systems. The recommendations highlight the need for a clear definition of responsibilities and procedures, well-engineered homogeneous systems across CERN, and they point to several important issues outside the mandate of the working group. These recommendations were presented, discussed and accepted by several CERN and LHC committees.

  11. Context-Aware Recommender Systems

    Science.gov (United States)

    Adomavicius, Gediminas; Tuzhilin, Alexander

    The importance of contextual information has been recognized by researchers and practitioners in many disciplines, including e-commerce personalization, information retrieval, ubiquitous and mobile computing, data mining, marketing, and management. While a substantial amount of research has already been performed in the area of recommender systems, most existing approaches focus on recommending the most relevant items to users without taking into account any additional contextual information, such as time, location, or the company of other people (e.g., for watching movies or dining out). In this chapter we argue that relevant contextual information does matter in recommender systems and that it is important to take this information into account when providing recommendations. We discuss the general notion of context and how it can be modeled in recommender systems. Furthermore, we introduce three different algorithmic paradigms - contextual prefiltering, post-filtering, and modeling - for incorporating contextual information into the recommendation process, discuss the possibilities of combining several contextaware recommendation techniques into a single unifying approach, and provide a case study of one such combined approach. Finally, we present additional capabilities for context-aware recommenders and discuss important and promising directions for future research.

  12. USGEO DMWG Cloud Computing Recommendations

    Science.gov (United States)

    de la Beaujardiere, J.; McInerney, M.; Frame, M. T.; Summers, C.

    2017-12-01

    The US Group on Earth Observations (USGEO) Data Management Working Group (DMWG) has been developing Cloud Computing Recommendations for Earth Observations. This inter-agency report is currently in draft form; DMWG hopes to have released the report as a public Request for Information (RFI) by the time of AGU. The recommendations are geared toward organizations that have already decided to use the Cloud for some of their activities (i.e., the focus is not on "why you should use the Cloud," but rather "If you plan to use the Cloud, consider these suggestions.") The report comprises Introductory Material, including Definitions, Potential Cloud Benefits, and Potential Cloud Disadvantages, followed by Recommendations in several areas: Assessing When to Use the Cloud, Transferring Data to the Cloud, Data and Metadata Contents, Developing Applications in the Cloud, Cost Minimization, Security Considerations, Monitoring and Metrics, Agency Support, and Earth Observations-specific recommendations. This talk will summarize the recommendations and invite comment on the RFI.

  13. Estimating Staffing Needs for In-Home Child Welfare Services with a Weighted Caseload Formula

    Science.gov (United States)

    Kaye, Sarah; Shaw, Terry V.; DePanfilis, Diane; Rice, Karen

    2012-01-01

    State child welfare risk and safety assessment data were analyzed to determine three levels of in-home service that correspond to the Child Welfare League of America's (CWLA) national caseload standards and to evaluate the number of staff needed to provide services at each level. The analysis revealed that 50% additional case-carrying in-home…

  14. Recommended waste handling operations and equipment

    International Nuclear Information System (INIS)

    Kingsbury, R.J.; Monaghan, D.A.

    1980-09-01

    Recommended waste handling operations and equipment were developed for the National Waste Terminal Storage geologic repositories. The concepts, approaches, and criteria developed are based on existing conceptual designs for repositories and descriptions of similar systems in other nuclear waste management programs. Detailed reviews of the conceptual designs for repositories in bedded and dome salt formations were performed to establish and characterize the waste flow paths through the repositories; identify the systems, subsystems, and components of the flow paths; and identify waste handling system similarities and differences. Alternatives to waste handling operations and equipment have been identified and evaluated for overall suitability in relation to a comprehensive set of evaluation parameters. The recommended waste handling operations have been incorporated into flow diagrams supplemented by equipment design and performance criteria. Individual components have also been assigned appropriate quality assurance levels based on a consequence-of-failure analysis. The results of this study are recommended operations and equipment for canistered and low-level waste handling systems. These results may be used as design bases and criteria for future repository design activities. Numerous advantages over existing designs have resulted from this study. Volume I contains the following: executive summary; recommended operations and equipment; technical approach; and appendix A - operations and equipment data sheets

  15. The 2014 Academic College of Emergency Experts in India′s Education Development Committee (EDC White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training

    Directory of Open Access Journals (Sweden)

    Praveen Aggarwal

    2014-01-01

    Full Text Available Emergency medicine services and training in Emergency Medicine (EM has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers′ eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India has been a powerful advocate for developing Academic EM in India. The ACEE′s Education Development Committee (EDC was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

  16. Avoiding congestion in recommender systems

    Science.gov (United States)

    Ren, Xiaolong; Lü, Linyuan; Liu, Runran; Zhang, Jianlin

    2014-06-01

    Recommender systems use the historical activities and personal profiles of users to uncover their preferences and recommend objects. Most of the previous methods are based on objects’ (and/or users’) similarity rather than on their difference. Such approaches are subject to a high risk of increasingly exposing users to a narrowing band of popular objects. As a result, a few objects may be recommended to an enormous number of users, resulting in the problem of recommendation congestion, which is to be avoided, especially when the recommended objects are limited resources. In order to quantitatively measure a recommendation algorithm's ability to avoid congestion, we proposed a new metric inspired by the Gini index, which is used to measure the inequality of the individual wealth distribution in an economy. Besides this, a new recommendation method called directed weighted conduction (DWC) was developed by considering the heat conduction process on a user-object bipartite network with different thermal conductivities. Experimental results obtained for three benchmark data sets showed that the DWC algorithm can effectively avoid system congestion, and greatly improve the novelty and diversity, while retaining relatively high accuracy, in comparison with the state-of-the-art methods.

  17. Avoiding congestion in recommender systems

    International Nuclear Information System (INIS)

    Ren, Xiaolong; Lü, Linyuan; Liu, Runran; Zhang, Jianlin

    2014-01-01

    Recommender systems use the historical activities and personal profiles of users to uncover their preferences and recommend objects. Most of the previous methods are based on objects’ (and/or users’) similarity rather than on their difference. Such approaches are subject to a high risk of increasingly exposing users to a narrowing band of popular objects. As a result, a few objects may be recommended to an enormous number of users, resulting in the problem of recommendation congestion, which is to be avoided, especially when the recommended objects are limited resources. In order to quantitatively measure a recommendation algorithm's ability to avoid congestion, we proposed a new metric inspired by the Gini index, which is used to measure the inequality of the individual wealth distribution in an economy. Besides this, a new recommendation method called directed weighted conduction (DWC) was developed by considering the heat conduction process on a user–object bipartite network with different thermal conductivities. Experimental results obtained for three benchmark data sets showed that the DWC algorithm can effectively avoid system congestion, and greatly improve the novelty and diversity, while retaining relatively high accuracy, in comparison with the state-of-the-art methods. (paper)

  18. Case Factors Affecting Hearing Aid Recommendations by Hearing Care Professionals

    DEFF Research Database (Denmark)

    Gioia, Carmine; Ben-Akiva, Moshe; Jørgensen, Ole

    2015-01-01

    Background: Professional recommendations to patients concerning hearing instrument (HI) technology levels are not currently evidence-based. Pre-fitting parameters have not been proven to be the primary indicators for optimal patient outcome with different HI technology levels. This results in sub...... in subjective decision-making as regards the technology level recommendation made by professionals. Purpose: The objective of this study is to gain insight into the decision-making criteria utilized by professionals when recommending HI technology levels to hearing-impaired patients.......Background: Professional recommendations to patients concerning hearing instrument (HI) technology levels are not currently evidence-based. Pre-fitting parameters have not been proven to be the primary indicators for optimal patient outcome with different HI technology levels. This results...

  19. The new ICRP general recommendations

    International Nuclear Information System (INIS)

    Sasaki, Y.; Lochard, J.; Holm, L.E.; Niwa, O.; Ishigure, N.; Kosako, T.; Kai, M.

    2007-01-01

    The new draft ICRP recommendations was presented by the ICRP chair, Professor Lars-Eric Holm. His presentation was followed by presentations by Japanese members of the various (CRP committees, discussing their views of the draft recommendations based on their own technical experience. After these presentations, questions from the floor raised many of the key issues of the conference: dose constrains, the LNT hypothesis, dose bands, etc. This showed that the conference participants had carefully and completely read the draft, and were very interested in building a final ICRP recommendation that appropriately addresses all their concerns. These issues were also discussed throughout the entire conference. (author)

  20. Ethical imperatives in staffing and managing a trauma intensive care unit.

    Science.gov (United States)

    Terry, Shawn; Kaplan, Lewis J

    2007-02-01

    As U.S. trauma surgery evolves to embrace the concept and practice of acute care surgery, the organization and management structure of the intensive care unit must also grow to reflect new challenges and imperatives faced by trauma surgeons. Key issues to be explored in light of acute care surgery include the role of the traumatologist/intensivist in the intensive care unit, as opposed to the traumatologist without specific critical care training, and a potentially expanded role for nonsurgical intensivists as the critical care time available for trauma/intensivists wanes due to increased surgical and non-critical care patient volume. Each of these changes to the practice of trauma/surgical critical care and acute care surgery are evaluated in light of the primacy of appropriately trained intensivists in the critical care unit. The ethics of providing the best care possible is interrogated in light of different service models in both the university and community settings. The roles of residents, fellows, and midlevel practitioners in supporting the goal of the intensivist and the critical care team is similarly explored. A recommendation for an ethical organizational and management structure is presented.

  1. Nutritional Recommendations for Cardiovascular Disease Prevention

    OpenAIRE

    Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov

    2013-01-01

    Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food it...

  2. RECOMMENDER SYSTEMS IN SOCIAL NETWORKS

    Directory of Open Access Journals (Sweden)

    Cleomar Valois Batista Jr

    2011-12-01

    Full Text Available The continued and diversified growth of social networks has changed the way in which users interact with them. With these changes, what once was limited to social contact is now used for exchanging ideas and opinions, creating the need for new features. Users have so much information at their fingertips that they are unable to process it by themselves; hence, the need to develop new tools. Recommender systems were developed to address this need and many techniques were used for different approaches to the problem. To make relevant recommendations, these systems use large sets of data, not taking the social network of the user into consideration. Developing a recommender system that takes into account the social network of the user is another way of tackling the problem. The purpose of this project is to use the theory of six degrees of separation (Watts 2003 amongst users of a social network to enhance existing recommender systems.

  3. Disability: recommendations for eye programmes

    Directory of Open Access Journals (Sweden)

    2013-05-01

    Full Text Available In 2012, CBM’s Medical Eye Care Advisory Working Group met in Hyderabad, India to discuss the inclusion of people with disabilities in eye care.As a result of these discussions, recommendations were made.

  4. Strategic Arrivals Recommendation Tool Project

    Data.gov (United States)

    National Aeronautics and Space Administration — During the conduct of a NASA Research Announcement (NRA) in 2012 and 2013, the Mosaic ATM team first developed the Strategic Arrivals Recommendation Tool concept, or...

  5. External validation of the ROSC after cardiac arrest (RACA) score in a physician staffed emergency medical service system.

    Science.gov (United States)

    Kupari, Petteri; Skrifvars, Markus; Kuisma, Markku

    2017-03-29

    The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated. The endpoint was ROSC defined as palpable pulse over 30 s. Calibration was assessed by comparing predicted and observed ROSC rates in the whole sample, separately for shockable and non-shockable rhythm, and separately for resuscitations lead by a specialist, registrar or medical supervisor (i.e., senior paramedic). Data are presented as medians and interquartile ranges. Statistical testing included chi-square test, the Mann-Whitney U test, Hosmer-Lemeshow goodness of fit test and calculation of 95% confidence intervals (CI) for proportions. A total of 680 patients were included of whom 340 attained ROSC. The RACA score was higher in patients with ROSC (0.62 [0.46-0.69] than in those without (0.46 [0.36-0.57]) (p system for out-of-hospital cardiac arrest patients would allow patient heterogeneity adjustment and measurement of quality of care in analogy to commoly used severity-of-illness- scores developed for the similar purposes for the general intensive care unit population. However, transferring RACA score to another country with different population and EMS system might affect the performance and generalizability of the score. This study found a good overall calibration and moderate discrimination of the RACA score in a physician staffed urban EMS system which suggests external validity of the score. Calibration was suboptimal in patients with a non-shockable rhythm which may due to a local do-not-attempt-resuscitation policy. The lower

  6. Recommendations

    DEFF Research Database (Denmark)

    Baumeister, Ruth

    2016-01-01

    This article discusses three book publications: C. Kerez: Uncertain Certainty, Tokyo, 2013 H. Hertzberger: Lessons for students in architecture, Rotterdam, 2006, (1991) A. Jorn: Om Formen, Silkeborg, 2014, (1958)...

  7. Hybrid context aware recommender systems

    Science.gov (United States)

    Jain, Rajshree; Tyagi, Jaya; Singh, Sandeep Kumar; Alam, Taj

    2017-10-01

    Recommender systems and context awareness is currently a vital field of research. Most hybrid recommendation systems implement content based and collaborative filtering techniques whereas this work combines context and collaborative filtering. The paper presents a hybrid context aware recommender system for books and movies that gives recommendations based on the user context as well as user or item similarity. It also addresses the issue of dimensionality reduction using weighted pre filtering based on dynamically entered user context and preference of context. This unique step helps to reduce the size of dataset for collaborative filtering. Bias subtracted collaborative filtering is used so as to consider the relative rating of a particular user and not the absolute values. Cosine similarity is used as a metric to determine the similarity between users or items. The unknown ratings are calculated and evaluated using MSE (Mean Squared Error) in test and train datasets. The overall process of recommendation has helped to personalize recommendations and give more accurate results with reduced complexity in collaborative filtering.

  8. Introduction on health recommender systems.

    Science.gov (United States)

    Sanchez-Bocanegra, C L; Sanchez-Laguna, F; Sevillano, J L

    2015-01-01

    People are looking for appropriate health information which they are concerned about. The Internet is a great resource of this kind of information, but we have to be careful if we don't want to get harmful info. Health recommender systems are becoming a new wave for apt health information as systems suggest the best data according to the patients' needs.The main goals of health recommender systems are to retrieve trusted health information from the Internet, to analyse which is suitable for the user profile and select the best that can be recommended, to adapt their selection methods according to the knowledge domain and to learn from the best recommendations.A brief definition of recommender systems will be given and an explanation of how are they incorporated in the health sector. A description of the main elementary recommender methods as well as their most important problems will also be made. And, to finish, the state of the art will be described.

  9. The recommendations of the noise working group

    International Nuclear Information System (INIS)

    Legerton, M.L.

    1997-01-01

    In 1993 the DTI set up a Working Group to define a framework which can be used to measure and rate the noise from wind turbines. The final report of the Noise Working Group is now available for publication. The advice on the setting of noise limits for wind farms is largely unaltered from the preliminary recommendations presented at the 17th BWEA Annual Conference [1]. This paper recaps on those recommendations and provides additional information on the measurement procedures to be used with the recommendations on noise limits. The paper describes the measurement of the existing background noise climate on which the limits are based and the procedure to be used for the measurement of turbine noise levels in the investigation of complaints. The noise limits are rated noise levels in that they can include a penalty for tones present in the noise. The level of penalty depends upon the audibility of the tone and measurement procedure for determining audibility and the associated penalty system are also described. (author)

  10. An overview of fertilizer-P recommendations in Europe: soil testing, calibration and fertilizer recommendations

    NARCIS (Netherlands)

    Jordan-Meille, L.; Rubaek, G.H.; Ehlert, P.A.I.; Genot, V.; Hofman, G.; Goulding, K.; Recknagel, J.; Provolo, G.; Barraclough, P.

    2012-01-01

    The procedure for applying phosphorus (P) fertilizer to soil can be divided into three consecutive steps: (i) Measurement of soil-P availability, (ii) calibration of the soil-P fertility level and (iii) estimation of the recommended P dose. Information on each of these steps was obtained for 18

  11. Physical activity recommendations for health: what should Europe do?

    Directory of Open Access Journals (Sweden)

    Fogelholm Mikael

    2010-01-01

    Full Text Available Abstract Background Accumulating scientific evidence shows physical activity to have profound health benefits amenable to substantial public health gains. Accordingly, recommendations on how much and what kind of physical activity enhances health have been issued. The 1995 recommendation from the U.S. Centres for Disease Control and Prevention and the American College of Sports Medicine has been adapted worldwide, including Europe. Recently an extensive review of new evidence was undertaken and refined recommendations were issued by the U.S. Department of Health and Human Services. We summarise the development of physical activity recommendations and consider the need and possible ways to update the current European situation. Discussion The new recommendations include several new elements when compared to the 1995 recommendation, the most notable being the greater emphasis on the contribution of vigorous-intensity activities, and the inclusion of activities for muscle strength and bone health. They also include specific recommendations for young people, middle-aged adults, older adults and some special groups. The existing Pan-European and national physical activity recommendations in Europe are mostly based on the 1995 recommendation and primarily target adults and young people. Thus the degree to which they are compatible with the new recommendations varies. In view of the growing public health importance of physical activity, we discuss the need to review the existing physical activity recommendations at the European level and assess their consistency with the new evidence and the new recommendations. Summary We argue that a review of the current physical activity recommendations in Europe should be undertaken in view of the most recent research evidence. We recommend that such a task should be taken on by WHO Europe in parallel with the ongoing work by WHO global Headquarters. Following this, each country should develop communication

  12. Nursing Management Minimum Data Set: Cost-Effective Tool To Demonstrate the Value of Nurse Staffing in the Big Data Science Era.

    Science.gov (United States)

    Pruinelli, Lisiane; Delaney, Connie W; Garciannie, Amy; Caspers, Barbara; Westra, Bonnie L

    2016-01-01

    There is a growing body of evidence of the relationship of nurse staffing to patient, nurse, and financial outcomes. With the advent of big data science and developing big data analytics in nursing, data science with the reuse of big data is emerging as a timely and cost-effective approach to demonstrate nursing value. The Nursing Management Minimum Date Set (NMMDS) provides standard administrative data elements, definitions, and codes to measure the context where care is delivered and, consequently, the value of nursing. The integration of the NMMDS elements in the current health system provides evidence for nursing leaders to measure and manage decisions, leading to better patient, staffing, and financial outcomes. It also enables the reuse of data for clinical scholarship and research.

  13. Is innovative workforce planning software the solution to NHS staffing and cost crisis? An exploration of the locum industry.

    Science.gov (United States)

    Theodoulou, Iakovos; Reddy, Akshaya Mohan; Wong, Jeremy

    2018-03-20

    Workforce planning in the British healthcare system (NHS) is associated with significant costs of agency staff employment. The introduction of a novel software (ABG) as a 'people to people economy' (P2PE) platform for temporary staff recruitment offers a potential solution to this problem. Consequently, the focus of this study was twofold - primarily to explore the locum doctor landscape, and secondarily to evaluate the implementation of P2PE in the healthcare industry. Documentary analysis was conducted alongside thirteen semi structured interviews across five informant groups: two industry experts, two healthcare consultants, an executive director, two speciality managers and six doctors. We found that locum doctors are indispensable to covering workforce shortages, yet existing planning and recruitment practices were found to be inefficient, inconsistent and lacking transparency. Contrarily, mobile-first solutions such as ABG seem to secure higher convenience, better transparency, cost and time efficiency. We also identified factors facilitating the successful diffusion of ABG; these were in line with classically cited characteristics of innovation such as trialability, observability, and scope for local reinvention. Drawing upon the concept of value-based healthcare coupled with the analysis of our findings led to the development of Information Exchange System (IES) model, a comprehensive framework allowing a thorough comparison of recruitment practices in healthcare. IES was used to evaluate ABG and its diffusion against other recruitment methods and ABG was found to outperform its alternatives, thus suggesting its potential to solve the staffing and cost crisis at the chosen hospital.

  14. Analisis Higiene dan Sanitasi Staf Instalasi Gizi Rumah Sakit Umum Daerah Kota Langsa Tahun 2013

    OpenAIRE

    Faizia, El

    2013-01-01

    Implementation of food in the hospital depends on hygiene and sanitation so that the food does not become a source of disease transmission to humans who consume the food. Implementation of food at the General Hospital Langsa power levels for installation nutrition wear headgear, gloves, masks, and some have not wear aprons while working, talking and there is smoke on the job. This research purposes to analyze the condition of nutrient installation hygiene and sanitasi at Langsa city hospit...

  15. Effect of a staffing strategy based on voluntary increase in working hours on quality of patient care in a hospital in KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    J. McIntosh

    2009-09-01

    Full Text Available Two of the issues facing the South African Health Care System are the shortage of nursing staff and a lack of adequate skills to provide quality patient care. The hospital under study experienced a critical shortage of applications from professional registered nurses, consequently a staffing strategy was implemented to overcome the shortage of nurses and to maintain quality patient care. The strategy introduced encouraged nurses to voluntarily work an additional ten hours per week with remuneration. A non-experimental, descriptive design with a quantitative approach was applied to investigate the effect of a staffing strategy aimed at improving the quality of care in a hospital in Kwa-Zulu Natal based on voluntarily increasing staff working hours. The investigation compared the quality of nursing care before and after the implementation of the staffing strategy through retrospective audits of randomly selected patient files 372 (11% of the total population of 400 files were audited. A random sample of 4 boxes each containing a 100 patient files, of a total of 34 boxes, was selected from the hospital filing system. Descriptive statistical analyses were performed and correlations between various variables using the Chi-square test. No statistically significant differences (p<0.05 were found between the quality of nursing care before and after the implementation of the management strategy, even though deterioration of results after the implementation was observed. The study shows that the quality of nursing care in most wards deteriorated after implementation. The staffing strategy failed to improve or maintain the quality of nursing care.

  16. Americans do not meet federal dietary recommendations.

    Science.gov (United States)

    Krebs-Smith, Susan M; Guenther, Patricia M; Subar, Amy F; Kirkpatrick, Sharon I; Dodd, Kevin W

    2010-10-01

    A longstanding goal of dietary surveillance has been to estimate the proportion of the population with intakes above or below a target, such as a recommended level of intake. However, until now, statistical methods for assessing the alignment of food intakes with recommendations have been lacking. The purposes of this study were to demonstrate the National Cancer Institute's method of estimating the distribution of usual intake of foods and determine the proportion of the U.S. population who does not meet federal dietary recommendations. Data were obtained from the 2001-2004 NHANES for 16,338 persons, aged 2 y and older. Quantities of foods reported on 24-h recalls were translated into amounts of various food groups using the MyPyramid Equivalents Database. Usual dietary intake distributions were modeled, accounting for sequence effect, weekend/weekday effect, sex, age, poverty income ratio, and race/ethnicity. The majority of the population did not meet recommendations for all of the nutrient-rich food groups, except total grains and meat and beans. Concomitantly, overconsumption of energy from solid fats, added sugars, and alcoholic beverages ("empty calories") was ubiquitous. Over 80% of persons age ≥ 71 y and over 90% of all other sex-age groups had intakes of empty calories that exceeded the discretionary calorie allowances. In conclusion, nearly the entire U.S. population consumes a diet that is not on par with recommendations. These findings add another piece to the rather disturbing picture that is emerging of a nation's diet in crisis.

  17. The new ICRP general recommendations

    International Nuclear Information System (INIS)

    Mason, Ch.; Kosako, T.; Kuniyoshi, H.; Kiryu, Y.; Choi, H.S.; Burns, P.A.; Pan, Z.Q.; Xia, Y.

    2007-01-01

    Regulatory views from Japan, South Korea, Australia, China and Indonesia were explained based on their regional context. Some issues, for example 'optimisation', 'dose constrains', 'natural radioactivity', were addressed from the viewpoint of how each country's current regulation system would adopt these new recommendations. It was noted that there would be a need for some flexibility in applying these new recommendations since different countries have different regulatory criteria and benchmarks as well different decision-making processes. It was also noted that definitions and terminologies should be given serious consideration with regard to non-English speaking countries to assure that the new ICRP recommendations are clearly understood, not misinterpreted, easily translated and finally applied in the field of radiation protection. In addition, some recent radiation protection activities, as well as views on utilisation of nuclear power in several countries were presented. (authors)

  18. Effects of learning climate and registered nurse staffing on medication errors.

    Science.gov (United States)

    Chang, YunKyung; Mark, Barbara

    2011-01-01

    Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.

  19. Recommended physical activity and intensity levels to reduce ...

    African Journals Online (AJOL)

    Bivariate logistic regression was used to assess the association between physical activities and body fat percentage. Result from this study highlighted that total time per week of commuting (OR = 2.92, 95% CI: 1.18-7.31, p < 0.05) and the activity score of leisure time activities (OR = 2.47, 95% CI: 1.37-5.34, p < 0.05) are ...

  20. Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes

    Science.gov (United States)

    Hunt, Selina R.; Corazzini, Kirsten; Anderson, Ruth A.

    2014-01-01

    Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided. PMID:24652943

  1. NCBO Ontology Recommender 2.0: an enhanced approach for biomedical ontology recommendation.

    Science.gov (United States)

    Martínez-Romero, Marcos; Jonquet, Clement; O'Connor, Martin J; Graybeal, John; Pazos, Alejandro; Musen, Mark A

    2017-06-07

    Ontologies and controlled terminologies have become increasingly important in biomedical research. Researchers use ontologies to annotate their data with ontology terms, enabling better data integration and interoperability across disparate datasets. However, the number, variety and complexity of current biomedical ontologies make it cumbersome for researchers to determine which ones to reuse for their specific needs. To overcome this problem, in 2010 the National Center for Biomedical Ontology (NCBO) released the Ontology Recommender, which is a service that receives a biomedical text corpus or a list of keywords and suggests ontologies appropriate for referencing the indicated terms. We developed a new version of the NCBO Ontology Recommender. Called Ontology Recommender 2.0, it uses a novel recommendation approach that evaluates the relevance of an ontology to biomedical text data according to four different criteria: (1) the extent to which the ontology covers the input data; (2) the acceptance of the ontology in the biomedical community; (3) the level of detail of the ontology classes that cover the input data; and (4) the specialization of the ontology to the domain of the input data. Our evaluation shows that the enhanced recommender provides higher quality suggestions than the original approach, providing better coverage of the input data, more detailed information about their concepts, increased specialization for the domain of the input data, and greater acceptance and use in the community. In addition, it provides users with more explanatory information, along with suggestions of not only individual ontologies but also groups of ontologies to use together. It also can be customized to fit the needs of different ontology recommendation scenarios. Ontology Recommender 2.0 suggests relevant ontologies for annotating biomedical text data. It combines the strengths of its predecessor with a range of adjustments and new features that improve its reliability

  2. Recommended Guidelines for PKU Programs.

    Science.gov (United States)

    Children's Bureau (DHEW), Washington, DC.

    A discussion of screening tests for phenylketonuria recommends and provides some data on two tests, lists five disadvantages of urine tests, and discusses three new tests. Also considered are the role of the central laboratory facility and seven suggestions for screening different types of infants at different times. Treatment or followup programs…

  3. Recommendations for open data science.

    Science.gov (United States)

    Gymrek, Melissa; Farjoun, Yossi

    2016-01-01

    Life science research increasingly relies on large-scale computational analyses. However, the code and data used for these analyses are often lacking in publications. To maximize scientific impact, reproducibility, and reuse, it is crucial that these resources are made publicly available and are fully transparent. We provide recommendations for improving the openness of data-driven studies in life sciences.

  4. ExpertFOAF recommends experts

    DEFF Research Database (Denmark)

    Iofcu, Tereza; Diederich, Joerg; Dolog, Peter

    2007-01-01

    recommender systems for finding users with similar interests and, hence, expertise in different domains. We consider a well-defined user profile to express best the user's current interests in a domain, where the domain (such as the research environment with students and professors) is defined by a collection...

  5. Towards a Legal Recommender System

    NARCIS (Netherlands)

    Winkels, R.; Boer, A.; Vredebregt, B.; van Someren, A.

    2014-01-01

    In this paper we present the results of ongoing research aimed at a legal recommender system where users of a legislative portal receive suggestions of other relevant sources of law, given a focus document. We describe how we make references in case law to legislation explicit and machine readable,

  6. Success rates of pediatric intubation by a non-physician-staffed critical care transport service.

    Science.gov (United States)

    Harrison, Timothy H; Thomas, Stephen H; Wedel, Suzanne K

    2004-02-01

    Previous researchers have found that institution of an endotracheal intubation (ETI) protocol into a large urban paramedic program resulted in low success rates and had no beneficial effects. The primary goal of the current study was to assess ETI success rates achieved by a small cadre of nonphysician critical care transport (CCT) providers. A secondary objective was to assess for association between ETI success and factors such as age group or ETI setting (eg, in-hospital, in-aircraft). This retrospective study analyzed transport records of consecutive pediatric patients (younger than 13 years) in whom ETI was attempted by a nurse/paramedic (RN/EMTP) CCT crew working under protocols which included neuromuscular blockade (NMB)-facilitated ETI. The CCT service performs scene and interfacility transports in helicopter, fixed-wing (airplane), and ground critical care vehicles; pediatric patients are transferred to 4 receiving tertiary care centers. Chi2 test, Fisher exact test, and logistic regression analysis (P = 0.05) examined ETI success rates and assessed for association between ETI success and various characteristics (eg, age group, ETI setting). The CCT crew attempted ETI in 143 patients, with success in 136 cases (95.1%). There were no unrecognized esophageal intubations. ETI success was of similar likelihood across pediatric age groups (P = 0.19) and in different ETI settings (P = 0.57). CCT crew airway management success was very high in all practice settings. These data support contentions that, with a high level of initial and ongoing training, nonphysician CCT crew can successfully manage pediatric airways in a variety of circumstances.

  7. Simulation of a Novel Schedule for Intensivist Staffing to Improve Continuity of Patient Care and Reduce Physician Burnout.

    Science.gov (United States)

    Geva, Alon; Landrigan, Christopher P; van der Velden, Meredith G; Randolph, Adrienne G

    2017-07-01

    Despite widespread adoption of in-house call for ICU attendings, there is a paucity of research on optimal scheduling of intensivists to provide continuous on-site coverage. Overnight call duties have traditionally been added onto 7 days of continuous daytime clinical service. We designed an alternative ICU staffing model to increase continuity of attending physician care for patients while also decreasing interruptions to attendings' nonclinical weeks. Computer-based simulation of a 1-year schedule. A simulated ICU divided into two daytime teams each covered by a different attending and both covered by one overnight on-call attending. Simulated patients were randomly admitted on different service days to assess continuity of care. A "shared service schedule" was compared to a standard "7 days on schedule." For the 7 days on schedule, an attending covered a team for 7 consecutive days and off-service attendings cross-covered each night. For the shared schedule, four attendings shared the majority of daytime and nighttime service for two teams over 2 weeks, with recovery periods built into the scheduled service time. Continuity of care as measured by the Continuity of Attending Physician Index increased by 9% with the shared schedule. Annually, the shared service schedule was predicted to increase free weekends by 3.4 full weekends and 1.3 weekends with either Saturday or Sunday off. Full weeks without clinical obligations increased by 4 weeks. Mean time between clinical obligations increased by 5.8 days. A shared service schedule is predicted to improve continuity of care while increasing free weekends and continuity of uninterrupted nonclinical weeks for attendings. Computer-based simulation allows assessment of benefits and tradeoffs of the alternative schedule without disturbing existing clinical systems.

  8. Home health care agency staffing patterns before and after the Balanced Budget Act of 1997, by rural and urban location.

    Science.gov (United States)

    McAuley, William J; Spector, William; Van Nostrand, Joan

    2008-01-01

    The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated with the BBA and related policies. Data were drawn from Medicare Provider of Service files and the Area Resource File. The unit of analysis was the 3,126 counties in the United States, grouped into 5 categories: metropolitan, nonmetropolitan adjacent, and 3 nonmetropolitan nonadjacent groups identified by largest town size. Only relatively stable HHAs were included. We generated summary HHA staff statistics for each county group and year. All staff categories, other than therapists, declined from 1997 to 2002 across the metropolitan and nonmetropolitan county groupings. There were substantial population-adjusted decreases in stable HHA-based home health aides in all counties, including remote counties. The limited presence of stable HHA staff in certain nonmetropolitan county types has been exacerbated since implementation of the BBA, especially in the most rural counties. The loss of aides in more rural counties may limit the availability of home-based long-term care in these locations, where the need for long-term care is considerable. Future research should examine the degree to which the presence of HHA staff influences actual access and whether other paid and unpaid sources of care substitute for Medicare home health care in counties with limited supplies of HHA staff.

  9. Treatment recommendations for non-infectious anterior uveitis.

    Science.gov (United States)

    Espinosa, Gerard; Muñoz-Fernández, Santiago; García Ruiz de Morales, José M; Herreras, José M; Cordero-Coma, Miguel

    2017-12-20

    To develop recommendations on the use of immunodepressors in patients with non-infectious, non-neoplastic anterior uveitis (AU) based on best evidence and experience. A multidisciplinary panel of five experts was established, who, in the first nominal group meeting defined the scope, users, and chapters of the document. A systematic literature review was performed to assess the efficacy and safety of immunosuppressors in patients with non-infectious, non-neoplastic AU. All the above was discussed in a second nominal group meeting and 33 recommendations were generated. Through the Delphi methodology, the degree of agreement with the recommendations was tested also by 25 more experts. Recommendations were voted on from one (total disagreement) to 10 (total agreement). We defined agreement if at least 70% voted ≥7. The level of evidence and degree of recommendation was assessed using the Oxford Centre for Evidence-based Medicine's Levels of Evidence. The 33 recommendations were accepted. They include specific recommendations on patients with non-infectious, non-neoplastic AU, as well as different treatment lines. In patients with non-infectious, non-neoplastic AU, these recommendations on the use of immunosuppressors might be a guide in order to help in the treatment decision making, due to the lack of robust evidence or other globally accepted algorithms. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. ACPSEM brachytherapy working group recommendations for quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    Dempsey, Claire; Smith, Ryan; Nyathi, Thulani; Ceylan, Abdurrahman; Howard, Lisa; Patel, Virendra; Dam, Ras; Haworth, Annette

    2013-01-01

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups in 2011 to develop recommendation papers for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, have been subject to independent expert reviews and have also been approved by the ACPSEM Council. For the Australian audience, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Practice Standards. This publication presents the recommendations of the ACPSEM Brachytherapy Working Group (BTWG) and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendation papers. It is hoped that the users of this and other ACPSEM recommendation papers will contribute to the development of future versions through the Radiation Oncology Specialty Group of the ACPSEM.

  11. A Flexible Electronic Commerce Recommendation System

    Science.gov (United States)

    Gong, Songjie

    Recommendation systems have become very popular in E-commerce websites. Many of the largest commerce websites are already using recommender technologies to help their customers find products to purchase. An electronic commerce recommendation system learns from a customer and recommends products that the customer will find most valuable from among the available products. But most recommendation methods are hard-wired into the system and they support only fixed recommendations. This paper presented a framework of flexible electronic commerce recommendation system. The framework is composed by user model interface, recommendation engine, recommendation strategy model, recommendation technology group, user interest model and database interface. In the recommender strategy model, the method can be collaborative filtering, content-based filtering, mining associate rules method, knowledge-based filtering method or the mixed method. The system mapped the implementation and demand through strategy model, and the whole system would be design as standard parts to adapt to the change of the recommendation strategy.

  12. Recommendations for citizen-oriented risk communication

    International Nuclear Information System (INIS)

    Fertmann, R.

    2005-01-01

    The purpose of recommendations for citizen-oriented risk communication should be to provide ''banisters'' which leave the players their freedom of action and allow them to adapt communicative structures to the situation at hand. Uncertainty and controversial issues at the levels of information, participation and assessment are identified as potential stumbling blocks in risk communication. The experiences gained in Hamburg shed a light on a diversity of processes in risk communication, which the present paper proceeds to evaluate. One of its essential recommendations is to have dialogic processes develop into forms of participation. A guide on risk communication which was formulated in the USA has been adapted to conditions as they prevail in Germany. The adapted version is more practically oriented than the rules of the EPA or the more recent CDC recommendations. Suitable success criteria include a fair procedure, a common baseline of what is known and not known, the acceptance of different assessment criteria, and the exchange of the pros and cons of different options

  13. Nutrition recommendations and science: next parallel steps.

    Science.gov (United States)

    Fogelholm, Mikael

    2016-03-15

    This article examines nutrition recommendations in relation to developments in nutrition science. Combining data on the genome, metabolome and microbiota is likely to open possibilities for personalized nutrition planning, but we are still far from practical applications. However, even these new steps are unlikely to challenge the role and importance of population-based nutrition recommendations as a tool to promote dietary patterns, policies and public health. Developments in science could help in deriving more benefits from nutrition recommendations. For instance, improved accuracy of dietary intake assessment is needed both for surveillance and for understanding the quantitative interplay between diet and health. Applying metabolomics together with food diaries or questionnaires, and also modern technologies such as digital photography, are potentially interesting methods in this respect. Research on consumer behaviour, attitudes and policy interventions, such as taxation of unhealthy foods and nutrition labelling, are needed to gain more insight into how to change eating behaviour for better health at the population level. © 2015 Society of Chemical Industry.

  14. Personalized recommendation based on heat bidirectional transfer

    Science.gov (United States)

    Ma, Wenping; Feng, Xiang; Wang, Shanfeng; Gong, Maoguo

    2016-02-01

    Personalized recommendation has become an increasing popular research topic, which aims to find future likes and interests based on users' past preferences. Traditional recommendation algorithms pay more attention to forecast accuracy by calculating first-order relevance, while ignore the importance of diversity and novelty that provide comfortable experiences for customers. There are some levels of contradictions between these three metrics, so an algorithm based on bidirectional transfer is proposed in this paper to solve this dilemma. In this paper, we agree that an object that is associated with history records or has been purchased by similar users should be introduced to the specified user and recommendation approach based on heat bidirectional transfer is proposed. Compared with the state-of-the-art approaches based on bipartite network, experiments on two benchmark data sets, Movielens and Netflix, demonstrate that our algorithm has better performance on accuracy, diversity and novelty. Moreover, this method does better in exploiting long-tail commodities and cold-start problem.

  15. Staffing an Academic Reference Desk with Librarians is not Cost-effective. A Review of: Ryan, Susan M. “Reference Transactions Analysis: The Cost-effectiveness of Staffing a Traditional Academic Reference Desk.” Journal of Academic Librarianship 34.5 (2008: 389-99.

    Directory of Open Access Journals (Sweden)

    Cari Merkley

    2009-06-01

    categories derived by the researcher: look-up (a search for a known item, directional (library-specific orientation to the space and collections, technology (assistance with using library technology and electronic resources, and reference. The category of reference was further subdivided into eight additional categories: catalogue search, citation help, database help, “guide to correct databases,” “personal knowledge or referral,” “quick internet search,” research, and Serials Solutions (392. “Guide to correct databases” referred to advice on the appropriate database to answer a question and serials solutions included questions that could be answered using the Serials Solutions product, such as the availability of a particular journal or article in the collection (392. Questions were assigned to the single most appropriate category by the researcher. Question categories were then mapped to “suggested staffing levels” (396. This determination was made by the researcher, and no details were given as to how the decision was made for each category. The three levels of staffing discussed were librarian, “trained student or staff,” and “well-trained staff/occasional librarian referral” (396. The cost of staffing the reference desk during the eight months captured in this study was calculated by multiplying the hours worked by each librarian by his/her individual average rate of pay across the four data collection periods. Indirect staff costs such as benefits were not included in this calculation. The average cost per reference transaction was determined by dividing the total salary costs by the total number of reference queries during the periods of study. Costs for those categories of questions best addressed by a librarian could then be determined. The actual number of librarians who participated in the study is unclear. The methodology refers to four full-time and two part-time librarians (391. However, later in the article there is reference to

  16. What we expect of ICRP new recommendations

    International Nuclear Information System (INIS)

    Yoshikawa, S.

    2004-01-01

    We believe that it is essential for Japan to continue to maintain and promote nuclear power generation. To promote nuclear power generation, we believe it is important that the effect of low-level radiation on humans and the exposure dose limits have to be widely and properly understood by the general public and radiation workers. From such a point of view, we express our agreement with ICRP latest attempt that is aimed at preparing a simple and easy-to understanding radiological protection system. We would like to express some of our opinions about ICRP new recommendations. - The relation between PAL and the conventional dose limit should be shown clearly. - Optimisation on low-enough level (natural background level) should be omitted. - The process of optimisation must take the state of affairs in each country into consideration. - The dose limits (100 mSv/5 yrs and 50 mSv/yr) for workers should not be changed. (Single-year dose limit of 20 mSv/yr has no flexibility and has serious impact on nuclear power operators.). - Full discussion is necessary to establish the radiological protection criteria for environment. We appreciate ICRP's releases and calls for opinions regarding the new recommendations. We hope ICRP continues to disclose the status of discussion in a timely manner, and invite opinions. (author)

  17. RARD: The Related-Article Recommendation Dataset

    OpenAIRE

    Beel, Joeran; Carevic, Zeljko; Schaible, Johann; Neusch, Gabor

    2017-01-01

    Recommender-system datasets are used for recommender-system evaluations, training machine-learning algorithms, and exploring user behavior. While there are many datasets for recommender systems in the domains of movies, books, and music, there are rather few datasets from research-paper recommender systems. In this paper, we introduce RARD, the Related-Article Recommendation Dataset, from the digital library Sowiport and the recommendation-as-a-service provider Mr. DLib. The dataset contains ...

  18. A systematic review on the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.

    Science.gov (United States)

    Gi, Toh Shir; Devi, Kamala M; Neo Kim, Emily Ang

    2011-01-01

    Nursing shortage is a global issue that which affects oncology nursing. Oncology nurses are more prone to experience job dissatisfaction, stress and burnout when they work in units with poor staffing. There is thus a need for greater understanding of the relationship between the nursing shortage and nursing outcomes in oncology/haematology settings. This review aimed to establish the best available evidence concerning the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings; and to make recommendations for practice and future research. Types of participants: This review considered studies that included oncology registered nurses (RNs) who were more than 18 years of age and worked in either inpatient or outpatient oncology/haematology wards or units for the adult or paediatric patients.Types of intervention: This review considered studies that evaluated the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.Types of outcomes: This review included studies that measured job satisfaction, stress and burnout levels using different outcomes measures. Job satisfaction was determined by the Measure of Job Satisfaction scale, the Misener Nurse Practitioner Job Satisfaction Scale and the Likert scale, stress by the Pediatric Oncology Nurse Stressor Questionnaire and burnout by the Maslash Burnout Inventory scale.Types of studies: This review included descriptive/descriptive-correlational studies which were published in English. The search strategy sought to identify published and unpublished studies conducted between 1990 and 2010. Using a three-step search strategy, the following databases were accessed: CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar. Two independent reviewers assessed each paper for methodological validity prior to inclusion in

  19. Analysis of foreign physical activity recommendations and guidelines for schools

    Directory of Open Access Journals (Sweden)

    Jan Pavelka

    2014-06-01

    Full Text Available Background:An adequate level of physical activity is an important part of children's lifestyle. The school environment plays a significant role in the area of interventions and strategies aiming to increase the level of physical activity in children. Objectives: The aim of this study is to analyse foreign recommendations leading to an increased level of physical activity in children and young people in Czech schools. Methods: A systematic search of studies published between 1988 and 2012 in the English language was completed in library databases Medline, Sport Discus, ProQuest, PsychInfo, ERIC, Wiley InterScience using the following keywords: physical activity, guidelines, recommendations, school and youth. The studies were then classified based on abstract and full-text analyses. Using a content analysis the expert team formulated the final recommendations to increase the level of physical activity for schools in the Czech Republic (CR. Results: Out of the total number of 91 identified foreign studies, 25 met the predetermined criteria and were used as a basis for formulating the recommendations. These foreign studies included 15 papers published in USA, two in Australia, two in Great Britain, two in Canada, one in the European Union, one in New Zealand and one international paper (an international consensus of experts from 34 countries. Based on the interpretation of the evidence, its justification and final consensus of the expert team, the basic areas for the recommendations to increase the level of physical activity in schools in the CR were identified. Conclusions: An analysis of foreign recommendations to increase the level of physical activity designed for schools and school facilities is one of the possible methods of formulating domestic recommendations. This recommendation could contribute to deeper understanding of the issue of the deteriorating lifestyle of school-aged children in the CR and reflects the efforts for improvement.

  20. Preliminary recommendations of the Noise Working Group

    International Nuclear Information System (INIS)

    Legerton, M.L.

    1995-01-01

    In 1993 the DTI set up a Working Group largely consisting of independent experts on wind turbine noise. The main objectives of the Working Group were to define a framework which can be used to measure and rate the noise from wind turbines and to provide indicative noise levels thought to offer a reasonable degree of protection to wind farm neighbours and encourage best practice in turbine design and wind farm siting and layout. This paper presents the preliminary recommendations of the Working Group. (Author)

  1. Scientific and educational recommender systems

    Science.gov (United States)

    Guseva, A. I.; Kireev, V. S.; Bochkarev, P. V.; Kuznetsov, I. A.; Philippov, S. A.

    2017-01-01

    This article discusses the questions associated with the use of reference systems in the preparation of graduates in physical function. The objective of this research is creation of model of recommender system user from the sphere of science and education. The detailed review of current scientific and social network for scientists and the problem of constructing recommender systems in this area. The result of this study is to research user information model systems. The model is presented in two versions: the full one - in the form of a semantic network, and short - in a relational form. The relational model is the projection in the form of semantic network, taking into account the restrictions on the amount of bonds that characterize the number of information items (research results), which interact with the system user.

  2. From micronutrient recommendations to policy

    DEFF Research Database (Denmark)

    Timotijevic, Lada; Raats, Monique M.; Barnett, Julie

    2010-01-01

    the Eurreca network of excellence (commissioned by the European Commission), the research involved in-depth desk research of key documents and communication channels linked to the process of setting micronutrient recommendations across seven countries: the United Kingdom, Norway, Denmark, Germany, Spain......, the Czech Republic and Hungary. Results: Stakeholder engagement is recognized by most countries as an important aspect of the process of setting micronutrient recommendations and their translation into policy, although there is notable variation in the extent to which this has been achieved across the seven...... of involvement include historical sociopolitical context; the extent to which food and nutrition are key policy agenda; and the relative power of stakeholders in influencing food and nutrition policy....

  3. Finding and Recommending Scholarly Articles

    Science.gov (United States)

    Kurtz, Michael J.; Henneken, Edwin A.

    2014-05-01

    The rate at which scholarly literature is being produced has been increasing at approximately 3.5 percent per year for decades. This means that during a typical 40 year career the amount of new literature produced each year increases by a factor of four. The methods scholars use to discover relevant literature must change. Just like everybody else involved in information discovery, scholars are confronted with information overload. Two decades ago, this discovery process essentially consisted of paging through abstract books, talking to colleagues and librarians, and browsing journals. A time-consuming process, which could even be longer if material had to be shipped from elsewhere. Now much of this discovery process is mediated by online scholarly information systems. All these systems are relatively new, and all are still changing. They all share a common goal: to provide their users with access to the literature relevant to their specific needs. To achieve this each system responds to actions by the user by displaying articles which the system judges relevant to the user's current needs. Recently search systems which use particularly sophisticated methodologies to recommend a few specific papers to the user have been called "recommender systems". These methods are in line with the current use of the term "recommender system" in computer science. We do not adopt this definition, rather we view systems like these as components in a larger whole, which is presented by the scholarly information systems themselves. In what follows we view the recommender system as an aspect of the entire information system; one which combines the massive memory capacities of the machine with the cognitive abilities of the human user to achieve a human-machine synergy.

  4. Paris convention - Decisions, recommendations, interpretations

    International Nuclear Information System (INIS)

    1990-01-01

    This booklet is published in a single edition in English and French. It contains decisions, recommendations and interpretations concerning the 1960 Paris Convention on Third Party Liability in the Field of Nuclear Energy adopted by the OECD Steering Committee and the OECD Council. All the instruments are set out according to the Article of the Convention to which they relate and explanatory notes are added where necessary [fr

  5. EULAR recommendations for patient education for people with inflammatory arthritis

    DEFF Research Database (Denmark)

    Zangi, Heidi A; Ndosi, Mwidimi; Adams, Jo

    2015-01-01

    , eight recommendations were developed, four with strength A evidence. The recommendations addressed when and by whom PE should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation. A high level of agreement was achieved for all recommendations (mean range 9......OBJECTIVES: The task force aimed to: (1) develop evidence-based recommendations for patient education (PE) for people with inflammatory arthritis, (2) identify the need for further research on PE and (3) determine health professionals' educational needs in order to provide evidence-based PE....... METHODS: A multidisciplinary task force, representing 10 European countries, formulated a definition for PE and 10 research questions that guided a systematic literature review (SLR). The results from the SLR were discussed and used as a basis for developing the recommendations, a research agenda...

  6. Staffing for Success

    Science.gov (United States)

    Perozzi, Brett; Seifert, Tricia; Al-Sharif, Mary Ann Bodine

    2016-01-01

    This chapter explores institutional capacity building in cross-border student affairs and services. The focus is on human capital and its importance to international higher education within local contexts.

  7. Folate recommendations for pregnancy, lactation, and infancy.

    Science.gov (United States)

    Lamers, Yvonne

    2011-01-01

    An adequate intake of folate during pregnancy, lactation, and infancy is essential for maternal and child health and normal growth. Higher folate requirements during pregnancy and lactation are difficult to meet by increased intake of folate-rich food products only. Supplementation with folic acid is recommended not only to meet the higher requirements but also to prevent adverse pregnancy outcomes such as neural tube defects (NTDs). In countries that have implemented food fortification with folic acid, the folate intake has raised but does not yet meet the recommended amount for NTD risk reduction. Women's awareness of the need to supplement with folic acid prior to conception shall be raised in all countries. It is under debate whether a high folic acid intake might have metabolic and functional effects in utero and for the infant. Research is needed to investigate potential alternative folate forms for food fortification programs and to test their efficacy in risk reduction of adverse pregnancy outcomes. Breast-fed infants most likely receive sufficient folate. While the folate level of human milk is simulated in infant formula, data are lacking on the bioavailability and effect of folic acid in infants and on whether a tolerable upper intake level should be defined. Copyright © 2011 S. Karger AG, Basel.

  8. Private personalized social recommendations in an IPTV system

    Science.gov (United States)

    Elmisery, Ahmed M.

    2014-04-01

    In our connected world, recommender systems have become widely known for their ability to provide expert and personalize referrals to end-users in different domains. The rapid growth of social networks and new kinds of systems so called "social recommender systems" are rising, where recommender systems can be utilized to find a suitable content according to end-users' personal preferences. However, preserving end-users' privacy in social recommender systems is a very challenging problem that might prevent end-users from releasing their own data, which detains the accuracy of extracted referrals. In order to gain accurate referrals, social recommender systems should have the ability to preserve the privacy of end-users registered in this system. In this paper, we present a middleware that runs on end-users' Set-top boxes to conceal their profile data when released for generating referrals, such that computation of recommendation proceeds over the concealed data. The proposed middleware is equipped with two concealment protocols to give users a complete control on the privacy level of their profiles. We present an IPTV network scenario and perform a number of different experiments to test the efficiency and accuracy of our protocols. As supported by the experiments, our protocols maintain the recommendations accuracy with acceptable privacy level.

  9. Towards Information Enrichment through Recommendation Sharing

    Science.gov (United States)

    Weng, Li-Tung; Xu, Yue; Li, Yuefeng; Nayak, Richi

    Nowadays most existing recommender systems operate in a single organisational basis, i.e. a recommender system recommends items to customers of one organisation based on the organisation's datasets only. Very often the datasets of a single organisation do not have sufficient resources to be used to generate quality recommendations. Therefore, it would be beneficial if recommender systems of different organisations with similar nature can cooperate together to share their resources and recommendations. In this chapter, we present an Ecommerce-oriented Distributed Recommender System (EDRS) that consists of multiple recommender systems from different organisations. By sharing resources and recommendations with each other, these recommenders in the distributed recommendation system can provide better recommendation service to their users. As for most of the distributed systems, peer selection is often an important aspect. This chapter also presents a recommender selection technique for the proposed EDRS, and it selects and profiles recommenders based on their stability, average performance and selection frequency. Based on our experiments, it is shown that recommenders' recommendation quality can be effectively improved by adopting the proposed EDRS and the associated peer selection technique.

  10. Word-of-mouth is more than recommendations

    DEFF Research Database (Denmark)

    Mattsson, Jan; Söderlund, Magnus

    2011-01-01

    Word-of-mouth (WOM) is often operationalized as recommendations, which is only one among several aspects of WOM. Therefore, a focus on recommendations is likely to misrepresent what customers say to other customers. Our empirical study found support for this argument: we found that the sender......’s telling of what had happened to him/her, in terms of a story, is an additional part of WOM. We also found that customer satisfaction, generally considered a main determinant of WOM (when it is narrowly defined as recommendations), is a less potent predictor of WOM than the level of incongruence...... of the event triggering WOM....

  11. Physical Exercise and MS Recommendations

    DEFF Research Database (Denmark)

    Dalgas, U; Ingemann-Hansen, T; Stenager, E

    2009-01-01

    The use of physical exercise programmes in the rehabilitation of patients with multiple sclerosis (MS) has been a controversial issue for many years. During the last decade, however, evidence from a number of studies has suggested that exercise is a safe and efficient way to induce improvements...... in a number of physiological functions, which ultimately can lead to functional improvements that have a positive effect on a patients daily life. The purpose of this review is, based on the existing research, to provide clinicians with some easily administrable recommendations for the application of exercise...

  12. Dietetic recommendations in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    María Rosa Alhambra-Expósito

    2013-12-01

    Full Text Available Rheumatoid arthritis (RA is a chronic autoimmune disease that has a significant effect on patients’ physical, emotional, and social functioning. For decades, patients have used different diets to try to improve the symptoms of RA. The possible benefits of dietary therapy for rheumatoid arthritis are reviewed in this article. Nutritional objectives for RA, are to halt the loss of bone mass, promote healing of bone fractures and improving bone-associated inflammatory disorders and joints. In general, diets low in saturated fat, rich in polyunsaturated fats: omega 3 and omega 6, rich in complex carbohydrates and fiber are recommended.

  13. WRS: The Wikipedia Recommender System

    Science.gov (United States)

    Lefévre, Thomas; Jensen, Christian Damsgaard; Korsgaard, Thomas Rune

    In 2005, the Wikipedia became the most popular reference website on the Internet and it has continued to grow in size and popularity ever since. With the increasing reliance on the Wikipedia comes issues of the credibility and provenance of content. In order to address these issues, we have developed a Recommender System for the Wikipedia, which allows the users of the Wikipedia to rate articles in order to guide other users about the quality of articles. This rating system provides both an incentive for authors to improve articles and a quantifiable measure of the perceived quality of articles.

  14. Physical Exercise and MS Recommendations

    DEFF Research Database (Denmark)

    Dalgas, U; Ingemann-Hansen, T; Stenager, E

    2009-01-01

    in a number of physiological functions, which ultimately can lead to functional improvements that have a positive effect on a patients daily life. The purpose of this review is, based on the existing research, to provide clinicians with some easily administrable recommendations for the application of exercise......The use of physical exercise programmes in the rehabilitation of patients with multiple sclerosis (MS) has been a controversial issue for many years. During the last decade, however, evidence from a number of studies has suggested that exercise is a safe and efficient way to induce improvements...

  15. Hybrid employment recommendation algorithm based on Spark

    Science.gov (United States)

    Li, Zuoquan; Lin, Yubei; Zhang, Xingming

    2017-08-01

    Aiming at the real-time application of collaborative filtering employment recommendation algorithm (CF), a clustering collaborative filtering recommendation algorithm (CCF) is developed, which applies hierarchical clustering to CF and narrows the query range of neighbour items. In addition, to solve the cold-start problem of content-based recommendation algorithm (CB), a content-based algorithm with users’ information (CBUI) is introduced for job recommendation. Furthermore, a hybrid recommendation algorithm (HRA) which combines CCF and CBUI algorithms is proposed, and implemented on Spark platform. The experimental results show that HRA can overcome the problems of cold start and data sparsity, and achieve good recommendation accuracy and scalability for employment recommendation.

  16. Recommender systems in knowledge-mining

    Science.gov (United States)

    Volna, Eva

    2017-07-01

    The subject of the paper is to analyse the possibilities of application of recommender systems in the field of data mining. The work focuses on three basic types of recommender systems (collaborative, content-based and hybrid). The goal of the article is to evaluate which of these three concepts of recommender systems provides forecast with the lowest error rate in the domain of recommending movies. This target is fulfilled by the practical part of the work - at first, the own recommender system was designed and created, capable of obtaining movies recommendation from the database based on the user's preferences. Next, we verified experimentally which recommender system produces more accurate results.

  17. Americans Do Not Meet Federal Dietary Recommendations1

    OpenAIRE

    Krebs-Smith, Susan M.; Guenther, Patricia M.; Subar, Amy F.; Kirkpatrick, Sharon I.; Dodd, Kevin W.

    2010-01-01

    A longstanding goal of dietary surveillance has been to estimate the proportion of the population with intakes above or below a target, such as a recommended level of intake. However, until now, statistical methods for assessing the alignment of food intakes with recommendations have been lacking. The purposes of this study were to demonstrate the National Cancer Institute’s method of estimating the distribution of usual intake of foods and determine the proportion of the U.S. population who ...

  18. Research on Long Tail Recommendation Algorithm

    Science.gov (United States)

    Hu, Xuezhi; Zhang, Chuang; Wu, Ming; Zeng, Yang

    2017-10-01

    Most recommendation systems in the major electronic commerce platforms are influenced by the long tail effect more or less. There are sufficient researches of how to assess recommendation effect while no criteria to evaluate long tail recommendation rate. In this study, we first discussed the existing problems of recommending long tail products through specific experiments. Then we proposed a long tail evaluation criteria and compared the performance in long tail recommendation between different models.

  19. Research of intelligent recommendation for mobile reading

    Science.gov (United States)

    Li, Qu

    2013-07-01

    Mobile reading is the trend of current publishing industry. Intelligent Recommendation system is useful and profitable for mobile reading platforms. Currently, intelligent recommendation systems mainly focus on news recommendation or production recommendation in e-commerce. In this paper, we designed and implemented an intelligent recommendation system based on slope one algorithm. Results show that our algorithm can help the users to find their interested books and thus greatly improve the income of mobile reading platform.

  20. Requirements Engineering for General Recommender Systems

    OpenAIRE

    Portugal, Ivens; Alencar, Paulo; Cowan, Donald

    2015-01-01

    In requirements engineering for recommender systems, software engineers must identify the data that drives the recommendations. This is a labor-intensive task, which is error-prone and expensive. One possible solution to this problem is the adoption of automatic recommender system development approach based on a general recommender framework. One step towards the creation of such a framework is to determine the type of data used in recommender systems. In this paper, a systematic review has b...

  1. Recommended system of application and development

    Science.gov (United States)

    Wang, Wei

    2018-04-01

    A recommender system is a project that helps users identify their wishes and needs. The recommender system has been successfully applied to many e-commerce environments, such as news, film, music, books and other areas of recommendation. This paper mainly discusses the application of recommendation technology in software engineering, data and knowledge engineering, configurable projects and persuasion technology, and summarizes the development trend of recommendation technology in the future.

  2. Classification of Recommender Expertise in the Wikipedia Recommender System

    DEFF Research Database (Denmark)

    Jensen, Christian D.; Pilkauskas, Povilas; Lefevre, Thomas

    2011-01-01

    The Wikipedia is a web-based encyclopedia, written and edited collaboratively by Internet users. The Wikipedia has an extremely open editorial policy that allows anybody, to create or modify articles. This has promoted a broad and detailed coverage of subjects, but also introduced problems relating...... to the quality of articles. The Wikipedia Recommender System (WRS) was developed to help users determine the credibility of articles based on feedback from other Wikipedia users. The WRS implements a collaborative filtering system with trust metrics, i.e., it provides a rating of articles "which emphasizes...... in the Wikipedia. In this paper, we examine different ways to classify the subject area of Wikipedia article according to well established knowledge classification schemes. We identify a number of requirements that a classification scheme must meet in order to be useful in the context of the WRS and present...

  3. Global Advisory Group: conclusions and recommendations.

    Science.gov (United States)

    1986-02-01

    The conclusions and recommendations formulated for the global program by the 8th meeting of the Expanded Program on Immunization (EPI) Global Advisory Group, which took place during November 1985, are summarized. The Global Advisory Group recommends that, in furtherance of the Five-Point Action Program endorsed by the World Health Assembly in 1983, 3 general and 4 specific actions be taken by national immunization programs with the support of the World Health Organization (WHO) to accelerate EPI progress. These recommendations reflect optimism that the 1990 goal of reducing morbidity and mortality by providing immunization for all children of the world can be realized but also acknowledge that many fundamental problems of national program management remain to be resolved. The general actions are: to promote the achievement of the 1990 immunization goal at national and international levels through collaboration among ministries, organizations, and individuals in both the public and private sectors; to adopt a mix of complementary strategies for program acceleration; and to ensure that rapid increases in coverage can be sustained through mechanisms which strengthen th delivery of other primary health care interventions. The specific actions are as follows: to provide immunization at every contact point; to reduce dropout rates between 1st and last immunizations; to improve immunization services to the disadvantaged in urban areas; and to increase priority for the control of measles, poliomyelitis, and neonatal tetanus. The WHO and the UN International Children's Emergency Fund (UNICEF) have collaborated in support of the EPI since the early days of the program. The acceleration of national efforts heightens the importance of this collaboration, particularly at the national level. It may be further facilitated by the provision of policy guidance from global and regional levels, by WHO and UNICEF collaborative agreements at the regional level, and by country agreements

  4. A heterogeneous graph-based recommendation simulator

    Energy Technology Data Exchange (ETDEWEB)

    Yeonchan, Ahn [Seoul National University; Sungchan, Park [Seoul National University; Lee, Matt Sangkeun [ORNL; Sang-goo, Lee [Seoul National University

    2013-01-01

    Heterogeneous graph-based recommendation frameworks have flexibility in that they can incorporate various recommendation algorithms and various kinds of information to produce better results. In this demonstration, we present a heterogeneous graph-based recommendation simulator which enables participants to experience the flexibility of a heterogeneous graph-based recommendation method. With our system, participants can simulate various recommendation semantics by expressing the semantics via meaningful paths like User Movie User Movie. The simulator then returns the recommendation results on the fly based on the user-customized semantics using a fast Monte Carlo algorithm.

  5. A Group Recommender System for Tourist Activities

    Science.gov (United States)

    Garcia, Inma; Sebastia, Laura; Onaindia, Eva; Guzman, Cesar

    This paper introduces a method for giving recommendations of tourist activities to a group of users. This method makes recommendations based on the group tastes, their demographic classification and the places visited by the users in former trips. The group recommendation is computed from individual personal recommendations through the use of techniques such as aggregation, intersection or incremental intersection. This method is implemented as an extension of the e-Tourism tool, which is a user-adapted tourism and leisure application, whose main component is the Generalist Recommender System Kernel (GRSK), a domain-independent taxonomy-driven search engine that manages the group recommendation.

  6. Alleviating bias leads to accurate and personalized recommendation

    Science.gov (United States)

    Qiu, Tian; Wang, Tian-Tian; Zhang, Zi-Ke; Zhong, Li-Xin; Chen, Guang

    2013-11-01

    Recommendation bias towards objects has been found to have an impact on personalized recommendation, since objects present heterogeneous characteristics in some network-based recommender systems. In this article, based on a biased heat conduction recommendation algorithm (BHC) which considers the heterogeneity of the target objects, we propose a heterogeneous heat conduction algorithm (HHC), by further taking the heterogeneity of the source objects into account. Tested on three real datasets, the Netflix, RYM and MovieLens, the HHC algorithm is found to present better recommendation in both the accuracy and diversity than two benchmark algorithms, i.e., the original BHC and a hybrid algorithm of heat conduction and mass diffusion (HHM), while not requiring any other accessorial information or parameter. Moreover, the HHC algorithm also elevates the recommendation accuracy on cold objects, referring to the so-called cold-start problem. Eigenvalue analyses show that, the HHC algorithm effectively alleviates the recommendation bias towards objects with different level of popularity, which is beneficial to solving the accuracy-diversity dilemma.

  7. Naturally occuring radiation in the Nordic countries - recommendations

    International Nuclear Information System (INIS)

    1986-01-01

    In the publication ''Report on the Applicability of International Radiation Protection Recommendations in the Nordic Countries'', published in 1976, the radiation protection authorities in Denmark, Finland, Iceland, Norway and Sweden expessed their agreement on the main principles of radiation protection. The general aspects of radiation protection were covered in the recommendations with the exception of exposure of the public from natural sources of radiation. In 1983 a working group published the report ''Naturally Occurring radiation in the Nordic Countries, - Levels'' in the Radiation Protection Information-Series from the Nordic countries. In that report the present knowledge of the population exposure from natural sources of external gamma-radiation and from radon and thoron daughters in air was reviewed as a basis for the development of the radiation protection recommendations for natural radiation. During preparation of these recommendations due account has also been taken of ICRP publication no. 39: ''Principles for Limiting Exposure of the Public to Natural Sources of Radiation'', which was published in 1984 and in which ICRP for the first time has issued more specific recommendations for natural sources. The recommendations may serve as a basis for more formal rules and regulations within each country, if this is seemed necessary. However, no attempt has been made to formulate identical rules for all the five countries since the exposure levels from natural sources, methods of application and the legal frameworks differ between the countries. (EG)

  8. Nutritional recommendations for cardiovascular disease prevention.

    Science.gov (United States)

    Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov

    2013-09-17

    Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.

  9. Nutritional Recommendations for Cardiovascular Disease Prevention

    Directory of Open Access Journals (Sweden)

    Yaakov Henkin

    2013-09-01

    Full Text Available Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD. This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.

  10. Nutritional Recommendations for Cardiovascular Disease Prevention

    Science.gov (United States)

    Eilat-Adar, Sigal; Sinai, Tali; Yosefy, Chaim; Henkin, Yaakov

    2013-01-01

    Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10. PMID:24067391

  11. FAVL work group: report and recommendations

    International Nuclear Information System (INIS)

    2011-01-01

    This document reports the works of a work group dedicated to the process of search for storage site for low activity and long life radioactive wastes. The authors recall the history of this process which started in the early 1990's, and resulted in the selection of two sites, in Auxon and in Pars-les-Chavanges, and finally in the withdrawal of both towns. Then, the authors analyse the whole process in terms of intervention or participation of local authorities, of information and participation of waste producers. They also discuss the roles of the ASN, IRSN, DGEC, ANDRA and ANDRA's Coesdic. They make recommendations regarding site selection, agenda, responsibilities, preferential representative at the local level, public information, consultation, and project support

  12. Measuring Your Fitness Level

    Science.gov (United States)

    ... test measures the strength and endurance of your abdominal muscles. Here's how to do the test: Lie on ... and Human Services recommends one of the following activity levels for adult fitness and health benefits: 150 ...

  13. Staff Knowledge, Adherence to Infection Control Recommendations ...

    African Journals Online (AJOL)

    Staff Knowledge, Adherence to Infection Control Recommendations and Seroconversion Rates in Hemodialysis Centers in Khartoum. ... Adherence of staff members to infection control recommendations was evaluated by direct observation. Results: ... A structured training program for HD staff members is urgently required.

  14. Travel Recommendations for the Nursing Mother

    Science.gov (United States)

    ... International Lactation Consultant Association Related Topics Diabetes Nutrition Travel Recommendations for the Nursing Mother Recommend on Facebook ... child from some environmental hazards When a Mother Travels Apart from Her Nursing Infant or Child Prior ...

  15. Recommender Systems in Technology Enhanced Learning

    NARCIS (Netherlands)

    Manouselis, Nikos; Drachsler, Hendrik; Vuorikari, Riina; Hummel, Hans; Koper, Rob

    2010-01-01

    Manouselis, N., Drachsler, H., Vuorikari, R., Hummel, H. G. K., & Koper, R. (2011). Recommender Systems in Technology Enhanced Learning. In P. B. Kantor, F. Ricci, L. Rokach, & B. Shapira (Eds.), Recommender Systems Handbook (pp. 387-415). Berlin: Springer.

  16. Second Workshop on New Trends in Content-based Recommender Systems (CBRecSys 2015)

    DEFF Research Database (Denmark)

    Bogers, Toine; Koolen, Marijn

    2015-01-01

    While content-based recommendation has been applied successfully in many different domains, it has not seen the same level of attention as collaborative filtering techniques have. However, there are many recommendation domains and applications where content and metadata play a key role, either...... these data sources should be combined to provided the best recommendation performance. The CBRecSys 2015 workshop aims to address this by providing a dedicated venue for papers dedicated to all aspects of content-based recommendation....

  17. CBRecSys 2015. New Trends on Content-Based Recommender Systems

    DEFF Research Database (Denmark)

    While content-based recommendation has been applied successfully in many different domains, it has not seen the same level of attention as collaborative filtering techniques have. However, there are many recommendation domains and applications where content and metadata play a key role, either...... these data sources should be combined to provided the best recommendation performance. The CBRecSys 2015 workshop aims to address this by providing a dedicated venue for papers dedicated to all aspects of content-based recommendation....

  18. Workshop on New Trends in Content-based Recommender Systems (CBRecSys 2014)

    DEFF Research Database (Denmark)

    Bogers, Toine; Koolen, Marijn; Cantádor, Ivan

    2014-01-01

    While content-based recommendation has been applied successfully in many different domains, it has not seen the same level of attention as collaborative filtering techniques have. However, there are many recommendation domains and applications where content and metadata play a key role, either...... these data sources should be combined to provided the best recommendation performance. The CBRecSys 2014 workshop aims to address this by providing a dedicated venue for papers dedicated to all aspects of content-based recommendation....

  19. Third Workshop on New Trends in Content-based Recommender Systems (CBRecSys 2016)

    DEFF Research Database (Denmark)

    Bogers, Toine; Koolen, Marijn; Musto, Cataldo

    2016-01-01

    While content-based recommendation has been applied successfully in many different domains, it has not seen the same level of attention as collaborative filtering techniques have. However, there are many recommendation domains and applications where content and metadata play a key role, either...... these data sources should be combined to provided the best recommendation performance. The CBRecSys 2016 workshop provides a dedicated venue for papers dedicated to all aspects of content-based recommendation....

  20. CBRecSys 2016. New Trends on Content-Based Recommender Systems

    DEFF Research Database (Denmark)

    While content-based recommendation has been applied successfully in many different domains, it has not seen the same level of attention as collaborative filtering techniques have. However, there are many recommendation domains and applications where content and metadata play a key role, either...... these data sources should be combined to provided the best recommendation performance. The CBRecSys 2016 workshop provides a dedicated venue for papers dedicated to all aspects of content-based recommendation....

  1. Automatic Recommendation of Astronomy Literature

    Science.gov (United States)

    Henneken, Edwin A.; Kurtz, M. J.; Accomazzi, A.; Grant, C. S.; Thompson, D.; Bohlen, E.; Di Milia, G.; Luker, J.; Murray, S. S.

    2011-01-01

    Authors publish because they want to transfer information. An essential ingredient for this transfer is being able to find this information. As the Literature Universe is expanding rapidly, finding your way in this deluge of information can be a daunting task. How do you find what you are looking for in a reasonable amount of time and more importantly, information you could not have found using the normal information discovery model? When you have some prior information (like author names and/or subject keywords), you can use your favorite search engine and apply that information as filters. There are also more sophisticated services like the myADS service of the SAO/NASA Astrophysics Data System (ADS), that do intelligent filtering for you and provide you with customized suggestions. Alternatively, you can ask somebody you consider to be an expert. On this poster we describe a method (the "recommender system") that mimics this information "ask the export" discovery model, argue that it is practically feasible to incorporate this method as a useful addition to the existing ADS service and show that it is able to produce meaningful results. The ADS is funded by NASA Grant NNX09AB39G.

  2. Recommendations, requirements, and radioactive particles

    International Nuclear Information System (INIS)

    Bell, J.M.

    1991-01-01

    Hot particles consisting of activated metal debris and fuel fragments have received increased attention in the last five years. This increased attention resulted from the increased use of more sensitive whole body friskers at nuclear power plants, the relatively high local skin doses associated with the particles, and skin dose limits that were established before hot particles, and skin dose limits that were established before hot particles became a problem and before radiobiological effects data for the particles became available. The skin dose distribution and biological effects associated with hot particles differ from those associated with more uniform skin contamination and differences exist in the scientific community as to which effects should be protected against by a limit on exposures from particles. The NRC staff recognized the need for provisions in the Federal regulations specific to hot particle exposures and requested guidance from the National Council on Radiation Protection and Measurements (NCRP). NCRP Report No. 106 was provided to the NRC early in 1990. The International Commission on Radiological Protection (ICRP) is also developing recommendations for limits on exposures from hot particles. The NRC is supporting research on hot particle effects and will likely develop a rule for hot particle exposures

  3. Nutritional recommendations for synchronized swimming.

    Science.gov (United States)

    Robertson, Sherry; Benardot, Dan; Mountjoy, Margo

    2014-08-01

    The sport of synchronized swimming is unique, because it combines speed, power, and endurance with precise synchronized movements and high-risk acrobatic maneuvers. Athletes must train and compete while spending a great amount of time underwater, upside down, and without the luxury of easily available oxygen. This review assesses the scientific evidence with respect to the physiological demands, energy expenditure, and body composition in these athletes. The role of appropriate energy requirements and guidelines for carbohydrate, protein, fat, and micronutrients for elite synchronized swimmers are reviewed. Because of the aesthetic nature of the sport, which prioritizes leanness, the risks of energy and macronutrient deficiencies are of significant concern. Relative Energy Deficiency in Sport and disordered eating/eating disorders are also of concern for these female athletes. An approach to the healthy management of body composition in synchronized swimming is outlined. Synchronized swimmers should be encouraged to consume a well-balanced diet with sufficient energy to meet demands and to time the intake of carbohydrate, protein, and fat to optimize performance and body composition. Micronutrients of concern for this female athlete population include iron, calcium, and vitamin D. This article reviews the physiological demands of synchronized swimming and makes nutritional recommendations for recovery, training, and competition to help optimize athletic performance and to reduce risks for weight-related medical issues that are of particular concern for elite synchronized swimmers.

  4. Decision-Guided Recommenders with Composite Alternatives

    Science.gov (United States)

    Alodhaibi, Khalid

    2011-01-01

    Recommender systems aim to support users in their decision-making process while interacting with large information spaces and recommend items of interest to users based on preferences they have expressed, either explicitly or implicitly. Recommender systems are increasingly used with product and service selection over the Internet. Although…

  5. Panorama of Recommender Systems to Support Learning

    NARCIS (Netherlands)

    Drachsler, Hendrik; Verbert, Katrien; Santos, Olga C.; Manouselis, Nikos

    2015-01-01

    This chapter presents an analysis of recommender systems in TechnologyEnhanced Learning along their 15 years existence (2000-2014). All recommender systems considered for the review aim to support educational stakeholders by personalising the learning process. In this meta-review 82 recommender

  6. Viewpoint Reading Conference Recommendations in a Wider ...

    African Journals Online (AJOL)

    This short Viewpoint paper considers the role and value of conference recommendations in shaping the field of environmental education. It explores the social politics, and often contested nature, of conference recommendations and their institutional histories, arguing that the act of producing conference recommendations ...

  7. Preference-Based Recommendations for OLAP Analysis

    Science.gov (United States)

    Jerbi, Houssem; Ravat, Franck; Teste, Olivier; Zurfluh, Gilles

    This paper presents a framework for integrating OLAP and recommendations. We focus on the anticipatory recommendation process that assists the user during his OLAP analysis by proposing to him the forthcoming analysis step. We present a context-aware preference model that matches decision-makers intuition, and we discuss a preference-based approach for generating personalized recommendations.

  8. Nordic Intervention Criteria for Nuclear or Radiological Emergencies. Recommendations

    International Nuclear Information System (INIS)

    2001-01-01

    Recommendations of the Nordic radiation protection authorities on application of international criteria in a nuclear or radiological emergency in the Nordic countries are presented. The recommendations are focused on the generic intervention levels for various actions to protect members of the public and workers undertaking an intervention. Prompt precautionary actions for the near zones around the Finnish and Swedish nuclear power plants are defined. These actions are; preventive sheltering, iodine prophylaxis and precautionary evacuation. No special intervention levels for these precautionary actions have been set, because implementation of these actions is always based on very limited information about an accident. These actions can be initiated on a mere indication of possible release of radioactivity. The indication might be an alarm or any other predefined signal. Intervention level for actions to protect members of the public are based on the concept of avertable dose. They are in line with the international recommendations. With regard to iodine prophylaxis, a national approach is recommended due to different national policies of advance distribution of iodine tablets. The longer term intervention actions, temporary relocation and permanent resettlement, will be based not only on radiation protection factors but also on wider judgement of the overall situation. For that reason, no generic intervention levels, in terms of radiation dose, are recommended. The intervention levels for various protective actions are in the following table.Table 1. Generic intervention levels for actions to protect members of the public.Protective action. Generic intervention level as an avertable dose. Sheltering: 10 mSv within two days (effective dose); Iodine prophylaxis: National recommendations; Evacuation: 50 mSv within one week (effective dose); Temporary relocation: No predetermined intervention level; Permanent resettlement: No predetermined intervention level. Workers

  9. Sell side recommendations during booms and busts

    Directory of Open Access Journals (Sweden)

    Christian W. Kretzmann

    2015-10-01

    Full Text Available Our study documents that the information content and the information processing of stock recommendations differ fundamentally between expansions and recessions. The initial market reaction to all recommendations is stronger in recessions, but “Buy” recommendations do not have long-term investment value. We find that in recessions sell side analysts are too optimistic about the stocks they recommend to buy, while investors initially overreact to these recommended stocks. In expansions, no such contradicting pattern exists. We also document that analysts favor “glamour” over “value” stocks irrespective of the state of the economy.

  10. Physician staffed helicopter emergency medical service dispatch via centralised control or directly by crew - case identification rates and effect on the Sydney paediatric trauma system.

    Science.gov (United States)

    Garner, Alan A; Lee, Anna; Weatherall, Andrew

    2012-12-18

    Severe paediatric trauma patients benefit from direct transport to dedicated Paediatric Trauma Centres (PTC). Parallel case identification systems utilising paramedics from a centralised dispatch centre versus the crew of a physician staffed Helicopter Emergency Medical Service (HEMS) allowed comparison of the two systems for case identification rates and subsequent timeliness of direct transfer to a PTC. Paediatric trauma patients over a two year period from the Sydney region with an Injury Severity Score (ISS) > 15 were retrospectively identified from a state wide trauma registry. Overall paediatric trauma system performance was assessed by comparisons of the availability of the physician staffed HEMS for patient characteristics, transport mode (direct versus indirect) and the times required for the patient to arrive at the paediatric trauma centre. The proportion of patients transported directly to a PTC was compared between the times that the HEMS service was available versus the time that it was unavailable to determine if the HEMS system altered the rate of direct transport to a PTC. Analysis of variance was used to compare the identifying systems for various patient characteristics when the HEMS was available. Ninety nine cases met the inclusion criteria, 44 when the HEMS system was operational. Patients identified for physician response by the HEMS system were significantly different to those that were not identified with higher median ISS (25 vs 18, p = 0.011), and shorter times to PTC (67 vs 261mins, p = 0.015) and length of intensive care unit stays (2 vs 0 days, p = 0.045). Of the 44 cases, 21 were not identified, 3 were identified by the paramedic system and 20 were identified by the HEMS system, (P system was available (RR 1.81, 95% CI 1.20-2.73). The median time (minutes) to arrival at the PTC was shorter when HEMS available (HEMS available 92, IQR 50-261 versus HEMS unavailable 296, IQR 84-583, P < 0.01). Physician staffed

  11. Stereotyping and nurses' recommendations for treating pain in hospitalized children.

    Science.gov (United States)

    Griffin, Ruth A; Polit, Denise F; Byrne, Mary W

    2007-12-01

    The purpose of this study was to examine whether nurses' recommendations for managing children's pain were influenced by stereotypes based on children's personal attributes. Three vignettes, in which hospitalized children's sex, race, and attractiveness were experimentally manipulated, were mailed to a national random sample of 700 pediatric nurses; 334 nurses responded. Responses to vignette questions indicated little evidence of stereotyping. Nurses perceived similar levels of pain and recommended similar pain treatments, regardless of sex, race, and attractiveness. Nurses, on average, perceived children's pain at levels consistent with the children's self-reports and recommended assertive analgesic and non-pharmacologic pain management strategies. The results appear consistent with prevailing views on providing adequate pain treatment for children.

  12. Defining and Supporting Narrative-driven Recommendation

    DEFF Research Database (Denmark)

    Bogers, Toine; Koolen, Marijn

    2017-01-01

    Research into recommendation algorithms has made great strides in recent years. However, these algorithms are typically applied in relatively straightforward scenarios: given information about a user's past preferences, what will they like in the future? Recommendation is often more complex......: evaluating recommended items never takes place in a vacuum, and it is often a single step in the user's more complex background task. In this paper, we define a specific type of recommendation scenario called narrative-driven recommendation, where the recommendation process is driven by both a log...... of the user's past transactions as well as a narrative description of their current interest(s). Through an analysis of a set of real-world recommendation narratives from the LibraryThing forums, we demonstrate the uniqueness and richness of this scenario and highlight common patterns and properties...

  13. The Definition of Novelty in Recommendation System

    Directory of Open Access Journals (Sweden)

    Liang Zhang

    2013-01-01

    Full Text Available With the development of information technology and application of the Internet, People gradually entered the time of information overload from information scarcity. User satisfaction with recommender systems is related not only to how accurately the system recommends but also to how much it supports the user’s decision making. Novelty is one of the important metrics of customer satisfaction. There is an increasing realization in the Recommender Systems (RS field that novelty is fundamental qualities of recommendation effectiveness and added-value. This paper combed research results about definition and algorithm of novel recommendation, and starting from the meaning of "novel", defined novelty of item in recommendation system. Experiment proved using the definition of novelty to recommend can effectively recognize the item that the user is familiar with and ensure certain accuracy.

  14. An Agent Framework of Tourism Recommender System

    Directory of Open Access Journals (Sweden)

    Jia Zhi Yang

    2016-01-01

    Full Text Available This paper proposes the development of an Agent framework for tourism recommender system. The recommender system can be featured as an online web application which is capable of generating a personalized list of preference attractions for tourists. Traditional technologies of classical recommender system application domains, such as collaborative filtering, content-based filtering and content-based filtering are effectively adopted in the framework. In the framework they are constructed as Agents that can generate recommendations respectively. Recommender Agent can generate recommender information by integrating the recommendations of Content-based Agent, collaborative filtering-based Agent and constraint-based Agent. In order to make the performance more effective, linear combination method of data fusion is applied. User interface is provided by the tourist Agent in form of webpages and mobile app.

  15. A general framework for intelligent recommender systems

    Directory of Open Access Journals (Sweden)

    Jose Aguilar

    2017-07-01

    Full Text Available In this paper, we propose a general framework for an intelligent recommender system that extends the concept of a knowledge-based recommender system. The intelligent recommender system exploits knowledge, learns, discovers new information, infers preferences and criticisms, among other things. For that, the framework of an intelligent recommender system is defined by the following components: knowledge representation paradigm, learning methods, and reasoning mechanisms. Additionally, it has five knowledge models about the different aspects that we can consider during a recommendation: users, items, domain, context and criticisms. The mix of the components exploits the knowledge, updates it and infers, among other things. In this work, we implement one intelligent recommender system based on this framework, using Fuzzy Cognitive Maps (FCMs. Next, we test the performance of the intelligent recommender system with specialized criteria linked to the utilization of the knowledge in order to test the versatility and performance of the framework.

  16. Persuasive Recommender Systems Conceptual Background and Implications

    CERN Document Server

    Yoo, Kyung-Hyan; Zanker, Markus

    2013-01-01

    Whether users are likely to accept the recommendations provided by a recommender system is of utmost importance to system designers and the marketers who implement them. By conceptualizing the advice seeking and giving relationship as a fundamentally social process, important avenues for understanding the persuasiveness of recommender systems open up. Specifically, research regarding influential factors in advice seeking relationships, which is abundant in the context of human-human relationships, can provide an important framework for identifying potential influence factors in recommender system context. This book reviews the existing literature on the factors in advice seeking relationships in the context of human-human, human-computer, and human-recommender system interactions. It concludes that many social cues that have been identified as influential in other contexts have yet to be implemented and tested with respect to recommender systems. Implications for recommender system research and design are dis...

  17. Recommended Practices in Thrust Measurements

    Science.gov (United States)

    2013-10-01

    measurement from mi- crothrusters,” Rev. Sci. Inst., Vol. 75, No. 10, 2004, pp. 3185–3190. 3McFall, K. and Tilley, D., “ Low Power Arcjet Performance...and Performance Summary,” 44th Joint Propulsion Conference, Hartford, CT, 2008, AIAA-2008-4824. 7Manzella, D. et al., “Evaluation of low power Hall...thrusters produce relatively low thrust levels, particularly microthrusters that have enjoyed increased attention in the last two decades, direct

  18. New recommendations for vitamin D intake

    Directory of Open Access Journals (Sweden)

    Evgen Benedik

    2013-10-01

    Full Text Available Vitamin D is a fat-soluble vitamin that plays an important role in bone metabolism and immune system. Low vitamin D levels (< 50 nmol/l have been widely reported in all age groups in recent years. Lack of vitamin D is associated with increased overall and cardiovascular mortality, cancer incidence and mortality, and autoimmune diseases. Vitamin D deficiency is rising, mainly due to modern lifestyle and malabsorption disorders. As an adequate intake of vitamin D is hard to achieve through the diet alone, the dietary supplements of vitamin D are recommended. Sun exposure (ultraviolet B radiation, UVB represents the main source of vitamin D, which is synthesised in the skin. UVB intensity varies through the year and the time of day. The peak UVB period is between 10 am to 4 pm from April till October (above 40° latitude. There is no universal consent on the amount and frequency of vitamin D supplementation. A sufficient supplementation of vitamin D is necessary through the whole life cycle, especially during lactation. With sufficient supplementation of vitamin D during lactation (4,000 IU/day mother covers her own and through her breast milk also the child`s nutritional needs (400 IU/day for vitamin D. However, further research in this field is needed before recommending such a high supplementation for nursing mothers. New German Reference values from 2012 advises 400 IU / day for infants during the first year of life, and afterwards 800 IU/day for the entire population.

  19. Knowledge of recommended dietary cholesterol allowance in an ...

    African Journals Online (AJOL)

    This study was designed to assess the plasma cholesterol level and consumer awareness of recommended dietary cholesterol allowance in an academic environment. A total of 100 structured questionnaires were randomly distributed within Babcock University community, Ilisan Remo, Ogun State, Nigeria. Ninety seven ...

  20. Characteristics of Public, Private, and Bureau of Indian Education Elementary and Secondary School Teachers in the United States: Results From the 2007-08 Schools and Staffing Survey. First Look. NCES 2009-324

    Science.gov (United States)

    Coopersmith, Jared

    2009-01-01

    This report presents selected findings from the school teacher data files of the 2007-08 Schools and Staffing Survey (SASS). SASS is a nationally representative sample survey of public, private, and Bureau of Indian Education-funded (BIE) K-12 schools, principals, and teachers in the 50 states and the District of Columbia. The public school…

  1. The Accreditation Council for Graduate Medical Education resident duty hour new standards: history, changes, and impact on staffing of intensive care units.

    Science.gov (United States)

    Pastores, Stephen M; O'Connor, Michael F; Kleinpell, Ruth M; Napolitano, Lena; Ward, Nicholas; Bailey, Heatherlee; Mollenkopf, Fred P; Coopersmith, Craig M

    2011-11-01

    The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine convened a task force to develop a white paper on the impact of changes in resident duty hours on the critical care workforce and staffing of intensive care units. A multidisciplinary group of professionals with expertise in critical care education and clinical practice. Relevant medical literature was accessed through a systematic MEDLINE search and by requesting references from all task force members. Material published by the Accreditation Council for Graduate Medical Education and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force corresponded by electronic mail and held several conference calls to finalize this report. The new rules mandate that all first-year residents work no more than 16 hrs continuously, preserving the 80-hr limit on the resident workweek and 10-hr period between duty periods. More senior trainees may work a maximum of 24 hrs continuously, with an additional 4 hrs permitted for handoffs. Strategic napping is strongly suggested for trainees working longer shifts. Compliance with the new Accreditation Council for Graduate Medical Education duty-hour standards will compel workflow restructuring in intensive care units, which depend on residents to provide a substantial portion of care. Potential solutions include expanded utilization of nurse practitioners and physician assistants, telemedicine, offering critical care training positions to emergency medicine residents, and partnerships with hospitalists. Additional research will be necessary to evaluate the impact of the new standards on patient safety, continuity of care, resident learning, and staffing in the intensive care unit.

  2. Potential benefit of physician-staffed helicopter emergency medical service for regional trauma care system activation: An observational study in rural Japan.

    Science.gov (United States)

    Abe, Tomohiro; Nagano, Takehiko; Ochiai, Hidenobu

    2017-05-01

    Objective: Involvement of all regional medical facilities in a trauma system is challenging in rural regions. We hypothesized that the physician-staffed helicopter emergency medical service potentially encouraged local facilities to participate in trauma systems by providing the transport of patients with trauma to those facilities in a rural setting. Materials and Methods: We performed two retrospective observational studies. First, yearly changes in the numbers of patients with trauma and destination facilities were surveyed using records from the Miyazaki physician-staffed helicopter emergency medical service from April 2012 to March 2014. Second, we obtained data from medical records regarding the mechanism of injury, severity of injury, resuscitative interventions performed within 24 h after admission, secondary transports owing to undertriage by attending physicians, and deaths resulting from potentially preventable causes. Data from patients transported to the designated trauma center and those transported to non-designated trauma centers in Miyazaki were compared. Results: In total, 524 patients were included. The number of patients transported to non-designated trauma centers and the number of non-designated trauma centers receiving patients increased after the second year. We surveyed 469 patient medical records (90%). There were 194 patients with major injuries (41%) and 104 patients with multiple injuries (22%), and 185 patients (39%) received resuscitative interventions. The designated trauma centers received many more patients with trauma (366 vs. 103), including many more patients with major injuries (47% vs. 21%, p service potentially encouraged non-designated trauma centers to participate in trauma systems while maintaining patient safety.

  3. Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice.

    Science.gov (United States)

    Booth, C M A; Moore, C E; Eddleston, J; Sharman, M; Atkinson, D; Moore, J A

    2011-10-01

    The incidence and prevalence of obesity are increasing world wide. In the UK, obesity governmental strategy has primarily focused on prevention measures, with less focus on the demands of treating obese patients in hospital. Increasing service demand by obese patients coupled with a lack of adequate provision for care of these patients may lead to an increase in patient safety incidents. By classifying patient safety incidents associated with obesity reported to the National Patient Safety Agency, this report aims to identify areas for improvement in the quality and safety of care of the obese patient. A search of the National Reporting and Learning System database was conducted for all incidents caused by or relating to obesity for the period 1 January 2005 to 31 August 2008. The keywords 'obesity', 'overweight', 'BMI' (body mass index), and 'bariatric' were used. The relevant free text fields of the resulting set of incidents were then searched for the terms designed to isolate incidents occurring in anaesthesia, critical care, and surgery. Reported incidents were analysed and subsequently categorised to identify incident themes. Levels of harm were also established. 555 patient safety incidents were identified; 388 met inclusion criteria for analysis. 148 incidents were related to assessment, diagnosis or treatment, 213 related to infrastructure and 27 related to staffing. The majority of incidents were classified as no or low harm. Three deaths were reported, all within the domain of anaesthesia. This report identifies that the majority of safety incidents associated with obesity were related to infrastructure, suggesting that there is inadequate provision in place for the care of obese patients. While levels of harm were mostly low, the occurrence of incidents resulting in severe harm or death highlights the specific dangers associated with the care of the obese patient. A global approach to improving the safety of care delivery for obese patients is

  4. State-Level Efforts to Transfer Manufacturing Technology: A Survey of Programs and Practices

    OpenAIRE

    Andrew W. Wyckoff; Louis G. Tornatzky

    1988-01-01

    This study analyzed state-level university-based efforts to increase manufacturing productivity through the transfer of technologies, such as robotics and microcomputers, to manufacturing establishments. A survey was conducted by phone interview of 15 state programs that were operating in 1985. Information was gathered on the goals, planning, budgets, marketing, staffing, organizational structure, technical focus, and evaluation practices of the programs. All of the programs were university-b...

  5. Developing curriculum recommendations for environmental health in nursing.

    Science.gov (United States)

    Leffers, Jeanne M; Smith, Claudia M; McDermott-Levy, Ruth; Resick, Lenore K; Hanson, Monica J; Jordan, Lisa C; Jackman-Murphy, Kathryn P; Sattler, Barbara; Huffling, Katie

    2015-01-01

    In 2010, the American Nurses Association (ANA) added an environmental health standard to the ANA Scope and Standards of Practice requiring that nurses implement environmental health strategies in nursing practice. To prepare nurse educators to integrate environmental health at all educational levels, nursing faculty members from the Alliance of Nurses for Healthy Environments developed environmental health competencies and curricular recommendations that address this need. Internet URLs are included for environmental health curricula for each level of nursing education.

  6. Missed hormonal contraceptives: new recommendations.

    Science.gov (United States)

    Guilbert, Edith; Black, Amanda; Dunn, Sheila; Senikas, Vyta

    2008-11-01

    To provide evidence-based guidance for women and their health care providers on the management of missed or delayed hormonal contraceptive doses in order to prevent unintended pregnancy. Medline, PubMed, and the Cochrane Database were searched for articles published in English, from 1974 to 2007, about hormonal contraceptive methods that are available in Canada and that may be missed or delayed. Relevant publications and position papers from appropriate reproductive health and family planning organizations were also reviewed. The quality of evidence is rated using the criteria developed by the Canadian Task Force on Preventive Health Care. This committee opinion will help health care providers offer clear information to women who have not been adherent in using hormonal contraception with the purpose of preventing unintended pregnancy. The Society of Obstetricians and Gynaecologists of Canada. SUMMARY STATEMENTS: 1. Instructions for what women should do when they miss hormonal contraception have been complex and women do not understand them correctly. (I) 2. The highest risk of ovulation occurs when the hormone-free interval is prolonged for more than seven days, either by delaying the start of combined hormonal contraceptives or by missing active hormone doses during the first or third weeks of combined oral contraceptives. (II) Ovulation rarely occurs after seven consecutive days of combined oral contraceptive use. (II) RECOMMENDATIONS: 1. Health care providers should give clear, simple instructions, both written and oral, on missed hormonal contraceptive pills as part of contraceptive counselling. (III-A) 2. Health care providers should provide women with telephone/electronic resources for reference in the event of missed or delayed hormonal contraceptives. (III-A) 3. In order to avoid an increased risk of unintended pregnancy, the hormone-free interval should not exceed seven days in combined hormonal contraceptive users. (II-A) 4. Back-up contraception should

  7. Mouthrinse recommendation for prosthodontic patients.

    Science.gov (United States)

    Cortelli, Sheila Cavalca; Costa, Fernando Oliveira; Rode, Sigmar de Mello; Haas, Alex Nogueira; Andrade, Ana Karina Pinto de; Pannuti, Claudio Mendes; Escobar, Elaine Cristina; Almeida, Eliete Rodrigues de; Cortelli, José Roberto; Pedrazzi, Vinicius

    2014-01-01

    Different reasons can contribute to classifying dental prosthesis wearers as high-risk individuals in relation to dental biofilm accumulation. These include a past history of oral disease, age and additional retentive areas. Other common complaints include inflammation and halitosis. Moreover, prosthesis replacement and prosthetic pillar loss are generally associated with caries and periodontal disease recurrence. Therefore, the present study undertook to make a critical review of the literature, aiming at discussing the main aspects related to chemical agent prescriptions for dental prosthesis wearers. Most of the articles were selected based on relevance, methods and availability in regard to the specific subject under investigation, without considering publication year limitations. Different types of prostheses and their impact on teeth and other oral tissues were reported. It was demonstrated that there is greater biofilm buildup and increased inflammatory levels in the presence of different types of prostheses, suggesting that additional measures are required both on population-wide and individual levels in order to control these factors. Mechanical control consists of a combination of manual or electric toothbrush and toothpaste, as well as specific devices for interdental cleaning. Although many chemical agents exhibit antimicrobial benefits when used for prosthesis disinfection, only a few agents can be used safely without causing damage. Regarding the selection of antiseptics by the overall population, chlorhexidine is the most indicated in the short term and in sporadic cases. The most indicated adjuncts to overcome the deficiencies and limitations of daily mechanical biofilm control are products containing essential oils as active ingredients.

  8. Recommender Systems for the Social Web

    CERN Document Server

    Pazos Arias, José J; Díaz Redondo, Rebeca P

    2012-01-01

    The recommendation of products, content and services cannot be considered newly born, although its widespread application is still in full swing. While its growing success in numerous sectors, the progress of the  Social Web has revolutionized the architecture of participation and relationship in the Web, making it necessary to restate recommendation and reconciling it with Collaborative Tagging, as the popularization of authoring in the Web, and  Social Networking, as the translation of personal relationships to the Web. Precisely, the convergence of recommendation with the above Social Web pillars is what motivates this book, which has collected contributions from well-known experts in the academy and the industry to provide a broader view of the problems that Social Recommenders might face with.  If recommender systems have proven their key role in facilitating the user access to resources on the Web, when sharing resources has become social, it is natural for recommendation strategies in the Social Web...

  9. Fusing Recommendations for Social Bookmarking Websites

    DEFF Research Database (Denmark)

    Bogers, Toine; van den Bosch, Antal

    2011-01-01

    Social bookmarking websites are rapidly growing in popularity. Recommender systems, a promising remedy to the information overload accompanying the explosive growth in content, are designed to identify which unseen content might be of interest to a particular user, based on his or her past...... that use tag overlap and metadata provide better results for social bookmarking data sets than the transaction patterns that are used traditionally in recommender systems research. In addition, we investigate how to fuse different recommendation approaches to further improve recommendation accuracy. We...... preferences. Most previous work in recommendation for social bookmarking suffers from a lack of comparisons between the different available approaches. In this article, we address this issue by comparing and evaluating eight recommendation approaches on four data sets from two domains. We find that approaches...

  10. RECOMMENDER SYSTEMS IN E-COMMERCE APPLICATIONS

    Directory of Open Access Journals (Sweden)

    Gyöngyvér KOVÁCS

    2016-12-01

    Full Text Available One of the major problem with online shopping is finingd the right product, because finding the right product presumes that we know its name, but in most cases it is not so. For this reason the users need help in the process of online searching/shopping. Recommender systems have became a popular technique and strategy for helping users to select desirable products or services. In the past few years the recommender systems have changed from novelties used by a few big e-commerce sites, to serious business tools that are re-shaping the world of e-commerce. In this paper, we provide a brief overview of the classification of recommendation systems based on technology used to create recommendations, and inputs they need from the customers. Furthermore we analyze a few algorithms used by recommender systems and we will also present some marketing recommender systems and their comparative analysis.

  11. Network-based recommendation algorithms: A review

    Science.gov (United States)

    Yu, Fei; Zeng, An; Gillard, Sébastien; Medo, Matúš

    2016-06-01

    Recommender systems are a vital tool that helps us to overcome the information overload problem. They are being used by most e-commerce web sites and attract the interest of a broad scientific community. A recommender system uses data on users' past preferences to choose new items that might be appreciated by a given individual user. While many approaches to recommendation exist, the approach based on a network representation of the input data has gained considerable attention in the past. We review here a broad range of network-based recommendation algorithms and for the first time compare their performance on three distinct real datasets. We present recommendation topics that go beyond the mere question of which algorithm to use-such as the possible influence of recommendation on the evolution of systems that use it-and finally discuss open research directions and challenges.

  12. Learning Points and Routes to Recommend Trajectories

    OpenAIRE

    Chen, Dawei; Ong, Cheng Soon; Xie, Lexing

    2016-01-01

    The problem of recommending tours to travellers is an important and broadly studied area. Suggested solutions include various approaches of points-of-interest (POI) recommendation and route planning. We consider the task of recommending a sequence of POIs, that simultaneously uses information about POIs and routes. Our approach unifies the treatment of various sources of information by representing them as features in machine learning algorithms, enabling us to learn from past behaviour. Info...

  13. Current Trends in Radiation Protection Recommendations

    International Nuclear Information System (INIS)

    Gomaa, M.A.

    2008-01-01

    The third generation of the ICRP recommendations was adopted in April 2007. The recommendations rely on situations (planned, emergency and existing), individual (occupational, public and patient) and radiation protection system (justification, optimization and dose limits). In the present work attention is paid to discuss the new recommendations and role of IAEA in updating its Basic Safety Standards for protection against ionizing radiation and safety of radiation sources and its impact for the national regulations

  14. Panorama of recommender systems to support learning

    OpenAIRE

    Drachsler, Hendrik; Verbert, Katrien; Santos, Olga; Manouselis, Nikos

    2015-01-01

    This chapter presents an analysis of recommender systems in Technology-Enhanced Learning along their 15 years existence (2000-2014). All recommender systems considered for the review aim to support educational stakeholders by personalising the learning process. In this meta-review 82 recommender systems from 35 different countries have been investigated and categorised according to a given classification framework. The reviewed systems have been classified into 7 clusters according to their c...

  15. Recommendation advertising method based on behavior retargeting

    Science.gov (United States)

    Zhao, Yao; YIN, Xin-Chun; CHEN, Zhi-Min

    2011-10-01

    Online advertising has become an important business in e-commerce. Ad recommended algorithms are the most critical part in recommendation systems. We propose a recommendation advertising method based on behavior retargeting which can avoid leakage click of advertising due to objective reasons and can observe the changes of the user's interest in time. Experiments show that our new method can have a significant effect and can be further to apply to online system.

  16. OMB Recommended vs Approved Operating Budget

    Data.gov (United States)

    Montgomery County of Maryland — This dataset includes the Fiscal Year 2015 County Executive Recommended and County Council Approved operating budgets for Montgomery County, for comparison purposes....

  17. Uncovering the information core in recommender systems

    Science.gov (United States)

    Zeng, Wei; Zeng, An; Liu, Hao; Shang, Ming-Sheng; Zhou, Tao

    2014-08-01

    With the rapid growth of the Internet and overwhelming amount of information that people are confronted with, recommender systems have been developed to effectively support users' decision-making process in online systems. So far, much attention has been paid to designing new recommendation algorithms and improving existent ones. However, few works considered the different contributions from different users to the performance of a recommender system. Such studies can help us improve the recommendation efficiency by excluding irrelevant users. In this paper, we argue that in each online system there exists a group of core users who carry most of the information for recommendation. With them, the recommender systems can already generate satisfactory recommendation. Our core user extraction method enables the recommender systems to achieve 90% of the accuracy of the top-L recommendation by taking only 20% of the users into account. A detailed investigation reveals that these core users are not necessarily the large-degree users. Moreover, they tend to select high quality objects and their selections are well diversified.

  18. ICRP-26, the recommendations on radiological protection

    International Nuclear Information System (INIS)

    Jun, J.S.

    1983-01-01

    Since the last ICRP recommendations on radiological protection was pubished in 1966 as it's publication 9, the revised edition of the recommendations had first been published in 1977, accommodating up-to-date knowledge of radiobiology and operational experiences of radiation protection built up for over a decade. In this article, the new version of the recommendations is reviewed in comparison with those of the publication 9, while the corrections and modifications made afterward are introduced together with the recent trends and responses of the experts in various countries for the pracical adoption or legislation of the recommendations. (Author)

  19. Mouthrinse recommendation for prosthodontic patients

    Directory of Open Access Journals (Sweden)

    Sheila Cavalca CORTELLI

    2014-01-01

    Full Text Available Different reasons can contribute to classifying dental prosthesis wearers as high-risk individuals in relation to dental biofilm accumulation. These include a past history of oral disease, age and additional retentive areas. Other common complaints include inflammation and halitosis. Moreover, prosthesis replacement and prosthetic pillar loss are generally associated with caries and periodontal disease recurrence. Therefore, the present study undertook to make a critical review of the literature, aiming at discussing the main aspects related to chemical agent prescriptions for dental prosthesis wearers. Most of the articles were selected based on relevance, methods and availability in regard to the specific subject under investigation, without considering publication year limitations. Different types of prostheses and their impact on teeth and other oral tissues were reported. It was demonstrated that there is greater biofilm buildup and increased inflammatory levels in the presence of different types of prostheses, suggesting that additional measures are required both on population-wide and individual levels in order to control these factors. Mechanical control consists of a combination of manual or electric toothbrush and toothpaste, as well as specific devices for interdental cleaning. Although many chemical agents exhibit antimicrobial benefits when used for prosthesis disinfection, only a few agents can be used safely without causing damage. Regarding the selection of antiseptics by the overall population, chlorhexidine is the most indicated in the short term and in sporadic cases. The most indicated adjuncts to overcome the deficiencies and limitations of daily mechanical biofilm control are products containing essential oils as active ingredients.

  20. Developing evidence-based immunization recommendations and GRADE.

    Science.gov (United States)

    Duclos, P; Durrheim, D N; Reingold, A L; Bhutta, Z A; Vannice, K; Rees, H

    2012-12-17

    The Strategic Group of Advisory Experts (SAGE) on immunization is an independent advisory committee with a mandate to advise the World Health Organization (WHO) on the development of vaccine and immunization related policies. SAGE working groups are established on a time-limited basis to review and provide evidence-based recommendations, together with their implications, for open deliberation and decision-making by SAGE. In making its recommendations, SAGE takes into consideration: the epidemiologic and clinical characteristics of the disease; vaccine and immunization characteristics; economic analysis; health system considerations; the existence of and interaction with other intervention and control strategies; costing and social impacts; and legal and ethical concerns. Since 1998, WHO has produced evidence-based vaccine position papers for use primarily by national public health officials and immunization programme managers. Since April 2006 all new or updated position papers have been based on SAGE recommendations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been adopted by WHO and, since 2008, GRADE tables that rate the quality of evidence have been produced in support of key recommendations. SAGE previously expressed concern that GRADE was not ideally suited to many immunization-specific issues such as the vaccine population level effect and the inclusion of surveillance system data, particularly for vaccine safety. Extensive productive interactions with various advisory groups including the US Advisory Committee on Immunization Practices, the European Centres for Disease Control, the German Standing Committee on Vaccination (STIKO), WHO's Global Advisory Committee on Vaccine Safety and the GRADE working group resulted in key enhancements to accommodate vaccine-relevant evidence. This facilitated integration and acceptability of the GRADE approach in the development of immunization related SAGE and WHO